Imisumari 10 ya mbere yintangiriro yo mu misumari (DTN) muri Amerika ya Ruguru muri Mutarama 2025

Gufunga amasahani

Ibyangiritse byoroshye byangiza, igipimo kinini cyanduye, gukira igihe kirekire

Umuyoboro wa Antegrade

Ibyago byo gukomeretsa ivi, gukosora bidahagije, bikunze gukwirakwiza

Igisubizo cya DTN

Uburyo buteye ubwoba bwo gutera hamwe na retrograde insceon igishushanyo

1Kuvunika kwa mubiri bya kure birasanzwe, kandi imiti gakondo ifite imbogamizi

Kuvunika imyanda ni ubwoko busanzwe bwo kuvunika ingingo yo hasi. Ubuvuzi gakondo nko gufunga hamwe na antegrade intterlary imisumari buri kimwe gikomoka. Isahani yo gufunga irashobora gutera indwara zo nyuma cyangwa tissue yoroshye necrosis, kuruhuka cyane; Nubwo imisumari ya antegrade iteye ubwoba, irashobora kwangiza ivi, itera ububabare, kandi itwara ibyago byo gukosorwa cyangwa gukinisha, kubangamira gukira.

2Igisubizo gishya: Umusumari wa kure (DTN)

Umuyoboro wo kuvura udusimba-disal tibial (DTN) -ububiko bushya bwo gucunga indabyo za kure na recrograde yihariye ya retrograde.

Igishushanyo 1: DTN RETROGRADE ISHYIRA

1Umwanya wo Kwitegura no Kwitegura Kugabanuka

Umurwayi ashyirwa mumwanya wo gutanga suptine. Kuvumburwa bigomba no kugabana intoki; Nibiba ngombwa, koresha imbaraga zo kugabanya mbere yo kwinjiza DTN. Niba hari intera iherekeza fibuland ya fibuland, guhuza fibular bikwiye birashobora gufasha kugabanuka.

2Uburyo bwo kwinjizamo DTN

Igice cya cm 2-3 kirekire gikorwa ku isonga rya Malleolus melleolus kugirango igaragaze ligamen eltoid. Igice cya PIN cyinjijwe kuri cyangwa meta gato kugeza ku isonga rya Malleolus, Mm 4-5 kuva hejuru yuburinganire.

Igishushanyo cya 2a: kuyobora pin kwinjiza

Igishushanyo cya 2b: kureba kuruhande

Igishushanyo cya 2c: Gusubiramo inzira

Porotokole

• Igikorwa cya Ankle gitangira ako kanya nyuma yo kubagwa

• Irinde kwitwaza ibiro ku byumweru 4-6

• Buhoro buhoro kwimura ibiro byuzuye mubyumweru 8-12

• Gukurikirana amaradiyo mugihe cyicyiciro cyo gukira

1Ibisubizo bya Clinical byabarwayi 10

Ubushakashatsi bwakurikiye abarwayi 10. Mugihe cyamezi 3 nyuma ya OP, hakira imanza 7 zari zakize; Abarwayi bose bageze gukiza mumezi 6. Urubanza rumwe buri munyamaziburo na relurvatum cyabaye. Nta gutakaza kugabanuka, kwandura, ingorane zijyanye n'imikorere, cyangwa ibikomere bya Iatrogenic byagaragaye.

1Biomena

Gusubiramo imisumari isumba byose kandi izunguruka ugereranije na plaque yo muri metale hamwe nimisumari. Greenfield et al. Yakozwe ikizamini cyibinyabuzima yerekana ko ukoresheje imigozi ibiri ya kure muri DTN yageze kuri 60-70% yo gukomera no gukomera kwa 90% ugereranije na screw eshatu.

2Ibyiza bya DTN

Ugereranije no gufunga amasahani, imisumari yo mu ntambara ituma ibyangiritse byoroheje, bikwiranye nabarwayi bageze mu zabukuru hamwe nabafite ibikomere byoroshye biva mu mbaraga zingufu nyinshi. Inzira ntisaba guhindagurika, kugabanya ibyago byo gutakaza kugabanuka no kuryozwa abarwayi bafite ivi rito.

3Kugereranya kwa Clinical

Ibiciro bya Noninion na Malalignament ku misumari ya antegrade ni 0-25% na 8.3-50%; yo gufunga amasahani, 0-17% na 0-17%. Muri ubu bushakashatsi, imanza zose zagezeho, kandi 20% gusa bari bafite ubumuga> 5 °, ugereranije nuburyo gakondo.

Umurongo wibicuruzwa bya DTN

Ikirangantego cya Tibial Intramedillary Umusumari (DTN)

Icyitegererezo: t1100-59

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Igikoresho cya Tal

Icyitegererezo: 1200-27

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Agasanduku k'ibikoresho bya kure

Icyitegererezo: 1000-0139

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