I. Selelekela
Humerus e fapana e na le likholomo tsa mediaria le tsa morao-rao, tse kenyeletsang litho tsa bolo le likhomphutha.
II. Ts'ebetso ea ho buoa
Ho rata ha humerus humeus ho bakoa ke tsietsi e tobileng (mohlala, mabotho a sa sebetseng (mohlala, ho hula kapa ho hula mesifa).
III. Post-op ntlafatso
Trossword ea Ao e arola likhechana tsa humeus humeus ho mefuta e meraro ea sehlooho: A, B le c.
IV. Liphello tsa ho Ithuta
Phekolo ea kalafo e latela melao-motheo ea AO: Phokotso e tsitsitseng, e tsitsitseng le phetoho ea pejana.
Lengolo la linyeoe
Ho koala lijana ho fana ka tšilafalo ea biomechani ea biomechanical biomechaniniki ea biomechaniniki ea biblechanical haholo.
VI. Puisano
Czmediture e fana ka mefuta e meraro: E sephara (01.1107), lateral (5100-17), le mealo (5100-18).
VII. Sephetho
Phekolo ea kalafo e latela melao-motheo ea AO: Phokotso e tsitsitseng, e tsitsitseng le phetoho ea pejana.
Ho ts'oaroa ha masapo a maholo a tloaelehile, 'me phekolo ea setso e na le meeli
Ho senyeha ha mesebetsi ea metsu ke mofuta o tloaelehileng oa ho putlama ha maoto a tlase. Litlhare tsa setso tse kang ho notlolla lipekere tsa ho notlela le e 'ngoe le e' ngoe ea ho itšireletsana. Ho theola lipolanete ho ka baka tšoaetso ea postoperati kapa necrosis e bonolo, ho hlaphoheloa ha nako e telele; Le ha lipekere tsa antefade li hlaseloa ka nakoana, li ka senya mohono, ebile li na le likotsi kapa litlokotsi tsa ho lokisoa ka mokhoa o sa lekaneng.
Ho notlela polasetiki:
Tšenyo e bonolo ea lisele tse bonolo tsa tishu, sekhahla se phahameng sa ts'oaetso, ho fola halelele
Mabokose a Agramora
Kotsi ea likotsi tse kopaneng tsa mangole, ho kenella ka tsela e sa lekaneng, e tloaetse ho
Tharollo e Ncha: Dal Tibial Nail (DTN)
Sekhetho sa Phetoho-Elvel Bontša Nail (DTN) --O -Offers ke pono e ncha ea ho sebetsana le masapo a moea o ikhethang le moralo oa eona o ikhethang oa ho emisa.
Moralo oa ho kenya hape o fana ka mokhoa o mocha
Ho ba le boemo bo botle le ho fokotsa ho fokotsa
Mokuli o beoa maemong a supine. Masholu a sehlōhō a lokela ho fokotseha ka letsoho; Haeba ho hlokahala, sebelisa ho fokotsa phokotso ho thusa pele u kenya DTN. Haeba ho na le ho robeha ha lithaka tse tsamaeang le lithaelese tse tsamaeang le lithaelese tse nepahetseng. Li-fimar lilakane li ka tsikinyeha ka lipekere tsa ho itšireletsa. Bakeng sa likhechana ho potoloha le phokotso ea anatom le ho khotsofala ha fibula e lokela ho ba ho etsa phokotso ea ma-manouria ea ho qoba ho fokola. Libakeng tse bulehileng tse nang le phihlello e teng ea kantle, lipekere e ka kenngoa ha li ntse li boloka toropo ho fihlela phokotso.
Boemo ba supine, sebelisa liphoso tsa phokotso haeba ho hlokahala
Peletela taolo ea li-fi motsoako ho netefatsa phokotso e nepahetseng ea majabajaba
Ho itlohella ho 2 cm cm cm ho etsoa ntlheng ea malinyane a mallleuse ho pepesa ligagoane tsa methapo ea kutlo. PIN ea Tataiso e kentsoe ka hare ho kapa hanyane hanyane ntlheng ea mallelulus (feiga. 2a), 4-5 mm ho tsoa ho bonono. Leitla la morao ho bontša ho kenya ho kenngoa ka groove ea botsoalle (sa feiga. 2b), e qoba ho senya mesifa ea Tibiaris ea Tibiaris. Arola ligaleteng tse phahameng tsa moea tse phahameng, ebe u sebelisa mohiri oa ho holisa canllary canatal ho fihlela sebakeng sa metaphyses (sa feiga. 2c). Tlosa lesapo la ho hlakoloa haufi le sebopeho sa Motheo ho kenya lipekere (sa feiga. 2d). 2D). Kenya leqeba la teko ho netefatsa boholo ba dtn (sa feiga. 2E). Qoba hamore kapa e feteletseng ho thibela ho thibela malrogenic malhalar. Fetola moea o fokang oa lipetlele ho netefatsa hore li-screws tse hole ha li kene sebakeng sa mabenkele kapa sa marang-rang. Ho lokisa ho fihleloa ka liqhobosheane tse hokahaneng haholo ebile li sa lebe.
