Ntu intramedullary stabilized stabilized (ESINs) bụ usoro a na-ahụkarị maka ịwa ahụ nke mgbaji ọkpụkpụ dị ogologo n'ime ụmụaka. A na-eji ya agwọ ọnya na-adịghị akwụsi ike nke radius, ulna, femur, na mgbe ụfọdụ tibia na humerus. A na-ejikwa ya na-agwọ mgbaji ọkpụkpụ nke ọkpụkpụ dị ogologo na ụmụaka. ESIN na-enye ndozi mgbaji mechiri emechi na-emegheghị ebe mgbawa ahụ, nkwụsi ike nke isi atọ, na ichekwa ogologo na ntụgharị na ntụgharị, mgbaji dị mkpụmkpụ. Dị ka ihe nkwụnye ibu na-ekekọrịta, ọ na-enye ohere ịmegharị ụkwụ n'oge. Ọ na-adịkarị, ntu intramedullary kwụsiri ike na-ewepụ ya mgbe ọgwụgwọ mgbaji gbajiri agbaji.
Ọkpụkpụ femoral
Ihe ngosi nke ESIN na mgbawa femoral bụ: afọ n'etiti 4 na 14 afọ na mgbaji femoral n'ime ọtụtụ trauma.
A na-edobe onye ọrịa ahụ na tebụl traction orthopedic, na nha akpụkpọ ụkwụ na-eme ka ọ bụrụ nha ụkwụ nwa. A na-achọ fluoroscope maka inweta echiche antero-posterior (AP) na latero-lateral (LL) nke apata ụkwụ emetụtara ma tinye ya ka o kwe ka anya nke femur site na hip ruo n'ogo ikpere. A na-enyocha inweta mbelata na ma echiche AP na LL, a na-enyochakwa ntụgharị .
Nhọrọ nke ntu Ogologo ntu kwesịrị idebe iwu izugbe maka ịhọrọ mbọ. Enwere ike iji nhazi ọkwa ndị a dị ka mgbanwe ọzọ, nke jikọtara ya na afọ nwata:
- 6-8 afọ: dayameta 3 mm;
- 9-11 afọ: 3.5 mm dayameta;
- 12-14 afọ: 4 mm dayameta.
Ogologo ntu ahụ hà nhata anya site na cartilage uto dị anya ruo na cartilage uto trochanter ka ukwuu.
Ọkpụkpụ diaphyseal
Nke dị nso na etiti nke atọ N'ihe gbasara mgbaji diaphyseal na nso nso na etiti nke atọ, a na-ahọrọ usoro ọdịdị C, na ntu etinyere retrograde site na metaphysis dị anya. N'ihe gbasara mgbaji dị nso, a na-ehulata ọnụ ntu ahụ, ebe maka etiti etiti diaphyseal, etiti ntu ahụ na-atụgharị. Na njedebe nke ọrụ ahụ, n'ihe gbasara mgbawa transverse, a na-emetụta akụkụ ndị ahụ iji zere ihe ndọpụ uche fọdụrụnụ, nke nwere ike bụrụ ihe kpatara ogologo oge na-adịghị mma nke obere ụkwụ. N'ihe gbasara mgbaji oblique ma ọ bụ nke mebiri emebi, a na-ehulata ọnụ nke dị anya ma na-emetụta n'ime ọkpụkpụ iji zere telescoping nke iberibe na njem ntu.
Ọdịdị ebumpụta ụwa nke mgbaji ndị a bụ ime ka 5-10 mm dị mkpụmkpụ ozugbo na-arụ ọrụ, nke a ga-akwụ ụgwọ site na mkpali nke uto n'oge nchikota nke mgbawa ahụ.
Ọkpụkpụ Tibial
Ndokwa na nkwadebe nke onye ọrịa ahụ ka edobere onye ọrịa ahụ na tebụl orthopedic iji mee ka mbelata. Ọnụnọ nke fluoroscope bụ iwu maka njikwa intraoperative. Ebe a na-arụ ọrụ ga-agụnye ikpere .
Ntinye nke mbọ
A na-etinye mbọ na-agbanwe mgbe niile na antegrade n'ime metaphysis dị nso, na akụkụ antero-lateral na anteromedial.
Dayameta ntu dị n'etiti 2.5 na 4 mm, dabere na afọ onye ọrịa. A na-anabata iji hama maka ịkwalite mbọ mana ekwesịrị iji nlezianya mee ya.
A na-eme ka mma nke mbelata site na ntu ntu na ogo nke na-ehulata.
