PFNA Intramedullary Nail: A Comprehensive Guide
Emkhakheni we-orthopedics, ukwelashwa kwe-hip fracture kuhlala kuwumsebenzi oyinselele. Nakuba izindlela zokuhlinza ezihlukene zakhiwe ngokuhamba kwesikhathi, ukubethelwa kwe-intramedullary kuye kwavela njengokukhetha okuthandwayo. I-Proximal Femoral Nail Antirotation (PFNA) iwuhlobo lwezinzipho ze-intramedullary ezithole ukunakwa okubalulekile ngenxa yokusebenza kahle kwayo ekwelapheni ukuphuka kwenyonga. Kulesi sihloko, sizohlinzeka ngomhlahlandlela ophelele mayelana ne-PFNA intramedullary nail, ehlanganisa yonke into kusukela ekuklanyweni kwayo kuya ekuhlinzeni, ukunakekelwa kwangemva kokuhlinzwa, kanye nezinkinga ezingaba khona.
1. Isingeniso
Ukuphuka kwe-Hip kuyimbangela evamile yokugula nokufa phakathi kwabantu asebekhulile. Ngokukhula kwabantu, inani lokuphuka kwe-hip kulindeleke ukuthi likhule ngokuhamba kwesikhathi. Ukwelashwa kwe-hip fracture kubalulekile, ngoba kungathinta kakhulu izinga lempilo yesiguli. I-Intramedullary nailing isiphenduke indlela yokuhlinza edumile yokwelapha ukuphuka kwenyonga ngenxa yokusebenza kahle nokuphepha kwayo. Phakathi kwezinhlobo ezahlukene zezinzipho ze-intramedullary, i-PFNA intramedullary nail ithole ukunakwa okuphawulekayo.
2. Yini i-PFNA Intramedullary Nail?
I-PFNA intramedullary nail iwuhlobo lwe-intramedullary nail eklanyelwe ukuzinzisa kanye nokulungisa ukuphuka kwe-hip. Kuyidivayisi emiswe cishe, i-anterograde, kanye ne-cephalomedullary efakwa ku-proximal femoral canal. I-PFNA nail inikeza ukuzinza endaweni yokuphuka ngokuvumela ukwabelana komthwalo phakathi kwesipikili nethambo. Iphinde inciphise ingozi yokwehluleka kokufakelwa kanye nokuxegiswa ngokunikeza ukuzinza okulwa nokujikeleza.
3. I-PFNA Design kanye nezici
I-PFNA intramedullary nail yenziwe nge-titanium noma i-titanium alloy, ehambisana ne-biocompatible futhi inikeza amandla amahle nokuqina. I-nail ine-helical blade ekupheleni kwe-proximal, eklanyelwe ukubandakanya ikhanda lesifazane futhi inikeze ukuzinza kokujikeleza. I-blade nayo inomshini wokulwa nokujikeleza, okuvimbela ukujikeleza kwe-nail ngaphakathi kwe-femur. Ukuphela okude kwe-nail kunomshini wokukhiya, okuvumela ukulungiswa kwe-distal nokuzinza kwe-axial.
4. Izinkomba Zokuhlinzwa kwe-PFNA
I-PFNA intramedullary nail isetshenziselwa ngokuyinhloko ukwelapha ukuphuka kwe-hip intertrochanteric kanye ne-subtrochanteric hip engazinzile. Ibuye isetshenziselwe ukwelapha okunye ukuphuka kwentamo yesifazane. Isinqumo sokusebenzisa i-PFNA intramedullary nail surgery sincike ezicini ezihlukahlukene ezifana neminyaka yesiguli, ikhwalithi yamathambo, uhlobo lokuphuka, kanye nokuthandwa ngudokotela ohlinzayo.
