Ọgwụ Ọthroscopic nke Enweghi ike

A na-esikarị ike ikuku na-enweghị atụ ma ọ bụ na-emegharị emegharị ma ọ bụ ihe omume ndị ọzọ na-eme ememme ma ọ bụ ihe omume ndị ọzọ na-eme kwa afọ nke 100000 ndị mmadụ 100000 kwa afọ. Ọtụtụ usoro ịwa ahụ maka ọgwụgwọ nke polter shower ubu, gụnyere mmezi anụ ahụ dị nro ma mepee ya na ọwa ahụ na-egbochi ịwa ahụ. Agbanyeghị, ndị a na-ahụ maka ịwa ahụ na ọnụego ntụgharị dị ka 14% na 67%, n'otu n'otu. Karịsịa, a na-edebekwa graft ọkpụkpụ, dozie nghazi na ọgwụgwọ ọnya ndị a na-eme ihe ịma aka. N'ihi ya, ọ dị mkpa ka a kwalite usoro ịwa ahụ.

Usoro Ọrụ:

• A rụrụ ọrụ ahụ n'okpuru Genesthesia jikọtara ya na mpaghara ngọngọ nke culcus culcus.

• Maka nchịkọta iliac crest, a na-etinye ọdịnala mpaghara na peristealy.

• E debere onye ọrịa ahụ n'oche osimiri ahụ na azụ na azụ na 45 Celsius iji kwe ka ịkpọtụrụ Iliac Crest. Mgbe a na-egbute ọkpụkpụ ọkpụkpụ ahụ, ọrụ ahụ gara n'ihu, onye ọrịa ahụ nọ ọdụ n'oga nke 70 Celsius. Akwụsịla onye ọrịa ahụ n'ụzọ na-enweghị atụ, ogwe aka na-arụ ọrụ na-agbaze 30 Celsius site na traction traction traction.

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Nnyocha nkwonkwo na nkwonkwo

• Usoro a na-eji nnọchi anya abụọ ma ọ bụ atọ. Enwere ike iji ihu mbu (e) ọnụ ụzọ na-enyocha maka njikọ ọnụ maka nyocha nke ọma.

  
  

• Enwere ike iwebata ranges ozugbo n'ime nkwonkwo site na etiti oge. N'ọnọdụ ụfọdụ, ọ gaghị ekwe omume iwebata ogo (ya bụ, anụ ahụ na-agba gburugburu etiti etiti.

  
  

• You nwere ike ịmepụta ọnụ ụzọ mbata Condal ma ọ bụ n'ọnụ ụzọ mbata dị ala, ka ị nwee ike ịbanye na mbara ala n'okpuru okwute acroma, ka ị wee nwee ike ịhụ oghere akwara.

  
  

• A na-eji ọgwụ redio na-eme ka a na-emeghe ngwa ngwa.

  
  

• A na-etinye Leverle lever na nkwonkwo site na ntinye site na nbanye na-agbanwuru nso na echiche ime ihe.

  
  

• Mgbe enwetara ntule zuru oke nke nkwonkwo, ọnya anụ ahụ dị nro ma jikọtara ọnụ nke ọkpụkpụ glenoid na ntutu isi, eriri aka, nkwonkwo ụkwụ na-enyocha ya.

  
  

• Mgbe a na-enyocha ya nke ọma na nkwenye nke ihe ngosi ziri ezi na nkwenye nke ngosipụta kwesịrị ekwesị, a na-enwetakwa aka ọkpụkpụ.

  
  

Ihe ubi na nkwadebe

• Enwetara Autograp na IPSILAter Anterter Iliac Crest iji chekwaa cortex nke pelvis. Mee mbepụ akpụkpọ ahụ dị ka 2cm n'azụ Iliiac Spine dị elu na 2cm n'okpuru crest n'akụkụ nke Iliia Crest iji zere ọkọlọtọ na-ekpuchi crest.

  
  

• Mgbe etinyere ọkpụkpụ α na β abụọ ndị ọzọ kirschner ka etinyere na ndagwurugwu ahụ, nke a na-ejikwa ya na saracroid cararject abụọ (Fig 1).

