Ukulungiswa kwangaphandle yindlela evavanyiweyo kwaye isetyenziswa ngokubanzi kunyango lweefractures. Le ndlela ibandakanya ukusetyenziswa kwezixhobo ezibekwe ngaphandle komzimba ukuzinzisa kunye nokulungelelanisa amathambo aphukileyo.
Isishwankathelo soLungiso lwaNgaphandle
Ukulungiswa kwangaphandle yindlela yokwenza utyando oluye lwasetyenziswa kangangeenkulungwane ukulawula iifractures. Le ngcamango yaqala yaziswa nguHippocrates, owayesebenzisa izikhonkwane zomthi ukuze angakwazi ukuhamba amathambo aphukileyo. Ngokuhamba kwexesha, iteknoloji iye yavela, kodwa umgaqo osisiseko uhlala ufana: ukubonelela ngokuzinza kwindawo yokuphuka ngelixa uvumela ukukhuselwa kwezicubu ezithambileyo kunye nokuphilisa.
Iinjongo zoLungiso lwaNgaphandle: Gcina ulungelelwaniso lokwaphuka, ubude, kunye nokujikeleza.Ukubonelela ngokuzinza okwethutyana okanye okuqinisekileyo.Inokudityaniswa nokulungiswa kwenxalenye yangaphakathi kwiimeko ezinzima.
Izinto ezichaphazela ukuzinza koLungiso
Izinto ezininzi ezichaphazela uzinzo lwesixhobo sokulungiswa kwangaphandle:
Uqwalaselo lwePin:
Ukwandisa inani lezikhonkwane, ukuwahlukanisa kude, kunye nokuwabeka kufutshane nendawo yokuphuka kwandisa ukuqina.
Izikhonkwane kufuneka zihanjiswe ngokulinganayo ukuphepha uxinzelelo olugqithiseleyo kwiindawo ezithile.
I-Pin Diameter:
Izikhonkwane ezinkulu zibonelela ngokuzinza okukhulu kodwa zinokunyusa umngcipheko woxinzelelo kunye nokucaphuka kwezicubu ezithambileyo.
Iintlobo zePin:
Izikhonkwane zokuzibhobhoza, izikhonkwane zetrocar, izikhonkwane ezigqunyiweyo, iintonga ze-carbon fiber.
Iintlobo zeZilungiso zangaphandle
Izilungisi zangaphandle ziyahluka kuyilo, nganye ibonelela ngeenzuzo ezizodwa:
Uniplanar Fixators:
Ilula kwaye kulula ukuyisebenzisa.
Uzinzo olulinganiselweyo xa kuthelekiswa nezixhobo ezininzi.
Ii-Multiplanar Fixators:
Sebenzisa izikhonkwane kwiinqwelomoya ezininzi, ukunika uzinzo olongezelelweyo.
Efanelekileyo kwiifractures ezinzima.
Iziqinisekiso eziManye/eziMabini:
Izilungisi ze-unilateral azihlali kakuhle, ngelixa i-fixator yamazwe amabini inika amandla amakhulu kunye nenkxaso.
Izilungisi zeSetyhula:
Ngokuqhelekileyo isetyenziselwa ukongezwa kwemilenze kunye nezilungiso ezinzima zokukhubazeka.
Ivumela ukuthwala ubunzima kunye nokuhlanganiswa ngokubambisana ngexesha lokuphilisa.
![Uhlobo loLungiso lwangaphandle]()
Iingqwalasela ze-Anatomical kunye neMimandla yoKhuseleko
Ukubekwa kwezikhonkwane kubalulekile ukuphepha iingxaki ezifana ne-nerve okanye ukulimala kwe-vascular. Iingqwalasela eziphambili ze-anatomical ziquka:
![Isixhobo soLungiso lwangaphandle]()
I-Femur:
Izikhonkwane zangaphambili kufuneka zifakwe kwi-5.8 cm ngaphantsi kwe-trochanter encinci kunye ne-7.4 cm ngaphezu kwe-patellar apex.
Izikhonkwane zangasemva kufuneka ziphephe i-nerve ye-sciatic kunye neenqanawa ezijikelezayo.
I-Tibia:
Izikhonkwane kufuneka zibekwe ubuncinane kwi-14 mm kude nomgca odibeneyo ukukhusela ukungena kwe-intra-articular.
Iziphelo eziPhezulu:
Izikhonkwane ze-Humerus kufuneka ziphephe i-axillary kunye ne-radial nerves.
Izikhonkwane ze-forearm kufuneka zibekwe kwindawo engaphantsi kwe-ulna ukunciphisa umonakalo we-nerve.
Iimpawu zoLungiso lwangaphandle
Ukulungiswa kwangaphandle kuluncedo ngakumbi kwezi meko zilandelayo:
Ukulimala komsesane ongazinzanga.
