Agbaye To ti ni ilọsiwaju Tibia Nailing Instruments Name 2025 Top 6 Innovations

Distal Tibial Intramedullary Nail (DTN)

Ọna Suprapatellar Tibial Intramedullary Nail

Amoye Tibia intramedullary Nail

1.Proximal Oblique Ge

Ige oblique iwaju ni opin isunmọ ṣe idilọwọ irritation si ligamenti patellar.

2. Onitẹsiwaju Titiipa Apẹrẹ

Ilọsiwaju apẹrẹ titiipa isunmọtosi pọ si iduroṣinṣin ti o fẹ fun ajẹkù isunmọ.

3. Titiipa Oblique Distal

Aṣayan titiipa oblique jijin lati ṣe idiwọ ibajẹ àsopọ rirọ ati alekun iduroṣinṣin ti ajẹkù jijin.

4. Double O tẹle dabaru

Titiipa skru ti a ṣe pẹlu okun asiwaju meji fun fifi sii rọrun.

Titiipa Mechanism

Apẹrẹ titiipa fun imuduro ti o ni okun sii, dinku iyọkuro ajẹku lẹhin iṣẹ-abẹ.

Olona-ojuami Support

Awọn aaye pupọ ti imuduro pese iduroṣinṣin angula ati atilẹyin iduroṣinṣin fun tibial palteau.

Awọn ipele funmorawon

Ẹrọ naa ṣe ẹya iṣẹ atunṣe aṣamubadọgba, pẹlu awọn iyipada ti ara ẹni ti o han ninu awọn apejuwe labẹ mejeeji iṣaju-funmorawon (ipo alaimuṣinṣin) ati awọn ipo titẹ-lẹhin (ni ibamu ni wiwọ).

Isunmọ-Distal Fixation

Ọna imuduro pupọ lati isunmọ ati jijin, tọka isunmọ to gaju ati awọn fifọ tibial jijin.

Alapin Apẹrẹ fun Easy Fi sii

Ipari jijin ti eekanna akọkọ ni apẹrẹ alapin, ṣiṣe irọrun fi sii irọrun sinu iho medullary.

Angular Titiipa skru

Awọn skru titiipa igun meji ni opin isunmọ ṣe idiwọ yiyi ati yipo ti apakan fifọ.

Anatomical ìsépo

Isépo anatomical pataki kan ṣe idaniloju àlàfo akọkọ ti wa ni ipo aipe laarin iho medullary.

Intersecting Angle Titiipa skru

Awọn skru titiipa igun mẹta intersecting ni opin jijin pese atilẹyin ti o munadoko ati imuduro.

Ilọpo:

Dara fun pupọ julọ awọn fifọ ọpa tibial (midshaft ati diẹ ninu awọn fifọ jijin/isunmọ isunmọ), lakoko ti awọn iru miiran (fun apẹẹrẹ, DTN tabi Eekanna Amoye) jẹ apẹrẹ fun awọn agbegbe anatomical kan pato tabi awọn fifọ eka.

Ilana Iṣẹ abẹ ti ogbo:

Ọna ti o ṣe deede (parapatellar tabi transpatellar) tẹle ilana ti iṣeto ti o dara pẹlu ọna kika ẹkọ kekere, lakoko ti awọn ọna amọja (fun apẹẹrẹ, suprapatellar) nilo ikẹkọ imọ-ẹrọ afikun.

Lilo-iye:

Ti a ṣe afiwe si awọn eekanna amọja bii àlàfo Amoye tabi DTN, awọn eekanna intramedullary tibial boṣewa jẹ ti ifarada diẹ sii, ṣiṣe wọn dara fun awọn ọran igbagbogbo.

Ibamu Gbigbe Gbooro:

Ni ibamu pẹlu ohun elo gbogbo agbaye (fun apẹẹrẹ, awọn skru titiipa, awọn ẹrọ ifọkansi), lakoko ti awọn eekanna amọja (fun apẹẹrẹ, Eekanna Amoye pẹlu awọn ọna titiipa itọnisọna pupọ) le nilo awọn irinṣẹ ohun-ini.

1. Preoperative Igbaradi

Ayẹwo Aworan: X-ray/CT ti iṣaaju lati jẹrisi iru fifọ, iwọn ila opin ikanni medullary ati ipari, pẹlu wiwọn tibia ti o lodi si bi itọkasi.

Ipo: Ipo ti o wa ni ẹhin pẹlu iṣipopada orokun 90 °-120 ° ati igbasilẹ ibadi diẹ (lati dinku ẹdọfu tendoni patellar). Fireemu radiolucent onigun mẹta le ṣe atilẹyin fossa popliteal fun isunki.

