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Global Advanced Tibia Emisumaali Ebivuga Erinnya 2025 Ebisinga Obuyiiya 6

Views: 0     Omuwandiisi: Omuwandiisi w'omukutu Publish Time: 2025-07-07 Ensibuko: Ekibanja

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Ebikutuka by’omugongo .

Ekikondo ky’omugongo kye kimu ku bifo ebisinga okukumenya, nga bikola ebitundu 13.7% ku kumenya kwonna mu mubiri. Distal tibia erina ensengekera y’omubiri ng’okuliyirira obubi omusaayi n’okubikka ebitundu ebigonvu ebitono. Okumenyeka bwe kumala, okwonooneka kw’ebitundu ebigonvu n’omusaayi mu kitundu ogutabuddwa kiyinza okwongera ku buzibu bw’okuwona kw’okumenya. Okugatta ku ekyo, emikisa mingi egy’okumenyaamenya kw’ebizimba n’obutabeera mu ntebenkevu mu kiseera kye kimu bifuula okulonda enkola y’okulongoosa entuufu eyetaagisa.

Ekitundu eky’omusalaba eky’ekikondo ky’omugongo ekiri wakati okutuuka waggulu kiriko enjuyi essatu, ate ekitundu eky’okusatu ekya wansi kiba kya nnya. Enkulungo y’ebitundu bisatu eby’omu makkati n’ebya wansi nfunda nnyo era ekiikirira enkyukakyuka mu nkula, ekigifuula ekifo eky’awamu eky’okumenya.

Ekitundu eky’okusatu eky’omu maaso eky’ekisambi kibikkibwako olususu lwokka nga tewali binywa bibikka, ekifuula okuggulawo okumenya amagumba nga ebitundutundu by’amagumba bifumita olususu. Ne mu kumenya okuggaddwa, okumenya kw’omugongo okusinga kuwerekerwako okwonooneka kw’olususu n’ebitundu ebiri wansi w’olususu. Ekitundu ekiri wakati tekirina binywa, era waliwo ebisenge bina eby’enkovu ebyetoolodde ekisambi n’ekisambi. Obulwadde bwa compartment syndrome buba bungi mu kumenyeka kw’omugongo bw’ogeraageranya n’emmeeme endala.

Okugabanya okumenya .

AO/OTA okumenya okusannyalala .

Ensengeka y’ennamba ya AO/OTA ey’Oluwarabu etegeeza okumenya kw’ekikondo ky’omugongo nga 4 (Tibia) 2 (Ekitundu). Ekika kya A kikwatagana n’okumenya okwangu nga kuliko layini emu emenya, nga eno y’ekika ekisinga okumanyibwa. Emmenya za kika kya B zirina akatundu akafaanana nga wedge. Okumenyeka okw’ekika kya C kuva ku buvune obw’amaanyi amangi era nga bimenya ebitundutundu ebikwatagana.

Gustilo Classification ku kumenya okumenya:

  • Ekika kya I: Obuwanvu bw’ekiwundu obutasukka sentimita emu, ebiseera ebisinga kiba kiwundu ekifunda ekiyonjo nga n’ensonga y’amagumba efulumye mu lususu. Okwonoonebwa kw’ebitundu ebigonvu kutono, nga tewali buvune bwa kunyiga. Okumenyeka kwangu, kuyita mu bbanga, oba kuserengeta mu bbanga ttono, awatali kugeraageranya.

  • Ekika kya II: Ekiwundu kisukka sentimita emu, nga kirimu ebitundu ebigonvu ebisingako naye nga tewali kuvuma oba okutondebwa kwa flap. Ebitundu ebigonvu biraga obuvune obutono oba obw’ekigero obw’okumenya, obucaafu obw’ekigero, n’okukendeeza ku kumenya okw’ekigero.

  • Ekika kya III: Okwonoonebwa okunene mu bitundu ebigonvu nga kuzingiramu ebinywa, olususu, emisuwa, n’obusimu, nga bifuuse ebicaafu ennyo.

