Ta yaya ake kula da karaya na periprosthetic?

Manufar

Ragewar ɓarna na mata na kusa shine matsala mai tsanani a cikin arthroplasty na hip. Rahoton da aka ruwaito shine 3.5% 20 shekaru bayan dasawa na farko kuma yana ƙaruwa tare da abubuwan maye gurbin haɗin gwiwa. Ana haɗuwa da karaya ta ciki tare da mai tushe mara tushe. Fiye da haka, karaya yana faruwa a cikin tsofaffi masu rauni waɗanda suka faɗi na biyu zuwa tiyata. Ko da yake akwai bambance-bambance na kasa da kasa game da amfani da ciminti da kuma ciminti, babu wata bayyananniyar shaida cewa nau'in nau'in ciminti yana da alaƙa da haɗarin karaya fiye da ɗayan. Tsarin rarrabuwar kawuna na Vancouver don karyewar femoral na mace ya sami karbuwa sosai daga likitocin fiɗa kuma an nuna ya zama abin dogaro.

Babban makasudin wannan binciken shine don tantance alakar da ke tsakanin rabe-raben Vancouver na karaya da siminti da mara tushe. Manufar ta biyu ita ce bincika bambance-bambance a cikin halayen asali na marasa lafiya tare da nau'i biyu na karaya.

Kaya da matakai

Mara lafiya:

1. Jerin marasa lafiya tare da karaya na kusa da juna a jere.

2. Marasa lafiya da ke da faɗuwar ɓarna na hip-periprosthetic kawai an haɗa su.

3. An cire marasa lafiya tare da raguwa na ciki, gyaran gyare-gyare na hip, da kuma raguwa na interprosthetic.

   
   

Rikodin bayanai:

1. Radiyon rediyo na dijital da ƙididdiga na ƙididdiga dangane da takaddun lantarki da bincike.

2. Bayanan tushe da aka yi rikodin sun haɗa da shekaru, jima'i, ƙididdigar jiki, da rage yawan motsi kafin farawa ko dogara mai kulawa.

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Rikodin bayanan tiyata:

1. Lokacin da za a fara dasawa, nuni ga arthroplasty (osteoarthritis ko fracture), nau'in kara (cemented ko uncemented), da nau'in arthroplasty (jimillar ko semiarthroplasty) an haɗa su.

2. Cikakkun bayanan hoto sun haɗa da rarrabuwa na Vancouver, matsayi na kashin baya, da rarrabuwar Dorr.

3. Geometry mai tushe (conical ko fili don ciminti mai tushe, madaidaiciya ko siffa mai siffa don mai tushe mara tushe) an yi rikodi bisa ga bayyanar rediyo.

4. Ƙaddamar da rabe-raben Vancouver ya dogara ne akan binciken hoto da kuma binciken da aka yi a cikin marasa lafiya na tiyata.

5. An yi nazarin ƙididdiga ta amfani da ci gaba da canji T-gwajin da kuma ainihin gwajin Fisher don bambance-bambancen ƙididdiga don kwatanta halaye na asali da rabe-raben Vancouver na marasa lafiya a cikin ƙungiyoyin cimined da marasa ƙarfi.

6. Duk gwaje-gwajen sun kasance masu gefe biyu tare da mahimmancin matakin 0.05. An yi nazarin ƙididdiga ta amfani da sigar GraphPad Prism 8.0.0.

   
   

Sakamako

Adadin marasa lafiya:

1. An gano jimlar marasa lafiya 1181 ta hanyar tambayar bayanan asibiti.

2. An cire marasa lafiya 978 tare da raunin femur da ba na prosthetic ba.

3. Daga cikin sauran marasa lafiya na 203, 8 sun sami karaya a cikin ciki, 6 suna da karaya na ɓarna na ɓarna, kuma 17 suna da raunin ɓarna na na'urar gyaran haɗin gwiwa na hip, wanda aka ƙara cirewa.

