Uzipho Oluhlehlisiwe Lwe-Femoral Intramedullary: Indlela Ethembisayo Yokuphuka Kwabesifazane

Ukuphuka kwe-femoral, okuthinta ithambo lethanga, kungaba inselele ukwelapha ngempumelelo. Indlela ye-femoral intramedullary nail ehlehlisiwe iye yavela njengendlela ethembisayo yokuphatha lokhu kuphuka. Kulesi sihloko, sizohlola izinzuzo, indlela yokuhlinza, izinkinga ezingase zibe khona, kanye nokululama okuhlobene ne-femoral intramedullary nail ehlehlisiwe.

Isingeniso

Ukuphuka kwe-femur kungabangela ubuhlungu obukhulu, ukunyakaza, nokulinganiselwa kokusebenza. Izindlela zokwelapha zendabuko zingase zibe nemikhawulo ekuzuzeni imiphumela emihle. Indlela ye-femoral intramedullary nail ehlehlisiwe inikeza umbono omusha ekulawuleni ukuphuka, ukunikeza ukuzinza nokusekelwa phakathi nenqubo yokuphulukisa.

Ukuqonda Okuhlehlisiwe Kwe-Femoral Intramedullary Nail

I-femoral intramedullary nail ehlehlisiwe iyisisetshenziswa sezokwelapha esiklanyelwe ukuzinzisa futhi sikhuthaze ukuphulukiswa kokuphuka kwesifazane. Ifana ne-intramedullary nail evamile, kodwa inomumo ohlanekezelwe. I-nail ifakwe kusukela ekupheleni kwe-distal ye-femur futhi idlulela eduze, inikeze ukuzinza nokuqondanisa ezingxenyeni zamathambo eziphukile.

Izinkomba zokuhlehliswa kwe-Femoral Intramedullary Nail

I-femoral intramedullary nail ehlehlisiwe ifaneleka ngokukhethekile ezinhlotsheni ezithile zokuphuka kwezinsikazi. Kuvame ukusetshenziselwa ukuphuka okutholakala esifundeni esikude se-femur, kuhlanganise ne-supracondylar kanye ne-intracondylar fractures. Lezi ziphuka ngokuvamile zidinga ukulungiswa okuzinzile kanye nokuqondanisa okunembile ukuze kupholeke kahle.

Isu Lokuhlinza Lozipho Oluhlehlisiwe Lwe-Femoral Intramedullary

Ukuhlela Kwangaphambi Kokuhlinzwa

Ukuhlela kahle ngaphambi kokuhlinzwa kubalulekile ekuhlinzeni okuyimpumelelo kwe-femoral intramedullary nail. Lokhu kubandakanya ukuhlolwa okuphelele kwephethini yokuphuka, impilo yonke yesiguli, nanoma yikuphi ukulimala okuhlobene. Amasu okucabanga, njengama-X-ray, ama-CT scan, noma i-MRI, asetshenziselwa ukuhlola izici zokuphuka nokuqondisa ukwenziwa kwezinqumo ngokuhlinzwa.

Ukuma Kwesiguli

Ngesikhathi sokuhlinzwa, isiguli sibekwe phezu kwetafula lokusebenza. Umlenze othintekile ulungiselelwe futhi udwetshwe ngendlela eyinyumba. Ukuma ngendlela efanele kubalulekile ukuze kuvunyelwe ukufinyelela endaweni ephukile futhi kube lula ukufakwa kwezinzipho kusukela ekugcineni kwe-femur.

Ukusika kanye Nokufinyelela

Kusikwa indawo yokuhlinzwa ukuze kufinyelelwe ithambo eliphukile. Ubude nendawo yokusikeka kuncike ohlotsheni lokuphuka kanye nendawo ekuyo eduze kwe-distal femur. Ukuphatha izicubu ezithambile ngokucophelela kubalulekile ukuze kuncishiswe ukuhlukumezeka nokunciphisa ingozi yokutheleleka.

