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Isi Yambere Yambere ya Tibia Imisumari Ibikoresho Izina 2025 Top 6 Udushya

Reba: 0     Umwanditsi: Muhinduzi wurubuga Gutangaza Igihe: 2025-07-07 Inkomoko: Urubuga

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Ibice bya Tibial

Uruti rwa tibial ni rumwe mu mbuga zikunze kuvunika, zingana na 13.7% byavunitse mu mubiri. Tibia ya kure ifite imiterere idasanzwe nko kwishyurwa nabi kwamaraso no gukwirakwiza ingirabuzimafatizo ntoya. Iyo kuvunika bimaze kubaho, kwangirika kwinyama zoroheje no guhungabana kwamaraso yaho birashobora kongera ingorane zo gukira kuvunika. Byongeye kandi, amahirwe menshi yo kuvunika kwa fibular hamwe no guhungabana bituma guhitamo uburyo bukwiye bwo kubaga ari ngombwa.

Igice cyambukiranya hagati-hejuru-hejuru ya tibial shaft ni mpandeshatu, mugihe icya gatatu cyo hepfo ni impande enye. Ihuriro ryo hagati na gatatu bya gatatu biragufi kandi byerekana inzibacyuho, bigatuma iba urubuga rusanzwe rwo kuvunika.

Igice cya gatatu cyimbere cya tibia gitwikiriwe nuruhu gusa rutarinze gukingira imitsi, bigatuma rukunda kuvunika aho ibice byamagufwa bitobora uruhu. Ndetse no kuvunika gufunze, kuvunika kwa tibial kwinshi guherekezwa no kwangiza uruhu nuduce duto duto. Hagati ya tibia ntikabura imitsi, kandi hari ibice bine bya fassiya bikikije tibia na fibula. Indwara ya syndrome yibice irarenze mubice bya tibial ugereranije nibindi byavunitse.


Intera-Tibial - Intramedullary-Nail- (DTN)

Intera ya Tibial Intramedullary Nail (DTN)

Suprapatellar-Yegereye-Tibial-Intramedullary-Nail

Suprapatellar Yegereye Tibial Intramedullary Nail

Impuguke-Tibia-Intramedullary-Umusumari

Impuguke Tibia Intramedullary Nail


Ibyiciro byavunitse

Ibyiciro bya AO / OTA Kumeneka

Icyiciro cya AO / OTA Icyarabu cyerekana umubare wavunitse tibial shaft nka 4 (tibia) 2 (shaft). Ubwoko A bujyanye no kuvunika kworoheje hamwe numurongo umwe wavunitse, nubwoko busanzwe. Ubwoko B bwavunitse B bufite igice giciriritse kimeze nkigice. Ubwoko bwa C kuvunika biterwa nihungabana ryingufu nyinshi kandi ni ibice byavunitse.

Itondekanya rya Gustilo kumeneka ifunguye:

  • Ubwoko bwa I: Uburebure bwakomeretse buri munsi ya cm 1, mubisanzwe igikomere gisa neza gisukuye hamwe namagufwa yamagufa asohoka muruhu. Kwangirika kwinyama byoroshye ni bike, nta gukomeretsa. Ivunika riroroshye, rihindagurika, cyangwa rigufi, ridafite inkomyi.

  • Ubwoko bwa II: Ibikomere birenga cm 1, hamwe no kwangirika kwinyama zoroshye ariko nta avulsion cyangwa flap. Uturemangingo tworoheje twerekana igikomere cyoroheje kandi giciriritse, kwanduza mu rugero, no kugabanuka kuvunika.

  • Ubwoko bwa III: Kwangirika kwinshi kwinyama zirimo imitsi, uruhu, imiyoboro yamaraso, n imyakura, hamwe no kwanduza cyane.

    • Ubwoko bwaA

    • Ubwoko bwa IIIB: Kwangirika kwinshi kwinyama no gutakaza, hamwe no gukuramo periosteal hamwe namagufwa yerekanwe, biherekejwe no kwanduza cyane.

    • Ubwoko bwa IIIC: Bifitanye isano no gukomeretsa kwa arterial bisaba gusanwa.

