Intramedullary nailing chanchin hi i hria em?

Intramedullary nail lo chhuahna chuan ruh sei tak tak, ruh tliak enkawlna kawngah nasa takin a tidanglam a ni. Kum zabi tam tak chhung chu he technique hi awm tawh mah se, tuna a dinhmun hi kum zabi 20-na chanve tawp lam thleng khan a thleng thei lo.

Hlawhtlinna kawng chu a awlsam ngai lo va, kum zabi 20-na chanve hmasa berah khan he technique hi mithiam tam takin rinhlelhna leh hnialna an tawk nasa hle a ni. Tunah chuan metallurgy, surgical technique leh fluoroscopic skills lama thil thar siam hmangin intramedullary nailing chu ruh rei tak tliak enkawlna atana standard a lo ni ta a ni.

Mihring biomechanical hriatna lama hmasawnna chuan he tunlai design siam hi a ti thei ta a ni. Tunlai intramedullary nailing hi infection rate hniam, scarring tlem, fracture stability tha, leh damlo kal theihna nghal te a ni.

He thuziak-a historical review neih hian intramedullary nail evolution khaikhawm a tum a, a thil pawimawh tak takte tarlan a tum a, intramedullary nail hman hmasak ber leh a hnu lama evolution period atmosphere tarlan a tum a, tunlai orthopedics leh traumatology-a intramedullary nail awmna hmun hriattir a tum bawk (eg, Figure 1).

Intramedullary nail pian chhuahna

Hmanlai Aigupta mite chuan nail ang chi intramedullary device an hmang hmasa ber a. Complex surgical fracture care hi kum tam tak kalta khan a awm a rinawm loh.

Mahse, thil chiang tak chu hmân lai Aigupta mite chuan thih hnua taksa thawhlehna an rinna aṭanga lo chhuak embalming technique ropui tak tak an nei tih hi a ni.

Hei hi Tutankhamun thlanah Usermontu an tih mummy hmuh a ni a, chutah chuan khup ruh nghet turin femur leh tibia inkarah threaded nail dah a ni (Figure 2-a kan hmuh ang hian).

Archaeologist-te chuan sarcophagus chhunga mummy chu Usermontu ngei a ni lo va, BCE 600-a hmân lai thlan rukbotute thlaktu mi dang a ni tih an sawi.

Kum 2000 hnuah Hernando Cortes expedition-a anthropologist Bernardino de Sahagun chuan Mexico rama damlo nung pakhatah intramedullary nailing hman hmasak ber a nih thu a sawi a.

Kum 1524 khan Aztec ruh surgeon (a hming 'Tezalo') chuan obsidian knife hmangin osteotomy a tih lai a hmu a, chutah chuan medullary cavity-ah resin rod a dah a, chu chuan a ruh chu a ti nghet thei a ni. Surgery technique leh antiseptics mumal tak a awm loh avangin heng procedure te hian complication rate sang tak a nei a, thihna rate pawh a sang hle.

Kum 1800 chho: Step hmasa ber

Kum 1800 chho lai vel khan medical journal hmasa berte chuan intramedullary nailing chungchang an tarlang a. Diefenbach, Langenbeck, Bardenheuer leh German tawng hmang surgeon dangte chuan ruh sei tak takte marrow-a ivory nail hmangin ruh inzawmna nei lo enkawlna atan an hmang tih an sawi.

Hetihlai hian Chicago khuaa mi Nicholas Senn, zirchiangtu leh sipai surgeon tui tak chuan intramedullary fixation hmanga experiment a nei a. Bovine ruh atanga siam hollow perforated splint hmangin a ruh tliak hnua 'pseudarthrosis' enkawl nan medulla chhungah a dah ang.

Kum 1886 khan Switzerland mi Heinrich Bircher chuan surgical meeting-ah complex fracture acute treatment atan medulla-ah ivory nail dah a nih thu a sawi a (Figure 3).

Kum tlemte hnuah Germany rama Themistocles Gluck chuan ivory intramedullary nail hmasa ber a siam a, a nail tawp lamah khur a awm a, chu chuan a vawi khat nan interlocking concept a rawn hmang ta a ni.

Hemi hun chhung vek hian Norway atanga lo kal Julius Nicolaysen chu proximal femoral fractures-a intramedullary nailing biomechanical principles chungchang ziak hmasa ber a ni. Biomechanical advantage nasa zawk neih theih nan leh ruh pumpui deuhthaw venhimna pe turin intramedullary nail sei zawng tihpun a tul thu a sawi bawk.

