Nigute kuvunika periprosthetic bivurwa?

Intego

Ibicuruzwa bya periprosthetic bya femur feximal nikibazo gikomeye muri hip arthroplasy. Impanuka yavuzwe ni 3,5% nyuma yimyaka 20 nyuma yo guterwambere kandi yiyongera hamwe nintera yo gusimburwa hamwe. Kuvunika imitekerereze akenshi bifitanye isano nibiti bitamenyerejwe. Mubisanzwe, kuvunika bibaho mubantu bakuru bakuze bakuze baguye kubarwa kubagwa. Nubwo hariho itandukaniro mpuzamahanga mu gukoresha ibiti mpuzamahanga bifatika, nta bimenyetso bigaragara byerekana ko ubwoko bumwe bwo guhamya bufitanye isano no kuvunika gukabije kurenza undi. Sisitemu yo gutondekanya Vancouver yo kuvunika femoral ya periprosthel yemejwe cyane nabaga ubukana kandi bwerekanwe ko yizewe.

Intego y'ibanze y'ubu bushakashatsi kwari ukumenya isano iri hagati y'imibare ya Vancouver yamenetse kandi itavunika ridasobanutse. Intego ya kabiri kwari ugukora iperereza ku itandukaniro ryibiranga ibyingenzi byabarwayi hamwe nubwoko bubiri buvunika.

Ibikoresho nuburyo

Umurwayi:

1. Urukurikirane rwabarwayi bafite imibare ikurikiranye.

2. Gusa abarwayi bafite ibibuno byibanze bya perimerosthetic barimo.

3. Abarwayi bafite imivurungano ihindagurika, kuvugurura imibuno, hamwe no kuvunika mu gaciro ntibyakuweho.

   
   

Inyandiko ya Data:

1. Rando ya digitale kandi ikabarwa tomography ishingiye ku nyandiko za elegitoronike nisesengura.

2. Ibisobanuro Byibanze byanditswe harimo imyaka, igitsina, indangagaciro z'umubiri, no kugabanuka kwimikoranire mbere yo gutangira cyangwa kwishingikiriza.

3. 
   

Ibisobanuro birambuye:

1. Igihe cyo Guhinduka, kwerekana kuri arthroplasty (osteoplasty (osteoplaty cyangwa kuvunika), ubwoko bwimpande (byatanzwe), hamwe na arthroplasty (byose cyangwa sembaartplasty) byashyizwemo.

2. Inyandiko zirambuye zirimo zirimo ibyiciro bya Vancouver, umwanya wa vartubral strobral, na dorr gutondekanya.

3. Stem geometrie (ubwumvikane cyangwa ibigo byometseho, bigororotse cyangwa umugozi-bifatika kubiti bitamenyerewe) byanditswe hashingiwe kumiterere ya radiyo.

4. Kwemeza ibyiciro bya Vancouver byari bishingiye kumashusho hamwe nubushakashatsi bufatika mubarwayi babaga.

5. Isesengura ryibarurishamibare zakozwe hakoreshejwe impinduka zihoraho T-Ikizamini kandi kikaba cyarahindutse kubiranga imiterere no kugereranya imiterere ya vanne hamwe nitsinda rya Vancouver mumatsinda ya Stemer kandi atamenyerejwe.

6. Ibigeragezo byose byari impande zombi hamwe nurwego rwa 0.05. Isesengura ryibarurishamibare ryakozwe ukoresheje Igishushanyo cya Prisms wa mbere 8.0.0.

   
   

Ibisubizo

Umubare w'abarwayi:

1. Abarwayi 1181 bamenyekanye no kubaza Ububiko bwibitaro.

2. 978 abarwayi bafite imivuruke idasanzwe ya pelur yakuweho.

3. Mu barwayi 203 basigaye, 8 bari bafite imivurure y'imiterere, 6 yari afite ivugurura rya periprosthique, kandi 17 yari ifite imibare ya periprosthique y'ibikoresho byo gukosora ikibuno, byakomeje.

4. Abarwayi 172 bose bashyizwe nyuma yo guhezwa.

5. Kuvunika byose byabaye nyuma yo kugwa. Stem Amagufwa Amagufwa Itsinda Kuvunika mumibare 84 nta siveme

6. Muri iryo tsinda hari ibiranga 88.

   
   

Ibiranga ishingiro:

1. Hariho itandukaniro rikomeye hagati yitsinda mumyaka, igihe cyo gucika intege, ibimenyetso kuri arthroplasty yo kuvunika ijosi, gushira straartlaplasty, gushyira ahagaragara stem stem, hamwe nurwego rwumubiri.

2. By'umwihariko, mu itsinda rya sima, benshi bari hecaartplasty.

3. Nta tandukaniro rikomeye riri hagati yitsinda kubijyanye nigitsina, gutondekanya Dorr, no kugabanuka gukabije cyangwa kwishingikiriza.

4. Mu itsinda ryashima, ibiti byinshi byarasenyutse kandi ahasigaye byari ibishushanyo mbonera.

5. Mu itsinda ritaramenyewe, ibiti byinshi byari bigororotse kandi ibisigaye byari ishingiro.

   
   

Ibyiciro bya Vancouver:

1. Vancouverb2 kuvunika bishyizwe mubikorwa bine byasobanuwe neza: Byasobanuwe mbere 'bikubye ', Clamshell, hamwe nubushake bwumuvugizi, hamwe na 'reverhell ishusho. Uhagarariye x-ray isura yuruhererekane kandi ijyanye no gukuramo amashusho yerekanwe (Ishusho 1).

