External fixation nye mɔnu si wodo kpɔ ɣeyiɣi didi aɖe eye wozãnɛ le afisiafi le gbagbãƒewo dada me. Mɔnu sia bia be woazã mɔ̃ siwo woda ɖe ŋutilãa godo atsɔ ana ƒu siwo gbã la nali ke ahawɔ wo ɖe ɖoɖo nu.
External Fixation ƒe Kpɔɖeŋu
External fixation nye amekokomɔnu si wozãna ƒe alafa geɖe tsɔ kpɔa lãmekawo ƒe gbagbãwo gbɔ. Hippocrates ye to nukpɔsusu sia vɛ zi gbãtɔ, amesi zã ati ƒe aŋenuwo tsɔ na ƒu gbagbãwo meʋãna o. Le ɣeyiɣi aɖe megbe la, mɔ̃ɖaŋununya la va trɔ, gake gɔmeɖose vevitɔa gakpɔtɔ le nenema: be wòana teƒe si wògbã la nali ke evɔ wòana lãmeka falɛfalɛawo nakpɔ wo ta ahada gbe le wo ŋu.
Taɖodzinuwo le gotagome Fixation:Beléle na fracture alignment, didime, kple rotation.Na ɣeyiɣi kpui aɖe alo kakaɖedzi stabilization.Can be woatsɔ akpe ɖe akpa aɖe ememe fixation le nɔnɔme sesẽwo me.
Nusiwo Kpɔa Ŋusẽ Ðe Fixation ƒe Liƒo Dzi
Nu geɖe kpɔa ŋusẽ ɖe gotagome nusi wotsɔna léa nu ɖe te ƒe liƒo dzi:
Pin ƒe Ðoɖowɔwɔ:
Ne wodzi pinawo ƒe xexlẽme ɖe edzi, wo dome didi tso wo nɔewo gbɔ, eye wotsɔ wo ɖo afisi te ɖe afisi wogbã le ŋu la, enaa woƒe sesẽme dzina ɖe edzi.
Ele be woama pinwo sɔsɔe be woaƒo asa na nuteɖeamedzi si gbɔ eme ɖe teƒe aɖewo koŋ ŋu.
Pin ƒe Kekeme:
Pin siwo lolo wu naa li ke wu gake ate ŋu ana nuteɖeamedzi ƒe nuteɖeamedzi kple lãmeka falɛfalɛwo ƒe dzikudodo ƒe afɔkua nadzi ɖe edzi.
Pin Ƒomeviwo:
Pin siwo woate ŋu aku le wo ɖokui si, trocar pins, pin siwo wofa ɖe wo ŋu, carbon fiber rods.
External Fixators Ƒomeviwo
Gotagome fixatorwo ƒe wɔwɔme to vovo, eye viɖe tɔxɛwo le wo dometɔ ɖesiaɖe ŋu:
Uniplanar Fixators: Nusiwo Wotsɔna Ðea Nu Ðekae:
Ele bɔbɔe eye eŋudɔwɔwɔ le bɔbɔe.
Liƒo si seɖoƒe li na ne wotsɔe sɔ kple mɔ̃ siwo le anyigba geɖe dzi.
Multiplanar Fixators: Nusiwo wotsɔna dzraa nu geɖe ɖo:
Zã pins le yameʋu geɖe me, si ana nàli ke nyuie wu.
Enyo ŋutɔ na gbagbãƒe sesẽwo.
Akpa Ðeka/Akpa Eve ƒe Fixators:
Akpa ɖeka ƒe fixatorwo meli ke tututu o, gake akpa eve ƒe fixators ya naa ŋusẽ kple kpekpeɖeŋu geɖe wu.
Nusiwo Wotsɔna Klɔa Nu Siwo Le Kplɔ̃ Ŋu:
Wozãnɛ zi geɖe hena abɔwo didi kple abɔ kple afɔ ɖɔɖɔɖo sesẽwo.
Enaa kpekpeme ƒe akpa aɖe tsɔtsɔ kple ƒunukpeƒewo ƒe ʋuʋu le dɔyɔɣi.
![External Fixation Ƒomevi]()
Lãmetsiŋusẽ Ŋuti Nuŋububu Kple Dedienɔnɔ ƒe Afisiwo
Pinwo ɖoɖo le vevie ŋutɔ be woaƒo asa na kuxiwo abe lãmeka alo ʋukawo ƒe abixɔxɔ ene. Nu vevi siwo ŋu woabu le ŋutilã ƒe wɔwɔme ŋu dometɔ aɖewoe nye:
![Mɔ̃ si Wotsɔ Dzra Nu Le Gome]()
Afɔkpodzi:
Ele be woatsɔ ŋgɔgbekpawo ade trochanter suetɔ te sentimeta 5.8 eye woatsɔ sentimeta 7.4 aɖo patellar apex tame.
