Ubumenyi bwuzuye bwibyiza nibibi byumuco wo gukosora gukosora ijosi ry'ijosi rya femoral

Kuvunika ijosi ry'umunyagihugu ni kimwe mu byakunze gukomeretsa amagufwa mu myitozo y'amavuriro, hamwe n'abarwayi benshi bageze mu zabukuru kuba bararenza barenga 50%. Nk'uko imibare ivuga ko imivurungano y'ijosi yiyongereye buhoro buhoro yiyongereye mu myaka yashize, bafite ibyago byinshi mu bagore kuruta mu bantu. Indwara ya Vergogo, Guswera, indwara mbi kandi y'ubutabiro no mu bikomere bikuze mu rubyiruko ni ibintu bigira ingaruka nyinshi zo kuvura indwara z'umunya femoral.

Mu myaka yashize, ibikoresho byinshi byo gukosora byimbere nka screw hollow, imigozi yibumba (DHS), kunyerera imigozi ya hip (hsh), amasahani yo gutandukana, imisumari ya pammo yavuyemo. Muri ibi bikoresho byo gukosora imbere, imigozi ya Hollow niyo ikoreshwa cyane. Ubushakashatsi bwerekanye ko umubare munini wubucuruzi ukunda kwivuza, kandi uruhara rukomeye rwabaganga bahitamo gukoresha imigozi ya feral. 3 Basangiwe igice cyurutonde rwabitswe neza nuburyo bwemewe bwo gukosora imbere.

Ibiranga anatomical biranga ijosi rya femoral

Ubu muri rusange yemerwa ko imiterere yimibare yumutwe wibinyabibu aricyo kintu cyingenzi kigira ingaruka ku gukiza gukira no kunyerera. Ibyangiritse ku nzego zitanga amaraso umutwe nicyo kintu nyamukuru cyingenzi cya Ischemic Necrosime yumutwe wumunya femoral. Kwiga kuri sisitemu ya anatomiya yijosi ryaka umuriro byasanze umuyoboro wa V ErophySeal na Sisitemu yo Gushyigikirwa Sisitemu yo mu maraso.

Igishushanyo 1 Gutanga Amaraso kumutwe wibitsina, anterolate (a) hamwe ninyuma (b) kureba. Hariho itandukaniro ryo gutanga amaraso kumutwe wa femoral, ariko imitsi ya spinofel kandi yo hagati ikomoka mumisozi miremire yimbitse muri 60% byabarwayi.

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(2) Itanga amashami 3 cyangwa 4 ashyigikira imiyoboro ya strap. Aya mashami yurugendo nyuma yurugendo rwinyuma kandi hejuru yigice cya retrofleed cyicyuma cya sinovial cya femur kugeza kumutwe wumutwe. Ibikoresho mu nzego zizengurutse.

(3) yakomokaga mu muhanzi wa foramen. Kuzamura ishami ryumuboneza wa rotor.

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Imiyoboro ya Hollow yo kuvunika ijosi

Calnical, ububiko butatu bwimfuruka ya mm 6.5 cyangwa 7.0 mm cyangwa 7.3 mm irashobora gukoreshwa mugukosora abarwayi bato cyangwa mubarwayi bo hagati cyangwa abarwayi bakuze bafite amagufwa meza. Igitabo kigomba gukoreshwa kugirango imisumari 3 ihwanye kugirango yemere gukandamira kwikuramo. Mu ijosi ry'imyenda, imigozi igomba guswera mu mpande, witondere imigozi isenyutse mu mutwe w'imyenda kandi itarengeje umutwe mu murongo w'amavuko, kuko ubu aribwo buryo bwonyine bwo kubona kwikuramo hagati. Imigozi igomba gukomera no kwemezwa inshuro nyinshi. Niba uburiri bukurura bukoreshwa, igitego kigomba kuruhuka. Imigozi iboneye irashobora kandi gushyirwa buri kintu. Imbere, kuruhande, na 45 ° oblique fluoscopy igomba gukorwa kugirango imigozi idashingiraho ikibuno.

1, uburyo bwihariye bwo kubaga.

