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Iterambere ryibikoresho byimisumari byigihe cya 2025 Top 6 Guhangashya

Reba: 0     Umwanditsi: Muhinduzi Yurubuga Itanga Igihe: 2025-07-07 Inkomoko: Urubuga

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Kuvunika tibial

Igiti cya tibial ni kimwe mu mbuga zisanzwe zo kuvunika, kubazwa 13.7% by'imivuza yose mu mubiri. Tibia ya kure ifite ibiranga anatomique nko kwishyura amaraso make na timal yoroheje. Iyo kuvunika bibaho, kwangirika kworoheje no guterwa amaraso yaho birashobora kongera ingorane zo gukiza. Byongeye kandi, amahirwe menshi yo kuvunika fibular hamwe na kamere ahitamo guhitamo uburyo bukwiye bwo kubaga.

Igice cyambukiranya hagati ya Tibial Nout ni mpandeshatu, mugihe cya gatatu cyo hepfo. Ihuriro ryaba gatatu kandi hepfo ya gatatu ni rigufi kandi ryerekana inzibacyuho muburyo, bituma habaho urubuga rusanzwe.

Imbere ya gatatu ya Tibia ikubiyemo uruhu gusa idafite ubwishingizi bwimitsi, bigatuma ikunda gufungurwa aho ibice byamagufwa gutobora uruhu. Ndetse no mu mvura ifunze, kuvunika amabati menshi baherekejwe no kwangirika kuruhu no mu ngingo zigabanywa. Hagati ya Tibia Kuvura imitsi, kandi hari ibice bine bishimishije bikikije Tibia na fibula. Interuro ya Syndrome y'uruhishya iri hejuru mu mivurungano ugereranije n'izindi kuvura.

Gutondeka

Ao / OTA Kuvunika Kwitegura

Ao / Ota Icyarabu Icyiciro cyumubare kigamijwe gucika intege nka 4 (Tibia) 2 (Shaft). Andika ihuye no kuvunika byoroshye hamwe numurongo umwe wavunitse, ni ubwoko bukunze kugaragara. Andika b fractare zifite igice cyometseho. Andika c kuvunika biterwa nihungabana ryingufu nyinshi kandi zishinzwe kuvunika gutandukanya.

Gutondekanya Gustilo Kuvuka:

  • Andika I: Uburebure bwa Gukomeretsa munsi ya CM 1, mubisanzwe igikomere gisukuye gisukuye hamwe namagufwa agasahuwe nisuka unyuze kuruhu. Ibyangiritse byoroshye ni bike, nta gukomeretsa. Kuvunika biroroshye, guhindura, cyangwa oblique ngufi, idafite umubyimba.

  • Ubwoko bwa II: igikomere kirenze cm 1, hamwe nibikorwa byinshi byoroheje byangiritse ariko ntahoreye cyangwa flap. Inyito yoroshye yerekana ubwitonzi bworoheje kugirango ucike intege, uciriritse giciriritse, hamwe nubwitonzi buciriritse.

  • Ubwoko bwa III: Kwangiza imitsi yoroheje birimo imitsi, uruhu, imiyoboro y'amaraso, n'amatungo, hamwe no kwanduza cyane.

    • Ubwoko bwa III: Nubwo imvura nyinshi zikomeretsa cyangwa gufunga flap, cyangwa ihungabana ryinshi utitaye ku bunini bwa gikomere, hari imiti ihagije yo kuvunika.

    • Ubwoko III: Kwangiza imisoro yagutse no gutakaza, hamwe no gutahura amagufwa no gutanyagurika, biherekejwe no kwanduza cyane.

    • Ubwoko bwa IIC: bifitanye isano n'imvune ya arrine isaba gusanwa.

Amahitamo yo kuvura

Ubuvuzi budasanzwe bwo kuvunika muri tibial burimo imirongo, plaster ikosora, gukurura, kugabanya ururimi, no gukoresha bisanzwe, no gukoresha amakadiri yo hanze. Amahitamo yo kubaga arimo isahani ifunze imbere na intramedillary imisumari, mubindi.

Intramedillary imisumari

Intramedillary Sexailes Sexation itoneshwa nabaganga benshi bahungabana kubera kubaga byoroshye, imiti mito, ihahamuka rito, kandi byoroshye kuvana umusumari gukira. Itanga ikosora ryimbere, yemerera imyitozo yo nyuma yo gutangiza no kwirinda ibibazo byaho no kuri sisitemu. Izi nyungu zihuza n'amahame ya ao.

Czmeditech Tibial Intramedillary Umusaruro

Impuguke Tibia Intramedilllary Umusumari & Igikoresho cyashyizweho

1.Korekana

Imbere ya Oblialic Gukata iherezo rya Proximal birinda kurakara ligament.

