Ko kana iyo yekugadziriswa kwemukati yeiyo intertator lracture ikakundikana?

HIP Fractures inofungidzirwa kuti inokanganisa zviuru mazana mashanu ezviuru muUnited States gore rega rega. Ivo vane mararamiro makuru pamhando yehupenyu, parizvino accounting ye3-7% yechipatara muchipatara uye gore rimwe-kufa kwegore re19,4-58%. Dzingangoita hafu yeyese maroyi mapundu ari kukanganisika (iyo) fractures. Izvo zviviri zvinowanzoitika zvishandiso zvinoshandiswa kurapa zvikanganiso ndizvo zveCEPhaalnosomellary zvipikiri (CMN) uye iyo inotsvedza hip screw (shs).

Pasinei nekufambira mberi mune tekinoroji, kupfupika kwepafupa uye kugadziriswa kukundikana kwakadai sekupinda mumusoro wechikadzi kuchiri kuitika uye kunogona kukuvadza. Zvidzidzo zvazvino zvasara zvakataura zvakaringana mitengo inosvika 6% nezvirevo zvazvino. Zvinhu zvine njodzi zvekutadza kwekutadza zvinosanganisira tip-tip kure (tad) >>> Kuchembera uye osteoporosis zvakare inosanganiswawo nekutadza kwekugadzirisa.

Varwere uye Nzira

Uku kwaive kungoongorora kwevarwere kunobatwa pamasangano maviri ari mukati mehutano hwehutano mune yakakura nzvimbo yeMetropolitan. Mhosva dzematanho evanovhiya maviri (JS uye BC) vakabvunzwa nevarwere vese vakagamuchira nzvimbo yekudzokorora kwekutanga kwekutanga 2018 kusvika munaGunyana makumi maviri neshanu. Iko kushandiswa kweSimbiso Kusimbiswa panguva Yekudzokorora Kuvhiya kwakasimbiswa neyemagetsi zvekurapa (EMR) Ongororo yezvinyorwa zvekushandisa uye postoperative radiographs. Isu takasanganisira vese varwere vane zviratidzo zvekusimbisa masimba mukudzokorora gadziriso mushure mekukundikana kwekutanga cmn kana shs gadziriso yeiyo fractures (Mufananidzo 1). Isu hatina kusarudzika varwere vane tsvina kana subtrochanttic fractures, varwere vasina kudzorwa nekugadziriswa kwesimbe, uye varwere vane artroplasty panguva yekutanga kuvhiya kwekutanga.

Mufananidzo 1. Mukadzi ane makore makumi manomwe nemanomwe ekutenderera achivhiringidzika

Kuvhiya Maitiro

Kune varwere vari kugamuchira yekutanga kugadziriswa ne cmn, isu takajaira musoro wenhumbi wakashandurwa zvipikiri nekupararira kwepopa. Pakutanga, iyo yegumi nemana Tevere, iyo Hexagonal Screwdriver yakashandiswa kusunungura iyo fixation screw kumusoro kweiyo cmn (Mufananidzo 2).

Mufananidzo 2, Intrapaeperative Fluoroscopy inoratidza hexagonal Screwdriver kuisunungura kuendesa uye kusunungura yakambosvikirwa yakasungirirwa screw.

A 1 Musoro wepakutanga musoro wenhumbi unobviswa uine reverse yakadzoserwa gwara (Mufananidzo 3). Munyaya yemusoro wemusoro wechiokomesa, gwara rehasha nehombodo yekuvhiya inokwereta inoshandiswa kuitira kuti udzivise kusvibiswa mubatanidzwa (Mufananidzo 3a). Zvikurukuru, matrix akatanga kuiswa mushure mekubviswa kwematanho ekunze ezvikamu zviviri zvematatu ematani uye akazoiswa munzvimbo yakadzika nekudzoreredzwa kunze kwematanho maviri.

Mufananidzo 3, Intraoperative anteroposter (a) uye yakazotevera (b) mifananidzo yemumwe murwere inoratidza musoro wechikadzi neIntertitial pfupa rekrisiti.

Tevere, rumbudzi runotarisirwa uye ipapo kupwanya kunopindirwa mune zvimwe zvexostosis yekudzokorora gadziriso. Mune zviitiko zvelunion kana fibrous kurapa, percutaneous osteotomy inoitwa uchishandisa nzira yeAnterody

Chikwangwani chitsva kana kuti chinotsvedza chinobva chaiswa muhombodo yepamhepo mumusoro wechikadzi padhuze neiyo dexis mutsipa, kuita chokwadi chekungwarira kuti urege kupinda mumusoro (Mufananidzo 4). Iyo screw inoiswa nechinangwa ichidzivisa iyo yepamberi chipikiri turakiti, asi ichiri kunongedza kuti ipere pakati peiyo yemusoro wemusoro. (Mufananidzo 5)

Mufananidzo 4, anteroposter (a) uye yakazotevera (b) mifananidzo yemumwe murwere inoratidza kusagadzikana kweiyo kerfing sindano munzira yetsika nyowani.

Mufananidzo 5, Intrapaeperative Fluoroscopy inoratidza kuiswa kweiyo nyowani yeCephaallalary blade padivi pechitima Wire nzira, iyo yakazonyorwa yakasimbiswa ne screw setrew.

