Uyawazi umlando we-intramedullary nailing?

Ukufika kwe-intramedullary nail kwaguqula ukwelashwa kokuphuka kwamathambo amade. Nakuba le nqubo yayikhona amakhulu eminyaka, ayizange ifinyelele isimo sayo samanje kwaze kwaba yingxenye yesibili yekhulu lama-20.

Indlela eya empumelelweni yayingelula ngaso sonke isikhathi, njengoba le nqubo yahlangatshezwa nokungabaza nokuphikiswa yizazi eziningi engxenyeni yokuqala yekhulu lama-20. Namuhla, ngokusebenzisa izinto ezintsha ze-metallurgy, amasu okuhlinza kanye namakhono e-fluoroscopic, ukubethelwa kwe-intramedullary kuye kwaba indinganiso yokunakekelwa kokuphuka kwamathambo amade.

Intuthuko olwazini lomuntu lwe-biomechanical yenze ukudalwa kwalo mklamo wesimanje kwaba nokwenzeka. Ukubethelwa kwe-intramedullary yesimanje kubonakala ngamazinga aphansi okutheleleka, izibazi ezincane, ukuqina okuhle kokuphuka, kanye nokuhamba kwesiguli ngokushesha.

Ukubuyekezwa komlando okwenziwa kulesi sihloko kuhloswe ukufingqa ukuvela kwe-intramedullary nail, ukugqamisa amaphuzu ayo abalulekile, ukwethula umkhathi wenkathi yokusetshenziswa kokuqala nokuvela okulandelayo kwe-nail ye-intramedullary, futhi wethule indawo ye-intramedullary nail ku-orthopedics yesimanje kanye ne-traumatology (isb, Umfanekiso 1).

Ukuzalwa kwe-intramedullary nail

Abantu baseGibhithe lasendulo baqale basebenzisa i-intramedullary device efana nozipho. Ukunakekelwa kokuhlinzwa okuyinkimbinkimbi kwakungenakwenzeka ukuthi kube khona eminyakeni eminingi edlule.

Nokho, okuqinisekileyo ukuthi abaseGibhithe lasendulo babenamasu amakhulu okugqumisa avela enkolelweni yabo ekuvukeni komzimba ekuphileni kwangemva kokufa.

Kwakunjalo ngomama obizwa ngokuthi u-Usermontu owatholakala ethuneni likaTutankhamun, lapho kwafakwa khona isipikili esinentambo phakathi kwe-femur ne-tibia ukuze kunzinziswe ilunga ledolo (njengakuMdwebo 2).

Abavubukuli bacabanga ukuthi umama ongaphakathi kwe-sarcophagus wayengeyena u-Usermontu ngokwakhe, kodwa omunye owathathelwa indawo abaphangi bamathuna basendulo ngo-600 BCE.

Eminyakeni engu-2000 kamuva, uBernardino de Sahagun, isazi se-anthropologist ohambweni lukaHernando Cortes, wabika ukusetshenziswa kokuqala kokubethelwa kwe-intramedullary esigulini esiphilayo eMexico.

Ngo-1524, wabona udokotela ohlinzayo wama-Aztec (obizwa ngokuthi 'i-Tezalo') enza i-osteotomy esebenzisa ummese we-obsidian bese efaka induku ye-resin emgodini we-medullary ukuze kuqiniswe ukuphuka. Ngenxa yokuntuleka kwezinqubo zokuhlinza ezanele nezibulala-magciwane, lezi zinqubo zazinezinga eliphezulu lezinkinga kanye nezinga eliphezulu lokufa.

1800s: Izinyathelo Zokuqala

Maphakathi nawo-1800, amajenali okuqala ezokwelapha abika ngokubethelwa kwe-intramedullary. I-Diefenbach, i-Langenbeck, i-Bardenheuer kanye nabanye odokotela abahlinzayo abakhuluma isiJalimane kubikwa ukuthi basebenzisa izinzipho zendlovu emnkantsheni wamathambo amade ukuze belaphe ukubola kwamathambo.