5. Indlela Yokuhlinza ye-PFNA Intramedullary Nailing
Indlela yokuhlinza ye-PFNA intramedullary nailing ibandakanya izinyathelo ezimbalwa. Inqubo ngokuvamile yenziwa ngaphansi kwe-anesthesia ejwayelekile noma yomgogodla. Isiguli sibekwe phezu kwetafula lokuphuka, futhi i-fluoroscope isetshenziselwa ukuqondisa ukufakwa kwezipikili.Isu lokuhlinza le-PFNA le-intramedullary nailing lihilela izinyathelo ezimbalwa. Inqubo ngokuvamile yenziwa ngaphansi kwe-anesthesia ejwayelekile noma yomgogodla. Isiguli sibekwe etafuleni lokuphuka, futhi i-fluoroscope isetshenziselwa ukuqondisa ukufakwa kwezinzipho. Indlela yokuhlinzwa ihilela ukusika okuncane okwenziwe phezu kwe-trochanter enkulu, okuvumela ukufinyelela ku-proximal femur. Intambo yomhlahlandlela ibe isifakwa ngokusikwa bese idluliswa emseleni wezinsikazi ngaphansi kokuqondisa kwe-fluoroscopic. I-proximal femoral canal bese ishintshwa ibe usayizi ofanele, bese kufakwa i-PFNA intramedullary nail. I-helical blade ifakwe ekhanda lesifazane, futhi indlela yokukhiya ihileleke ku-distal femur ukuze inikeze ukuzinza kwe-axial.
6. Ukunakekelwa Kwangemva Kokuhlinzwa ngemva Kokuhlinzwa kwe-PFNA
Ngemuva kokuhlinzwa kwe-PFNA kwe-intramedullary nail, isiguli ngokuvamile sigcinwa endaweni yokuphumula yombhede izinsuku ezimbalwa. Umlenze othintekile awunyakazi ngensimbi noma ngensimbi amasonto ambalwa ukukhuthaza ukuphulukiswa. Isiguli siyeluleka ukuba sigweme imisebenzi yokuthwala isisindo izinyanga ezimbalwa ukuze sivumele ukuphulukiswa okufanele. Ukwelapha ngokomzimba kuvame ukuqalwa kusenesikhathi ukuze kuthuthukiswe uhla oluhlangene lokunyakaza namandla emisipha.
7. Izinkinga nokuphatha kwe-PFNA
Njenganoma iyiphi inqubo yokuhlinzwa, i-PFNA intramedullary nailing ithwala ubungozi obuthile kanye nezinkinga ezingaba khona. Lezi zinkinga zihlanganisa ukutheleleka, ukwehluleka kokufakelwa, ukulimala kwenzwa, ukulimala komkhumbi wegazi, nokungahlangene. Kodwa-ke, inani eliphelele lenkinga ye-PFNA intramedullary nailing liphansi uma kuqhathaniswa. Ukulawulwa kwalezi zinkinga ngokuvamile kuhilela ukuhlinzwa okubukeziwe noma ukwelashwa okuvamile, kuye ngobunzima benkinga.
8. PFNA vs. Ezinye Izinzipho ze-Intramedullary
Uma kuqhathaniswa nezinye izinhlobo zezinzipho ze-intramedullary, i-PFNA intramedullary nail inezinzuzo eziningana. Enye yezinzuzo ezibalulekile ze-PFNA nail indlela yayo yokulwa nokujikeleza, ehlinzeka ngokuzinza kokujikeleza kwekhanda lesifazane. Iphinde ivumele ukwabelana ngomthwalo phakathi kwesipikili nethambo, kunciphisa ingozi yokwehluleka kokufakelwa. I-PFNA nail nayo kulula ukuyifaka futhi inengozi ephansi yezinkinga.
9. Izinzuzo ze-PFNA Intramedullary Nailing
I-PFNA intramedullary nailing inezinzuzo ezimbalwa ngaphezu kwamanye amasu okuhlinza okwelapha ukuphuka kwenyonga. Enye yezinzuzo eziyinhloko ukusebenza kwayo ekwelapheni i-intertrochanteric engazinzile kanye ne-subtrochanteric hip fractures. I-PFNA nail iphinde ivumele ukuhlangana kusenesikhathi kanye nokuhlala esibhedlela okufushane uma kuqhathaniswa namanye amasu okuhlinza. Iphinde ibe nengozi ephansi yokuhluleka kokufakelwa futhi inikeza imiphumela emihle yokusebenza.
10. Ububi be-PFNA Intramedullary Nailing
Ngenkathi i-PFNA intramedullary nailing inezinzuzo ezimbalwa, futhi inobubi obuthile. Okunye okungalungile okuyinhloko ingozi engaba khona yezinkinga, njengokuhluleka kokufakelwa, ukutheleleka, nokulimala kwenzwa. I-PFNA nail nayo ibiza kakhulu uma iqhathaniswa namanye amasu okuhlinza.
