Ekuqaleni kwee-1990, abaphengululi bamazwe angaphandle bakhokela ekusebenziseni i-anchors ye-suture ukulungisa izakhiwo ezifana ne-rotator cuff phantsi kwe-arthroscopy. Ithiyori yavela kumgaqo wenkxaso ophantsi komhlaba "wezinto ezizikayo" eMzantsi Texas, eU.SA, oko kukuthi, ngokutsala ucingo lwentsimbi olungaphantsi komhlaba kwi-angle ye-45 ° yokucwila emhlabeni, isakhiwo esingaphantsi komhlaba sigxininiswe ngokuqinileyo "kwinto ezikayo" kwelinye isiphelo socingo lwensimbi.
Iyeza lezemidlalo livela kwi-orthopedic traumatology. Sisicelo esisisiseko kunye neseklinikhi esibanzi samayeza kunye nemidlalo. Injongo kukufezekisa ukulungiswa okuphezulu kokusebenza kunye nokulimala okuncinci, kubandakanywa ukulimala kwe-meniscus, ukulimala kwe-cruciate ligament, i-rotator cuff tear, ukungazinzi kwegxalaba, ukulimala kwe-SLAP, njl.
I-Anchor sisixhobo sonyango esiqhele ukusetyenziswa kwiyeza lezemidlalo kunye notyando lwamathambo. Isetyenziselwa kakhulu ukulungisa izicubu ezithambileyo (ezifana neetendon, iigaments, njl.) kumathambo ukukhuthaza ukuphulukiswa kwezicubu kunye nokubuyisela. Ii-anchors zihlala zenziwe ngezinto ezihambelana ne-biocompatible ukuqinisekisa ukhuseleko kunye nokuzinza emzimbeni.
Ngokokuhlelwa kwezinto eziphathekayo zee-ankile, kukho iindidi ezimbini eziphambili: ii-anchors ezingenayo i-biodegradable kunye ne-biodegradable anchors.
Izinto eziphambili ze-anchors ezingenayo i-biodegradable ziyi-titanium, i-nickel-titanium alloy, insimbi engenasici, i-titanium kunye ne-poly-L-lactic acid; Uninzi lweehange ze-suture ezisetyenziswa kwiklinikhi zenziwe ngezixhobo zetsimbi, ezineenzuzo zokubamba kakuhle amandla, ukufakwa lula kunye novavanyo olulula lwe-X-ray.
Izinto eziphambili zee-anchors ze-biodegradable ziyi-poly-D-lactic acid, i-poly-L-lactic acid, i-polyglycolic acid, njl. Zisenokusetyenziselwa abantwana.
Izinto eziphambili zee-ankile
1. Iiankile zentsimbi
• Izinto: Ubukhulu becala imathiriyeli yentsimbi efana ne-titanium alloy.
• Iimpawu: Inamandla kwaye ihlala njalo, ikwazi ukubonelela ngesiphumo esizinzileyo sokulungisa. Nangona kunjalo, ii-artifacts ze-imaging zingenzeka kwaye kukho umngcipheko wokuwa.
2. Iiankile ezinokufunxwa
• Izinto eziphathekayo: izinto ezifunxayo ezifana ne-polylactic acid (PLLA).
• Iimpawu: Ukunciphisa ngokuthe ngcembe emzimbeni, akukho tyando lwesibini olufunekayo ukuze lususwe. Nangona kunjalo, izinga lokuthotywa lisenokungazinzi, kwaye amandla okulungisa anokuncipha ngokuhamba kwexesha.
3. Polyetheretherketone (PEEK) iankile
• Izinto eziphathekayo: iipolima eziphezulu zokusebenza ezifana ne-polyetheretherketone.
• Iimpawu: Ibonelela ngamandla omzimba wezikhonkwane kunye neempawu zoomatshini, ngelixa une-biocompatibility efanelekileyo kunye neziphumo ezifanelekileyo zokucinga emva kokuhlinzwa.
4. Ii-ankile zonke ze-suture
• Ukwakheka: Ikakhulu yenziwe ngesifakeli, i-ankile kunye nomthungo.
• Iimpawu: Ubukhulu buncinci kakhulu, buthambileyo bubunjwa, bufanele iimeko apho ubunzima bamathambo endalo bulahlekile okanye indawo yokufakelwa kwayo ilinganiselwe.
Ngokweempawu zokuyilwa kwee-ankile, zinokwahlulwa zibe ziindidi ezimbini: iiankile ezinamaqhina kunye ne-knotless (ezifana ne-suture epheleleyo) iiankile:
1. Iiankile ezinamaqhina
Ii-anchor ezinamaqhina ziintlobo ze-anchor zendabuko, ezibonakaliswe licandelo le-suture exhunywe kumsila we-anchor. Ugqirha kufuneka adlulise i-suture ngokusebenzisa izicubu ezithambileyo kunye nenaliti kwaye ubophe iqhosha ukulungisa izicubu ezithambileyo kwi-anchor, oko kukuthi, ithambo.
