Ị maara akụkọ ihe mere eme nke intramedullary nailing?

Ọbịbịa nke ntu intramedullary gbanwere ọgwụgwọ ogologo ọkpụkpụ ọkpụkpụ. Ọ bụ ezie na usoro ahụ adịlarị kemgbe ọtụtụ narị afọ, ọ nwetaghị ọnọdụ ya ugbu a ruo na ọkara nke abụọ nke narị afọ nke 20.

Ụzọ nke ịga nke ọma adịghị adị mfe mgbe nile, n'ihi na usoro ahụ nwere obi abụọ na mgbagha site n'aka ọtụtụ ndị ọkà mmụta na ọkara mbụ nke narị afọ nke 20. Taa, site na ihe ọhụrụ na metallurgy, usoro ịwa ahụ na nkà fluoroscopic, intramedullary nailing aghọwo ọkọlọtọ nlekọta maka ọkpụkpụ ọkpụkpụ ogologo.

Ọganihu na ihe ọmụma biomechanical mmadụ emeela ka imepụta ihe nke oge a nwee ike. A na-eji ntu intramedullary ọgbara ọhụrụ mara ọnụ ọgụgụ ọrịa dị ala, ọnya ọnya dị ntakịrị, nkwụsi ike mgbaji dị mma, yana mmegharị onye ọrịa ozugbo.

The akụkọ ihe mere eme nyochaa eme n'isiokwu a aims ichikota evolushọn nke intramedullary ntu, pụta ìhè ya dị mkpa milestones, na-ewetara oge ikuku nke mbụ ojiji na ụdi evolushọn nke intramedullary ntu, na-ewebata ebe nke intramedullary ntu na oge a orthopedics na traumatology (eg, Figure 1).

Ọmụmụ nke intramedullary ntu

Ndị Ijipt oge ochie na-ebu ụzọ jiri ngwaọrụ intramedullary yiri ntu. Nlekọta mgbawa mgbawa siri ike agaghị adị adị ọtụtụ afọ gara aga.

Otú ọ dị, ihe e ji n’aka bụ na ndị Ijipt oge ochie nwere ụzọ mgbaze dị ukwuu sitere n’okwukwe ha nwere ná mbilite n’ọnwụ nke ahụ́ ná ndụ mgbe a nwụsịrị.

Nke a bụ ihe gbasara mummy a na-akpọ Usermontu a chọtara n'ili Tutankhamun, ebe etinyere ntu eri n'etiti femur na tibia iji mee ka nkwonkwo ikpere kwụsie ike (dị ka ọ dị na foto 2).

Ndị ọkà mmụta ihe ochie na-eche na mummy nọ n'ime sarcophagus abụghị Usermontu n'onwe ya, kama ọ bụ onye ọzọ nke ndị na-apụnara mmadụ ihe n'oge ochie dochie anya na 600 TOA.

Afọ 2000 ka e mesịrị, Bernardino de Sahagun, onye ọkà mmụta banyere mmadụ na njem Hernando Cortes, kọrọ na mbụ eji intramedullary nailing na onye ọrịa dị ndụ na Mexico.

Na 1524, ọ hụrụ otu dọkịta na-awa ọkpụkpụ Aztec (nke aha ya bụ 'Tezalo') na-eji mma obsidian na-eme osteotomy ma tinyezie mkpanaka resin n'ime oghere medullary iji mee ka mgbaji ahụ guzosie ike. N'ihi enweghị usoro ịwa ahụ zuru oke na ọgwụ antiseptik, usoro ndị a nwere nnukwu mgbagwoju anya na ọnụ ọgụgụ ọnwụ dị elu.

1800s: Nzọụkwụ mbụ

N'ihe dị ka n'etiti 1800s, akwụkwọ akụkọ ahụike mbụ kọrọ gbasara ntu intramedullary. A kọrọ na Diefenbach, Langenbeck, Bardenheuer na ndị dọkịta na-asụ German na-eji mbọ ọdụm na ụmị ọkpụkpụ dị ogologo na-agwọ nkwụsị ọkpụkpụ.

Ka ọ dị ugbu a, Nicholas Senn nke Chicago, onye nyocha na dọkịta na-awa ndị agha na-anụ ọkụ n'obi, mere nnwale na nhazi intramedullary. Ọ ga-eji oghere gbawara agbawa nke ọkpụkpụ anụ mee ma tinye ya na medulla ka ọ gwọọ 'pseudarthrosis' mgbe ọ gbajiri agbaji.

