PFNA Intramedullary Nail: A Comprehensive Guide
Mumunda we orthopedics, kurapwa kwehudyu kuputsika kunoramba kuri basa rakaoma. Nepo nzira dzakasiyana dzekuvhiya dzakagadzirwa nekufamba kwenguva, intramedullary nailing yakabuda sesarudzo yakakurumbira. Iyo Proximal Femoral Nail Antirotation (PFNA) imhando ye intramedullary mbambo yakawana kutariswa kwakanyanya nekuda kwekushanda kwayo mukurapa kuputika kwehudyu. Muchikamu chino, tichapa gwara rakakwana paPFNA intramedullary nail, inovhara zvese kubva pakugadzira kwayo kusvika pakuvhiya, kuchengetwa kwemashure, uye zvinogona kunetsa.
1. Nhanganyaya
Hip fractures ndicho chikonzero chinowanzokonzera kurwara uye kufa pakati pevakwegura. Nehuwandu hwekukwegura, nhamba yehudyu fractures inotarisirwa kuwedzera nekufamba kwenguva. Kurapa kwehudyu kuputsika kwakakosha, sezvo kunogona kukanganisa zvakanyanya hupenyu hwemurwere. Intramedullary nailing yave yakakurumbira nzira yekuvhiya yekurapa hudyu kutyoka nekuda kwekuita kwayo uye kuchengeteka. Pakati pemhando dzakasiyana dze intramedullary misumari, PFNA intramedullary nail yakawana kutariswa kwakanyanya.
2. Chii chinonzi PFNA Intramedullary Nail?
Iyo PFNA intramedullary nail imhando ye intramedullary chipikiri chakagadzirirwa kudzikamisa uye kugadzirisa hudyu kuputsika. Icho chinhu chakanyatsogadziriswa, anterograde, uye cephalomedullary mudziyo unoiswa kuburikidza neproximal femoral canal. Iyo PFNA chipikiri inopa kugadzikana kune iyo yekuputsika saiti nekubvumira mutoro-kugovana pakati pembambo nebhonzo. Iyo inoderedzawo njodzi yekutadza kuisirwa uye kusunungura nekupa anti-kutenderera kugadzikana.
3. PFNA Dhizaini uye Zvimiro
Iyo PFNA intramedullary chipikiri inoumbwa netitanium kana titanium alloy, iyo inopindirana uye inopa simba rakanaka uye kusimba. Iyo mbambo ine helical blade pamagumo ekupedzisira, iyo yakagadzirirwa kubatanidza musoro wechikadzi uye kupa kugadzikana kwekutenderera. Iyo blade inewo anti-rotation mechanism, iyo inodzivirira kutenderera kwembambo mukati memukadzi. Iyo kureba kwembambo ine nzira yekuvhara, iyo inobvumira distal fixation uye axial kugadzikana.
4. Zviratidzo zvePFNA Surgery
PFNA intramedullary nail inonyanya kushandiswa pakurapa kusagadzikana kwe intertrochanteric uye subtrochanteric hip fractures. Inoshandiswawo pakurapa kwevamwe vakadzi vemutsipa kuputsika. Sarudzo yekushandisa PFNA intramedullary mbambo kuvhiyiwa kunoenderana nezvinhu zvakasiyana sezera remurwere, mhando yebhonzo, rudzi rwekutyoka, uye kufarira kwachiremba.