Ngaleso sikhathi, uNicholas Senn waseChicago, umcwaningi kanye nodokotela ohlinzayo wezempi oshisekayo, wenza ucwaningo ngokulungiswa kwe-intramedullary. Wayesebenzisa umphetho onembobo ongenalutho owenziwe ngethambo lenkomo futhi awufake ku-medulla ukwelapha 'pseudarthrosis' ngemva kokuphuka.

Ngo-1886, u-Heinrich Bircher waseSwitzerland wachaza emhlanganweni wokuhlinza ukufakwa kwezipikili zezinyo lendlovu ku-medulla yokwelashwa okunamandla kokuphuka okuyinkimbinkimbi (Umfanekiso 3).

Eminyakeni embalwa kamuva, u-Themistocles Gluck eJalimane wadala isikhonkwane sokuqala se-ivory intramedullary esinembobo ekugcineni kwesipikili, ngaleyo ndlela wethula umqondo wokuxhumanisa okokuqala.

Ngaleso sikhathi, uJulius Nicolaysen waseNorway waba ngowokuqala ukubhala ngezimiso ze-biomechanical zokubethelwa kwe-intramedullary of proximal femoral fractures. Wagcizelela isidingo sokwandisa ubude bezipikili ze-intramedullary ukuze kutholwe inzuzo enkulu ye-biomechanical futhi kunikeze isivikelo cishe lonke ithambo.

Uphinde waba ngowokuqala ukuphakamisa umqondo we-proximal kanye ne-distal nail/bone interlocking ukuklama ukukhiya okumile. Ezinye izazi zimbheka njengoyise wezipikili ze-intramedullary.

Maphakathi nawo-1800, amaphayona anjengo-Ignaz Philipp Semmelweis eVienna noJosephLister eGlasgow base bebeke isisekelo sokuvala inzalo ngokuhlinzwa. Lokhu kwaba impumelelo edabukisayo ngoba ivumele ukuthuthukiswa kwamasu amasha okuhlinza ngaphansi kwezimo ze-aseptic.

1900s: Evolution

Ngo-1912, udokotela ohlinzayo waseBrithani u-Ernest Hay Groves wayengudokotela ohlinzayo wokuqala ukusebenzisa induku yensimbi eqinile njengesikhonkwane esingaphakathi kwe-intramedullary futhi wayeyiphayona lendlela yokubuyisela emuva intramedullary nail.

Okuhlangenwe nakho kwakhe wakuthola phakathi neMpi Yezwe I lapho elapha iziguli ezine-pseudarthrosis ezinegciwane ezazingathandi ukunqunywa izitho zomzimba. Akazange nje achaze indlela yokuqala ye-intramedullary nailing technique eyavumela i-osseointegration ngokusebenzisa ukuhlukumezeka okuncane, kodwa futhi wayenekhono ekusebenziseni izipikili ze-intramedullary nezinzipho ezincane ukuze alungise ukuphuka.

Wahlola izimila ezenziwe nge-aluminium, i-magnesium nensimbi futhi wabona ukubaluleka kwe-biomechanics ekwelapheni ukuphuka. Noma kunjalo, indlela ka-Ernest Hay Groves yayinezinga eliphezulu lokutheleleka ngakho-ke yayingadumile kubantu besikhathi sakhe.

Ngo-1931, uSmith-Petersen, udokotela ohlinzayo wamathambo waseMelika, wethula isikulufu sensimbi engagqwali esinamaphiko amathathu ukuze ekwelaphe ukuphuka kwentamo ye-intra-articular capsule femoral. Waklama indlela evulekile eyasika ingxenye yesithathu yangaphambili ye-iliac crest, wangena endaweni yokusebenza eduze konqenqema lwangaphambili lwe-fascial tensor, wabe esebeka kabusha ukuphuka futhi wasebenzisa i- impactor ukushayela isikulufu sensimbi engagqwali ekhanda lesifazane (Umfanekiso 4).

Ngenxa yokuphumelela kwesivivinyo sikaSmith-Petersen, odokotela abaningi abahlinzayo baqala ukuhlola izimila zensimbi zokuphuka. u-sven Johansson wasungula isikhonkwane se-intramedullary esingenalutho ngo-1932; ukusungula kwakhe okuhlakaniphile wasebenzisa inaliti ye-kerfing eyayivumela ukufakwa okulawulwayo kwe-radiologically kwesipikili se-intramedullary. Izingxenye zobuchwepheshe eziwumgogodla azifakile zisasetshenziswa nanamuhla.

