Kuvura ubwinshi bwa Stem Stem Stem Stem na Tekinike

Guhagarika ibiro byasubije hanze bigomba kubungabungwa ku kilo ntarengwa kugeza ku gukiza ibintu byagezweho. Mubisanzwe Kuvunika Ibipimo (HSF) birasanzwe, bibazwa hafi 1%. Amafaranga yumwaka ni 13 kugeza kuri 20 kuri 20.000 kandi yasanze yiyongera hamwe nimyaka Impinga ya kabiri ibaho mu bagore bari hagati yimyaka 60 na 80, mubisanzwe bakurikiza ihungabana ryo hasi.

Kwivuza

一. Gukosora imbere hamwe nisahani yo gusubiramo

Ibimenyetso:

• Imitsi ya Radial Palsy (RNP) muri HSF ntabwo yerekanaga kubagwa kuko ifitanye isano nigipimo kinini cyo gukira (reba kandi - imitsi / imitsi ya Radial hepfo).

• Ubundi, igikomere cyose gisaba gusana cyangwa kurenganura ni ibimenyetso byuzuye byo kubaga byo kubaga byo kuvunika, nkuko bikosorwa birengera anastomosis.

• Muri uru rubanza rwihariye, gukosora imbere ni isahani byihuse kandi byizewe kuruta imin kuko gusana bikozwe muburyo butaziguye (mubisanzwe uburyo bwo hagati).

• HSF hamwe na proximal cyangwa kure ya artra-articular of thecticuland nubundi bihe orif hamwe nisahani ni amahitamo meza.

  
  

Kubaga kubaga:

• Kuvunika biherereye muri proximal na / cyangwa hagati ya gatatu bivurwa ukoresheje uburyo bwa kera.

• Mugihe bikenewe, ubu buryo bwari bwaramutse kugirango tugaragaze Humerus yose.

• Ariko, ubu buryo ntibusabwa kuvunika kure-artra.

• Kuvunika kwa matal nyuma yubusanzwe bishyirwa ahagaragara na Triceps.

• Kuri kure kandi hagati ya gatatu, uburyo bwihuse bwahinduwe bwasobanuwe na Gerezile et Al30 burashobora kwerekana 76-94% bya Humerus (bitewe no kurekura imitsi ya sidail).

  
  

Ubuhanga bwo kubaga:

• Umurwayi ashyirwa kumugezi wa intebe kugirango inzira y'ibigega. Gukoresha ukuboko gufashwa kubungabunga ubusobeji. Kuburyo bwibanze, umwanya wuruhande numwanya ukunda.

• Isahani nziza yo gushushanya igizwe nisahani ya mm 4.5 cyangwa ihwanye kandi igomba gutwikira byibuze cortices 6 hejuru no munsi yurubuga, ariko munsi ya 8 cortices irasa.

• Mugihe bikenewe, guhuza ikibanza gito kandi igice kinini cya fragrement, nkisahani ya tubular ya tubular cyangwa ikinyugunyugu), hanyuma yuzuzwa hamwe nikimenyetso cya mm 45 cyo gukosora kuvuka.

• Kuburangaza kwa gatatu, inkingi yinyuma yinyuma ya plasic playe (3.5 / 4.5) birasabwa kwemerera epephyseal ikosora.

  
  

Gukoresha imigozi yo gufunga muri HSF ikomeza kurenganurwa

• Mugihe ugereranya amasahani yo gufunga hamwe namasahani yo gufunga kubwububiko bwimiterere yuburyo bwiza, nta nyungu zibinyabuzima muri torsion, kunyerera cyangwa gukomera cyangwa gukomera kwimiterere byombi.

• Ku rundi ruhande, iyo uhuye n'ubwiza bwamagufwa, gukoresha ibyapa byo gufunga birashobora kuba byiza.

• Mu bushakashatsi bwibinyabuzima bwakozwe na Gardner et al. By'umwihariko kuri Osteoporotic Flaque Models, inyubako 34 zidafunze ntabwo zari zihagaze neza kuruta gufunga cyangwa imbogamizi.

Ibifunga bike bitera ibifunga ni amahitamo yo kubaga asa nkaho atanga urugero rwinshi rwo gutsinda no kugorana. Ariko, muburyo bwo gusubira inyuma burimo abarwayi 76, Van de rukuta et al. yerekanye ko gutuza rwose byo kuvunika imisoro yonyine byonyine byonyine bigabanya igihe cyo gukira ku buryo buhebuje.

Imiyoborere y'iposita:

• Mubisanzwe, gukosora bihamye biboneka hamwe no gukoresha isahani. Rero, umurwayi yemerewe gukora ibikorwa bifatika kandi bifasha ibikorwa adafite aho bigarukira kurwego rwibitugu cyangwa inkokora.

• Umugozi urashobora gukoreshwa muminsi myinshi yo gucunga ububabare.

• Guhagarika ibiro bigomba kubungabungwa kurwego ntarengwa rwa kilo kugeza gukiza ibintu bikomeye bigerwaho (mubisanzwe amezi atatu).