Fata inyabutatu 'guhinduranya ' Gushyira Umusaruro, bikunze gukoreshwa mumyitozo ya clinique, nkurugero.

a. Mbere ya byose, munsi ya flueroscopy, koresha x-ray mu ndege ebyiri za flueroscopy kugirango umenye imiterere yimiterere yo hepfo no hagati.

b. Gutemagura uruhu byateguwe bituma abantu 2-3 bahangayikishije cyane.

c. Igice giciriritse gitandukanijwe hamwe na Direct ya Cobb ikoreshwa mugutandukanya fibre ndende kumubiri wa femoral.

d. Shira urushinge ruyobora mumwanya aho indege zombi zitunganye.

e. Igice kimwe kiyobora cyashyizwe kumurongo wimbere mu ijosi ry'umunyamerika hamwe n'umufasha wa kumenya inguni y'imbere.

f. Nyuma yo gukosora umurongo wa mbere PIN, POSTESROSTUPER NA PISROSTUPERS PINS YEREKEYE UKORESHEJE UBUYOBOZI BWO KUBONA INYIGISHO N'INGENZI N'INGENZI

g. Ibi bikorwa mu kwinjiza PIG PIN hejuru yigituba gito kuruhande rwijosi rya femoral bakoresheje umugongo wa femore; Amapine abiri akurikira yashyizwemo byimazeyo imyambarire ibangikanye, uko bishoboka kuri mm 5 kuva cortex iri imbere na portE; Ubujyakuzimu bwo kwinjira muri PIN ya Pnos noneho ihindurwa kugera kuri mm 5 munsi ya karitsiye; Hanyuma, umwobo wasubiwemo, upimirwa, kandi imigozi yubusakuro irasenyuka.

h. Menya neza ko utinjira mu rushinge munsi ya CORCANTER nkeya hanyuma ugende neza kumugongo wa femoral.

Njye. Menya neza ko PIN yubuyobozi bwimbitse ihagaze munsi yingingo.

j. Ntukemere ko umuyobozi wa PIN yinjira hejuru yuburinganire.

k. Menya uburebure bukwiye mugupima uburebure bwa PIN hanyuma ukureho mm 5.

l. Mubisanzwe kwikinisha, imigozi yo kwigumirwa ikoreshwa, ariko rimwe na rimwe ibanziriza cortex yimbunda irasabwa mubarwayi b'indahemuka bafite igufwa ryinshi.

m. Niba imyanya yemereye, ahantu hashobora gukoreshwa.

n. Umugozi wa 4 (gahunda ya diyama) birashobora gukenerwa kubayoboke b'indahemuka bafite imibare ikaze yo mu ntoki.

Nubwo imigozi yuzuye ijosi ubu irasanzwe cyane, haracyari ibitekerezo bitandukanye bijyanye numubare niboneza ubudaconwa, mubisanzwe bitewe nimiyoboro ifatika, mubisanzwe bitewe nibyifuzo byumukoresha; Ibintu nkibigufwa yumurwayi ubucucike, bukwegera imbaraga, kandi gutsinda kwivuza nabyo bifite ingaruka.

1, umubare wa shorew.

• Kuvunika ijosi mubusanzwe mubisanzwe bifatwa na screw 2-4.

• Mubihe byinshi, imigozi 3 ikoreshwa kuko ishobora kwihanganira imihangayiko ikomeye yimbere, ongera imbaraga, kandi ugabanye kwimura imirongo irangiye.

• Ku miterere y'ijosi hamwe na pauwell angle> 50 °, imigozi 2 irakwiriye.

• Mu barwayi bafite ivuza rikabije ry'ijosi ry'inyuma ry'imyenda, imigozi 4 yuzuye.

• Ariko, imyitozo yiganje iracyakoresha imigozi 3 yuzuye yo gukosora.

2, Iboneza rya Show Lowrew.

• Iyo imigozi 3 yuzuye ikoreshwa mugukosora ijosi ry'ijosi, muri rusange yizeraga ko igitekerezo cya 'kunyerera ' kunyerera 'kunyerera ' bigomba gukurikizwa, kugira ngo imigozi 3 ikozwe mu buryo bwa ORTHOGNAL kandi ifite iboneza rya mpandeshatu kandi ugire iboneza rya mpandeshatu.

• Muri ubu buryo, imigozi itatu ibangikanye irashobora gutanga inkunga nziza ya imashini kandi igakora inzira yo kunyerera, kugirango ikomatarure ishobora kunyerera mu ijosi ry'ibinyabuzima, igatera igitutu ku gukiza.