Eqhubeka nesinyathelo esisodwa, uRush nomfowabo bethula umqondo we-elastic intramedullary nail ngo-1937.

Basebenzise isipikili se-intramedullary enwebekayo, esigobe ngaphambili sensimbi engenasici futhi bazama ukwakha isakhiwo sokulungisa samaphuzu amathathu e-intramedullary ukuze simelane nokuthambekela kokugudluka kwe-axial eduze nokuphuka.

Emcabangweni wabo, indawo yethishu ethambile engaguquki isebenza njengebhande elicindezelayo elimelana nokucindezeleka okukhiqizwa uzipho olunwebekayo olugobe ngaphambili. Ukwakhiwa kwazo kwakunqunyelwe izakhiwo ezinwebekayo zensimbi engagqwali, ezashintsha kusenesikhathi zisuka ku-elastic deformation zaya ekubeni yipulasitiki. Lokhu kwakamuva kungase kuholele ekususweni kwesibili nasekuphulukisweni kokukhubazeka.

Ngaphezu kwalokho, izinzipho ze-intramedullary zivame ukuphuma emnyango noma zingene ezinhlakeni zamathambo akhansela, noma zibhoboze ngaphakathi kwelunga. Noma kunjalo, isazi sase-Viennese u-Ender saqhubeka nokusebenzisa le ndlela njengesisekelo sesikole i-Ender sokulungisa ukuphuka futhi isasetshenziswa nanamuhla ukulungisa okuguquguqukayo kokuphuka kwezingane.

Isipikili somnkantsha

Ngo-1939, udokotela ohlinzayo waseJalimane uGerhard Küntscher, owaqokwa uMklomelo KaNobel, wenza isikhonkwane sensimbi engagqwali esisetshenziswa ekwelapheni ukuphuka kwesiqu sesifazane.

U-Küntscher nabanye bagqugquzelwa izikulufu zensimbi engagqwali yakwaSmith-Petersen ezisetshenziselwa ukwelapha ukuphuka kwentamo yesifazane futhi babekholelwa ukuthi izimiso ezifanayo zingasetshenziswa ekuqhekekeni kwesiqu. Uzipho lwe-intramedullary abalwenzile ekuqaleni lwalumise okwe-V esigabeni esiphambanayo kanye nobubanzi obungu-7-10 mm.

Ngemva kwezifundo ze-cadaveric nezilwane, wethula isipikili se-intramedullary kanye nendlela yokuhlinza emhlanganweni wokuhlinza eBerlin ngo-1940. Ekuqaleni, ukuqanjwa kwakhe kwahlekwa usulu ozakwabo baseJalimane, nakuba indlela yakhe yathola ukuthandwa ngemva kweMpi Yezwe II.

UHippocrates (460-370 BC), udokotela wasendulo wamaGreki ovame ukubizwa ngokuthi ubaba wezokwelapha, wake wathi, 'Lowo ofisa ukuhlinza kufanele aye empini'; kwakunjalo nangoKüntscher.

Phakathi nenkathi yamaNazi, uKüntscher wayelaliswe esibhedlela esingaphambi kweFinland. Lapho, wakwazi ukuhlinza iziguli neziboshwa zempi endaweni. Wethula umqondo wokubethela umnkantsha esebenzisa indlela yokuhlinzwa evaliwe nevulekile, ngokulandelana.

Endleleni evaliwe, wadlulisa isipikili se-intramedullary ngendlela ye-prograde ngokusebenzisa i-trochanter enkulu futhi wasibeka etafuleni lokuhlehlisa elisebenza ngesihlilingi. I-fracture ihlelwe kabusha futhi isipikili sifakwe ezindizeni ezimbili kusetshenziswa i-head fluoroscopy. Endleleni evulekile, uzipho lwe-intramedullary lufakwa ngokuphuka ku-medulla ngokusika eduze komugqa wokuphuka.U-Küntscher usebenzisa i-intramedullary nail ukwelapha ukuphuka kwesiqu sesifazane kanye nokuphuka kwe-tibial kanye ne-humeral.

