I-Elastically stabilized intramedullary nails (ESINs) yindlela eqhelekileyo yokuzinzisa utyando lwamathambo amade kubantwana. Isetyenziselwa kakhulu ukuphatha iifractures ezingazinzanga zeradius, ulna, femur, kwaye ngamanye amaxesha i-tibia kunye ne-humerus. Ikwasetyenziselwa ukunyanga i-pathological fractures yamathambo amade ebantwaneni. I-ESIN inikezela ukulungiswa kwe-fracture evaliweyo ngaphandle kokuvula indawo yokuphuka, ukuzinza kwamanqaku amathathu, kunye nokugcinwa kobude kunye nokujikeleza kwi-transverse, i-oblique fractures emfutshane. Njengokufakelwa kokwabelana ngomthwalo, ivumela ukuhamba kwangoko kwelungu. Ngokuqhelekileyo, izikhonkwane ze-intramedullary ezizinzile zisuswe emva kokuphiliswa kwe-fracture.
Ukwaphuka kweFemoral
Izibonakaliso ze-ESIN kwi-fractures ye-femal yilezi: ubudala phakathi kwe-4 kunye ne-14 iminyaka kunye nokwaphuka kwe-femal ngaphakathi kwe-trauma eninzi.
Isigulane sibekwe kwitheyibhile ye-orthopedic traction, kwaye ubukhulu be-boot bulungelelaniswe nobukhulu bomlenze womntwana. I-fluoroscope iyadingeka ekufumaneni iimbono ze-antero-posterior (AP) kunye ne-latero-lateral (LL) yethanga elichaphazelekayo kwaye ibekwe ukuze ivumele ukubonwa kwe-femur ukusuka kwi-hip ukuya kwinqanaba lamadolo. Ukufunyanwa kokunciphisa kuhlolwe kuzo zombini iimbono ze-AP kunye neLL, kwaye ukujikeleza kuqinisekisiwe.
Ukukhethwa kwezipikili Ububanzi besikhonkwane kufuneka bugcine umgaqo jikelele wokukhetha izipikili. Olu luhlelo lulandelayo lunokusetyenziswa njengolunye uhlobo, olunxulunyaniswa nobudala bomntwana:
- 6-8 iminyaka: 3 mm ububanzi;
- 9-11 iminyaka: 3.5 mm ububanzi;
- 12-14 iminyaka: 4 mm ububanzi.
Ubude bezikhonkwane bulingana nomgama ukusuka kwi-distal growth cartilage ukuya kwi-trochanter enkulu yokukhula kwe-cartilage.
Ukuqhekeka kwe-diaphyseal
I-proximal kunye neyesithathu ephakathi Kwimeko ye-diaphyseal fractures kwi-proximal kunye ne-middle third, indlela ye-C-shaped, kunye nezikhonkwane ezifakwe kwi-retrograde ngokusebenzisa i-distal metaphysis, ikhethwa. Kwimeko ye-proximal fractures, i-proximal tip yezikhonkwane igobile, ngelixa i-mid-diaphyseal fractures, umbindi wesikhonkwane ugobile. Ekupheleni komsebenzi, kwimeko yokuqhekeka okunqamlekileyo, iziqwenga zithinteka ukwenzela ukuphepha ukuphazamiseka okushiyekileyo, okunokuthi kube noxanduva lobude obungalinganiyo bemilenze ephantsi. Kwimeko ye-oblique okanye i-fractures comminuted, i-distal tip igobile kwaye ichaphazeleke kwithambo ukuphepha i-telescoping yamaqhekeza kunye nokufuduka kwezipikili.
Ukutyekela kwendalo kwezi ziqhekeza kukubangela ukunciphisa i-5-10 mm ngokukhawuleza emva kokuhlinzwa, okuya kuhlawulwa ngokukhuthazwa kokukhula ngexesha lokuqiniswa kweqhekeza.
Ukuqhekeka kweTibial
Ukubeka kunye nokulungiswa kwesigulane Isigulane sibekwe kwitafile yamathambo ukwenzela ukuba kube lula ukunciphisa. Ubukho be-fluoroscope bunyanzelekile kulawulo lwe-intraoperative. Intsimi yokusebenza kufuneka ibandakanye idolo .
Ukufakwa kwezikhonkwane
Izikhonkwane ezi-elastic zihlala zifakwe i-antegrade kwi-proximal metaphysis, kwindawo ye-antero-lateral kunye ne-anteromedial.
Ububanzi bezikhonkwane buhluka phakathi kwe-2.5 kunye ne-4 mm, kuxhomekeke kwiminyaka yesigulane. Ukusetyenziswa kwehamile yokuqhubela phambili izikhonkwane kuvunyelwe kodwa kufuneka kusetyenziswe ngononophelo.
Umgangatho wokunciphisa uqinisekiswa ngobubanzi besikhonkwane kunye neqondo lokugoba.
Izikhonkwane akufanele zichaphazeleke kwithambo lokukhansela le-distal metaphysis ngaphambi kokuba ukunciphisa kugqibelele; ngaphandle koko, iinkqubo zokulungiswa zingenza i-osteosynthesis ingazinzi.
Ngaphambi kwempembelelo, ukujikeleza kwamaqhekeza kuhlolwe kwaye, kwimeko yobukho be-varus deformity eseleyo, oku kulungiswa ngokugoba ngokugqithiseleyo kwesikhonkwane. Ekupheleni komsebenzi, i-traction ikhululekile kwaye iziqwenga ziyachaphazeleka.