• I-Material: Ii-ankile ezinamaqhina zikholisa ukwenziwa ngezinto ezingafunxwanga (ezifana ne-titanium alloy) okanye imathiriyeli efunxayo (efana ne-polylactic acid).
• Inkqubo yokwenza: I-ankile igxininiswe ethanjeni ngemisonto okanye ngamaphiko okwandisa, ngelixa i-suture isetyenziselwa ukudibanisa i-tissue ethambileyo kwi-ankile, kunye nesiphumo sokulungiswa okuzinzileyo senziwa emva kokubopha iqhina.
• Izinto eziluncedo nezingeloncedo: I-advanteji yee-ankile ezinamaqhina kukuba isiphumo sokulungisa sithembekile kwaye sifanelekile kwiintlobo ezahlukeneyo zokonzakala kwezicubu ezithambileyo. Nangona kunjalo, inkqubo yokuqhina inokunyusa ukuntsonkotha kunye nexesha lotyando, kwaye ubukho beqhina bunokukhokelela ekugxininiseni koxinzelelo lwendawo, kwandisa umngcipheko wokuqhekeka kwe-suture okanye ukukhulula i-ankile.
2. Iiankile ezingenamaqhina
Ii-ankile ezingenamaqhina, ngakumbi ii-ankile ze-suture ezigcweleyo, luhlobo olutsha lwe-ankile oluphuhliswe kwiminyaka yakutshanje. Uphawu lwayo kukuba i-anchor yonke iqulethwe nge-sutures, kwaye ukulungiswa kwezicubu ezithambileyo kunokufezekiswa ngaphandle kokubopha amaqhina.
• Izixhobo: Ii-ankile zokuthunga ezigcweleyo zidla ngokusebenzisa imathiriyeli ethambileyo neyomeleleyo ye-suture, efana ne-ultra-high molecular weight polyethylene (UHMWPE) fibers.
• Indlela yokwenza: Ii-ankile ze-suture ezigcweleyo zinokuzinziswa ngokuthe ngqo kwithishu yethambo ngokusebenzisa ulwakhiwo olukhethekileyo lwe-suture kunye nendlela yokufakelwa, ngelixa kusetyenziswa ukunyanzeliswa kwe-suture ukulungisa ngokuqinileyo izicubu ezithambileyo kumphezulu wethambo. Ekubeni akukho mfuneko yokubopha amaqhina, ubunzima kunye nexesha lokusebenza liyancipha, kwaye umngcipheko wokuphulwa kwe-suture kunye nokukhulula i-anchor nayo iyancitshiswa.
• Izinto eziluncedo kunye nezingeloncedo: Iingenelo zeehange ezipheleleyo ze-suture lutyando olulula, isiphumo esithembekileyo sokulungiswa kunye nomonakalo omncinci kwizicubu ezithambileyo. Nangona kunjalo, ngenxa yesakhiwo sayo esikhethekileyo, ineemfuno eziphezulu zeendlela zotyando kunye nendawo yokufakelwa. Ukongezelela, ixabiso le-anchors epheleleyo ye-suture ingaba phezulu, oko kwandisa umthwalo wemali kwizigulane.
Ii-anchors zisetyenziswa ngokubanzi kwiinkqubo ezahlukeneyo zotyando lwamayeza ezemidlalo, ezifana nokulungiswa kwe-rotator cuff, ukulungiswa kwe-tendon, ukwakhiwa kwakhona kwe-ligament, njl. Oku kulandelayo kukwazisa kwisicelo sotyando lwe-anchors usebenzisa ukulungiswa kwe-rotator cuff njengomzekelo:
• Amanyathelo otyando: Okokuqala, ugqirha uya kucoca kwaye alungiselele indawo yokulimala ye-rotator cuff; emva koko, faka i-ankile kwindawo efanelekileyo; ke, sebenzisa i-sutures ukulungisa i-rotator cuff tissue kwi-anchor; ekugqibeleni, i-suture kunye ne-bandage.
• Impembelelo yokuhlinzwa: Ngokulungiswa kwe-anchor, ukuzinza kunye nomsebenzi we-rotator cuff tissue kunokubuyiselwa, ukukhuthaza ukubuyiswa kwesigulane.
Izinto eziluncedo, izinto ezingeloncedo kunye nokunyanzelwa kwee-ankile
Iingenelo
• Ukubonelela ngolungiso oluzinzileyo.
• Isebenza kwiintlobo ezahlukeneyo zokonzakala kwezicubu ezithambileyo.
• Ezinye iiankile ziyafunxwa kwaye azifuni utyando lwesibini ukuze lususwe.
Iingxaki
• Iiankile zentsimbi zinokuvelisa izinto ezenziwe ngemifanekiso.
• Izinga lokuthotywa kwee-ankile ezifunxayo lisenokungazinzanga.
