Yuav kho tus kab mob periprothetic li cas?

Lub hom phiaj

Periprosthetic fractures ntawm proximal femur yog ib qho teeb meem loj hauv hip arthroplasty. Qhov tshwm sim tau tshaj tawm yog 3.5% 20 xyoo tom qab pib cog thiab nce nrog qhov tshwm sim ntawm kev sib koom ua ke. Intraoperative fractures feem ntau txuam nrog uncemented stems. Feem ntau, pob txha tawg tshwm sim hauv cov neeg laus laus uas tsis muaj zog uas tau poob qis rau kev phais. Txawm hais tias muaj kev sib txawv thoob ntiaj teb hauv kev siv cov cemented thiab uncemented stems, tsis muaj pov thawj tseeb tias ib hom cemented qia cuam tshuam nrog kev pheej hmoo tawg ntau dua li lwm yam. Vancouver kev faib tawm cov txheej txheem rau periprosthetic femoral fractures tau dav siv los ntawm cov kws phais thiab tau pom tias muaj kev ntseeg siab.

Lub hom phiaj tseem ceeb ntawm txoj kev tshawb no yog los txiav txim siab txog kev sib raug zoo ntawm Vancouver kev faib tawm ntawm cov cemented thiab uncemented qia tawg. Lub hom phiaj thib ob yog los tshawb xyuas qhov sib txawv ntawm cov yam ntxwv ntawm cov neeg mob uas muaj ob hom pob txha.

Cov ntaub ntawv thiab cov txheej txheem

Tus neeg mob:

1. Ib tug series ntawm cov neeg mob uas sib law liag proximal periprothetic puas.

2. Tsuas yog cov neeg mob uas muaj thawj pob txha pob txha periprothetic tau suav nrog.

3. Cov neeg mob uas muaj kev puas tsuaj hauv kev ua haujlwm, kho cov pob txha pob txha, thiab cov pob txha pob txha interprosthetic raug cais tawm.

   
   

Cov ntaub ntawv:

1. Digital radiography thiab xam tomography raws li cov ntaub ntawv hluav taws xob thiab kev tshuaj xyuas.

2. Cov ntsiab lus hauv paus tau sau tseg suav nrog hnub nyoog, poj niam txiv neej, lub cev qhov hnyav, thiab txo qis kev txav mus los ua ntej pib lossis kev vam khom rau tus neeg zov me nyuam.

3. 
   

Surgical details record:

1. Lub sij hawm rau thawj implantation, qhia rau arthroplasty (osteoarthritis los yog puas), hom qia (cemented los yog uncemented), thiab hom arthroplasty (tag nrho los yog semiarthroplasty) tau suav nrog.

2. Cov ntaub ntawv ntxaws ntxaws suav nrog Vancouver kev faib tawm, varus vertebral txoj hauj lwm, thiab kev faib Dorr.

3. Qe geometry (conical los yog compound rau cemented stems, ncaj los yog wedge-shaped rau uncemented stems) tau sau tseg raws li radiographic tsos.

4. Kev txiav txim siab ntawm Vancouver kev faib tawm yog ua raws li cov duab tshawb pom thiab kev tshawb pom hauv cov neeg mob phais.

5. Kev txheeb xyuas kev txheeb xyuas tau ua los ntawm kev siv qhov sib txawv tsis tu ncua T-test thiab Fisher qhov kev ntsuas tseeb rau categorical variables los sib piv cov yam ntxwv hauv qab thiab Vancouver kev faib tawm ntawm cov neeg mob hauv pawg cemented thiab uncemented qia.

6. Txhua qhov kev sim yog ob sab nrog qhov tseem ceeb ntawm 0.05. Kev txheeb cais tau ua tiav siv GraphPad Prism version 8.0.0.

   
   

Cov txiaj ntsig

Tus naj npawb ntawm cov neeg mob:

1. Tag nrho ntawm 1181 tus neeg mob tau txheeb xyuas los ntawm kev nug cov ntaub ntawv hauv tsev kho mob.

2. 978 cov neeg mob uas tsis yog-periprosthetic proximal femur fractures raug cais tawm.

3. Ntawm cov 203 cov neeg mob uas tseem tshuav, 8 muaj cov pob txha tawg, 6 tau kho cov pob txha periprothetic, thiab 17 muaj cov pob txha periprothetic ntawm lub duav sib koom ua ke, uas tau raug cais tawm ntxiv.