N'afọ 1886, Heinrich Bircher nke Switzerland kọwara na nzukọ ịwa ahụ, ntinye ntu ọdụm n'ime medulla maka ọgwụgwọ nnukwu mgbaji gbajiri agbaji (Njirimara 3).

Afọ ole na ole ka e mesịrị, Themistocles Gluck na Germany kere ọdụm intramedullary mbụ nke nwere oghere na njedebe nke ntu ahụ, si otú a na-ewebata echiche nke ịgbakọ ọnụ na nke mbụ.

N'otu oge ahụ, Julius Nicolaysen si Norway bụ onye mbụ dere banyere ụkpụrụ biomechanical nke nku intramedullary nke mgbaji femoral dị nso. O kwusiri ike na ọ dị mkpa ịbawanye ogologo ntu intramedullary iji nweta uru biomechanical ka ukwuu na iji nye nchebe maka ihe fọrọ nke nta ka ọ bụrụ ọkpụkpụ dum.

Ọ bụkwa onye mbụ tụpụtara echiche nke ntu dị nso na nke dị anya na njikọta ọkpụkpụ iji chepụta mkpọchi static. Ụfọdụ ndị ọkà mmụta na-ewere ya dị ka nna nke ịkụ nku intramedullary.

Ka ọ na-erule n'etiti 1800s, ndị ọsụ ụzọ dịka Ignaz Philipp Semmelweis na Vienna na JosephLister na Glasgow tọrọ ntọala maka ịwa ahụ. Nke a bụ nnukwu ihe ịga nke ọma n'ihi na ọ nyere ohere ịmepụta usoro ịwa ahụ ọhụrụ n'okpuru ọnọdụ aseptic.

1900s: Evolution

N'afọ 1912, dọkịta na-awa Britain bụ Ernest Hay Groves bụ dọkịta na-awa ahụ nke mbụ jiri mkpanaka ígwè siri ike dị ka ntu intramedullary ma bụrụ onye ọsụ ụzọ nke ntu ntu retrograde intramedullary.

O nwetara ahụmahụ ya n'oge Agha Ụwa Mbụ mgbe ọ na-agwọ ndị ọrịa nwere pseudarthrosis bu ọrịa bụ ndị na-achọghị ibipụ ụkwụ ha. Ọ bụghị naanị na ọ kọwara usoro ntu mbụ intramedullary nke na-ekwe ka osseointegration site na obere trauma, ma ọ bụkwa ọkachamara n'iji mbọ intramedullary na ntu nta na-edozi mgbaji.

Ọ nwalere ihe etinyere nke aluminom, magnesium na ígwè wee mata mkpa biomechanics dị na ọgwụgwọ mgbaji. N'agbanyeghị nke ahụ, usoro Ernest Hay Groves nwere nnukwu ọrịa na-efe efe, ya mere ọ bụghị ihe a ma ama na ndị ha na ya dịkọrọ ndụ.

N'afọ 1931, Smith-Petersen, bụ dọkịta na-awa ọkpụkpụ ọkpụkpụ nke America, webatara eriri igwe anaghị agba nchara nwere nku atọ maka ọgwụgwọ nke intra-articular capsule femoral neck fractures. Ọ haziri ụzọ mepere emepe nke na-eme ka akụkụ nke atọ nke mgbawa nke iliac, banye n'ọhịa na-arụ ọrụ n'akụkụ ihu ihu nke nnukwu tensor fascial, wee megharịa mgbaji ahụ ma jiri onye na-eme ihe na-eme ka ọkpụkpụ igwe anaghị agba nchara n'ime isi femoral (Nyocha 4).

N'ihi ihe ịga nke ọma nke ikpe Smith-Petersen, ọtụtụ ndị dọkịta na-awa ahụ malitere ịnwale n'ime ígwè maka mgbaji. Sven Johansson chepụtara ntu intramedullary oghere na 1932; ihe ohuru ohuru ya jiri agịga kerfing na-ekwe ka ntinye ntu intramedullary na-achịkwa usoro redio. Isi ihe ndị o tinyere n'ọrụ ka na-eji ya eme ihe taa.

N'ịga n'ihu otu nzọụkwụ, Rush na nwanne ya nwoke webatara echiche nke ntu intramedullary na-agbanwe agbanwe na 1937.

