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Ulapha: Ekhaya » Iindaba » Izikhonkwane ezili Ukwenzakala - 10 eziphezulu ze-Distal Tibial Intramedullary (DTN) eMntla Melika ngoJanuwari ka-2025

Izikhonkwane ezili-10 eziphezulu ze-Distal Tibial Intramedullary (DTN) eMntla Melika ngoJanuwari ka-2025

Iimboniselo: 0 uMbhali: Ixesha lokupapasha loMhleli weSiza: 2025-06-17 Imvelaphi: Isiza

I-Distal Tibial Intramedullary Nail (DTN) i-Clinical Study

Uhlalutyo oluBanzi lweTeknikhi yoTyando, iZiphumo, kunye nezicelo

Ipapashwe: ngoJuni 17, 2025

I-Distal Tibial Intramedullary Nail (i-DTN) iboniswa kwiintlobo ezahlukeneyo zeemeko ze-tibial, ezibandakanya ilula, i-spiral, i-comminuted, i-oblique ende, kunye ne-segmental shaft fractures (ingakumbi i-distal tibia), kunye ne-distal tibial metaphyseal fractures, non-/mal-unions; inokuphinda isetyenziswe, rhoqo ngezixhobo ezikhethekileyo, ukulawula iziphene zamathambo okanye ukungangqinelani kobude belungu (njengokwandiswa okanye ukufinyeza).

Amacwecwe okutshixa

Umonakalo obalulekileyo wezicubu ezithambileyo, izinga eliphezulu losulelo, ukubuyisela ixesha elide

Izikhonkwane ze-Antegrade

Umngcipheko wokulimala kwamadolo, ukulungiswa okunganelanga, ukulungelelaniswa nokungahambi kakuhle

Isisombululo se-DTN

Indlela ehlaselayo encinci kunye noyilo lofakelo lokubuyisela umva

Khuphela iTekhnoloji yoLwando epheleleyo (PDF)

I. Intshayelelo

1I-distal tibial fractures ixhaphakile, kwaye unyango lwendabuko lunemida

I-distal tibial fractures luhlobo oluqhelekileyo lokuphuka kwemilenze ephantsi. Unyango lwesintu olufana neepleyiti zokutshixa kunye nezikhonkwane ze-antegrade intramedullary nganye inemiqobo yazo. Iipleyiti zokutshixa zinokubangela izifo emva kokuhlinzwa okanye i-necrosis yezicubu ezithambileyo, ukwandisa ukubuyiswa; nangona izikhonkwane ze-antegrade zincinci, zingonakalisa idolo elihlangeneyo, zibangele intlungu, kwaye zithwale imingcipheko yokungalungiswa ngokwaneleyo okanye ukungahambi kakuhle, ukuthintela ukubuyiswa.

2Isisombululo esitsha: I-Distal Tibial Nail (DTN)

Inketho yonyango entsha-i-Distal Tibial Nail (i-DTN)-inika imbono entsha yokulawula i-distal tibial fractures kunye noyilo olukhethekileyo lokubuyisela.

Umzobo 1: uyilo lofakelo lokubuyisela i-DTN

II. Inkqubo yoTyando

1Ukubekwa kwesigulane kunye nokulungiswa kokunciphisa

Isigulane sibekwe kwindawo yokulala. Iifractures ezifudusiweyo kufuneka zincitshiswe ngesandla; ukuba kuyimfuneko, sebenzisa iiforcep zokunciphisa ukuncedisa phambi kokufaka i-DTN. Ukuba kukho i-fibular fracture ehamba kunye, ukulungelelaniswa okufanelekileyo kwe-fibular kunokuncedisa ukunciphisa i-tibial.

Iingcamango eziphambili: Isikhundla esiphezulu, sebenzisa i-forceps yokunciphisa ukuba kuyimfuneko. Ukubeka phambili ulawulo lwe-fibular fracture ukuqinisekisa ukunciphisa okuchanekileyo kwe-tibial.

2Inkqubo yokufaka i-DTN

I-2-3 cm ye-longitudinal incision yenziwa kwincam ye-medial malleolus ukuveza i-superficial deltoid ligament. Ikhoni yesikhokelo ifakwe okanye iphakathi kancinci kwincam ye-malleolus, i-4-5 mm ukusuka kwi-articular surface.

