Omanyi ebyafaayo by'okukuba emisumaali mu mubiri?

Okujja kw’omusumaali ogw’omu lubuto kwakyusa enkola y’okujjanjaba okumenya amagumba amawanvu. Wadde ng’enkola eno yali ebaddewo okumala ebyasa bingi, teyatuuka ku mbeera yaayo eriwo kati okutuusa mu kitundu eky’okubiri eky’ekyasa eky’amakumi abiri.

Oluguudo lw’okutuuka ku buwanguzi terwabanga lwangu bulijjo, anti akakodyo kano kaasisinkana okubuusabuusa n’okugaana abamanyi bangi mu kitundu ekisooka eky’ekyasa eky’amakumi abiri. Leero, okuyita mu buyiiya mu byuma, obukodyo bw’okulongoosa n’obukugu mu kulongoosa, okukuba emisumaali mu mubiri kifuuse omutindo gw’okulabirira okumenya amagumba okuwanvu.

Enkulaakulana mu kumanya kw’ebiramu eby’obulamu (human biomechanical knowledge) zisobozesezza okutondebwa kw’enteekateeka eno ey’omulembe. Omusumaali ogw’omulembe ogw’omu lubuto gumanyiddwa olw’okukwatibwa obulwadde obutono, enkovu entono, okunyweza okumenya obulungi, n’okutambula amangu mu balwadde.

Okuddamu okwetegereza ebyafaayo okukolebwa mu kiwandiiko kino kugenderera okufunza enkulaakulana y’omusumaali ogw’omu lubuto, okulaga ebikulu byagwo ebikulu, okwanjula embeera y’ekiseera eky’okukozesa okusooka n’okukulaakulana okuddirira okw’omusumaali ogw’omu lubuto, n’okuyingiza ekifo ky’omusumaali ogw’omu lubuto mu nkula y’amagumba n’okulumwa ennyo (okugeza, ekifaananyi 1).

Okuzaalibwa kw'omusumaali ogw'omu lubuto .

Abamisiri ab’edda baasooka kukozesa kyuma kya intramedullary ekifaananako n’omusumaali. Okulabirira okumenya okumenya okuzibu kwali tekuyinza kubaawo emyaka mingi bwe gityo emabega.

Kyokka, ekikakafu kiri nti Abamisiri ab’edda baalina obukodyo bungi obw’okusiiga eddagala obusibuka mu kukkiriza kwabwe mu kuzuukira kw’omubiri mu bulamu obw’oluvannyuma lw’okufa.

Kino kyali bwe kityo ku mummy eyitibwa usermontu eyasangibwa mu ntaana ya Tutankhamun, omusumaali ogw’obuwuzi we gwateekebwa wakati w’ekisambi n’ekisambi okutebenkeza ekinywa ky’okugulu (nga mu kifaananyi 2).

Abakugu mu by’okukuula eby’edda bateebereza nti mummy eyali munda mu sarcophagus teyali usermontu yennyini, wabula omuntu omulala eyasikizibwa ababbi b’entaana ab’edda mu 600 B.C.E.

Nga wayise emyaka 2000, Bernardino de Sahagun, omukugu mu by’enkula y’abantu ku lugendo lwa Hernando Cortes, yategeeza nti okusooka okukozesa emisumaali egy’omu lubuto mu mulwadde omulamu mu Mexico.

Mu 1524, yalaba omusawo w'amagumba aztec (ayitibwa 'Tezalo') ng'akola amagumba ng'akozesa ekiso kya obsidian n'oluvannyuma n'ateeka omuggo gwa resin mu kisenge ky'omubiri okutebenkeza ekitundu ekimenya. Olw’obutaba na bukodyo bumala obw’okulongoosa n’eddagala eritta obuwuka, enkola zino zaali n’omuwendo omunene ogw’okuzibuwalirwa n’omuwendo gw’abafa ennyo.

1800s: Emitendera egisooka .

Mu makkati g’emyaka gya 1800, ebitabo by’abasawo ebyasooka byategeeza ku kusumagira emisumaali egy’omu lubuto. Diefenbach, Langenbeck, Bardenheuer n’abasawo abalala aboogera olulimi Olugirimaani kyategeezeddwa nti bakozesezza emisumaali egy’amasanga mu busigo bw’amagumba amawanvu okujjanjaba obuzibu bw’amagumba.

