Isikhonkwane se-Femoral Intramedullary: Isisombululo esithembisayo kwiiFractures zeFemoral

Iifractures ze-Femoral, ezichaphazela ithambo lethanga, zingabangela intlungu enkulu, ukungasebenzi, kunye nokunciphisa ukusebenza. Iinketho zonyango ezisebenzayo zibalulekile ekuphumezeni iziphumo eziyimpumelelo kwizigulana ezinala maqhekeza. Olunye ukhetho olunjalo oluye lwafumana ukuthandwa kwiminyaka yamuva kukusetyenziswa kwesikhonkwane se-femoral intramedullary. Eli nqaku liphonononga iingenelo, ubuchule botyando, imingcipheko, kunye nokuchacha okunxulumene nale ndlela yonyango yolutsha.

Intshayelelo

Ukuqhekeka kwe-femur kunokuphazamisa, kufuna unyango olukhawulezileyo kunye oluchanekileyo. Izindlela zonyango zendabuko, ezifana nokuphosa okanye ukulungiswa kwangaphandle, kunokuba nemida ekufezekiseni iziphumo ezilungileyo. I-femoral intramedullary nail technique iye yavela njengesisombululo esithembekileyo nesisebenzayo sokulawula iifractures ze-femoral.

Yintoni iFemoral Intramedullary Nail?

Isikhonkwane se-femoral intramedullary sisixhobo sonyango esenzelwe ukuzinzisa kunye nokukhuthaza ukuphilisa kwiifractures ze-femur. Iqukethe intonga yensimbi efakwe kwiziko elingenalutho le-femur, inika uzinzo kunye nenkxaso ngexesha lokuphulukisa. Isikhonkwane senziwe nge-titanium okanye intsimbi engenastainless kwaye iza ngobukhulu obahlukeneyo ukuze ikwazi ukwamkela izigulana ezahlukeneyo.

Iimpawu zeFemoral Intramedullary Nail

Izikhonkwane ze-Femoral intramedullary ziqhele ukusetyenziswa kunyango lwe-femoral shaft fractures. Zisebenza ngokukodwa kwiifractures ezifuna ukulungiswa okuzinzile, ezifana nokufuduka okanye ukuphulwa kwe-comminuted fractures. Olu buchule lukwafanelekile kwiimeko apho ukuthwala ubunzima ngokukhawuleza kufunwa okanye xa kukho umgangatho ophantsi wamathambo.

Ubuchwephesha boTyando lwe-Femoral Intramedullary Nail

UCwangciso lwaphambi kokuSebenza

Ucwangciso olucokisekileyo lwangaphambi kotyando luyimfuneko kuqhaqho oluyimpumelelo lwe-femoral intramedullary nail. Oku kubandakanya uvandlakanyo olubanzi lwepateni yokwaphuka, impilo yesigulane iyonke, kunye naluphi na ukwenzakala okunxulumeneyo. Iindlela zokucinga, ezifana ne-X-ray, i-CT scans, okanye i-MRI, zisetyenziselwa ukuvavanya iimpawu zokuphuka kunye nesikhokelo sokwenziwa kwesigqibo sotyando.

Ukubekwa kwesigulane

Ngexesha lotyando, isigulane ngokuqhelekileyo sibekwe phezulu kwitafile yokusebenza. Umlenze ochaphazelekayo ulungiselelwe kwaye ugxothwe ngendlela eyinyumba. Ukuma okufanelekileyo kubalulekile ukuvumela ukufikelela ngokufanelekileyo kwindawo yokuphuka kunye nokuququzelela ukufakwa kwezikhonkwane.

Ukusika kunye noFikelelo

Ukusikwa kwenziwa phezu kwendawo yotyando ukufikelela kwithambo elaphukileyo. Ubude kunye nendawo ye-incision ixhomekeke kuhlobo lokuphuka kunye nendawo yalo kunye ne-femur. Ukuphatha iithishu ezithambileyo ngononophelo kubalulekile ukunciphisa umonzakalo kunye nokunciphisa umngcipheko wosulelo.

Ukufakwa Kwezikhonkwane

Emva kokudala indawo yokungena kwi-proximal femur, ugqirha ufaka ngokucophelela i-femoral intramedullary nail kwi-medullary canal. Isikhokelo seFluoroscopic sisetyenziselwa ukuqinisekisa ukubekwa okuchanekileyo kunye nokulungelelaniswa. Isikhonkwane sihamba phambili ngethambo, silungelelanisa nawaphi na amaqhekeza asusiweyo kunye nokubuyisela ukulungelelaniswa okufanelekileyo kwe-anatomical.