Isu lika-Küntscher lathola ukuqashelwa emhlabeni wonke kuphela ngemva kokubuyiswa kweziboshwa zempi Ezihlangene.

Ngale ndlela odokotela abahlinzayo baseMelika nabaseBrithani bajwayelana nozipho lwe-intramedullary olwakhiwa u-Küntscher futhi babona izinzuzo zalo ezicacile kule nkathi yezindlela zokwelapha ukuphuka.

Ngemva kwesikhathi esifushane, odokotela abahlinzayo abaningi ngokwengeziwe emhlabeni wonke baqala ukusebenzisa indlela yakhe, futhi uzipho luka-Küntscher olungaphakathi kwe-intramedullary lwashintsha indlela yokwelapha ukuqhekeka ngokunciphisa isikhathi sokululama kwesiguli cishe unyaka. Iziguli obekuzodingeka ukuthi zinganyakazi ekhondweni izinyanga manje sezingakwazi ukuhamba ezinsukwini ezimbalwa.

Kuze kube manje, udokotela ohlinzayo waseJalimane uthathwa njengomthuthukisi oyinhloko wezipikili ze-intramedullary, futhi unendawo ebalulekile emlandweni wokuhlinzwa okubuhlungu.

Ukunweba I-Intramedullary Nail

Ngo-1942, uFisher et al. okokuqala kuchazwe ukusetshenziswa komshini wokugaya okwandisa umnkantsha ukuze kwandiswe indawo yokuxhumana phakathi kwe-intramedullary nail kanye nethambo kanye nokuthuthukisa ukuzinza kokulungiswa kwe-fracture.

Noma kunjalo, u-Küntscher wethule umshini wokuzibhoboza oqondiswa oguquguqukayo osasetshenziswa nanamuhla futhi usekela ukubuyisela kabusha kubo bonke ubude bomgodi we-medullary wesiqu sethambo ukuze kube lula ukufakwa kwezinzipho ezinkulu ze-intramedullary.

Ekuqaleni, ukuvuselelwa kwe-intramedullary kwakuklanyelwe ukwandisa kakhulu indawo yokuxhumana kwamathambo ne-intramedullary nail ukuze kulungiswe okuzinzile kokuphuka kanye nokunyakaza kwesiguli ngokushesha.

Njengoba kuchazwe nguSmith et al, yonke i-1 mm yokwandisa i-medullary inyusa indawo yokuxhumana ngama-38%. Lokhu kuvumela ukusetshenziswa kwezipikili ezinkulu neziqinile ze-intramedullary, okuthuthukisa ukuzinza okuphelele kwesakhiwo sokulungisa ukuphuka.

Nokho, nakuba isikhonkwane se-Küntscher esine-intramedullary esine-flexible intramedullary reming drill saba inketho efanelekile yedivayisi yokulungisa yangaphakathi ye-osteotomy, isikhungo semfundo ephakeme salahlekelwa umusa yiso ngasekupheleni kwawo-1960 sivuna amapuleti asanda kwakhiwa e-Arbeitsgemeinschaft für Osteosynthesefragen (O).

1960s: Inkathi Yobumnyama

Ngawo-1960s, ukubethelwa kwe-intramedullary kwaqedwa kungazelelwe kuvumela ukulungiswa kwepuleti nokuphuka kwesikulufu.

Nakuba indlela kaKüntscher yayisebenza ngokushelela, odokotela abahlinzayo emhlabeni wonke bayenqaba ngenxa yemiphumela emibi ngemva kokuhlinzwa.

Ngaphezu kwalokho, abanye odokotela abahlinzayo baqala ukulahla amasu okukhishwa kwemisebe, njenge-fluoroscopy yekhanda, ngoba odokotela abahlinzayo banengeka ngenxa yemiphumela emibi ehlobene nemisebe. Ukuthuthukiswa kwezipikili ze-intramedullary akuzange kugcine lapho, naphezu kokuvumelana okujwayelekile kwamazwe ngamazwe ngokusetshenziswa kwezinhlelo zokulungiswa kwangaphakathi kwamapuleti.