Incisition:
Khalemela ka ntlheng ea marllelus matluolus
Ho beha boemo ba Pic Picta:
4-5 limilimithara ho tloha sebakeng se kopaneng
Ho Ts'oaroa le ho qosoa
Khutlela ho Metaphysis, netefatsa boholo ba nail
Nail Conction:
Qoba ho itšunya, ho fetola botebo ho itšireletsa lenonyeletso
TLHOKOMELISO:
Ho kopanya likhoto tse sa tloaelehang le ka mokhoa o sa lebelloang
Ts'ebetso ea ho kenya DTN
Ho sisinyeha ha mohloa o potlakileng le ho ikopanya le maoto a maoto a ka tlase
ho boima ba ho boloka boima
ba 'mele ka ho felletseng pakeng tsa libeke tse 8-12, ha u ntse u lekola tsebo le bohlokoTs'ebetso e kopaneng ea Ankle e qala hang hang kamora ho buoa
Qoba ho ba le boima ba 'mele bakeng sa libeke tse 4-6
Phetoho ea butle-butle ho ho be le boima bo felletseng ba boima ba 8-12
Latela bakuli ba 10
Thuto e ile ea latela bakuli ba 10 (tafole 1). Ka likhoeli tse 3 Post-op, linyeoe tse 7 li ne li folile; Bakuli bohle ba atlehile ho folisa nakong ea likhoeli tse 6. Nyeoe e le 'ngoe ea mefuta e mengata ea varus le phepo e etsahetseng. Ha ho taolo ea phokotso, tšoaetso, mathata a amanang le ho amana a ho bonoa kapa likotsi tse neng li bonoa (Lethathamo 2).
Lietsi tse 7 li folile ka hare ho likhoeli tse 3; Tsohle li folile ka likhoeli tse 6
2 Lintho tse bonolo tse bonolo (1 varus, 1 reprurvatum)
Ha ho na tšoaetso, mathata a ho kenella, kapa tahlehelo ea phokotso
69-batho ba baholo ba lilemo li 69
Mofuta oa ho robeha:
THERECH E THUSANG + MOTSI
Bothata:
Lisele tse bonolo tsa tiris tse bobebe
Post-Op:
Ke litlolo tse ka bang 6 feela tse nyane, pholiso e felletseng nakong ea selemo se le seng
Lipalo 3 & 4:
Litšoantšo tsa pholiso ea seea-le-moea le tsa polelong
Matšoao a DTN
Phuputso ena e ne e kenyelletsa Ao 43-A le C1 Frocture; C2 e boetse e hlokometsoe. Li-DTN li fumaneha ka bolelele ba 7 MM le likhoeli tse 8, tse khethollang ho kenngoa setsi sa likhomo tsa proximal. Likhechana tse fumanehang ka holimo ho sethala sa tsebo ke likhetho tse loketseng ho fumana thepa ea DTN. Matšoao a ka atolosoa ho AO 42.
E sebetsa Ao 43-A, C1, nahana ka ho hola ho C2 le 42
Liphello tse ntle ka ho fetisisa bakeng sa litsotsi tsa 2-9 cm ho tloha sebakeng se kopaneng
Biomechani ea Biomechani
Lisebelisoa tsa maiketsetso li na le ho tepella ha axial le ho potoloha ha ho bapisoa le medicking plates le lipekere tsa antenode. Greenfield et al. Liteko tse tsamaisoang tsa biomechanizary tse bonts'ang hore u sebelisa li-screws tse peli tse mpe tsa DTL tse fihletseng 60-70% ea ho salafela ho bapisoa le likhakanyo tse tharo. DTN e fokotsang motsamao oa lijalo ka tlasa mojaro. Maemong a 3 a neng a sa fole nakong ea likhoeli tse 3, ho ne ho kenyelletsa lintlha tse bonolo tsa kemiso, keketseho ea medullary, sebaka se robehileng. Kaha li-DTN li tla ka boholo ba boholo bo ba bararo feela bo lekantsoeng ho li-screws tse tharo, li ka fana ka botsitso bo sa lekaneng boteng kapa lesapo la osteoporotic. Boima ba pele - ho lokela ho ata le ho ba hlokolosi maemong a joalo.
