Ibisobanuro byavunitse Intertrochanteric ya Femur
Ivunika rya intertrochanteric ya femur (nanone izwi nka trachanteric fracure) bivuga kuvunika kugaragara kuva munsi yijosi ryumugore kugeza kurwego rwo hejuru ya trocanter nto. Kugaragara harimo ububabare bwaho, kubyimba, ecchymose. Abarwayi ntibashobora kugenda, hamwe no kugabanya, kwiyongera, no kuzunguruka hanze yingingo zanduye, hamwe nintera ntarengwa yo kugenda yibibuno.
Ivunika rifite 3% - 4% byavunitse byose mumubiri na 35.7% byavunitse ikibuno. Indwara yiyongera uko imyaka igenda ishira, ikaba igaragara cyane ku bantu barengeje imyaka 70, kandi ikunze kugaragara ku bagore kurusha abagabo.
Gukoresha Anatomy ya Intertrochanteric Ivunika rya Femur
Inyabutatu ya Ward
Agace ka mpandeshatu yibasiwe nigice cyo hagati aho ijosi ryigitsina gore trabeculae ryambukiranya. Ku bantu bageze mu zabukuru barwaye osteoporose, kariya gace karimo amavuta gusa.
Calcar
Isahani yuzuye amagufwa aherereye inyuma - hagati yo guhuza ijosi ryigitsina gore nigiti cyimbitse kugera kuri trocanter nto. Nukwagura inyuma yinyuma - hagati ya cortex yo hagati yigitereko cyigitsina gore mumagufwa ya kanseri kandi niyo ngingo yo gushira umutwaro wa eccentricique kuri femur yegeranye.
Itondekanya rya Hip Bone Trabeculae
Gutanga imbaraga zumukanishi wa femur yegeranye:
(1) Icyiciro cya 6; (2) Icyiciro cya 5; (3) Icyiciro cya 4; (4) Icyiciro cya 3; (5) Icyiciro cya 2; (6) Icyiciro cya 1
Uburyo bwo Gukomeretsa Imvune za Intertrochanteric za Femur
Byinshi - Gukomeretsa ingufu mubarwayi bato
Ivunika rya intertrochanteric ku barwayi bakiri bato riterwa no gukomeretsa cyane - kugwa nko mu burebure no mu mpanuka z’imodoka. Ibi bihe bishobora kuviramo kuvunika cyane, kandi abarwayi bakeneye gukurikiranirwa hafi kubikomere bifitanye isano, harimo nibiri kumutwe, urutirigongo, hamwe na thoracic nu nda.
Ibintu byo kugwa mubarwayi bageze mu zabukuru
90% byavunitse hagati yabasaza biterwa no kugwa. Ibintu bigira uruhare mubyifuzo byabasaza bagwa harimo kutabona neza, kugabanya imitsi, umuvuduko wamaraso udahungabana, kugabanuka kwimyitwarire, indwara zifata imitsi, n'amagufwa n'indwara zifatika.
Niba kugwa bivamo kuvunika bigenwa nimpamvu eshanu zikurikira: ubukana bwa osteoporose, icyerekezo cyo kugwa, cyane cyane mugihe ikibuno cyangwa agace kegereye ikibuno gikubise hasi, kuba udafite imbaraga zo gukingira kugirango ugabanye ingufu zo kugwa, kutagira imbaraga zoroshye zo mu kibuno gukuramo imbaraga zihagije, nimbaraga zidahagije zamagufwa yibibuno.
Ubwoko bwihohoterwa nuburyo bukoreshwa
Ihohoterwa ritaziguye: Gukomeretsa cyane imbaraga bikora ku kibuno, nk'impanuka zo mu muhanda cyangwa kugwa aho ikibuno kibasiwe, bikaviramo kuvunika.