Ukuqhekeka kwe-intra-articular fractures (umzekelo, i-pilon, i-distal femur, i-tibial plateau, i-elbow, kunye ne-distal radius).
Ukudumba okukhulu kwezicubu ezithambileyo okanye i-ecchymosis.
ukungazinzi kwe-hemodynamic okanye ukungakwazi ukwenza utyando oluvulekileyo.
I-Osteoporosis, usulelo, ukolulwa kwamalungu, i-osteomyelitis, i-joint immobilization, i-nonunions, kunye nonyango losulelo.
Contraindications
Ukulungiswa kwangaphandle kusenokungafaneleki kwezi meko zilandelayo:
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Izigulana ezityebe ngokugqithiseleyo.
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Izigulane ezingathobeliyo.
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Izigulane ezinomgangatho ongonelanga wamathambo.
Izigulane ezilandula utyando okanye azikwazi ukunyamezela inkqubo.
Ubuchwephesha kunye nezicelo
![Isixhobo soLungiso lwangaphandle]()
iPin-Bone Interface:
Gwema ukutsalwa kwezicubu ezithambileyo ngexesha lokufakwa kwepini.
Sebenzisa iitrocars kunye nemikhono yokubhola ukunciphisa umonakalo wezicubu.
Ukugrumba kwangaphambili kunye nokugungxulwa (ukunkcenkceshela) kubalulekile ukunciphisa ungcoliseko.
Ukulungiswa kwePelvic:
Ngokuqhelekileyo ibekwe kwi-iliac crest okanye i-anterior inferior iliac spine (AIIS).
I-C-arm fluoroscopy iqinisekisa ukubekwa kwepini ngokufanelekileyo.
Ukulungiswa komda oPhezulu:
Izikhonkwane ze-Humerus kufuneka ziphephe izakhiwo ze-neural.
Izikhonkwane ze-forearm zibekwe kwindawo engaphantsi kwe-ulna.
Ukulungiswa komda osezantsi:
Izikhonkwane ze-Femoral zibekwe kwindawo ye-anterolateral.
Izikhonkwane zeTibial zibekwe kwindawo ye-anteromedial ukuphepha ukungena ngokudibeneyo.
I-Pilon Fractures:
I-delta-frame configuration isetyenzisiweyo, idibanisa zombini i-calcaneal kunye ne-tibial pins ukuphucula ukuzinza.
Iingxaki zoLungiso lwangaphandle
Ngaphandle kweenzuzo zayo, ukulungiswa kwangaphandle kuhambelana neengxaki ezinokuthi zibe khona, kuquka:
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Usulelo lwe-Pin phecana
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Osteomyelitis
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Ukusilela kwesixhobo okanye ukukhulula
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I-Malunion okanye i-nonunion
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Ukucaphuka kwezicubu ezithambileyo okanye ukungena
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Ukulimala kwe-nerve okanye i-vascular
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I-compartment syndrome
Iirefractures
Ukubaluleka kweklinikhi
Ukulungiswa kwangaphandle kudlala indima ebalulekileyo kulawulo lomonzakalo:
Ibonelela ngokukhawuleza ukuzinza kulawulo lomonakalo wamathambo.
Ukunciphisa umngcipheko wokulimala kwesibini kunye neengxaki.
Iququzelela indlela yeendlela ezininzi ezibandakanya oogqirha bamathambo, abongikazi, iingcali zonyango, kunye neengcali zonyango ukuze kuphuculwe iziphumo zesigulane.
Imveliso ye-CZMEDITECH
Isilungisi sangaphandle esetyhula:
Iimpawu: Iqulunqwe ngamakhonkco esinyithi kunye neengcingo ezintle, ezijikelezayo kunye nokuvumela ukulungiswa kweeplani ezininzi.
I
i-fixator yangaphandle ejikelezayo sisixhobo sonyango esisetyenziselwa ukulungiswa kwe-fracture kunye nokuvuselelwa kwamathambo. Iimpawu zoyilo kunye neenzuzo zibonakaliswa ikakhulu kule miba ilandelayo:
Iimpawu zoyilo
Isakhiwo sendandatho: I-fixator yangaphandle yesetyhula yenzelwe ukumila kwendandatho, yenza isangqa esipheleleyo malunga nendawo yokuphuka ukubonelela ngenkxaso epheleleyo kunye nokulungiswa.
Amanqaku okulungisa amaninzi: Ngokuqhelekileyo kukho iindawo ezininzi zokulungisa kwisakhelo sesetyhula, esinokudibaniswa nethambo ngokusebenzisa izikhonkwane ezininzi zamathambo okanye izikhonkwane. Oku kusasaza amandla okulungisa kunye nokunciphisa uxinzelelo kwindawo eyodwa yokulungisa.
