Pamusoro gumi Distal Tibial Intramedullary Nails (DTN) muNorth America muna Ndira 2025
Maonero: 0 Munyori: Saiti Edhita Nguva Yekuburitsa: 2025-06-17 Mavambo: Site
Distal Tibial Intramedullary Nail (DTN) Clinical Study
Kuongorora Kwakakwana Kwekuvhiya Technique, Migumisiro, uye Mashandisirwo
Rakabudiswa: June 17, 2025
The Distal Tibial Intramedullary Nail (DTN) inoratidzirwa kune zvakasiyana-siyana zvetibial mamiriro, kusanganisira nyore, spiral, comminuted, long oblique, uye segmental shaft fractures (kunyanya ye distal tibia), pamwe chete ne distal tibial metaphyseal fractures, kwete-/ mal-union; inogona zvakare kushandiswa, kazhinji nemidziyo yakasarudzika, yekugadzirisa kuremara kwemapfupa kana kureba kwemakumbo (sekurebesa kana kupfupisa).
Kukiya Plates
Yakakosha kukuvara kwenyama yakapfava, huwandu hwehutachiona hwepamusoro, kupora kwenguva refu
Antegrade Nails
Ngozi yekukuvara kwemabvi akabatanidzwa, kugadzirisa kusina kukwana, kunowanzoita malalignment
DTN Solution
Minimally invasive maitiro ane retrograde yekuisa dhizaini
I. Nhanganyaya
1Distal tibial fractures inowanzoitika, uye marapirwo echinyakare ane miganhu
Distal tibial fractures imhando yakajairika yekuputsika kwegumbo rezasi. Mishonga yechinyakare senge maplate ekukiya uye antegrade intramedullary mbambo imwe neimwe ine zvayakaipira. Kukiya mahwendefa kunogona kukonzera postoperative zvirwere kana soft tissue necrosis, kuwedzera kupora; kunyange zvazvo zvipikiri zveantegrade zvisinganyanyi kupindira, zvinogona kukuvadza majoini emabvi, kukonzera marwadzo, uye kutakura njodzi dzekugadzirisa kusina kukwana kana kukanganisa, kutadzisa kupora.
2Mhinduro nyowani: Distal Tibial Nail (DTN)
Iyo itsva yekurapa sarudzo-Distal Tibial Nail (DTN)-inopa maonero matsva ekugadzirisa distal tibial fractures neyakasiyana yekudzoreredza dhizaini.
Mufananidzo 1: DTN retrograde yekuisa dhizaini
II. Kuvhiya Maitiro
1Kuiswa kwemurwere uye kuderedza kugadzirira
Murwere anoiswa panzvimbo yepamusoro. Displaced fractures inofanira kuderedzwa nemaoko; kana zvichidikanwa, shandisa reduction forceps kubatsira usati waisa iyo DTN. Kana paine kufambidzana kwefibular fracture, kurongeka kwakakodzera kwefibula kunogona kubatsira kuderedza tibial.
Mafungiro Akakosha: Supine chinzvimbo, shandisa kuderedza forceps kana zvichidikanwa. Isa pamberi fibular fracture manejimendi kuti uve nechokwadi chekudzikisa tibial.
2Nzira yekuisa DTN
A 2-3 cm longitudinal incision inoitwa pamuromo wemedial malleolus kuburitsa pachena deltoid ligament. Pini yegwara inoiswa mukati kana zvishoma pakati kusvika kumuromo wemalleolus, 4-5 mm kubva kune articular surface.