U-Küntscher, udokotela waseJalimane, wabona izinzuzo zokuhlangana futhi wenza isipikili se-intramedullary esimise okwe-clover, asiqamba ngokuthi 'isipikili sokuboshwa'. Isithende se-Achilles se-intramedullary nail design yangaleyo nkathi kwakuwukungakwazi ukuzinzisa ukuphuka noma ukuphuka okwenziwe kakhulu okwasuswa ema-engeli amakhulu Isixazululo sale nkinga kwakuwukusetshenziswa kwezikulufu zokukhiya.

Isixazululo sale nkinga kwaba ukuzinzisa isipikili se-intramedullary ngesikulufu sokukhiya.

Ngale ndlela, ukufakelwa kungamelana kangcono namandla okugoba kanye namandla okugoba ngenkathi kuvimbela ukufinyezwa kwezitho. Kusetshenziswa inhlanganisela yemibono evela ku-Küntscher, Klaus Klemm, kanye no-Wolf-Dieter Schellmann, isikhonkwane esingaphakathi kwe-intramedullary sathuthukiswa ukuze sinikeze ukuzinza okukhulu ngokubhoboza ngaphambili izimbobo zesikulufu ezisondelene neziyi-distal kuzipho lwe-intramedullary, olwalukhiyelwe kusikulufa esifakiwe.

Eminyakeni embalwa eyalandela, intuthuko ekucaciseni isithombe se-fluoroscopic yavumela ukukhethwa kabusha kwezindlela zokuvala ukuphuka nezindlela zokunciphisa.

1970 kanye 1980s: Imvuselelo

Ngawo-1970s, isithakazelo kumqondo wokubethelwa kwezipikili we-intramedullary kadokotela ohlinzayo waseJalimane u-Küntscher wawushubile.

Ukulungiswa kwe-intramedullary kwe-intramedullary yokunciphisa ukunciphisa ukuqhekeka, nokuphambana kwayo kwemiqondo eguquguqukayo yokuvuselela kabusha kanye ne-interlocking kanye nokucaca okuthuthukisiwe kwamasu we-fluoroscopic, kwaqhubekisela phambili intuthuko nokusabalalisa le nqubo yokuhlinza enhle kakhulu, ebonakala ngokulimala okuncane kwezicubu ezithambile, ukuzinza okuhle, nokuhamba kwesiguli ngokushesha.

Ngaleso sikhathi, umhlaba wezemfundo wawususelwe ochungechungeni lwezinqubo ezintsha ezaqhuba ukuthuthukiswa kwesizukulwane sesibili sokubethelwa kwe-intramedullary.

Ngo-1976, u-Grosse no-Kempf bakha isipikili se-intramedullary esifakwe kancane ukuxazulula inkinga ye-elastic modulus ye-intramedullary nail. Isipikili se-intramedullary besingaboshiwe endaweni eseduze futhi sinembobo yezipikili yesikulufu esiseduze, esafakwa nge-engeli engama-degree angu-45 ukuze kwandiswe amandla okuzinza kwesakhiwo sokulungisa sangaphakathi se-intramedullary nail.

Eminyakeni embalwa kamuva, i-AO yajoyina umkhuba wokuthuthukiswa kwezinzipho ze-intramedullary ngokuthuthukisa izinzipho ze-intramedullary ezifanayo (Umfanekiso 5)

Ngo-1984, u-Weinquist et al. ihlongoze indlela eguquguqukayo, okwakuwukuthuthukisa ukuphulukiswa kwesiphetho sokuphuka ngokusebenzisa izimbobo zokukhiya ezinkulu zokukhiya, ukususa izikulufu zokukhiya ezimile, bese ngokulandelayo kulungiswe izimbobo zezikulufo zokukhiya zibe izimbobo eziyisiyingi zezinzipho ngedizayini yesimanjemanje.

Inhloso yendlela eguquguqukayo ukukhuthaza ukuphulukiswa kokuphuka kanye nokugwema ukungezwani kwethambo ngenxa yokusebenza sekwephuzile.