Ukusika:

I-longitudinal cut in the medial malleolus tip

Isikhonkwane sokubekwa kwesikhokhelo:

4-5 mm ukusuka kwindawo edibeneyo

Ukulungiswa:

Izikrufu ezidibeneyo ngokusondeleyo kunye ne-distally

Umzobo 2a: Ufakelo lwesikhonkwane sesikhokelo

Umzobo 2b: Imbono esecaleni

Umzobo 2c: Inkqubo yokubuyisela kwakhona

III. Ukubuyisela kwimo yesiqhelo emva kokuphuma

0-6

Iiveki Ukuthwala ubunzima

Ukuhamba ngokudibeneyo kwe-ankle kunye nokuqhagamshelana nonyawo ukuya kumgangatho

6-8

Iiveki Ukuthwala ubunzima

Inkqubela phambili ukuya kwi-50% yomthamo wokuthwala ubunzima

8-12

Iiveki Ubunzima obugcweleyo

Ngelixa esweni ukubunjwa kweefowuni kunye neentlungu

Umgaqo wokubuyisela kwisimo sangaphambili

Umsebenzi odibeneyo we-Ankle uqala ngokukhawuleza emva kokuhlinzwa
Kuphephe ukuthwala ubunzima kwiiveki ezi-4-6
Ukutshintshela ngokuthe ngcembe kwisisindo esipheleleyo kwiiveki ezi-8-12
Ukujongwa rhoqo kweradiographic ngexesha lesigaba sokubuyisela

IV. Iziphumo zoFundo

1Iziphumo zoNyango lwezigulane ezili-10

Uphononongo lulandele izigulane ezili-10. Kwiinyanga ezi-3 emva kokuphuma, iimeko ezi-7 sele ziphilisiwe; zonke izigulane zifumene ukuphiliswa kwiinyanga ezi-6. Imeko enye yevarus kunye ne-recurvatum deformities yenzeka. Akukho kulahleka kokunciphisa, ukusuleleka, iingxaki ezinxulumene nokufakelwa, okanye ukulimala kwe-iatrogenic kwabonwa.

70%

Uphiliswe kwiinyanga ezi-3

100%

Uphiliswe ngeenyanga ezi-6

Usulelo

Umlinganiselo weSiphumo	Iziphumo zeDTN	Iindlela zesiNtu
Umyinge weManyano (iinyanga ezi-3)	70%	40-60%
Ukungahambi kakuhle (>5°)	20%	25-40%
Inqanaba losulelo	0%	5-15%
Amanqaku e-AOFAS	92.6	73-88

V. Ingxelo yeCase

Umguli oneminyaka engama-69 ubudala

Uhlobo lokuqhekeka: I-Transverse tibial fracture + i-fibular fracture
Ingxaki: Ukwenzakala kwezicubu ezithambileyo
I-Post-op: I-6 kuphela i-incision encinci, ukuphilisa okupheleleyo ngaphakathi kwe-1 unyaka

IsiShwankathelo soNyango

I-DTN ifakwe ngokusikeka okuncinci ngogcino lwethishu ethambileyo. I-Fibular fracture izinzile nge-intramedullary nail. Isigulana siphumelele ukuchacha ngokupheleleyo kwaye akukho zingxaki.

Ukufanekisa kwangaphambili

Kwangoko Post-op

Ulandelelwano lweenyanga ezi-3

Unyaka we-1 wokuphila

VI. Ingxoxo

1Ukuzinza kweBiomechanical

Izikhonkwane ze-retrograde zine-axial ephezulu kunye nokuqina okujikelezayo xa kuthelekiswa namacwecwe okutshixa aphakathi kunye nezikhonkwane ze-antegrade. Greenfield et al. kwenziwe uvavanyo lwe-biomechanical olubonisa ukuba ukusebenzisa izikrufu ezibini ze-distal kwi-DTN kuzuze i-60-70% yokuqina koxinzelelo kunye ne-90% yokuqina kwe-torsional xa kuthelekiswa nezikrufu ezithathu.