Ukufakwa Kwezinzipho

Uzipho oluhlehlisiwe lwe-femoral intramedullary lufakwa kusukela ekugcineni kwe-femur, lunwebeka lubheke endaweni yokuphuka. Isiqondiso esinembile siyadingeka ukuze kuqinisekiswe ukubekwa nokuqondanisa okunembile. I-Fluoroscopic imaging isetshenziselwa ukuqinisekisa ukuma kozipho ngaphakathi komsele wesifazane.

I-Distal Locking Screw Placement

Uma isipikili sesibekwe ngendlela efanele, izikulufo zokukhiya i-distal ziyafakwa ukuze kuvikeleke isipikili phakathi kwethambo. Lezi zikulufu zinikeza ukuzinza okwengeziwe futhi zivimbela ukunyakaza okujikelezayo noma kwe-axial kwezingcezu zokuphuka. Inombolo nokubekwa kwezikulufu kuncike kuphethini yokuphuka kanye nokuncamelayo kodokotela ohlinzayo.

Ukuvalwa Kwenxeba

Ngemuva kokuqinisekisa ukuqondanisa nokulungiswa okufanele, ukusika kuyavalwa kusetshenziswa ama-sutures noma ama-staples. Ukuvalwa kwamanxeba kwenziwa ngokucophelela ukuze kuthuthukiswe ukuphulukiswa nokunciphisa ingozi yokutheleleka. Kusetshenziswa okokugqoka okuyinyumba, kanti indawo yokuhlinza ivikelekile.

Izinzuzo ze-Reversed Femoral Intramedullary Nail

Ukusetshenziswa kwe-femoral intramedullary nail ehlehlisiwe kunikeza izinzuzo eziningana kunezindlela zokwelapha zendabuko. Ezinye zezinzuzo ezibalulekile zifaka:

1. Ukuqondanisa okunembile: Indlela yezinzipho ehlehlisiwe ivumela ukuqondanisa okunembile kwezingxenye zamathambo aphukile, ukukhuthaza ukuphulukiswa okuphelele nokunciphisa ingozi yokungahambi kahle.

2. Ukuzinza okuthuthukisiwe: I-femoral intramedullary nail ehlehlisiwe inikeza ukuzinza okuthuthukisiwe endaweni yokuphuka, okuvumela umthamo ongcono wokuthwala umthwalo kanye nemiphumela yokuphulukisa ethuthukisiwe.

3. Ukulondolozwa kokunikezwa kwegazi: Ngokusebenzisa umsele we-intramedullary kanye nokufaka uzipho ukusuka ekugcineni okukude, inqubo ye-femoral intramedullary nail ehlehlisiwe inciphisa ukuphazamiseka ekunikezeni igazi kwethambo. Lokhu kulondolozwa kokugeleza kwegazi kubalulekile ukuze amathambo aphuluke kahle kanye nokuhlangana kokuphuka.

4. Ukunciphisa ukuhlukumezeka kwezicubu ezithambile: Indlela ye-nail ehlehlisiwe ihlanganisa ukuhlukaniswa kwezicubu ezithambile ezincane, okuholela ekunciphiseni ukuhlukumezeka kwezicubu ezithambile. Lokhu kungaholela ekululameni okusheshayo, ukunciphisa ubuhlungu be-postoperative, nokunciphisa ingozi yezinkinga zezicubu ezithambile.

5. Ukuhlanganisa kusenesikhathi: Ngozipho oluhlehlisiwe lwe-femoral intramedullary, ukuhlanganisa kusenesikhathi kungenzeka. Lokhu kuvumela iziguli ukuthi ziqale ukuthwala isisindo nokuzivocavoca umzimba ngokushesha, ukukhuthaza ukululama ngokushesha kanye nemiphumela ethuthukisiwe yokusebenza.

   
   

Izinkinga Ezingenzeka kanye Nezingozi

Nakuba indlela ye-femoral intramedullary nail ehlehlisiwe ngokuvamile ibhekwa njengephephile futhi isebenza ngempumelelo, kunezinkinga ezingaba khona kanye nezingozi ezihlobene nenqubo. Kubalulekile ukuthi iziguli ziqaphele lezi zinto ezingenzeka ngaphambi kokwelashwa. Ezinye zezinkinga zihlanganisa:

• Ukutheleleka: Njenganoma iyiphi inqubo yokuhlinzwa, kunengozi yokutheleleka. Kodwa-ke, amasu afanele oyinyumba, i-antibiotic prophylaxis, nokunakekelwa kwangemva kokuhlinzwa kunganciphisa kakhulu le ngozi.

