Femoral Intramedullary Nail: A Promising Solution for Femoral Fractures

Kutyoka kwechikadzi, kunokanganisa pfupa rehudyu, kunogona kukonzera kurwadziwa kukuru, kusafamba, uye kusakwanisa kushanda. Sarudzo dzekurapa dzinoshanda dzakakosha kuti uwane mibairo yakabudirira muvarwere vane mafractures aya. Imwe sarudzo yakadaro yakawana mukurumbira mumakore achangopfuura ndeye kushandiswa kwechikadzi intramedullary nail. Ichi chinyorwa chinoongorora mabhenefiti, maitiro ekuvhiya, njodzi, uye kupora zvine chekuita neiyi nzira yekurapa yehunyanzvi.

Nhanganyaya

Kuputsika kwechikadzi kunogona kukanganisa, kunoda kurapwa nokukurumidza uye kwakarurama. Nzira dzechinyakare dzekurapa, dzakadai sekukanda kana kugadzirisa kwekunze, dzinogona kunge dziine miganhu mukuwana mhedzisiro yakanaka. Iyo femoral intramedullary nail tekinoroji yakabuda seyakavimbika uye inoshanda mhinduro yekugadzirisa kutsemuka kwechikadzi.

Chii chinonzi Femoral Intramedullary Nail?

A femoral intramedullary chipikiri chigadzirwa chekurapa chakagadzirirwa kudzikamisa uye kukurudzira kuporeswa mukutyoka kwechikadzi. Iyo ine simbi yesimbi inoiswa mukati megomba pakati pemukadzi, ichipa kugadzikana uye kutsigirwa panguva yekupora. Iyo mbambo inowanzo gadzirwa netitanium kana simbi isina tsvina uye inouya muhukuru hwakasiyana kuti igare akasiyana evarwere anatomies.

Zviratidzo zveFemoral Intramedullary Nail

Femoral intramedullary misumari inowanzoshandiswa pakurapa femoral shaft fractures. Izvo zvinonyanya kushanda kune zvimedu zvinoda kugadziriswa kwakagadzikana, zvakadai sekudzingwa kana comminuted fractures. Iyi nzira yakakodzerawo kune zviitiko apo kukurumidza kurema-kutakura kunodiwa kana kana pane hurombo husina kunaka hwemapfupa.

Kuvhiya Technique yeFemoral Intramedullary Nail

Preoperative Planning

Kunyatsoronga preoperative yakakosha pakubudirira kuvhiya kwechikadzi intramedullary chipikiri. Izvi zvinosanganisira kuongororwa kwakadzama kwepateni yekutyoka, hutano hwese hwemurwere, uye chero kukuvara kwakabatana. Maitiro ekufungidzira, akadai seX-rays, CT scans, kana MRI, anoshandiswa kuongorora maitiro ekutyoka uye kutungamira sarudzo yekuvhiya.

Patient Positioning

Munguva yekuvhiyiwa, murwere anowanzoiswa supine patafura yekushandisa. Gumbo rakabatwa rakagadzirirwa uye rakaputirwa nenzira isina utachiona. Kumisikidzwa kwakakodzera kwakakosha kuti ubvumire kuwana kwakaringana nzvimbo yekutyoka uye kufambisa zvipikiri.

Incision uye Access

Incision inoitwa pamusoro penzvimbo yekuvhiya kuti uwane bhonzo rakatyoka. Kureba uye nzvimbo yekucheka kunoenderana nerudzi rwekutsemuka uye nzvimbo yaro pamwe nefemur. Kungwarira kubata matishu akapfava kwakakosha kuderedza kukuvadzwa uye kuderedza njodzi yekutapukirwa.

Kupinza Kwezvipikiri

Mushure mekugadzira nzvimbo yekupinda mukati meiyo proximal femur, chiremba anovhiya anonyatsoisa iyo femoral intramedullary chipikiri mu medullary canal. Fluoroscopic nhungamiro inoshandiswa kuve nechokwadi chekuiswa uye kurongeka. Iyo mbambo inokwidziridzwa kuburikidza nebhonzo, ichigadzirisa chero zvimedu zvakatamiswa uye kudzoreredza kwakaringana anatomical kurongeka.