  
  

• Ihe ntuziaka a na-eme ka a na-eme elu elu nke mere na ogwe ọkpụkpụ nwere ike ijikọ ya na mma dị egwu. Ntinye nke nduzi na-enye ohere nke elu ya nke elu dika akuku ulo ahihia.

  
  

• Mgbe ahụ, kunye oghere Houlloid Usoro Ntanetị Ntinye aka na Kirschner Wire ma gwuo olulu abụọ 2.9mM na ọkpụkpụ ọkpụkpụ. A na-ewepụ ntụtụ ihe na ntụtụ Kirschner. Tupu itinye okpu elu nke dị elu na olulu mmiri, pịa onu na okpu elu okpu.

  
  

• Ozugbo okpu dị elu dị na ebe a na-emegharị ma ọ bụ ọkpụkpụ ma ọ bụ ọkpụkpụ ma ọ bụ iji chekwaa cortex nke iliac crest na cm × 1-cm × 1-cm × 1-cm grafts (fig 2 na 3). Mgbe ejikwa ya na-egbute, a na-ejikọkwa ọkpụkpụ ahụ na mpempe akwụkwọ dị na Creroid Metholl na-ejikwa skivas usoro nke a nwere ike iji megharịa ya (Fig 4).

  
  

• Iliac crest ọnya na-emechi oyi na-emechi oyi akwa na akwa ejiji. Mgbe ahụ mezie azụ tebụl arụmọrụ ka ọ bụrụ akụkụ nke 70 Celsius.

Ọgụgụ 1 A na-edobere kirschner abụọ a na ngwaọrụ nduzi abụọ, yana aka nke cannala dị elu. (Ant.

Ọgụgụ 2. Mgbe onye ọrịa nọ n'ọdụ ụgbọ mmiri, a na-ewere ihe mgbochi ọkpụkpụ. Wepu ihe eji eme ihe na Kirschner Wire mgbe ị na-alọcha mmiri nke ebiac crest cortex, wee tinye okpu 2 '. (Ant, n'ihu; DCG, okpukpu abụọ;

Ọgụgụ 3 Olulu dị n'ime Iliia Crest na-anọgide na-emebi emebi mgbe aftere na-egbute ya. (Ant.

Ọgụgụ 4. Kwadebe ngọngọ n'ime tebụl. Mgbe ejiri ya na-egbute, ejikọtara ọkpụkpụ ọkpọ na abụọ candula site na iji luru overtura. (Ant.

Ahịrị ụzọ na-agagharị na ụzọ

• A na-ejikarị ọwa abụọ ruo atọ. Ebumnuche bụ itinye aka na mpempe akwụkwọ na eriri nke glenoomimeral eriri dị ka o kwere mee. Ya mere, artroscope na-achịkwa ya. Ya mere, ọ na-arụbu na mgbe ọrụ ahụ si na ihu akụkụ n'akụkụ mbata.

  
  

• A na-etinye ọnụ ụzọ acteoloateral e na oghere akwara na-agbagharị n'elu akwara anụ ahụ, nke nwere ike igosipụta akụkụ ahụ nke telel (Isiokwu 1).

  
  

• N'ọtụtụ oge, ọnweghị ụzọ ọ bụla dị mkpa. Agbanyeghị, ọ bụrụ na ọ dị mkpa, ọzọ, posheroolater b inlet site na azụ cuff nwere ike iji (dịka ọmụmaatụ, ijikwa ndị na-emegharị emegharị emegharị).

  
  

• Kwesịrị, ụzọ mbata dị na axis nke eriri nkwonkwo glanoshotumal.

  
  

• Site na nlele ihu na azụ banyere ọnụ ụzọ e, itinye 2 spayer lara na anya 2.5 na 3 cm, ma tinye nkwonkwo na elekere asaa (ubu aka nri).

  
  

• Mee ka akpụkpọ ahụ na-emekọ ihe n'etiti 2 agịga ma jiri ya dị ka n'azụ ọnụ ụzọ (fig 5a na b).

Ọgụgụ 5. Iji mezuo ntinye kacha mma n'etiti azụ na nkwonkwo glenoshomeral nkwonkwo, a na-etinye spain abụọ azụ iji chọpụta ihe ịrịba ama nke akpịrị akpụkpọ ahụ.