Chekupedzisira, musoro wechikadzi wazadzwa nekero yepafupa uchishandisa jekiseni yemahombekombe eparamende (Mufananidzo 6). Chenjera chinotorwa kuti udzivise kuwedzeredzwa mubatanidzwa nekushandisa chaiyo-nguva radiographs uye kugadzirisa kudzika uye kutaridzika kweiyo canmen cannula.

Mufananidzo 6, kufungidzira kuratidza sment kuwedzera pakutanga (a), kuzadza zvishoma nezvishoma (B) kusvikira urema hwechikadzi hwakazara (c).

Kune varwere vari kugamuchira yekutanga kugadziriswa kweiyo shs, tinobvisa iyo shs uye isa cmn refu. Mushure mekuita 5-cm incision yakapfuura pazasi peiyo trochantter yakakura uye kuzivisa iyo ITB, iyo incision inodzikiswa pasi kune iyo inotevera ndiro. Zvese zviyero zvemapururu zvinobviswa uchishandisa yakakodzera ruoko ruoko screwdriver uye iyo yakatevera ndiro yabviswa. Iyo tension screws inobva yabviswa neyakagadziridzwa squithajira seyakambotsanangurwa kuti ishandise kupwanyika kusvika padanho rakakura kwazvo realgus. A 5-cm incision inozoitwa pakapetwa kweiyo huru trochanter sezvakambotsanangurwa. Aitungamira waya yakaiswa pane yakanyanya proximal kupera kweiyo huru trochantter uye yakakwira mudenga rechikadzi. Chinyorwa chakavhurika chinounzwa munzira yemutungamiriri. Iyo yakareba bhora-yakatsemuka inotungamira iyo yakabva yabikwa mukati mekadzi femm femur pazasi pePatella. Tevere, kudzokorora kufambira mberi kwakaitwa kusvikira trebhiti akanzwikwa mumusana. Vese vevarwere vedu vakagamuchira nguva refu cmn neTFN-Advanced (tfna) proximal femorelulary nailing system (depuy-synthes, rayynham, ma).

Kukurukurirana

Maitiro edu anoshandisa bone simende kusimbiswa panguva yekudzokorora gadziriso. Bone SEment Kusimbiswa kwekutanga kugadziriswa kweOsteoporotic Proximal Femur Fractures yakadzidzwa uye yakaratidza yakanaka biomechanical uye ekiriniki mhedzisiro. Ongororo ichangobva kuitika yakashuma kuti simende yekusimbisa yakakonzerwa nekukwira kwakakwirira kutadza, kuderedza kudzikama, uye mashoma matambudziko uye kudzoreredza kuenzaniswa nekugadziriswa kweisina kugadziriswa. A meticalized, multicenter fundo yakataurawo kuti hapana kudzorerazve kana chiratidzo cheChepit

Hip inokwezva kufa yakakwira. Zvidzidzo zvichangobva kuitika zvakatorondedzera 3-7% muchipatara mwero, neyakafa-gore rekufa kuderera kubva 19,4% kusvika 58%. Kunyanya, fani dzakaratidzirwa kuti dzakaratidzirwa ne 27% yekufa kwegore rimwe. Yedu Clinsical Series yakaratidza kusa-muchipatara kufa uye huwandu hwemwaka mumwe chete hwekufa kwe13.66%, izvo zvakaderera zvichienzaniswa nemabhuku. Nekuti kufamba kwemubhedha kwekutanga mushure mekuvhiyiwa kwakabatana nekufa kwakakura, kushanya kwakanaka uye zvinobuda mumapepa edu munhevedzano kunogona kutsanangura zvakaderera zvakaonekwa muvarwere vedu.

Mhedziso

SEMEN-yakasimbiswa yekudzokorora yekugadziriswa, yakachengeteka, uye inodhura nzira yekusavimbika yeripoltrochantt

Varwere vane vakakundikana kugadziriswa kwepristrantic fractsEC. Maitiro acho akashandiswa chete mumatare okuti ruzhinji rwezvakanyorwa neakarukwa rwakachengetedzwa uye musoro wenyaya wakaramba uri mukati memutsipa wechikadzi. Kufunga nezvezvisingakwanisi kudzokorora arthroplasty murwere akwegura, maitiro aya anoratidza vimbiso mukudzora matambudziko akanyanya uye achideredza nguva yakanyanya uye achidzora muboka iri revarwere.

Matenga sei kuti utenge orthopedic mispende uye zviridzwa zveOrthopedic?

Nekuti Czmeditech​ Spine Implants, intramedullary zvipikiri, Traumal Plate, Locking Plate, cranial-maxillofacial, prostisesa, Zvishandiso zvine simba, vekunze taxators, arthroscopy, kutarisirwa kwevaterinary uye yavo inotsigira chiridzwa.

Mukuwedzera, isu takazvipira kuramba tichikudziridza zvigadzirwa zvitsva uye tichiwedzera mitsara yechigadzirwa, kuti tisangane nezvinodiwa zvevamwe vanachiremba nevarwere, uyezve vanokwanisawo kukwikwidza vese muzvinyorwa zvepasirese uye zviridzwa.

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