5. Kuvhiya Technique yePFNA Intramedullary Nailing
Nzira yekuvhiya yePFNA intramedullary nailing inosanganisira matanho akati wandei. Iyo nzira inowanzoitwa pasi pe general kana musana anesthesia. Murwere anoiswa patafura yakaputsika, uye fluoroscope inoshandiswa kutungamira kuiswa kwembambo.Nzira yekuvhiya yePFNA intramedullary nailing inosanganisira matanho akawanda. Iyo nzira inowanzoitwa pasi pe general kana musana anesthesia. Murwere anoiswa patafura yakaputsika, uye fluoroscope inoshandiswa kutungamira kuiswa kwembambo. Nzira yekuvhiya inosanganisira diki incision yakaitwa pamusoro peiyo trochanter yakakura, iyo inobvumira kupinda kune proximal femur. Waya yegwara inozopinzwa kuburikidza nekuchekwa uye yopfuudzwa pasi pemugero wemukadzi pasi pekutungamira kwefluoroscopic. Iyo proximal femoral canal inobva yadzokororwa kuhukuru hwakakodzera, uye PFNA intramedullary nail inoiswa. Iyo helical blade inopinzwa mumusoro wemukadzi, uye iyo yekuvhara nzira inoitwa mu distal femur kuti ipe axial kugadzikana.
6. Post-operative Care mushure mekuvhiyiwa kwePFNA
Mushure mekuvhiyiwa kwePFNA intramedullary nail, murwere anowanzo chengetwa pamubhedha wekuzorora kwemazuva mashoma. Nhengo inenge yabatwa inovharwa nebhureshi kana kuti kukandwa kwemavhiki akati wandei kuti apore. Murwere anorayirwa kuti arege kuita mabasa anorema kwemwedzi mishoma kuti abvumire kuporeswa kwakakodzera. Physical therapy inowanzotangwa kare kuti ivandudze majoini ekufamba uye simba remhasuru.
7. PFNA Matambudziko uye Management
Senge chero nzira yekuvhiya, PFNA intramedullary nailing inotakura dzimwe njodzi uye zvinogona kunetsa. Matambudziko aya anosanganisira kutapukirwa, kutadza kudyara, kukuvara kwetsinga, kukuvara kwetsinga yeropa, uye kusabatana. Nekudaro, iyo yakazara complication rate yePFNA intramedullary nailing yakadzikira. Kutarisira kwematambudziko aya kunowanzobatanidza kuvhiyiwa kwekudzokorora kana kurapwa kwekuchengetedza, zvichienderana nekuoma kwedambudziko.
8. PFNA vs. Zvimwe Intramedullary Nails
Kuenzaniswa nedzimwe mhando dze intramedullary mbambo, iyo PFNA intramedullary nail ine akawanda mabhenefiti. Imwe yemabhenefiti akakosha ePFNA chipikiri ndeye anti-kutenderera maitiro, ayo anopa kutenderera kugadzikana kumusoro wemukadzi. Inobvumirawo kugovanisa-mutoro pakati pembambo nebhonzo, kuderedza njodzi yekutadza kuisirwa. Iyo PFNA chipikiri zvakare iri nyore kuisa uye ine njodzi yakaderera yematambudziko.
9. Zvakanakira PFNA Intramedullary Nailing
PFNA intramedullary nailing ine mabhenefiti akati wandei pane mamwe maitiro ekuvhiya ekurapa hudyu kuputsika. Imwe yemabhenefiti makuru ndeyekubudirira kwayo mukurapa kusagadzikana intertrochanteric uye subtrochanteric hip fractures. Iyo PFNA chipikiri inobvumirawo kuunganidzwa kwekutanga uye kupfupika kwekugara muchipatara zvichienzaniswa nedzimwe nzira dzekuvhiya. Iyo inewo njodzi yakaderera yekutadza kuisirwa uye inopa yakanaka inoshanda mhedzisiro.
10. Zvakaipa zvePFNA Intramedullary Nailing
Nepo PFNA intramedullary nailing ine akati wandei mabhenefiti, inewo zvimwe zvayakaipira. Imwe yezvakanyanya kuipa ndeye njodzi inogona kuitika yematambudziko, akadai sekutadza kwekudyara, kutapukirwa, uye kukuvara kwetsinga. Iyo PFNA chipikiri zvakare inodhura zvichienzaniswa nedzimwe nzira dzekuvhiya.