• Abarwayi bato bemerewe gutanga uburemere aho byemewe (urugero, bisaba imigano kugenda), ariko mubarwayi bakuze ibi bigomba kuganirwaho kubibazo-byabaye.

Ibisubizo byatangajwe

• Ibiciro byo gukiza nyuma yo kwipimisha kuva 87% kugeza 96%, hamwe nigihe cyo gukira cyibyumweru 12.

• Ibiciro by'ibibazo biva kuri 5% kugeza kuri 25%, hamwe nibibazo bikomeye bidafite ishingiro nko kwandura, osteoneCrosis, na malunion.

• Ubuvuzi bwakomokaga muri RNP ni akaga kubera uruti rwumusobe munini. Streufert ET AL50 yasuzumye imanza 261 za HSF yavuwe na ORF kandi iboneka ko RNP ikomoka mu buvuzi bwabaye muri 7.1% yegeranye na Tricelate yegereje, kandi 17.9% ya Triceps yabitswe yegereje.

• Kubwibyo, ni ngombwa kumenya no kurinda imitsi ya radial muburyo bwose bwo gufungura.

  
  

二. Intramedillary Umusumari

Ibimenyetso:

• Mubyukuri, IMN irashobora gutanga inyungu ziomenical kandi zibaruye zisumba

• Kuva aho biliomeri, umwanya wa Intramedullary uhagaze hamwe na axis ya mashini ya stem yubukorikori.

• Kubera iyo mpamvu, imbaraga zikorwa n'imbaraga zo hasi kandi zemerera kugabana neza. Ibimenyetso byo kubaga byo kuba intera intera ni kimwe no kwiyegurira.

• Ariko, nkuko byavuzwe haruguru, kuvunika ibintu byiza bikwiranye no gutondeka kuruta imisumari.

• Kuvunika ibiranga hamwe nibishushanyo byabonetse ko biruta IMN nibiranga pathologique no kwegeranye, ibikomere bya kabiri, no kuvunika kwa Osteorotic.

• Kurohama byoroshye hagati hagati nabyo nibimenyetso byiza kuri IMN.

• Byongeye kandi, umusumari arashobora kwinjizwamo binyuze muri streque ntoya, igabanya tissue yoroshye yambukiranya ugereranije na tekinike yo gutanga.

• Ibi ni ukuri cyane kubiranga hagati ya gatatu ya humerus.

Tekinike yo kubaga:

• Umwanya wigihugu wihangana kuri ubu buryo uri ku ntebe yinyanja. Gukoresha ukuboko kwamaboko ni ingirakamaro cyane mugukomeza guhuza uruziga kimwe no gukora imigozi yo gufunga Freehand.

• Ingingo yo kwinjira iterwa nigishushanyo cyimisumari, ariko mubisanzwe iherereye mu buryo buhebuje umusoro mwinshi, bivuze ko umutwe wubuhinzi, bivuze ko rotator cuft imitsi igomba kwinjira.

• Kuri ubu buryo, birasabwa gukora uburyo bwo gutandukanya Dltoid kugirango ugaragaze umutegarugori.

• Mubyukuri, mugihe winjiye mumutwe wubuhinzi hagati yumusanzu wa suppespinatus, umuntu azisanga imbere yumutwe mu ndege ya Sagittal.

• Ni ngombwa gukoresha Keratomile munsi ya flushscopi kugirango urebe ko aho byinjira biri mumwanya wemewe haba muri sagittal na coronal indege ya sagittal na coronal.

• Nyuma yibi, insinga igomba kuba iteye imbere mbere yo gufungura Tendespinatus Tenden Longton imaze igihe iyerekwa ritaziguye.

• Intambwe ikurikira igizwe no gufungura umuyoboro hejuru ya kirschner inshinge, kureba ko kuvunika bihujwe no gukurura no / cyangwa gukoresha nabi, hanyuma bigatera imbere mu mwobo.

• Gusubiramo byagaragaye ko ari byiza mubarwayi bato kandi ntabwo buri gihe bikenewe kubarwayi bakuru.

• Kuri Delt Bolt, gufunga AP ni umutekano kandi bisaba uburyo buto bwa cm 2-3 kugirango ugabanye ibyago byo gukomeretsa imitsi.

• Hanyuma, imn ihwanye na retrograde IMN kubera ingorane zihariye za nyuma ziterwa no kuvugurura amakuru ya supracondy, gutakaza imbaraga zo mu maboko, kandi igihembo cya heterotopic.

  
  

Kwitaho bidasanzwe bigomba kwishyurwa muburebure bwimisumari yatowe, nkimisumari ndende cyane irashobora kuganisha kumakosa abiri ya tekiniki:

• Kurangaza kurubuga rwavuza mugihe cyingaruka

• na / cyangwa imisumari isohoka mumwanya wa stacmial

  
  

Kuri Helix ya gatatu ya Helix cyangwa Kuvuka Birebire, abanditsi basaba ubunini bwa miniature kugirango bagabanye kuvuka bakurikirwa no gukosorwa hamwe ninkweto. Mubyukuri, kuri iyi mvururu subtype, imitsi ya deltoid ikunda gushimuta agace kwomerwa mugihe cya pectoral ikurura igice cyo kuvunika kure cyane muburyo butandukanye, bwo gukiza.