Mu kiseera kye kimu, Nicholas Senn ow’e Chicago, omunoonyereza era omusawo w’amagye omunyiikivu, yakoze okugezesa ku kussa mu mubiri. Yandikozesezza ekituli ekirimu ebituli nga kikoleddwa mu ggumba ly'ente n'akiyingiza mu medulla okujjanjaba 'pseudarthrosis' oluvannyuma lw'okumenya.

Mu 1886, Heinrich Bircher ow’e Switzerland yayogera ku kulongoosa okusisinkana okuyingiza emisumaali egy’amasanga mu medulla olw’okujjanjaba okw’amaanyi okw’okumenya okuzibu (Figure 3).

Nga wayise emyaka mitono, Themistocles Gluck mu Germany yatonda omusumaali ogusooka ogw’amasanga ogw’omu lubuto nga guliko ekituli ku nkomerero y’omusumaali, bwe kityo ne kireeta endowooza y’okukwatagana omulundi ogusooka.

Mu kiseera kye kimu, Julius Nicolaysen okuva mu Norway ye yasooka okuwandiika ku misingi gy’obutonde egy’okusumagira emisumaali mu mubiri (intramedullary nailing of proximal femoral fractures). Yaggumiza obwetaavu bw’okwongera ku buwanvu bw’omusumaali ogw’omu lubuto okufuna enkizo ennene ey’obulamu n’okuwa obukuumi kumpi ku ggumba lyonna.

Era ye yasooka okuteesa ku ndowooza ya proximal ne distal nail/bone interlocking okukola design static locking. Abamanyi abamu bamutwala nga taata w’okukuba emisumaali egy’omu lubuto.

Mu makkati g’emyaka gya 1800, bapayoniya nga Ignaz Philipp Semmelweis mu Vienna ne Josephlister mu Glasgow baali bataddewo omusingi gw’okulongoosa okuzaala. Kino kyali kituukiddwaako okumenyawo kubanga kyasobozesa okukola obukodyo obupya obw’okulongoosa mu mbeera ya aseptic.

Emyaka gya 1900: Enkulaakulana .

Mu 1912, omusawo w’e Bungereza alongoosa Ernest Hay Groves ye yali omusawo eyasooka okulongoosa omuggo omugumu ng’omusumaali ogw’omu lubuto era nga ye yali omutandisi w’enkola y’omusumaali ogw’omu lubuto ogw’emabega.

Yafuna obumanyirivu bwe mu kiseera kya Ssematalo I bwe yajjanjaba abalwadde abalina obulwadde bwa pseudarthrosis abaali bafunye obulwadde abaali tebaagala kusalako bitundu byabwe. Teyakoma ku kunnyonnyola nkola ya kukuba emisumaali egy’omu lubuto (intramedullary nailing technique) esooka eyakkiriza amagumba okuyita mu buvune obutono, naye era yalina obukugu mu kukozesa emisumaali egy’omu lubuto n’emisumaali emitonotono okutereeza ebikutuka.

Yagezesa ebiteekebwa mu aluminiyamu, magnesium n’ekyuma era n’ategeera obukulu bwa biomechanics mu kuwonya okumenya. Wadde kyali kityo, enkola ya Ernest Hay Groves yafuna obulwadde obw’amaanyi era n’olwekyo yali temanyiddwa nnyo mu bantu ab’omulembe gwe.

Mu 1931, Smith-Petersen, omusawo w’amagumba Omumerika, yaleeta sikulaapu ey’ekyuma ekitali kizimbulukuse eky’ebiwaawaatiro bisatu okusobola okulongoosa okumenya kw’ensingo y’ekisambi ey’omu kifuba wakati. Yakola enkola enzigule eyasalasala ekitundu eky’okusatu eky’omu maaso eky’ekitundu ky’omutwe ekiyitibwa iliac crest, yayingira mu kifo eky’okulongoosebwa okuyita ku bbali w’omu maaso ow’ekisenge ekigazi ekya fascial tensor, oluvannyuma n’addamu okuteeka okumenya n’akozesa ekikuba okuvuga sikulaapu ey’ekyuma ekitali kizimbulukuse mu mutwe gw’ekisambi (Figure 4).