Ele be megbeƒuwo naƒo asa na sciatic nerve kple ʋuka siwo ƒo xlãe.
Tibia: .
Ele be woatsɔ pinwo aɖo afisi didi tso ƒunukpeƒea gbɔ milimeta 14 ya teti be woaxe mɔ na ƒunukpeƒea ƒe gege ɖe ƒunukpeƒea.
Etame ƒe Akpawo:
Ele be humerus pins naƒo asa na axillary kple radial nerves.
Ele be woatsɔ abɔta ƒe ʋuƒo ade ulna ƒe ŋutigbalẽ te be lãmekawo nagblẽ nu le wo ŋu o.
Dzesi siwo woatsɔ aɖɔe ɖo le gotagome
External fixation ɖea vi ŋutɔ le nɔnɔme siwo gbɔna me:
Pelvic ring ƒe abi siwo meli ke o.
Ƒunukpeƒe ƒe gbagbã siwo nu sẽ (le kpɔɖeŋu me, pilon, distal femur, tibial plateau, elbow, kple distal radius).
Lãmetsi falɛfalɛwo ƒe vuvu sesẽ alo ecchymosis.
ʋumenugbagbeviɣidɔ ƒe malikenyenye alo ŋutete manɔamesi be woawɔ dɔ na ame le gaglãgbe.
Ƒumeŋuɖui, dɔlékuiwo, abɔ kple afɔ ƒe didime, ƒumeŋuɖui, ƒunukpeƒetetedɔ, ƒunukpeƒetetedɔ, kple dɔlékuiwo dada.
Nusiwo tsi tre ɖe eŋu
Ðewohĩ gotagome fixation masɔ le nɔnɔme siwo gbɔna me o:
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Dɔnɔ siwo lolo akpa.
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Dɔnɔ siwo mewɔa se dzi o.
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Dɔnɔ siwo ƒe ƒu ƒe nyonyome mede o.
Dɔnɔ siwo gbe amekoko alo womate ŋu ado dzi le dɔa wɔwɔ me o.
Aɖaŋuwo Kple Wo Zazã
![Mɔ̃ si Wotsɔ Dzra Nu Le Gome]()
Pin-Bone ƒe Dɔwɔƒe:
Ƒo asa na lãkusi falɛfalɛwo ƒe hehe le pin dede eme.
Zã trocars kple drill sleeves be nàɖe lãmenugbagbeviwo ƒe gbegblẽ dzi akpɔtɔ.
Do ŋgɔ na tomekuku kple tsilele (tsidede) le vevie be woaɖe ɖiƒoƒo dzi akpɔtɔ.
Akɔta ƒe Ðoɖowɔwɔ:
Zi geɖe la, wotsɔa wo dana ɖe akɔta ƒe ta alo anterior inferior iliac spine (AIIS) dzi.
C-arm fluoroscopy kpɔa egbɔ be wotsɔ pin ɖo nyuie.
Dzigbe Nuwuƒe ƒe Fixation:
Ele be humerus pins naƒo asa na ahɔhɔ̃mekawo ƒe wɔwɔme.
Wotsɔa abɔta ƒe asikewo dana ɖe ulna ƒe ŋutigbalẽ te.
Lower Extremity Fixation: Eƒe Nuwuƒe ƒe Nuwuwu:
Wotsɔa afɔkpodzi ƒe asikewo dana ɖe ŋgɔgbe ƒe nɔnɔme me.
Wotsɔa tibial pins dana ɖe anteromedial nɔnɔme me be woaƒo asa na ƒunukpeƒewo ƒe gege ɖe eme.
Pilon ƒe Gbagbãwo:
Wozãa delta-frame ƒe ɖoɖo, si me wotsɔa afɔkpodzi kple afɔkpodzi ƒe ʋuƒo siaa dea eme be wòana wòali ke.