Incision:
Longitudinal yakachekwa pane medial malleolus tip
Pini yekumisikidza
4-5 mm kubva pajojo pamusoro
Kugadzirisa:
Interlocking screws proximally uye disally
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Mufananidzo 2a: Kuiswa kwepini yekutungamira
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Mufananidzo 2b: Maonero eparutivi
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Mufananidzo 2c: Maitiro ekugadzirisa zvakare
III. Post-op Rehabilitation
0-6
Vhiki Non-weight Bearing
Pakarepo ankle kubatana kwekufamba uye tsoka-kusvika-pasi kubata
6-8
Weeks Partial Weight-kutakura
Kufambira mberi kusvika ku50% inorema-kutakura simba
8-12
Mavhiki Akazara Weight-kutakura
Paunenge uchitarisa kuumbwa kwe callus uye kurwadziwa
Rehabilitation Protocol
Ankle joint basa rinotanga pakarepo mushure mekuvhiyiwa
Dzivisa kurema kwemavhiki 4-6
Zvishoma nezvishoma shanduko kusvika kuzere uremu-kubereka pamavhiki 8-12
Regular radiographic monitoring panguva yekudzoreredza chikamu
IV. Zvidzidzo zvekudzidza
1Clinical Migumisiro yeVarwere gumi
Chidzidzo chakatevera varwere gumi. Pakazosvika 3 months post-op, 7 nyaya dzakanga dzapora; varwere vese vakawana kuporeswa mukati memwedzi mitanhatu. Imwe nyaya imwe neimwe yevarus uye recurvatum deformities yakaitika. Hapana kurasikirwa kwekuderedza, hutachiona, matambudziko ane chokuita nekudyara, kana kukuvara kweatrogenic kwakaonekwa.
70%
Yakaporeswa mukati memwedzi mitatu
100%
Yakaporeswa nemwedzi mitanhatu
| Mhedzisiro Yedza |
DTN Migumisiro |
Traditional Methods |
| Union Rate (mwedzi mitatu) |
70% |
40-60% |
| Kusarurama (>5°) |
20% |
25-40% |
| Infection Rate |
0% |
5-15% |
| AOFAS Score |
92.6 |
73-88 |
V. Nyaya Yenyaya
Murwere ane makore 69 okuberekwa
Rudzi rwekutsemuka: Transverse tibial fracture + fibular fracture
Dambudziko: kukuvara kwenyama yakapfava
Post-op: Chete 6 diki incisions, kupora kwakazara mukati me1 gore
Kurapa Summary
DTN yakasimwa kuburikidza nedikidiki incisions ine yakanakisa nyoro kuchengetedzwa kwenyama. Fibular fracture yakagadzikana ne intramedullary nail. Murwere akawana kupora kuzere pasina matambudziko.
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Pre-op Imaging
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Pakarepo Post-op
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3-mwedzi Kutevera
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1-gore Kuporesa
VI. Kukurukurirana
1Biomechanical Kugadzikana
Retrograde misumari ine yepamusoro axial uye inotenderera kuoma kana ichienzaniswa neyemukati yekukiya mahwendefa uye antegrade zvipikiri. Greenfield et al. yakaita biomechanical test kuratidza kuti kushandisa distal screws muDTN kwakawana 60–70% yekuomarara kwakasimba uye 90% yekuomarara kwepamuviri zvichienzaniswa nemasruuru matatu.
2Zvakanakira zveDTN
Zvichienzaniswa nekuvhara mahwendefa, intramedullary misumari inokonzeresa kushomeka kwematishu akapfava, kunyanya akakodzera kuvarwere vakura uye avo vane kukuvara kwakanyanya kwenyama yakapfava kubva mukukuvadzwa kukuru kwesimba. Iyo nzira haidi kuchinjika kwemabvi, kuderedza njodzi yekuderedza kurasikirwa uye kuita kuti ive yakakodzera kune varwere vane mabvi mashoma kufamba.
3Clinical Kuenzanisa
Izvo zvisizvo uye mazinga ekukanganisa kwezvipikiri zveantegrade ndeye 0-25% uye 8.3-50%, zvichienderana; yekuvhara mahwendefa, 0-17% uye 0-17%. Muchidzidzo ichi, nyaya dzese dzakawana kubatana, uye 20% chete yaive nehurema> 5 °, inofananidzwa nemaitiro echinyakare.
VII. Mhedziso
Muchidimbu, DTN inopa zvakanakira pamusoro pekuvhara mahwendefa uye antegrade intramedullary zvipikiri uye inomiririra mhinduro inoshanda yekurapa distal tibial fractures. DTN inoratidzira kushomeka kwekupinda, kugadzikana kwakanyanya, uye nekukurumidza kupora. Iyo yakakosha kune mamwe marapirwo echinyakare uye akakodzera kusimudzira.
DTN Product Line
Distal Tibial Intramedullary Nail (DTN)
Distal Tibial Intramedullary Nail (DTN) Instrument Set
Distal Tibial Intramedullary Nail (DTN) Instrument Bhokisi
