I-PFNA Nail: Isisombululo esisebenzayo se-Orthopedic

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I-PFNA Nail: Isisombululo esisebenzayo se-Orthopedic

Ukuphuka kwe-femoral fractures ekufutshane kuhlala enye yeyona nto ixhaphakileyo kunye nomngeni wokulimala kwi-orthopedic trauma, ngakumbi phakathi kwezigulane ezisebekhulile ezine-osteoporosis. Ngokunyuka kwexesha lokuphila kunye neziganeko eziphezulu zokuphuka kwe-hip emhlabeni jikelele, iinkqubo ezizinzileyo zokulungisa ezivumela ukuhlanganiswa kwangaphambili kunye nokuphulukiswa okuthembekileyo kwe-fracture kuye kwaba yinto ephambili kwikliniki.

Isikhonkwane sePFNA (Proximal Femoral Nail Antirotation) saphuhliswa ukujongana nezi mfuno. Ngokudibanisa i-intramedullary load-sharing mechanics kunye noyilo lwe-antirotation blade, inkqubo ye-PFNA iye yaba sisisombululo esamkelwe ngokubanzi sokungazinzi kokwaphuka kwe-femoral engazinzanga.

Eli nqaku libonelela ngombono obanzi wenkqubo ye-PFNA yesikhonkwane, kubandakanywa izibonakaliso zayo, izibonelelo ze-biomechanical, imigaqo yotyando, ukubuyisela emva kokuhlinzwa, kunye nokuqwalaselwa kokulawulwa komngcipheko.

Ukuqonda iNkqubo yeZikhonkwane zePFNA kunye neNgcaciso yoYilo

I-PFNA isikhonkwane yinkqubo yokulungiswa kwe-intramedullary eyenzelwe ngokukodwa iifractures ze-femur proximal. Ngokungafaniyo nezixhobo zemveli ze-extramedullary, i-PFNA isebenza ecaleni kwe-axis yomatshini we-femur, ivumela ukuhanjiswa komthwalo ongaphezulu.

Isici esicacileyo senkqubo ye-PFNA yi- helical antirotation blade , edibanisa ithambo lokukhansela ngexesha lokufakwa. Oku kuhambelana kwandisa ukuthengwa ngaphakathi kwethambo le-osteoporotic kwaye kuphucula ukuxhathisa ukujikeleza kunye ne-varus ukuwa kwemikhosi. Ngenxa yoko, iPFNA ibonelela uzinzo olongeziweyo xa kuthelekiswa neenkqubo eziqhelekileyo ezisekwe kwisikrufu, ngakumbi kwizigulana ezinomgangatho ophantsi wamathambo.

Izibonakaliso zeklinikhi kunye nokuKhethwa kwesigulane kwi-PFNA yokuLungiswa kwezikhonkwane

Iipateni zoKuqhekezwa okuPhakamileyo koBufazi okuNyangwa ngePFNA

Izikhonkwane ze-PFNA zibonakaliswe ngokukodwa kwiifractures ezibandakanya i-femur ehamba phambili, kuquka:

• Ukuqhekeka kwe-Intertrochanteric femoral

• Ukungazinzi okanye ukuxhatshazwa kwe-trochanteric fractures

• Iifractures ze-subtrochanteric femoral

• Ukubuyisela umva iipateni zokwaphuka kwe-obliquity

Ezi ntlobo zokuphuka zihlala zibonisa ukungazinzi kwe-biomechanical, okwenza ukulungiswa kwe-intramedullary kube yinto ekhethiweyo.

PFNA Ukusetyenziswa Kwezikhonkwane kwi-Osteoporotic kunye nezigulane eziDala

I-Osteoporosis ibeka emngciphekweni kakhulu amandla okulungiswa kwe-screw kwintloko ye-femal. I-PFNA antirotation blade inenzuzo ngakumbi kwezi meko, njengoko icinezela ithambo le-trabecular kunokulisusa. Olu luyilo lunciphisa umngcipheko wokusikwa kokufakelwa kunye nokulahleka kokulungiswa, okwenza i-PFNA ibe yinto ethembekileyo yokukhetha izigulana ezisele zikhulile ezine-osteoporotic hip fractures.