Kuxi siwo dona tso gotagome Fixation me
Togbɔ be viɖe le eŋu hã la, gotagome nuléle do ƒome kple kuxi siwo ate ŋu ado tso eme, siwo dometɔ aɖewoe nye:
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Pin tract ƒe dɔlékuiwo
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Ƒumeŋuɖui ƒe dɔléle
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Mɔ̃a ƒe kpododonu alo eƒe ʋuʋu
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Malunion alo nonunion
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Lãmetsi falɛfalɛwo ƒe dzikudodo alo woƒe gege ɖe lãme
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Lãmetsi alo ʋukawo ƒe abixɔxɔ
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Compartment syndrome ƒe dɔléle si nye Compartment syndrome
Nusiwo gblẽa nu le anyigba ŋu
Dɔnɔdzikpɔƒe ƒe Vevienyenye
Gotagome fixation wɔa akpa vevi aɖe le nuveviwɔame dzi kpɔkpɔ me:
Enaa liƒo kabakaba le ƒumeŋuɖui siwo gblẽa nu le ame ŋu dzi ɖuɖu me.
Eɖea abi evelia kple kuxiwo ƒe afɔkua dzi kpɔtɔna.
Enaa mɔnu si me wowɔa dɔ vovovowo le si me ƒumeŋutinunyalawo, dɔnɔdzikpɔlawo, ŋutilãmedɔdalawo, kple dɔdamɔnufialawo le be woana dɔnɔwo ƒe dɔwɔwɔ nanyo ɖe edzi la nɔa bɔbɔe.
CZMEDITECH ƒe Adzɔnu
Gotagome fixator si le gota:
Nɔnɔmewo: Ga ƒe asigɛwo kple ka nyuiwoe wotsɔ wɔe, woƒo xlã abɔa eye wòna woate ŋu atrɔ asi le eŋu le mɔ vovovowo nu.
The
circular external fixator nye atikewɔmɔ̃ si wozãna tsɔ léa ƒu ƒe gbagbã kple ƒumeŋuɖui ƒe ɖɔɖɔɖo. Eƒe aɖaŋuwɔwɔ ƒe nɔnɔmewo kple viɖe siwo le eŋu dzena le akpa siwo gbɔna me koŋ:
Aɖaŋuwɔwɔ ƒe nɔnɔmewo
Kpẽa ƒe wɔwɔme: Wotrɔ asi le gotagome nusi wotsɔ léa nu ɖe te si le gota la ŋu wòzu asigɛ ƒe nɔnɔme, si wɔa gotagome blibo ƒo xlã teƒe si wogbãe be wòana kpekpeɖeŋu bliboe eye wòalée ɖe te.
Teƒe geɖe siwo woate ŋu alé ɖe ƒua ŋu: Zi geɖe la, teƒe geɖe nɔa ƒua ƒe xɔtunu si le gota la dzi, eye woate ŋu atsɔ ƒu ƒe gavi alo ɖa geɖe atsɔ aƒo ƒu ɖe ƒua ŋu. Esia kakaa ŋusẽ si wotsɔ léa nu ɖe te la eye wòɖea nyaƒoɖeamenu si le teƒe ɖeka si wotsɔ léa nu ɖe te dzi kpɔtɔna.
Alesi woate ŋu atrɔ asi le eŋu: Alesi gotagome nusi wotsɔ blaa nu si le gota la wɔe be ɖɔktawo te ŋu trɔa asi le dɔnɔa ƒe nɔnɔme tɔxɛwo nu, siwo dometɔ aɖewoe nye asigɛawo ƒe lolome, afisi woléa nu ɖo, kple ŋusẽ ƒe mama, be wòasɔ ɖe ƒu ƒe gbagbã ƒomevi vovovowo kple ƒu ƒe nɔnɔmewo nu.
Woƒe kpekpeme le bɔbɔe eye wonɔa anyi didina: Zi geɖe la, wotsɔa nusiwo le bɔbɔe eye ŋusẽ le wo ŋu abe titanium alloy alo carbon fiber ene wɔa egbegbe gotagome fixator siwo le gota, si wɔnɛ be woli ke esime woɖea agba si le dɔnɔa dzi dzi kpɔtɔna.
Ele bɔbɔe be woatsɔe ade eme ahaɖee ɖa: Alesi wowɔ asigɛae na be eɖoɖo kple eɖeɖe ƒe ɖoɖoa le bɔbɔe wu, si wɔnɛ be amekoko ƒe ɣeyiɣi kple dɔnɔa ƒe vevesese dzi ɖena kpɔtɔna.
Viɖe siwo le eŋu
Liƒo si kɔkɔ:
Kplɔ̃ɖoƒea naa全方位 kpeɖeŋutɔ, si xea mɔ nyuie na ƒu si gbã la ƒe ʋuʋu eye wòkpɔa egbɔ be ƒua gakpɔtɔ le teƒe nyuitɔ le dɔyɔyɔa me.