Locking Screws Placement

Kana chipikiri chaiswa zvakanaka, zvikwiriso zvekukiya zvinopinzwa kuchengetedza chipikiri mukati mebhonzo. Aya screws anopa kumwe kugadzikana uye kudzivirira kutenderera kana axial mafambiro ezvimedu zvekutsemuka. Nhamba uye kuiswa kwe screws zvinoenderana nepeteni yekutyoka uye zvaanoda chiremba wekuvhiya.

Kuvharwa Kwemaronda

Mushure mekuona kurongeka kwakakodzera uye kugadzirisa, iyo incision yakavharwa uchishandisa sutures kana staples. Kuvharwa kwemaronda kunoitwa zvine hungwaru kukurudzira kuporeswa uye kuderedza njodzi yehutachiona. Chipfeko chisina kuchena chinoiswa, uye nzvimbo yekuvhiya inodzivirirwa.

Zvakanakira Femoral Intramedullary Nail

Kushandiswa kwechikadzi intramedullary chipikiri kunopa zvakati wandei zvakanakira pane echinyakare nzira dzekurapa. Mamwe emabhenefiti akakosha anosanganisira:

1. Kugadziriswa kwakagadzikana: Kushandiswa kwechikadzi intramedullary nail kunopa kugadziriswa kwakasimba, kubvumira kurongeka kwakakodzera uye kubatana kwezvimedu zvekuputsika. Uku kugadzikana kunokurudzira kuporeswa kuri nani uye kunoderedza njodzi yekusagadzikana.

2. Kuunganidza kwekutanga: Neye intramedullary chipikiri nzira, kuunganidza kwekutanga kunogoneka. Izvi zvinoreva kuti varwere vanogona kutanga kutakura uremu uye maitiro ekugadzirisa maitiro nokukurumidza, zvichiita kuti kukurumidza kupora uye kuvandudza kushanda kwemigumisiro.

3. Kuchengetedzwa kweropa: Nekushandisa iyo intramedullary canal, iyo femoral intramedullary nail nzira inoderedza kukanganisa kuropa kwebhonzo. Kuchengetedza kuyerera kweropa kwakakwana kwakakosha pakurapa kwemapfupa uye mubatanidzwa wekutyoka.

4. Kuvandudzwa kwezvizoro mhedzisiro: Kuenzaniswa nekunze kwekugadzirisa nzira, iyo femoral intramedullary chipikiri kuvhiya kunosanganisira madiki madiki. Izvi zvinoguma nezvibereko zviri nani zvekuzora nekuderedzwa kwevanga uye kugutsikana kwevarwere.

5. Yakaderedzwa njodzi yezvakapfava matishu matambudziko: Maitiro ekushandisa femoral intramedullary chipikiri anosanganisira kushoma kwenyama yakapfava kukanganisa. Izvi zvinoderedza njodzi yematambudziko akadai sematambudziko ekupora maronda, hutachiona hwetishu dzakapfava, uye kunonoka kupora.

   
   

Matambudziko uye Njodzi

Nepo kuvhiyiwa kwechikadzi intramedullary chipikiri kuchiwanzoonekwa kwakachengeteka uye kunoshanda, pane zvinogona kunetsa uye njodzi dzine chekuita nemaitirwo acho. Zvakakosha kuti varwere vazive zvingangoitika izvi vasati varapwa. Mamwe ematambudziko anosanganisira:

• Utachiona: Sezvinongoita chero nzira yekuvhiya, pane njodzi yekutapukirwa. Nekudaro, nzira dzakakodzera dzekudzivirira, antibiotic prophylaxis, uye postoperative care zvinogona kuderedza zvakanyanya njodzi iyi.

