Ukulungiswa kwangaphandle kuyindlela ehlolwe isikhathi futhi esetshenziswa kabanzi ekwelapheni ukuphuka. Le ndlela ihlanganisa ukusetshenziswa kwemishini ebekwe ngaphandle komzimba ukuze kuzinziswe futhi kuqondiswe amathambo aphukile.
Uhlolojikelele Lokulungiswa Kwangaphandle
Ukulungiswa kwangaphandle kuyindlela yokuhlinzwa eseye yasetshenziswa amakhulu eminyaka ukuphatha ukuphuka. Lo mqondo wethulwa okokuqala ngu-Hippocrates, owasebenzisa izintambo zokhuni ukuze aqinise amathambo aphukile. Ngokuhamba kwesikhathi, ubuchwepheshe buye bavela, kodwa isimiso esiyisisekelo sihlala sifana: ukunikeza ukuzinza endaweni yokuphuka ngenkathi kuvumela ukuvikelwa kwezicubu ezithambile kanye nokuphulukiswa.
Izinjongo Zokulungisa Kwangaphandle:Londoloza ukuqondana kokuphuka, ubude, nokuzungezisa.Nikeza ukuqiniswa kwesikhashana noma okuqondile.Kungahlanganiswa nokulungisa ingxenye yangaphakathi ezimweni eziyinkimbinkimbi.
Izinto Ezithonya Ukuzinza Kokulungisa
Izinto ezimbalwa ezithinta ukuqina kwedivayisi yokulungisa yangaphandle:
Ukucushwa Kwephini:
Ukwandisa inani lamaphini, ukuwahlukanisa ngokuqhelelana, nokuwabeka eduze nendawo yokuphuka kuthuthukisa ukuqina.
Izikhonkwane kufanele zisakazwe ngokulinganayo ukuze kugwenywe ukucindezeleka ngokweqile ezindaweni ezithile.
Phina Ububanzi:
Izikhonkwane ezinkulu zinikeza ukuzinza okukhulu kodwa zingandisa ingozi yokugxila ekucindezelekeni kanye nokucasuka kwezicubu ezithambile.
Izinhlobo zephinikhodi:
Izikhonkwane zokuzibhoboza, izikhonkwane ze-trocar, izikhonkwane eziboshwe, izinduku ze-carbon fiber.
Izinhlobo ze- Izilungisi zangaphandle
Izilungisi zangaphandle ziyahlukahluka ngedizayini, ngayinye inikezela ngezinzuzo ezihlukile:
Uniplanar Fixators:
Ilula futhi kulula ukuyisebenzisa.
Ukuzinza okulinganiselwe uma kuqhathaniswa namadivayisi anezinhlelo eziningi.
Ama-Multiplanar Fixators:
Sebenzisa izikhonkwane ezindizeni eziningi, unikeze ukuzinza okuthuthukisiwe.
Ilungele ukuphuka okuyinkimbinkimbi.
I-Unilateral/Bilateral Fixators:
Izilungisi ezihlangothini zombili azinzile kangako, kuyilapho izilungisi zamazwe amabili zinikeza amandla amakhulu nokusekelwa.
Izilungisi eziyindilinga:
Okuvame ukusetshenziselwa ukulungisa izitho nokukhubazeka okuyinkimbinkimbi.
Ivumela ukuthwala isisindo kancane kanye nokuhlanganisa ngokuhlanganyela ngesikhathi sokwelashwa.
![Uhlobo Lokulungisa Kwangaphandle]()
Ukucatshangelwa kwe-Anatomical Nezindawo Zokuphepha
Ukubekwa kwezikhonkwane kubalulekile ukuze kugwenywe izinkinga ezinjengokulimala kwenzwa noma imithambo. Ukucatshangelwa okuyinhloko kwe-anatomical kufaka:
![Idivayisi Yokulungisa Yangaphandle]()
I-Femur:
Izikhonkwane zangaphambili kufanele zibekwe ngo-5.8 cm ngaphansi kwe-trochanter encane futhi zibe ngu-7.4 cm ngaphezu kwe-patellar apex.
Izikhonkwane ezingemuva kufanele zigweme i-nerve ye-sciatic nemikhumbi ezungezile.
I-Tibia:
Izikhonkwane kufanele zibekwe okungenani i-14 mm kude nomugqa ohlanganyelwe ukuvimbela ukungena kwe-intra-articular.
Amaphethelo aphezulu:
Izikhonkwane ze-Humerus kufanele zigweme izinzwa ze-axillary kanye ne-radial.
Izikhonkwane zengalo kufanele zibekwe endaweni engaphansi kwe-ulna ukuze kuncishiswe ukulimala kwezinzwa.
Izinkomba Zokulungiswa Kwangaphandle
Ukulungiswa kwangaphandle kuyasiza ikakhulukazi kulezi zimo ezilandelayo:
Ukulimala kweringi ye-pelvic engazinzile.
