Elastically stabilized intramedullary nails (ESINs) nye mɔnu si bɔ si wozãna tsɔ naa ƒu didi siwo gbã le ɖeviwo me la li ke to amekoko me. Wozãnɛ geɖe tsɔ daa akɔtaƒu, afɔkpodzi, afɔkpodzi, kple afɔkpodzi kple afɔkpodzi ƒe gbagbã siwo meli ke o. Wozãnɛ hã tsɔ daa ƒu didi siwo gblẽ le ɖeviwo ŋu le dɔléle ta. ESIN naa gbagbãƒea ƒe nutete si wotu evɔ meʋua gbagbãƒea o, teƒe etɔ̃ ƒe liƒo, kple didime kple tɔtrɔ takpɔkpɔ le gbagbãƒe kpui siwo le tsia dzi me. Esi wònye nusi wotsɔ dea ame me si me agba le ta la, enaa afɔkpodzia ʋãna kaba. Zi geɖe la, woɖea ɖa siwo le lãkusi me siwo li ke le elastically la ɖa le woƒe gbagbã ƒe dɔyɔyɔ vɔ megbe.
Afɔkpodzi ƒe gbagbã
Nusiwo fia be ESIN le afɔkpodzi ƒe gbagbã me enye: ƒe si woxɔ tso ƒe 4 va ɖo ƒe 14 kple akɔta ƒe gbagbã le nuveviwɔame geɖe me .
Wotsɔa dɔnɔa dana ɖe ƒunukpeƒetetedɔ ƒe kplɔ̃a dzi, eye wotrɔa asi le afɔkpaa ƒe lolome ŋu wòsɔna ɖe ɖevia ƒe afɔ ƒe lolome nu. Wohiãa fluoroscope la be woatsɔ akpɔ akɔta si ŋu dɔlélea le ƒe antero-posterior (AP) kple latero-lateral (LL) eye wodae ale be woate ŋu akpɔ afɔkpodzia le susu me tso akɔta vaseɖe klo dzi. Woléa ŋku ɖe edziɖeɖekpɔtɔ ƒe xɔxɔ ŋu le AP kple LL ƒe nukpɔkpɔwo siaa me, eye woɖoa kpe tɔtrɔ hã dzi .
ɖaawo tiatia Ele be ɖa ƒe didime nawɔ ɖe se si wozãna le ɖaawo tiatia me dzi. Woate ŋu azã hatsotso si gbɔna abe vovototo bubu ene, si do ƒome kple ɖevia ƒe ƒexɔxɔ:
- Ƒe 6–8: 3 mm ƒe didime;
- Ƒe 9–11: 3.5 mm ƒe didime;
- Ƒe 12–14: 4 mm ƒe didime.
Aɖakaawo ƒe didime sɔ kple didime si tso ƒunukpeƒe si le didiƒe ʋĩ si tsina gbɔ va ɖo ƒunukpeƒe si le tsitsim le trochanter si lolo wu gbɔ .
Diaphyseal ƒe gbagbãƒewo
Akpa etɔ̃lia si te ɖe eŋu kple titina Le diaphyseal fractures le proximal kple titina etɔ̃lia gome la, wotia mɔnu si le abe C ene, si me wotsɔa ɖaawo dea megbe to didiƒe metaphysis me. Le ɖa siwo le ŋgɔgbe gome la, ɖaa ƒe nugbɔ si te ɖe eŋu la bɔbɔna, gake le ɖaa ƒe titina ƒe gbagbã gome la, ɖaa titina ƒoa xlãe. Le dɔwɔwɔa ƒe nuwuwu la, le afɔkpodzi ƒe gbagbã gome la, wogblẽa nu le kakɛawo ŋu be woaƒo asa na susuhenuwo susɔea, si ate ŋu anye nusi gbɔ abɔ kple afɔwo ƒe didime si mesɔ o tso. Le ƒu gbagbã siwo le tsia dzi alo esiwo wogbã gome la, wobɔbɔa nugbɔ si le didiƒe eye wòƒonɛ ɖe ƒua me be woaƒo asa na kakɛawo ƒe didiƒekpɔkpɔ kple ɖaawo ƒe ʋuʋu.
Dzɔdzɔme ƒe nɔnɔme si le gbagbãƒe siawo ŋue nye be woana wòanɔ kpuie milimeta 5–10 le dɔwɔwɔ vɔ megbe teti, si woatsɔ axe fe ɖe tsitsi ƒe ʋuʋu le gbagbãƒea ƒe sesẽɣi me .
