Elastically stabilized intramedullary nails (ESINs) inzira yakajairika yekuvhiya kugadzika kwekutsemuka kwepfupa refu muvana. Inoshandiswa zvakanyanya kurapa kusagadzikana kuputsika kweradius, ulna, femur, uye dzimwe nguva tibia uye humerus. Inoshandiswawo kurapa pathological kuputsika kwemapfupa marefu muvana. ESIN inopa yakavharwa fracture fixation pasina kuvhura nzvimbo yekutsemuka, matatu-point kugadzikana, nekuchengetedza kureba uye kutenderera mukuchinjika, pfupi oblique fractures. Sekuremerwa-kugovera kudyara, inobvumira kufamba kwekutanga kwenhengo. Kazhinji, elastically yakagadzikana intramedullary misumari inobviswa mushure mekupwanyika kuporeswa.
Kutyoka kwechikadzi
Zviratidzo zveESIN mukuputsika kwevakadzi ndezvi: makore pakati pe4 ne14 makore uye kuputika kwevakadzi mukati mekutambudzika kwakawanda.
Murwere akaiswa patafura yemapfupa emapfupa, uye ukuru hwebhoti hunofananidzwa nehukuru hwegumbo remwana. Iyo fluoroscope inodiwa pakuwana antero-posterior (AP) uye latero-lateral (LL) maonero echidya chakakanganiswa uye inoiswa kuitira kuti ibvumire kuonekwa kwechikadzi kubva muhudyu kusvika kumabvi. Kuwana kwekudzikisa kunotariswa mune ese AP uye LL maonero, uye kutenderera kunosimbiswa zvakare.
Sarudzo yezvipikiri Iyo dhayamita yembambo inofanirwa kucherechedza mutemo mukuru wekusarudza zvipikiri. Iyo inotevera kupatsanurwa inogona kushandiswa seimwe mutsauko, inofambirana nezera remwana:
- 6-8 makore: 3 mm dhayamita;
- 9-11 makore: 3.5 mm dhayamita;
- 12-14 makore: 4 mm dhayamita.
Kureba kwezvipikiri kwakaenzana nechekure kubva kune distal growth cartilage kusvika kune yakakura trochanter growth cartilage .
Diaphyseal fractures
The proximal uye yepakati yechitatu Muchiitiko chekuputsika kwediaphyseal muchidimbu nechepakati chechitatu, nzira yeC-yakaita, ine misumari inoiswa retrograde kuburikidza ne distal metaphysis, inosarudzwa. Panyaya yekutsemuka kwepedyo, muromo wembambo wezvipikiri wakakotama, nepo pakati pe-diaphyseal fractures, pakati pembambo yakakombama. Pakupera kwekushanda, munyaya yekuputsika kwepakati, zvimedu zvinogadziriswa kuitira kuti zvidzivirire kukanganiswa kwakasara, izvo zvinogona kuva nemhosva yehurefu husina kuenzana hwemakumbo ezasi. Panyaya ye oblique kana comminuted fractures, iyo distal tip inokotama uye inobata mubhonzo kudzivirira telescoping yezvidimbu uye kutama kwezvipikiri.
Maitiro echisikigo ezvimedu izvi ndezvekuita kupfupisa 5-10 mm pakarepo mushure mekushanda, iyo ichabhadharwa nekukurudzira kwekukura panguva yekubatanidzwa kwekuputsika.
Tibial fractures
Kuisa uye kugadzirira kwemurwere Murwere anoiswa patafura yemapfupa kuitira kuti abatsire kuderedza. Kuvapo kwefluoroscope kunosungirwa kune intraoperative control. Munda wekushanda unofanira kusanganisira ibvi .
Kuiswa kwezvipikiri
Zvipikiri zve elastic zvinogara zvakaiswa antegrade mune proximal metaphysis, pane antero-lateral uye anteromedial nzvimbo.
Kureba kwembambo kunosiyana pakati pe2.5 ne4 mm, zvichienderana nezera remurwere. Kushandiswa kwesando kufambisira mberi zvipikiri kunobvumirwa asi kunofanira kushandiswa nokungwarira.
Unhu hwekudzikisa hunosimbiswa nehupamhi hwembambo uye chiyero chekukotama.
Zvipikiri hazvifanirwe kukanganiswa mukati mekanzura pfupa re distal metaphysis kusati kwadzikiswa kwakaringana; kana zvisina kudaro, nzira dzekugadzirisa dzinogona kukanganisa osteosynthesis.
Pamberi pekubatana, kutenderera kwezvimedu kunotariswa uye, kana pane kuvapo kwezvakasara varus deformity, izvi zvinogadziriswa nekukotama kwakanyanya kwembambo. Pakupera kwekushanda, kudhonza kunozorora uye zvidimbu zvinokanganiswa.
Panyaya yekutyoka kwakapetwa, matipi ezvipikiri akasara kunze kwebhonzo akakotama pa90 ° uye akabatwa mu cortical bone kudzivirira telescoping yezvidimbu.
