Kodi mungatani ngati kukhazikika kwamkati kwa vatitor fratotor sikulephera?

Chiwopsezo cha m'chiuno chikuyembekezeka kukhudza anthu 500,000 ku United States chaka chilichonse. Amakhala ndi vuto lalikulu pa moyo, pakadali pano laimfa 3-7% ya kufa kwa chipatala komanso kufa kwa zaka 19.4-58%. Pafupifupi theka la zojambula zonse zakumwa zam'mimba ndi ma incrochantic (izo). Zingwe ziwiri zomwe zimagwiritsidwa ntchito pochiza matendawa ndi a cmmalomdulullary msomali (cmn) ndi screw scress (shs).

Ngakhale atapita ndi ukadaulo, anthu osazindikira ndi kukonza zolephera monga kulowera m'mutu wachikazi kumachitika ndipo akhoza kukhala owononga. Kafukufuku waposachedwa wanena kuti mapangidwe azaka zokwanira 6% okhala ndi ziphuphu zamakono. Zowopsa za kulephera kusintha zimaphatikizapo mtunda wa nsonga ya Tip-THE, 25 mm, mawonekedwe osakhazikika, mawonekedwe owoneka bwino, komanso pansi pakati pa mutu wa feminical. Kukalamba ndi mafupa kumalumikizidwanso ndi kulephera kokhazikika.

Odwala ndi njira

Izi zinali kafukufuku wochokera kwa odwala omwe amathandizidwa m'mabungwe awiri omwe ali mkati mwamitundu ikuluikulu ya mzinda waukulu. Forces mitengo ya madokotala awiri (JS ndi BC) amafunsidwa kwa odwala onse omwe adalandira kukonzanso kwa simenti-kotsimikizika pambuyo poyambira kuyambira Januware 2018 mpaka Seputembara 2021, atavomerezedwa ndi gulu lowunikira. Kugwiritsa ntchito kutsitsa kwa simenti pokonzanso opaleshoni ya zamagetsi kunatsimikiziridwa ndi mbiri yamagetsi (Emr) kuwunikira zolemba zogwira ntchito ndi ma radiograograography. Tinaphatikizapo odwala onse okhala ndi zizindikiro za kukhazikika molimbika pokonzanso kukonzanso kapena kukhazikika kwa ma fin kapena shs kukhazikika kwa fraction (Chithunzi 1). Tinapatula odwala omwe ali ndi khosi lodzikongoletsera kapena odwala omwe sanakonzekere kukonzanso kwa simenti, ndi odwala omwe amayambitsa opaleshoni koyamba.

Chithunzi 1. Mkazi wazaka 76 yemwe wakwanitsa kukhazikika kwa matenda a femur (a), omwe ali ndi ululu wa m'chiuno 2 miyezi ingapo.

Njira Zopaleshoni

Kwa odwala omwe amalandila koyamba ndi cnn, tinachita m'malo amisomali yosinthidwa ndi kukongoletsa kwa mafupa. Poyamba, mawonekedwe a masentimita 5 adapangidwa pamtunda wa Trochant Brochants wamkulu wa msomali, ndipo fupa lonse lidachotsedwa mbali yoyambirira ya msomali pogwiritsa ntchito malo osungirako msomali. Kenako, chiboli cha hexagonal chinali chogwiritsidwa ntchito kuti amasule chitseko cha nthawi ya cnn (Chithunzi 2).

Chithunzi 2, ma fluorotive fluoroscopy akuwonetsa screwdriver yolumikizira ndikumasula mawu omwe aperekedwa kale.

Chizindikiro cha 1-2 masentimita chimapangidwa kudutsa mu Ilutibials Fascia (ITB) Fascia. Msomali woyambayo amachotsedwa ndi chitsogozo cholumikizidwa (Chithunzi 3). Pankhani ya matenda am'mimba, chitsogozo cha Hollow chokhala ndi cholembera chokhoma chimagwiritsidwa ntchito popewa kutaya kwa simenti. Chithunzi 3a). Makamaka, matrix adayamba koyamba kuchotsa zigawo ziwiri zakunja za canning canning kenako ndikuyika malo opangidwa ndi anthu awiri.

Chithunzi 3, zovuta anterolaative atero (a) ndi ofananira (b) zithunzi za wodwala wina akuwonetsa mitu ya feducal.

Chotsatira, nthambiyo imayang'anira kenako kusokonekera kumayikidwa mu exolom yambiri yamakonzedwe. Pankhani yaukhondo kapena machiritso am'madzi, percuroous osctotomy imachitika pogwiritsa ntchito njira imodzi ya 1/4 'mosafunikira, koma othandiza pakafunika kubereka, koma chandamale> 130 °).

Chongani chatsopano kapena tsamba lapachipata limayikidwa mu fupa la subworil mu ntchentche ya femisolo, ndikuonetsetsa kuti musamale mutu (Chithunzi 4). Chonganicho chimayikidwa mwadala kupewetsa phokoso lam'mbuyomu, koma kuloza kumapeto kwa mutu wachisoni. (Chithunzi 5)

Chithunzi 4, anterotembamba (a) ndi ofananira (b) zithunzi za wodwala wina akuwonetsa kuyikiridwa kwa singano ya mutu wamutu.

Chithunzi 5, mbiya fluoroscopy akuwonetsa kuyika tsamba la ceplomdulullarylarylarylarylary cuad monday njira ya waya, yomwe idapendekeka ndi screw.