    • Ekika kya IIIA: Wadde nga waliwo obuvune obw’amaanyi obw’okuvunda oba okutondebwa kw’ekifuba, oba okulumwa amaanyi amangi awatali kulowooza ku bunene bw’ekiwundu, waliwo ebigonvu ebibikka ku kumenya.

    • Ekika kya IIIB: Okwonooneka kw’ebitundu ebigonvu ennyo n’okufiirwa, nga waliwo okuggyamu amagumba n’amagumba agabikkuddwa, nga gawerekerwako obucaafu obw’amaanyi.

    • Ekika kya IIIC: Ekikwatagana n’obuvune mu misuwa nga kyetaagisa okuddaabiriza.

Enkola z’obujjanjabi .

Enzijanjaba ezitali za kulongoosa ku kumenyeka kw’omugongo mulimu ebisiba, okunyweza pulasita ebweru, okusika, okukendeeza mu ngalo, n’okukozesa fuleemu z’okunyweza ebweru. Enkola z’okulongoosa mulimu okunyweza pulati ey’omunda n’okukuba emisumaali egy’omu lubuto, n’ebirala.

Intramedullary Okusiba emisumaali .

Intramedullary nailing fixation is favored grian trauma orthopedic surgeons olw’okulongoosa kwayo okwangu, okusalako okutono, okulumwa okutono, n’okuggyawo omusumaali mu ngeri ennyangu oluvannyuma lw’okumenya okumenya. Ewa okunyweza okw’amaanyi okw’omunda, okusobozesa okukola dduyiro nga bukyali oluvannyuma lw’okulongoosebwa n’okwewala ebizibu eby’omu kitundu n’eby’enkola. Ebirungi bino bikwatagana n’emisingi gya AO egy’obujjanjabi.

Czmeditech Tibial Omusumaali ogw'omu lubuto

Omukugu Tibia Intramedullary Nail & Instrument Set .

1.Ekiseera ekitemeddwa okusalako ekiserengeto .

Anterior oblique cutting mu proximal end kiziyiza okunyiiga okutuuka ku patellar ligament.

2. Design ey’omulembe ey’okusiba .

Advance proximal locking design eyongera ku nnywevu eyagala eri ekitundu eky’okumpi.

3. Distal Oblique Lock .

Distal oblique locking option okuziyiza ebitundu ebigonvu okwonooneka n’okwongera okutebenkera kw’ekitundu eky’ewala.

4. Sikulufu y’obuwuzi obw’emirundi ebiri .

Sikulaapu okusiba ekoleddwa n’obuwuzi bwa lead obw’emirundi ebiri okusobola okwanguyirwa okuyingiza.

suprapaTellar enkola tibial intramedullary nail & instrument set .

Enkola y’okusiba .

Okusiba dizayini okusobola okunyweza ennyo, kendeeza ku kuseeseetula ebitundutundu oluvannyuma lw’okulongoosebwa.

Obuwagizi bwa Multi-Point .

Multi points of fixation ziwa obutebenkevu obw’enjuba n’obuwagizi obutebenkevu eri tibial palteau.

Emitendera gy’okunyigiriza .

Ekyuma kino kirimu omulimu gw’okutereeza adaptive, n’enkyukakyuka zaakyo mu nkula eragiddwa mu bifaananyi wansi w’embeera zombi nga tezinnaba kunyigirizibwa (loose state) n’oluvannyuma lw’okunyigirizibwa (ezikwatagana obulungi).

Okunyweza okutono-okumpi .

Enkola ya multi fixation okuva mu proximal ne distal, eraga okumenya tibial fractures ez’okumpi n’ez’ewala.

Distal tibial intramedullary omusumaali (DTN) & ekintu set .

flat design okusobola okwanguyirwa okuyingiza .