(B) nlele arthroscopic, ubu aka nri, na nlekota elektrọnik nke onye ọrịa nwere agịga na 70 Celsius. (Ant, DCG, nduzi nke afọ abụọ; glonoid; Infer; Post; Post; Post; Post; spane.

Nkwadebe glunoid

• A na-ewebata ngwa ahụ site na azụ (a) inlet.

  
  

• Wepu lablum na capters polsule site na 7 ruo 10 (ubu nri) site na iji vapr na agu na b, vidiyo 1).

  
  

• Mike na-acha uhie uhie na arthroscopic burrs ruo mgbe ọkpụkpụ ọbara na-ekpughe na ụgbọ elu a kwadebere (fig 7). Ozugbo olu glunoid dị njikere, akwụkwọ mpịakọta a na-abawanye iji mee ka akụkụ nke aka na corla cracoid abụọ.

  
  

• Enwere ike iji skal nke a na-ewuli elu na cystotomy, ebe enwere ike iji ụgbọ mmiri nke cystotom.

Ọgụgụ 6. N'oge nkwadebe nke glunoid, jiri Vapr na agụba wee depụ egbugbere ọnụ glanoid na polsiriole site na 7:00 ruo 10:00. (Ant, gold; glonoid; hh, hh, hel, ala; Post; Post;

Ọgụgụ 7. Arthoscopic nlele nke nkwadebe nke glenoid: onye ọrịa nọdụrụ na akụkụ nke 70 Celsius, echiche ziri ezi, echiche e-enweghị atụ. Yiri nke na-acha uhie uhie na-enwu enwu n'oge nkwadebe glenoid. (Ant, GL, Burr; Glen, Glenoid; Nner, ala; PGN, Planters Glenoid olu; post, na elu.)

Ọgụgụ 8. Ọrịa Arthoscopic nke nkwadebe nke glenoid: onye ọrịa nọdụrụ na akụkụ nke 70 Celsius, echiche ziri ezi, echiche e-enweghị atụ. Mee ka azụ dị na tracar nke dị anya. (Ant, FT: BT: GL, Glenoid; Nner, ala; Postter; Post; Post;

Ọnọdụ aka na ndozi

A na-etinyekwa aka ya site na ọnụ ụzọ mbata ahụ na-eche ihu elu (fig 9) ma kewaa olu nke glenoid na-acha uhie uhie. Nzọụkwụ a kwesịrị ilekwasị anya na nkwadebe nke nkewa, karịchaa emeghe oke ma sie ike infrafrinatus na-egbochi akụkụ nke aka.

• Ọ dị mkpa iji skalpel na-agụcha imeghe fascenis ọtụtụ. Ọ bụrụ na ọ dị mkpa, na ọkwa nke ịwa ahụ mgbe e mesịrị, ọ bụrụ na ịbelata ala dị oke mkpa iji nọgide na-enwe nrụgide zuru oke na ubu, dịka ọmụmaatụ, ọnya ọnya).

  
  

• A na-etinye corloid Canclula ruo na elu elu nke na-esote wires na skru na-esochi nkwonkwo.

  
  

• A na-etinye eriri ogologo abụọ nke millchner site na oghere cracoid stacoid na-eme ka aka dozie aka ahụ na oghere nke glenoid. 10).

  
  

• Ntinye nke Kirschner waya ekwesịghị gafere 40mm ka ọ ghara ịgafe olu anụ ahụ na-acha uhie uhie, ọ bụ ezie na naanị akụkụ nke akwara na akwara iji chebe ya.

Ọgụgụ 9 A na-etinyekwa aka ya site na azụ azụ na aka ahụ na-eche ihu n'elu. (Ant.

Ọgụgụ 10. Arthoscopic nlele nke idobe anya, onye ọrịa nọdụrụ na 70 Celsiusle, ubu aka nri, echiche m. Abụọ etinyere Kirschner na-etinye aka na obere ahụ na olu na-acha uhie uhie. (Ant, GL, Glenoid; IBG, IBG, ILAC Ọkpụkpụ;

Kemgbe 30 Celsion arthroscope na-ele n'ihu akwara nke Portal, ọ dị iche iche na akuku, na-eme ka ala dị ala karịa nke kwụ ọtọ. Ọ dị mkpa iji lelee ma ihe ọkpụkpụ ahụ ka dị ka ọ dị mma mgbe etinye aka.