11. PFNA Intramedullary Nail Imiphumela kanye Namazinga Empumelelo
Ucwaningo luye lwabonisa ukuthi i-PFNA intramedullary nailing inemiphumela emihle kanye namazinga empumelelo ekwelapheni ukuphuka kwe-hip. Amazinga empumelelo ye-PFNA yokubethelwa kwezipikili asukela ku-70% kuya ku-90%, okunemiphumela emihle yokusebenza okubikiwe ezimweni eziningi. I-PFNA nail nayo inezinga eliphansi lokuhlinzwa okubukeziwe kanye nokwehluleka kokufakelwa.
12. I-PFNA Ezigulini Ezikhulile
Ukuphuka kwe-hip kuvame kakhulu kubantu asebekhulile, futhi i-PFNA intramedullary nailing iye yavela njengendlela yokuhlinzwa ethandwayo yokwelapha ukuphuka kwe-hip ezigulini ezikhulile. I-PFNA nail iboniswe ukuthi inemiphumela emihle kulesi sibalo sabantu, ngenani eliphansi lezinkinga kanye nokuhlala esibhedlela okufushane.
13. Ukuthuthukiswa Kwekusasa
I-PFNA intramedullary nail seyenziwe izinguquko eziningana kusukela yethulwa, ngenhloso yokuthuthukisa ukusebenza kwayo kanye nokunciphisa izingozi zayo. Ezinye zezinguquko zihlanganisa izinguquko ekwakhiweni kwe-helical blade, ukuthuthukiswa kwendlela yokukhiya, nokuguqulwa kobude nobubanzi bezinzipho. Ukuthuthukiswa kwezinto ezintsha, njengama-titanium alloys nezinto ezingaboli, nakho kuyahlolwa ukuze kuthuthukiswe ukusebenza kwesipikili se-PFNA.
14. Isiphetho
Kafushane, i-PFNA intramedullary nail iyindlela yokuhlinzwa ethandwayo yokwelapha ukuphuka kwe-hip, ikakhulukazi kubantu asebekhulile. I-PFNA nail inikeza imiphumela emihle, ngezinga eliphansi lezinkinga kanye nokuhlala esibhedlela okufushane. Kodwa-ke, njenganoma iyiphi inqubo yokuhlinzwa, ithwala ubungozi obuthile kanye nezinkinga ezingaba khona. Ukuthuthukiswa kwezinto ezintsha kanye nokuguqulwa ekwakhiweni kwezinzipho cishe kuzothuthukisa ukusebenza kwe-PFNA nail esikhathini esizayo.
Imibuzo Evame Ukubuzwa
Iyini i-PFNA intramedullary nail?
I-PFNA intramedullary nail iyisifakelo sokuhlinzwa esisetshenziselwa ukwelapha ukuphuka kwenyonga. Ifakwa emseleni wesifazane futhi inikeza ukuzinza kwekhanda lesifazane.
Ifakwa kanjani i-PFNA intramedullary nail?
I-PFNA intramedullary nail ifakwa ngokusika okuncane okwenziwe phezu kwe-trochanter enkulu. Intambo yomhlahlandlela ifakwa emseleni wesifazane, bese umsele ushintshwa ube usayizi ofanele. Khona-ke i-PFNA nail iyafakwa, futhi indlela yokukhiya ihileleke ku-distal femur.
Yiziphi izinzuzo ze-PFNA intramedullary nail?
I-PFNA intramedullary nail inezinzuzo ezimbalwa, okuhlanganisa indlela yayo yokulwa nokujikeleza, izakhiwo zokwabelana ngomthwalo, kanye nokufaka kalula. Isebenza ngempumelelo futhi ekwelapheni ukuphuka kwe-hip okungazinzile futhi ivumela ukuhlanganisa kusenesikhathi.
Yiziphi izinkinga ezingaba khona ze-PFNA intramedullary nailing?
Izinkinga ezingaba khona ze-PFNA nailing intramedullary zihlanganisa ukutheleleka, ukwehluleka kokufakelwa, ukulimala kwenzwa, ukulimala komkhumbi wegazi, nokungahlangene.
Lithini izinga lempumelelo ye-PFNA intramedullary nailing?
Amazinga okuphumelela e-PFNA e-intramedullary nailing asukela ku-70% kuya ku-90%, okunemiphumela emihle yokusebenza okubikiwe ezimweni eziningi.