Static locking design turin proximal leh distal nail/bone interlocking concept a rawn rawt hmasa ber bawk. Mithiam thenkhat chuan intramedullary nailing pa angin an ngai a.

Kum 1800 chho lai vel khan Vienna-a Ignaz Philipp Semmelweis leh Glasgow-a JosephLister te ang pioneer te chuan surgical sterilization dinna tur lungphum an phum ta a ni. Hei hi aseptic condition hnuaia surgical technique thar siam chhuah theihna a nih avangin groundbreaking achievement a ni.

Kum 1900 chho: Evolution

Kum 1912 khan British surgeon Ernest Hay Groves chu solid metal rod intramedullary nail atana hmang hmasa ber a ni a, retrograde intramedullary nail approach hmahruaitu a ni bawk.

Indopui I-na lai khan a thil tawn chu pseudarthrosis natna vei damlo, an ke ruh tan duh lote a enkawl lai khan a hmu a ni. Minimal trauma hmanga osseointegration theihna intramedullary nailing technique hmasa ber a sawi mai bakah, intramedullary nail leh nail te zawk hmanga ruh tliak siamthatna kawngah pawh a thiam hle.

Aluminium, magnesium leh steel hmanga siam implant a experiment a, fracture tihdamna atana biomechanics pawimawhzia a hre chiang hle. Chuti chung pawh chuan Ernest Hay Groves-a technique chuan hri kai tamna a tuar a, chuvang chuan a hun laia mite tan chuan a lar lo hle.

Kum 1931 khan American orthopedic surgeon Smith-Petersen chuan intra-articular capsule femoral neck fracture enkawlna atan thla thum nei stainless steel screw a rawn siam chhuak a. Open approach a design a, iliac crest hmalam pathumna chu a incise a, broad fascial tensor hmalam kil zawhin operative field-ah a lut a, chutah chuan fracture chu a dah leh a, impactor hmangin stainless steel screw chu femoral head chhungah a khalh lut ta a ni (Figure 4).

Smith-Petersen trial hlawhtlinna avang hian surgeon tam tak chuan ruh tliak te tan metal implant hmangin an enchhin tan ta a ni. sven Johansson hian kum 1932 khan hollow intramedullary nail a siam chhuak a; a thil thar siam thiam tak chuan kerfing needle a hmang a, chu chuan intramedullary nail chu controlled radiologically guided insertion a phalsak a ni. A hmanna tur core technical components te chu tun thlengin hman a la ni reng a ni.

Step khat kal zelin Rush leh a unaupa chuan kum 1937 khan elastic intramedullary nail concept an rawn hmang ta a ni.

Elastic, pre-bent stainless steel intramedullary nail an hmang a, fracture chhehvela axial displacement awm duhna do let nan intramedullary three-point fixation structure siam an tum a ni.

An concept-ah chuan intact soft tissue area hian tension band angin hna a thawk a, chu chuan pre-bent elastic nail atanga tension siam chu a do thei a ni. An siam dan chu stainless steel-a elastic property vangin a tlahniam a, chu chu elastic deformation atanga plastic deformation-ah a inthlak hmasa ber a ni. Hemi hnuhnung zawk hian secondary displacement leh deformity healing a thlen thei a ni.

Chu bakah, intramedullary nails te hi a luhna lamah a chhuak emaw, cancellous bone structures ah emaw a lut duh a, a nih loh leh joint chhungah pawh a perforate duh bawk. Chuti chung pawh chuan Viennese scholar Ender chuan he technique hi Ender school of fracture fixation dinna bulpui atan a hmang chhunzawm zel a, tun thlengin naupang fracture flexible fixation atan pawh hman a la ni reng a ni.

Bone marrow nail a awm

Kum 1939 khan German surgeon Gerhard Küntscher, Nobel Prize nominee chuan femoral stem ruh tliak enkawlna atan stainless steel intramedullary nail a siam a.

Küntscher leh midangte chuan Smith-Petersen stainless steel screw hmanga femoral neck fracture enkawlna atanga infuih an ni a, chutiang principle chu stem fracture-ah pawh hman theih a nih an ring a ni. An intramedullary nail siam chu a tir lamah chuan cross-section-ah V-shaped niin, diameter chu 7-10 mm a ni.