Enkomerero y’omusumaali omukulu ogw’ewala erina dizayini ya fulaati, eyanguyiza okuyingiza okwangu mu kisenge ky’omubiri ekiyitibwa medullary cavity.

Sikulaapu ezisiba mu nsonda .

Sikulufu bbiri ez’okusiba ku nkomerero ey’okumpi ziziyiza okuzimbulukuka n’okusengulwa kw’ekitundu ky’okumenya.

Okukoonagana kw’omubiri .

Enkoona ey’enjawulo ey’omubiri ekakasa nti omusumaali omukulu guteekebwa bulungi munda mu kisenge ky’omubiri (medullary cavity).

Okusalasala Ebikulukusi by’okusiba enkoona .

Sikulufu ssatu ezisalasala ezisiba enkoona ku nkomerero ey’ewala ziwa obuwagizi obulungi n’okunyweza.

Tibial Intramedullary Omusumaali & Ekivuga Ekiteekeddwawo

Obumanyirivu mu kukola ebintu bingi:

Esaanira okumenya kw’ekikondo ekisinga obungi (midshaft n’emmeeme ezimu ez’ewala/ez’ewala), so nga ebika ebirala (okugeza, DTN oba omusumaali omukugu) bikoleddwa ku bitundu by’omubiri ebitongole oba okumenya okuzibu.

Enkola y’okulongoosa enkuze:

Enkola ya mutindo (parapatellar oba transpatellar) egoberera enkola etegekeddwa obulungi ng’erina enkola ey’okuyiga eya wansi, so nga enkola ez’enjawulo (okugeza, suprapatellar) zeetaaga okutendekebwa okw’ekikugu okw’enjawulo.

Okukendeeza ku nsimbi:

Bw’ogeraageranya n’emisumaali egy’enjawulo nga Expert Nail oba DTN, emisumaali egy’omu nnyindo egy’omutindo ogwa tibial intramedullary gitera okuba egy’ebbeeyi, ekigifuula esaanira emisango egya bulijjo.

Okukwatagana mu bugazi bw’okuteekebwamu:

Ekwatagana n’ebikozesebwa eby’ensi yonna (okugeza, sikulaapu ezisiba, ebyuma ebitunuulira), so nga emisumaali egy’enjawulo (okugeza, omusumaali ogw’ekikugu ogulina enkola z’okusiba ez’enjuyi nnyingi) guyinza okwetaaga ebikozesebwa eby’obwannannyini.

Ekika Ebisinga Ebiraga Ebirungi Ebikulu Ebirungi .
Omusumaali Omukugu . Okumenyeka kw’ekikondo okuzibu, okulwala amagumba . Okusiba kwa pulaani nnyingi, okutebenkera okw’amaanyi .
Omusumaali ogw'ekika kya suprapatellar . Okumenyeka okumpi, abalwadde abagejjulukuka . Enkola ya suprapaTellar, ekendeeza ku bizibu by’okugulu eby’omu maaso .
DTN . okumenya ewala (okumpi n’ekinywa ky’omu kigere) . Multi-directional distal locking, eziyiza okufunza .
Omusumaali ogwa mutindo . okumenya okwangu okw’omu makkati . Enkola ennyangu, ekendeeza ku nsimbi .

Okugabanya ebikozesebwa mu kukuba emisumaali ku bisambi .

  1. Ebikozesebwa mu kusima : Mulimu ebitundu ebisima, ebivuga, n’ebikozesebwa ebirala ebikozesebwa butereevu mu kusima amagumba.

  2. Ebikozesebwa mu kutunuulira : Ebikozesebwa mu kuteeka n’okulungamya okusima oba okuteekebwamu ebyuma, gamba nga waya ezilungamya, emikono egy’okulungamya, n’ebyuma ebigenderera.

  3. Ebikozesebwa mu kunyweza : Ebikozesebwa mu kuyungako, okusiba, oba okutereeza ebiteekebwamu, gamba ng’ebiyungo eby’ensi yonna, ebisumuluzo, sikulaapu, n’ennyondo.

