Yintoni i-DHS kunye ne-DCS?
DHS (Isikruqa seHip esiDynamic)sisifakelo sotyando esisetyenziswa ngokuyintloko kunyango lokuqhekeka kwentamo ye-femoral kunye ne-intertrochanteric fractures. Iqukethe i-screw kunye nenkqubo yeplate enikezela ukulungiswa okuzinzile ngokuvumela ukunyanzeliswa okuguquguqukayo kwindawo yokuphuka, ukukhuthaza ukuphilisa.
I-DCS (i-Dynamic Condylar Screw)sisixhobo sokulungisa esisetyenziselwa ukuphuka kwe-distal femur kunye ne-proximal tibia. Idibanisa izibonelelo ze-screws ezininzi ze-cannulated (MCS) kunye nokufakelwa kwe-DHS, ukubonelela ngoxinzelelo oluguquguqukayo olulawulwayo ngokusebenzisa izikrufu ezithathu ezicwangciswe kuqwalaselo oluguquliweyo lwe-triangular.
Yintoni uMahluko phakathi kwe-DHS kunye neDCS?
I-DHS (i-Dynamic Hip Screw) isetyenziselwa ngokukodwa kwintamo ye-femoral kunye ne-intertrochanteric fractures, ukubonelela ukulungiswa okuzinzileyo kunye ne-screw kunye ne-plate system. I-DCS (i-Dynamic Condylar Screw) yenzelwe i-distal femur kunye ne-proximal tibia fractures, inikezela ngokucinezelwa okuguquguqukayo okulawulwayo ngokusebenzisa uqwalaselo lwe-screw engunxantathu.
Isetyenziselwa ntoni i-DCS?
I-DCS isetyenziselwa unyango lweefractures kwi-distal femur kunye ne-proximal tibia. Isebenza ngokukhethekileyo ekuboneleleni uzinzo kunye nokukhuthaza ukuphilisa kule mimandla ngokusebenzisa ukunyanzeliswa okuguquguqukayo okulawulwayo kwindawo yokuphuka.
Yintoni uMahluko phakathi kwe-DCS kunye ne-DPL?
DPL (Dynamic Pressure Locking)lolunye uhlobo lwenkqubo yokulungisa esetyenziselwa utyando lwamathambo. Ngelixa zombini i-DCS kunye ne-DPL zijolise ekuboneleleni ukulungiswa okuzinzileyo kokwaphuka, i-DPL ngokuqhelekileyo isebenzisa izikrufu zokutshixa kunye neepleyiti ukufezekisa ukulungiswa okuqinileyo, ngelixa i-DCS igxile kuxinzelelo oluguquguqukayo ukunyusa ukuphiliswa kwe-fracture.
Uthini Umahluko phakathi kweDPS kunye neCPS?
I-DPS (Inkqubo yepleyiti eDynamic)kwayeI-CPS (Inkqubo yepleyiti yokuNxinzelela)zombini zisetyenziselwa ukulungiswa kokwaphuka. I-DPS ivumela ukunyanzeliswa okuguquguqukayo, okunokuphucula ukuphulukiswa kwe-fracture ngokukhuthaza ukuhamba kwe-interfragmentary ngexesha lobunzima. I-CPS, ngakolunye uhlangothi, ibonelela ngoxinzelelo lwe-static kwaye isetyenziselwa ukuphuka okuzinzile ngakumbi apho ukunyanzeliswa okuguquguqukayo kungenasidingo.
Yintoni uMahluko phakathi kwe-DCS 1 kunye ne-DCS 2?
I-DCS 1 kunye ne-DCS 2 zibhekisela kwizizukulwana ezahlukeneyo okanye ulungelelwaniso lwenkqubo ye-Dynamic Condylar Screw. I-DCS 2 inokubonelela ngophuculo ngokoyilo, imathiriyeli, okanye ubuchule botyando xa kuthelekiswa ne-DCS 1. Nangona kunjalo, umahluko othile unokuxhomekeka kuhlaziyo lomenzi kunye nokuqhubela phambili kwinkqubo.
Yenziwa njani i-DHS?
I-DHS yinkqubo yotyando esetyenziselwa ukunyanga i-fractures ye-proximal femur, kuquka i-intertrochanteric kunye ne-subtrochanteric fractures. Inkqubo ibandakanya la manyathelo alandelayo:
I-1.Ukulungiswa kwangaphambili: Isigulane sivavanywa ngokucokisekileyo, kwaye i-fracture ihlelwa ngokusebenzisa izifundo ze-imaging ezifana ne-X-rays.
I-2.I-Anesthesia: I-anesthesia jikelele okanye i-anesthesia yengingqi (umzekelo, i-anesthesia yomgogodla) ilawulwa.
