Mɔnu siwo gbɔna dometɔ kae wozãna tsɔ dzraa ʋukawo dome gbagbãwo ɖo?

Afɔkpodzi ƒe gbagbã le lãkusiwo dome, si wogayɔna be akɔta ƒe gbagbã, nye ƒunukpeƒetetedɔ ƒe gbagbã. Nu vevi siwo ɖena fiana le intertrochanteric fracture me enye vevesese kple vuvu le teƒea vevie, ecchymosis si keke ta, dɔnɔa ƒe ŋutete be wòatsi tre alo azɔ o, eƒe kpuiƒe ɖedzesi, abɔ si ŋu dɔlélea le ƒe tɔtrɔ le ememe kple egodo, kple akɔta ƒe ƒunukpeƒe ƒe ʋuʋu le mɔ aɖeke nu kple esi mewɔa dɔ o ƒe seɖoƒe.

Dɔvɔ̃ŋutinunya

1. Wo dometɔ akpa gãtɔ do ƒome kple ƒumeŋuɖui, zi geɖe le ame tsitsiwo me, nyɔnuwo sɔ gbɔ wu ŋutsuwo.

2. Nusiwo dzɔna la do ƒome kple ameƒomevinyenye, ŋutsu alo nyɔnu nyenye kple nuto.

3. abi si ame tsitsiwo xɔna zi geɖe, ƒe si woxɔna le afɔkpodzi ƒe ʋuʋu le ʋukawo dome le mama dedie nu enye ƒe 75.2. Vovototo gã aɖeke menɔ ƒe si ŋutsuwo kple nyɔnuwo xɔ le intertrochanteric fracture me o.

4. Le ʋu ƒe sisi fũ le trochanter me ta la, ƒã hafi gbagbãƒea mehayana o, gake ele bɔbɔe be wòadzɔ be akɔta ƒe tɔtrɔ, eye kuxi geɖe wu dona tso aba dzi gbɔɖeme ɣeyiɣi didi le dɔnɔ tsitsiwo me, eye dɔléle kple ku ƒe agbɔsɔsɔme nye 15%-20%, eyata woyɔnɛ be gbagbã mamlɛtɔ le ame tsitsiwo me.

Mɔnu si dzi woato axɔ abi

1. Sɔhɛ tsitsiwo ƒe akpa gãtɔ nyea abi siwo ŋu ŋusẽ geɖe le, ele be woalé ŋku ɖe ahɔhɔ̃, akɔta, ƒodo kple abi la ƒe akpa bubuwo ŋu; ame tsitsiwo ƒe akpa gãtɔ nye tsitsi function of the limbs coordination response agility decline and fall caused by.

2. Ŋutasẽnuwɔwɔ tẽ: ŋusẽkpɔɖeamedzi tẽ ɖe trochanter ƒe akpa gãtɔ dzi. Ne ŋutilãa dze anyigba kple axadziŋusẽ ne ele gegem.

3. Ŋutasẽnuwɔwɔ si metso tẽ o: ŋutilãa trona le anyidzedze me, eye akɔta ƒe nuteɖeamedzi si nye be woatrɔ megbe kple ŋgɔgbe gome le ɣeyiɣi ɖeka me.

4. Dɔléle ƒe gbagbã, si nye ƒumeŋuɖui siwo bɔ dometɔ ɖeka.

5. Ŋutasẽnuwɔwɔ si metso tẽ o koŋue hea intertrochanteric fracture vɛ.

Dɔnɔdzikpɔƒe ƒe dzesiwo

1. Nu vevitɔ si woɖena fiana la sɔ kple afɔkpodzi ƒe kɔ ƒe gbagbã, eye abɔ kple afɔ si ŋu dɔlélea le ƒe vevesese le teƒea, vuvu kple dɔwɔwɔ ƒe seɖoƒe.

2. Esi wònye be enye ƒunukpeƒe ƒe gbagbã ta la, mɔxenu aɖeke mele ƒunukpeƒea ƒe lãkusi ŋu o, eyata abɔta ƒe gotagome tɔtrɔ kpuie (dzidzenu 90) ƒe nɔnɔme madeamedzia nu sẽ wu.

3. Axial percussion vevesese.

4. Ʋumenugbagbeviɣidɔ si le teƒea nu sẽ vie, eye ate ŋu anye be abi le ŋutigbalẽ te si keke ta wu.

