Nlele: 235 Odee: Saịtị Editọ Oge mbipụta: 2023-06-06 Mmalite: Saịtị
Ọkpụkpụ femoral dị nso na-anọgide na-abụ otu n'ime mmerụ ahụ na-ahụkarị na nke siri ike na trauma orthopedic, karịsịa n'etiti ndị agadi ndị ọrịa nwere ọkpụkpụ ọkpụkpụ. N'ịbawanye atụmanya ndụ na ọnụ ọgụgụ dị elu nke mgbawa hip n'ụwa nile, usoro nhazi kwụsiri ike nke na-enye ohere ịchịkọta n'oge na ọgwụgwọ mgbaji a pụrụ ịdabere na ya aghọwo ihe kacha mkpa ụlọ ọgwụ.
a . Emepụtara ntu PFNA (Proximal Femoral Nail Antirotation) iji gboo mkpa ndị Site na ijikọ igwe na-ekekọrịta ibu intramedullary na nhazi agụba mgbochi, usoro PFNA abụrụla ihe ngwọta anabatara nke ọma maka mgbaji femoral na-adịghị akwụsi ike.
Edemede a na-enye nkọwa zuru oke nke sistemu ntu PFNA, gụnyere ihe ngosi ya, uru biomechanical, ụkpụrụ ịwa ahụ, mgbake mgbe arụchara ọrụ, yana echiche njikwa ihe egwu.

Ntu PFNA bụ usoro ndozi intramedullary emebere maka mgbaji nke femur dị nso. N'adịghị ka ngwaọrụ extramedullary ọdịnala, PFNA na-arụ ọrụ n'akụkụ axis nke femur, na-enye ohere ịnyefe ibu physiological karịa.
Akụkụ na-akọwapụta usoro PFNA bụ agụba mgbochi mgbochi helical , nke na-ejikọta ọkpụkpụ ịkagbu n'oge ntinye. Mkpokọta a na-abawanye ịzụrụ ihe n'ime ọkpụkpụ osteoporotic ma na-eme ka nguzogide ike mgbagha na mgbagha. N'ihi ya, PFNA na-enye nkwụsi ike na-abawanye ma e jiri ya tụnyere sistemu screw-based lag, karịsịa na ndị ọrịa na-adịghị mma ọkpụkpụ.

A na-egosi mbọ PFNA nke ọma maka mgbaji na-emetụta femur dị nso, gụnyere:
Intertrochanteric femoral mgbaji
Ọkpụkpụ trochanteric na-adịghị akwụsi ike ma ọ bụ kwụsịrị
Subtrochanteric femoral mgbaji
Weghachite ụkpụrụ mgbaji agbaji
Ụdị mgbawa ndị a na-ebutekarị enweghị ike biomechanical, na-eme ka nhazi intramedullary bụrụ nhọrọ kacha mma.
Ọkpụkpụ osteoporosis na-emebi ike nrụzi n'isi femoral. Akara mgbochi PFNA bara uru karịsịa n'ọnọdụ ndị a, ebe ọ na-akpakọ ọkpụkpụ trabecular kama iwepu ya. Nhazi a na-ebelata ihe ize ndụ nke ịkụnye ihe ọkụkụ na nkwụsị nke nhazi, na-eme ka PFNA bụrụ nhọrọ a pụrụ ịdabere na ya maka ndị agadi nwere ọkpụkpụ ọkpụkpụ ọkpụkpụ ọkpụkpụ osteoporotic.
Site n'echiche biomechanical, mbọ intramedullary na-enye oke ibu dị elu ma e jiri ya tụnyere usoro ndị dabere na efere. Ntu PFNA dabara na axis arụ ọrụ femoral, na-ebelata oge ịgbagọ na saịtị mgbaji.
Ọkpụkpụ mgbochi rotion na-eme ka nkwụsi ike ngbanwe ngbanwe site n'ịbawanye kọntaktị elu na ọkpụkpụ kagburu, nke na-enyere aka ịnọgide na-enwe mbelata mgbaji n'okpuru ibu axial na torsional n'oge ibu ibu.
Ntinye PFNA chọrọ ikpughe ịwa ahụ pere mpe ma e jiri ya tụnyere usoro ndozi mepere emepe. Mbelata nke anụ ahụ dị nro na-eme ka mfu ọbara dị ala, ibelata mgbu mgbe ịwachara ahụ gasịrị, na mgbake ngwa ngwa-ihe ndị dị mkpa karịsịa na ndị ọrịa geriatric trauma.