Ukutshixa izikrufu zokubeka

Nje ukuba isikhonkwane sibekwe kakuhle, izikrufu zokutshixa zifakwa ukuze kukhuseleke isikhonkwane ngaphakathi kwethambo. Ezi zikrini zibonelela ngokuzinza okongeziweyo kunye nokuthintela ukunyakaza okujikelezayo okanye kwe-axial yeeqhekeza zokuphuka. Inani kunye nokubekwa kwezikrufu kuxhomekeke kwipateni yokwaphuka kunye nokukhethwa ngugqirha wotyando.

Ukuvalwa Kwenxeba

Emva kokuqinisekisa ukulungelelaniswa okufanelekileyo kunye nokulungiswa, i-incision ivaliwe ngokusebenzisa i-sutures okanye i-staples. Ukuvalwa kwamanxeba kwenziwa ngobunono ukukhuthaza ukuphiliswa kunye nokunciphisa umngcipheko wosulelo. Kufakwe isinxibo esingenazintsholongwane, kwaye indawo yotyando ikhuselekile.

Izinto eziluncedo zeFemoral Intramedullary Nail

Ukusetyenziswa kwesikhonkwane se-femoral intramedullary kunika iingenelo ezininzi kwiindlela zonyango zendabuko. Ezinye zezibonelelo eziphambili ziquka:

1. Ukulungiswa okuzinzile: Ukusetyenziswa kwesikhonkwane se-femoral intramedullary kunika ukulungiswa okuzinzile, okuvumela ukulungelelaniswa okufanelekileyo kunye nokudibanisa kweengcezu zokuphuka. Oku kuzinza kukhuthaza ukuphilisa okungcono kwaye kunciphisa umngcipheko wokungahambi kakuhle.

2. Ukuhlanganiswa kwangethuba: Ngobuchule be-intramedullary nail, ukuhlanganisa kwangethuba kunokwenzeka. Oku kuthetha ukuba izigulane zinokuqala ukuthwala ubunzima kunye nokuzivocavoca umzimba ngokukhawuleza, okukhokelela ekubuyiseleni ngokukhawuleza kunye nokuphucula iziphumo zokusebenza.

3. Ukugcinwa kwegazi: Ngokusebenzisa umjelo we-intramedullary, ubuchule be-femoral intramedullary nail bunciphisa ukuphazamiseka kunikezelo lwegazi lwethambo. Ukugcina ukuhamba kwegazi okwaneleyo kubalulekile ekuphileni kakuhle kwamathambo kunye nomanyano lokwaphuka.

4. Iziphumo eziphuculweyo zokuzihombisa: Xa kuthelekiswa neendlela zokulungiswa kwangaphandle, utyando lwezikhonkwane lwe-femoral intramedullary lubandakanya izithintelo ezincinci. Oku kubangela iziphumo ezingcono zokuzihombisa kunye nokunciphisa amanxeba kunye nokuphucula ukwaneliseka kwesigulane.

5. Ukunciphisa umngcipheko weengxaki zezicubu ezithambileyo: Indlela yokusebenzisa i-femoral intramedullary nail ibandakanya ukuphazamiseka okuncinci kwezicubu ezithambileyo. Oku kunciphisa umngcipheko weengxaki ezifana neengxaki zokuphulukisa isilonda, usulelo lwezicubu ezithambileyo, kunye nokulibaziseka ukubuyiswa.

   
   

Iingxaki kunye nemingcipheko

Ngelixa utyando lwezikhonkwane lwe-femoral intramedullary lubonwa ngokubanzi lukhuselekile kwaye lusebenza, kukho iingxaki ezinokubakho kunye neengozi ezinxulumene nenkqubo. Kubalulekile ukuba izigulana zizazi ezi zinto zinokwenzeka phambi kokuba zingene kunyango. Ezinye zeengxaki ziquka:

• Usulelo: Njengayo nayiphi na inkqubo yotyando, kukho umngcipheko wokosuleleka. Nangona kunjalo, ubuchule obufanelekileyo bonyumba, i-antibiotic prophylaxis, kunye nokhathalelo lwasemva kokuhlinzwa kunokunciphisa kakhulu le ngozi.