Cadaveric leh rannung zirchianna a neih hnuah kum 1940-a Berlin-a surgical meeting-ah intramedullary nail leh surgical approach chu a rawn present a, a tirah chuan a thil thar siam hi a German thawhpuiten an nuihzat a, mahse a method chu Indopui II-na hnuah chuan a lar hle a ni.

Hmanlai Greek hunlaia damdawi lam thiam, damdawi lam pa tia sawi fo thin Hippocrates (460-370 BC) chuan vawi khat chu, 'Surgery tih duh chuan indonaah a kal tur a ni' a ti a; chutiang bawk chu Küntscher-a chungah pawh a ni.

Nazi hunlai khan Küntscher hi Finnish front-a damdawi inah a awm a. Chutah chuan damlo leh indonaa tangte chu a zai thei ta a ni. Bone marrow nailing concept chu closed leh open surgical approach hmangin a rawn hmang a ni.

Closed approach-ah chuan intramedullary nail chu prograde direction-in greater trochanter kaltlangin a pass a, sling hmanga operated retraction table-ah a dah a. Fracture chu reposition-in head fluoroscopy hmangin nail chu plane pahnih-ah dah a ni. Open approach-ah chuan intramedullary nail chu fracture kaltlangin fracture line bula incision hmangin medulla chhungah dah a ni.Küntscher hian intramedullary nail hi femoral stem fracture bakah tibial leh humeral fracture enkawlna atan a hmang a ni.

Küntscher-a technique hian Allied indonaa tangte an rama an hruai kir hnuah chauh international recognition a hmu a ni.

Chutiang chuan American leh British surgeon-te chuan Küntscher-a siam intramedullary nail chu an hre chiang ta a, he fracture treatment modalities hunlai hian a thatna chiang tak an hre ta a ni.

Hun rei vak lo chhungin khawvel hmun hrang hrangah surgeon tam zawkin a hman dan chu an hmang tan ta a, Küntscher-a intramedullary nail chuan damlo dam leh hun chhung kum khat dawn lai a tihtlem avangin ruh tliak enkawlna kawngah nasa takin a tidanglam ta a ni. Thla tam tak chhung cast-a immobilized ngai tur damlote chu ni rei lote chhungin mobile an ni thei tawh dawn a ni.

Tun thleng hian German surgeon hi intramedullary nail siamtu ber nia ngaih a ni a, trauma surgery chanchinah hmun pawimawh tak a chang a ni.

Intramedullary Nail tihzauh

Kum 1942 khan Fisher leh a thawhpuiten an sawi. a hmasa berin intramedullary nail leh ruh inkar contact area tihpun nan leh fracture fixation stability tihchangtlun nan marrow-expanding grinding drill hman dan a sawi.

Chuti chung pawh chuan Küntscher chuan flexible-guided reaming drill chu a rawn siam chhuak a, chu chu tun thlengin hman a ni a, ruh stem-a medullary cavity sei zawng zawngah reaming chu a thlawp a, chu chuan diameter lian zawk intramedullary nails dah awlsamna a siamsak a ni.

A tirah chuan intramedullary reaming hi intramedullary nail nena ruh inzawmna hmun nasa taka tihpun theih nan ruahman a ni a, chu chuan ruh ruh chu a nghet thei ang bera fixation a siam a, damlote chu a che rang thei ang.

Smith leh a thawhpuiten an sawi angin medullary expansion mm 1 apiangin contact area chu 38% in a tipung a ni. Hei hian intramedullary nail lian zawk leh khauh zawk hman theihna a siam a, hei hian fracture fixation structure pumpui stability a ti sang a ni.

Mahse, a flexible intramedullary reaming drill nei Küntscher intramedullary nail chu osteotomy atana internal fixation device thlan tling tak ni mahse, academia chuan kum 1960 chho tawp lam khan Arbeitsgemeinschaft für Osteosynthesefragen (AO) plate siam tharte chu an duh lo hle.

Kum 1960 chho: Hun Thim (Dark Ages) kha

Kum 1960 chhoah chuan intramedullary nailing chu a tawp nghal a, plate leh screw fracture fixation lam hawiin a awm ta a ni.

Küntscher-a hman dan chu tluang takin thawk mah se, khawvel hmun hrang hranga surgeon-te chuan operation hnua result ṭha lo a nih avangin an hnawl a ni.

