Isixhobo Sezixhobo Zezipikili Ezinxibelelanayo Nezithende

By I-CAHEzonyango | Sichuan, eTshayina

Kubathengi abafuna ii-MOQ eziphantsi kunye nohlobo oluphezulu lwemveliso, ababoneleli beMultispecialty banikezela ngokwezifiso ze-MOQ eziphantsi, izisombululo zezothutho ukusuka ekuqaleni ukuya ekugqibeleni, kunye nokuthengwa kweendidi ezininzi, kuxhaswa ngamava abo atyebileyo kushishino kunye neenkonzo kunye nokuqonda okuqinileyo kweendlela ezintsha zemveliso.

Ⅰ. Ziziphi iintlobo ezine zokuqhekeka kwe-femoral?

1. Ukuqhekeka kwe-femur ekufutshane

Ukuphuka kwentamo ye-femoral: Kuqhelekile kwizigulana ezindala ezine-osteoporosis kwaye kunokukhokelela ngokulula kwi-ischemia kunye ne-necrosis yentloko ye-femoral.

Ukuqhekeka kwe-Intertrochanteric: Umgca wokuqhekeka uphakathi kwe-trochanter enkulu kunye ne-trochanter encinci, apho igazi lihamba ngcono kwaye izinga lokuphiliswa liphezulu.

Ukuqhekeka kwe-subtrochanteric: kwenzeka phantsi kwe-trochanter encinci, ikakhulu okubangelwa kukwenzakala okunamandla aphezulu, kwaye kudla ngokufuna unyango lotyando.

2. Ukuqhekeka komngxuma we-femoral

Ukwaphuka kwenzeka embindini we-femur kwaye kudla ngokubangelwa lugonyamelo oluthe ngqo (umz., iingozi zeemoto, ukuwa), kudla ngokuhamba kunye nokufuduka okukhulu kunye nomonakalo wezicubu ezithambileyo.

3. Ukuqhekeka kwefemur ekude

Ukuqhekeka kwe-supracondylar ye-femur: kufutshane nedolo, kunokubandakanya umphezulu we-articular, kwaye kufuna ukunciphisa i-anatomical ukubuyisela ukusebenza kwamalungu.

Ukuqhekeka kwe-interfemoral intercondylar: okubandakanya ii-medial kunye ne-outer femoral condyles, i-articular plane flat kufuneka ihlolwe ukuthintela i-arthritis ebuhlungu

Ⅱ. Ngawaphi amanyathelo okhuseleko ekufuneka athathwe ngexesha lotyando lwezinzipho ze-femoral?

Emva kotyando, ingqwalasela ephambili kufuneka inikwe kwezi zinto zilandelayo: Okokuqala, qwalasela ukuvuza kwegazi kwindawo yotyando, kwaye usebenzise amayeza okubulala iintsholongwane ngokufanelekileyo iiyure ezingama-24 ukuya kuma-48 emva kotyando ukuthintela usulelo. Utyando lutshintshwa rhoqo, kwaye ukukhupha amanzi kususwe kwiiyure ezingama-24. Okwesibini, yenza imisebenzi yamalungu esinqe kunye namadolo kunye nokuzilolonga ngokukhawuleza emva kotyando. Izipikili ze-intramedullary zokuqhekeka kwe-femoral shaft ziquka izipikili ezifuna ukubethelwa kwi-hip okanye kwi-dolo joints, eziya kubangela umonakalo othile kwizicubu ezithambileyo ezijikeleze amalungu kwaye zinokubangela ukuqokelelana kwegazi kwi-joints. Ke ngoko, kucetyiswa ukuba kwenziwe ukuhlanganiswa kwamalungu kwangethuba emva kotyando ukuthintela iingxaki ezinje ngokunamathelana kwamalungu, kunye nokunciphisa ukwakheka kwe-deep vein thrombosis kwimilenze esezantsi. Okwesithathu, akukhuthazwa ukuba uthwale ubunzima kwangethuba emva kotyando, kwaye kuyimfuneko ukuphonononga rhoqo ii-X-ray ukuze uqonde ukukhula nokuphiliswa kwe-fracture stump, kunye nokukhuthaza ukuphiliswa kwamalungu ngokufanelekileyo ngamayeza.

Ⅲ. Yintoni umahluko phakathi kwe-PFN A kunye ne-A2?

I-PFN-A kunye ne-A2 ziingcamango ezimbini ezahluke ngokupheleleyo, eyokuqala sisixhobo sokulungisa ngaphakathi sonyango lwee-femoral intertrochanteric fractures (i-anti-rotation proximal femoral intramedullary nail), kwaye eyokugqibela luhlelo lwee-femoral intertrochanteric fractures kwinkqubo yokubhala ye-AO.

I-PFN-A sisixhobo esithile sokufakelwa kwangaphakathi sotyando, esimele "iProximal Femoral Nail Anti-rotation". Yinkqubo yezinzipho zangaphakathi elungisa ukwaphuka ngokuzifaka kwi-femoral medullary cavity, eneempawu zokulwa nokujikeleza kunye nokuqina okuzinzileyo, kwaye isetyenziselwa kakhulu unyango lwakwaphuka kwe-intertrochanteric ye-femoral femoral eneentlobo ze-AO A1, A2, A3 kunye nokwaphuka kwe-subtrochanteric ephezulu.

I-A2 yinkcazo yohlobo lwezaphuko ze-femoral ze-intertrochanteric kwinkqubo yokwahlulwa kwe-AO kwaye ihlelwa njengokwaphuka okungazinziyo. Ngokwendlela yokwahlulwa kwe-AO, izaphuko zohlobo lwe-A2 zibonakaliswa ngumgca wokwaphuka odlula kummandla we-trochanteric kunye nokuqhekeka kwe-medial cortex ubuncinane kwiindawo ezimbini ezinenani elikhulu leebhloko zokwaphuka. Yahlulwe ngakumbi:

Uhlobo A2.1: Kukho ubunzima bokuqhekeka obuphakathi phakathi kweetrochanters.

Uhlobo A2.2: Kukho iibhloko ezininzi zokuqhekeka eziphakathi phakathi kweetrochanters.

Uhlobo A2.3: Umgca wokuqhekeka udlula ngaphezulu kwe-1cm ngaphantsi kwe-trochanter encinci

Ngamafutshane, i-PFN-A sisixhobo sonyango kwaye i-A2 luhlobo lokwaphuka. Ngokwezonyango, oogqirha baya kukhetha indlela efanelekileyo yokulungisa ngaphakathi ngokwendlela ye-AO yokwaphuka kwesigulana (njengohlobo lwe-A2), kwaye i-PFN-A yenye yeendlela eziqhelekileyo zotyando zokunyanga ukwaphuka kwe-femoral okungazinzanga okufana nohlobo lwe-A2.