5. Le dɔnɔ tsitsiwo gome la, wodina be yewoatsi wu akɔta ƒe kɔ dɔnɔwo, eye dɔnɔawo ƒe akpa gã aɖe xɔ ʋusɔgbɔdɔ va yi.

Dɔlélea didi

Nuveviwɔame si dze ƒã, vevesese le abɔ kple afɔ si ŋu dɔlélea le, kple ʋuʋu ƒe seɖoƒe ƒe ŋutinya. Afɔkpodzi ƒe kpuiƒe kple gotagome tɔtrɔ ƒe nɔnɔmetɔtrɔ dzena vaseɖe 90°. Zi geɖe la, ehiãna be woado X-ray kpɔ be woakpɔ dɔlélea eye wotua agbalẽŋɔŋlɔ ɖe foto siwo woɖe le radio dzi dzi. Intertrochanteric fracture ƒe dzesiwo sɔ kple femoral neck fracture tɔ, gake mamlɛtɔa mesẽna boo o wu gbãtɔa le teƒea ƒe vevesese, vuvu, dɔwɔwɔ ƒe bu, kple abɔ si ŋu dɔlélea le ƒe kpuiƒe gome, eye abɔ si ŋu dɔlélea le ƒe akpa gãtɔ ƒe akɔta ƒe ƒoƒo fafɛ kple klo ƒe ƒoƒo kple gotagome tɔtrɔ ƒe gbɔdzɔgbɔdzɔ nɔa eŋu, zi geɖe la, enɔa 45°-60° dome.

Ƒomevi

AO kple Evans-Jensen ƒe gbagbãƒewoe nye gbagbã ƒomevi eve siwo wozãna wu, eye le eve siawo dome la, AO ƒe gbagbã ƒomevie bɔ wu.

Evans-Jensen ƒe nuŋɔŋlɔ

Ƒomevi I: Intertrochanteric fracture bɔbɔe si me fracture line si le ŋgɔgbe tso etame yi anyime, si me ʋuʋu kple liƒo mele o.

Ƒomevi II: Ʋuʋu si wotsɔ ƒo ƒu kple rotor avulsion fracture sue aɖe, gake femoral spur la me gblẽ o (femoral spur nye ƒu gbadzɛ si le afɔkpodzi ƒe kɔ kple rotor suea ƒe ŋutilã ƒe kadodo me goglo.

Ƒomevi III: Trochanteric fracture si lolo wu kple afɔkpodzi ƒe gbagbãƒe ƒe ƒuƒoƒo, kple ʋuʋu, zi geɖe kple megbe inter-rotor fracture.

Ƒomevi IV: Akpa 3 ƒe gbagbã si wotsɔ kpe ɖe ʋuka suetɔ ƒe gbagbã si wogbã ŋu, si ate ŋu adze kple afɔkpodzi ƒe kɔ kple akɔta ƒe akpa si lolo wu ƒe akɔta ƒe gbagbã si wogbã.

V ƒomevi: megbe ƒe axadzi kple titina ƒe gbagbã si womedo alɔe o (ƒomevi III kple IV ƒe ƒuƒoƒo).

Ƒomevi R: ŋgɔgbe ƒe ʋukawo dome gbagbã si ƒe fli si le tsia dzi tso titina si le etame va ɖo axa si le ete, si ate ŋu ado ƒome kple rotor ƒe gbagbã sue aɖe kple afɔkpodzi ƒe akɔta ƒe tsɔtsrɔ̃.