• Kusarurama kana kusabatana: Mune zvimwe zviitiko, zvimedu zvakaputsika hazvigone kuporesa mukurongeka kwaunoda kana kutadza kupora zvachose. Zvinhu zvakadai sokusakwana kuderedza, hurombo husina kunaka hwemapfupa, kana kuwandisa uremu hunogona kuita kuti pave nekusawirirana kana kusabatana. Kunyatsotarisa uye mamwe mapindiro, akadai sekuvhiyiwa kwekudzokorora, zvingave zvakakosha kugadzirisa nyaya idzi.

• Matambudziko ane chekuita nekudyara: Kunyangwe zvisingaite, matambudziko ane chekuita nekudyara anogona kuitika. Izvi zvinogona kusanganisira kusunungura kudyara, kuputsika, kana kushatirwa. Kana zvinetso zvakadaro zvikamuka, kumwe kupindira kwekuvhiya kunogona kudiwa.

• Nerve kana kukuvara kwemudziyo weropa: Panguva yekuvhiya, pane njodzi diki yekukuvara kwetsinga kana yeropa. Vana chiremba vanovhiya vanotora matanho ekudzikisa njodzi iyi, asi varwere vanofanirwa kuziva mukana uye nekukasira kutaura chero zviratidzo zvinoramba zvichiitika kana kuwedzera.

  
  

Kudzorera uye Kudzorera

Kutevera kuvhiyiwa kwechikadzi intramedullary chipikiri, chirongwa chakazara chekudzorera chakakosha pakugadzirisa kupora. Iyo chaiyo chirongwa chekudzorera chinogona kusiyana zvichienderana nekutyoka kuomarara, hunhu hwemurwere, uye kutungamira kwechiremba. Physical therapy, kusanganisira huwandu hwemaekisesaizi ekufamba, kusimbisa maekisesaizi, uye gait kudzidziswa, inoita basa rakakosha mukudzoreredza basa uye kuwana kupora kuzere.

Nyaya Dzidzo uye Nhau Dzakabudirira

Varwere vazhinji vakawana mhedzisiro dzakabudirira nekuvhiya kwechikadzi intramedullary chipikiri. Imwe nyaya yekuongorora yaisanganisira munhu ane makore makumi mana ekuzvarwa ane mukadzi akatyoka shaft. Mushure mekuvhiyiwa nefemoral intramedullary chipikiri, murwere akawana mubatanidzwa wakasimba wekutyoka, akawanazve huremu hwakazara, uye akadzokera kumabasa enguva dzose mukati memwedzi mitanhatu.

Kuenzanisa Nedzimwe Kurapa Sarudzo

Paunenge uchifunga nezve nzira dzekurapa dzekutyoka kwevakadzi, zvakakosha kuenzanisa mabhenefiti uye miganhu yenzira imwe neimwe. Nepo iyo femoral intramedullary chipikiri nzira inopa zvakati wandei, senge yakagadzika kugadzirisa, kukurumidza kuunganidza, uye yakagadziridzwa zvizorwa mhedzisiro, inogona kunge isiri yakakodzera kune yega yekutyoka pateni kana murwere. Dzimwe nzira, dzakadai sekugadzirisa kwekunze kana kuputira, dzinogona kudiwa mune zvimwe zviitiko. Kubvunzana nenyanzvi yemapfupa kuchabatsira kuona nzira yakakodzera yekurapa zvichienderana nemamiriro emunhu.

Mhedziso

Mukupedzisa, iyo femoral intramedullary chipikiri nzira inovimbisa uye inoshanda yekurapa sarudzo yekutyoka kwevakadzi. Inopa gadziriso yakagadzikana, inogonesa kuunganidza kwekutanga, uye inopa akati wandei mabhenefiti pamusoro pemaitiro echinyakare. Kunyange zvazvo pane njodzi dzingangovapo uye zvinetso zvine chokuita nokuvhiyiwa, kunyatsoronga kusati kwaitwa, nzira yokuvhiya chaiyo, uye kutarisirwa kwakakodzera pashure pokuvhiyiwa kunogona kubatsira kuderedza kunetseka uku. Varwere vanovhiyiwa femoral intramedullary nail operation, inoteverwa nechirongwa chekugadzirisa zvakanaka, vane mikana yekubudirira kubudirira uye kudzorerwa kwebasa.