Yimaphi amasu alandelayo asetshenziselwa ukulungisa ama-intertrochanterteric fractures?

Ukuqhekeka kwe-intertrochantteric kwe-femur, eyaziwa nangokuthi i-intertrochantteric fracture, ingukuphazamiseka okwengeziwe kwe-capsule. Ukubonakaliswa okuyinhloko kokuqhekeka kwe-intertrochanterteric kubuhlungu obukhulu bendawo kanye nokuvuvukala, ukungakwazi kwesiguli okumelwe kume noma ukuhamba, ukuguquguquka okuthe xaxa, ukuguquguquka kokujikeleza kwangaphakathi, ukunyakaza kokuhamba okusebenzayo nokungenasisekelo kwe-hip ehlanganisiwe kunoma iyiphi indlela.

I-Epidemiology

1. Iningi labo lihlobene ne-osteoporosis, evame kakhulu kubantu asebekhulile, abesifazane abaningi kunabesilisa.

2. Lesi sigameko sihlobene nohlanga, ubulili kanye nesifunda.

3. Ukulimala okuvamile kubantu asebekhulile, iminyaka enesihluku sokuqhekeka kwe-intertrochanterteric of femur yiminyaka engama-75,2. Kwakungekho mehluko omkhulu eminyakeni yobudala bokuqhekeka kwe-intertrochanterteric phakathi kwabesilisa nabesifazane.

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Indlela yokulimala

1. Abadala abancane balimala kakhulu kakhulu, kufanele banake ubuchopho, esifubeni, isisu kanye nezinye izingxenye zokulimala; Abantu asebekhulile basebenza kakhulu ukuguga kokuphathwa kwezinyawo ukuphendula kwe-agility ehle ukwehla futhi kuwa okubangelwa.

2. Udlame oluqondile: umthelela oqondile endaweni enkulu ye-trochanter. Uma umzimba uwela emhlabathini ngamandla alandelayo lapho uwa.

3. Udlame olungaqondile

4. Ukuqhekeka kwe-pathological, elinye lama-tumors ajwayelekile amathambo.

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Ukubonakaliswa Kwemitholampilo

1. Isethulo esiyisisekelo siyafana nalokho kwentamo yabesifazane ukuqhekeka, nobuhlungu bendawo, ukuvuvukala kanye nomkhawulo osebenza ngomlenze othintekile.

2. Ngoba yi-capsule ye-capsule ethe xaxa, akukho mkhawulo we-capsule ehlanganisiwe, ngakho-ke ukungabonakali kokushintshana kwangaphandle okufushane (ama-degrees angama-90) wemlenze ophansi angathi sína.

3. I-Axial Axial Pecussion Pain.

4. I-hematoma yendawo inzima kakhulu, futhi kungahle kube nokulimala okubanzi okwengeziwe okuphansi.

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Ukuxilonga

Umlando wokuhlukumezeka okusobala, ubuhlungu emlenzeni othintekile, kanye nomkhawulo wokunyakaza. Ukunciphisa nokushintshana kwangaphandle kokushintshana kwe-limb engezansi kubonakala kuze kube ngu-90 °. Ukuhlolwa kwe-X-ray kuvame ukudingeka ukusungula ukuxilongwa kanye nokuthayipha kususelwa kuma-radiographs. Izimpawu zokuqhekeka kwe-intertrochantteric ziyefana nalezo zomafulega umgexo, kepha eyokugcina ayikhuli kangako kunokwedlule kobuhlungu bendawo, kanti ukuncishiswa komlenze, kanye nokuguquguquka kwe-hip, kuvame ukuguquguquka kwe-45 -60.

Ukuthayipha

Amahlandla we-AO ne-Evans-jensen yilezi zinhlobo ezimbili ezisetshenziswa kakhulu, futhi kwalezi ezimbili, uhlobo lwe-Ao Fracture luvame kakhulu.

U-Evans-jensen uthayipha

Thayipha I: Ukuqhekeka okulula kwe-intertrochantteric ngentambo yomugqa ophazamisayo kusuka kokuphezulu kuya kokuphansi, ngaphandle kokufuduka nokuqina.

Uhlobo II: Ukuthungwa okuhlanganiswe nokuqhekeka okuncane kwe-rotor avulsion, kepha i-spur yesifazane iqinile (ipuleti yabesifazane yipuleti eliminyene elisendaweni ejulile entanyeni yabesifazane emzimbeni.