Pomaliza, mutu wachisoni umadzaza ndi simenti yamafupa pogwiritsa ntchito dongosolo la simenti yamagetsi (Chithunzi 6). Chisamaliro chimasungidwa kuti mupewe kuphatikizidwa ndi ma radiography enieni ndikusintha kuya ndi mawonekedwe a simenti cannila.

Chithunzi 6, kulingalira zosonyeza kuti simenti Kuchulukitsa koyamba (a), kudzazidwa pang'onopang'ono (b) Kuwonongeka kwa mutu wa chisoti kumadzazidwa (c).

Kwa odwala omwe amalandila koyamba ma shs, timachotsa ma shs ndikuyika cnn yayitali. Nditapanga chilengedwe 5-cm chapakatikati pansipa. Zomangira zonse zamagawo zimachotsedwa pogwiritsa ntchito screwddriver yabwino kwambiri ndipo mbale yofananira imachotsedwa. Zomangira zazingwe zimachotsedwa ndi chitsogozo chosinthiratu monga momwe zidafotokozedwera kale kuti zibwerekere kwamphamvu kwambiri ya Vurgus. Kuwonongeka kwa 5-cm kumapangidwa pamsonkhano waukulu wa Trochants monga momwe adafotokozera kale. Waya wotsogolera amaikidwa kumapeto kwenikweni kwa Trocharn Gromanter ndi kupita ku tsinde lokazinga. Wobwezeretsa wotseguka amayambitsidwa m'njira ya bizinesi. Dongosolo lalitali lalitali limakhazikika pakatikati pa kusala kwa femul pansi pa mitella. Kenako, kukonzanso kopita patsogolo kunachitika mpaka kugwedezeka kunamverera m'mutu kumbuyo. Odwala athu onse adalandira msomali wautali wokhala ndi TFN-Wamtundu wa TFN (TFNA) Proximal Carravellary System System (Disnthel-Ratul, Raynham, a).

Kukambirana

Njira yathu imagwiritsira ntchito zolimbitsa thupi pokonzanso. Mafupa a Sthuntal Kukhazikitsa koyamba kwa osteoporotic proximal fracraurs a femar aphunziridwa ndipo wawonetsa zotsatira zabwino komanso zotsatira zamankhwala. Ndemanga yaposachedwa yomwe imalimbikitsa fupa yomwe idapangitsa kuti katundu wambiri ukhale wolemera, adachepetsa kusamukira kwawo, ndipo zovuta zochepa komanso kusinthana kochepa poyerekeza ndi kusintha kosasunthika. Phunziro lokhazikika, lomwe likuyembekezeka la anthu wamba kapena zizindikiro zozikika za gulu la Conmenti mu gulu lomwe limatsimikizika m'gulu la simenti yofananizidwa poyerekeza ndi milandu isanu ndi umodzi yomwe ili pagulu losakhazikika.

Imfa ya m'chiuno ndiokwera. Kafukufuku waposachedwa afotokoza za 3-7% muyezo wa chipatala, omwe akumwalira chaka chimodzi akuchepa kuyambira 19.4% mpaka 58%. Makamaka, kumawonetsedwa kuwerengera kwa 27% ya kufa kwa chaka chimodzi. Nkhani zathu zamankhwala sizinawonekere kumwalira kwa chipatala komanso kufa kwa zaka 13.6%, yomwe ndi yotsika mtengo kuyerekeza ndi mabuku. Chifukwa kusungulumwa koyambirira pambuyo pa opaleshoni kumalumikizidwa ndi kufa kotsika, zomwe zikuyenera kuvomerezeka komanso zogwirira ntchito mu mndandanda wathu zitha kufotokozera kuti kufa kwa odwala athu.

Mapeto

Kukonzanso kwa simenti ndi njira yothandiza, yotetezeka, komanso yotsika mtengo kwa osalephera kukhazikika kwa odwala okalamba omwe ali ndi mafupa okwanira.

Odwala omwe alephera kukhazikika kwa ma incrochantic oyambitsidwa ndi chithandizo chosinthika ndi chithandizo cha simenti-chitsimikiziro chawonetsa zotsatira za nyengo yayitali komanso za moyo. Njirayi idagwiritsidwa ntchito pokhapokha pokhapokha ngati anthu ambiri acetaburm mawonekedwe adasungidwa ndipo msomali wam'mutu unakhalabe mkati mwa khosi lonong'oma. Poganizira zofooka za kusinthidwa kwa arthropasty odwala okalamba, njirayi imawonetsa lonjezo mosamala komanso moyenera kuchepetsa zovuta zazikulu ndikuchepetsa nthawi yogwira ntchito ndikuchepetsa gulu la odwala.

Momwe mungagulire zoimira za Orthopdic ndi zida za Orthopedic?

Wa Czmeditech , tili ndi gawo lathunthu lochita opaleshoni ya Orthopedic zokhala ndi zida komanso zida zofananira, zinthu kuphatikiza Zingwe za msana, intradedollary misomali, Zowopsa, Kutseka mbale, cranial-maxillofaal, Prosthesis, Zida Zamphamvu, Okondedwa akunja, arthroscopy, chisamaliro chanyama komanso zida zawo zothandizira.

Kuphatikiza apo, tili odzipereka kupitiliza kukulitsa zinthu zatsopano ndikukulitsa mizere yopanga, kuti akwaniritse zosowa za madokotala ochulukirapo, komanso kuti kampani ikuluyipire kwambiri padziko lonse lapansi.

Kutumiza padziko lonse lapansi, kuti uthe Lumikizanani nafe ku imelo adilesi@opdicic-chucdic-chuctina kuti mumve mawu aulere, kapena tumizani uthenga pa whatsapp kuti muyankhe mwachangu + 86- 18112515727 .

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