Ha na-eji ntu intramedullary igwe anaghị agba nchara, nke gbagoro agbagoro agbagoro wee nwaa imepụta nhazi ihe nrụnye nke intramedullary nke nwere isi atọ iji gbochie ọchịchọ nke mgbawa axial gburugburu mgbawa ahụ.

N'echiche ha, mpaghara anụ ahụ dị nro na-adịghị emebi emebi na-arụ ọrụ dị ka eriri mgbakasị ahụ nke na-egbochi mgbakasị ahụ nke ntu na-agbanwe agbanwe na mbụ. Eji nchara nke igwe anaghị agba nchara, nke gbanwere n'oge site na nrụrụ ngbanwe gaa na nrụrụ plastik. Nke ikpeazụ nwere ike ibute nchụpụ nke abụọ na ọgwụgwọ nrụrụ.

Na mgbakwunye, mbọ intramedullary na-apụ apụ n'ọnụ ụzọ ma ọ bụ banye n'ime ọkpụkpụ kagburu, ma ọ bụ ọbụna na-agbawa n'ime nkwonkwo. Ka o sina dị, ọkà mmụta Viennese Ender gara n'ihu na-eji usoro a dị ka ihe ndabere maka ụlọ akwụkwọ Ender nke nkwụsị mgbawa na a ka na-eji ya taa maka nhazi mgbanwe nke ọkpụkpụ ụmụaka.

Ntu ụmị ọkpụkpụ

N'afọ 1939, dọkịta na-awa German bụ Gerhard Küntscher, onye nwetara ihe nrite Nobel, mepụtara ntu intramedullary igwe anaghị agba nchara maka ọgwụgwọ mgbaji nke osisi femoral.

Küntscher na ndị ọzọ sitere n'ike mmụọ nsọ Smith-Petersen igwe anaghị agba nchara eji agwọ mgbaji n'olu femoral ma kwenye na otu ụkpụrụ ahụ nwere ike itinye n'ọrụ na mgbaji ụkwụ. Ntu intramedullary ha mepụtara bụ nke mbụ V-n'ụdị obe na 7-10 mm na dayameta.

Mgbe ọmụmụ cadaveric na anụmanụ gasịrị, o gosipụtara ntu intramedullary na usoro ịwa ahụ na nzukọ ịwa ahụ na Berlin na 1940. Na mbụ, ndị ọrụ ibe ya bụ German na-akwa emo ihe ọhụrụ ya, ọ bụ ezie na usoro ya nwetara ewu ewu mgbe Agha Ụwa nke Abụọ gasịrị.

Hippocrates (460-370 BC), dibia oge ochie nke Gris nke a na-akpọkarị nna ọgwụ, kwuru otu oge, 'Onye chọrọ ịwa ahụ aghaghị ịga agha'; Otú ahụ ka ọ dịkwa Küntscher.

N'oge ndị Nazi, Küntscher nọ n'ụlọ ọgwụ dị n'ihu ndị Finland. N'ebe ahụ, o nwere ike ịwa ndị ọrịa na ndị mkpọrọ agha n'ógbè ahụ ahụ. O webatara echiche ntutu ụmị ọkpụkpụ site na iji usoro ịwa ahụ mechiri emechi na nke mepere emepe, n'otu n'otu.

N'ebe a na-emechi emechi, ọ na-agafe ntu intramedullary na nhazi ọkwa site na nnukwu trochanter ma tinye ya na tebụl mgbagha nke ejiri èbè rụọ ọrụ. A na-emegharị mgbaji ahụ ma tinye ntu n'ime ụgbọ elu abụọ site na iji fluoroscopy isi. N'ebe a na-emepe emepe, a na-etinye ntu intramedullary site na mgbawa n'ime medulla site na mbepụ dị nso na eriri eriri.

Usoro Küntscher nwetara nkwanye ùgwù zuru ụwa ọnụ nanị mgbe a lọghachichara ndị mkpọrọ jikọrọ aka.

N'ụzọ dị otú a, ndị dọkịta na-awa America na Britain maara nke ọma na ntu intramedullary nke Küntscher mepụtara ma ghọta uru ya doro anya n'oge a nke usoro ọgwụgwọ mgbaji.

N'ime oge dị mkpirikpi, ọtụtụ ndị dọkịta na-awa gburugburu ụwa malitere ịmalite usoro ya, na ntu intramedullary Küntscher gbanwere ọgwụgwọ nke mgbaji site n'ibelata oge mgbake onye ọrịa ihe fọrọ nke nta ka ọ bụrụ otu afọ. Ndị ọrịa a ga-emerịrị ihe nkedo ruo ọnwa ole na ole nwere ike na-agagharị n'ime ụbọchị ole na ole.