Kwimeko yokwaphuka kwe-comminuted, iingcebiso ezikufutshane zezikhonkwane ezishiywe ngaphandle kwethambo zigobile kwi-90 ° kwaye zichaphazeleke kwithambo le-cortical ukukhusela i-telescoping yamaqhekeza.
Ukwaphuka kweHumeral
Izibonakaliso ze-ESIN kwi-humeral fractures ziyahluka ngokuxhomekeka kwindawo yokuphuka: i-metaphysis esondeleyo okanye i-diaphysis. Kwizahlulo zentamo yotyando ye-humerus, i-ESIN ibonakaliswe kuba inciphisa ixesha lokunyanzeliswa okufunekayo kwimeko yonyango olulondolozayo.
Kwimeko ye-diaphyseal fractures, ukusetyenziswa kwezikhonkwane ze-elastic kuboniswa kungakhathaliseki ukuba kukho izilonda ze-radial nerve.
Ukufakwa kwezikhonkwane Izikhonkwane zifakwe ngokusebenzisa indlela yokubuyisela. Amanqaku okufakwa afunyenwe kwi-lateral margin yendawo ye-supracondylar, ene-postero-lateral direction kunye ne-proximal inclination. Amanqaku okungena alungiselelwe ngokusebenzisa i-drill kuba ithambo le-cortical kule ndawo linzima kakhulu. Ububanzi bezikhonkwane buhluka phakathi kwe-2.5 kunye ne-3.5 mm, kwaye zigobile ngokufanayo. Izikhonkwane zifakwe ngoxinzelelo lwe-vertical manual kunye nokunyakaza okujikelezayo. Ukuba i-fracture kwindawo ye-metaphyseal ehamba phambili ayinakuncitshiswa ngokwaneleyo, ukujikeleza kwe-1800 yezipikili kuququzelela oku kunciphisa. Ukuba, nangona kunjalo, ukunciphisa akunakwenzeka, i-Kirschner guide-wire ifakwe kwi-proximal fragment ngaphambi kokunciphisa okuvulekileyo. Kwimeko ye-oblique diaphyseal fractures, kubalulekile ukuphepha izikhonkwane ezishiya i-medullary canal kwaye zifudukele ngasemva kwi-radial nerve sulcus. Emva kokuba zombini izikhonkwane ziye zawela indawo yokuphuka, zichaphazeleka kwithambo lokukhansela le-proximal metaphysis.
Ukuqhekeka komphambili
Ukunyangwa kwe-Orthopedic kwi-fractures ye-forearm yamkelwe, kodwa imida evunyelweyo yokuguqulwa ngokuzenzekelayo i-angulation iyaziwa. Ukuba le mida igqithisiwe okanye kwimeko yokungaphumeleli kwonyango lwamathambo, ukunciphisa ukuvala kunye ne-ESIN ibonakaliswe kwi-forearm fractures.
Ubuchule bokuSebenza Isigulana sibekwe kwi-dorsal decubitus, kunye nengalo echaphazelekayo kwitafile ye-radiotransparent.
Ububanzi bezikhonkwane ezisetyenzisiweyo buhluka phakathi kwe-2.5 kunye ne-3 mm. Isikhonkwane se-ulnar siphantse sathi tye, ngelixa isikhonkwane se-radial sinokugoba okuphawulweyo ukuze kubuyiselwe ijika le-pronatory ye-radius.
Ukulungiswa ngokuqhelekileyo kuqala ngethambo elilula ukunciphisa. Kwi-radius, indawo yokungena ifumaneka kwi-distal metaphysis, ngaphezu kwe-distal growth cartilage, phakathi kwee-tendon ze-extensors ezide kunye nezifutshane zesithupha. Ithambo le-cortical libonakaliswe nge-incision encinci kunye nomngxuma owenziweyo, owandiswa ngeentshukumo zesetyhula. Isikhonkwane sifakwe kwi-medullary canal ukuya kwindawo yokuphuka. Ukunciphisa ukuphuka kwenziwa kwaye isikhonkwane siqhubela phambili kwiqhekeza elisondeleyo phantsi kolawulo lwe-fluoroscopic.
Inkqubo efanayo iqhutyelwa kwi-ulna, kusetyenziswa ubuchule be-antegrade, kunye nendawo yokungena kumda we-medial we-olecranon.
Uzithenga njani ii-Orthopedic Implants kunye ne-Orthopedic Instruments?
Kuba I-CZMEDITECH , sinomgca wemveliso ogqityiweyo kakhulu wokufakelwa kotyando lwe-orthopedic kunye nezixhobo ezihambelanayo, iimveliso ezibandakanya ukufakelwa komqolo, iinzipho ze-intramedullary, ipleyiti yokwenzakala, ipleyiti yokutshixa, i-cranial-maxillofacial, iprosthesis, izixhobo zamandla, izilungisi zangaphandle, arthroscopy, ukhathalelo lwezilwanyana kunye neeseti zezixhobo ezixhasayo.
Ukongeza, sizibophelele ekuqhubekeni siphuhlisa iimveliso ezintsha kunye nokwandisa imigca yemveliso, ukuze sihlangabezane neemfuno zotyando zoogqirha abaninzi kunye nezigulana, kwaye senze inkampani yethu ikhuphisane ngakumbi kulo lonke ilizwe lehlabathi lokufakelwa kwamathambo kunye nezixhobo.
Sithumela kumazwe ngamazwe, ukuze ukwazi qhagamshelana nathi kwidilesi ye-imeyile ingoma@orthopedic-china.com ngesicatshulwa samahhala, okanye uthumele umyalezo kwi-WhatsApp ukuze uphendule ngokukhawuleza + 86- 18112515727 .
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