Olw’obuwanguzi bw’okugezesebwa kwa Smith-Petersen, abasawo bangi abalongoosa baatandika okugezesa ebyuma ebiteekebwamu ebyuma okusobola okumenya. Sven Johansson yayiiya omusumaali ogw’omu lubuto ogulimu ekituli mu 1932; Obuyiiya bwe obw’amagezi bwakozesa empiso y’okusimba ensukusa eyasobozesa okuyingiza omusumaali ogw’omu lubuto ogulung’amya mu ngeri ya radiologically. Ebitundu ebikulu eby’ekikugu bye yakozesa bikyakozesebwa n’okutuusa leero.

Nga bagenda mu maaso, Rush ne muganda we baayanjula endowooza y’omusumaali ogw’omu lubuto ogw’ekika kya elastic intramedullary nail mu 1937.

Baakozesa omusumaali ogw’ekyuma ekitali kizimbulukuse, nga tegunnabaawo nga tegunnabaawo era nga bagezaako okukola ensengekera y’okunyweza ensonga ssatu ez’omu lubuto okusobola okuziyiza omuze gw’okusengulwa okw’ekyekulungirivu okwetooloola okumenya.

Mu ndowooza yaabwe, ekitundu ekigonvu ekitaliiko kamogo kikola nga tension band eziyiza okusika okukoleddwa pre-bent elastic nail. Enzimba yaabwe yali ekoma olw’ebintu ebiwanvuwa eby’ekyuma ekitali kizimbulukuse, ekyakyuka nga bukyali okuva ku kukyukakyuka okuwanvuwa okudda ku kukyukakyuka kw’obuveera. Ekisembayo kiyinza okuvaako okusengulwa okw’okubiri n’okuwona okulema.

Okugatta ku ekyo, emisumaali egy’omu lubuto gitera okufuluma ku mulyango oguyingira oba okuyingira mu bizimbe by’amagumba ebisazaamu, oba n’okukutuka munda mu kiwanga. Wadde kiri kityo, Viennese Scholar Ender yagenda mu maaso n’okukozesa enkola eno ng’omusingi gw’essomero lya Ender erya Fracture Fixation era nga n’okutuusa leero likozesebwa okunyweza okumenya kw’abaana.

Omusumaali gw'obusajja bw'amagumba .

Mu 1939, omusawo Omugirimaani Gerhard Küntscher, eyalondebwa ku ngule ya Nobel, yakola omusumaali ogw’ekyuma ekitali kizimbulukuse olw’okujjanjaba okumenya kw’ekikolo ky’ekisambi.

Küntscher n’abalala baaluŋŋamizibwa Smith-Petersen stainless steel screws ezikozesebwa okujjanjaba okumenya ensingo y’ekisambi era nga balowooza nti emisingi gye gimu giyinza okukozesebwa ku kumenya ebikoola. Omusumaali ogw’omu lubuto gwe baakola mu kusooka gwali gwa ngeri ya V mu kusalasala ne mm 7-10 mu buwanvu.

Oluvannyuma lw’okunoonyereza ku mirambo n’ebisolo, yayanjula omusumaali ogw’omu lubuto n’enkola y’okulongoosa mu lukiiko lw’okulongoosa e Berlin mu 1940. Mu kusooka, obuyiiya bwe bwasekererwa banne Abagirimaani, wadde ng’enkola ye yafuna obuganzi oluvannyuma lwa Ssematalo II.

Hippocrates (460-370 BC), omusawo ow'edda ow'omulembe gw'Abayonaani atera okuyitibwa taata w'eddagala, lumu yagamba, 'Oyo ayagala okulongoosebwa alina okugenda mu lutalo'; Bwe kityo bwe kyali ne ku Küntscher.

Mu kiseera ky’Abanazi, Küntscher yasimbiddwa mu ddwaaliro erimu ku ludda lw’e Finland. Eyo, yasobola okulongoosa abalwadde n’abasibe b’olutalo mu kitundu ekyo. Yaleeta enkola y’okusala emisumaali gy’amagumba ng’akozesa enkola y’okulongoosa enzigale era enzigule, mu ngeri eyo.