Ka ọ dị ugbu a, a na-ewere dọkịta na-awa German dị ka onye na-emepụta ihe na-emepụta ntu intramedullary, na ọ nwere ebe dị mkpa na akụkọ ihe mere eme nke ịwa ahụ trauma.

Na-agbasa ntu intramedullary

Na 1942, Fisher et al. Nke mbụ kọwara iji ụmị-ịgbasa olulu na-egweri iji mee ka mpaghara kọntaktị dị n'etiti ntu intramedullary na ọkpụkpụ na iji meziwanye nkwụsi ike nke nkwụsi ike.

Ka o sina dị, Küntscher webatara ihe nrịbama nke na-agbanwe agbanwe nke a ka na-eji taa ma na-akwado ịghagharị n'ogologo oghere medullary nke ọkpụkpụ ọkpụkpụ iji kwado ntinye nke ntu intramedullary ka ukwuu.

Na mbụ, a haziri reaming intramedullary iji mee ka mpaghara kọntaktị ọkpụkpụ na ntu intramedullary dịkwuo ukwuu maka ịkwado mgbaji ahụ na mmegharị onye ọrịa ngwa ngwa.

Dị ka Smith et al kọwara, 1 mm ọ bụla nke mgbasawanye medullary na-abawanye mpaghara kọntaktị site na 38%. Nke a na-enye ohere iji mbọ intramedullary buru ibu ma sie ike, na-eme ka nkwụsi ike zuru oke nke nhazi nhazi mgbaji.

Agbanyeghị, ọ bụ ezie na ntu intramedullary Küntscher na mgbatị intramedullary na-agbanwe agbanwe ghọrọ nhọrọ dabara adaba nke ngwaọrụ ndozi ime maka osteotomy, agụmakwụkwọ tụfuru ihu ọma ya na ngwụcha afọ 1960 na-akwado efere ọhụrụ nke Arbeitsgemeinschaft für Osteosynthesefragen (AO).

1960s: Ọchịchịrị Ọchịchị

N'afọ ndị 1960, ntu intramedullary na-apụ na mberede maka nkwado nke efere na mkpọchi mgbaji.

Ọ bụ ezie na usoro Küntscher na-arụ ọrụ nke ọma, ndị dọkịta na-awa n'ụwa nile jụrụ ha n'ihi na ọ naghị arụpụta nke ọma mgbe a wachara ya ahụ.

Tụkwasị na nke ahụ, ụfọdụ ndị dọkịta na-awa ahụ malitere ịgbahapụ usoro radieshon, dị ka isi fluoroscopy, n'ihi na ndị dọkịta na-awa ahụ na-asọ oyi n'ihi mmetụta ọjọọ ndị metụtara radieshon. Mmepe nke intramedullary nailing akwụsịghị ebe ahụ, n'agbanyeghị nkwenye zuru ụwa ọnụ nke mba ụwa maka iji usoro nhazi nke ime efere efere.

Küntscher, bụ́ dọkịta German, ghọtara uru dị n'ịkpọkọta ọnụ wee mepụta ntu intramedullary nke yiri cloverleaf, bụ́ nke ọ kpọrọ aha 'ntu njide'. Achilles ikiri ụkwụ nke intramedullary ntu imewe nke oge ahụ bụ enweghị ike ime ka ọkpụkpụ ma ọ bụ mgbaji kpụ ọkụ n'ọnụ nke a na-agbanye n'ime akụkụ buru ibu Ihe ngwọta maka nsogbu a bụ iji kpochie mkpuchi.

Ihe ngwọta maka nsogbu a bụ iji mkpọchi akpọchi mee ka ntu intramedullary guzosie ike.

N'ụzọ dị otú a, ihe nkwụnye ahụ nwere ike ka mma iguzogide ike na-ehulata ma na-egbochi mbelata ụkwụ. N'iji nchikota echiche sitere na Küntscher, Klaus Klemm, na Wolf-Dieter Schellmann, a na-emepụta ntu intramedullary iji nye nkwụsi ike ka ukwuu site na-ebu ụzọ na-egwupụta oghere ndị dị nso na nke dị anya na ntu intramedullary, bụ nke a kpọchiri na ntinye ntinye.