• Ozugbo grash na-eme ka ọ dị mma na-achagharị marterior, wepụ ụzọ dị ogologo coracoid na igwu mmiri 3-2mm obosara bicorlical ricorlical ricer.

  
  

• Na usoro a, ọ dị mkpa ka ịnọ ebe ahụ ma emechaa. Ndị ọrụ inyeaka ga-ejikwa aka abụọ (ọgụgụ 11).

  
  

• Ọ ga-adị njikere itinye Kirschner Pin n'ime oghere, n'ihi na Kirschner PIN nke mbụ ya na-ejidekarị na moto na-enweghị aka.

  
  

• Ekwesịrị ịghara ilekọta Kirschner Wire mgbe ị na-adọpụta akụ ahụ site na uwe mkpuchi akwa. Mgbe ahụ, tinye ihe 4.5 mm akụkụ nke na-agbagharị na Kirschner Wire (Fig 12) ma tinye ya na ngbanwe, wee gwuo ala. Dị ka ọ dị mma, ogologo ịghasa ekwesịghị gafere 32 mm.

  
  

• Ogologo oge ọ bụla karịrị 40 mm chọrọ ule nlezianya, dị ka nke a nwere ike ịbụ n'ihi nke ahụ na-agbada n'akụkụ nke anụ ahụ, nke nwere ike ibute aka nri. Na ọkwa a, a ka nwere ike idozi ọkwa nke aka ike site na na-atụgharị glenoid n'akụkụ ala.

  
  

• Mgbe etinyere na mbụ (nke dị ala), enwere ike wepu PIRSchchner PIN mbụ. Tinye ihe nke abụọ n'otu ụzọ ahụ.

  
  

• Mgbe etinyere clash 2 na iwepu Kirschner waya, jiri nyocha a na-enyocha ọnọdụ nke ikpeazụ (ọgụgụ 13). Akụkụ nke aka ọ bụla nke aka kwesịrị idozi ya na burrs, na enweghị mmezi anụ ahụ dị nro ka a ga-eme iji gbochie nkwonkwo ụkwụ.

Ọgụgụ 11. Ahịrị ahụ na edozi. Onye ọrịa ahụ nọdụrụ na akụkụ nke 70 Celsius site n'ubu aka nri ya site n'elu. N'oge na mgbe ọ na-awụ mmiri, mee ka ihe nkiri ahụ ka nwere aka abụọ iji gbochie ahịrị k site na ịtọpụ ọwara. (Ant.

Ọgụgụ 12. Arthoscopic nlele edozi, onye ọrịa na-anọdụ na 70 Celsiusle, ubu aka nri, echiche elektrọnik. Nkeji 4.5mm na-ejikarị ya na Latarjet istarject bụ nke kachasị dị n'elu PINSCHNNNENNENNENNENNENNINE. (Ant, GL, Glenoid; IBG, IBG, ILAC Ọkpụkpụ; Ngalaba Iliam.

Onu ogugu 13 Mgbe etinyere skru abụọ ma wepu Kirschner waya, lelee ọnọdụ ntụgharị ikpeazụ. Kinddị ọkpụkpụ ara a nwere ezigbo ihe nzuzo na enweghị ikike mpako. (Ant, gold; glonoid; hh, HH, Helg, ala; Post; Post; ka ọ dị, elu.)

Mgbe a wachara ya, a na-emegharị ubu ya na akụkụ 20 Celsius na nchegharị nke narị izu isii:

• N'echi ya, mgbe a rụsịrị ọrụ, bido na Severfe, Ikike na aka na-emega ahụ. Ekwesịrị izere ịkpọọ na mmegharị na-egbu mgbu.

  
  

• Na izu atọ, bido usoro mmega ahụ.

  
  

• Mgbe nkwụsi ike nke aka ya site na-ewere foto 6 izu mgbe ọrụ ahụ, enwere ike ịmalite mmega ahụ.

  
  

• Maka ndị na-eme egwuregwu na-achọ mgbake ọsọ ọsọ, kọmputa a ga-arụ ọnwa 3 mgbe ọwachara ahụ iji chọpụta njikọta aka.

  
  

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