Yakadzoserwa Femoral Intramedullary Nail: Nzira Inovimbisa yeFemoral Fractures

Kuputsika kwechikadzi, kunobata pfupa rehudyu, kunogona kuva kwakaoma kurapa zvinobudirira. Iyo yakadzoserwa yefemoral intramedullary nail tekinoroji yabuda senzira inovimbisa yekugadzirisa uku kutsemuka. Muchinyorwa chino, isu tichaongorora mabhenefiti, nzira yekuvhiya, zvinogona kunetsa, uye kupora kwakabatana neyakadzoserwa femoral intramedullary chipikiri.

Nhanganyaya

Kuputsika kwechikadzi kunogona kukonzera kurwadziwa kukuru, kusafamba, uye kusakwanisa kushanda. Nzira dzechinyakare dzekurapa dzingave nemiganhu mukuwana mhedzisiro yakanaka. Iyo yakadzoserwa femoral intramedullary chipikiri nzira inopa maonero matsva pamusoro pekutyoka manejimendi, ichipa kugadzikana uye rutsigiro panguva yekupora.

Kunzwisisa Reversed Femoral Intramedullary Nail

Iyo yakadzoserwa femoral intramedullary chipikiri chishandiso chekurapa chakagadzirirwa kudzikamisa uye kukurudzira kuporeswa mukutyoka kwevakadzi. Iyo yakafanana neyakajairwa intramedullary nail, asi ine reversed orientation. Iyo mbambo inopinzwa kubva kumucheto kure kwechikadzi uye inotambanudzira kure, ichipa kugadzikana uye kurongeka kune yakaputsika pfupa zvikamu.

Zviratidzo zveReversed Femoral Intramedullary Nail

The reversed femoral intramedullary nail inonyanya kukodzera kune mamwe marudzi echikadzi fractures. Inowanzoshandiswa kune fractures iri munzvimbo iri kure yefemur, kusanganisira supracondylar uye intracondylar fractures. Aya mafractures anowanzoda kugadziriswa kwakadzikama uye kurongeka kwakanyatso kupora.

Kuvhiya Technique yeReversed Femoral Intramedullary Nail

Preoperative Planning

Kunyatsoronga preoperative kwakakosha pakubudirira kudzoreredza femoral intramedullary chipikiri kuvhiya. 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

Panguva yekuvhiyiwa, murwere anoiswa supine patafura yekushandisa. Gumbo rakabatwa rakagadzirirwa uye rakaputirwa nenzira isina utachiona. Kumisikidzwa kwakakodzera kwakakosha kuti ubvumire kuwana kwakaringana kunzvimbo yekutyoka uye kufambisa zvipikiri kupinza kubva kure kumagumo echikadzi.

Incision uye Access

Incision inoitwa pamusoro penzvimbo yekuvhiya kuti uwane bhonzo rakatyoka. Kureba uye nzvimbo yekucheka kunoenderana nerudzi rwekutsemuka uye nzvimbo yaro pamwe neiyo distal femur. Kunyatsobata matishu akapfava kwakakosha kuderedza kushungurudzika uye kuderedza njodzi yekutapukirwa.

Kupinza Kwezvipikiri

Iyo yakadzoserwa yefemoral intramedullary chipikiri inoiswa kubva kumucheto kwechikadzi, ichitambanuka yakananga kunzvimbo yekutyoka. Nhungamiro chaiyo inofanirwa kuve nechokwadi chekuiswa uye kurongeka. Fluoroscopic imaging inoshandiswa kuona nzvimbo yembambo mukati megero remukadzi.

Distal Locking Screws Placement

Kana chipikiri chaiswa zvakanaka, distal locking screws inopinzwa 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 Reversed Femoral Intramedullary Nail

Iko kushandiswa kweakadzoserwa femoral intramedullary chipikiri kunopa akawanda mabhenefiti pamusoro pechinyakare nzira dzekurapa. Mamwe emabhenefiti akakosha anosanganisira:

1. Kurongeka kwakananga: Iyo yakadzoserwa mbambo yezvipikiri inobvumira kurongeka kwakaringana kweakatyoka mapfupa ezvikamu, kukurudzira kupora kwakanyanya uye kuderedza njodzi yekusagadzikana.

2. Kuwedzeredzwa kugadzikana: Iyo yakadzoserwa femoral intramedullary chipikiri inopa yakawedzera kugadzikana kune yakatyoka saiti, ichibvumira zviri nani kutakura mutoro uye kuvandudza mhedzisiro yekuporesa.

3. Kuchengetedzwa kweropa: Nekushandisa intramedullary canal uye nekuisa mbambo kubva kumagumo ekupedzisira, iyo yakadzoserwa yefemoral intramedullary nail nzira inoderedza kukanganisa kugovera kweropa kwebhonzo. Uku kuchengetedzwa kwekuyerera kweropa kwakakosha pakupora kwemapfupa uye mubatanidzwa wekutyoka.

4. Yakaderedzwa yakapfava matishu trauma: Iyo yakadzoserwa mbambo nzira inosanganisira kushoma kwenyama yakapfava dissection, zvichikonzera kuderedzwa kwakapfava matishu trauma. Izvi zvinogona kutungamirira kukurumidza kupora, kuderedza kurwadziwa kwepashure, uye kuderera kwengozi yezvinyoro zvinyoro zvinetso.

5. Kuunganidza kwekutanga: Nekudzoreredzwa kwechikadzi intramedullary chipikiri, kuunganidza kwekutanga kunogoneka. Izvi zvinobvumira varwere kuti vatange kutakura uremu uye maitiro ekugadzirisa maitiro nokukurumidza, vachikurudzira kukurumidza kupora uye kuvandudza kushanda kwemigumisiro.

   
   

Zvinogona Kunetsa uye Njodzi

Nepo iyo yakadzoserwa femoral intramedullary chipikiri tekinoroji inowanzoonekwa yakachengeteka uye inoshanda, 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 kuchengetwa kwepashure kunogona kuderedza njodzi iyi zvakanyanya.

• 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 kudzoreredzwa kwechikadzi intramedullary chipikiri chirongwa, yakazara rehabilitation chirongwa chakakosha pakupora kwakanyanya. 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 zvakabudirira mhedzisiro neyakadzoserwa femoral intramedullary nail tekinoroji. Imwe nyaya yekudzidza yaisanganisira munhu ane makore makumi mana nemashanu ane distal femoral fracture. Mushure mekuvhiyiwa nechipikiri chakadzoserwa chefemoral intramedullary, murwere akawana mubatanidzwa wakasimba wekutyoka, akawanazve huremu hwakazara, uye akadzokera kumabasa enguva dzose mukati memwedzi mitanhatu.

Mhedziso

Mukupedzisa, iyo yakadzoserwa femoral intramedullary chipikiri nzira inopa inovimbisa mhinduro yekugadzirisa femoral fractures, kunyanya munharaunda iri kure. Inopa kugadzikana kwakakwidziridzwa, kurongeka chaiko, uye mukana wekukurumidza kuunganidza. Kunyange zvazvo kune ngozi nezvinetso zvinogona kuitika, kunyatsoronga kusati kwaitwa, nzira yokuvhiya chaiyo, uye kutarisirwa kwakakodzera pashure pokuvhiyiwa kunogona kubatsira kuderedza kunetseka uku. Varwere vanogadziriswa reversed femoral intramedullary nail kuvhiyiwa, inoteverwa nechirongwa chekugadzirisa zvakanaka, vane mikana yekubudirira kubudirira uye kudzorerwa kwebasa.