Uhlobo lwe-III: Kuhlanganiswe ukwaphuka okukhulu kwe-trochanterteric nokunqwabelana kwe-fracture yesisulu sowesifazane, nokufuduka, imvamisa ngokuqhekeka kwe-postor kwe-rotor.

Uhlobo IV: I-3-Part Fracture ehlanganiswe nokuqhekeka okuhlanganisiwe kwe-trochanter encane, engase iveze ngokuqhekeka kwentamo yabesifazane kanye ne-coronal ingaphezulu le-trochanter enkulu.

Thayipha v: Ukuqhekeka kwangemuva kwe-lateral kanye ne-medial axepped fracture (inhlanganisela yezinhlobo III no-IV).

Thayipha u-R: Umugqa we-interrochanterteric we-anteriko onomugqa we-oblique fracture kusuka emndenini ophakeme ukuya ngaphansi kwe-lateral ephansi, engahlotshaniswa nokuqhekeka okuncane kwe-rotor kanye nokucekelwa phansi komgogodla wowesifazane.

Ukuthayipha kwe-AO

A1.1 umugqa we-fracture udlula umugqa we-inter-rotor

I-A1.2 Fracture edlula nge-trochanter enkulu

I-A1.3 Ukuqhekeka okudlula ngaphansi kwe-trochanter encane

I-A2.1 Ukuqhekeka nge-1 Confinated Bone Fragment

I-A2.2 FRACTURE enezingcezwana eziningi zethambo

Ukuqhekeka kwe-A2.3 kunwebeka ngaphezulu kwe-1 cm ngaphansi kwe-trochanter encane

I-A3.1 elula ethambile

I-A3.2 Shape elula eguqukayo

A3.3 Kuthunyelwe

Ukwelashwa

Ukuqina kokulungiswa kwangaphakathi kwama-fractures ngokuvamile kuncike ezicini ezinhlanu: ikhwalithi yethambo, uhlobo lokuphuka, ukuncishiswa, ukukhetha kokulungiswa kwangaphakathi, kanye nesikhundla sokulungiswa kwangaphakathi maqondana nethambo. Ukuphindaphinda kwe-Fracture kubalulekile ukuze uzinqumo ngemuva kokulungiswa kwangaphakathi futhi kufanele uhlose ukufeza ukuphindiswa kwe-anatomic noma ukubuyiselwa okuzinzile kwe-anatomic. Ngamafuphi, inhloso yokuphinda uhlolisiswa kabusha ukuthola ukuqina kwe-fracture. Indlela yokubuyisela kabusha ingavalwa noma i-Amiival. Kungakhathalekile ukuthi kuyinkimbinkimbi yohlobo lwe-fracture, ukuncishiswa okuvaliwe kufanele kuzanywe kuqala.

• I-Power Hip Dowel (DHS)

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Izinzuzo eziphambili ze-DHS Power Hip Screws.

• Isikulufa sinomphumela oqinile wokulungisa ngaphakathi kwekhanda lowesifazane, ngisho nasendabeni ye-osteoporosis.

• Indlela yokuganisa emkhombeni ivimbela ukungena kwezipikili ekhanda labesifazane noma i-acetshabulum futhi kudluliswe ngokuqondile kokudonsela phansi okungahambi kahle kwithambo.

• Indlela yokuhlehlisa amandla igcina ukuqhekeka kusendaweni futhi kunciphisa okungeyona inyunyana.

• Inomsebenzi ophimbili wokucindezela futhi ucwilisa, ngethonya elinamandla elishukumisayo nelishisayo.

  
  

• Amandla we-Power Hip Dowel (DCS)

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  I-DCS nama-95 degree cutting amapuleti okuqhekeka kwe-anticrotal:

  

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Izinzuzo eziphambili ze-DCS Power CordLlar Screw zinjalo.

• Kungakhetha kahle iphuzu lokungena lesikulufo ngokuya ngesimo esithile sokuphuka, futhi ukusebenza kulula.

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• Isikulufu sokucindezela kwamandla kagesi sise-angle efanelekile epuletini, ehlangabezana nezidingo ze-biomechanical ze-hip. Ngesikhathi sokuthwala isisindo, amandla amabi aqala ukusetshenziswa kwengalo emfushane yepuleti abese ehlakazeka esikreyithi ngasinye, ukuze kuhlakazeke kahle futhi ukulungiswa kuqinile ngokuqinile.