4. Tag nrho ntawm 172 tus neeg mob tau suav nrog tom qab cais tawm.

5. Txhua qhov tawg tau tshwm sim tom qab lub caij nplooj zeeg. Femoral qia pob txha cement pawg fractures nyob rau hauv 84 mob tsis muaj cement

6. Muaj 88 pob txha hauv pab pawg.

   
   

Cov yam ntxwv tseem ceeb:

1. Muaj qhov sib txawv tseem ceeb ntawm cov pab pawg hauv hnub nyoog, lub sijhawm rau thawj implantation, qhia rau arthroplasty rau femoral caj dab pob txha, thawj hemiarthroplasty, varus qia placement, thiab lub cev qhov hnyav.

2. Tshwj xeeb, hauv pawg cement, feem ntau yog hemiarthroplasty.

3. Tsis muaj qhov sib txawv tseem ceeb ntawm cov pab pawg nrog rau kev sib deev, kev faib Dorr, thiab txo qis kev txav mus los lossis kev cia siab rau tus neeg zov me nyuam.

4. Hauv pab pawg cemented, feem ntau stems tau tapered thiab tus so yog composite designs.

5. Nyob rau hauv pawg uncemented, feem ntau stems yog ncaj thiab tus so yog wedge-puab.

   
   

Vancouver cov qeb:

1. VancouverB2 pob txha tawg tau muab faib ua plaub qhov sib txawv ntawm cov pob txha tawg: yav dhau los tau piav qhia comminuted 'burst', clamshell, thiab helical qauv, thiab cov qauv tshiab 'rov qab' clamshell qauv. Tus neeg sawv cev X-ray zoo li ntawm koob thiab cov duab qhia tau zoo sib xws (Daim duab 1).

2. Kev tawg tawg thiab kauv pob txha tau cuam tshuam nrog cov pob zeb cemented, qhov nrov plig plawg tawg tau cuam tshuam nrog cov stems tsis muaj zog.

3. Cov qauv rov qab clamshell tshwm sim zoo ib yam hauv ob lub stems.

4. Lub koom haum ntawm Vancouver kev faib tawm subtypes, suav nrog plaub hom B2 pob txha uas tau piav qhia saum toj no, nrog cov qia geometry qhia txog qhov sib txawv ntawm hom pob txha.

Sib tham

Txog niaj hnub no, qhov no yog qhov kev tshawb fawb loj tshaj plaws los sib piv cov kev sib raug zoo ntawm cov cemented thiab uncemented qia periprosthetic fractures thiab Vancouver kev faib tawm:

• Tsis muaj qhov sib txawv tseem ceeb hauv kev sib raug zoo ntawm cov cemented thiab uncemented stems nyob rau hauv Vancouver hom A, B, los yog C tawg. Qhov tshwm sim ntawm VancouverB2 pob txha pob txha yog tib yam hauv ob pawg, qhia tias tib qhov xwm txheej ruaj khov thiab tsis ruaj khov hauv cov pob txha periprosthetic hauv ob pawg.

• Hauv kev sib piv, Fenelon et al. soj ntsuam periprosthetic puas nrog cemented thiab uncemented stems. Nws yog qhov tseeb tias cov neeg mob pob txha hauv Vancouver B2 thiab B3 muaj ntau dua.

• Phillips et al. piav qhia txog qhov ua tau zoo heev ntawm 'burst' qauv ntawm conical cement segments thiab 'crack' raws lub tsho cement, zoo ib yam li 'axe taub hau'. Qhov kev puas tsuaj no tau pom tias muaj feem cuam tshuam nrog cov cemented stems hauv txoj kev tshawb no.

• 
  

• Qhov siab comminuted xwm ntawm cov pob txha no ua rau muaj kev txhawj xeeb txog cov pob txha deactivation, thiab cov pob txha tawg no feem ntau yuav tsum tau ceev faj tshem tawm cov cement thiab bypassing nrog lub distal bearing qia.

• Capello et al. piav txog qhov 'flip-flop' pob txha txuam nrog uncemented stems, thiab cov kev tshawb pom qhia txog qhov kev tshawb pom no. Cov pob txha pob txha pib los ntawm lub hauv paus nruab nrab ntawm qhov loj dua trochanter, txuas mus rau qhov nruab nrab cortex, thiab khaws cia rau sab cortex, distal mus rau qhov tsawg dua trochanter. Kev loj hlob ntawm thaj av talar thiab kev tawg ntawm qia yog radiographic cim ntawm qia instability. Cov kev tshawb fawb yav dhau los tau pom tias muaj kev sib koom ua ke tseem ceeb ntawm qhov tawg no nrog cov kab tsis sib xws nrog cov qauv tsim anatomical thiab wedge-shaped, thiab txoj kev tshawb fawb no txhawb nqa lub koom haum no.