O phahame ho theola plates le ho amohela lipekere
Leano la ho hlophisa lintho tse khothalelitsoeng: 2 proximal + 3
Melemo ea DTN
Ha ho bapisoa le lipokato, lipekere tsa ho hloea li baka tšenyo e fokolang ea lithane, haholo-holo ho baruti ba ho lemala le likotsi tse matla. Thutong ena, li-shod li ne li kentsoe ka har'a litlokotsi tse nyane feela tse se nang mathata a bonolo. Ts'ebetso eo ha e hloke makhapetla a kokoana-hloko, a fokotsa kotsi ea tahlehelo ea ho fokotsa meeli le ho e etsa hore e be e loketseng bakuli ba nang le menoana e fokolang ea mangole kapa poso-tka).
Ka mokhoa o hlakileng, e loketseng, bakeng sa bakuli ba nang le matla a tebileng
Ho hlokahala hore ho be le mangole a mangole, e loketse ho tsamaisa mangole a fokolang
Likotsi tsa ho buoa le litlholisano
Likotsi li kenyelletsa ho lemala mesifa ea manyolo ea Tibiatior le mallar mallucture. Ho malimafa malhala ho ka tšoaroa ka liphokojoe tsa mallule li ka tšoaroa ka meroalo ea boemo bo sithabetsang ea ho tsitsipana, e qalang kapa ea ka ntle.
Tlhokomeliso e tlameha ho nkuoa ho qoba ho bokella ho kenella ho Fibular Nochs. Sesebelisoa sa boemo ba boemo se ka baka potoloho e potolohileng ea DTN ka lebaka la boima ba eona; Fetola moqhaka oa bobeli ho supa fibula (feiga 4).Litekanyetso tse ka bang teng:
Mafuputsi a Maketsoana a Tibeelis, malselelar a robeha
Tsamaiso:
Sehlopha sa tsitsipano, ho qala, kapa sethala sa kantle
Screw mmaraka le boima ba sesebelisoa sa sesebelisoa se hloka tlhokomelo e ka hare-hare
Papiso ea bongaka
Litefiso tsa thibelo ea li-nounign tsa li-antelign Bakeng sa ho koala lipolanete, 0-17% le 0-17%. Thutong ena, linyeoe tsohle tse fumanoeng bo kopanele, 'me ke 20% feela ea ho fokola> 5 °, ke mekhoa ea setso. Tšoaetso e tebileng ke 0-23% le 0-8.3%, ka ho latellana. Phuputso ena e tlaleha hore ho se na mathata a bonolo a linama tse bonolo, e fetisang lintlha tse ling.
Linomoro tsa AAFAS tsa ATQUAD Nails: 86-88 (thaepa a), 73 (thaepa c); Plates plates: 84-88 (thaepa a)
Boithuto bona: Kakaretso ea AOFAS: 92.6
Eq-5d-5l-5l: Plates ea ho notlela: 0,62-0.76; Phuputso ena: 0.876
Ts'ireletso e bolokehileng-q (leoto le bakuli ba maoto): 67-75; Boithuto bona: 83-91.7 (tafoleng ea 3)
Union sekhahla, sekhahla sa phapanyetsano le sekhahla sa ts'oaetso le lefu la tšoaetso ea lefutso
Lintlha tse sebetsang (Aafas, Eq-5d-5l, Ts'ireletso e Nepahetse
Ka kakaretso, DTN e fana ka melemo ea ho notlela lipekere le ho amohela lipekere tsa intramed le e emela tharollo e sebetsang.
DTN e na le litšitiso tse nyane tse tsitsitseng, botsitso bo phahameng le ho fola kapele
Ke mofuta oa bohlokoa oa kalafo ea setso le ka nepo ho khothaletsa ho ntšetsa pele
Yamakawa Y, Auhalira T, Shigemoto K, Et al. Liphetho tsa pelehi tsa maemo a phahameng a lintho tse hole tsa Tibia tibia tsa Tibia: e tla ba e mong. Kotsi, 2024: 111344.
创伤骨科智能科技 智汇骨. (2024 年 12月 4) 4,2). 胫骨远端髓内钉突破胫骨远端骨折 的 的 的 的]. 创伤骨科智能科技 智汇骨. https://mpmp.weixin.qq.com/s/9uqqvjke2u4nq8q (a fihlele: 2025 年 06月 ka lilemo tse 2025 年 06月.