• Ukungalungi noma ukungaboni ngaso linye: Kwezinye izimo, izingcezu zokuphuka zingase zingaphuluki ekuhleleni okufunayo noma zehluleke ukuphulukisa ngokuphelele. Izici ezinjengokuncishiswa okunganele, ikhwalithi ephansi yamathambo, noma ukuthwala isisindo ngokweqile kungaba nomthelela ekungaqondiseni kahle noma ekungakhulumisani. Ukuqapha okuseduze nokungenelela okwengeziwe, njengokuhlinza okubukeziwe, kungase kudingeke ukuze kubhekwane nalezi zinkinga.

• Izinkinga ezihlobene nokufakelwa: Nakuba zingavamile, izinkinga ezihlobene nokufakelwa zingenzeka. Lokhu kungase kuhlanganise ukuxega kwe-implant, ukuphuka, noma ukucasuka. Uma izinkinga ezinjalo ziphakama, ukungenelela okwengeziwe kokuhlinzwa kungase kudingeke.

• Ukulimala kwemizwa noma imithambo yegazi: Phakathi nenqubo yokuhlinzwa, kunengozi encane yokulimala kwenzwa noma imithambo yegazi. Odokotela abahlinzayo bathatha izinyathelo zokuphepha ukuze banciphise le ngozi, kodwa iziguli kufanele ziqaphele ukuthi kungenzeka futhi zibike ngokushesha noma yiziphi izimpawu eziphikelelayo noma eziba zimbi kakhulu.

  
  

Ukuvuselela kanye Nokubuyisela

Ngemuva kokuhlinzwa kwe-femoral intramedullary nail, uhlelo oluphelele lokuvuselela lubalulekile ukuze umuntu alulame ngokuphelele. Uhlelo oluthile lokubuyisela esimweni esivamile lungahluka kuye ngobunzima bokuphuka, izici zesiguli, nesiqondiso sikadokotela ohlinzayo. Ukwelapha ngokomzimba, okuhlanganisa uhla lokuzivocavoca umzimba, ukuvivinya umzimba okuqinisayo, nokuqeqeshwa kokuhamba ngezinyawo, kudlala indima ebalulekile ekubuyiseleni ukusebenza nasekuzuzeni ukululama okuphelele.

Izibonelo Nezindaba Zempumelelo

Iziguli eziningi zithole imiphumela eyimpumelelo ngenqubo ye-femoral intramedullary nail ehlehlisiwe. Ucwaningo olulodwa lwabandakanya umuntu oneminyaka engu-45 ubudala owaphuka i-distal femoral. Ngemva kokuhlinzwa ngozipho oluhlehlisiwe lwe-femoral intramedullary, isiguli sazuza ukuhlanganiswa kwe-fracture eqinile, saphinde sathola amandla okuthwala isisindo, futhi sabuyela emisebenzini evamile phakathi nezinyanga eziyisithupha.

Isiphetho

Sengiphetha, indlela ye-femoral intramedullary nail ehlehlisiwe inikeza isixazululo esithembisayo sokuphatha ukuphuka kwe-femoral, ikakhulukazi esifundeni esikude. Inikeza ukuzinza okuthuthukisiwe, ukuqondanisa okunembayo, kanye namandla okuhlanganisa kusenesikhathi. Nakuba kunezingozi nezinkinga ezingase zibe khona, ukuhlela ngokucophelela ngaphambi kokuhlinzwa, indlela yokuhlinzwa enembile, nokunakekelwa okufanele kwangemva kokuhlinzwa kungasiza ekunciphiseni lokhu kukhathazeka. Iziguli ezibhekana nokuhlinzwa kwe-femoral intramedullary nail okuhlehlisiwe, okulandelwa uhlelo lokuvuselela oluhlelekile, lunamandla okubuyisela ngempumelelo nokubuyisela umsebenzi.