Ihohoterwa ritaziguye: Torsion yumubiri itera ikibuno kuri varus hamwe no guhangayika imbere. Hamwe na trocanter ntoya nka fulcrum, irahagarikwa cyane, kandi hashobora no kubaho ingaruka zo gukurura imitsi ya iliopsoas, igakora ikinyugunyugu - igufwa ryamagufwa. Trochanter nini irashobora kandi gukora igufwa ryatandukanijwe bitewe no gukurura cyane imitsi ya gluteus medius.
Itondekanya rya Clinical ya Intertrochanteric Ivunika rya Femur
Ibyiciro bya Evans
Bikunze gukoreshwa mubikorwa byubuvuzi. Evans yagabanije kuvunika hagati yubwoko bubiri:
Ubwoko I: Trans - kuvunika trochanteric Ukurikije ituze mbere na nyuma yo kugabanuka, irongera igabanywamo amoko 4:
Ⅰa: Babiri - kuvunika igice nta kwimurwa.
Ⅰb: Babiri - kuvunika igice hamwe no kwimurwa, cortex yo hagati irasa neza, kandi kuvunika guhagarara nyuma yo kugabanuka.
Ⅰc: Trochanter ntoya ni ubuntu, hamwe no kuvunika kuvunika no guhindura varus; cyangwa trocanter nini nigice cyamagufwa atandukanye.
Ⅰd: Usibye kuvunika kwa intertrochanteric, byombi binini kandi bito bihinduka ibice byamagufwa atandukanye, hamwe nubumuga bwa varus.
Muri byo, ubwoko Ⅰa na Ⅰb ni ubwoko butajegajega, naho ubundi ni ubwoko butajegajega.
Ubwoko bwa II: Gusubira inyuma - kuvunika kwa oblique intertrochanteric
Ubwoko bwa II ni ikinyuranyo - kuvunika kwa trochanteric, hamwe n'umurongo wavunitse urambuye cyane kuva munsi ya trocanter nini kugeza igice cyo hejuru cya trocanter.
AO Ibyiciro
Andika A1: Byoroheje bibiri - kuvunika igice binyuze muri trochanter, hamwe ninkunga nziza ya cortex yo hagati yo hagati hamwe na cortex yamagufwa.
Kuruhande rwumurongo uhuza.
Binyuze muri trocanter nini.
Binyuze muri trocanter ntoya.
Ubwoko A2: Ivunika ryagabanijwe binyuze muri trochanter, hamwe no kuvunika kwa cortex yo hagati mu ndege ebyiri, ariko cortex yamagufwa yinyuma ikomeza kuba ntamakemwa.
Hamwe nigice cyo kuvunika hagati.
Hamwe nibice byinshi byavunitse.
Kwagura hejuru ya cm 1 munsi ya trocanter ntoya.
Ubwoko A3: Subiza - kuvunika hagati, hamwe no kuvunika kwa cortex kuruhande.
Oblique.
Guhindura.
Byarangiye.
Mubisanzwe, ubwoko A1.1 kugeza A2.1 bufatwa nkaho butajegajega, naho ubwoko A2.2 kugeza A3.3 bufatwa nkaho budahagaze.
Kubaga Ubuvuzi bwa Fertur ya Intertrochanteric
Intego yibanze yubuvuzi bwo kubaga ni ukugera ku gukosorwa gukomeye kuvunika kwa intertrochanteric nyuma yo kugabanuka. Gukomera gukosorwa biterwa nimpamvu zikurikira: ubwiza bwamagufwa, ubwoko bwavunitse, kugabanuka, igishushanyo mbonera cyimbere, hamwe nu mwanya wibikoresho byimbere.
Mu myaka yashize, ibikoresho byo gukosora imbere byo kuvura imvubura zagiye zikorwa kandi bikomeza kuvugururwa. Muri byo, gukosora intramedullary, nka PFNA na INTERTAN, bikunze gukoreshwa nkigikoresho gisanzwe cyo gutunganya imbere.