Ubuyobozi bw'iposita

• Abarwayi barashishikarizwa gukora ibikorwa bifatika kandi bifasha kwimuka ku rutugu n'inkokora nk'uwihanganirwa.

• Imirasire irashobora gukoreshwa muminsi mike yo kugenzura ububabare.

• Gusohoza ibiro byo gutakaza uburemere bibungabungwa ku kilo ntarengwa kugeza igihe cyo gukiza bigaragarira (mubisanzwe amezi atatu).

• Mubihe byinshi, kwitwarika ibiro byemewe

  
  

Byagaragaye:

• Ubuvanganzo bujyanye no gufunga ibikoresho byimisumari kugirango imicungire ya HSF idahuye. Ku ruhande rumwe, umubare watangajwe n'amagufwa adarion urahinduka cyane (hagati ya 0% na 14%), hamwe nibisekuru byisumbuye mugihe gishaje cyimisumari. Ku rundi ruhande, abantu b'igitugu (harimo ububabare, kudahinduka, kubura icyerekezo cyangwa imbaraga) (kuva kuri 6% kugeza ku 100%.

• Igice cyikibazo gishobora gusobanurwa nihungabana ryagaburirwa kubera imbaraga zidakira ziterwa nimisumari isohoka, inyama zinkovu na / cyangwa rotator cuff muri iki gice gikomeye cyo kwibasirwa.

• Abanditsi benshi basobanuye uburyo butandukanye bwo kwirinda iyi karere k'uburyo h'ibiryo kandi bagasana tendon muburyo bwubwenge, bwerekanye ibipimo biri hasi byigitugu.

  
  

Gufata conservateur ya HSF yatanze umusaruro mwiza hamwe nibiciro byinshi byo gukiza byibuze 80% byabarwayi. Kubera iyo mpamvu, ikomeje kuba ihitamo rya HSF nyinshi. Niba guhuza bitemewe, kubaga bigomba gusuzumwa. Ibi ni ukuri cyane kubarwayi barengeje imyaka 55 berekana hamwe nubutaka bwa gatatu bwa oblima (igipimo cyo gukiza. Ku bijyanye no kwivuza, ibitabo ntabwo byerekana itandukaniro rikomeye hagati ya plate na IMn mubipimo byo gukiza cyangwa ingorane za radiyo, ariko ingorane zitungu (kudashimangira kurengana hamwe na IMN. Kubwibyo, cuff igomba gucungwa neza haba murwego rwo kwinjira no mugihe cyo gufunga.

Hafi Czmeditech

Gutwarwa no kwizera ko umuntu wese kuri iyi si akwiye serivisi nziza yubuzima. Czmeditech  ikora cyane kugirango ifashe abandi kubaho badatinya. Twishimiye iyo abarwayi bungukiwe cyane kandi bafite ubuzima bwiza kubera ibicuruzwa byacu hamwe nibirenge byacu byagutse bigera ku bihugu birenga 70, aho abarwayi, abaganga n'abafatanyabikorwa n'abafatanyabikorwa, bashingiye  Czmeditech ku gutera imbere. Ibikorwa byose byamagufwa byakozwe natwe byujuje ubuziranenge bwo hejuru.

Twatangiye urugendo rudasanzwe hamwe na orthopedique hashize imyaka 13. Mubikorwa, umurongo utanga umusaruro watandukanye kugirango ugabanye umugongo, ihahamuka, cranial-maxillofacial, prostas, ibikoresho by'ingufu, ibicuruzwa byo hanze, arthroscopy  na kwita ku matungo , hamwe na ibikoresho  bikoreshwa muburyo bwo kubaga bifitanye isano.

Ibikoresho byacu bibisi byose biva hejuru yo gutanga ubuziranenge mu gihugu no mumahanga. Ku bijyanye n'ubuziranenge, ntabwo twigera twitagura ibiciro mu nshingano zacu kugirango tugume intambwe imbere, bityo dushyiraho laboratoire yacu yo kwipimisha kugirango tumenye neza ubuziranenge. Imashini zacu zose z'umusaruro zituruka muri Amerika, Ubudage, Ubuyapani n'ibirango byo hejuru mu gihugu kugirango ibicuruzwa byose dukorerwe.

Igihe kinini nimbaraga zishora mubikorwa byubushakashatsi no gushiraho ibicuruzwa byanyuma. Dufite itsinda ryubushakashatsi bwabishaka, ikipe yumusaruro hamwe nitsinda rya QC kugirango tumenye neza kandi inkunga yacu yo kugurisha kugirango ikemure ibibazo byose no gutanga serivisi nziza nyuma yo kugurisha.

Dushishikajwe no kwizera kwacu, duhora dusunika imipaka yo kumenya kwacu - uburyo bwo gutanga ibicuruzwa byo mu rwego rwo hejuru, guhanga udushya ku isi hose kandi bugatanga imbaraga mu buzima bw'abantu.