Kev kho sab nrauv yog ib lub sijhawm sim thiab siv dav hauv kev kho cov pob txha. Txoj kev no suav nrog kev siv cov cuab yeej tso tawm sab nraud lub cev kom ruaj khov thiab ua kom cov pob txha tawg.
Txheej txheem cej luam ntawm External Fixation
Sab nrauv fixation yog ib txoj kev phais uas tau siv rau ntau pua xyoo los tswj cov pob txha. Lub tswv yim yog thawj zaug los ntawm Hippocrates, uas tau siv ntoo splints rau immobilize cov pob txha tawg. Sij hawm dhau mus, thev naus laus zis tau hloov zuj zus, tab sis lub hauv paus ntsiab lus tseem zoo ib yam: muab kev ruaj ntseg rau qhov chaw tawg thaum tso cai rau cov ntaub so ntswg tiv thaiv thiab kho.
Lub Hom Phiaj ntawm Kev Txhim Kho Sab Nraud: Txhim kho kev puas tsuaj ntawm cov pob txha, qhov ntev, thiab kev sib hloov.Muaj kev ruaj khov ib ntus lossis ruaj khov.Can tuaj yeem ua ke nrog kev kho ib nrab hauv cov rooj plaub nyuaj.
Factors Influencing Fixation Stability
Muaj ntau yam cuam tshuam rau kev ruaj ntseg ntawm cov khoom siv kho kom raug sab nraud:
Pin Configuration:
Ua kom tus pins ntau dua, sib nrug deb dua, thiab muab lawv los ze zog rau ntawm qhov chaw tawg, txhim kho rigidity.
Pins yuav tsum tau muab faib kom sib npaug kom tsis txhob muaj kev ntxhov siab ntau dhau ntawm cov chaw tshwj xeeb.
Pin Diameter:
Cov pins loj dua muab kev ruaj ntseg dua tab sis tuaj yeem ua rau muaj kev pheej hmoo ntawm kev ntxhov siab thiab cov nqaij mos khaus.
Pin hom:
Self-drilling pins, trocar pins, coated pins, carbon fiber rods.
Hom External Fixators
Sab nrauv fixators sib txawv hauv kev tsim, txhua qhov muab cov txiaj ntsig tshwj xeeb:
Uniplanar Fixators:
Yooj yim thiab yooj yim rau kev thov.
Txwv tsis pub muaj kev ruaj ntseg piv rau cov khoom siv multiplanar.
Multiplanar Fixators:
Siv cov pins hauv ntau lub dav hlau, muab kev ruaj ntseg zoo dua.
Zoo tagnrho rau cov pob txha tawg.
Unilateral/Bilateral Fixators:
Unilateral fixators tsis ruaj khov, thaum ob tog fixators muab ntau zog thiab kev txhawb nqa.
Circular Fixators:
Feem ntau siv rau limb lengthening thiab complex deformity kho.
Tso cai ib feem ntawm qhov hnyav-cov kabmob thiab sib koom ua ke thaum kho.
![Sab nrauv Fixation Hom]()
Anatomical Considerations thiab Safety Zones
Kev tso cov pins yog qhov tseem ceeb kom tsis txhob muaj teeb meem xws li paj hlwb lossis vascular raug mob. Cov ntsiab lus tseem ceeb anatomical suav nrog:
![Sab nrauv Fixation Device]()
Femur:
Cov pins anterior yuav tsum tau muab tso rau 5.8 cm hauv qab ntawm qhov tsawg dua trochanter thiab 7.4 cm saum lub patellar apex.
Posterior pins yuav tsum zam cov hlab ntsha sciatic thiab cov hlab ntsha ib puag ncig.
Tibia:
Pins yuav tsum tau muab tso rau tsawg kawg yog 14 hli ntawm txoj kab sib txuas kom tiv thaiv kev nkag mus rau hauv cov kab ke.
Upper Extremities:
Humerus pins yuav tsum zam lub axillary thiab radial qab haus huv.
Lub forearm pins yuav tsum tau muab tso rau hauv thaj tsam subcutaneous ntawm lub ulna kom txo qis cov paj hlwb.
Indications rau External Fixation
External fixation yog tshwj xeeb tshaj yog pab tau nyob rau hauv cov nram no scenarios:
Tsis ruaj tsis khov pelvic nplhaib raug mob.
Comminuted intra-articular fractures (piv txwv li, pilon, distal femur, tibial toj siab, luj tshib, thiab distal radius).