4. An haɗa jimlar marasa lafiya 172 bayan an cire su.

5. Duk karaya sun faru ne bayan faɗuwa. Rukunin simintin kashi na mata ya karye a lokuta 84 ba tare da siminti ba

6. An samu karaya guda 88 a cikin kungiyar.

   
   

Halayen Tushen:

1. An sami bambance-bambance masu mahimmanci tsakanin ƙungiyoyi a cikin shekaru, lokacin da za a fara dasawa, alamun arthroplasty don karyewar wuyan mata, na farko na hemiarthroplasty, wuri mai tushe na varus, da ma'auni na jiki.

2. Musamman, a cikin rukunin siminti, yawancin su ne hemiarthroplasty.

3. Babu wani bambance-bambance mai mahimmanci tsakanin ƙungiyoyi dangane da jima'i, Dorr rarrabuwa, da rage yawan motsin motsi ko dogaro da kulawa.

4. A cikin rukunin da aka yi da siminti, yawancin ƙwanƙwasa an yi su ne kuma sauran ƙirar ƙira ce.

5. A cikin rukunin da ba a gama ba, yawancin mai tushe sun kasance madaidaiciya kuma sauran suna da siffa mai siffa.

   
   

Rukunin Vancouver:

1. An rarraba raunin VancouverB2 zuwa nau'ikan nau'ikan karaya guda hudu: wanda aka kwatanta a baya 'fashewa', da clamshell, da sifofi, da sabon tsarin 'reverse' da aka lura. Ana nuna bayyanar X-ray mai wakilci na jerin da madaidaicin hoton hoto (Hoto 1).

2. Fashewar fashe da karkace sun kasance suna da alaƙa sosai tare da ciminti mai tushe, yayin da fashe fashe yana da alaƙa sosai da mai tushe mara tushe.

3. Juyin clamshell ya faru iri ɗaya a cikin duka mai tushe.

4. Ƙungiyar rabe-raben rabe-rabe na Vancouver, gami da nau'ikan karaya guda huɗu na B2 da aka bayyana a sama, tare da ginshiƙai mai tushe yana nuna yanayin gaba ɗaya a cikin nau'ikan karaya.

Tattaunawa

Har zuwa yau, wannan shine mafi girman binciken don kwatanta alaƙar kai tsaye tsakanin ciminti da karaya mara ƙarfi da kuma rarrabuwar Vancouver:

• Babu wani muhimmin bambanci a cikin alaƙa tsakanin ciminti da mai tushe mara ƙarfi a cikin faɗuwar nau'in A, B, ko C na Vancouver. Abubuwan da suka faru na raunin VancouverB2 sun kasance iri ɗaya a cikin ƙungiyoyin biyu, yana nuna irin abubuwan da suka faru na barga da rashin kwanciyar hankali a cikin ɓarna na ɓarna a cikin ƙungiyoyin biyu.

• Sabanin haka, Fenelon et al. nazarin karaya na periprosthetic tare da ciminti da ciminti mai tushe. A bayyane yake cewa adadin marasa lafiya da raunin da ya faru a Vancouver B2 da B3 ya fi girma.

• Phillips et al. siffanta tsarin 'fashewa' da aka ƙera sosai na sassan sassan siminti conical da 'crack' tare da jaket ɗin siminti, kama da 'kan gatari'. An gano wannan karaya yana da alaƙa da mahimmancin tushen ciminti a cikin wannan binciken.

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• Halin da aka samu na waɗannan karaya yana haifar da damuwa game da raguwar kashi, kuma waɗannan karaya sau da yawa suna buƙatar cire siminti a hankali da ƙetare tare da tushe mai nisa.

