Isikhonkwane se-Femoral Intramedullary ebuyiselwe umva: Indlela ethembisayo yoKwaphuka kweFemoral

Ukuqhekeka kwe-Femoral, okuchaphazela ithambo lethanga, kunokuba nzima ukunyanga ngokufanelekileyo. Ubuchwephesha bezikhonkwane be-femoral intramedullary obubuyisiweyo buvele njengendlela ethembisayo yokulawula ezi fractures. Kweli nqaku, siza kuphonononga izibonelelo, ubuchule botyando, iingxaki ezinokubakho, kunye nokuchacha okuhambelana nesikhonkwane se-femoral intramedullary.

Intshayelelo

Ukuqhekeka kwe-femur kunokubangela intlungu enkulu, ukungasebenzi, kunye nokunciphisa ukusebenza. Iindlela zonyango zemveli zinokuba nemida ekuphumezeni iziphumo ezilungileyo. Ukuguqulwa kwe-femoral intramedullary nail technique inika imbono entsha yokulawula ukuphuka, ukubonelela ngokuzinza kunye nenkxaso ngexesha lenkqubo yokuphulukisa.

Ukuqonda Reversed Femoral Intramedullary Nail

Isikhonkwane se-femoral intramedullary esiguquliweyo sisixhobo sonyango esenzelwe ukuzinzisa kunye nokukhuthaza ukuphilisa kwiifractures zesifazane. Ifana nesikhonkwane esiqhelekileyo se-intramedullary, kodwa ngokuqhelaniswa nokuguqulwa. Isikhonkwane sifakwe kwi-distal end ye-femur kwaye sihamba ngokusondeleyo, sibonelela ngokuzinza kunye nokulungelelaniswa kumacandelo amathambo aphukileyo.

Iimpawu zeNail ye-Femoral Intramedullary eguqulweyo

I-reverse ye-femoral intramedullary nail ifanelekile ngokukodwa kwiindidi ezithile zokuphulwa kwe-femoral fractures. Ngokuqhelekileyo isetyenziselwa iifractures ezibekwe kwindawo ekude ye-femur, kuquka i-supracondylar kunye ne-intracondylar fractures. Ezi ziqhekeza zihlala zifuna ukulungiswa okuzinzile kunye nokulungelelaniswa okuchanekileyo ukuphiliswa ngokufanelekileyo.

Ubuchwephesha boTyando kwiNail ye-Femoral Intramedullary ebuyiselwe umva

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 sibekwe phezu kwetafile yokusebenza. Umlenze ochaphazelekayo ulungiselelwe kwaye ugxothwe ngendlela eyinyumba. Ukuma okufanelekileyo kubalulekile ukuvumela ukufikelela ngokufanelekileyo kwindawo yokuphuka kunye nokuququzelela ukufakwa kwezikhonkwane ukusuka ekupheleni kwe-femur.

Ukusika kunye noFikelelo

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

Ukufakwa Kwezikhonkwane

Isikhonkwane se-femoral intramedullary esibuyiselwe umva sifakwe ukusuka kwisiphelo esikude se-femur, siqhubela phambili ngokubhekiselele kwindawo yokuphuka. Isikhokelo esichanekileyo siyimfuneko ukuze kuqinisekiswe ukubekwa okuchanekileyo kunye nokulungelelaniswa. I-Fluoroscopic imaging isetyenziselwa ukuqinisekisa ukuma kwesikhonkwane ngaphakathi komsele we-femoral.

I-Distal Locking Screw Placement

Nje ukuba isikhonkwane sibekwe ngokuchanekileyo, izikrufu zokutshixa ezikude zifakwe 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 kwi-Femoral Intramedullary Nail eguqulweyo

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

1. Ukulungelelaniswa okuchanekileyo: Ubuchule besikhonkwane obutshintshileyo buvumela ukulungelelaniswa okuchanekileyo kwamacandelo amathambo aphukileyo, ukukhuthaza ukuphilisa ngokufanelekileyo kunye nokunciphisa umngcipheko wokungahambi kakuhle.

2. Uzinzo oluphuculweyo: Isikhonkwane esiguquliweyo se-femoral intramedullary sinikezela ukuzinza okuphuculweyo kwindawo yokuphuka, okuvumela ukuthwala umthwalo ongcono kunye neziphumo eziphuculweyo zokuphilisa.

3. Ukulondolozwa konikezelo lwegazi: Ngokusebenzisa umjelo we-intramedullary kunye nokufaka isikhonkwane ukusuka ekupheleni kwe-distal, ubuchule obubuyiselweyo be-femoral intramedullary nail bunciphisa ukuphazamiseka kunikezelo lwegazi lwethambo. Oku kugcinwa kokuhamba kwegazi kubalulekile ukuze amathambo aphile kunye nomanyano lokwaphuka.

4. Ukunciphisa ukwenzakala kwezicubu ezithambileyo: Indlela yezikhonkwane ebuyiselwe umva ibandakanya ukuqhekeka kwezicubu ezithambileyo, okukhokelela ekunciphiseni ukwenzakala kwezicubu ezithambileyo. Oku kunokukhokelela ekubuyiseleni ngokukhawuleza, ukunciphisa intlungu emva kokuhlinzwa, kunye nokunciphisa umngcipheko weengxaki zezicubu ezithambileyo.

5. Ukuhlanganiswa kwangethuba: Ngesikhonkwane se-femoral intramedullary esibuyiselwe umva, ukuhlanganisa kwangethuba kunokwenzeka. Oku kuvumela izigulane ukuba ziqale ukuthwala ubunzima kunye nokuzivocavoca umzimba ngokukhawuleza, ukukhuthaza ukubuyiswa ngokukhawuleza kunye nokuphucula iziphumo zokusebenza.

   
   

Iingxaki ezinokuthi zibekho kunye nemingcipheko

Ngelixa i-femoral intramedullary nail technique ithathwa njengekhuselekile kwaye iyasebenza, kukho iingxaki ezinokubakhona kunye nemingcipheko ehambelana 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 uqhaqho lwe-femoral intramedullary nail, 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 nge-femoral intramedullary nail technique. Olunye uphononongo lwalubandakanya umntu oneminyaka engama-45 ubudala onoqhekeko olukude lobufazi. Emva kokwenziwa utyando ngesikhonkwane se-femoral intramedullary esibuyiselwe umva, isigulana safumana umanyano oluqinileyo lokwaphuka, saphinda safumana amandla okuthwala ubunzima, saza sabuyela kwimisebenzi yesiqhelo kwisithuba seenyanga ezintandathu.

Ukuqukumbela

Ukuqukumbela, i-femoral intramedullary nail technique ebuyisiweyo inika isisombululo esithembisayo sokulawula iifractures zabasetyhini, ngakumbi kwingingqi ekude. Inika uzinzo olongezelelweyo, ulungelelwaniso oluchanekileyo, kunye nokubanakho ukuhlanganisa kwangethuba. Nangona kusenokubakho iingozi neengxaki, ukuceba ngenyameko kwangaphambi kotyando, ubuchule obuchanekileyo botyando, nonyango olufanelekileyo lwasemva kotyando lunokunceda ekunciphiseni ezi nkxalabo. Izigulane ezityhutyha utyando lwe-femoral intramedullary nail, olulandelwa yinkqubo yokuvuselela kakuhle, inamandla okubuyisela ngempumelelo kunye nokubuyisela umsebenzi.