Tibial Intramedullary Nail: Igisubizo cyizewe kumeneka ya Tibial

Kuvunika kwa Tibial, bigira ingaruka kuri shinbone, birashobora guhindura cyane ibikorwa byimikorere nibikorwa bya buri munsi. Kuvura ibyo byavunitse bisaba gutekereza cyane kubintu bitandukanye, harimo ubwoko bwavunitse, aho biherereye, nibiranga abarwayi. Uburyo bumwe bwo kubaga bwagaragaye neza mumyaka yashize ni ugukoresha umusumari wa tibial intramedullary. Iyi ngingo iragaragaza inyungu, tekinike yo kubaga, ingaruka, no gukira bijyanye nubu buryo bwo kuvura.

Intangiriro

Ivunika rya tibia rirashobora gucika intege, bigatera ububabare, guhungabana, ningorane zo kugenda. Uburyo bwo kuvura gakondo, nko gutara cyangwa gukosorwa hanze, bufite aho bugarukira, bigatuma habaho ubushakashatsi bwibisubizo byateye imbere nka tibial intramedullary nail.

Umusumari wa Tibial Intramedullary ni iki?

Umusumari wa tibial intramedullary nigikoresho cyubuvuzi cyagenewe gutuza no guteza imbere gukira kuvunika mumitsi ya tibial. Igizwe n'inkoni y'icyuma yinjijwe hagati mu magufwa, itanga ituze hamwe n'inkunga mugihe cyo gukira. Ubusanzwe imisumari ikozwe muri titanium cyangwa ibyuma bidafite ingese kandi biza mubunini butandukanye kugirango habeho anatomiya zitandukanye z'abarwayi.

Ibimenyetso bya Tibial Intramedullary Nail

Imisumari ya Tibial intramedullary ikoreshwa muburyo bwo kuvura imitsi ya tibial shaft. Zifite akamaro cyane cyane kuvunika bisaba gukosorwa bihamye, nkibimuwe cyangwa byavunitse. Ubu buhanga kandi burakwiriye kubibazo bifite ubuziranenge bwamagufwa cyangwa mugihe byihutirwa kwikorera ibiro.

Ubuhanga bwo kubaga Tibial Intramedullary Nail

Gutegura mbere yo gutangira

Gutegura neza mbere yo gutangira ni ngombwa kugirango umuntu abone imisumari ya tibial intramedullary. Ibi bikubiyemo gusuzuma byimazeyo uburyo bwo kuvunika, ubuzima rusange bwumurwayi, nibikomere byose bifitanye isano. Uburyo bwo gufata amashusho nka X-imirasire, CT scan, cyangwa MRI birashobora gukoreshwa mugusuzuma ibiranga kuvunika no kuyobora ibyemezo byo kubaga.

Umwanya w'abarwayi

Mugihe cyo kubaga, umurwayi ubusanzwe ashyirwa supine kumeza yo kubaga. Ukuguru kwanduye kurateguwe kandi kurigata muburyo budasanzwe. Guhagarara neza ni ngombwa kugirango wemererwe kugera kurubuga rwacitse kandi byoroshye kwinjiza imisumari.

Gukata no Kubona

Gucibwa bikozwe kurubuga rwo kubaga kugirango igufwa ryacitse. Uburebure n'ahantu ho gutemberera bivana n'ubwoko bwavunitse hamwe na tibia. Kwitonda witonze byoroshye byoroshye ni ngombwa kugabanya ihungabana no kugabanya ibyago byo kwandura.

Kwinjiza imisumari

Nyuma yo gukora aho yinjira muri tibia yegeranye, umuganga ubaga yinjije yitonze umusumari wa tibial intramedullary mu muyoboro wa medullary. Ubuyobozi bwa Fluoroscopique bukoreshwa kugirango habeho gushyira neza no guhuza. Umusumari utera imbere unyuze mu magufa, ugahindura ibice byose byimuwe kandi ukagarura guhuza neza.

Gufunga imigozi

Iyo umusumari umaze guhagarara neza, hashyizwemo imigozi yo gufunga kugirango umusumari uri mu magufa. Iyi miyoboro itanga ituze ryinyongera kandi irinda kuzenguruka cyangwa kugendagenda kumutwe. Umubare nogushyira imigozi biterwa nuburyo bwo kuvunika no kubaga kwa muganga.

Gufunga ibikomere

Nyuma yo kwemeza guhuza no gukosora neza, gutema bifunze ukoresheje suture cyangwa staples. Gufunga ibikomere bikorwa neza kugirango biteze imbere gukira no kugabanya ibyago byo kwandura. Imyambarire idasanzwe ikoreshwa, kandi urubuga rwo kubaga rurinzwe.

Ibyiza bya Tibial Intramedullary Nail

Gukoresha imisumari ya tibial intramedullary itanga ibyiza byinshi muburyo bwo kuvura gakondo. Zimwe mu nyungu zingenzi zirimo:

1. Gukosora neza: Umusumari utanga gukosorwa neza, kwemerera guhuza neza no guhuza ibice byavunitse.

2. Gukangura hakiri kare: Umusumari utanga ubukangurambaga hakiri kare, bigafasha abarwayi gutangira imyitozo yo kwikorera ibiro no gusubiza mu buzima busanzwe vuba ugereranije n'ubundi buryo bwo kuvura.