E kwesịghị imetụta mbọ n'ime ọkpụkpụ kagbuo nke metaphysis distal tupu mbelata zuru oke; ma ọ bụghị ya, usoro mgbazi nwere ike imebi osteosynthesis.
Tupu mmetụta ahụ, a na-enyocha ntụgharị nke iberibe ma, n'ihe banyere ọnụnọ nke nrụrụ varus fọdụrụnụ, a na-edozi nke a site na ntu oke nke ntu. Na njedebe nke ọrụ ahụ, traction na-adị jụụ ma na-emetụta iberibe.
N'ihe banyere mgbaji agbaji agbaji, a na-ehulata nso nso nke mbọ nke na-ahapụ n'èzí ọkpụkpụ na 90 Celsius ma na-emetụta n'ime ọkpụkpụ cortical iji gbochie telescoping nke iberibe.
Ọkpụkpụ humeral
Ngosipụta nke ESIN na mgbaji humeral dị iche iche dabere na saịtị mgbaji: metaphysis proximal ma ọ bụ diaphysis. N'ime mgbaji nke olu ịwa ahụ nke humerus, a na-egosi ESIN n'ihi na ọ na-ebelata oge nkwụsị nke a chọrọ n'ihe gbasara ọgwụgwọ mgbanwe.
N'ihe banyere mgbaji diaphyseal, a na-egosipụta iji mbọ na-agbanwe agbanwe n'agbanyeghị ọnụnọ nke akwara radial.
Ntinye ntu a na-etinye ntu ahụ site na iji usoro retrograde. A na-ahụ ihe ntinye ntinye n'akụkụ akụkụ nke mpaghara supracondylar, na-enwe ntụzịaka n'azụ na nchigharị anya. A na-akwadebe ihe ntinye ntinye site na iji mgbịrịgba n'ihi na ọkpụkpụ cortical dị na mpaghara a siri ike. Dayameta nke mbọ ahụ dịgasị n'etiti 2.5 na 3.5 mm, na ha na-ehulata otu. A na-etinye mbọ ahụ site na nrụgide ntuziaka kwụ ọtọ na mmegharị ntụgharị. Ọ bụrụ na enweghi ike ibelata mgbaji dị na mpaghara metaphyseal dị nso, ntụgharị 1800 nke mbọ na-eme ka mbelata a dị mfe. Otú ọ dị, ọ bụrụ na mbelata agaghị ekwe omume, a na-etinye waya nduzi Kirschner n'ime mpekere dị nso tupu emeghee mbelata. N'ihe banyere mgbaji diaphyseal oblique, ọ dị mkpa iji zere mbọ na-ahapụ oghere medullary ma na-akwaga n'azụ n'ime radial nerve sulcus. Mgbe ntu abụọ ahụ gafechara ebe mgbaji ahụ, a na-emetụta ha n'ime ọkpụkpụ akagbuola nke metaphysis proximal.
Mgbaji aka n'ihu
A na-anabata ọgwụgwọ Orthopedic na mgbaji aka mgbaji, mana oke ekwenyere nke a na-emezigharị angulation na-akpaghị aka bụ nke ọma. Ọ bụrụ na agafeela oke ndị a ma ọ bụ n'ihe gbasara ọdịda ọgwụgwọ orthopedic, a na-egosipụta mbelata mechiri emechi na ESIN na mgbaji ụkwụ.
Usoro eji arụ ọrụ Onye ọrịa ahụ nọ na decubitus azụ azụ, ya na aka ya emetụtara na tebụl transperent redio.
Dayameta nke mbọ a na-eji dị iche n'etiti 2.5 na 3 mm. Ntu ulnar fọrọ nke nta ka ọ kwụ ọtọ, ebe ntu radial nwere nrịda akara iji weghachi usoro pronatory nke radius.
Ndozi na-amalitekarị site na ọkpụkpụ nke dị mfe iji belata. Maka radius, a na-achọta ebe ntinye na metaphysis distal, n'elu cartilage uto dị anya, n'etiti akwara nke ogologo na mkpụmkpụ nke mkpịsị aka. A na-ekpughe ọkpụkpụ cortical site na obere mbepụ na oghere, nke na-abawanye site na mmegharị okirikiri. A na-etinye ntu n'ime ọwa medullary ruo ebe mgbaji. A na-eme mbelata mgbaji ma tinye ntu n'ime mpekere dị nso n'okpuru njikwa fluoroscopic.
A na-eme usoro yiri nke ahụ maka ulna, na-eji usoro antegrade, na ntinye ntinye na etiti etiti nke olecranon.
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