PFNA yo kuvura imvune za Intertrochanteric za Femur
PFNA ikoreshwa muguhagarika osteoporotic intertrochanteric ivunika nka Evans Ic, Id, na Type II. Ifite imikorere myiza, anti-rotation ubushobozi, igihe gito cyo gukora, gutakaza amaraso make, ingorane nke, hamwe nubushobozi buke bwo gufunga imisumari hafi - hanze, byerekana ibyiza byo kuvura.
PFNA yerekanwe kumvune idahindagurika osteoporotic intertrochanteric ivunika (nkubwoko bwa Evans Ic, Id, na II). Yerekana imikorere isumba iyindi irwanya anti-rotation, igihe gito cyo gukora, kugabanya amaraso, hamwe nibibazo bike. Igishushanyo mbonera cya sisitemu ihuza igufwa neza, itanga imbaraga zikomeye zo gufata no kugabanya cyane ibyago byo gucibwa mumutwe wumugore, bitanga ibyiza byo kuvura.
INTERTAN yo kuvura imvune za Intertrochanteric za Femur
Hamwe niterambere ryubuhanga bugezweho bwubuvuzi, INTERTAN ni ubwoko bushya bwimisumari yimbere yabugenewe kugirango ivurwe n’imvune hagati y’igitsina gore. Umusaraba - igice cyumusumari wacyo nyamukuru ni trapezoidal. Iyo ikoreshejwe ifatanije nu musumari uhuza hamwe, irashobora gukumira ingaruka 'Z '. Kwiyongera k'umusumari wa kabiri uva mumutwe wigitsina gore byongera ingaruka zo kurwanya-kuzunguruka ya lag screw. Uyu musumari uteganijwe ufite uburyo bwinshi bwo gusaba kandi ubereye abarwayi bafite ostéoporose ikabije.
INTERTAN ni umusumari udasanzwe imisumari yagenewe umwihariko wo kuvunika hagati, byerekana iterambere mubuhanga bugezweho mubuvuzi. Umusumari wacyo nyamukuru urimo trapezoidal yambukiranya igice kugirango yongere ituze. Igice cyegeranye gikoresha uburyo bwo guhuza ibikorwa (umugozi wa lag na compression ya compression), birinda neza 'Z-ngaruka ' (aho umugozi umwe usubira inyuma mugihe undi winjiye mumutwe wumugore). Amashanyarazi yinyongera yemerera lag screw gukora umushinga imbere mumutwe wigitsina gore, byongera ubushobozi bwo kurwanya kuzunguruka. Uyu musumari ufite ibimenyetso byinshi kandi birakwiriye cyane cyane kubarwayi barwaye osteoporose.
CHANGZHOU MEDITECH TECHNOLOGY CO., LTD. kabuhariwe mubikorwa-byimikorere ya orthopedic hamwe nibisubizo bigezweho byo kubaga. Numushinga wubuhanga buhanitse uhuza R&D, umusaruro, kugurisha, na serivisi.
Dukurikije filozofiya ya 'Guhanga udushya, Gukurikirana indashyikirwa, ' isosiyete ikora ibicuruzwa byuzuye ikubiyemo umugongo, imisumari yimbere, imisumari ifunga, gukosora hanze, ingingo, craniomaxillofacial, veterineri, ibikoresho byamashanyarazi, ibikoresho byibanze, na ballon. Iyi mirongo y'ibicuruzwa byerekana ibice by'ingenzi byo guhanga udushya mu ikoranabuhanga mu nganda zita ku buzima, byiyemeje gutanga uburyo bwuzuye kandi bwizewe bwo kubaga abaganga bo ku isi. Hamwe nibicuruzwa bitandukanye bitandukanye hamwe nubushobozi bukomeye bwa tekiniki, isosiyete iteza imbere cyane iterambere ryiterambere nubuhanga bwubuvuzi.
Amafoto yafashwe muri ibyo birori, harimo imikoranire n’abaganga n’abaganga, yerekanaga umwuka w’ubufatanye n’ubwitange busangiwe mu guteza imbere ubuvuzi bw’abarwayi.
