I-Tibial Intramedullary Nail: Isixazululo Esinokwethenjelwa Sokuhlukana Kwe-Tibial

Ukuphuka kwe-Tibial, okuthinta i-shinbone, kungathinta kakhulu ukuhamba kanye nemisebenzi yansuku zonke. Ukwelashwa kwalokhu kuphuka kudinga ukucatshangelwa ngokucophelela kwezici ezihlukahlukene, okuhlanganisa uhlobo lokuphuka, indawo, nezici zesiguli. Enye inketho yokuhlinzwa eye yabonakala iphumelela eminyakeni yamuva ukusetshenziswa kwe-tibial intramedullary nail. Lesi sihloko sihlola izinzuzo, indlela yokuhlinzwa, izingozi, nokululama okuhlobene nale ndlela yokwelapha.

Isingeniso

Ukuphuka kwe-tibia kungase kubangele, kubangele ubuhlungu, ukungazinzi, nobunzima bokuhamba. Izindlela zokwelapha zendabuko, ezifana nokuphonsa noma ukulungiswa kwangaphandle, zinemikhawulo, okwenza ukuhlolwa kwezixazululo ezithuthuke kakhulu njenge-tibial intramedullary nail.

Iyini i-Tibial Intramedullary Nail?

I-tibial intramedullary nail iyisisetshenziswa sezokwelapha esiklanyelwe ukuzinza nokukhuthaza ukuphulukiswa kwama-fractures ku-shaft tibial. Iqukethe induku yensimbi efakwe phakathi nendawo engenalutho yethambo, ehlinzeka ngokuzinza nokusekelwa phakathi nenqubo yokuphulukisa. Uzipho luvamise ukwenziwa nge-titanium noma insimbi engagqwali futhi lufika ngosayizi abahlukahlukene ukuze kufakwe ama-anatomi esiguli.

Izinkomba ze-Tibial Intramedullary Nail

Izinzipho ze-Tibial intramedullary zivame ukusetshenziselwa ukwelashwa kwe-tibial shaft fractures. Zisebenza kahle kakhulu ekuqhekekeni okudinga ukulungiswa okuzinzile, njengokuhlukana okususiwe noma okuncishisiwe. Le nqubo ibuye ifaneleke kumacala anekhwalithi ephansi yamathambo noma lapho kufunwa isisindo esisheshayo.

Indlela Yokuhlinza ye-Tibial Intramedullary Nail

Ukuhlela Kwangaphambi Kokuhlinzwa

Ukuhlela kahle ngaphambi kokuhlinzwa kubalulekile ukuze kuhlinzekwe ngempumelelo izinzipho ze-tibial intramedullary. Lokhu kuhlanganisa ukuhlolwa okuphelele kwephethini yokuphuka, impilo evamile yesiguli, nanoma yikuphi ukulimala okuhlobene. Amasu okucabanga afana nama-X-ray, ama-CT scan, noma i-MRI angase asetshenziselwe ukuhlola izici zokuphuka nokuqondisa izinqumo zokuhlinzwa.

Ukuma Kwesiguli

Ngesikhathi sokuhlinzwa, isiguli sivamise ukubekwa phezu kwetafula lokuhlinza. Umlenze othintekile ulungiselelwe futhi udwetshwe ngendlela eyinyumba. Ukuma ngendlela efanele kubalulekile ukuze kufinyeleleke endaweni ephukile futhi kube lula ukufakwa kwezinzipho.

Ukusika kanye Nokufinyelela

Kusikwa indawo yokuhlinzwa ukuze kufinyelelwe ithambo eliphukile. Ubude nendawo ye-incision incike ohlotsheni lokuphuka kanye nendawo yalo eduze kwe-tibia. Ukuphatha izicubu ezithambile ngokucophelela kubalulekile ukuze kuncishiswe ukuhlukumezeka nokunciphisa ingozi yokutheleleka.

Ukufakwa Kwezinzipho

Ngemva kokudala indawo yokungena ku-proximal tibia, udokotela ohlinzayo ufaka ngokucophelela i-tibial intramedullary nail emgodini we-medullary. Isiqondiso se-Fluoroscopic sisetshenziselwa ukuqinisekisa ukubeka nokuqondanisa okunembile. Uzipho luthuthukisiwe ngethambo, lulungisa kabusha noma yiziphi izingcezu ezisusiwe futhi lubuyisela ukuqondanisa okufanele kwe-anatomical.

Ukukhiya Izikulufu Ukubekwa

Uma isipikili sesibekwe ngendlela efanele, izikulufo zokukhiya 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-Tibial Intramedullary Nail

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

1. Ukulungiswa okuzinzile: I-nail inikeza ukulungiswa okuzinzile, okuvumela ukuqondanisa okufanele kanye nokuhlanganiswa kwezingcezu zokuphuka.

2. Ukugqugquzela kusenesikhathi: Uzipho luhlinzeka ngokuhlanganisa kusenesikhathi, okwenza iziguli zikwazi ukuqala ukuthwala isisindo kanye nokuzivocavoca umzimba ngokushesha uma kuqhathaniswa nezinye izindlela zokwelapha.