Njengamanje, i-intramedullary nailing dynamics ilahlekelwe abagqugquzeli bayo njengendlela yokuma yodwa futhi okwamanje isetshenziswa kuphela njengesixazululo esingabizi kakhulu kunokushintshwa okuphelele kwesistimu yokulungisa yangaphakathi ekwelapheni ukuphuka okungapholi.

Ocwaningweni lwe-biomechanical, u-Gimeno et al. ibike ukuthi indawo yoguquko phakathi kwezingxenye ezingavalekile nezivaliwe zezipikili ze-intramedullary zibangele ukugxilisa ingqondo nokwehluleka kokuhlinzwa kokufakelwa kwangaphakathi kokulungisa.

Ukubhekana nalezi zinkinga, uRussel noTaylor et al. waklama uzipho lokuqala lwe-intramedullary olunganaslot, olunganwetshiwe ngo-1986, lwaba nemiphumela egculisayo.

Ngalesi sikhathi, inkinga yezinzipho ezixhumene ze-intramedullary nayo yaqhubeka nokuthuthuka, futhi njengoba sazi namuhla, ukuhlangana nesikulufu ngembobo ebhobozwe ngaphambili ye-intramedullary kwakuwumklamo ka-Klemm noSchleman eJalimane. Ukufakwa kwesikulufu kuzoqondiswa i-fluoroscopy yamahhala, ezodalula udokotela ohlinzayo emisebeni eminingi.

Namuhla, le nkinga isixazululiwe ngohlelo lokukhomba olukude oluhlanganisa ubuchwepheshe bokulandelela insimu ye-electromagnetic, ubuchwepheshe bamahhala obuqondiswa yi-fluoroscopically, kanye nomhlahlandlela onembile wokufaka izinzipho.

1990s: Titanium intramedullary nail

Eminyakeni eyishumi eyalandela, i-Russel-Taylor intramedullary nail yaduma kakhulu emphakathini wamathambo wamazwe ngamazwe. Izinga lokunakekela kancane kancane laba ukubethelwa kwe-intramedullary ngokukhiya okumile kwezikulufu, njengoba kuboniswa imiphumela yocwaningo lukaBrumback et al.

Kulolu cwaningo oluzokwenzeka, imiphumela ibike ukuthi ukukhiya kwakhiqiza imiphumela emihle ezimweni eziningi futhi akuzange kuhlotshaniswe nokungewona inyunyana yokuphuka.

Ukuthuthuka kwe-metallurgy kwaholela ekuveleni kwezinzipho ze-titanium intramedullary, ezisetshenziswa kakhulu embonini ye-biomedical ngenxa yamandla azo, ukumelana nokugqwala okuhle kanye nokuvumelana kwezinto eziphilayo.

I-Alta intramedullary nailing system yayiyi-titanium intramedullary nail yokuqala etholakalayo, futhi iye yamukelwa kakhulu umphakathi wezokwelapha ngenxa yezakhiwo zemishini ye-titanium, okuyinsimbi enamandla kodwa engaqinile kangako kunensimbi engagqwali.

Kodwa-ke, izincwadi zamanje ziyangabaza ukuthi i-titanium iyimpahla efanele yini ukulungiswa kwangaphakathi kunensimbi engagqwali, ikakhulukazi ngenxa yezindleko ezikhulayo ezihlobene nokusetshenziswa kwe-titanium.

Kodwa-ke, izinzuzo ezithile ze-titanium, njenge-elastic modulus eseduze ne-cortical bone kanye nokuhambisana kwe-magnetic resonance imaging, kuyenza ibe inketho ekhangayo.

Ngaphezu kwalokho, i-titanium iyindlela ekhangayo kakhulu lapho kudingeka izipikili ze-intramedullary ezincane ezinobubanzi obuncane.

Amathrendi amanje

Ngemuva kwempumelelo nokwehluleka kwamashumi eminyaka adlule, odokotela abahlinzayo bamathambo banokuhlangenwe nakho okwengeziwe ngokubethelwa kwe-intramedullary.