Draping Sterile: Diidiwọn ọwọ ẹsẹ ati sisọ, ni idaniloju gbigbe C-apa.

2. Egugun Idinku

Awọn ilana Idinku pipade

Gbigbọn afọwọṣe: Oluranlọwọ n lo isunmọ gigun lakoko ti oniṣẹ abẹ palpates tibial crest ati dada anteromedial lati ṣatunṣe titete (gigun, yiyi, angula).

Irinṣẹ-Iranlọwọ:

• Imọ-ẹrọ Joystick: Awọn skru Schanz ti a fi sii sinu isunmọ/ajẹjẹ jijin fun idinku lefa.

• Percutaneous Clamping: Tokasi idinku forceps fun oblique/ ajija dida egungun.

• Distractor: Idamu nla ti a gbe si iṣọn-alọ ọkan (isunmọ Schanz skru ni afiwe si tibial Plateau, PIN jijin ni talus tabi tibia jijin) lati ṣetọju gigun.

3. Titẹsi Point isọdibilẹ

Awọn ami-ilẹ:

• Aaye titẹsi 1cm jijina si eti tibial Plateau iwaju, ti o ni ibamu pẹlu ipo medullary.

• Ìmúdájú Fluoroscopic: Wiwo AP ṣe deede pẹlu crest tibial, wiwo ita ni afiwe tibial axis.

Awọn irinṣẹ ṣiṣi:

• Cannulated lu lori guidewire (pẹlu aabo apo) tabi te ri to awl.

• Ọwọ reamers (6-8mm) fun atijọ dida egungun pẹlu lila occlusion.

4. Guidewire Fi sii & Reaming

Ibi Guidewire: Bọọlu-tipped guidewire ti tẹ 10-15mm ni sample fun dida egungun. Ijẹrisi Fluoroscopic ni aleebu physeal jijinna (aarin kokosẹ).

Ilana Reaming:

• Awọn reamers rọ ti o bẹrẹ ni 8mm, npọ si 0.5mm titi ti cortical 'chatter' (ni deede 1-1.5mm > iwọn ila opin eekanna).

• Akiyesi: Yiyọkuro lainidii n pa idoti kuro; yago fun negirosisi gbona.

5. àlàfo Fi sii

Ipinnu Gigun:

• Iwọn intraoperative: Ọna ọna agbekọja Guidewire tabi alakoso fluoroscopic (ojuami titẹsi si isẹpo kokosẹ).

• Rii daju pe àlàfo àlàfo de aleebu physeal laisi isunmọ isunmọ.

Ilana fifi sii:

• Ọwọ-ilọsiwaju lori guidewire; satunṣe idinku ti o ba ti resistance waye.

• Ṣe itọju idinku lakoko aye fun awọn fifọ jijin.

6. Interlocking dabaru Fixation

Ọkọọkan nwon.Mirza

• Awọn fifọ-iduroṣinṣin gigun: Titiipa isunmọ ni akọkọ (skru ẹyọkan ngbanilaaye dynamization).

• Gigun-aiduro/awọn fifọ fifọ: Titiipa jijin ni akọkọ atẹle pẹlu ' backslap ' lati funmorawon.

Titiipa isunmọtosi

• ≥2 skru nipasẹ ẹrọ ifọkansi (multidirectional fun awọn fractures isunmọ).

Titiipa jijin

• Ilana Fluoroscopic: Central tan ina papẹndikula si dabaru ihò (' Circle pipe '), liluho percutaneous.

• ≥2 skru fun awọn dida egungun jijin (le darapọ awọn itọnisọna AP/oblique).

7. Awọn ilana ipari

Fila ipari: Ifibọ iyan (idilọwọ awọn ingrowth egungun), rii daju pe ko si ilọsiwaju apapọ.

Pipade ọgbẹ: Atunṣe tendoni patellar ti o fẹlẹfẹlẹ pẹlu awọn sutures subcutaneous alaimuṣinṣin.

8. Ifiranṣẹ lẹhin iṣẹ abẹ

Imudotun tete:

• Igbega ẹsẹ; ṣe atẹle fun iṣọn-ẹjẹ apakan laarin awọn wakati 24.

• Bẹrẹ iṣiṣẹpọ apapọ ti nṣiṣe lọwọ (awọn ifasoke kokosẹ, yiyi orokun) lori POD 1-2.

Ilana Gbigbe iwuwo:

• Gbigbe iwuwo apakan fun ọsẹ 6 (atunse fun iduroṣinṣin), lilọsiwaju si kikun nigbati ipe ba han.

Atẹle: Isẹgun / igbelewọn redio ni 2, 6, ati 12 ọsẹ.