Tibial ƒe gbagbã
Dɔnɔa ƒe nɔƒe kple dzadzraɖo Wotsɔa dɔnɔa ɖoa ƒumeŋuɖui ƒe kplɔ̃ dzi be wòana woaɖe edzi bɔbɔe. Fluoroscope ƒe anyinɔnɔ nye sedziwɔwɔ be woatsɔ akpɔ edzi le dɔwɔwɔ me. Ele be kloa nanɔ amekokoƒea .
Aɖabɛwo dede eme
Wotsɔa ɖa siwo te ŋu trɔna la dea ŋgɔ ɣesiaɣi le metaphysis si te ɖe eŋu me, le teƒe siwo le ŋgɔgbe kple titina .
Aɖaka ƒe didime toa vovo tso milimeta 2.5 va ɖo 4, le ƒe si dɔnɔa xɔ nu. Woɖe mɔ ɖe akplɔa zazã hena ɖaawo dodo ɖe ŋgɔ ŋu gake ele be woaɖɔ ŋu ɖo be woazãe.
Wotsɔa ɖaa ƒe didime kple alesi gbegbe wòbɔbɔe kpɔa egbɔ be woɖea edzi kpɔtɔnae ƒe nyonyome.
Mele be woaƒo ɖaawo ɖe ƒu si nye cancellous bone si le distal metaphysis me hafi dzi ɖeɖe kpɔtɔ nade blibo o; ne menye nenema o la, ɖɔɖɔɖomɔnu ate ŋu ana ƒu ƒe dɔwɔwɔ natɔ te.
Hafi woaƒoe la, woléa ŋku ɖe kakɛawo ƒe tɔtrɔ ŋu eye ne varus ƒe nɔnɔme madeamedzi susɔe aɖe li la, woɖɔa esia ɖo to ɖa ƒe ƒoƒo fũu akpa me. Le dɔwɔwɔa ƒe nuwuwu la, woɖea hehea dzi kpɔtɔna eye wògblẽa nu le kakɛawo ŋu.
Le ɖa siwo wogbã gome la, wobɔbɔa ɖa siwo wogblẽ ɖe ƒu godo ƒe nugbɔ siwo te ɖe wo nɔewo ŋu le 90° eye woƒoa wo ɖe ƒu si le ƒua me la me be woagakpɔ kakɛawo le didiƒe o.
Akɔta ƒe gbagbã
ESIN ƒe dzesiwo le akɔta ƒe gbagbãƒewo toa vovo le afisi wògbã le nu: proximal metaphysis alo diaphysis. Le akɔta ƒe kɔ si wowɔ dɔ na ƒe gbagbãwo me la, woɖea ESIN fiana elabena eɖea ɣeyiɣi si hiã be woagaʋã o si hiã le atikewɔwɔ si me womezãa nu geɖe le o gome dzi kpɔtɔna .
Le diaphyseal fractures gome la, woɖee fia be woazã elastic nails metsɔ le radial nerve lesions ƒe anyinɔnɔ me o.
ɖaawo dede eme Wozãa mɔnu si nye retrograde tsɔ dea ɖaawo me. Wokpɔa teƒe siwo wotsɔa nu dea eme le supracondylar area ƒe axadzi, eye woƒe mɔfiame le megbe-axadzi eye woƒe ŋgɔgbe le proximal . Wozãa drill tsɔ dzraa teƒe siwo woage ɖo la ɖo elabena ƒu si woyɔna be cortical bone si le teƒe sia la sesẽ ŋutɔ. Aɖabɛawo ƒe didime toa vovo tso milimeta 2.5 va ɖo 3.5, eye wobɔbɔna ɖekae. Wotsɔa asi ƒe nyaƒoɖeamenu le tsitrenu kple ʋuʋu si le tɔtrɔm dea ɖaawo me. Ne womate ŋu aɖe gbagbãƒe si le metaphyseal ƒe akpa si te ɖe eŋu dzi akpɔtɔ nyuie o la, ɖaawo ƒe tɔtrɔ 1800 naa edziɖeɖe sia nɔa bɔbɔe. Gake ne womate ŋu aɖe edzi akpɔtɔ o la, wotsɔa Kirschner ƒe mɔfianu-ka dea kakɛ si te ɖe eŋu me hafi woɖea edzi le gaglãgbe. Le oblique diaphyseal fractures gome la, ele vevie be woaƒo asa na ɖaawo ƒe dzodzo le medullary canal me eye woaʋu ayi megbe ayi radial nerve sulcus me. Ne ɖa eveawo tso afisi wogbã le vɔ la, woƒoa wo ɖe ƒu si nye cancellous bone si le proximal metaphysis me.