2. Kuvunika no kugongurwa byatewe cyane cyane nibiti byahamye, mugihe kuvunika flap byari bifitanye isano cyane nibiti bitamenyerewe.

3. Igishushanyo mbonera cya clamshell cyabaye kimwe muri Stems zombi.

4. Ishyirahamwe rya Vancouver Subtypes, harimo ubwoko bune B2 B2 byasobanuwe haruguru, hamwe na Geomtrie ya Geometrie yerekana icyerekezo rusange muburyo rusange.

Muganire

Kugeza ubu, ubu ni bwo bushakashatsi bunini bwo kugereranya neza isano iri hagati yakomeretse kandi itavugijwe steprosthet fructures no mu byiciro bya Vancouver:

• Nta tandukaniro rikomeye ryerekanaga isano iri hagati ya Claime kandi itemewe mu bwoko bwa Vancouver A, b, cyangwa c kuvunika. Interuro ya Vancouverb2 ni imwe mu matsinda yombi, byerekana ko ibiti bimwe bihamye kandi bidahungabanye mu mvururu za periprosthetic mu matsinda yombi.

• Ibinyuranye, fenelon et al. Gusesengurwa bya periprosthetic hamwe nibiti byangirika kandi bidasobanutse. Biragaragara ko umubare wabarwayi ufite ibirangaza muri Vancouver B2 na B3 binini cyane.

• Phillips et al. Sobanura ibikorwa byashyizweho cyane 'biturika ' ishusho ya sima yo guhuza ibice na 'crack ' ku ikoti rya sima, bisa na 'ax '. Iri vunika ryabonetse rifitanye isano cyane na Cediri muri ubu bushakashatsi.

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• Imiterere y'Ikirere Yimiterere yizivuriro ritera impungenge zerekeye ihohoterwa ryamagufwa, kandi ibi bikunze bikunze gukuraho sima no kurengana hamwe nimpande za kure.

• Capello et al. byasobanuwe a 'flip-flop ' kuvunika bifitanye isano nibiti bitamenyerejwe, kandi ibisubizo byerekana uku kubishaka. Kuvunika bikomoka ku mpinga minini ya trochanter Ntoya, agera kuri cortex medial, kandi irinda cortex ya Lating, itandukanya na gari ntoya. Kwaguka kw'akarere ka takola no guhindukirira uruti ni ibimenyetso bya radiokarasi byo guhungabana. Ubushakashatsi bwambere bwerekanye ishyirahamwe rikomeye ryuku kuvunika hamwe nibiti bitamenyerejwe hamwe nibishushanyo bya anatomical na wetge.

• GrammantopoloUST et al sobanura urukurikirane rwibishushanyo mbonera byatanzwe mububiko bwa periprosthetic hamwe nibiti byahamye, mubisanzwe bifitanye isano nibice byambere hamwe nubwishingizi bukabije. Umubare w'ibitingiri mu gace ka Claime wabaye wiyongereye cyane muri uru ruhererekane, ushobora kwerekana imyumvire yo kuvunika hafi y'umutwe wa tubular wakwirakwije mu buryo busa n'amagufwa asanzwe.

• Mu isesengura rya radiyo yimibare minini ya periprosthetic, itsinda ryubushakashatsi ryabonye uburyo bwo kuvunika ntibusobanuwe mbere mubitabo. Kuvunika bikomoka kuri chasskalike-mebare inyura muri cortex iri kuruhande, kuva muri cortex mediaction. Ubu bwoko bwo kuvunika bwitwa a 'gusubiramo ' clamshell kuvunika, ubushakashatsi bwafatwaga nkurwenya rusange b2.

• Iri zina ryatoranijwe kubwimpamvu ebyiri: Icya mbere, ni ishusho y'indorerwamo ya 'flip ', yitwara nkigice cya oblimale ivunika femoxique ya stlimoral ivuza ibishishwa byinshi byibasiye ibishishwa bikurura igice cyambere. Isarake nkiryo ryabaye hamwe nibiti bimaze igipimo (Ishusho 2).

• Nubwo intego yo muri ubu bushakashatsi ntabwo yari iyo gukora iperereza ku mibuto, muri ubu bushakashatsi, rihindura flip-flop kumenagura ahantu haterwa no gukosorwa no gukosorwa no gukosora ibice bya Feximine hamwe na corremlage insinga cyangwa ibyapa.

• Urugero rwumurwayi rwafashwe nubu buryo rwerekanwa, rwerekana ibyagezweho kugirango usohoke (Ishusho 3).

Igishushanyo 2 Hindura flip-top tocretire nziza.

Igishushanyo 3 arthroplasy na cerllage insinga yo gukosora ya retacrade flap.

Umwanzuro

Nk'uko sisitemu yo gutondekanya Vancouver ivuga, ubwoko bwa periprosthetic bufite ibintu bimwe na bimwe byurutonde rwa periprosthetic muri chimenthes kandi idasobanutse. Kubwibyo, ibintu byitirirwa bihamye kandi bidahungabana nyuma yo kuvunika byari bingana mumatsinda yombi. Kumenya ibipimo bine bitandukanye bya vancouverb2, harimo na nyamara byahimbwe neza. Ubushakashatsi buzaza burakenewe kugirango dukore iperereza kumibanire hagati yuburyo bwo kuvura no gutunganya uburyo bwo kuvura bugamije kumenya amakuru yubuvuzi bwibyavuye muri ubu bushakashatsi.

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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