Humeral fractures
Zviratidzo zveESIN muhumeral fractures zvinosiyana zvichienderana nenzvimbo yekuputsika: iyo proximal metaphysis kana diaphysis. Mukuputsika kwemutsipa wekuvhiya wehumerus, ESIN inoratidzwa nokuti inoderedza nguva yekudzivirira inodiwa munyaya yekurapa kwekuchengetedza.
Munyaya ye diaphyseal fractures, kushandiswa kwezvipikiri zve elastic kunoratidzwa pasinei nekuvapo radial nerve maronda.
Kuiswa kwezvipikiri Zvipikiri zvinopinzwa uchishandisa nzira yekudzorera. Mapoinzi ekuisa anowanikwa pamucheto weparutivi rwenzvimbo yesupracondylar, ine postero-lateral direction uye proximal inclination. Mapoinzi ekupinda anogadzirwa pachishandiswa chibooreso nekuti bhonzo recortical munzvimbo iyi rakaoma kwazvo. Iyo dhayamita yezvipikiri inosiyana pakati pe2.5 ne3.5 mm, uye ivo vakakotama zvakafanana. Zvipikiri zvinopinzwa ne vertical manual pressure uye kutenderera kutenderera. Kana kuputsika munzvimbo yeproximal metaphyseal hakugone kuderedzwa zvakakwana, kutenderera kwe1800 kwezvipikiri kunobatsira kuderedza uku. Kana, zvakadaro, kudzikisira kusingagoneke, Kirschner gwara-waya inoiswa muchikamu chepamusoro chisati chadzikiswa. Muchiitiko che oblique diaphyseal fractures, zvakakosha kuti udzivise zvipikiri zvichisiya medullary canal uye kutamira kumashure kune radial nerve sulcus. Mushure mekunge zvipikiri zvese zvayambuka nzvimbo yekutyoka, zvinokanganiswa mupfupa rinodzima reproximal metaphysis.
Forearm fractures
Kurapa kweOrthopedic mukutyoka kweruoko kunogamuchirwa, asi miganhu inotenderwa yekungoerekana yagadziridzwa angulation inozivikanwa. Kana iyi miganhu yakapfuudzwa kana munyaya yekukundikana kwekurapa kwemapfupa, kuvharwa kuderedzwa uye ESIN inoratidzwa mune forearm fractures.
Operative technique Murwere anoiswa mudorsal decubitus, neruoko rwakakanganiswa patafura yeradiotransparent.
Iyo dhayamita yezvipikiri inoshandiswa inosiyana pakati pe2.5 ne3 mm. Chipikiri chepamusoro chinenge chakatwasuka, ukuwo chipikiri cheradial chine chiratidzo chakakombama kuitira kudzoreredza curve yeradius.
Kugadzirisa kunowanzotanga nepfupa iri nyore kuderedza. Kune radius, nzvimbo yekupinda inowanikwa mu distal metaphysis, pamusoro peiyo distal kukura cartilage, pakati pematendon ehurefu uye mapfupi extensors echigunwe. Iyo cortical bone inoratidzirwa kuburikidza nediki incision uye gomba rinoboorwa, iro rinowedzerwa nekufamba kwedenderedzwa. Chipikiri chinopinzwa mukati memedullary canal kusvika panzvimbo yakatsemuka. Kudzikiswa kwekutsemuka kunoitwa uye chipikiri chinokwidziridzwa mukati mechikamu chepamusoro pasi pefluoroscopic control.
Nzira yakafanana inoitwa kune ulna, uchishandisa nzira yeantegrade, ine nzvimbo yekupinda pamucheto wepakati weolecranon.
Nzira yeKutenga Orthopedic Implants uye Orthopedic Instruments?
For CZMEDITECH , tine mutsara wakakwana wechigadzirwa we orthopedic oparesheni yekuvhiya uye zviridzwa zvinoenderana, zvigadzirwa zvinosanganisira ma implants emusana, intramedullary misumari, trauma plate, kukiya ndiro, cranial-maxillofacial, prosthesis, zvishandiso zvemagetsi, Zvigadziriso zvekunze, arthroscopy, veterinary care uye yavo inotsigira chiridzwa seti.
Pamusoro pezvo, takazvipira kuenderera mberi nekugadzira zvigadzirwa zvitsva uye kuwedzera mitsara yezvigadzirwa, kuitira kuti tisangane nekuvhiyiwa kwevamwe vanachiremba nevarwere, uye zvakare kuita kuti kambani yedu ive nemakwikwi mupasi rose Ma-implanti emapfupa neindasitiri yezviridzwa.
Isu tinotumira kunze kwenyika pasi rose, saka iwe unogona taura nesu pa email kero song@orthopedic-china.com nokuda kwekotesheni yemahara, kana kutumira meseji paWhatsApp kuti upindure nekukurumidza +86- 18112515727 .
Kana uchida kuziva rumwe ruzivo, tinya CZMEDITECH kuti uwane rumwe ruzivo.