Ukulungiswa kwezinzipho ze-Intramedullary ze-femoral, tibial kanye ne-humeral fractures sekuye kwaba indinganiso yokunakekelwa kwezingxenye eziningi ezivaliwe kanye nokuphuka okuvulekile. Izinhlelo ezintsha zokukhomba kanye nokubeka indawo zenze inqubo yaba lula futhi yakwazi ukukhiqiza ngisho nodokotela abahlinzayo abangenalwazi.

Amathrendi akamuva abonisa ukuthi i-titanium nezinsimbi zensimbi engagqwali zinemodulus ephezulu kakhulu yokunwebeka futhi lokho kugcizelela kusitha ingcindezi ecasulayo edingekayo ukuze alulame amathambo. Ama-biomaterials amasha afana nama-magnesium alloys, ama-alloys enkumbulo yomumo nezinto ezisebenzisekayo kabusha ziyavivinywa ezifundweni.

Izinzipho ze-Intramedullary ezenziwe ngama-polymers e-carbon fibre-reinforced eqhubekayo enemodulus enwebekayo ethuthukisiwe namandla amakhulu okukhathala ayatholakala njengamanje. Ama-alloys e-Magnesium ane-modulus of elasticity efana neyethambo le-cortical futhi ayakwazi ukubola.

Izifundo zakamuva zika-Li et al. baye babonisa izinzuzo eziphawulekayo ekwelapheni ukuphuka kwe-osteoporotic kumamodeli ezilwane okubangelwa ukuhlanganiswa kwe-magnesium ne-zoledronate yokugqoka ukulungisa ukuphuka, indlela engase ibe ukwelashwa kokuphuka kwamathambo esikhathini esizayo.

Isiphetho

Ngokuhamba kweminyaka, ngokuthuthuka okuphawulekayo ekuklanyweni kwezinzipho ze-intramedullary, amasu e-metallurgical, kanye namasu okuhlinza, ukubethelwa kwe-intramedullary kuye kwathuthukiswa kwaba izinga lamanje lokunakekelwa kokuphuka kwamathambo amade amaningi futhi kuyindlela ephumelelayo, engavamile, futhi inqubo ephindaphindayo.

Kodwa-ke, ngenxa yemiklamo eminingi ye-intramedullary nail, ulwazi oluningi luyashoda mayelana nemiphumela yabo yangemva kokuhlinzwa. Ucwaningo olwengeziwe luyadingeka ukuze kutholwe usayizi wohlobo wezinzipho ze-intramedullary, izici kanye ne-radius yokugoba.

Sibikezela ukuthi izinto ezintsha emkhakheni we-biomaterials zizodala ukuvela kwemiklamo emisha ye-intramedullary nail.

Ungawathenga Kanjani Ama-Orthopedic Implants kanye Nezinsimbi Zamathambo?

Ngoba I-CZMEDITECH , sinomugqa womkhiqizo ophelele kakhulu wezimila zokuhlinzwa kwamathambo nezinsimbi ezihambisanayo, imikhiqizo ehlanganisa izimila zomgogodla, izipikili ze-intramedullary, ipuleti lokuhlukumezeka, ipuleti lokukhiya, i-cranial-maxillofacial, izitho zokufakelwa, amathuluzi amandla, izilungisi zangaphandle, i-arthroscopy, ukunakekelwa kwezilwane kanye namasethi amathuluzi asekelayo.

Ngaphezu kwalokho, sizibophezele ekuthuthukiseni imikhiqizo emisha ngokuqhubekayo nokwandisa imigqa yemikhiqizo, ukuze sihlangabezane nezidingo zokuhlinzwa zodokotela abaningi neziguli, futhi senze inkampani yethu iqhudelane kakhulu kuwo wonke umkhakha womhlaba wonke wokufakwa kwamathambo nezinsimbi.

Sithumela emhlabeni wonke, ukuze ukwazi xhumana nathi ekhelini le-imeyili elithi song@orthopedic-china.com ukuze uthole isilinganiso samahhala, noma uthumele umlayezo ku-WhatsApp ukuze uthole impendulo esheshayo +86- 18112515727 .

Uma ufuna ukwazi okwengeziwe, chofoza CZMEDITECH ukuthola imininingwane eyengeziwe.