Amahitamo yo kuvura

Ubuvuzi butari bwo kubaga kuvunika tibial burimo imirongo, gukata plaster hanze, gukurura, kugabanya intoki, no gukoresha amakadiri yo gukosora hanze. Amahitamo yo kubaga arimo isahani ifunze imbere hamwe no gutera imisumari, mubindi.

Gukosora imisumari

Gutera imisumari imbere byatewe inkunga nabaganga benshi babaga ihungabana kubera uburyo bworoshye bwo kubaga, kubagwa bito, guhahamuka gake, no kuvanaho umusumari nyuma yo gukira kuvunika. Itanga imbaraga zo gukosora imbere, zemerera imyitozo yimikorere hakiri kare kandi ikirinda ingorane zaho na sisitemu. Izi nyungu zihuza n'amahame ya AO yo kuvura.

CZMEDITECH Tibial Intramedullary Umusumari

Impuguke ya Tibia Intramedullary Nail & Igikoresho

1.Gukata hafi ya Oblique

Gukata imbere imbere kuruhande rwa hafi birinda kurakara kuri patellar ligament.

2. Igishushanyo mbonera cyo gufunga

Gutezimbere hafi yo gufunga igishushanyo byongera ituze ryifuzwa kubice byegeranye.

3. Gufunga intera ndende

Uburyo bwo gufunga intera ndende kugirango wirinde kwangirika kwinyama no kongera ituze ryigice cya kure.

4. Imirongo ibiri

Gufunga umugozi wateguwe hamwe ninshuro ebyiri ziyobora kugirango byoroshye kwinjiza.

Impuguke ya Tibia Intramedullary Imisumari Igikoresho

1200-09
BISHYUSHYE

Suprapatellar Yegereye Tibial Intramedullary Nail & Igikoresho

Uburyo bwo gufunga

Gufunga igishushanyo cyo gukosorwa gukomeye, gabanya ibice nyuma yo gutangira gutandukana.

Inkunga-Ingingo nyinshi

Ingingo nyinshi zo gukosora zitanga inguni zifatika hamwe ninkunga ihamye ya tibial palteau.

Ibyiciro byo kwikuramo

Igikoresho kiranga imikorere yo guhuza n'imihindagurikire y'ikirere, hamwe n'imihindagurikire y’imiterere yerekanwe mu mashusho haba mbere yo kwikuramo (imiterere idahwitse) na nyuma yo kwikuramo (bikwiranye).

Ikigereranyo cyegeranye

Uburyo bwinshi bwo gukosora kuva hafi kandi kure, byerekana hafi ya hafi ya tibial yamenetse.

Suprapatellar Yegereye Tibial Intramedullary Imisumari Igikoresho

1200-15
 BISHYUSHYE

Intera ya Tibial Intramedullary Nail (DTN) & Igikoresho

Igishushanyo mbonera cyo gushiramo byoroshye

Impera ya kure yimisumari nkuru ifite igishushanyo kiboneye, cyoroshya kwinjiza byoroshye mumyanya ya medullary.

Inguni zifunga inguni

Imiyoboro ibiri ifunga inguni kumpera yegeranye irinda kuzunguruka no kwimuka igice cyacitse.

Kugabanuka kwa Anatomical

Umwihariko wa anatomical curvature yemeza ko umusumari wingenzi uhagaze neza mumyanya ya medullary.

Gutandukanya Inguni Ifunga Imiyoboro

Imiyoboro itatu ihuza impande zifunga impande zanyuma zitanga inkunga nziza kandi ikosorwa.

Intera ya Tibial Intramedullary Nail (DTN) Igikoresho cyashyizweho

1200-27
GISHYA

Tibial Intramedullary Nail & Igikoresho

Guhindura:

Bikwiranye no kuvunika kwinshi kwa tibial (midshaft hamwe na bimwe byavunitse / byegeranye), mugihe ubundi bwoko (urugero, DTN cyangwa Impuguke Yinzobere) bwagenewe uturere tumwe na tumwe cyangwa kuvunika bigoye.