Ukuphuka kwe-intra-articular okuhlanganisiwe (isb., i-pilon, i-distal femur, i-tibial plateau, indololwane, ne-distal radius).
Ukuvuvukala okukhulu kwezicubu ezithambile noma i-ecchymosis.
ukungazinzi kwe-hemodynamic noma ukungakwazi ukuhlinzwa okuvulekile.
I-osteoporosis, izifo, ukunwetshwa kwezitho, i-osteomyelitis, ukukhubazeka kwamalunga, okungezona inyunyana, nokwelashwa kwezifo.
Contraindications
Ukulungiswa kwangaphandle kungase kungafaneleki kulezi zimo ezilandelayo:
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Iziguli ezikhuluphele.
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Iziguli ezingahambisani nemithetho.
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Iziguli ezinekhwalithi enganele yamathambo.
Iziguli ezenqaba ukuhlinzwa noma ezingakwazi ukubekezelela inqubo.
Amasu Nezicelo
![Idivayisi Yokulungisa Yangaphandle]()
I-Pin-Bone Interface:
Gwema ukudonsa kwezicubu ezithambile ngesikhathi sokufaka iphini.
Sebenzisa ama-trocars kanye nemikhono yokubhoboza ukuze unciphise ukulimala kwezicubu.
Ukubhoboza ngaphambili nokushaywa kwamanzi (ukuchelela) kubalulekile ukuze kuncishiswe ukungcola.
Ukulungiswa Kwe-Pelvic:
Ivamise ukubekwa ku-iliac crest noma i-anterior inferior iliac spine (AIIS).
I-C-arm fluoroscopy iqinisekisa ukubekwa kwephinikhodi ngendlela efanele.
Ukulungiswa Kwe-Upper Extremity:
Izikhonkwane ze-Humerus kufanele zigweme izakhiwo ze-neural.
Izikhonkwane zengalo zangaphambili zibekwe endaweni engaphansi kwe-ulna.
Ukulungiswa Kwe-Lower Extremity:
Izikhonkwane zesifazane zibekwe endaweni ye-anterolateral.
Izikhonkwane ze-Tibial zibekwe endaweni ye-anteromedial ukugwema ukungena ngokuhlanganyela.
I-Pilon Fractures:
Kusetshenziswa ukulungiswa kwe-delta-frame, okuhlanganisa kokubili izikhonkwane ze-calcaneal kanye ne-tibial ukuze kuthuthukiswe ukuzinza.
Izinkinga Zokulungiswa Kwangaphandle
Naphezu kwezinzuzo zako, ukulungiswa kwangaphandle kuhlotshaniswa nezinkinga ezingase zibe khona, okuhlanganisa:
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Izifo ze-pin tract
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I-Osteomyelitis
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Ukuhluleka kwedivayisi noma ukuxega
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I-Malunion noma i-nonunion
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Ukucasuka kwezicubu ezithambile noma ukungena
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Ukulimala kwe-nerve noma kwe-vascular
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I-Compartment syndrome
Ama-refractures
Ukubaluleka Komtholampilo
Ukulungiswa kwangaphandle kudlala indima ebalulekile ekulawuleni ukuhlukumezeka:
Inikeza ukuzinza okusheshayo kuma-orthopedics okulawula umonakalo.
Yehlisa ubungozi bokulimala kwesibili kanye nezinkinga.
Ilungiselela indlela yemikhakha eminingi ebandakanya odokotela abahlinzayo bamathambo, abahlengikazi, abelaphi bomzimba, nabelaphi bomsebenzi ukuze kuthuthukiswe imiphumela yesiguli.
CZMEDITECH Umkhiqizo
Isiyingi Isilungisi sangaphandle :
Izici: Ihlanganiswe nezindandatho zensimbi nezintambo ezinhle, ezizungeza isitho futhi zivumela ukulungiswa kwezinhlelo eziningi.
I
i-circular Isilungisi sangaphandle iyisisetshenziswa sezokwelapha esisetshenziselwa ukulungisa ukuphuka nokuvuselela amathambo. Izici zayo zokuklama kanye nezinzuzo zibonakala ngokuyinhloko kulezi zici ezilandelayo:
Izici zokuklama
Isakhiwo sendandatho: Indilinga Isilungisi sangaphandle iklanywe ngomumo wendandatho, yenza umbuthano ophelele ozungeze isayithi lokuphuka ukuze unikeze ukusekela okuphelele nokulungisa.
Amaphuzu amaningi okulungisa: Ngokuvamile kunamaphuzu amaningi okulungisa kufreyimu eyindilinga, engaxhunywa ethanjeni ngokusebenzisa izikhonkwane eziningi zamathambo noma izinzipho. Lokhu kusabalalisa amandla okulungisa futhi kunciphisa ingcindezi endaweni eyodwa yokulungisa.