Chu bâkah, surgeon ṭhenkhat chuan radiation hman dân, lu fluoroscopy ang chite chu an bânsan ṭan a, a chhan chu surgeon-te chuan radiation-a nghawng ṭha lo a neihte chu an huat phah hle a ni. Plate internal fixation system hman chungchangah international consensus tlangpui awm mah se, intramedullary nailing siam chhuahna chu chutah chuan a tawp lo.

German doctor Küntscher chuan interlocking thatna chu a hre chiang hle a, cloverleaf ang maia interlocking intramedullary nail a siam a, chu chu 'detention nail' tiin a vuah a ni. Chutih hunlaia intramedullary nail design-a Achilles heel chu angle lian tak takah a inthlau hle a, a chhe tawh tak tak emaw, a ruh tliak emaw chu a stabilize theih loh vang a ni He harsatna chinfelna chu locking screw hman a ni.

He harsatna chinfelna chu intramedullary nail chu locking screw hmanga stabilize a ni.

Chutiang chuan implant hian bending leh torsional force te chu a do tha zawk thei a, chutih rualin limb shortening a veng thei bawk. Küntscher, Klaus Klemm leh Wolf-Dieter Schellmann te ngaihdan inzawmkhawm hmangin, intramedullary nail chu intramedullary nail hnaih leh hlaa screw holes te chu pre-drilling hmanga stability nasa zawk pe turin an siam a, chu chu inserted screw-ah lock a ni.

Kum engemaw zat hnuah chuan fluoroscopic image clarity lama hmasawnna chuan fracture closure leh reduction technique te chu thlan nawn leh theihna a siam ta a ni.

Kum 1970 leh 1980 chho: Harhna

Kum 1970 chhoah khan German surgeon Küntscher-a intramedullary nailing concept hi a ngaihven hle a.

Closed reduction intramedullary nail fixation for fractures, a intersection of flexible reaming and interlocking concepts leh enhanced clarity of fluoroscopic techniques te hian he surgical technique tha tak, soft tissue chhiatna tlem ber, stability tha tak, leh damlote kal theihna nghal maia hriat lar tak hi hmasawnna leh thehdarh a tipung a ni.

Chutih lai chuan zirna khawvel chu thil thar hrang hrangin a rawn luah khat a, chu chuan intramedullary nailing thlah hnihna lo piang chhuak ta a ni.

Kum 1976 khan Grosse leh Kempf te chuan intramedullary nail-a elastic modulus buaina chinfel nan partially slotted intramedullary nail an siam a. Intramedullary nail hi proximal region-ah slot a ni lo va, proximal screw atan nail hole a nei a, chu chu intramedullary nail internal fixation structure stability strength tihpun nan 45-degree angle-ah dah a ni.

Kum tlemte hnuah AO chuan intramedullary nail development trend chu a zawm ve ta a, chutiang bawka ngaihtuah intramedullary nail siam chhuak ta a ni (Figure 5)

Kum 1984 khan Weinquist leh a thawhpuiten an sawi. dynamic approach an rawt a, chu chu locking screw hole lian zawk hmanga fracture end healing tihchangtlun a ni a, static locking screw te chu paih chhuah a ni a, chumi hnuah locking screw holes chu oval nail hole-ah design thar zawka siam danglam a ni.

Dynamic approach hman chhan chu fracture healing tihhmasawn leh late activity avanga bone nonunion awm loh nan a ni.

Tunah hian intramedullary nailing dynamics hian stand-alone technique angin a thlawptute a hloh tawh a, tunah chuan non-healing fracture enkawlnaah internal fixation system thlak kim vek ai chuan solution man tlawm zawk atan chauh hman a ni.

Biomechanical study-ah Gimeno leh a thawhpuiten an zirchiannaah chuan, report chuan intramedullary nail-a non-slotted leh slotted portion inkar transition zone a awm avangin stress concentration a awm a, internal fixation implant surgical failure a awm bawk.

Heng harsatnate sutkian nan hian Russel leh Taylor et al. kum 1986 khan non-slotted, non-dilated intramedullary nail hmasa ber a design a, result lawmawm tak a nei.