Ezi atụmatụ tupu ịwa ahụ dị mkpa maka ndozi PFNA na-aga nke ọma. Nyocha redio, gụnyere echiche anteroposterior na mpụta nke hip na femur, na-enyere aka ikpebi nhazi ọkwa mgbaji, ogologo ntu, nha agụba, na ebe ntinye kacha mma.
N'okwu ndị dị mgbagwoju anya, enwere ike iji onyonyo CT nyochaa ọdịdị mgbawa na-eduzi usoro ịwa ahụ.

Isi usoro usoro gụnyere:
Ndokwa onye ọrịa na tebụl mgbaji na traction kwesịrị ekwesị
Mbelata mgbawa mechiri emechi ma ọ bụ obere aka n'okpuru fluoroscopy
Ịmepụta ebe ntinye ntu ziri ezi
Ntinye ntu intramedullary na nhazi
Ịtụnye agụba mgbochi n'ime isi femoral
Mkpọchi dị anya iji jikwaa ntụgharị na ogologo
Ndokwa agụba ziri ezi n'ime isi femoral dị oke mkpa iji belata nsogbu arụ ọrụ ma hụ na nkwụsi ike ogologo oge.
Otu n'ime ebumnuche bụ isi nke ndozi PFNA bụ ikwe ka ịchịkọta ngwa ngwa. Dabere na nkwụsi ike mgbaji na ọnọdụ onye ọrịa, enwere ike ịmalite ibu akụkụ ma ọ bụ ibu zuru oke n'oge na-adịghị anya ka a wachara ya ahụ n'okpuru nlekọta ụlọ ọgwụ.
Ịchịkọta oge mbụ na-enyere aka ibelata nsogbu ndị dị ka thrombosis miri emi, nsogbu akpa ume, na atrophy muscle.
Ndozigharị mgbatị ahụ mgbe arụchara ọrụ gasịrị na-elekwasị anya na iweghachi usoro mmegharị hip, ike akwara, na nkwụsi ike gait. A na-enyochakarị nsonaazụ ọrụ site na iji akara mgbu, ike ịga ije, na ihe akaebe redio nke ọgwụgwọ mgbaji.
Okwu intraoperative nwere ike ime gụnyere ntinye ntu na-ezighi ezi, idobe agụba dị mma, ma ọ bụ mbelata mgbaji ezughị ezu. Ihe ndị a nwere ike ịbawanye ihe ize ndụ nke nkwụsị nkwụsị na ekwesịrị iji nlezianya chịkwaa ya site na nduzi fluoroscopic na ahụmahụ ịwa ahụ.
Ọ bụ ezie na PFNA jikọtara ya na nsonaazụ dị mma, nsogbu ndị dị ka mbelata agụba, ọrịa, njikọ egbu oge, ma ọ bụ mgbu metụtara ịkụnye nwere ike ime. Usoro ịwa ahụ nke ọma, nhọrọ onye ọrịa kwesịrị ekwesị, na nlekọta a haziri ahazi bụ isi iji belata ihe egwu ndị a.
Ọmụmụ ụlọ ọgwụ na-egosipụtakarị ọnụ ọgụgụ otu dị elu yana nsonaazụ ọrụ na-eju afọ site na ntinye PFNA na mgbaji femoral dị nso. Tụnyere ngwaọrụ extramedullary, PFNA egosila uru dị n'ibelata ọnụego ọdịda arụrụ arụ, ọkachasị n'ụdị mgbaji na-akwụghị ọtọ na ọkpụkpụ osteoporotic.
Nchọpụta ndị a na-akwado PFNA dị ka ihe ngwọta a pụrụ ịdabere na ya na nke a nabatara n'ọtụtụ ebe na omume trauma orthopedic ọgbara ọhụrụ.
Ọnụ ego ọgwụgwọ PFNA n'ozuzu gụnyere nhọrọ ntinye, usoro ịwa ahụ, ụlọ ọgwụ, na nhazigharị. Ọ bụ ezie na sistemu intramedullary nwere ike ịnwe ọnụ ahịa mbido mbụ dị elu, ikike ha ịkwado mkpokọta n'oge yana ibelata mmefu metụtara mgbagwoju anya nwere ike inye uru akụ na ụba dị ogologo oge.