2. Igishushanyo mbonera cyo gufunga

Iterambere Igishushanyo mbonera cyo gufunga cyongera umutekano wifuza kubice bya Proxima.

3. Kuramo stlique

Ihitamo rya Demol Gufunga kugirango wirinde kwangirika kworoheje no kongera ituze ryibice bya kure.

4. Imigozi ibiri

Gufunga umugozi byakozwe hamwe ninsanganyamatsiko ebyiri zo kwinjiza byoroshye.

Suprapatellar yegera Tibial Intramedillary Umusumari & Igikoresho cyashyizweho

Gufunga Mechanism

Gufunga igishushanyo cyo gukosora gukomeye, kugabanya imyigaragambyo yamaposita.

Inkunga y'amanota menshi

Ingingo nyinshi zo gukosora zitanga inguni no gushyigikira ingufu za palteau.

Kwitegura Kwiyongera

Igikoresho gigaragaramo imikorere yo guhindura agaciro, hamwe nimpinduka za morhologiya yerekanwe mubishushanyo birimbike (leta idahwitse) hamwe na post-compressions (ifitiye) imiterere.

Proximal-kure

Uburyo bwiza bwo gukosora kuva Proximal na kure, yerekana kuvunika bihebuje kandi bya kure.

Ikirangantego cya Tibial Intramedily Umusumari (DTN) & igikoresho cyashyizweho

Igishushanyo mbonera cyo kwinjiza byoroshye

Iherezo ryimisumari nyamukuru ifite igishushanyo mbonera, zorohereza kwinjiza byoroshye mubisambanyi.

Imigozi yo gufunga inguni

Imigozi ibiri yo gufunga inguni kumurongo wa paraximil irinde kuzunguruka no kwimura igice cyo kuvunika.

Kugorana Anatomical

Kugabanuka kwihariye Anatomical bituma isuku nkuru ihagaze neza mubyago bisabire.

Guhuza inguni zo gufunga

Imigozi itatu yo gufunga imigozi yimbuga ya kure itanga inkunga myiza no gukosora.

Tibial Intramedillary Umusumari & Igikoresho cyashyizweho

Bitandukanye:

Birakwiye kubice byinshi bya tibial (impyisi hamwe nibice bimwe bya kure / byihuse), mugihe ubundi bwoko (urugero, dtn cyangwa umuhanga cyangwa umuhanga ufite isuku).

Tekinike yo kubaga:

Uburyo busanzwe (parapatellar cyangwa transpatellar) ikurikira uburyo bwashizweho neza hamwe numurongo woroshye wo kwiga, mugihe inzira zihariye (urugero, suprapatellar) bisaba amahugurwa yinyongera.

Ibiciro-byiza:

Ugereranije nimisumari yihariye nkimisumari cyangwa DTN, intera ntoya intramedulllary imisumari isanzwe ihendutse, ikatuma iba imanza zisanzwe.

Guhuza imbaraga:

Bihuye nigikoresho rusange (urugero, gufunga imigozi, ibikoresho byibasiye), mugihe imisumari yihariye (urugero, imisumari ifunzwe na sisitemu yo gufunga byinshi) irashobora gusaba ibikoresho byibyo.

Andika ibimenyetso byiza byingenzi
Umuhanga musumari Shacrati yinguzanyo, Osteoporose Gufunga byinshi, gushikama cyane
Suprapatellar Umusumari Kuvunika kwangirika, abarwayi bababaye Uburyo bwo kwerekana, bugabanya ingorane zo mu mavi
DTN Kuvunika kwa kure (hafi ya Akle hamwe) Gufata icyerekezo cyiza cyane, kibuza kugabanya
Umusumari Hagati ya Stichures Imikorere yoroshye, igiciro-cyiza

Ibyiciro bya Tibia Ibikoresho byimisumari

  1. Gucukura ibikoresho : Harimo imyitozo yimbyo, itoborane, nibindi bikoresho bikoreshwa mumagufwa.

  2. Ibikoresho byibasiye : Ibikoresho byo gushyira mu gaciro no guhinduranya imiyoboro cyangwa imbaraga, nko kuyobora insinga, kuyobora amaboko, n'ibikoresho bigamije.

  3. Ibikoresho byo gukosora : Ibikoresho bikoreshwa muguhuza, gufunga, cyangwa guhindura ingufu, nkibikorwa byisi yose, gukora, imigozi, imigozi, n'inyundo.

  4. Gupima ibikoresho : ibikoresho byo gupima ubujyakuzimu, umwanya, cyangwa gufasha kubagwa, nk'imigenzo yimbitse, kugabanya imbaraga, n'amagufwa awls (awl).