• Capello et al. ya bayyana karaya da ke da alaƙa da tushe mara ƙarfi, kuma sakamakon binciken yana nuna wannan binciken. Karyewar ya samo asali ne daga tsakiyar tsakiya na mafi girma trochanter, ya shimfiɗa zuwa tsakiya na tsakiya, kuma yana kiyaye cortex na gefe, mai nisa zuwa ƙananan trochanter. Girman yanki na talar da raguwar tushe sune alamun radiyo na rashin kwanciyar hankali. Nazarin da suka gabata sun nuna babban haɗin gwiwa na wannan karaya tare da tushe maras tushe tare da zane-zane na jiki da nau'i mai nau'i, kuma wannan binciken yana goyan bayan wannan ƙungiya.

• Grammatopolous et al sun bayyana jerin nau'ikan nau'ikan karyewar helical a cikin ɓangarorin ɓarna tare da ciminti mai tushe, yawanci suna haɗuwa da keɓantaccen gutsuttsura da comminution mai tsanani. Adadin raunin da aka samu a cikin ciminti mai tushe ya karu sosai a cikin wannan jerin, wanda zai iya nuna halin karaya a kusa da tubular siminti mai tushe don yaduwa ta hanyar kama da kashi na halitta.

• A cikin bincike na rediyo na adadi mai yawa na ɓarna na ɓarna, ƙungiyar bincike ta lura da wani nau'i na raguwa wanda ba a bayyana a baya ba a cikin wallafe-wallafen. Karyewar ya samo asali ne daga tsaka-tsakin tsaka-tsakin tsaka-tsakin da ke wucewa ta cikin cortex na gefe, yana barin tsakiya na tsakiya. Wannan nau'in karaya ana kiransa 'reverse' fracture clamshell, wanda binciken yayi la'akari da karayar Vancouver B2 na kowa.

• An zaɓi wannan sunan don dalilai guda biyu: na farko, hoton madubi ne na 'flip', na biyu kuma, yana yin kama da karaya na kusa da mace, tare da maƙalla irin wannan na baya na mai satar yana jan guntun kusa. Irin wannan karaya ya faru tare da ciminti da mai tushe marasa ciminti (Hoto na 2).

• Ko da yake manufar wannan binciken ba don bincika sakamakon jiyya ba ne, a cikin wannan binciken, ɓangarorin juye-juye yawanci ana bitar su tare da arthroplasty na tushe mai ɗaukar nauyi mai nisa da gyara guntuwar ɓarna na kusa tare da wayoyi ko faranti.

• An nuna misalin mara lafiyar da aka bi da wannan hanya, yana nuna nasarar warkarwa (Hoto 3).

Hoto 2 Juya tsarin karaya.

Hoto 3 Arthroplasty da gyare-gyaren waya na ceclage don karyewar motsi.

Kammalawa

Dangane da tsarin rarrabawa na Vancouver, nau'ikan karaya na periprosthetic suna da nau'ikan karaya iri ɗaya a cikin siminti da na'urori marasa ƙarfi. Sabili da haka, abin da ya faru na barga da rashin ƙarfi mai tushe bayan karaya ya kasance daidai a cikin ƙungiyoyi biyu. Gano nau'ikan nau'ikan karaya guda huɗu daban-daban na VancouverB2, gami da sabon tsarin jujjuyawar da aka lura, zai taimaka wa likitocin su gano rashin kwanciyar hankali. Ana buƙatar karatun gaba don bincika alaƙar da ke tsakanin nau'in ɓarna da dabarun jiyya don sanin mahimmancin asibiti na binciken wannan binciken.

Yadda Ake Siyan Kayan Gyaran Orthopedic da Instruments?

Domin CZMEDITECH , muna da cikakken samfurin layi na kayan aikin tiyata na orthopedic da kayan aiki masu dacewa, samfurori ciki har da kashin baya implants, intramedullary kusoshi, farantin rauni, farantin kulle, cranial-maxillofacial, prosthesis, kayan aikin wuta, masu gyara waje, arthroscopy, kula da dabbobi da saitin kayan aikinsu.

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