11. PFNA Intramedullary Nail Migumisiro uye Kubudirira Matengo
Zvidzidzo zvakaratidza kuti PFNA intramedullary nailing ine mhedzisiro yakanaka uye mitengo yebudiriro mukurapa hudyu kuputsika. Huwandu hwebudiriro yePFNA yekuroverera inotangira kubva pa70% kusvika 90%, ine yakanaka inoshanda mhedzisiro inoshumwa mune dzakawanda zviitiko. Iyo PFNA chipikiri zvakare ine yakaderera mwero wekuvhiyazve uye kutadza kuisirwa.
12. PFNA muGeriatric Patients
Hip fractures yakajairika muhuwandu hwevakweguru, uye PFNA intramedullary nailing yakabuda senzira yakakurumbira yekuvhiya yekurapa hudyu kuputsika muvarwere vane geriatric. PFNA mbambo yakaratidzwa kuva nemigumisiro yakanaka muhuwandu hwevanhu, nehuwandu hwematambudziko uye nguva pfupi yekugara muchipatara.
13. Kukura Kweramangwana
Iyo PFNA intramedullary chipikiri yakagadziridzwa akati wandei kubva payakaunzwa, nechinangwa chekuvandudza kushanda kwayo uye kuderedza njodzi dzayo. Zvimwe zvezvigadziriso zvinosanganisira shanduko mune helical blade dhizaini, kuvandudzwa kwekiyi nzira, uye kugadziridzwa mukureba kwembambo uye dhayamita. Kugadziridzwa kwezvinhu zvitsva, senge titanium alloys uye biodegradable zvinhu, kuri kuongororwa zvakare kuvandudza mashandiro ePFNA chipikiri.
14. Mhedziso
Muchidimbu, iyo PFNA intramedullary chipikiri inzira yakakurumbira yekuvhiya yekurapa kuputika kwehudyu, kunyanya muhuwandu hwevakuru. Iyo PFNA chipikiri inopa mhedzisiro yakanaka, ine yakaderera mwero wezvinetso uye kupfupika kwechipatara kugara. Nekudaro, senge chero nzira yekuvhiya, inotakura dzimwe njodzi uye zvinogona kunetsa. Kuvandudzwa kwezvinhu zvitsva uye kugadziridzwa mukugadzirwa kwembambo kungangovandudza mashandiro ePFNA chipikiri mune ramangwana.
FAQs
Chii chinonzi PFNA intramedullary nail?
PFNA intramedullary chipikiri idyarwa rekuvhiya rinoshandiswa kurapa hudyu kutyoka. Inopinzwa mumugero wechikadzi uye inopa kugadzikana kumusoro wemukadzi.
PFNA intramedullary nail inoiswa sei?
Iyo PFNA intramedullary chipikiri inopinzwa kuburikidza nediki incision yakagadzirwa pamusoro pehombe trochanter. Waya yekutungamira inopinzwa mugero remukadzi, uye mugero wacho unodzokororwa kuhukuru hwakakodzera. Iyo PFNA chipikiri inozopinzwa, uye iyo yekuvhara nzira inobatwa mune distal femur.
Ndezvipi zvakanakira PFNA intramedullary chipikiri?
Iyo PFNA intramedullary chipikiri ine zvakati wandei zvakanakira, kusanganisira yayo inopokana-kutenderera maitiro, mitoro yekugovanisa zvivakwa, uye nyore kuisa. Inoshandawo mukurapa kusagadzikana kwehudyu fractures uye inobvumira kutanga kuunganidza.
Ndeapi matambudziko anogona kuitika ePFNA intramedullary nailing?
Matambudziko anogona kuitika ePFNA intramedullary nailing anosanganisira kutapukirwa, kutadza kuisirwa, kukuvara kwetsinga, kukuvara kwetsinga yeropa, uye isiri-mubatanidzwa.
Ndeipi mwero wekubudirira wePFNA intramedullary nailing?
Huwandu hwebudiriro yePFNA intramedullary nailing kubva pa70% kusvika 90%, ine yakanaka inoshanda mhedzisiro inoshumwa kazhinji.