Ŋusẽ si kaka:
Teƒe geɖe siwo wotsɔ léa nu ɖe te la kakaa ŋusẽ si wotsɔ léa nu ɖe te la, si ɖea nyaƒoɖeamenu si ƒo ƒu ɖe ƒuwo kple lãkusi falɛfalɛwo ŋu dzi kpɔtɔna, eye wòɖea kuxi siwo dona tso nusiwo wotsɔ léa nu ɖe te nyuie me ƒe afɔkua dzi kpɔtɔna.
Dɔwɔwɔ vovovowo:
External fixator si le gota la sɔ na gbagbã ƒomevi vovovowo, vevietɔ gbagbã sesẽwo, gbagbãƒe siwo le ʋuʋu ɖi, kple nɔnɔme siwo hiã be woatsɔ ablae ɣeyiɣi didi.
Dɔyɔyɔ dodo ɖe ŋgɔ:
To nɔnɔme si li ke nana me la, gotagome fixator si le dzogoe ene me kpena ɖe ame ŋu be gbagbãƒea ƒe dɔyɔyɔ kabakaba eye wòɖea afɔku si le nonunion alo dɔyɔyɔ megbe dzi kpɔtɔna.
Ðe kuxi siwo dona tsoa eme dzi kpɔtɔ:
Le fixation ŋusẽ si kaka ta la,... circular external fixator ɖea lãmeka falɛfalɛwo ƒe gbegblẽ dzi kpɔtɔna eye wòɖea kuxiwo abe dɔlékuiwo kple pin tract ƒe dɔdzẽ ene ƒe dzɔdzɔ dzi kpɔtɔna.
![CZMEDITECH Dɔwɔnu si Wotsɔ Dzra Nu Le Gome]()
Esɔ na beléle na ame le dɔwɔwɔ vɔ megbe:
Alesi wowɔe abe asigɛ ene la na wònɔa bɔbɔe na dɔnɔwo be woakpɔ wo ɖokui dzi le amekoko vɔ megbe, abe akɔtaɖonu kple aŋekotokuwo ɖɔliɖɔli ene, evɔ makpɔ ŋusẽ ɖe nusiwo wotsɔ blaa woe dzi o.
Nɔnɔme siwo sɔ
Wozãa gotagome fixator siwo le gota zi geɖe le nɔnɔme siwo gbɔna me:
Ƒu ƒe gbagbã sesẽ: Esɔ na ƒu gbagbã sesẽ siwo me ƒu ƒe akpa alo ƒunukpeƒe geɖe le.
Gbagbãƒe: Le eƒe ŋusẽ-kaka ƒe nɔnɔme ta la, gotagome fixator si ƒo xlãe la sɔ na gbagbãƒe siwo le ʋuʋu ɖi dzi kpɔkpɔ eye wòɖea dɔlékuiwo xɔxɔ ƒe afɔkua dzi kpɔtɔna.
Non-union alo delayed union: Le go aɖewo me la, gotagome fixation frames siwo le gota ate ŋu akpe ɖe ƒuwo ƒe dɔyɔyɔ ŋu to liƒo kple kpekpeɖeŋu si hiã nana me.
Dɔwɔwɔ vɔ megbe ƒe nuléle ɖe te: Wozãnɛ tsɔ naa ƒumeŋuɖui ƒe liƒo kple kpekpeɖeŋu le ƒumeŋuɖui ƒe dɔwɔwɔ vɔ megbe, si wɔnɛ be amekokoa ƒe teƒea li ke.
Aɖaŋu si wotsɔ wɔa gotagome nusi wotsɔna léa nu ɖe gota si le gota la hã ku ɖe dɔnɔa ŋu, eye wòléa fɔ ɖe liƒo kple akɔfafa ŋu, eye wònye dɔwɔnu vevi aɖe le ƒumeŋutinunya me.
Nyanuwuwuw
Gotagome fixation gakpɔtɔ nye dzogoedzikpe le gbagbãƒewo dada me, si naa woate ŋu azãe le mɔ vovovowo nu eye woate ŋu atrɔ ɖe dɔdamɔnu vovovowo ŋu. Ne atikewɔlawo tsɔ mɔnu sia tsaka kple dɔ vovovowo wɔwɔ ƒe mɔnu la, woate ŋu akpɔ nu nyuitɔ kekeake na dɔnɔwo. Esi mɔ̃ɖaŋununya ƒe ŋgɔyiyi yi edzi ta la, . gotagome fixation yi edzi le tɔtrɔm, si na be esɔ le egbegbe ƒumeŋutinunya me.