2Izinto ezilungileyo ze-DTN

Xa kuthelekiswa neepleyiti zokutshixa, izikhonkwane ze-intramedullary zenza umonakalo omncinci wezicubu ezithambileyo, ngakumbi ezifanelekileyo kwizigulane ezisele zikhulile kunye nezo zonzakele kakhulu kwizicubu ezithambileyo ezivela kumonzakalo wamandla aphezulu. Inkqubo ayifuni ukuguqa ngamadolo, ukunciphisa umngcipheko wokunciphisa ilahleko kunye nokwenza ukuba ifaneleke izigulane ezinedolo elilinganiselweyo.

3Uthelekiso lweklinikhi

Amazinga angabonakaliyo kunye nokungahambi kakuhle kwezikhonkwane ze-antegrade yi-0-25% kunye ne-8.3-50%, ngokulandelanayo; kwiipleyiti zokutshixa, 0-17% kunye ne-0-17%. Kolu phononongo, zonke iimeko ezifunyenwe umanyano, kwaye kuphela i-20% yayinokukhubazeka> 5 °, xa kuthelekiswa neendlela zendabuko.

VII. Ukuqukumbela

Isishwankathelo, i-DTN inikezela ngeenzuzo ngaphezu kweeplate zokutshixa kunye ne-antegrade intramedullary izikhonkwane kwaye imele isisombululo esisebenzayo sokunyanga i-distal tibial fractures. I-DTN ibonakalisa ukungahlaseli okuncinci, ukuzinza okuphezulu, kunye nokuchacha ngokukhawuleza. Yeyona ndlela ixabisekileyo kunyango lwesintu kwaye ifanele ukukhuthazwa.

DTN Product Line

I-Distal Tibial Intramedullary Nail (DTN)

Umzekelo: T1100-59

Iinkcukacha zeMveliso

Iseti yesixhobo se-Distal Tibial Intramedullary (DTN).

Umzekelo: 1200-27

Iinkcukacha zeMveliso

I-Distal Tibial Intramedullary Nail (DTN) Ibhokisi Yesixhobo

Umzekelo: 1000-0139

Iinkcukacha zeMveliso

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  ' +' ' +'' +'' +' ' +'

Inkonzo

Buza Ngoku

*Zichaze

OoGqirha Abasasazi Abavelisi Izigulana

Izikhonkwane ezili-10 eziphezulu ze-Distal Tibial Intramedullary (DTN) eMntla Melika ngoJanuwari ka-2025

I-Distal Tibial Intramedullary Nail (DTN) i-Clinical Study

Amacwecwe okutshixa

Izikhonkwane ze-Antegrade

Isisombululo se-DTN

I. Intshayelelo

1I-distal tibial fractures ixhaphakile, kwaye unyango lwendabuko lunemida

2Isisombululo esitsha: I-Distal Tibial Nail (DTN)

II. Inkqubo yoTyando

1Ukubekwa kwesigulane kunye nokulungiswa kokunciphisa

2Inkqubo yokufaka i-DTN

Ukusika:

Isikhonkwane sokubekwa kwesikhokhelo:

Ukulungiswa:

III. Ukubuyisela kwimo yesiqhelo emva kokuphuma

Iiveki Ukuthwala ubunzima

Iiveki Ukuthwala ubunzima

Iiveki Ubunzima obugcweleyo

Umgaqo wokubuyisela kwisimo sangaphambili

IV. Iziphumo zoFundo

1Iziphumo zoNyango lwezigulane ezili-10

V. Ingxelo yeCase

Umguli oneminyaka engama-69 ubudala

IsiShwankathelo soNyango

VI. Ingxoxo

1Ukuzinza kweBiomechanical

2Izinto ezilungileyo ze-DTN

3Uthelekiso lweklinikhi

VII. Ukuqukumbela

DTN Product Line

I-Distal Tibial Intramedullary Nail (DTN)

Iseti yesixhobo se-Distal Tibial Intramedullary (DTN).

I-Distal Tibial Intramedullary Nail (DTN) Ibhokisi Yesixhobo

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