N'ime afọ ole na ole sochirinụ, ọganihu nke ihe oyiyi fluoroscopic na-enye ohere maka ịhọrọghachi usoro mmechi mgbaji na mbelata.

Afọ 1970 na 1980: Mweghachi

N'afọ ndị 1970, mmasị na echiche intramedullary nailing nke dọkịta na-awa German bụ Küntscher siri ike.

Mbelata ntu ntu intramedullary mechiri emechi maka mgbaji, yana njikọ ya nke mgbanwe mgbanwe na echiche na-emekọrịta ihe yana nkwalite doro anya nke usoro fluoroscopic, kpalitere ọganihu na mgbasa nke usoro ịwa ahụ a magburu onwe ya, nke e ji obere mmebi anụ ahụ dị nro, nkwụsi ike dị mma, na mmegharị ndidi ozugbo.

N'oge ahụ, a na-ekpochapụ ụwa agụmakwụkwọ n'ọtụtụ ihe ọhụrụ nke mere ka e nwee ọganihu nke ọgbọ nke abụọ nke ntu intramedullary.

N'afọ 1976, Grosse na Kempf mepụtara ntu intramedullary nke nwere obere oghere iji dozie nsogbu nke ngbanwe nke ntu intramedullary. A naghị agbanye ntu intramedullary na mpaghara dị nso ma nwee oghere ntu maka screw proximal, nke a na-etinye n'ogo 45-ogo iji mee ka ike kwụsie ike nke ntu ntu intramedullary dị n'ime ụlọ.

Afọ ole na ole ka e mesịrị, AO sonyeere usoro nke mmepe ntu intramedullary site n'ịmepụta mbọ ntu intramedullary a tụrụ n'otu otu ahụ (Nyocha 5)

Na 1984, Weinquist et al. tụpụtara usoro ahụ siri ike, nke bụ ịkwalite ọgwụgwọ nkwụsị mgbaji site n'itinye oghere mkpuchi ka ukwuu, wepụ skru static, ma mechaa gbanwee oghere mkpọchi ka ọ bụrụ oghere ntu oval n'ụdị ọgbara ọhụrụ.

Ebumnuche nke usoro ahụ siri ike bụ ịkwalite ọgwụgwọ mgbawa na iji zere nkwụsị nke ọkpụkpụ n'ihi ọrụ oge.

Ka ọ dị ugbu a, intramedullary nailing dynamics efunahụla ndị na-akwado ya dị ka usoro kwụ ọtọ ma na-eji ugbu a dị ka ihe ngwọta dị ọnụ ahịa karịa ngbanwe zuru oke nke usoro nhazi nke ime n'ime ọgwụgwọ nke ọkpụkpụ na-adịghị agwọ ọrịa.

N'ime ọmụmụ ihe biomechanical, Gimeno et al. kọrọ na mpaghara mgbanwe n'etiti akụkụ ndị na-abụghị oghere na oghere nke ntu intramedullary mere ka nrụgide nrụgide na ọdịda ịwa ahụ nke ntinye ntinye n'ime ime.

Iji dozie nsogbu ndị a, Russel na Taylor et al. haziri ntu intramedullary nke mbụ na-enweghị oghere, nke na-agbasaghị na 1986, nwere nsonaazụ na-eju afọ.

N'oge a, nsogbu nke ịgbanye mbọ aka intramedullary nọgidere na-aga n'ihu, ma dị ka anyị maara taa, na-ejikọta ya na ịghasa site na oghere intramedullary na-ebute ụzọ bụ nhazi nke Klemm na Schleman na Germany. A ga-eduzi ntinye nke ịghasa ahụ site na fluoroscopy freehand, nke ga-eme ka dọkịta na-awa ahụ nwee ọtụtụ radieshon.

Taa, edozila nsogbu a site na sistemụ nledo anya nke na-agụnye teknụzụ nleba anya mpaghara electromagnetic, teknụzụ freehand na-eduzi fluoroscopically, yana ntuziaka ntinye ntu dị nso.

1990s: Titanium intramedullary ntu

N'ime afọ iri sochirinụ, ntu intramedullary Russel-Taylor ghọrọ ewu ewu nke ukwuu na obodo orthopedic mba ụwa. Ụkpụrụ nlekọta ahụ ji nwayọọ nwayọọ ghọọ nkuku intramedullary na mkpọchi nke skru, dị ka e gosiri site na nchọpụta nke Brumback et al.