• Ukunganyaniseki okanye ukungahambi kakuhle: Kwezinye iimeko, iziqhekeza eziqhekezayo azikwazi ukuphilisa ukulungelelaniswa okufunwayo okanye ukuhluleka ukuphilisa ngokupheleleyo. Izinto ezinjengokuncipha ngokwaneleyo, umgangatho ophantsi wamathambo, okanye ukuthwala ubunzima obugqithiseleyo kunokufaka isandla ekungalungelelani okanye ukungahambi kakuhle. Ukubeka iliso olusondeleyo kunye nokungenelela okongeziweyo, njengokuhlinzwa ngokutsha, kunokufuneka ukujongana nale miba.

• Iingxaki ezinxulumene nokufakelwa: Nangona kunqabile, iingxaki ezinxulumene nokufakelwa zingenzeka. Oku kunokubandakanya ukukhulula implanti, ukwaphuka, okanye ukucaphuka. Ukuba iingxaki ezinjalo zivela, ungenelelo olongezelelweyo lotyando lunokufuneka.

• Ukulimala kwe-nerve okanye kwi-blood vessel: Ngexesha lotyando, kukho umngcipheko omncinci wokulimala kwe-nerve okanye kwi-blood vessel. Oogqirha botyando bathatha inyathelo lokunciphisa lo mngcipheko, kodwa izigulane kufuneka ziqaphele ukuba zinokwenzeka kwaye zixele ngokukhawuleza naziphi na iimpawu eziqhubekayo okanye ezisandayo.

  
  

Ukubuyisela kwisimo sangaphambili kunye noBuyiselo

Ukulandela utyando lwezikhonkwane lwe-femoral intramedullary, inkqubo yokubuyisela kwisimo sangaphambili ibalulekile ukuze uchache ngokugqibeleleyo. Isicwangciso esithile sokubuyisela kwimeko yesiqhelo sinokuhluka ngokuxhomekeke kubunzima bokuphuka, iimpawu zesigulane, kunye nesikhokelo sogqirha. Unyango lomzimba, kubandakanywa uluhlu lweendlela zokuzivocavoca, ukuqinisa ukuzivocavoca, kunye nokuqeqeshwa kwe-gait, kudlala indima ebalulekileyo ekubuyiseleni umsebenzi kunye nokuphumelela ngokupheleleyo.

Izifundo zeCase kunye neMpumelelo yamabali

Izigulana ezininzi ziye zafumana iziphumo eziyimpumelelo ngotyando lwezikhonkwane lwe-femoral intramedullary. Olunye uphononongo lwalubandakanya umntu oneminyaka engama-40 ubudala owaphukelwa yi-femoral shaft fracture. Emva kokwenziwa utyando ngesikhonkwane se-femoral intramedullary, isigulana safumana umanyano oluqinileyo lokwaphuka, saphinda safumana amandla okuthwala ubunzima, sabuyela kwimisebenzi yesiqhelo kwisithuba seenyanga ezintandathu.

Ukuthelekiswa nolunye uKhetho loNyango

Xa ucinga ngokhetho lonyango lokuqhekeka kwe-femoral, kubalulekile ukuthelekisa iinzuzo kunye nemida yendlela nganye. Ngelixa ubuchule besikhonkwane be-femoral intramedullary bubonelela ngeengenelo ezininzi, ezinjengokulungiswa okuzinzile, ukuhlanganisa kwangethuba, kunye neziphumo zokuthambisa eziphuculweyo, isenokungalungeli yonke ipateni yokwaphuka okanye isigulana. Iindlela ezizezinye, ezifana nokulungiswa kwangaphandle okanye ukubethelwa, kunokukhethwa kwiimeko ezithile. Ukubonisana nengcali yamathambo kuya kunceda ukumisela eyona ndlela ifanelekileyo yonyango esekelwe kwiimeko zomntu ngamnye.

Ukuqukumbela

Ukuqukumbela, ubuchule besikhonkwane se-femoral intramedullary lukhetho oluthembisayo nolusebenzayo lonyango lokwaphuka kwabasetyhini. Ibonelela ngolungiso oluzinzileyo, yenza ukuhlanganisa kwangethuba, kwaye ibonelela ngeenzuzo ezininzi kwiindlela zemveli. Nangona kukho iingozi ezinokubakho kunye neengxaki ezinxulumene nenkqubo, ukucwangciswa ngenyameko kwangaphambi kotyando, ubuchule obuchanekileyo botyando, kunye nokunyamekela okufanelekileyo emva kokuhlinzwa kunokunceda ukunciphisa oku kukhathazeka. Izigulane ezenza utyando lwezikhonkwane ze-femoral intramedullary, ezilandelwa yinkqubo yokuvuselela kakuhle eyakhiwe kakuhle, ziyakwazi ukubuyisela ngempumelelo kunye nokubuyisela umsebenzi.