AO ƒe nuŋɔŋlɔ

A1.1 Fli si wogbã la toa fli si le rotor dome la me

A1.2 Gbagbã si to trochanter gãtɔ me

A1.3 Gbagbã si to trochanter suetɔ te

A2.1 Ƒu ƒe gbagbã kple ƒu kakɛ 1 si wogbã

A2.2 Ƒu ƒe gbagbã kple ƒu kakɛ geɖe siwo wogbã

A2.3 Gbagbã si keke wu sentimeta 1 le trochanter suetɔ te

A3.1 Nɔnɔme bɔbɔe si le tsia dzi

A3.2 Nɔnɔme bɔbɔe si le ŋgɔgbe

A3.3 Woɖe gbeƒãe

Atikewɔwɔwo

Zi geɖe la, alesi ƒu gbagbãwo ƒe ememe léle ɖe te nɔ te ɖe nu atɔ̃ dzi: ƒua ƒe nyonyome, ƒu ƒe gbagbã ƒomevi, edziɖeɖe, ememetɔ ƒe tiatia, kple afisi ememetɔ ƒe nɔnɔme le ne wotsɔe sɔ kple ƒua. Gbugbɔgaɖɔɖo ƒe teƒe yeye ɖoɖo le vevie na liƒo le ememe fixation megbe eye ele be wòaɖoe be woaɖo ŋutilã ƒe nɔnɔme yeye alo teƒe si li ke si menye ŋutilã ƒe nɔnɔme o. Kpuie ko la, taɖodzinu si le teƒe si wogbugbɔ ɖo teƒee nye be woana woali ke le gbagbãƒea. Woate ŋu atu mɔnu si dzi woato agbugbɔ aɖo teƒea alo atsoe. Aleke kee gbagbãƒe ƒomevi si sesẽ o, ele be woate eɖeɖeɖa si wotu ɖe enu la kpɔ gbã.

• Ŋusẽ ƒe akɔta Dowel (DHS) .

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Viɖe vevi siwo le DHS Power Hip Screws ŋu.

• Kplu la kpɔa ŋusẽ sesẽ ɖe afɔkpodzi ƒe ta me, le ƒumeŋuɖui gɔ̃ hã gome.

• Mɔ̃ si wotsɔna ƒua du le abɔta la xea mɔ na ɖaa ƒe nuwuwu be wòagage ɖe afɔkpodzi ƒe ta alo acetabulum me eye wòatsɔ nuheŋusẽ gbegblẽ ayi ƒua me tẽ o.

• Power gliding mɔ̃a nana be gbagbãƒea nɔa teƒea eye wòɖea non-union dzi kpɔtɔna.

• Dɔ eve le eŋu si nye nutete kple ʋuʋu, eye eƒe nutete ƒe ŋusẽkpɔɖeamedzi si trɔna eye wònɔa teƒe ɖeka.

  
  

• Ŋusẽ ƒe Akɔta Dowel (DCS) .

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  DCS kple 95 degree lãɖeɖe gbadzɛwo na anticrotal gbagbãwo:

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Viɖe vevi siwo le DCS ŋusẽ condylar screw ŋue nye.

• Ate ŋu atia afisi gavi la age ɖo nyuie le nɔnɔme tɔxɛ si me gavi la le nu, eye dɔwɔwɔa sɔ.

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• Ŋusẽ ƒe nutete ƒe teteɖeanyi ƒe gavi la le dzogoe dzɔdzɔe dzi kple agbaa, si ɖo akɔta ƒe biomechanical nudidiwo gbɔ. Le kpekpeme tsɔtsɔ me la, wotsɔa ŋusẽ gbegblẽa dea agbaa ƒe alɔ kpui la dzi gbã eye emegbe wokakanɛ ɖe gavi ɖesiaɖe ŋu, ale be nuteɖeamedzia kaka eye nusi wotsɔ blae la sesẽna etɔxɛe.

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• DCS-gaviwo ƒe xexlẽme si lolo vie le afisi wogbãe la nana wòsẽna ɖe edzi, eye woate ŋu atɔ te afisi gbagbãƒea le ahaɖɔe ɖo, si wɔnɛ be dɔwɔwɔ vɔ megbe kuxiwo dzi ɖena kpɔtɔna.

Proximal Femoral Locking Intramedullary Nail (PFN) ƒe Ʋuʋudedi .

Viɖe siwo le PFN fixation ŋu.

• Sue wu ɖa ƒe didime (zi geɖe la, 9mm), woate ŋu atsɔ ʋu ayi eme kekeɖenudɔ manɔmee. (ekɔ wu Gamma ɖa ƒe asike ƒe nuwuwu si le kpekpem wu - 17mm)

• PFN ƒe nuwuwu si te ɖe eŋu la ƒe camber anɔ abe dzidzenu 6 ene, si ɖea valgus ƒe dzogoe dzi kpɔtɔna eye mehiã be woagbugbɔ ememe sesĩe le heheɣi o.

• Eƒe akpa si le etame la ɖea mɔ be woatsɔ gavi eve ade afɔkpodzi ƒe ta me, eye wotsɔa gavi si tsi tre ɖe tɔtrɔ ŋu kple ɖa eve siwo wotsɔna ƒoa afɔkpodzi ƒe kɔa kpena ɖe eŋu, si wɔnɛ be ɖeɖiteameŋu ƒe tsitretsitsi dzina ɖe edzi.