• Ariko, niba imigozi 3 yuzuye yashyizwe mu mbogamizi za orthotricaular cyangwa ihindagurika yatunganijwe.

  
  

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Gutera imbere mu buhanga bwo gukosora uburyo bwo kuvunika ijosi

YueenYongviwat et al. Yashizeho igishushanyo gishya cyo gucumura neza kugirango ushyireho imigozi ihumeka mugukosora ijosi no gukosorwa imbere, ugasanga ubu buyobozi bushya bushobora kugabanya igihe cyakazi hamwe nuburyo bwa fluoscouscopique ugereranije nuburyo bwo kubaga bushimishije.

Filipov et al. Yashizeho biplane ashyigikiwe inshuro ebyiri. Ubu buryo butuma inkunga ikaze, bityo itanga imbaraga zihagije zo gukosora mugihe cyo kugenda.



Ubushakashatsi bwibinyabuzima bukoresha ingero za Cadaveric yerekanaga ko uburyo bwo gukosora BDSF butanga neza kuruta uburyo bwa gakondo bwa sikopine. Ibisubizo by'ibinyabuzima bishingiye ku binyabuzima ukoresheje ingendo za CADAVERIC zerekanye ko Serame ya CALCUM yashimangiye ko ijosi ryakozwe mu busahuzi, ryongerera imbaraga ku ijosi ry'imyenda, kandi rikangirira kurwana no gukomera kwa comoneral, no gukomera kwa torsionine, bifite agaciro kanini.



Kubera uburyo bwo hejuru bwumutwe wa necrosise yumubiri nyuma yo gukosora imisumari yo kuvuza imisumari, ubundi buryo bwakomeje gufasha imisumari yuzuye kugirango igabanye imisumari imbere kugirango igabanye ingorane nkigikorwa cyumutwe. Intandaro yumutwe wa necrosise yubusarure nyuma yo kuvunika ijosi ni ugutakaza amaraso kumutwe wibinyabibu, bityo intego yo kwivuza ni uburyo bwo kunoza amaraso. Intangiriro ya maraso yatanzwe mumaraso ahantu h'umutwe wa necrotic yumutwe wa necroral yumutwe wimyanya ya periobres hamwe na osteoblaut ya perioblats, ifite ingaruka za osteogic ningaruka zombi.

Incamake

Gukuramo ibinyomo byo gukosora ijosi nuburyo bwiza bwo gukosora, bufite ibyiza byo gukora byoroshye, igihe gito cyo gukora, ihahamuka rito, gukosora byihuse no gukosora byihuta. Ariko, kubera ibiranga anatolique byo kuvunika ijosi, ingorane za Ischesime za Ischesime yumutwe wubutaka kandi utarinze ubumwe zirashobora kwirindwa rwose no gukosorwa byimbere mu ijosi ryimbere. Kubwibyo, ibimenyetso kugirango imikoreshereze yubu buryo bwo gukosora bugomba gusobanurwa mbere yo gukoreshwa, kandi abarwayi bageze mu zabukuru bavuza ijosi ry'ibinyabuzima ndetse n'imiterere rusange isaba ibikorwa bya mbere bagomba kwirinda gukosorwa imbere mu ijosi ry'ibinyabuzima bishoboka. Ibintu bishobora guteza ingaruka bireba prognose yumurwayi, nkubwoko bwo kuvunika, ubucucike bwigunze, hamwe nuburyo bwumurwayi bukorwa, kandi bikaba bigomba kwitabwaho kugirango bigabanye ibibazo byigihe kirekire nyuma yo kuvura ijosi ry'ijosi.

Nigute wagura amagufwa hamwe nibikoresho bya orthopedic?

Kuri Czmeditech , dufite umurongo wuzuye wibicuruzwa byubasaguro orthopperic bitera kandi nibikoresho bihuye, ibicuruzwa birimo Umugongo, Intramedillary Imisumari, Isahani, gufunga isahani, cranial-maxillofacial, prostas, ibikoresho by'ingufu, ibicuruzwa byo hanze, arthroscopy, Kwitaho ku matungo n'ibikoresho byabo byo gushyigikira.

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