Izinto eziluncedo zeBiomechanical zePFNA xa kuthelekiswa nezinye iiNkqubo zokuLungisa

UKwabelana ngomthwalo we-Intramedullary Fixation kunye noZinzo olujikelezayo

Ukususela kumbono we-biomechanical, izikhonkwane ze-intramedullary zibonelela ngokwabelana ngomthwalo ophezulu xa kuthelekiswa neenkqubo ezisekelwe kwiplate. I-PFNA isikhonkwane ihambelana ngokusondeleyo kunye ne-femoral mechanical axis, ukunciphisa amaxesha okugoba kwindawo yokuphuka.

I-antirotation blade iphucula ukuzinza okujikelezayo ngokunyusa ukudibana komphezulu kunye nethambo lokukhansela, elinceda ukugcina ukuncitshiswa kwe-fracture phantsi kwemithwalo ye-axial kunye ne-torsional ngexesha lokuthwala ubunzima bokuqala.

UbuChwepheshe obuHlangeneyo obuncinci kunye nokuGcinwa kweTissue ezithambileyo

Ufakelo lwe-PFNA lufuna ukuvezwa kotyando okuncinci xa kuthelekiswa neendlela ezivulelekileyo zokulungisa. Ukunciphisa ukuphazamiseka kwezicubu ezithambileyo kuncedisa ekulahlekeni kwegazi eliphantsi, ukunciphisa intlungu emva kokuhlinzwa, kunye nokubuyisela ngokukhawuleza okusebenzayo-izinto ezibaluleke kakhulu kwizigulane ze-geriatric trauma.

UbuChwepheshe boTyando kunye naManyathelo aPhambili eNkqubo yoFakelo lwe-PFNA lweZikhonkwane

UCwangciso lwangaphambi kokuSebenza kunye noVavanyo lweMifanekiso

Ucwangciso oluchanekileyo lwangaphambi kotyando luyimfuneko kulungiso oluyimpumelelo lwePFNA. Uvavanyo lwe-Radiographic, kubandakanywa neembono ze-anteroposterior kunye ne-lateral ye-hip kunye ne-femur, inceda ukucacisa ukuhlelwa kwe-fracture, ubude be-nail, ubukhulu be-blade, kunye neyona ndawo yokungena.

Kwiimeko ezinzima, i-CT imaging ingasetyenziselwa ukuvavanya i-morphology ye-fracture kunye nesikhokelo seqhinga lotyando.

INyathelo ngeNyathelo Isishwankathelo seNkqubo yoTyando yePFNA

Amanyathelo enkqubo angundoqo aquka:

1. Ukubekwa kwesigulana kwitafile yokuqhekeka kunye ne-traction efanelekileyo

2. Ukunciphisa ukuphuka okanye ukuncediswa kancinci phantsi kwe-fluoroscopy

3. Ukusekwa kwendawo yokungena echanekileyo

4. Ukufakwa kwe-Intramedullary nail kunye nokulungelelaniswa

5. Ukubekwa kwe-antirotation blade kwintloko ye-femal

6. Ukutshixa i-Distal ukulawula ukujikeleza kunye nobude

Ukubekwa kwe-blade ngokuchanekileyo ngaphakathi kwentloko ye-femal kubalulekile ukunciphisa iingxaki zoomatshini kunye nokuqinisekisa ukuzinza kokulungiswa kwexesha elide.

Ukubuyiselwa kwimeko yesiqhelo emva kokusebenza kunye nokuBuyiselwa kokuSebenza emva koTyando lwe-PFNA

UkuHlanganisa kwangethuba kunye neeNgqwalaselo zokuZithwala ubunzima

Enye yeenjongo eziphambili zokulungiswa kwePFNA kukuvumela ukuhlanganisa kwangethuba. Ngokuxhomekeke ekuzinzeni kwe-fracture kunye nemeko yesigulane, ubunzima obupheleleyo okanye obupheleleyo bunokuqaliswa ngokukhawuleza emva kokuhlinzwa phantsi kweliso lonyango.

Ukuhlanganiswa kwangaphambili kunceda ukunciphisa iingxaki ezifana ne-thrombosis ye-vein deep, imiba ye-pulmonary, kunye ne-muscle atrophy.