3. Kubungabunga amaraso: Ukoresheje umuyoboro wimbere, tekinike ya tibial intramedullary tekinike igabanya ihungabana ryamaraso yamagufwa, aringirakamaro mugukiza kuvunika.

4. Kunoza imikorere yibikorwa: Hamwe no gukosorwa neza no gukangurwa hakiri kare, abarwayi barimo kubagwa imisumari ya tibial intramedullary bakunze kubona umusaruro ushimishije kandi bagaruka vuba mubikorwa bya buri munsi.

5. Kugabanya ibyago byo guhura nibibazo byoroshye: Ugereranije nuburyo bwo gutunganya ibintu hanze, tekinike yimisumari yimbere ikubiyemo uduce duto kandi igabanya ihungabana ryoroshye, bikaviramo ibyago bike byo guhura nibibazo byoroshye byanduye.

   
   

Ingorane n'ingaruka

Mugihe kubaga imisumari ya tibial intramedullary muri rusange bifite umutekano kandi bifite akamaro, harashobora kubaho ingorane ningaruka zijyanye nuburyo. Ni ngombwa kumenya ibyo bishoboka mbere yo kwivuza. Zimwe mu ngorane zirimo:

Indwara

Kimwe nuburyo ubwo aribwo bwose bwo kubaga, hari ibyago byo kwandura. Nyamara, hamwe nubuhanga bukwiye bwa sterile, antibiyotike ya prophylaxis, hamwe nubuvuzi nyuma yo kubagwa, ibyago byo kwandura birashobora kugabanuka.

Malalignment cyangwa Nonunion

Rimwe na rimwe, ibice byavunitse ntibishobora gukira muburyo bwifuzwa cyangwa kunanirwa gukira burundu. Ibintu nko kugabanuka bidahagije, kutagira amagufwa mabi, cyangwa kwikorera ibiro birenze urugero bishobora kugira uruhare mubi cyangwa kudahuza. Gukurikiranira hafi kandi, nibiba ngombwa, ingamba zinyongera nko kubaga ubugororangingo zirashobora gukenerwa.

Ingorane zijyanye no Ingorane

Mugihe bidasanzwe, ingorane ziterwa no guterwa zirashobora kubaho, nko kurekura, kumeneka, cyangwa kurakara. Ibi bibazo birashobora gusaba ubundi buryo bwo kubaga kugirango bikemuke.

Gukomeretsa imitsi cyangwa amaraso

Mugihe cyo kubaga, hari ibyago bike byo gukomeretsa imitsi cyangwa imiyoboro y'amaraso. Abaganga babaga bafata ingamba zo kugabanya ibi byago, ariko abarwayi bagomba kumenya ko bishoboka kandi bagahita batangaza ibimenyetso byose bikomeje cyangwa bikabije.

Gusubiza mu buzima busanzwe no gukira

Nyuma yo kubagwa imisumari ya tibial intramedullary, gahunda yuzuye yo gusubiza mu buzima busanzwe ni ngombwa kugirango umuntu akire neza. Gahunda yihariye yo gusubiza mu buzima busanzwe irashobora gutandukana bitewe n'uburemere bwavunitse, ibiranga abarwayi, hamwe n'ubuyobozi bw'abaganga. Imyitozo yo hakiri kare, kwikorera buhoro buhoro, hamwe nubuvuzi bwumubiri bigira uruhare runini mugusubiza imikorere, kunoza imbaraga, no guteza imbere amagufwa.

Inyigo hamwe ninkuru zitsinzi

Abarwayi benshi babonye umusaruro ushimishije hamwe no kubaga imisumari ya tibial intramedullary. Ubushakashatsi bumwe bwakorewe ku muntu w'imyaka 35 ufite imvune ya tibial shaft. Nyuma yo kubagwa umusumari wa tibial intramedullary, umurwayi yageze ku bumwe bukomeye bwo kuvunika, agarura ubushobozi bwuzuye bwo gutwara ibiro, hanyuma asubira mubikorwa byabo byabanje mumezi atandatu.

Gereranya nubundi buryo bwo kuvura

Mugihe usuzumye uburyo bwo kuvura kuvunika tibial, ni ngombwa kugereranya inyungu nimbibi za buri nzira. Mugihe kubaga imisumari ya tibial intramedullary itanga ibyiza byinshi, nko gukosorwa neza, gukanguka hakiri kare, no kugabanya ingorane zoroshye, ntibishobora kuba byiza muburyo bwose bwo kuvunika cyangwa umurwayi. Ubundi buryo, nkibisahani cyangwa gukosora hanze, birashobora guhitamo mubihe bimwe. Kugisha inama inzobere mu magufa bizafasha kumenya uburyo bukwiye bwo kuvura bushingiye ku bihe byihariye.

Umwanzuro

Mu gusoza, kubaga imisumari ya tibial intramedullary ni uburyo bwizewe kandi bwiza bwo kuvura kuvunika tibial. Tekinike itanga gukosorwa neza, itanga ubukangurambaga hakiri kare, kandi itanga ibyiza byinshi muburyo gakondo. Mugihe hari ingaruka zishobora kuvuka hamwe nibibazo bifitanye isano nuburyo bukoreshwa, gutegura neza mbere yo gutangira, tekinike yo kubaga neza, hamwe nubuvuzi bukwiye nyuma yo kubagwa birashobora kugabanya izo mpungenge.