Mu nkola enzigale, yayita ku musumaali ogw’omu lubuto mu kkubo erya prograde okuyita mu greater trochanter n’agiteeka ku mmeeza ey’okudda emabega ekolebwa n’ekyuma ekikuba. Ekimenya kiddamu okuteekebwa mu kifo era omusumaali ne guteekebwa mu nnyonyi bbiri nga tukozesa okukebera omutwe (head fluoroscopy). Mu nkola enzigule, omusumaali ogw’omu lubuto guyingizibwa okuyita mu kumenyeka mu medulla okuyita mu kutema okumpi ne layini y’okumenya.Küntscher akozesa omusumaali ogw’omu lubuto okujjanjaba okumenya kw’ekikolo ky’ekisambi awamu n’okumenya kw’omugongo n’okusenya.

Enkola ya Küntscher yafuna okusiimibwa mu nsi yonna oluvannyuma lw’okuzzaayo abasibe b’olutalo ab’omukago.

Mu ngeri eno abasawo abalongoosa Abamerika ne Bungereza baamanyiira omusumaali ogw’omu lubuto ogwakolebwa Küntscher era ne bategeera ebirungi ebitegeerekeka mu mulembe guno ogw’engeri y’okujjanjaba okumenya.

Mu bbanga ttono, abasawo abalongoosa mu nsi yonna beeyongera obungi baatandika okwettanira enkola ye, era omusumaali gwa Küntscher ogw’omu lubuto ne gukyusa enkola y’okumenya emmese ng’akendeeza ku budde bw’omulwadde okuwona kumpi omwaka mulamba. Abalwadde abandibadde nga balina okutambuzibwa mu kifo ekisuuliddwa kati bayinza okuba nga batambula mu nnaku ntono.

N’okutuusa kati, omusawo alongoosa Omugirimaani atwalibwa ng’omukulu mu kukola omusumaali ogw’omu lubuto, era alina ekifo ekikulu mu byafaayo by’okulongoosa obuvune.

Okugaziya omusumaali ogw’omu lubuto .

Mu 1942, Fisher et al. Yasooka kunnyonnyola nkozesa ya marrow-expanding grinding drill okwongera ku kitundu ky’okukwatagana wakati w’omusumaali ogw’omu lubuto n’eggumba n’okulongoosa obutebenkevu bw’okunyweza okumenya.

Wadde kiri kityo, Küntscher yaleeta drill ya reaming ekyukakyuka ekyukakyuka era nga ekyakozesebwa n’okutuusa leero era nga ewagira okuwuuma ku buwanvu bwonna obw’ekisenge ky’omugongo eky’ekikolo ky’amagumba okusobola okwanguyiza okuyingiza emisumaali egy’omu ndwadde ennene egy’omu dayamita.

Mu kusooka, intramedullary reaming yakolebwa okwongera ennyo ku kitundu ky’okukwatagana kw’amagumba n’omusumaali ogw’omu lubuto okusobola okunyweza okunywevu kw’okumenya n’okutambula kw’omulwadde okw’amangu.

Nga bwe kyayogerwako Smith et al, buli mm 1 ez’okugaziwa kw’omubiri (medullary expansion) kyongera ku kitundu ky’okukwatagana ne 38%. Kino kisobozesa okukozesa emisumaali eminene era egy’omu lubuto, okutumbula obutebenkevu okutwalira awamu obw’ensengekera y’okunyweza okumenya.

Naye, newankubadde nga Küntscher intramedullary nail n’ekyuma kyayo ekigonvu intramedullary reaming drill yafuuka eky’okulonda ekituufu eky’ekyuma ekinyweza munda mu osteotomy, academia yafiirwa okusiimibwa kwayo ku nkomerero y’emyaka gya 1960 mu bulungi bw’ebipande ebipya ebyakolebwa mu arbeitsgeinschaft für osteosynthesynhesynhesyserynhesersyserynhesersyseryenfragen)

Emyaka gya 1960: Emirembe egy’ekizikiza .

Mu myaka gya 1960, okukuba emisumaali egy’omu lubuto (intramedullary nailing) gyaggyibwawo mu bwangu ne givaamu plate ne screw fracture fixation.

Wadde ng’enkola ya Küntscher yakola bulungi, abasawo abalongoosa okwetoloola ensi yonna baazigaana olw’ebivaamu ebibi oluvannyuma lw’okulongoosebwa.