Ukulungelelaniswa: Uyilo lwesetyhula lwangaphandle lwesetyhula luvumela oogqirha ukuba benze uhlengahlengiso ngokwemiqathango ethile yesigulane, kubandakanywa nobukhulu beendandatho, indawo yokulungiswa kwamanqaku, kunye nokusabalalisa kwamandla, ukulungiselela iintlobo ezahlukeneyo zokuphuka kunye neemeko zamathambo.
I-Lightweight kunye neyomelele: Izilungisi zangaphandle zesetyhula zanamhlanje zihlala zenziwe ngezinto ezilula kunye neziphakamileyo ezifana ne-titanium alloy okanye i-carbon fiber, ziqinisekisa ukuzinza ngelixa zinciphisa umthwalo kwisigulane.
Kulula ukuyifaka kunye nokususa: Uyilo lwendandatho lwenza ukuba ukufakela kunye nenkqubo yokususwa kube lula ngakumbi, ukunciphisa ixesha lotyando kunye nokukhathazeka kwesigulane.
Iingenelo
Uzinzo oluphezulu:
Isakhiwo se-annular sibonelela ngenkxaso ye-全方位, ukukhusela ngokufanelekileyo ukufuduka kwendawo yokuphuka kunye nokuqinisekisa ukuba ithambo lihlala kwindawo echanekileyo ngexesha lokuphulukisa.
Amandla okusasaza:
Amanqaku okulungisa amaninzi asasaza amandla okulungisa, ukunciphisa uxinzelelo olugxininisiweyo kumathambo kunye nezicubu ezithambileyo, kunye nokunciphisa umngcipheko weengxaki ezibangelwa ukulungiswa okungafanelekanga.
Uluhlu olubanzi lwezicelo:
I-fixator yangaphandle yesetyhula ifanelekile kwiindidi ezahlukeneyo zokuqhekeka, ngokukodwa iifractures ezinzima, iifractures ezivulekileyo, kunye namatyala afuna ukulungiswa kwexesha elide.
Ukukhuthaza ukuphiliswa:
Ngokubonelela ngokuzinzile kwendawo yokulungisa, i-fixator yangaphandle yesetyhula inceda ukukhawuleza ukuphulukiswa kwe-fracture kunye nokunciphisa umngcipheko wokungabi nonunion okanye ukulibaziseka ukuphulukiswa.
Nciphisa iingxaki:
Ngenxa yamandla okulungisa asasaziweyo, i I-fixator yangaphandle ejikelezayo inciphisa umonakalo wezicubu ezithambileyo kwaye inciphisa izehlo zeengxaki ezifana nosulelo kunye nokudumba kwephecana.
![CZMEDITECH Isixhobo sangaphandle sokuLungisa]()
Ilungele ukhathalelo lwasemva kotyando:
Uyilo lwe-annular lwenza kube lula ukuba izigulane zizinakekele emva kokuhlinzwa, njengokucoca kunye nokutshintsha iingubo zokugqoka, ngaphandle kokuchaphazela umphumo wokulungisa.
Iimeko ezisebenzayo
Izilungisi zangaphandle ezisetyhula ziqhele ukusetyenziswa kwezi meko zilandelayo:
Iifractures eziyinkimbinkimbi: Zilungele iifractures ezinzima ezibandakanya amacandelo amaninzi amathambo okanye amalunga.
IiFractures ezivulekileyo: Ngenxa yeempawu zayo zokusabalalisa amandla, i-fixator yangaphandle ejikelezayo ifanelekile kulawulo lweefractures ezivulekileyo kunye nokunciphisa umngcipheko wokusuleleka.
Umanyano olungelulo umanyano okanye ulibazisekile umanyano: Kwezinye iimeko, izakhelo zokulungiswa kwangaphandle zesetyhula zinokunceda ekuphulukiseni amathambo ngokubonelela ukuzinza okuyimfuneko kunye nenkxaso.
Ukulungiswa kwe-Postoperative: Isetyenziselwa ukuzinzisa kunye nenkxaso emva kokuhlinzwa kwamathambo, ukuqinisekisa ukuzinza kwendawo yotyando.
Ingcamango yoyilo lwesetyhula yangaphandle ye-fixator nayo igxininise isigulane, igxininise ekuzinzeni nasekuthuthuzeleni, kwaye sisixhobo esibalulekileyo kunyango lwamathambo.
Ukuqukumbela
Ukulungiswa kwangaphandle kuhlala kusisiseko kunyango lweefractures, ukubonelela ngeendlela ezahlukeneyo kunye nokulungelelanisa kwiimeko ezahlukeneyo zeklinikhi. Ngokudibanisa le ndlela kunye neendlela ezininzi, oogqirha banokufikelela kwiziphumo ezilungileyo kwizigulane. Ngenkqubela phambili yetekhnoloji, ukulungiswa kwangaphandle kuyaqhubeka nokuguquka, ukuqinisekisa ukufaneleka kwayo kwindlela yanamhlanje yamathambo.