Hetih lai hian intramedullary nail inzawmkhawm buaina pawh a lo thang zel a, tunlaia kan hriat angin intramedullary nail pre-drilled hole hmanga screw hmanga inzawmkhawm chu Germany rama Klemm leh Schleman-a te design a ni. Screw dahna tur chu freehand fluoroscopy hmanga kaihhruai a ni ang a, chu chuan surgeon chu radiation tam tak a tawk ang.

Tunah chuan he harsatna hi distal targeting system hmanga chinfel a ni ta a, chutah chuan electromagnetic field tracking technology, fluoroscopically guided freehand technology, leh proximal nail installation guide dik tak te a tel a ni.

Kum 1990 chho: Titanium intramedullary nail hmanga siam a ni

Kum sawm hnuah chuan Russel-Taylor intramedullary nail chu international orthopedic community-ah a lar hle a. Standard of care chu zawi zawiin intramedullary nailing with static locking of screws a lo ni ta a, hei hi Brumback et al.

He prospective study-ah hian result-ah chuan locking hian a tam zawkah result tha tak a siam a, non-union of the fracture nen a inzawm lo tih a tarlang.

Metallurgy lama hmasawnna avang hian titanium intramedullary nails a lo chhuak a, hei hi a chakna, corrosion resistance tha tak leh biocompatibility vangin biomedical industry-ah hman lar tak a ni.

Alta intramedullary nailing system hi titanium intramedullary nail awm hmasa ber a ni a, stainless steel aiin titanium hi a chak zawk mahse a rigid lo zawk a, a mechanical property avang hian medical community-te chuan an lawm hle a ni.

Mahse, tuna literature-ah chuan titanium hi stainless steel aiin internal fixation atana hmanraw tha zawk a ni em tih hi rinhlelhna a awm a, a bik takin titanium hmanna avanga sum senso sang lutuk vang a ni.

Mahse, titanium hian a thatna thenkhat, cortical bone hnaih tak elastic modulus leh magnetic resonance imaging compatibility te hian duhthlan tur ngaihnawm tak a siam a ni.

Tin, titanium hi diameter te zawk intramedullary nail mamawh a nih chuan duhthlan tur hmuhnawm tak a ni.

Tuna Trends awm mek

Kum sawmhnih kalta lama hlawhtlinna leh hlawhchhamna hnuah chuan orthopaedic surgeon-te chuan intramedullary nailing chungchangah hian tawnhriat an nei tam zawk a ni.

Femoral, tibial leh humeral fracture-a intramedullary nail fixation chu closed fracture tam zawk leh open fracture thenkhat enkawlna standard a lo ni ta a ni. Targeting leh positioning system thar hmangin surgeon thiam lo ber berte tan pawh he procedure hi a awlsamin a siam leh thei ta a ni.

Tun hnaia thil thlengte chuan titanium leh stainless steel metal te hian modulus of elasticity sang tak an nei tih a tarlang a, stress hian ruh tihdamna atana mamawh irritating stress te chu a khuh bo a ni. Tunah hian biomaterial thar magnesium alloy, shape memory alloy leh resorbable materials te chu academia lamah enchhin mek a ni.

Tunah hian continuous carbon fiber-reinforced polymers hmanga siam intramedullary nails, elastic modulus tihchangtlun leh fatigue strength nasa tak nei te chu a awm mek a ni. Magnesium alloy te hian cortical bone ang bawkin modulus of elasticity an nei a, biodegradable an ni.

Tun hnaia zirchianna Li et al. an hmuchhuak a, rannung model-a ruh tliak enkawlnaah hlawkna nasa tak an nei a, chu chu ruh tliak siamthatna atana magnesium leh zoledronate coating inzawmkhawm vang a ni a, hei hi nakin lawkah ruh tliak enkawlna atana hman theih tur modality a ni.

Tawpna

Kum tam tak chhung chu intramedullary nail design, metallurgical technique, leh surgical technique-a hmasawnna nasa tak a awm avangin, intramedullary nailing chu ruh sei tak tak tam zawk enkawlna atana hman mek standard-ah a lo chang ta a, a hlawhtling a, a invasive lo hle a, reproducible procedure a ni.

Mahse, intramedullary nail design tam tak avang hian an postoperative outcome chungchangah hian information tam tak a tlachham a ni. Intramedullary nail type size, characteristic leh radius of curvature tha ber tur hriat chian nan zirchianna tam zawk neih a ngai a ni.

Biomaterials lama thil thar chhuah hian intramedullary nail design thar a siam chhuak dawn niin kan sawi.

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