IiNjongo eziSebenzayo zokuJonga nokuBuyiselwa kwisimo sangaphambili

Ukuvuselelwa kwe-postoperative kugxile ekubuyiseleni uluhlu lwe-hip lokuhamba, amandla emisipha, kunye nokuzinza kwe-gait. Iziphumo ezisebenzayo zivame ukuvavanywa kusetyenziswa amanqaku eentlungu, amandla okuhamba, kunye nobungqina be-radiographic bokuphulukiswa kokuphuka.

Iingxaki ezinokwenzeka kunye noLawulo loMngcipheko kwi-PFNA yokuLungiswa kwezikhonkwane

Imingeni yobuchwephesha yangaphakathi

Imiba enokubakho ye-intraoperative ibandakanya ukungena okungafanelekanga kwezikhonkwane, ukubekwa kwe-blade suboptimal, okanye ukuncitshiswa kwe-fracture engonelanga. Ezi zinto zinokunyusa umngcipheko wokungaphumeleli kokulungiswa kwaye kufuneka zilawulwe ngononophelo ngesikhokelo se-fluoroscopic kunye namava otyando.

Iingxaki zePostoperative kunye neZicwangciso zoThintelo

Nangona i-PFNA inxulunyaniswa neziphumo ezithandekayo, iingxaki ezinjengokusikwa kwe-blade, usulelo, ukulibaziseka komanyano, okanye iintlungu ezinxulumene nokufakelwa zingenzeka. Ubuchule botyando obucokisekileyo, ukhetho olufanelekileyo lwesigulane, kunye nokhathalelo olucwangcisiweyo lwasemva kotyando lungundoqo ekunciphiseni le mingcipheko.

Iziphumo zeklinikhi kunye nobungqina obuxhasa iPFNA yokusetyenziswa kwezikhonkwane

Uphononongo lwezonyango luye lwabonisa ngokungaguquguqukiyo amazinga aphezulu omanyano kunye neziphumo ezanelisayo zokusebenza ngokulungiswa kwe-PFNA kwi-proximal femoral fractures. Xa kuthelekiswa nezixhobo ze-extramedullary, i-PFNA ibonise inzuzo ekunciphiseni izinga lokungaphumeleli koomatshini, ngakumbi kwiipateni zokuphuka okungazinzanga kunye ne-osteoporotic bone.

Ezi zinto zifunyanisiweyo zixhasa i-PFNA njengesisombululo esithembekileyo nesamkelwe ngokubanzi kwindlela yokwenzakala yale mihla yamathambo.

Ukuqwalaselwa kweendleko kunye noCwangciso loNyango

Indleko iyonke yonyango lwe-PFNA ibandakanya ukhetho lokufakelwa, inkqubo yotyando, ukulaliswa esibhedlele, kunye nokuvuselelwa. Ngelixa iinkqubo ze-intramedullary zinokuba neendleko eziphezulu zokufakelwa kwasekuqaleni, ukukwazi kwazo ukuxhasa ukuhlanganisa kwangethuba kunye nokunciphisa iindleko ezinxulumene nobunzima kunokubonelela ngeenzuzo zezoqoqosho zexesha elide.

Izigqibo zonyango kufuneka zilinganise ukusebenza kweklinikhi, imiba yesigulane, kunye nemigaqo yeziko.

Ukuqukumbela: Indima ye-PFNA isikhonkwane kuLawulo lwangoku loLwahlulo loLwahlulo lweFemoral oluPhakamileyo

Isikhonkwane se-PFNA simele isisombululo esisekelwe kakuhle se-orthopedic kunyango lwe-fractures ye-femoral proximal. Uyilo lwayo lwe-intramedullary, iteknoloji ye-antirotation blade, kunye nokufaneleka kwethambo le-osteoporotic yenza ukuba isebenze ngokukodwa ekulawuleni i-hip fractures engazinzanga.

Xa isetyenziswe ngobuchule obufanelekileyo botyando kunye nokukhethwa kwesigulane, ukulungiswa kwe-PFNA kuxhasa ukuphulukiswa okuzinzileyo kwe-fracture, ukuvuselelwa kwangaphambili, kunye nokuphuculwa kweziphumo zokusebenza-iinjongo eziphambili kukhathalelo lwangoku lwamathambo amathambo.

FAQ of PFNA Nail Fixation

Sisetyenziselwa ntoni isikhonkwane sePFNA?