Cov ntaub so ntswg mob hnyav los yog ecchymosis.
hemodynamic instability los yog tsis muaj peev xwm mus phais qhib.
Osteoporosis, kab mob, limb lengthening, osteomyelitis, sib koom ua ke immobilization, nonunions, thiab kev kho mob.
Contraindications
Kev kho sab nraud yuav tsis haum rau hauv cov xwm txheej hauv qab no:
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Cov neeg mob rog rog.
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Cov neeg mob tsis ua raws cai.
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Cov neeg mob uas muaj pob txha tsis txaus.
Cov neeg mob uas tsis kam phais lossis tsis tuaj yeem zam qhov txheej txheem.
Cov txheej txheem thiab kev siv
![Sab nrauv Fixation Device]()
Pin-Bone Interface:
Tsis txhob rub cov nqaij mos thaum lub sij hawm muab tus pin.
Siv trocars thiab lub tes tsho xyaum kom txo tau cov nqaij mos puas.
Pre-drilling thiab flushing (irrigation) yog qhov tseem ceeb kom txo tau cov kab mob.
Pelvic Fixation:
Feem ntau muab tso rau ntawm iliac crest lossis anterior inferior iliac spine (AIIS).
C-arm fluoroscopy xyuas kom zoo tus pin tso.
Upper Extremity Fixation:
Humerus pins yuav tsum zam cov qauv neural.
Forearm pins yog muab tso rau hauv subcutaneous cheeb tsam ntawm lub ulna.
Lower Extremity Fixation:
Femoral pins yog muab tso rau hauv txoj hauj lwm anterolateral.
Tibial pins muab tso rau hauv txoj hauj lwm anteromedial kom tsis txhob sib koom ua ke.
Pilon Fractures:
Lub delta-thav duab configuration yog siv, siv ob qho tib si calcaneal thiab tibial pins los txhim kho kev ruaj ntseg.
Teeb meem ntawm External Fixation
Txawm hais tias nws cov txiaj ntsig, kev kho sab nraud yog cuam tshuam nrog cov teeb meem tshwm sim, suav nrog:
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Pin kab mob
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Osteomyelitis
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Ntaus tsis ua hauj lwm los yog loosening
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Malunion los yog nonunion
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Cov nqaij mos khaus khaus lossis nkag mus
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Cov hlab ntsha los yog vascular raug mob
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Compartment Syndrome
Rov qab
Clinical tseem ceeb
External fixation plays lub luag haujlwm tseem ceeb hauv kev tswj kev raug mob:
Muab ceev stabilization hauv kev puas tsuaj tswj orthopedics.
Txo qhov kev pheej hmoo ntawm kev raug mob thib ob thiab teeb meem.
Ua kom muaj kev qhuab qhia ntau yam nrog rau cov kws phais mob orthopedic, kws saib xyuas neeg mob, kws kho lub cev, thiab cov kws kho mob ua haujlwm txhawm rau txhim kho cov txiaj ntsig ntawm tus neeg mob.
CZMEDITECH khoom
Circular sab nraud fixator:
Yam ntxwv: Ua los ntawm cov hlau rings thiab cov xov hlau zoo, thaiv cov ceg tawv thiab tso cai rau ntau qhov kev hloov kho.
Cov
ncig sab nraud fixator yog ib qho khoom siv kho mob siv rau kev txhim kho pob txha thiab orthopedic rehabilitation. Nws cov qauv tsim thiab qhov zoo yog feem ntau cuam tshuam hauv cov hauv qab no:
Tsim nta
Lub nplhaib qauv: Lub voj voog sab nraud fixator yog tsim los nrog lub nplhaib puab, ua kom tiav lub voj voog nyob ib ncig ntawm qhov chaw tawg kom muab kev txhawb nqa thiab kho.
Ntau cov ntsiab lus fixation: Feem ntau muaj ntau cov ntsiab lus fixation ntawm lub voj voog, uas tuaj yeem txuas nrog cov pob txha los ntawm ntau cov pob txha pins lossis rau tes. Qhov no disperses lub fixation quab yuam thiab txo lub siab ntawm ib tug fixation point.
Adjustability: Tus tsim ntawm lub voj voog sab nraud fixator tso cai rau cov kws kho mob ua kom hloov kho raws li tus neeg mob cov kev mob tshwj xeeb, suav nrog qhov loj ntawm lub nplhaib, txoj hauj lwm ntawm cov ntsiab lus fixation, thiab kev faib tawm ntawm lub zog, kom haum rau ntau hom kev puas tsuaj thiab cov pob txha.