• Kukho umngcipheko wokuqhawuka kwe-ankile okanye ukuqhawuka komthungo.
Ii-ankile zamayeza ezemidlalo zingasetyenziselwa olu tyando lulandelayo:
1. I-epicondylitis ye-lateral ephindaphindiweyo (i-tennis elbow) engazange iphathwe ngokufanelekileyo ngamaxesha amaninzi: Xa unyango olulondolozayo lungasebenzi, unyango lotyando lunokukhethwa, kwaye i-anchor ingasetyenziselwa ukuphinda idibanise indawo yokufakwa kwe-radial extensor carpi brevis kwi-epicondyle esecaleni ye-humerus.
2. I-Distal biceps tendon tear: Iinyembezi ezibangelwa uluhlu olungaqhelekanga lwentshukumo, ukutsala, impembelelo, njl. Ii-ankile ezimbini zingcwatywe kwi-tuberosity ye-radial, kwaye ucingo lomsila lufakwe kwisiphunzi se-biceps tendon.
3. I-elbow collateral ligament rupture: Ukuchithwa kwe-posterior ye-elbow kudla ngokuhamba kunye nokulimala kwe-ulnar collateral ligament, ngokukodwa ukulimala kwe-bundle yangaphambili. Ngokulimala kwe-elbow collateral ligament, abaphengululi abaninzi badla ngokukhetha unyango lwakwangoko. Indlela ye-ankile yocingo isetyenziselwa ukwenza rhabaxa umphezulu wethambo apho i-ligament iqhotyoshelwe khona. Emva kokuphuma kwegazi okutsha, i-anchor ifakwe kwindawo yethambo apho i-ligament ifakwe khona, kwaye ucingo oluphothiweyo ekupheleni kwesikhonkwane lusetyenziselwa ukubopha isiphunzi se-ligament kwaye siqinise okanye silungise i-ligament ngenaliti.
4. Ukuqhekeka kwenqaku elingaphantsi kwe-attachment ye-cruciate ligament: I-anterior cruciate ligament (ACL) i-tibial attachment point avulsion fracture luhlobo olukhethekileyo lwe-ACL yokulimala kwaye kufuneka ilungiswe kwangaphambili. Ukusetyenziswa kwendlela ye-anchor yocingo kunoluhlu olubanzi lwezibonakaliso kwaye alukhawulelwanga ngobukhulu beqhekeza leqhekeza. Ayifuni i-fluoroscopy ye-intraoperative ukulungelelanisa ulwalathiso lwe-screw. Umsebenzi ulula kwaye ixesha lokusebenza lifutshane ngokuhambelanayo.
I-5.Ukungazinzi kwePatellar: kubangelwa ukungaqhelekanga kwe-anatomical yamathambo kunye nokungonelanga kwezicubu ezithambileyo. Uninzi lwabaphengululi lukhuthaza unyango olusebenzayo lotyando kusetyenziswa iiankile zocingo.
6. I-Patellar inferior pole fracture: Iteknoloji ye-anchor yocingo ingasetyenziselwa ukunyanga i-patellar inferior pole fracture. Ngokulungisa i-patellar inferior pole fracture kunye ne-weaving kunye ne-suturing i-patellar ligament, ukunyaniseka kwendlela yokwandisa idolo inokubuyiselwa kwaye ubude obusebenzayo be-physiological of the knee extensor mechanism bunokugcinwa.
7. Ukulungele ukudibanisa kunye nokulungiswa kwamathambo kunye nezicubu ezithambileyo emadolweni, intambo yomgogodla, igxalaba, i-elbow, i-ankle, unyawo, i-wrist kunye nokuhlinzwa kwesandla: I-anchor ine-design thread corrugated, ekulula ukuyifakela kwaye inika ukuchasana okunamandla okukhupha, kwaye ifanelekile utyando kwiindawo ezahlukeneyo.
Ukulumkela
• Imeko yethambo lesigulana kunye nesakhiwo se-anatomical kwindawo yotyando kufuneka ihlolwe ngokupheleleyo phambi kotyando.
• Khetha uhlobo lwe-ankile olufanelekileyo kunye neenkcukacha zokuqinisekisa isiphumo sotyando.
• Ukuzivocavoca okufanelekileyo kokubuyisela kufuneka kwenziwe emva kokuhlinzwa ukukhuthaza ukuphulukiswa kwezicubu kunye nokubuyisela umsebenzi.
Isishwankathelo, iihange zidlala indima ebalulekileyo kwiyeza lezemidlalo. Ngokukhetha uhlobo olufanelekileyo lwe-anchor kunye neenkcukacha kunye nokulandela amanyathelo achanekileyo otyando kunye nezilumkiso, umphumo wokuhlinzwa unokuqinisekiswa kwaye ukubuyiswa kwesigulane kunokukhuthazwa.
Ixesha lokuposa: Dec-17-2024