• Do si le didiƒe si wotu kple ɖa vevitɔa ƒe nuwuwu si le didiƒe (tapered extension) dome didi wu, si ate ŋu aɖe nuteɖeamedzi si le afɔkpodzi ƒe ke me dzi akpɔtɔ.

• Nuveviwɔame si mesɔ gbɔ kura o.

Gammar ƒe ɖawo

Viɖe siwo le Gammar nail fixation ŋu.

• Enye mɔnu si me womezãa nu boo aɖeke le o si me woɖea afɔ sue aɖe le eye womewɔa nuvevi ame boo o.

• Gamma- ɖaa wɔa akɔta ƒe akpa si le etame kple akɔta ƒe kɔ ɖekae sesĩe to ɖa si le lãkusi me kple gavi si wotsɔna ƒoa ƒui me, eye wotsɔa ɖa si le didiƒe si tsia eɖokui nu la léa ɖa si le lãkusia me la ɖe te, si xea mɔ na eƒe tɔtrɔ kple eƒe ʋuʋu kpuie eye wònaa woate ŋu atsɔe ablae si ŋu kakaɖedzi le.

Gammar ƒe ŋgɔyiyi - PFNA

Ememe fixator tiatia (PFNA).

• Tu nyui aɖe si wotu ɖe eme na afɔkpodzi ƒe intertrochanteric gbagbã siwo meli ke o.

• Eléa afɔkpodzi ƒe ta kple kɔ ɖe te sesĩe eye wòxea mɔ na afisi gbagbãƒea ƒe nuwuƒe ƒe tɔtrɔ.

• Exea mɔ na kuxiwo abe ƒu ƒe gbagbã le ƒu ƒe gbugbɔgaxɔ ta le titina ƒe kpeɖeŋutɔ ƒe bu megbe, inversion deformity, kple afɔkpodzi ƒe ta ɖeɖe ɖa kple nusi wotsɔ de eme.

• Esɔ na ƒumeŋuɖui dome gbagbãwo katã kloe, vevietɔ na ƒu ƒe gbagbã siwo meli ke o (le kpɔɖeŋu me, ŋgɔgbe lãkusiwo dome gbagbã) kple ƒumeŋuɖui si wotsɔ ƒo ƒui.

• Kuxi aɖewo gakpɔtɔ li, abe afɔkpodzi ƒe ta ƒe ʋuʋu ene, si wɔnɛ be womate ŋu aɖɔli ememe nu bubu siwo wotsɔ blaa nu bubuwoe o.

Ƒunukpeƒetetedɔ si Wowɔ Ðekae

Nusiwo woatsɔ awɔ dɔ na ame si wotsɔ asi wɔe be woatsɔ aɖɔli ƒunukpeƒetetedɔ hena afɔkpodzi ƒe gbagbã le ʋukawo dome:

• Ƒe si xɔ wu ƒe 80.

• Intertrochanteric fracture si nu sẽ eye meli ke o.

• Ƒumeŋuɖui dze ƒã, eye esesẽna be woaɖɔ ƒu ƒe ƒumeŋuɖui ɖo nyuie.

• Seɖoƒe gã aɖeke meli na akɔta alo klo ƒe ʋuʋu hafi abi la o.

• Ŋutilã bliboa ƒe nɔnɔme ate ŋu ado dzi le amekoko ƒe atikewɔwɔa me.

Dɔnɔ siwo womate ŋu ada dɔ na le aba dzi ɣeyiɣi didi o.

Viɖe siwo le eŋu: amekokoa ƒe nɔnɔme si le anyigba kaba le dɔwɔwɔ vɔ megbe. Ƒo asa na kuxi siwo dona tso aba dzi. Di agbetsitsi ƒe ɣeyiɣi ɖe edzi eye nàna agbenɔnɔ nanyo ɖe edzi.

Ale Si Nàƒle Ƒumeŋuɖuiwo Kple Ƒumeŋuɖui Dɔwɔnuwo?

Elabena CZMEDITECH , míekpɔa adzɔnuwo ƒe hatsotso si de blibo ŋutɔ si me 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 .

Ne èdi be yeanya nyatakaka bubuwo la,zi edzi CZMEDITECH be nàkpɔ nyatakaka bubuwo.