3. Ukulondolozwa kokunikezwa kwegazi: Ngokusebenzisa umsele we-intramedullary, inqubo ye-tibial intramedullary nail inciphisa ukuphazamiseka kokunikezwa kwegazi kwethambo, okubalulekile ekuphulukiseni ukuphuka.

4. Imiphumela ethuthukisiwe yokusebenza: Ngokulungiswa okuzinzile nokugqugquzela kusenesikhathi, iziguli ezihlinzwa nge-tibial intramedullary nail ngokuvamile zithola imiphumela ethuthukisiwe yokusebenza nokubuyela ngokushesha emisebenzini yansuku zonke.

5. Ukunciphisa ingozi yezinkinga zezicubu ezithambile: Uma kuqhathaniswa nezindlela zokulungisa zangaphandle, inqubo ye-intramedullary nail ihilela ukusika okuncane nokunciphisa ukuphazamiseka kwezicubu ezithambile, okuholela engozini ephansi yezinkinga zezicubu ezithambile kanye nezifo.

   
   

Izinkinga Nezingozi

Nakuba ukuhlinzwa kwe-tibial intramedullary nail ngokuvamile kuphephile futhi kusebenza kahle, kunezinkinga ezingase zibe khona kanye nezingozi ezihlobene nenqubo. Kubalulekile ukuqaphela lawa mathuba ngaphambi kokwelashwa. Ezinye zezinkinga zihlanganisa:

Ukutheleleka

Njenganoma iyiphi inqubo yokuhlinzwa, kunengozi yokutheleleka. Kodwa-ke, ngamasu afanele okuvimbela inzalo, i-antibiotic prophylaxis, nokunakekelwa kwangemva kokuhlinzwa, ingozi yokutheleleka ingancishiswa.

Ukungalungi kahle noma ukungenzi lutho

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 eduze futhi, uma kunesidingo, ukungenelela okwengeziwe okufana nokuhlinzwa okubukeziwe kungase kudingeke.

Izinkinga ezihlobene nokufakelwa

Nakuba kungavamile, izinkinga ezihlobene nokufakwa kwe-implant zingenzeka, njengokuxebuka kokufakelwa, ukuphuka, noma ukucasuka. Lezi zinkinga zingadinga ukungenelela okwengeziwe ukuze kubhekwane nazo.

Ukulimala Kwezinzwa noma Igazi

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

Ukulandela ukuhlinzwa kwe-tibial intramedullary nail, uhlelo oluphelele lokuvuselela lubalulekile ukuze ululame kahle. Uhlelo oluthile lokubuyisela esimweni esivamile lungahluka kuye ngobunzima bokuphuka, izici zesiguli, nesiqondiso sikadokotela ohlinzayo. Ukuzivocavoca kwangaphambi kwesikhathi, ukuthwala isisindo kancane kancane, nokwelashwa ngokomzimba kudlala indima ebalulekile ekubuyiseleni ukusebenza, ukuthuthukisa amandla, nokukhuthaza ukuphulukiswa kwamathambo.

Izibonelo Nezindaba Zempumelelo

Iziguli eziningi zithole imiphumela ephumelelayo ngokuhlinzwa kwe-tibial intramedullary nail. Ucwaningo olulodwa lwabandakanya umuntu oneminyaka engu-35 ubudala owaphuka i-tibial shaft fracture. Ngemva kokuhlinzwa nge-tibial intramedullary nail, isiguli sazuza inyunyana eqinile ye-fracture, saphinde sathola amandla okuthwala isisindo esigcwele, futhi sabuyela ezingeni laso langaphambili lomsebenzi phakathi nezinyanga eziyisithupha.

Ukuqhathanisa Nezinye Izinketho Zokwelashwa

Uma ucabangela izinketho zokwelapha ze-tibial fractures, kubalulekile ukuqhathanisa izinzuzo nemikhawulo yendlela ngayinye. Nakuba ukuhlinzwa kwe-tibial intramedullary nail kunikeza izinzuzo eziningana, ezifana nokulungiswa okuzinzile, ukuhlanganisa kusengaphambili, nokunciphisa izinkinga zezicubu ezithambile, kungase kungafaneleki kuwo wonke iphethini noma isiguli sokuphuka. Ezinye izindlela, ezifana nokucwenga noma ukulungisa kwangaphandle, zingakhethwa ezimweni ezithile. Ukubonisana nochwepheshe wamathambo kuzosiza ekunqumeni indlela yokwelapha efaneleke kakhulu ngokusekelwe ezimweni zomuntu ngamunye.

Isiphetho

Ekuphetheni, ukuhlinzwa kwe-tibial intramedullary nail kuyindlela yokwelapha enokwethenjelwa futhi ephumelelayo ye-tibial fractures. Inqubo ihlinzeka ngokulungiswa okuzinzile, ivumela ukuhlanganisa kusenesikhathi, futhi inikeza izinzuzo ezimbalwa kunezindlela zendabuko. Nakuba kunezingozi ezingaba khona kanye nezinkinga ezihlobene nenqubo, ukuhlela ngokucophelela ngaphambi kokuhlinzwa, indlela yokuhlinzwa enembile, nokunakekelwa okufanele kwangemva kokuhlinzwa kunganciphisa lokhu kukhathazeka.