Ubuhanga bwo kubaga bukuze:

Uburyo busanzwe (parapatellar cyangwa transpatellar) bukurikiza inzira yashyizweho neza hamwe nu murongo wo hasi wo kwiga, mugihe uburyo bwihariye (urugero, suprapatellar) busaba amahugurwa yubuhanga.

Ikiguzi-cyiza:

Ugereranije n'imisumari yihariye nka Nail Impuguke cyangwa DTN, imisumari isanzwe ya tibial intramedullary imisumari isanzwe ihendutse cyane, bigatuma ikwiranye nibisanzwe.

Ubwinshi bwagutse bwo guhuza:

Bihujwe nibikoresho byose (urugero, gufunga imigozi, ibikoresho bigenewe), mugihe imisumari yihariye (urugero, Nail Impuguke hamwe na sisitemu yo gufunga ibyerekezo byinshi) irashobora gusaba ibikoresho byihariye.

Tibial Intramedullary Imisumari Igikoresho

1200-02
BISHYUSHYE
Andika Ibyiza Byiza Ibyingenzi
Impuguke Ivunika rikomeye rya shaft, osteoporose Gufunga-planari nyinshi, guhagarara neza
Umusumari Ivunika ryegeranye, abarwayi bafite umubyibuho ukabije Uburyo bwa Suprapatellar, bugabanya ingorane zivi imbere
DTN Kuvunika kure (hafi yamaguru) Gufunga ibyerekezo byinshi gufunga, birwanya kugabanuka
Umusumari usanzwe Hagati ya shaft yoroheje Igikorwa cyoroshye, kirahendutse
Intera-Tibial - Intramedullary-Nail- (DTN)

Intera ya Tibial Intramedullary Nail (DTN)

Suprapatellar-Yegereye-Tibial-Intramedullary-Nail

Suprapatellar Yegereye Tibial Intramedullary Nail

Impuguke-Tibia-Intramedullary-Umusumari

Impuguke Tibia Intramedullary Nail

Gutondekanya ibikoresho bya Tibia

  1. Ibikoresho byo gucukura : Harimo bits ya drill, reamers, nibindi bikoresho bikoreshwa muburyo bwo gucukura amagufwa.

  2. Ibikoresho byo Kwibandaho : Ibikoresho byo guhagarara no kuyobora gucukura cyangwa gushyirwaho, nk'insinga ziyobora, amaboko yo kuyobora, hamwe nibikoresho bigamije.

  3. Ibikoresho byo gukosora : Ibikoresho bikoreshwa muguhuza, gufunga, cyangwa guhindura ibyatewe, nkibihuriweho nisi yose, imashini, imigozi, ninyundo.

  4. Ibikoresho byo gupima : Ibikoresho byo gupima ubujyakuzimu, guhagarara, cyangwa gufasha mu kubaga, nk'ibipimo byimbitse, imbaraga zo kugabanya, hamwe n'amagufwa (AWL).

Ibikoresho byo gukosora
Ibikoresho byo gucukura
Ibikoresho byo gupima
Intego yibikoresho

Kubaga Intambwe ku yindi

1. Gutegura mbere yo gutangira

Isuzuma ryerekana amashusho: Mbere yo gutangira X-ray / CT kwemeza ubwoko bwavunitse, diameter ya kanal medullary nuburebure, hamwe no gupima tibia itandukanijwe nkibisobanuro.

Umwanya: Guhitamo neza hamwe no guhindagurika kw'ivi 90 ° -120 ° hamwe no kongeramo ikibuno gito (kugirango ugabanye impagarara za patellar). Ikadiri ya mpandeshatu irashobora gushigikira fossa ya popliteal kugirango ikurure.

Gufata Sterile: Guhindura ingingo zisanzwe no kuvoma, kwemeza C-ukuboko kugenda.

2. Kugabanya kuvunika

Uburyo bwo kugabanya gufunga

Gukwega intoki: Umufasha akoresha igihe kirekire mugihe umuganga ubaga atera tibial crest hamwe nubuso bwa anteromedial kugirango ahindure guhuza (uburebure, kuzunguruka, kurakara).

Ibikoresho bifashwa:

  • Tekinike ya Joystick: Schanz yamashanyarazi yinjijwe mubice byegeranye / bya kure kugirango bigabanye lever.