Ibikoresho byo gukosora
Gucukura ibikoresho
Gupima ibikoresho
Ibikoresho byo kwibasira
    

Kubaga intambwe ku ntambwe

1. Gutegura

Gusuzuma: Gukora X-Ray / CT kugirango wemeze ubwoko bwo kuvunika, umuyoboro wagutse ubuvuzi nuburebure, hamwe no gupima tibia ivuguruzanya.

Umwanya: Umwanya wongereranya hamwe na ivi 90 ° -120 ° no kwitanga gato (kugabanya impagarara za patellar). Ikadiri ya nyarika ya Rapelumisiyo irashobora gushyigikira Fessa ya POPLITEAL yo gukururwa.

Sterile yashushanyaga: Libb isanzwe no gushushanya, kwemeza gukangura c-ry.

2. Kugabanya

Gufunga uburyo bwo kugabanya

Gutoranya intoki: Umufasha asobanura gukurura igihe kirekire mugihe umuganga ubaga yagabanutseho cyane na anteromedial kugirango ahindure guhuza (uburebure, kuzunguruka, kurakara).

Igicurarangisho-gifasha:

  • Tekinike ya Joystick: Imiyoboro ya Schanz yinjijwe mubice bya Proximal / kure kugirango igabanuke.

  • Gushushanya perbaraous: Kugabanya ingufu za oblique / kuzunguruka.

  • Kurangaza: Kurangaza cyane byashyizwe imbere (Proximal Scanz Screw bibangikanye muri Tibial Plateau, Pin ya Main muri Talis cyangwa Talial Tibia) kugirango akomeze uburebure.

3. Kwinjira ahantu

Ibiranga:

  • Ingingo yinjira 1cm itandukanya na Interima Imbere, ihujwe na Axis.

  • Kwemeza Fluscopic: AP Reba ihuza hamwe na tibial crest, reba kuruhande rumwe.

Gufungura ibikoresho:

  • Gutobora Gutobora Kurenga Kuyobora (hamwe no gukingira) cyangwa kugoramye Awl.

  • Kumenyera amaboko (6-8mm) kubirangagura bishaje hamwe na canal oclus.

4. Ongeramo inshinge & reaming

Gushyira Hejuru Gushyira: Talekire-Texped Urntewire yunamye 10-15mm kumasoko yo kuvunika. Kwemeza Fluscopic kuri Grid Physeal Scal (Ikigo cya Akle).

Gusubiramo Porotokole:

  • Reameles yoroshye guhera kuri 8mm, yongera 0.5mm kugeza contic 'kuganira ' (mubisanzwe 1-1.5mm> diameter).

  • Icyitonderwa: Gukuramo rimwe na rimwe bihanagura imyanda; irinde necrosis.

5. GUSHYIRA MU BIKORWA

Icyemezo kirekire:

  • Gupima Kuzara: Kuyobora uburyo bwo guhuzagurika cyangwa umutegetsi wa flueroscopic (ibyinjira ahantu hamwe.

  • Menya neza ko inama zigera kuri Physeal Scar idafite produsion.

Tekinike yoment:

  • Intoki-iterambere hejuru yayobora; hindura kugabanuka niba kurwanywa bibaye.

  • Kubungabunga kugabanya mugihe cyimirongo yo kuvunika kure.

6. Guhuza ibicuruzwa

Ingamba zikurikiranye

  • Uburebure-buke: Gufunga kwambere (screw imwe yemerera imbaraga).

  • Uburebure-budashidikanywaho / bwakozwe: gufunga kure byakurikiyeho na 'inyuma ' kugirango ugabanye.

Gufunga

  • Imiyoboro ya Hit ikoresheje ibikoresho bigamije (Multimaliccal kubicuruzwa bya Proximile).

Gufunga kure

  • Tekinike ya fluescopique: BEAM Hagati ya Beam Perpendicular to Screw Interuro ( 'uruziga rwiza '), gushimisha.

  • Imiyoboro yo kuvunika kure (irashobora guhuza icyerekezo cya AP / Oblique).

7. Inzira yanyuma

Iherezo rya CUT: Kwinjiza bidahitamo (birinda amabuye), ntanubwo uhuza ingingo.

Gufunga ibikomere: Patellar Patellar Tendon gusana hamwe na sutire zidakabije.

8. Ubuyobozi bw'iposita

Gusubiza mu buzima busanzwe:

  • Ubutumburuke; gukurikirana syndrome yicyumba mugihe cya 24h.

  • Tangiza Gukora ubukangurambaga bukora (pompe ya Ankle, Flagion) kuri pod 1-2.