I-3.I-Incision kunye ne-Exposure: I-lateral incision yenziwa phezu kwe-hip, kwaye izihlunu zihlanjululwa ukuze ziveze i-femur.
4.Ukunciphisa kunye nokulungiswa: Ukuqhekeka kuncitshisiwe (ukulungelelaniswa) phantsi kwesikhokelo se-fluoroscopic. I-screw enkulu ye-cancellous (i-lag screw) ifakwe kwintamo ye-femoral kunye nentloko. Esi sikrufu sifakwe ngaphakathi komkhono wesinyithi, odityaniswe kwipleyiti egxininiswe kwi-lateral femoral cortex enezikrufu. I-DHS ivumela ukunyanzeliswa okuguquguqukayo, oku kuthetha ukuba isikhonkwane sinokutyibilika ngaphakathi komkhono, ukukhuthaza ukunyanzeliswa kwe-fracture kunye nokuphilisa.
I-5.Ukuvalwa: I-incision ivaliwe kwiingqimba, kwaye i-drain ingafakwa ukukhusela ukubunjwa kwe-hematoma.
Yintoni i-PFN Surgery?
I-PFN (I-Proximal Femoral Nail) utyando yenye indlela esetyenziswayo ukunyanga i-proximal femoral fractures. Kubandakanya ukufakwa kwesikhonkwane se-intramedullary kwi-canal ye-femal, ebonelela ngokuzinza ngokuzinzile ukusuka ngaphakathi kwethambo.
Yintoni i-Z Phenomenon kwi-PFN?
"I-Z phenomenon" kwi-PFN ibhekisela kwingxaki enokubakho apho isikhonkwane, ngenxa yoyilo lwaso kunye nemikhosi esetyenzisiweyo, inokubangela ukuwa kwe-varus entanyeni ye-femal. Oku kunokukhokelela ekungalungelelani kakuhle kunye neziphumo ezibi zokusebenza. Kwenzeka xa ijiyometri yesikhonkwane kunye namandla asetyenziswayo ngexesha lobunzima zibangela ukuba isikhonkwane sifuduke okanye sigqwetheke, nto leyo ekhokelela kuphawu “Z” uguquko kwimilo yesikhonkwane.
Yeyiphi eNgcono: I-Intramedullary Nail okanye i-Dynamic Hip Screw?
Ukhetho phakathi kwesikhonkwane se-intramedullary (njenge-PFN) kunye ne-Dynamic Hip Screw (DHS) kuxhomekeke kwizinto ezininzi, kubandakanywa uhlobo lokuphuka, umgangatho wamathambo, kunye neempawu zesigulane. Uphononongo lubonise ukuba iPFN ngokubanzi ibonelela ngeenzuzo ezithile:
I-1.I-Reduced Blood Loss: Utyando lwe-PFN lukhokelela ekulahlekelweni kwegazi ngaphantsi kwe-intraoperative xa kuthelekiswa ne-DHS.
I-2.Ixesha elifutshane loTyando: Iinkqubo ze-PFN zihlala zikhawuleza, zinciphisa ixesha phantsi kwe-anesthesia.
3.UkuHlanganisa kwangethuba: Izigulana ezinyangwa nge-PFN zihlala ziqokelelana kwaye zithwele ubunzima kwangethuba, ezikhokelela ekuchacheni ngokukhawuleza.
I-4.Iingxaki eziNcitshisiweyo: I-PFN idibene neengxaki ezimbalwa, ezifana nokusuleleka kunye ne-malunion.
Nangona kunjalo, i-DHS ihlala iyindlela esebenzayo, ngakumbi kwiintlobo ezithile zeefractures ezizinzileyo apho ukuyila kwayo kunokubonelela ngokulungiswa okusebenzayo. Isigqibo kufuneka senziwe ngokusekelwe kwiimfuno zesigulane ngasinye kunye nobuchule bogqirha.
Ngaba i-PFN inokususwa?
Kwiimeko ezininzi, i-PFN (i-Proximal Femoral Nail) ayifuni ukuba isuswe xa i-fracture ipholile. Nangona kunjalo, ukususwa kunokuqwalaselwa ukuba isigulane sifumana ukungahambi kakuhle okanye iingxaki ezinxulumene nokufakelwa. Isigqibo sokususa i-PFN kufuneka senziwe ngokubonisana nogqirha wamathambo onyanga, ngokuqwalasela izinto ezifana nempilo yonke yesigulane kunye neengozi ezinokwenzeka kunye neenzuzo zenkqubo yokususa.
Ixesha lokuposa: Apr-19-2025