Ukulungiswa: Umklamo wesiyingi Isilungisi sangaphandle uvumela odokotela ukuba benze izinguquko ngokuvumelana nezimo ezithile zesiguli, kuhlanganise nobukhulu bamasongo, indawo yokulungisa amaphuzu, nokusatshalaliswa kwamandla, ukuze kuhlangatshezwane nezinhlobo ezahlukene zokuphuka nezimo zamathambo.
Ilula futhi ihlala isikhathi eside: Isiyingi sesimanje Izilungisi zangaphandle ngokuvamile senziwe ngezinto ezingasindi futhi ezinamandla aphezulu njenge-titanium alloy noma i-carbon fiber, iqinisekisa ukuzinza kuyilapho kunciphisa umthwalo esigulini.
Kulula ukuyifaka nokuyikhipha: Idizayini yeringi yenza inqubo yokufaka nokususwa ibe lula, inciphise isikhathi sokuhlinzwa kanye nokungakhululeki kwesiguli.
Izinzuzo
Ukuzinza okuphezulu:
Isakhiwo se-annular sinikeza ukusekelwa kwe-全方位, kuvimbela ngokuphumelelayo ukugudluzwa kwendawo yokuphuka nokuqinisekisa ukuthi ithambo lihlala lisendaweni efanele ngesikhathi sokuphulukiswa.
Amandla okuhlakazeka:
Amaphuzu amaningi okulungisa ahlakaza amandla okulungisa, anciphisa ukucindezela okugxilile emathanjeni nasezicutshini ezithambile, futhi ehlisa ingozi yezinkinga ezibangelwa ukulungiswa okungalungile.
Ibanga elibanzi lezinhlelo zokusebenza:
Indilinga Isilungisi sangaphandle ifanele izinhlobo ezihlukahlukene zokuphuka, ikakhulukazi ukuphuka okuyinkimbinkimbi, ukuphuka okuvulekile, namakesi adinga ukulungiswa kwesikhathi eside.
Ukukhuthaza ukuphulukiswa:
Ngokuhlinzeka ngendawo yokulungisa ezinzile, isiyingi Isilungisi sangaphandle isiza ukusheshisa ukuphulukiswa kokuphuka nokunciphisa ingozi yokungahlangani noma ukuphulukiswa okubambezelekile.
Yehlisa izinkinga:
Ngenxa yamandla okulungisa ahlakazekile, i i-circular Isilungisi sangaphandle inciphisa ukulimala kwezicubu ezithambile futhi yehlise izehlakalo zezinkinga ezifana nokutheleleka kanye nokuvuvukala kwepheshana lephini.
![CZMEDITECH Idivayisi Yokulungisa Yangaphandle]()
Ilungele ukunakekelwa kwangemva kokuhlinzwa:
Idizayini ye-annular yenza kube lula kakhulu ukuthi iziguli zizinakekele ngemuva kokuhlinzwa, njengokuhlanza nokushintsha izingubo zokugqoka, ngaphandle kokuphazamisa umphumela wokulungisa.
Izimo ezisebenzayo
Isiyingi Izilungisi zangaphandle ivamise ukusetshenziswa ezimeni ezilandelayo:
Ukuphuka okuyinkimbinkimbi: Kulungele ukuphuka okuyinkimbinkimbi okubandakanya izingxenye zamathambo amaningi noma amalunga.
Ama-Open Fractures: Ngenxa yezici zayo zokuhlakaza amandla, i-circumferential Isilungisi sangaphandle ifanele ukuphathwa kokuphuka okuvulekile futhi yehlisa ingcuphe yokutheleleka.
Inyunyana engeyona inyunyana noma ebambezelekile: Kwezinye izimo, amafreyimu okulungisa angaphandle ayindilinga angasiza ekwelapheni kwamathambo ngokunikeza ukuzinza nokusekelwa okudingekayo.
Ukulungiswa kwangemuva kokuhlinzwa: Kusetshenziselwa ukuzinzisa nokusekelwa ngemva kokuhlinzwa kwamathambo, ukuqinisekisa ukuzinza kwendawo yokuhlinza.
Umqondo wokuklama wesiyingi Isilungisi sangaphandle nawo ugxile esigulini, ugxile ekuzinzeni nasekunethezekeni, futhi iyithuluzi elibalulekile ekwelashweni kwamathambo.
Isiphetho
Ukulungiswa kwangaphandle kuhlala kuyinsika ekwelapheni ukuphuka, okunikeza ukuguquguquka nokuvumelana nezimo ezihlukahlukene zomtholampilo. Ngokuhlanganisa le nqubo nendlela yokwenza izinto eziningi, odokotela bangakwazi ukuthola imiphumela emihle ezigulini. Ngokuthuthuka okuqhubekayo kwezobuchwepheshe, ukulungiswa kwangaphandle kuyaqhubeka nokuguquguquka, kuqinisekisa ukuhlobana kwakho emisebenzini yesimanje yamathambo.