Porotokole ifite ibiro

  • Ibiro bitwara ibyumweru 6 (byahinduwe kumutekano), gutera imbere byuzuye iyo Callit igaragara.

Gukurikirana: Isuzuma rya Clinical / radiyo kuri 2, 6, na 12 ibyumweru 12.

Ikirangantego


Synthes (Johnson & Johnson)

Icyicaro gikuru: Raynham, Massachusetts, Amerika

Ibicuruzwa bya Flaghip:

  • Impuguke Tibial Isumari (Etn) - Yateguwe kumutekano mubicuruzwa bigoye.

  • T2 imisumari ya tibial - itanga koherezwa no kwikuramo.

Imbaraga zingenzi: R & D Ikomeye R & D, Gukwirakwiza kwisi yose, no kwishyira hamwe nibisubizo byahahamuka.

Ikirangantego-1
★★★★★
Synthes (Johnson & Johnson)
Impuguke Tibial Isumari (Etn)
T2 Umusumari

Stryker

Icyicaro gikuru: Kalamazoo, Michigan, Amerika

Ibicuruzwa bya Flaghip:

  • T2 imisumari yo muri Tibial - sisitemu ya modular kubice bya tibial.

  • Gamma3 Umusumari - Gahuza intera imisumari hamwe no gufunga.

Imbaraga nkuru: robotike zigezweho (Mako), ibisubizo bidafite ishingiro, hamwe nihungabana rikomeye.

Ikirangantego-2
★★★★★
Stryker
T2 Tibial Nail
Gamma3 Tibial Umusumari 

Smith & mwishywa

Icyicaro gikuru: London, UK

Ibicuruzwa bya Flaghip:

  • Umusumari wa Trigen - yagenewe koroshya kwinjiza no gutuza.

  • Im tibial isukari - Intramedillary gukosora kuvugurura.

Imbaraga zingenzi: Wibande kumiti ya siporo nihahamuka, ibikoresho bishya.

Ikirangantego-3
★★★★★
Smith & mwishywa
Trigen Tibial Nail
im tibial umusumari

Czmeditech

Icyicaro gikuru: Changhou, Ubushinwa

Ibicuruzwa bya Flaghip:

  • Ikirangantego cya Tibial Intramedillary Umusumari (DTN) - Byagurika ku kuvunika kure.

  • Impuguke Tibia Intramedilllary Umusumari - Imbaraga nyinshi za Titanium.

  • Suprapatellar yegera Tibial Intramedilary umusumari - kwinjiza bike.

  • Tibial Intramedily Umusumari - Amahitamo akosowe.

Imbaraga nkuru: Ibisubizo-byiza-ibisubizo, kwagura isi yose.

Ikirangantego-6
★★★★★
Czmeditech
Umusuko wa Tarishing Intramediclary (DTN)
Impuguke Tibia Intramedilllary
Umusumari Poprapatellar yegera
Tibial IntramediLlary Umusuko

Zimmer Biomet

Icyicaro gikuru: Warsaw, Indiana, Amerika

Ibicuruzwa bya Flaghip:

  • Znn Tibial Umusumari - Igishushanyo cya Anatomic kugirango cyuzuye.

  • Sisitemu yimisumari karemano - kwigana amagufwa karemano.

Imbaraga zingenzi: gukomera mugusubiramo hamwe, guhuza ibinyabuzima, hamwe nibisubizo byihariye.

Ikirangantego-4
★★★★★
Zimmer Biomet
Znn Tibial Nail
Status Kamere

Orthofix

Icyicaro gikuru: Lewisville, Texas, Amerika

Ibicuruzwa bya Flaghip:

  • Lon Tibial Umusumari (Umusumari wa Orthoper, - Yagenewe inzira yinjira kuruhande.

Imbaraga zingenzi: Inzitizi mugutegura amagufwa, gukosorwa.

Ikirangantego-5
★★★★★
Orthofix
Lon Tibial Umusumari (Umusumari ya Orthoper)

Umwanzuro

Czmeditech itanga igisubizo cyuzuye cyo mumisumari rusange, kure cyane, hamwe nibishushanyo bishya (urugero, icyerekezo kinini, uburyo bwo gufata icyerekezo kinini, uburyo bwo gufunga) ugereranije nibirango bya Biomenics na Clinical.

INGINGO

[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 Nzeri 2024, https://mp.weixin.qq.com/s/g7pe8xf-25zsvlbxbluc9q.

[2] .Ao (nd). Intramedillary imisumari ya Tibial Stoft Kuvunika [Tekinike yo kubaga]. Ao kubaga. Kugarurwa 10 Nyakanga 2024, Kuva https://surgeryeference

Twandikire

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