Lub teeb yuag thiab ruaj khov: Cov niaj hnub ncig sab nrauv fixators feem ntau yog ua los ntawm cov khoom siv hnyav thiab muaj zog xws li titanium alloy lossis carbon fiber, ua kom muaj kev ruaj ntseg thaum txo lub nra ntawm tus neeg mob.
Yooj yim rau nruab thiab tshem tawm: Lub nplhaib tsim ua rau kev teeb tsa thiab tshem tawm cov txheej txheem yooj yim dua, txo lub sijhawm phais thiab tus neeg mob tsis xis nyob.
Qhov zoo
High stability:
Cov qauv annular muab 全方位 kev txhawb nqa, zoo tiv thaiv kev txav ntawm qhov chaw tawg thiab ua kom cov pob txha tseem nyob hauv txoj haujlwm raug thaum lub sijhawm kho.
Dispersive zog:
Ntau cov ntsiab lus fixation disperse lub fixation quab yuam, txo cov concentration ntawm cov pob txha thiab cov nqaij mos, thiab txo cov kev pheej hmoo ntawm cov teeb meem tshwm sim los ntawm kev kho tsis raug.
Kev siv ntau yam:
Lub voj voog sab nrauv fixator yog tsim rau ntau hom kev puas tsuaj, tshwj xeeb tshaj yog cov pob txha tawg, qhib pob txha, thiab cov rooj plaub uas yuav tsum tau kho lub sijhawm ntev.
Txhawb kev kho mob:
Los ntawm kev muab qhov chaw kho kom ruaj khov, lub voj voog sab nraud fixator pab txhawm rau txhawm rau kho pob txha thiab txo qhov kev pheej hmoo ntawm nonunion lossis qeeb kho.
Txo cov teeb meem:
Vim lub dispersed fixation quab yuam, lub ncig sab nraud fixator txo cov ntaub so ntswg puas thiab txo qhov tshwm sim ntawm cov teeb meem xws li kab mob thiab tus pin ib ntsuj av o.
![CZMEDITECH Sab Nraud Fixation Device]()
Yooj yim rau kev saib xyuas tom qab phais:
Tus qauv tsim ua rau nws yooj yim dua rau cov neeg mob saib xyuas lawv tus kheej tom qab kev phais, xws li ntxuav thiab hloov cov khaub ncaws, tsis muaj kev cuam tshuam rau kev txhim kho.
Muaj cov xwm txheej
Lub voj voog sab nraud fixators feem ntau siv nyob rau hauv cov xwm txheej hauv qab no:
Complex fractures: Haum rau cov pob txha pob txha uas muaj ntau yam pob txha lossis pob qij txha.
Qhib Fractures: Vim nws qhov kev quab yuam-dispersing yam ntxwv, lub circumferential sab nraud fixator yog haum rau kev tswj ntawm qhib pob txha thiab txo qhov kev pheej hmoo ntawm kev kis kab mob.
Kev tsis sib haum xeeb lossis ncua kev koom ua ke: Qee qhov xwm txheej, kev sib txuas sab nraud tuaj yeem pab kho pob txha los ntawm kev muab kev ruaj ntseg thiab kev txhawb nqa tsim nyog.
Postoperative fixation: Siv rau stabilization thiab kev txhawb nqa tom qab phais orthopedic, kom muaj kev ruaj ntseg ntawm qhov chaw phais.
Lub tswv yim tsim ntawm lub voj voog sab nrauv fixator kuj tseem yog tus neeg mob hauv nruab nrab, tsom rau kev ruaj ntseg thiab kev nplij siab, thiab yog ib qho tseem ceeb hauv kev kho mob orthopedic.
Xaus
Kev kho sab nrauv tseem yog lub hauv paus hauv kev kho mob pob txha, muab ntau yam thiab yoog raws rau ntau yam xwm txheej kho mob. Los ntawm kev sib txuas cov txheej txheem no nrog ntau txoj kev qhuab qhia, cov kws kho mob tuaj yeem ua tiav cov txiaj ntsig zoo rau cov neeg mob. Nrog kev nce qib hauv kev siv technology tsis tu ncua, Kev kho sab nrauv txuas ntxiv mus ntxiv, kom ntseeg tau tias nws muaj feem cuam tshuam hauv kev xyaum orthopedic niaj hnub.
