I-Intramellary saisingyindlela eqhelekileyo esetyenziswayo ye-orthopedic ye-orthopedic yangaphakathi ehamba nge-1940s. Isetyenziswe ngokubanzi kunyango lwethambo elide lokuqhekeka, imibutho yabasebenzi, kunye nezinye izinto ezenzakeleyo. Ubuchwephesha bubandakanya ukufaka isikhonkwane se-intramellary kwi-Central Canal yethambo lokuzinzisa indawo yokuqhekeza. Ngamaxesha alula, isikhonkwane se-intramellary sisiseko sexesha elideUkutshixa isikrelemImingxunya yomibini iziphelo, ezisetyenziselwa ukulungisa i-proximal kunye ne-distal eziphelweni zefratshi. Kuxhomekeka kwisakhiwo sabo, izikhonkwane zangaphakathi zinokuhlelwa njengeziqinileyo njengeziqinileyo, i-tubimar, okanye i-tubimar, okanye i-qeng-candelo, kwaye zisetyenziselwa ukunyanga iintlobo ezahlukeneyo zezigulana. Umzekelo, izikhonkwane eziqinileyo ze-intramellary zinokuchasana ngcono kusulelo ngenxa yokuswela kwabo indawo yangaphakathi.
Zeziphi iintlobo zefratshi ezifanelekileyo kwizikhonkwane ze-intramellary?
I-Intramellary NailYinto efanelekileyo ekuthatheni iqhekeza ledayaphysey, ngakumbi kwi-femur neTibia. Ngeendlela ezihlaselayo ezincinci, isikhonkwane se-Inramellary sinokubonelela ngokuzinza kakuhle ngelixa kuncitshiswa ukonakala kwe-tissue ethambileyo kwindawo yokuqhekeka.
Ukuncitshiswa okuvaliweyo kunye nokulungiswa kwe-Inramellary
Ukuncitshiswa okuvaliweyo kunye ne-Intramellary Thaing (i-crin) ineengenelo zokuphepha ukubekwa kwendawo yokuqhekeka kunye nokunciphisa umngcipheko wokosulelo. Ngokuphatheleleka okuncinci, inokuthintela ukungabikho kwesicubu esinqabileyo kunye nomonakalo wokubonelela ngegazi kwindawo yokuqhekeka, oko kuphucula inqanaba lokuphilisa lokuqhekeka. Iindidi ezithile zeI-Proximal Bone Fractures. Kuyanceda ngakumbi ngokwemigaqo yokuthwala uxinzelelo lwe-axial xa kuthelekiswa nezinye iindlela zokulungisa ze-eccentric ngokwee-biomechanics. Kungathi kungcono ukuthintela ukukhulula ulungiso lwangaphakathi emva kotyando ngokwandisa indawo yoqhakamshelwano phakathi kokufakwa kwempahla kunye nethambo, iyenza ilungele ukuba ilungele izigulana nge-osteoporosis.
Ifakwe kwi-tibia:
Njengoko kubonisiwe kumzobo, inkqubo yotyando ibandakanya ukwenza i-3-5 cm kuphela ngaphezulu kwe-tubercle, kunye nokufaka isikreqo sokutshixa kwe-2-3 nge-1 cm kwi-1 cm kwi-proximal kunye ne-dister yomlenze ongezantsi. Xa kuthelekiswa nokuncitshiswa kwemveli okuvulekileyo kunye nokulungiswa kwangaphakathi ngeplate yentsimbi, oku kunokubizwa ngokuba yindlela encinci engahlambulukanga.
Ifakwe kwi-femur:
1.Umsebenzi we-1.InterLoct
Ibhekisa kubuchule bayo ukumelana nokujikeleza ngendlela yokutshixa kwendlela ye-intramellary.
2.Ukusasazwa kwesikhonkwane se-intramellary evaliweyo:
Ngokumalunga nomsebenzi: Imigangatho ye-intramedlary yangaphakathi kunye nokwakhiwa ngokutsha kwendawo yokungena ngaphakathi; ikakhulu zimiselwe ngoxinzelelo oluvela kwi-hip edibeneyo ukuya edolweni elihlanganisiweyo, nokuba iinxalenye ezingaphezulu nangaphantsi phakathi kweetawuli (ngaphakathi kwe-5cm) zizinzile. Ukuba ayizinzanga, ukwakhiwa ngokutsha kosulelo loxinzelelo lwe-Hip kuyafuneka.
Ngokuphathelele kubude: mfutshane, i-proximal, kunye neentlobo ezandisiweyo, zikhethwe ngokusekwe kubude bendawo yokuqhekeka xa khetha ubude besikhonkwane se-intramellary.
2.1 Ukudibanisa umgangatho
Umsebenzi ophambili: Ukuzinza kwe-axial yoxinzelelo.
IZAKHONO: I-PROSTRY SHOMORAL (ayisebenzi kwi-subtrichateric quations)
2.2 Ukwakhiwa kwakhona kokudibanisa isikhonkwane se-intramellary
Umsebenzi ophambili: Ukuhanjiswa koxinzelelo ukusuka kwi-hip ukuya kwi-fift shaft ayinakukwazi, kwaye uzinzo losulelo loxinzelelo kule ndawo kufuneka lufumaneke kwakhona.
Isalathiso: 1. Amaqhekeza amachaphaza; 2. I-quartsure ye-themoral yentamo idityaniswe ne-themoral shaft fackeres kwicala elinye (i-bilateral ye-bilateral kwicala elinye).
I-PFAN ikwaluhlobo lokwakhiwa ngokutsha lwe-Intramellary!
2.3 Indlela yokutshixa ye-distal ye-Inramelimerary Nail
Indlela yokutshixa i-distal yezipikili ze-intramellary iyahluka ngokuxhomekeke kumvelisi. Ngokubanzi, isikhafu esifunekileyo esifunekileyo sisetyenziselwa i-proximal ye-proximal ye-proximal ye-proximal, kodwa ngenxa ye-suft fackeres, kodwa yomelele izikhonkwane ze-feramic okanye ezintathu okanye ezintathu ezitshintshelayo zihlala zisetyenziswa ukuphucula uzinzo. Zombini i-femoral kunye ne-tibial yazolile izikhonkwane ze-intramellary zilungisiwe ngezikrelem ezimbini ezitshixwayo.
Ixesha lokuphumla: Mar-29-20233