Mkpebi ọgwụgwọ kwesịrị ịhazi ịdị irè ụlọ ọgwụ, ihe ndị ọrịa, na ụkpụrụ ụlọ ọrụ.
Ntu PFNA na-anọchite anya ngwọta orthopedic nke ọma maka ọgwụgwọ nke mgbaji femoral dị nso. Nhazi intramedullary ya, teknụzụ mgbochi mgbochi, na ịdị mma maka ọkpụkpụ osteoporotic na-eme ka ọ dị irè karịsịa n'ịchịkwa mgbaji ụkwụ na-adịghị akwụsi ike.
Mgbe etinyere ya na usoro ịwa ahụ kwesịrị ekwesị yana nhọrọ onye ọrịa, ndozi PFNA na-akwado ọgwụgwọ mgbawa kwụsiri ike, nrụzigharị oge mbụ, yana nsonaazụ arụrụ arụrụ - ebumnobi bụ isi na nlekọta trauma orthopedic nke oge a.
A na-eji ntu PFNA emezi n'ime ime nke mgbaji femoral dị nso, ọkachasị intertrochanteric na mgbaji hip anaghị akwụsi ike. Emebere ya iji nye ndozi intramedullary kwụsiri ike ma na-enye ohere ịchịkọta ndị ọrịa n'oge.
A na-egosipụtakarị PFNA maka mgbaji intertrochanteric, mgbaji trochanteric na-akwụghị ọtọ, mgbaji subtrochanteric, na tụgharịa ụkpụrụ mgbaji agbaji, ọkachasị ndị agadi ma ọ bụ ndị ọrịa osteoporotic.
Akara mgbochi mgbochi PFNA na-agbakọ ọkpụkpụ ịkagbu mgbe a na-etinye ya, na-eme ka ịzụrụ ihe ọkụkụ na-ebelata ihe ize ndụ nke ịkpụpụ. Nke a na-eme ka ọ dị irè karịsịa na ndị ọrịa na-adịghị mma ọkpụkpụ.
N'adịghị ka sistemu screw hip siri ike (DHS), PFNA na-enye ndozi nkekọrịta ibu intramedullary. Nhazi etiti ya na agụba mgbochi rotation na-enye nkwụsi ike biomechanical ka mma, ọkachasị maka usoro mgbaji na-akwụghị ọtọ.
Ee. A na-eme ntinye nke PFNA site na usoro mkpasu iwe dị ntakịrị na obere mbepụ, belata mmebi anụ ahụ dị nro, yana na-agbadata ọbara ọbara ma e jiri ya tụnyere usoro ndozi mepere emepe.
Usoro iwu ibu ibu na-adabere na nkwụsi ike mgbaji na ọnọdụ onye ọrịa. N'ọtụtụ ọnọdụ, ibu ibu akụkụ ma ọ bụ nke a na-achịkwa nwere ike ịmalite n'isi ụtụtụ, n'okpuru nduzi nke dọkịta na-awa ahụ na otu nhazigharị.
Nsogbu ndị nwere ike ime gụnyere igbupu agụba, ọnọdụ adịghị mma, ọrịa, njikọ na-egbu oge, ma ọ bụ mgbu metụtara ịkụnye. Enwere ike ibelata ọtụtụ ihe egwu site na usoro ịwa ahụ kwesịrị ekwesị na nhọrọ ndị ọrịa.
Ọgwụgwọ mgbawa redio na-emekarị n'ime ọtụtụ ọnwa, dabere n'ụdị mgbaji, ogo ọkpụkpụ, na ahụike onye ọrịa. Mgbake arụ ọrụ nwere ike ịga n'ihu na mbụ site na nhazigharị kwesịrị ekwesị.
Ee. Enwere ike iji PFNA mee ihe n'ime ndị ọrịa na-eto eto nwere mgbaji mgbaji femoral na-adịghị eguzosi ike n'ihe kpatara nhụsianya ike dị elu, ma ọ bụrụhaala na enwetara mbelata anatomical na nkwụsi ike.
Nhọrọ nke etinyere na-adabere na onyonyo tupu a rụọ ya, ụkpụrụ mgbaji, mmewere femoral, na nyocha fluoroscopic intraoperative iji hụ na nhazi kacha mma na nkwụsi ike biomechanical.