Abɔta ƒe gbagbã
Wolɔ̃ ɖe ƒumeŋuɖui ƒe atikewɔwɔ le abɔta ƒe gbagbã me dzi, gake wonya seɖoƒe si woɖe mɔ na le dzogoe si wogbugbɔ trɔ asi le le eɖokui si ŋu nyuie. Ne wowu seɖoƒe siawo nu alo le ƒumeŋuɖui ƒe atikewɔwɔ me la, woɖea edzi ɖeɖe kpɔtɔ si wotu kple ESIN fiana le abɔta ƒe gbagbã me .
Dɔwɔwɔ ƒe mɔnu Wotsɔa dɔnɔa dana ɖe akɔta ƒe akɔta, eye wotsɔa abɔta si ŋu dɔlélea le la ɖoa kplɔ̃ si dzi keklẽŋusẽ le la dzi.
Aɖabɛ siwo wozãna ƒe didime toa vovo tso milimeta 2.5 va ɖo 3. Ulnar nail la le dzɔdzɔe kloe, gake radial nail ya ƒe akpa aɖe le ƒoƒom wòdze ƒã be woate ŋu agbugbɔ pronatory curve si le radius la me aɖo anyi.
Zi geɖe la, ƒu si dzi ɖeɖe kpɔtɔ le bɔbɔe wu dzie wodzea eɖoɖo gɔme. Le didime gome la, wokpɔa afisi woage ɖo le didiƒe metaphysis, le didiƒe tsitsi ƒunukpeƒe tame, le asibidɛ ƒe kekeɖenudɔ didi kple kpui ƒe lãkusiwo dome. Woɖea ƒu si le lãkusia me la ɖe go to lãɖeɖe sue aɖe me eye woɖea do aɖe, si lolona to ʋuʋu godoo me. Wotsɔa ɖaa dea lãkusia me vaseɖe afisi wògbã le. Woɖea ɖaa ƒe gbagbã dzi kpɔtɔna eye wodoa ɖaa ɖe ŋgɔ yia ɖaa ƒe akpa si te ɖe eŋu la me le fluoroscopic dziɖuɖu te .
Wowɔa dɔ ma tɔgbe na ulna la, wozãa antegrade mɔnu, eye afisi woage ɖo le olecranon ƒe titina ƒe axadzi.
Ale Si Nàƒle Ƒumeŋuɖuiwo Kple Ƒumeŋuɖui Dɔwɔnuwo?
Elabena CZMEDITECH , míekpɔa adzɔnuwo ƒe hatsotso si de blibo ŋutɔ si nye ƒumeŋuɖui ƒe amekoko ƒe nusiwo wotsɔ dea ame me kple dɔwɔnu siwo sɔ kplii, nusiwo dometɔ aɖewoe nye akɔta ƒe akpa siwo wotsɔ dea ame me, ɖa siwo le lãkusi me, trauma plate, ʋuƒo si wotsɔ xea mɔ na nu, cranial-maxillofacial ƒe tagbɔ, ametia ƒe ŋutilã ƒe akpa aɖe, elektrikdɔwɔnuwo, gotagome fixators, ƒunukpeƒetetedɔ (arthroscopy)., lãwo ƒe dɔlélewo gbɔ kpɔkpɔ kple woƒe kpeɖeŋutɔ dɔwɔnuwo.
Tsɔ kpe ɖe eŋu la, míeɖoe kplikpaa be míayi edzi anɔ atike yeyewo wɔm eye míakeke adzɔnuwo ƒe hatsotsowo ɖe enu, ale be míakpɔ ɖɔkta kple dɔnɔ geɖe ƒe amekoko ƒe nuhiahiãwo gbɔ, eye míana míaƒe dɔwɔƒea hã nate ŋu aʋli ho geɖe wu le xexeame katã ƒe ƒumeŋuɖui kple dɔwɔnuwo ƒe dɔwɔƒe bliboa me.
Míeɖoa nu ɖe xexeame katã, eyata àte ŋui te ɖe mía ŋu le email adrɛs song@orthopedic-china.com hena nyayɔyɔ femaxee, alo ɖo gbedasi ɖe WhatsApp hena ŋuɖoɖo kaba +86- 18112515727 .
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