• Grammatopolous thiab al piav qhia txog cov qauv ntawm cov pob txha helical hauv cov pob txha periprosthetic nrog cov cemented stems, feem ntau cuam tshuam nrog cov kab sib cais thiab kev sib tsoo hnyav. Tus naj npawb ntawm cov pob txha helical hauv cov qia cemented tau nce ntau hauv cov koob no, uas tuaj yeem cuam tshuam qhov kev nyiam ntawm cov pob txha nyob ib ncig ntawm cov tubular cemented qia kom nthuav tawm zoo ib yam li cov pob txha ntuj.

• Nyob rau hauv ib tug radiographic tsom xam ntawm ib tug loj tus naj npawb ntawm periprosthetic fractures, pab neeg tshawb fawb tau pom ib tug tawg qauv uas tsis tau piav yav tas los nyob rau hauv cov ntaub ntawv. Kev puas tsuaj tshwm sim los ntawm qhov nruab nrab calcar dhau los ntawm lub lateral cortex, tawm hauv nruab nrab cortex tsis zoo. Hom pob txha no hu ua 'reverse' clamshell fracture, uas txoj kev tshawb no suav hais tias yog ib qho kev sib tsoo Vancouver B2.

• Lub npe no tau raug xaiv rau ob qho laj thawj: thawj, nws yog daim iav duab ntawm 'flip', thiab qhov thib ob, nws coj zoo li qhov rov qab oblique proximal femoral fracture, nrog rau qhov zoo sib xws supralateral hloov chaw ntawm tus abductor rub lub proximal fragment. Cov pob txha zoo sib xws tau tshwm sim nrog cov cemented thiab uncemented stems (Daim duab 2).

• Txawm hais tias lub hom phiaj ntawm txoj kev tshawb no tsis yog los tshawb xyuas cov txiaj ntsig kev kho mob, hauv txoj kev tshawb no, qhov rov qab flip-flop fractures feem ntau tau hloov kho nrog lub arthroplasty ntawm lub distal load-bearing qia thiab fixation ntawm proximal fracture fragments nrog cerclage xov hlau los yog daim hlau.

• Ib qho piv txwv ntawm tus neeg mob kho nrog txoj hauv kev no tau qhia, qhia txog kev ua tiav ntawm kev kho mob (Daim duab 3).

Daim duab 2 Reverse flip-top fracture pattern.

Daim duab 3 Arthroplasty thiab cerclage hlau fixation rau retrograde nrov plig plawg fractures.

Xaus

Raws li Vancouver kev faib tawm, hom periprosthetic pob txha muaj tib qhov xwm txheej ntawm periprosthetic fractures hauv cemented thiab uncemented prostheses. Yog li ntawd, qhov tshwm sim ntawm qhov ruaj khov thiab tsis ruaj khov stems tom qab tawg yog sib npaug ntawm ob pawg. Kev txheeb xyuas plaub qhov txawv ntawm VancouverB2 tus qauv pob txha, suav nrog cov qauv tshiab uas tau hloov pauv hloov pauv, yuav pab cov kws phais txheeb xyuas cov qia instability. Cov kev tshawb fawb yav tom ntej yog xav tau los tshawb xyuas qhov kev sib raug zoo ntawm hom pob txha thiab cov tswv yim kho mob los txiav txim siab qhov tseem ceeb ntawm qhov kev tshawb pom ntawm txoj kev tshawb no.

Yuav Ua Li Cas Orthopedic Implants thiab Orthopedic Instruments?

Rau CZMEDITECH , peb muaj cov khoom lag luam ua tiav ntawm orthopedic phais implants thiab cov cuab yeej siv, cov khoom suav nrog txha caj qaum, intramedullary rau tes, kev raug mob phaj, xauv phaj, cranial-maxillofacial cov, prosthesis, cov cuab yeej siv zog, sab nraud fixators, arthroscopy, Veterinary saib xyuas thiab lawv cov cuab yeej txhawb nqa.

Tsis tas li ntawd, peb tau cog lus los tsim cov khoom tshiab thiab nthuav dav cov khoom lag luam, txhawm rau ua kom tau raws li kev xav tau ntawm kev phais ntawm ntau tus kws kho mob thiab cov neeg mob, thiab tseem ua rau peb lub tuam txhab muaj kev sib tw ntau dua nyob rau hauv tag nrho lub ntiaj teb orthopedic implants thiab instruments kev lag luam.

Peb xa tawm thoob ntiaj teb, yog li koj tuaj yeem ua tau tiv tauj peb ntawm email chaw nyob song@orthopedic-china.com rau ib qho kev tsocai pub dawb, lossis xa lus ntawm WhatsApp rau cov lus teb ceev +86- 18112515727 .

Yog xav paub ntxiv, nyem CZMEDITECH kom paub meej ntxiv.