  4. Ebikozesebwa mu kupima : Ebikozesebwa mu kupima obuziba, okuteeka mu kifo, oba okuyamba mu kulongoosa, gamba ng’ebipima obuziba, okukendeeza ku buziba, n’okuziyiza amagumba (AWL).

Ebikozesebwa mu kunyweza .
Ebikozesebwa mu kusima .
Ebikozesebwa mu kupima .
Ebyuma ebitunuulira ebigendererwa .
    

Okulongoosa mu mitendera .

1. Okuteekateeka nga tonnalongoosebwa .

Okukebera ebifaananyi: X-ray/CT nga tebannaba kulongoosa okukakasa ekika ky’okumenya, medullary canal diameter n’obuwanvu, nga okupima ekisambi eky’oku mabbali (contralateral tibia) nga reference.

Okuteeka mu kifo: Ekifo eky’okuwummuliramu n’okugulu okufukamira 90°-120° n’okunyiga ekisambi ekitono (okukendeeza ku kusika omusuwa gwa patellar). Fuleemu ya radiolucent ey’enjuyi essatu eyinza okuwanirira ekifo ekiyitibwa popliteal fossa okusobola okusika.

Sterile draping: standard limb sterilization and draping, okukakasa nti C-arm mobility.

2. Okukendeeza ku kumenya .

Obukodyo bw'okukendeeza obuggaddwa .

Okusika mu ngalo: Assistant ekozesa okusika okuwanvu ate omusawo alongoosa akwata omugongo n’oludda olw’omu maaso okutereeza okulaganya (obuwanvu, okukyusakyusa, okukoona).

Ebivuga-ebiyambibwako:

  • Enkola ya joystick: SCHANZ screws eziyingizibwa mu bitundu ebiriraanye/eby’ewala okukendeeza ku lever.

  • Okusiba okuyita mu lususu: Okukendeeza ku kukendeeza okusongovu ku bitundu ebimenyese/eby’omwoyo ebiserengese.

  • Ekiwugulaza: Ekiwugulaza ekinene kiteekeddwa mu coronally (proximal Schanz screw parallel to tibial plateau, distal pin mu talus oba distal tibia) okukuuma obuwanvu.

3. Okuyingira mu kifo ekifo .

Ebintu ebikulu:

  • Entry point 1cm distal okutuuka ku anterior tibial plateau edge, ekwatagana ne medullary axis.

  • Okukakasa kwa Fluoroscopic: Okulaba kwa AP kukwatagana n’ekikolo ky’omugongo, okulaba okw’ebbali kufaanagana n’ekisiki ky’omugongo.

Ebivuga ebiggulawo:

  • Cannulated drill over guidewire (nga eriko omukono ogw’obukuumi) oba curved solid awl.

  • Engalo z’omu ngalo (6-8mm) ez’okumenya okukadde n’okuzibikira omwala.

4. Okuyingiza waya mu ndagiriro n’okutereeza .

Okuteeka mu kifo ekiragiro: Omutendera ogulagiddwa ku nsonga y’omupiira gufukamidde 10-15mm ku tip for fracture passing. Okukakasa kwa fluoroscopic ku nkovu y’ekika kya distal physeal (enkizi wakati).

Enkola ya Reaming:

  • Ebiwujjo ebikyukakyuka ebitandikira ku mm 8, ne byongera mm 0.5 okutuuka ku cortical 'chatter' (ekitera okuba 1-1.5mm > dayamita y’omusumaali).

  • Weetegereze: Okuggyayo ebintu mu biseera ebitali bimu kigogola ebifunfugu; Weewale obulwadde bwa thermal necrosis.

5. Okuyingiza omusumaali .

Okusalawo obuwanvu:

  • Okupima mu kulongoosa: Enkola ya Wirelap Overlap oba Fluoroscopic olufuzi (entry point to ankle joint).