N'ime ọmụmụ ihe a na-atụ anya ya, nsonaazụ na-akọ na mkpọchi na-emepụta ihe dị mma n'ọtụtụ ọnọdụ ma ejikọtaghị ya na enweghị njikọ nke mgbaji.

Ọganihu nke metallurgy mere ka ọ pụta ìhè nke ntu intramedullary titanium, bụ nke a na-ejikarị eme ihe na ụlọ ọrụ biomedical n'ihi ike ha, ezigbo nkwụsị corrosion na biocompatibility.

Sistemụ ntu intramedullary nke Alta bụ ntu intramedullary nke mbụ dị na ya, ndị ọrụ ahụike nabatakwara ya nke ukwuu n'ihi ihe eji arụ ọrụ nke titanium, nke bụ ọla siri ike mana nke siri ike karịa igwe anaghị agba nchara.

Otú ọ dị, akwụkwọ ndị dị ugbu a na-enwe obi abụọ ma ọ bụrụ na titanium ọ bụ ihe dị mma maka nhazi nke ime ụlọ karịa igwe anaghị agba nchara, karịsịa n'ihi ụbara ọnụ ahịa jikọtara ya na iji titanium.

Agbanyeghị, ụfọdụ uru titanium dị, dị ka modul na-agbanwe dị nso na ọkpụkpụ cortical na ndakọrịta ihe onyonyo resonance magnet, na-eme ka ọ bụrụ nhọrọ mara mma.

Na mgbakwunye, titanium bụ nhọrọ mara mma nke ukwuu mgbe achọrọ obere mbọ intramedullary pere mpe.

Usoro dị ugbu a

Mgbe ihe ịga nke ọma na ọdịda nke iri afọ gara aga gasịrị, ndị dọkịta na-awa ahụ ọkpụkpụ nwere ahụmahụ karịa na ntu intramedullary.

Ntuzi ntu intramedullary nke femoral, tibial na humeral fractures abụrụla ụkpụrụ nlekọta maka ọtụtụ mgbaji mechiri emechi na ụfọdụ mgbaji na-emeghe. Usoro nlebara anya na nhazi ọhụụ emeela ka usoro ahụ dị mfe ma bụrụ nke a na-emegharị maka ọbụna ndị dọkịta na-awa ahụ na-enweghị ahụmahụ.

Ihe na-eme n'oge na-adịbeghị anya na-egosi na titanium na igwe anaghị agba nchara nwere ụdị mgbanwe dị elu nke na-emesi ike na-ekpuchi nrụgide na-ewe iwe dị mkpa maka ọgwụgwọ ọkpụkpụ. A na-anwale ihe ọhụrụ biomaterials dị ka magnesium alloys, shape memory alloys na resorbable ihe ugbu a na-anwale na agụmakwụkwọ.

Ntu intramedullary nke polymers na-eme ka carbon fiber na-aga n'ihu nwere modul na-agbanwe agbanwe yana ike ike ọgwụgwụ dị ugbu a. Magnesium alloys nwere modul nke elasticity yiri nke ọkpụkpụ cortical ma bụrụ ihe na-emebi emebi.

Ọmụmụ ihe ọhụrụ nke Li et al. egosila uru dị ịrịba ama n'ịgwọ ọkpụkpụ ọkpụkpụ osteoporotic na ụdị anụmanụ ndị a na-ejikọta na nchikota magnesium na mkpuchi zoledronate maka nrụzi mgbaji, usoro nke nwere ike ịghọ ọgwụgwọ maka ọkpụkpụ osteoporotic n'ọdịnihu.

Mmechi

N'ime afọ ndị gafeworonụ, na mmụba dị ịrịba ama na nhazi ntu intramedullary, usoro metallurgical, na usoro ịwa ahụ, nku intramedullary etolitela n'ụdị nlekọta nke ugbu a maka ọtụtụ mgbaji ọkpụkpụ dị ogologo ma bụrụ nke dị irè, nke na-adịghị emerụ ahụ, na usoro mmeghari.

Agbanyeghị, n'ihi ọtụtụ atụmatụ ntu intramedullary, enweghị ọtụtụ ozi gbasara nsonaazụ ha gachara. Achọkwuru nyocha iji chọpụta ụdị ntu intramedullary kacha mma, njirimara na radius nke curvature.

Anyị na-ebu amụma na ihe ọhụrụ na ngalaba nke biomaterials ga-eme ka mpụta nke ụdị ntu intramedullary ọhụrụ.

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