Isikhonkwane se-PFNA sisetyenziselwa ukulungiswa kwangaphakathi kweefractures ze-femal proximal, ngokukodwa i-intertrochanteric kunye ne-hip fractures engazinzanga. Yenzelwe ukubonelela ngokuzinza kwe-intramedullary fixation ngelixa ivumela ukuhlanganiswa kwangaphambili kwesigulane.

 Zeziphi iintlobo zeefracture ezifanelekileyo zokulungiswa kwePFNA?

I-PFNA iqhele ukuboniswa kwi-intertrochanteric fractures, i-trochanteric fractures engazinzanga, i-subtrochanteric fractures, kunye neepateni zokuqhawula umva, ngakumbi kubantu abadala okanye izigulane ze-osteoporotic.

Kutheni i-PFNA ikhethwa kwithambo le-osteoporotic?

I-PFNA i-antirotation blade idibanisa ithambo lokukhansela ngexesha lokufakwa, ukuphucula ukuthengwa kokufakelwa kunye nokunciphisa umngcipheko wokusika. Oku kwenza ukuba isebenze ngokukodwa kwizigulane ezinomgangatho ophantsi wamathambo.

I-PFNA yohluke njani kwi-DHS okanye izikrufu eziqhelekileyo ze-hip?

Ngokungafaniyo neenkqubo ze-hip screw (DHS), i-PFNA ibonelela ngokulungiswa kokwabelana ngomthwalo we-intramedullary. Ukulungelelaniswa kwayo okuphakathi kunye ne-antirotation blade inikeza ukuzinza okuphuculweyo kwe-biomechanical, ngakumbi kwiipateni zokuqhekeka okungazinzanga.

Ngaba utyando lwe-PFNA alungeneleli kancinci?

Ewe. Ufakelo lwe-PFNA lwenziwa ngendlela ehlaselayo kancinane kunye nokusikelelwa okuncinci, ukunciphisa ukonakala kwezicubu ezithambileyo, kunye nokulahleka kwegazi okuqhelekileyo xa kuthelekiswa neendlela ezivulekileyo zokulungisa.

Ngaba izigulana zinokuqala nini ukuthwala ubunzima emva kotyando lwe-PFNA?

Iiprothokholi ezithwala ubunzima zixhomekeke ekuzinzeni kwefracture kunye nemeko yesigulane. Kwiimeko ezininzi, ukuthwala ubunzima obungaphelelanga okanye obulawulwayo kunokuqala kwangoko, phantsi kwesikhokelo sogqirha onyangayo kunye neqela lokubuyisela kwimeko yesiqhelo.

Ziziphi iingxaki eziqhelekileyo ezinxulumene nezikhonkwane ze-PFNA?

Iingxaki ezinokuthi zibekho ziquka ukusikwa kweblade, ukungahambi kakuhle kokufakelwa, usulelo, ukulibaziseka komanyano, okanye iintlungu ezinxulumene nokufakelwa. Uninzi lweengozi zinokuncitshiswa ngobuchule obufanelekileyo botyando kunye nokukhethwa kwesigulana.

Kuthatha ixesha elingakanani ukuba iifracture ziphole emva kokulungiswa kwe-PFNA?

Ukuphiliswa kwe-Radiographic fracture ngokuqhelekileyo kwenzeka kwiinyanga ezininzi, kuxhomekeke kuhlobo lokuphuka, umgangatho wamathambo, kunye nempilo yesigulana. Ukuchacha okusebenzayo kunokuqhubela phambili kwangaphambili kunye nokubuyisela okufanelekileyo.

Ngaba i-PFNA ilungele abaguli abancinci abaneezaphulelo zamandla aphezulu?

Ewe. I-PFNA inokuphinda isetyenziswe kwizigulana ezincinci ezineefractures ze-femoral ezingazinzanga ezibangelwa kukwenzakala kwamandla aphezulu, ukunikezelwa kokunciphisa i-anatomical kunye nokulungiswa okuzinzile kufezekisiwe.

Ingaba ubude bezikhonkwane zePFNA kunye nobukhulu bencakuba bumiselwa njani?

Ukukhethwa kokufakelwa kusekelwe kwi-imaging yangaphambili, ipateni yokuphuka, i-femoral anatomy, kunye novavanyo lwe-fluoroscopic lwe-intraoperative ukuqinisekisa ukulungiswa okulungileyo kunye nokuzinza kwe-biomechanical.