Kubikwa ukuba iSebe leMithi yoNyango kunye neSifo seMithi kwiSibhedlele iWuhan Union ligqibe utyando lokuqala "oluprintiweyo nge-3D reverse shoulder arthroplasty kunye nokwakhiwa kwakhona kwe-hemi-scapula". Olu tyando luphumeleleyo luphawula ukuphakama okutsha kwitheknoloji yokususwa kwethumba kunye nokwakhiwa kwakhona kwesibhedlele, nto leyo ezisa iindaba ezimnandi kwizigulana ezineengxaki ezinzima.
UAnti Liu, oneminyaka engama-56 ubudala kulo nyaka, wayenentlungu yegxalaba lasekunene kwiminyaka embalwa eyadlulayo. Iye yaba mandundu kakhulu kwiinyanga ezi-4 ezidlulileyo, ingakumbi ebusuku. Isibhedlele sasekuhlaleni sifumene "izilonda ze-tumor ecaleni kwe-humeral cortical" kwifilimu. Weza kwiSebe le-Orthopedics kunye ne-Tumor kwiSibhedlele iWuhan Union ukuze afumane unyango. Emva kokuba iqela likaNjingalwazi uLiu Jianxiang lifumene isigulane, kwenziwa uvavanyo lwe-CT kunye ne-MR joint yegxalaba, kwaye ithumba lalibandakanya i-humerus kunye ne-scapula, ngoluhlu olubanzi. Okokuqala, kwenziwa i-biopsy yendawo yesigulana, kwaye ukuxilongwa kwe-pathological kwaqinisekiswa njenge "biphasic synovial sarcoma yegxalaba lasekunene". Ukucinga ukuba ithumba lithumba elibi kwaye isigulane okwangoku sigxile emzimbeni wonke, iqela lenze isicwangciso sonyango somntu ngamnye sokususa ngokupheleleyo isiphelo se-humerus kunye nesiqingatha se-scapula, kunye nokutshintshwa kwe-3D-printed artificial reverse joint. Injongo kukufezekisa ukususwa kwethumba kunye nokwakhiwa kwakhona kwe-prosthesis, ngaloo ndlela kubuyiselwe isakhiwo kunye nomsebenzi wesiqhelo welungu legxalaba lesigulana.
Emva kokwazisa imeko yesigulana, isicwangciso sonyango, kunye neziphumo zonyango ezilindelekileyo kwisigulana kunye nosapho lwaso, kunye nokufumana imvume yabo, iqela laqala ukulungiselela utyando lwesigulana ngokunzulu. Ukuze kuqinisekiswe ukususwa ngokupheleleyo kwethumba, isiqingatha se-scapula kufuneka sisuswe kolu tyando, kwaye ukwakhiwa kwakhona kwegxalaba liyingongoma enzima. Emva kokuphononongwa ngononophelo kweefilimu, uvavanyo lomzimba, kunye nengxoxo, uNjingalwazi uLiu Jianxiang, uGqr. Zhao Lei, kunye noGqr. Zhong Binlong bayile isicwangciso sotyando esineenkcukacha baza baxoxa ngoyilo kunye nokucutshungulwa kwe-prosthesis nonjineli amaxesha amaninzi. Balingise ukufakwa kwe-tumor osteotomy kunye ne-prosthesis kwimodeli eprintiweyo ye-3D, bedala "ukwenziwa ngokwezifiso kwabucala" kwesigulana - i-prosthesis yokwenziwa yegxalaba elingasemva elihambelana namathambo abo e-autologous kwi-ratio ye-1:1.
A. Linganisa uluhlu lwe-osteotomy. B. Yila i-3D prosthesis. C. Shicilela i-3D prosthesis. D. Faka i-prosthesis kwangaphambili.
I-reverse shoulder joint yahlukile kwi-reverse shoulder yendabuko, kunye nomphezulu we-spherical joint obekwe kwicala le-scapular ye-glenoid kunye ne-cup ebekwe kwi-proximal half-limited humerus kwi-prosthesis ye-semi-restrictive total shoulder joint prosthesis. Olu tyando lunezi nzuzo zilandelayo: 1. Lungalingana kakhulu neziphene ezinkulu zamathambo ezibangelwa kukususwa kwe-tumor; 2. Imingxunya yokwakha i-ligament eyenziwe kwangaphambili ingalungisa izicubu ezithambileyo ezijikelezileyo kwaye iphephe ukungazinzi kwamalungu okubangelwa kukususwa kwe-rotator cuff; 3. Isakhiwo se-bio-mimetic trabecular kumphezulu we-prosthesis sinokukhuthaza ukukhula kwamathambo ajikelezileyo kunye nezicubu ezithambileyo; 4. I-reverse shoulder joint eyenzelwe wena inokunciphisa ngempumelelo izinga lokuphuma kwe-prosthesis emva kotyando. Ngokungafaniyo nokutshintshwa kwe-reverse shoulder eqhelekileyo, olu tyando lukwafuna ukususwa kwentloko yonke ye-humeral kunye nesiqingatha se-scapular cup, kunye nokwakhiwa kwakhona kwentloko ye-humeral kunye ne-scapular cup njengebhloko epheleleyo, efuna uyilo oluchanekileyo kunye nobugcisa obuhle botyando.
Emva kokucwangcisa ngononophelo nokulungiselela ngexesha lotyando, utyando lwenziwe ngempumelelo kwisigulana kutshanje, phantsi kolwalathiso lukaNjingalwazi uLiu Jianxiang. Iqela lisebenzisane ngokusondeleyo kwaye lenze utyando oluchanekileyo ukuze kugqitywe ukususwa ngokupheleleyo kwethumba, i-osteotomy echanekileyo ye-humerus kunye ne-scapula, ukufakwa kunye nokuhlanganiswa kwe-prosthesis yokwenziwa, eyathatha iiyure ezi-2 ukugqitywa.
D: Sika ngokuchanekileyo yonke ihumerus kunye ne-scapula ngepleyiti yesikhokelo sokusika amathambo ukuze ususe ithumba (H: I-fluoroscopy yokususwa kwethumba ngexesha lotyando)
Emva kotyando, imeko yesigulana yayilungile, kwaye bakwazile ukuhamba ngoncedo lwe-brace kwilungu elichaphazelekayo ngosuku lwesibini baze benze iintshukumo zegxalaba ezingasebenziyo. Ii-X-ray ezilandelelweyo zibonise indawo efanelekileyo ye-prosthesis yegxalaba kunye nokuchacha kakuhle kokusebenza.
Olu tyando lwangoku lolona tyala lokuqala kwiSebe leeOrthopedics leSibhedlele saseWuhan Union elamkela isikhokelo sokusika esiprintiweyo se-3D kunye neeprostheses ezenzelwe wena ukuze kufakwe i-reverse shoulder joint kunye ne-hemi-scapula endaweni yayo. Ukuphunyezwa ngempumelelo kolu buchwephesha kuya kuzisa ithemba lokusindisa amalungu kwizigulana ezininzi ezineethumba zamagxa, kwaye kuncede inani elikhulu lezigulana.
Ixesha lokuthumela: Epreli-28-2023