  • Kakasa nti ensonga y’omusumaali etuuka ku nkovu ya physeal nga tewali proximal protrusion.

Enkola y’okuyingiza:

  • Okukulaakulanya emikono ku ndagiriro; Okutereeza okukendeeza singa resistance ebaawo.

  • Kuuma okukendeera mu kiseera ky’okuyisa okumenya ewala.

6. Okunyweza sikulaapu ezikwatagana .

Enkola y'omutendera .

  • Okumenyeka okuwanvuwa okuwanvuwa: Okusiba okumpi (single screw allows dynamization).

  • Obuwanvu-obutabeera/comminute fractures: Distal locking esooka okugobererwa 'backslap' okunyigiriza.

Okusiba okumpi .

  • ≥2 ebikulukusi nga biyita mu kyuma ekigenderera (okulungamya okungi ku kumenya okumpi).

Okusiba ewala .

  • Enkola ya Fluoroscopic: Ekikondo ekiri wakati nga kyesimbye ku bituli bya sikulaapu ('perfect circle'), okusima okuyita mu lususu.

  • ≥2 ebikulukusi by’okumenya ewala (biyinza okugatta AP/oblique orientations).

7. Enkola ezisembayo .

End cap: Okuyingiza mu ngeri ey’okwesalirawo (okuziyiza okuyiwa amagumba), okukakasa nti tewali kufuluma kwa kiwanga.

Okuggalawo ebiwundu: Okuddaabiriza omusuwa gwa patellar ogwa layeri nga guliko emisono egy’okunsi wansi w’olususu.

8. Enzirukanya y’emirimu oluvannyuma lw’okulongoosebwa .

Okuddaabiriza nga bukyali:

  • Obugulumivu bw’ebitundu by’omubiri; Londoola obulwadde bw’ekisenge mu 24hrs.

  • Tandika okukungaanya kw’ebinywa ebikola (pampu z’enkizi, okufukamira kw’okugulu) ku POD 1-2.

Enkola y’okusitula obuzito:

  • Ekitundu-okusitula okumala wiiki 6 (okutereezebwa buli stability), okugenda mu maaso okutuuka mu bujjuvu nga callus alabika.

Okugoberera: Okukebera mu bujjanjabi/okukebera amasannyalaze ku wiiki 2, 6, ne 12.

Enjawulo ezikwata ku kika ky’ebintu .


Depuy Synthes (Johnson & Johnson) .

Ekitebe ekikulu: Raynham, Massachusetts, Amerika

Ebintu ebikulu:

  • Expert Tibial Nail (ETN) – Ekoleddwa okutebenkera mu kumenya kw’omugongo okuzibu.

  • T2 Tibial Nail – Awa okunyweza okunywezeddwa n’okunyigiriza.

Amaanyi amakulu: R&D ey’amaanyi, okusaasaana kw’ensi yonna, n’okukwatagana n’okugonjoola ebizibu.

Logo-1.
★★★★★ .
Depuy Synthes (Johnson & Johnson) .
Omusumaali Omukugu Omusumaali (ETN)
T2 Omusumaali gw'omugongo .

Stryker .

Ekitebe ekikulu: Kalamazoo, Michigan, Amerika

Ebintu ebikulu:

  • T2 Omusumaali gw’omugongo – Enkola ya modulo ey’okumenya ekikondo ky’omugongo.

  • Gamma3 Tibial Nail – Egatta okukuba emisumaali mu mubiri n’engeri y’okusiba.

Amaanyi amakulu: Robotics ez’omulembe (mako), okugonjoola ebizibu ebitali bikulu nnyo, n’ekifo eky’amaanyi eky’okulumwa.

Logo-2.
★★★★★ .
Stryker .
T2 Omusumaali gw'omugongo
gamma3 Omusumaali gw'omugongo . 

Smith & muganda we .