Okugatta ku ekyo, abasawo abamu abalongoosa baatandika okulekawo obukodyo bw’okukuba emisinde, gamba ng’okukebera omutwe (head fluoroscopy), kubanga abasawo abalongoosa baafuna okwetamwa olw’ebizibu ebitali birungi ebikwatagana n’obusannyalazo. Okukola emisumaali egy’omu lubuto tekwakoma awo, wadde nga mu nsi yonna okukkaanya ku kukozesa enkola z’okunyweza munda mu pulati.

Küntscher, omusawo Omugirimaani, yategeera ebirungi ebiri mu kukwatagana era n'akola omusumaali ogw'omu lubuto ogw'ekika kya cloverleaf, gwe yatuuma 'omusumaali gw'okukuumirwa mu kkomera'. Ekisinziiro kya Achilles eky’omusumaali ogw’omu lubuto ogw’omulembe ogwo gwali gwa butasobola kutebenkeza kumenyeka oba okumenya okwakwatagana ennyo okwali kusenguddwa mu nkoona ennene eky’okugonjoola ekizibu kino kwali kukozesa sikulaapu ezisiba.

Ekizibu kino kyali kya kutebenkeza omusumaali ogw’omu lubuto n’ekikulukusi ekisiba.

Mu ngeri eno, ekyuma ekisimbibwamu kyali kisobola bulungi okuziyiza amaanyi g’okubeebalama n’okuziyira nga bwe kiziyiza okufunza ebitundu by’omubiri. Nga tukozesa ebirowoozo ebigatta okuva mu Küntscher, Klaus Klemm, ne Wolf-Dieter Schellmann, omusumaali ogw’omu lubuto gwakolebwa okusobola okuwa okutebenkera okusingawo nga basooka okusima ebituli bya sikulaapu eby’okumpi n’eby’ewala ku musumaali ogw’omu lubuto, ogwasibirwa ku sikulaapu eyayingizibwa.

Mu myaka mitono egijja, enkulaakulana mu kutegeera kw’ebifaananyi eby’ekika kya fluoroscopic yasobozesa okuddamu okulonda obukodyo bw’okuggalawo n’okukendeeza ku kumenya.

Emyaka gya 1970 ne 1980: okuzuukira .

Mu myaka gya 1970, okwagala endowooza y’okusumba emisumaali egy’omu lubuto (intramedullary nailing concept) y’omusawo Omugirimaani Küntscher kwali kwa maanyi.

Closed Reduction intramedullary nail fixation for fractures, n'okutabaganya kwayo okukyukakyuka reaming and interlocking concepts n'okutumbula clarity of fluoroscopic techniques, yavuga enkulaakulana n'okubunyisa enkola eno ennungi ey'okulongoosa, emanyiddwa olw'okwonooneka okutono mu bitundu ebigonvu, okutebenkera okulungi, n'okutambula amangu omulwadde.

Mu kiseera ekyo, ensi y’abayivu yasanyizibwawo mu buyiiya obw’omuddiring’anwa obwavuga enkulaakulana y’omulembe ogw’okubiri ogw’okukuba emisumaali egy’omu lubuto.

Mu 1976, Grosse ne Kempf baakola omusumaali ogw’omu lubuto ogw’ekitundu okugonjoola ekizibu kya modulo ya laasitiki ey’omusumaali ogw’omu lubuto. Omusumaali ogw’omu kisenge (intramedullary nail) tegwali guteekeddwa mu kitundu eky’okumpi era nga gulina ekituli ky’omusumaali eky’ekikulukusi eky’okumpi, ekyayingizibwa mu nkoona ya diguli 45 okwongera ku maanyi g’okutebenkera kw’ensengekera y’okunyweza omusumaali ogw’omu lubuto ogw’omu lubuto.

Nga wayise emyaka mitono, AO yeegatta ku muze gw’okukulaakulanya emisumaali egy’omu lubuto (intramedullary nail development) ng’akola emisumaali egy’omu lubuto egyali gifaanagana mu ngeri y’emu (Ekifaananyi 5)

Mu 1984, Weinquist et al. yateesa enkola ya dynamic, eyali ey’okutumbula okuwona kw’enkomerero y’okumenya nga esiiga ebituli ebinene eby’okusiba ebisiba, okuggyawo sikulaapu ezisiba ezitakyukakyuka, n’oluvannyuma okukyusa ebituli bya sikulaapu ebisiba ku bituli by’emisumaali eby’ekika kya oval mu dizayini ey’omulembe ennyo.