  • Kwifata ku buryo butandukanye: Kugabanya imbaraga zo kugabanya kuvunika kwa oblique / spiral.

  • Ikirangaza: Ikirangaza kinini cyashyizwe kumurongo (prokisi ya Schanz yegeranye ihwanye na tibial plateau, pin ya kure muri talus cyangwa tibia ya kure) kugirango ikomeze uburebure.

3. Ahantu ho kwinjirira

Ibiranga ibimenyetso:

  • Icyinjiriro cya 1cm intera yimbere ya tibial plateau yimbere, ihujwe na medullary axis.

  • Kwemeza kwa Fluoroscopique: AP kureba ihuza na tibial crest, impande zombi zisa na tibial axis.

Ibikoresho byo gufungura:

  • Imyitozo ya kanseri hejuru yubuyobozi (hamwe nintoki ikingira) cyangwa igoramye ikomeye awl.

  • Reamers y'intoki (6-8mm) kumeneka ishaje hamwe no gufunga imiyoboro.

4. Kwinjiza Guidewire & Reaming

Gushyira Guidewire: Umupira wifashishijwe umupira wunamye 10-15mm kumutwe kugirango ucike. Fluoroscopic yemeza ku nkovu ya physeal ya kure (hagati y'ibirenge).

Gusubiramo Porotokole:

  • Imikorere ihindagurika itangirira kuri 8mm, ikiyongera 0.5mm kugeza cortical 'kuganira ' (mubisanzwe 1-1.5mm> diameter yimisumari).

  • Icyitonderwa: Gukuramo rimwe na rimwe bikuraho imyanda; irinde necrosis yumuriro.

5. Kwinjiza imisumari

Kumenya uburebure:

  • Ibipimo bitangirwa: Guidewire uburyo bwo guhuzagurika cyangwa umuyobozi wa fluoroscopique (aho winjirira kumugongo).

  • Menya neza ko imisumari igera ku nkovu idafite umubiri.

Ubuhanga bwo Kwinjiza:

  • Intoki-imbere hejuru yubuyobozi; hindura kugabanuka niba kurwanywa bibaye.

  • Komeza kugabanuka mugihe cyo gucamo kure.

6. Guhuza imiyoboro yo guhuza

Ingamba zikurikirana

  • Uburebure buhamye-kuvunika: Gufunga hafi yambere (umugozi umwe utanga imbaraga).

  • Uburebure-budahinduka / kuvunika kuvunika: Gufunga intera yabanje gukurikirwa na 'gusubira inyuma ' kugirango ugabanye.

Gufunga hafi

  • ≥2 imigozi ikoresheje igikoresho kigamije (ibyerekezo byinshi kumeneka yegeranye).

Gufunga kure

  • Tekinike ya Fluoroscopique: Hagati yo hagati igana imyobo ( 'uruziga rutunganijwe '), gucukura percutaneous.

  • ≥2 imigozi yo kuvunika kure (irashobora guhuza icyerekezo cya AP / oblique).

7. Inzira zanyuma

Impera yanyuma: Kwinjiza kubushake (birinda amagufwa kwinjira), menya ko ntaho bihurira.

Gufunga ibikomere: Gushyira patellar tendon gusana hamwe na suture zidasanzwe.

8. Ubuyobozi bwa nyuma yibikorwa

Gusana hakiri kare:

  • Kuzamura ingingo; gukurikirana syndrome yibice bitarenze 24h.

  • Tangiza ibikorwa bifatanyiriza hamwe (pompe yamaguru, ivi) kuri POD 1-2.

Porotokole yo gutwara ibiro:

  • Ibice bimwe-bitwara uburemere bwibyumweru 6 (byahinduwe kuri stabilite), bitera imbere byuzuye iyo callus igaragara.

Gukurikirana: Isuzuma rya Clinical / radiologue mubyumweru 2, 6, na 12.

Ibiranga-Byihariye


DePuy Synthes (Johnson & Johnson)

Icyicaro gikuru: Raynham, Massachusetts, Amerika

Ibicuruzwa byamamaye:

  • Impuguke ya Tibial Nail (ETN) - Yashizweho kugirango ituze mu kuvunika kwa tibial bigoye.