Ekitebe ekikulu: London, Bungereza

Ebintu ebikulu:

  • Trigen Tibial Nail – Ekoleddwa okusobola okwanguyirwa okuyingiza n’okutebenkera.

  • Im tibial nail – okunyweza intramedullary olw’okumenya kw’omugongo.

Amaanyi amakulu: Essira lisse ku ddagala ly’emizannyo n’okulumwa, ebikozesebwa ebiyiiya.

Logo-3.
★★★★★ .
Smith & muganda we .
trigen tibial omusumaali
im tibial omusumaali .

CZMEDITECH .

Ekitebe ekikulu: Changzhou, China

Ebintu ebikulu:

  • Distal tibial intramedullary nail (DTN) – erongooseddwa okusobola okumenya ewala.

  • Omusumaali ogw’omusumaali ogw’omu kifuba ogw’ekikugu – Design ya titanium ey’amaanyi amangi.

  • suprapatlar approach tibial intramedullary nail – Okuyingiza okutali kwa maanyi nnyo.

  • Tibial Intramedullary Nail – Ebintu ebikozesebwa mu kunyweza eby’enjawulo.

Amaanyi amakulu: eby’okugonjoola ebitali bya ssente nnyingi, okugaziya okubeerawo kw’ensi yonna.

Logo-6.
★★★★★ .
CZMEDITECH .
Distal tibial intramedullary nail (DTN)
Omukugu Tibia Omusumaali Omusumaali
Omusumaali Okusemberera Omusumaali Omusumaali
Omusumaali Omusumaali

Zimmer Biomet .

Ekitebe ekikulu: Warsaw, Indiana, Amerika

Ebintu ebikulu:

  • ZNN Tibial Nail – Design y’omubiri okusobola okulongoosa.

  • Enkola y’emisumaali ey’obutonde – ekoppa makanika w’amagumba ag’obutonde.

Amaanyi amakulu: Amaanyi mu kuddamu okuzimba ebinywa, okugatta ebiramu, n’okugonjoola okw’obuntu.

Logo-4.
★★★★★ .
Zimmer Biomet .
ZNN Tibial Omusumaali
ogw'obutonde Enkola y'omusumaali .

Orthofix .

Ekitebe ekikulu: Lewisville, Texas, Amerika

Ebintu ebikulu:

  • Lon tibial nail (lateral orthopedic nail) – Ekoleddwa okusemberera okuyingira okw’ebbali.

Amaanyi amakulu: gakuguse mu kukula kw’amagumba, okutereeza obulema bw’omubiri.

Logo-5.
★★★★★ .
Orthofix .
Lon Tibial Omusumaali (Omusumaali gw’amagumba ogw’oku mabbali) .

Mu bufunzi

CZMeditech egaba eby’okugonjoola emisumaali egy’omugongo egy’enjawulo egy’okumenyaamenya okw’okumpi, ewala, n’okuzibu, nga waliwo dizayini eziyiiya (okugeza, okusiba okw’oludda olumu, enkola ya suprapatellar) okugeraageranya n’ebika ebikulembedde mu nsi yonna mu biomechanics n’ebiva mu bujjanjabi.

Ebiwandiiko ebijuliziddwa .

[1].德康医疗. 德康医疗胫骨骨折解决方案——胫骨髓内钉. 德康医疗, 26 September 2024, 10000.00..

[2].Ekitongole kya AO. (ND). Okukuba emisumaali egy’omu lubuto (intramedullary nailing) ku kikondo ky’omugongo (tibial shaft) eky’enjawulo eky’enkulungo (simple spiral fracture) [enkola y’okulongoosa]. AO Okulongoosa Reference. Yaggibwa nga July 10, 2024, okuva mu https://surgeryreference.aofoundation.org/orthopedic-trauma/adult-trauma/tibial-shaft/simple-fracture-spiral/intramedullary-nailing?Searchurl=/Okunoonya

Tukwasaganye

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