Ekigendererwa ky’enkola ey’amaanyi kwe kutumbula okuwona kw’okumenya n’okwewala obutakwatagana bw’amagumba olw’okulwawo okukola.

Mu kiseera kino, intramedullary nailing dynamics efiiriddwa abawagizi baayo ng’enkola ey’okwetongola era mu kiseera kino ekozesebwa yokka ng’eky’okugonjoola ekikendeeza ku nsimbi okusinga okukyusa mu bujjuvu enkola y’okunyweza munda mu kujjanjaba emmenya ezitali za kuwonya.

Mu kunoonyereza okwakolebwa mu ngeri y’obulamu, Gimeno et al. yategeeza nti ekitundu ky’enkyukakyuka wakati w’ebitundu ebitali biteekeddwaako n’ebiwanvu eby’omusumaali ogw’omu lubuto kyavaamu okunyigirizibwa kw’okunyigirizibwa n’okulongoosa okulemererwa kw’ekintu eky’omunda eky’okunyweza.

Okusobola okukola ku bizibu bino, Russel ne Taylor et al. Yakola dizayini y’omusumaali ogwasooka ogutali gwa ssupu, ogutagabanyizibwamu mu 1986, nga guvuddemu ebimatiza.

Mu kiseera kino, ekizibu ky’okukwatagana n’emisumaali egy’omu lubuto nakyo kyagenda mu maaso, era nga bwe tumanyi leero, okukwatagana ne sikulaapu okuyita mu kinnya eky’omusumaali ogw’omu lubuto nga tebannaba kuzinda kyali dizayini ya Klemm ne Schleman mu Girimaani. Okuyingiza sikulaapu kwandikulemberwa freehand fluoroscopy, ekyandibadde kiraga omusawo omulongoosa ku radiation nnyingi.

Leero, ekizibu kino kigonjoddwa n’enkola y’okutunuulira ewala erimu tekinologiya w’okulondoola ennimiro y’amasannyalaze, tekinologiya ow’eddembe alungamizibwa mu ngeri ya fluoroscopic, n’ekitabo ekituufu eky’okuteeka emisumaali egy’okumpi.

1990s: Omusumaali gwa titanium intramedullary .

Mu myaka kkumi egyaddirira, omusumaali gwa Russel-Taylor intramedullary gwafuuka gwa ttutumu nnyo mu nsi yonna ey’amagumba. Omutindo gw’okulabirira gwafuuka mpola mpola mu kusalira emisumaali egy’omu lubuto n’okusiba sikulaapu mu ngeri etakyukakyuka, nga bwe kiragibwa ebivudde mu kunoonyereza okwakolebwa Brumback et al.

Mu kunoonyereza kuno okusuubirwa, ebivuddemu byalaga nti okusiba kwavaamu ebirungi mu mbeera ezisinga obungi era tekwali kukwatagana na non-union of the fracture.

Enkulaakulana mu byuma byavaako okuvaayo kw’emisumaali gya titanium intramedullary, egyakozesebwa ennyo mu mulimu gw’obusawo bw’ebiramu olw’amaanyi gazo, okuziyiza okukulukuta okulungi n’okukwatagana n’ebiramu.

Enkola ya Alta intramedullary nailing system ye yali omusumaali ogwasooka okubeerawo mu titanium intramedullary, era nga gwayanirizibwa nnyo abasawo olw’ebyuma bya titanium, nga kino kyuma kya maanyi naye nga tekikaluba nnyo okusinga ekyuma ekitali kizimbulukuse.

Naye, ebiwandiiko ebiriwo kati bibuusabuusa oba titanium kintu ekisaanira okunyweza munda okusinga ekyuma ekitali kizimbulukuse naddala olw’ebisale ebyeyongedde ebikwatagana n’okukozesa titanium.

Naye, ebirungi ebimu ebiri mu titanium, nga modulo ya elastic okumpi n’eggumba ly’omubiri (cortical bone) ne magineeti ebikwatagana (magnetic resonance imaging compatibility), bigifuula eky’okulonda ekisikiriza.

Okugatta ku ekyo, titanium nkola esikiriza nnyo ng’emisumaali emitono egy’omu lubuto (diameter intramedullary nails) kyetaagisa.

Emitendera egy'omulembe .