  • T2 Nail Tibial Nail - Itanga uburyo bunoze bwo gukosora no kwikuramo.

Imbaraga zingenzi: Gukomera R&D, gukwirakwiza kwisi, no kwishyira hamwe nibisubizo byihungabana.

LOGO-1
★★★★★
DePuy Synthes (Johnson & Johnson)
Impuguke ya Tibial Nail (ETN)
T2 Umusumari wa Tibial

Stryker

Icyicaro gikuru: Kalamazoo, Michigan, Amerika

Ibicuruzwa byamamaye:

  • T2 Umusumari wa Tibial - Sisitemu ya modular yo kuvunika tibial shaft.

  • Gamma3 Tibial Nail - Ihuza imisumari yimbere hamwe nuburyo bwo gufunga.

Imbaraga zingenzi: Imashini za robo zateye imbere (Mako), ibisubizo byibasiye byoroheje, hamwe nihungabana rikomeye.

LOGO-2
★★★★★
Stryker
T2 Umusumari wa Tibial
Gamma3 Umusumari wa Tibial

Smith & Mwishywa

Icyicaro gikuru: London, Ubwongereza

Ibicuruzwa byamamaye:

  • TRIGEN Tibial Nail - Yashizweho kugirango yorohereze kwinjiza no gutuza.

  • IM Tibial Nail - Gukosora intramedullary yo kuvunika tibial.

Imbaraga z'ingenzi: Wibande ku buvuzi bwa siporo n'ihahamuka, ibikoresho bishya.

LOGO-3
★★★★★
Smith & Mwishywa
TRIGEN Nail Tibial Nail
IM Tibial Nail

CZMEDITECH

Icyicaro gikuru: Changzhou, Ubushinwa

Ibicuruzwa byamamaye:

  • Intebe ya Tibial Intramedullary Nail (DTN) - Gukwirakwiza kuvunika kure.

  • Impuguke ya Tibia Intramedullary Nail - Igishushanyo mbonera cya titanium alloy igishushanyo.

  • Suprapatellar Yegereye Tibial Intramedullary Nail - Kwinjiza byibuze.

  • Tibial Intramedullary Nail - Amahitamo atandukanye.

Imbaraga zingenzi: ibisubizo bikoresha neza, kwagura isi yose.

LOGO-6
★★★★★
CZMEDITECH
Impuguke ya Tibial Intramedullary Nail (DTN) Impuguke
ya Tibia Intramedullary Nail
Suprapatellar Uburyo bwo Tibial Intramedullary Nail
Tibial Intramedullary Nail

Zimmer Biomet

Icyicaro gikuru: Warsaw, Indiana, Amerika

Ibicuruzwa byamamaye:

  • ZNN Tibial Nail - Igishushanyo cya Anatomic kugirango gikorwe neza.

  • Sisitemu yimisumari isanzwe - Yigana ubukanishi bwamagufwa karemano.

Imbaraga zingenzi: Mukomere mukwiyubaka hamwe, guhuza ibinyabuzima, hamwe nibisubizo byihariye.

LOGO-4
★★★★★
Zimmer Biomet
ZNN Tibial Nail
Sisitemu Yumusumari Kamere

Orthofix

Icyicaro gikuru: Lewisville, Texas, Amerika

Ibicuruzwa byamamaye:

  • LON Tibial Nail (Lateral Orthopedic Nail) - Yashizweho kugirango yinjire kuruhande.

Imbaraga zingenzi: Zinzobere mu gukuza amagufwa, gukosora ubumuga.

LOGO-5
★★★★★
Orthofix
LON Tibial Nail (Umusumari wa orthopedic)

Umwanzuro

CZMEDITECH itanga ibisubizo byuzuye bya tibial imisumari kubibazo byavunitse byegeranye, byitaruye, kandi bigoye, hamwe nibishushanyo mbonera (urugero, gufunga ibyerekezo byinshi, uburyo bwa suprapatellar) ugereranije nibirango byamamaye kwisi yose mubinyabuzima ndetse nibisubizo byubuvuzi.

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