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• Inani elikhudlwana le-DCS Screws ku-Fracture likhulisa ukuqina, futhi indawo yokuqhekeka ingavinjelwa futhi ilungiswe, ngaleyo ndlela inciphisa izehlakalo zezinkinga zokusebenzisa imali.

I-Proximal Femoral Locker Intrauntary Nail (PFN)

Izinzuzo zokulungiswa kwe-PFN.

• Ububanzi bezipikili ezincane (ngokuvamile 9mm), kungaqhutshwa ngaphandle kokuhlaziywa. (mkhulu ngokuphela okukhulu kwe-caudal ye-gamma nail - 17mm)

• Ukuphela kweProximal ye-PFN kunesilinganiso se-camber esilinganiselwe sama-degree ayi-6, kunciphisa i-angle ye-VALGUS futhi kuqede isidingo sokubuyiselwa kwangaphakathi okuqinile ngesikhathi sokukhishwa kwangaphakathi.

• Isiphetho esiphezulu sivumela ukubekwa kwezikulufo ezimbili ekhanda lowesifazane, ngokufakwa kwesikulufa sokulwa nokujikeleza kanye nokuthwala izipikili eziphindaphindwayo entanyeni yabesifazane, okwandisa ukumelana nokukhathala.

• Ibanga phakathi kwe-distal Loking Hole kanye ne-distal ukuphela kwesipikili esikhulu (ukunwetshwa kwe-tapered) kukude, okunganciphisa ukugxila kwengcindezi esiqwini sosizi.

• Ngokuhlukumezeka okuncane.

Izinzipho ze-gammar

Izinzuzo zokulungiswa kwezipikili ze-gammar.

• Kuyindlela yokuzikhandla engahlangene ne-intrametuundary enobunzima obuncane nokuhlukumezeka okuncane.

• I-Gamma nail ihlanganisa i-femur ephezulu kanye nentamo yabesifazane ngenhlanganisela ye-intramerary nail screw nesikulufa, kanti ne-intramerary nail ihlelwe yisipikili sokuzikhiya esikade, esivimbela ukujikeleza nokuncipha.

Ukuthuthuka kukaGammar - Pfna

Ukukhetha kwe-Fishator yangaphakathi (PFNA).

• Eyakhelwe eyakhelwe ngaphakathi kokuqhekeka kwe-interrochantteric kwe-femur.

• Ilungisa ngokuqinile ikhanda labesifazane nentamo futhi livimbela ukujikeleza kokuphela kokuphela.

• Kuvimbela izinkinga ezifana nokuwa ngenxa yokuhlelwa kabusha kwethambo ngemuva kokulahleka kokuxhaswa kwezindlela, ukuguquguquka kokungenisa, nokusika ekhanda lowesifazane ngokufakwa.

• Ilungele cishe wonke ama-intertrochantteric fracteric, ikakhulukazi ukuphazamiseka okungazinzile (isib. Ukuqhekeka kwe-interrochanterteric enterior) kanye ne-osteoporosis ehlanganisiwe.

• Kusenezigameko ezithile zezinkinga, ezinjenge-femoral ikhanda avilsion, okwenza kube nzima ukufaka okunye ukulungiswa kwangaphakathi.

Ukubuyiselwa okuhlangene okuhlangene

Izinkomba zokuhlinzwa okuhlangene kokufakelwa kokunye kokuqhekeka kwe-intertrochanterteric of femur:

• Iminyaka engaphezulu kweminyaka engama-80.

• Kuthulwe futhi kungazinzile kwe-interrochanterteric.

• I-Bone Osteoporosis isobala, futhi ukulungiswa kwangaphakathi kunzima ukulungisa ngempumelelo.

• Akukho mkhawulo ophambili wokunyakaza kwe-hip noma knee ngaphambi kokulimala.

• Isimo somzimba wonke singakubekezelela ukwelashwa okuhlinzwa.

Iziguli ezingakwazi ukwelashwa embhedeni isikhathi eside.

Izinzuzo: Ukuma kusenesikhathi ngemuva kokusebenza phansi. Gwema izinkinga ezigcwele umbhede. Nweba isikhathi sokusinda futhi uthuthukise ikhwalithi yempilo.

Ungayithenga kanjani izimila zamathambo namathuluzi ama-orthopedic?

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