Oluvannyuma lw’obuwanguzi n’okulemererwa kw’emyaka egiyise, abasawo b’amagumba balina obumanyirivu bungi nnyo mu kukuba emisumaali egy’omu lubuto.

Okunyweza emisumaali mu mubiri (intramedullary nail fixation of femoral, tibial and humeral fractures) kifuuse omutindo gw’okulabirira okumenya okusinga okuggaddwa n’okumenya okumu okuggule. Enkola empya ez’okutunuulira n’okuteeka mu kifo zifudde enkola eno ennyangu era eddibwamu n’abasawo abalongoosa abasinga obungi abatalina bumanyirivu.

Emitendera egyakafuluma giraga nti ebyuma bya titanium ne stainless steel birina modulus ya elasticity eya waggulu ennyo era nti stresses ziziba situleesi ezinyiiza ezeetaagisa okuwona amagumba. Ebiramu ebipya nga magnesium alloys, shape memory alloys ne resorbable ebintu mu kiseera kino bigezesebwa mu academia.

Emisumaali egy’omu lubuto (intramedullary nails) egyakolebwa mu biwuziwuzi ebinyweza carbon fiber ebitasalako nga biriko modulo ya elastic erongooseddwa n’amaanyi amanene ag’obukoowu mu kiseera kino biriwo. Magnesium alloys zirina modulus ya elasticity okufaananako n’eggumba ly’omubiri (cortical bone) era nga zivunda.

Okunoonyereza okwakakolebwa Li et al. balaze ebirungi ebinene mu kujjanjaba okumenya amagumba mu bikolwa by’ebisolo ebiteekebwa ku kugatta magnesium ne zoledronate coating okuddaabiriza okumenya, enkola eyinza okufuuka eddagala eri okumenya amagumba mu biseera eby’omu maaso.

Mu bufunzi

Emyaka bwe gizze giyitawo, n’okulongoosa okw’amaanyi mu kukola emisumaali mu mubiri, obukodyo bw’ebyuma, n’obukodyo bw’okulongoosa, emisumaali egy’omu lubuto gikulaakulanye ne gifuuka omutindo gw’okulabirira okumenya amagumba okusinga okuwanvu okuliwo kati era nga nkola nnungi, eyingirira nnyo, era nga esobola okuddamu okukolebwa.

Naye olw’okukola emisumaali mingi egy’omu lubuto, amawulire mangi gabula ku bikwata ku bivaamu byabwe oluvannyuma lw’okulongoosebwa. Okunoonyereza okusingawo kwetaagibwa okuzuula obunene bw’ekika ky’omusumaali mu mubiri, engeri n’obuwanvu bw’okukoonagana (radius of curvature).

Tulagula nti obuyiiya mu kitundu ky’ebintu ebiramu bijja kuzaala okuvaayo kwa dizayini z’emisumaali emipya egy’omu lubuto.

Engeri y'okugulamu amagumba agateekebwamu amagumba n'ebikozesebwa mu kuzimba amagumba) .

A CZMEDITECH , Tulina ekintu ekijjuvu ennyo eky'ebintu ebiteekebwa mu kulongoosa amagumba n'ebikozesebwa ebikwatagana, ebintu omuli Ebisimbibwa omugongo ., Emisumaali egy'omu lubuto ., Ekipande ky’okulumwa obuvune ., Essowaani y’okusiba ., Omutwe-Maxillofacial ., Prosthesis ., Ebikozesebwa mu maanyi ., Abatereeza eby’ebweru ., Okukebera ebinywa ., Obulabirizi bw’ebisolo n’ebikozesebwa byabwe ebibayamba.

Okugatta ku ekyo, twewaddeyo okukola ebintu ebipya obutasalako n’okugaziya layini z’ebintu, okusobola okutuukiriza ebyetaago by’okulongoosa eby’abasawo n’abalwadde abawera, era n’okufuula kkampuni yaffe okuvuganya ennyo mu nsi yonna ey’amagumba n’amakolero g’amagumba.

Tufulumya ebweru mu nsi yonna, kale osobola . Tukwasaganye ku email address song@orthopedic-china.com okufuna quote ey'obwereere, oba weereza obubaka ku WhatsApp okufuna eky'okuddamu eky'amangu +86-18112515727.

Bwoba oyagala okumanya ebisingawo,click CZMEDITECH Okuzuula ebisingawo.