Ngokwezikrufu zentloko kunye nentamo, ithatha uyilo oluphindwe kabini lwe-lag screws kunye ne-compression screws.Ukudibanisa okudibeneyo kwe-2 screws kwandisa ukuchasana nokujikeleza kwentloko yesifazane.
Ngexesha lenkqubo yokufaka i-screw compression, intshukumo ye-axial ye-screw ye-lag iqhutywa yintambo ye-occlusal phakathi kwe-screw compression kunye ne-screw ye-lag, kwaye uxinzelelo oluchasene nokujikeleza luguqulwa lube yi-linear compression ekupheleni kwe-fracture, ngaloo ndlela iphucula kakhulu. amandla achasene nokujikeleza kwesikrufu.Sika ukusebenza.Izikrufu ezi-2 zidityaniswe ngokudibeneyo ukunqanda umphumo "Z".
Uyilo lwesiphelo esisondeleyo sesikhonkwane esiphambili esifana neso sombhobho odibeneyo wenza ukuba umzimba we-nail uhambelane ngakumbi ne-medullary cavity, kwaye ngakumbi ngokuhambelana neempawu ze-biomechanical ze-proximal femur.
Amanyathelo otyando
Isikhundla: Isigulana sinokukhetha indawo esecaleni okanye ephezulu.Ngesigulane kwisigxina esiphezulu, kwitafile yokusebenza ye-radiolucent okanye i-orthopedic traction table.Icala eliphilileyo lesigulane lidityanisiwe kwaye ligxininiswe kwi-bracket, kwaye icala elichaphazelekayo lifakwe kwi-10 ° -15 ° ukuququzelela ukulungelelaniswa kunye ne-medullary cavity.
Ukusetha kwakhona ngokuchanekileyo: Ukutsalwa kwelungu elichaphazelekayo kunye nebhedi yokutsala ngaphambi kokuba usebenze, kwaye ulungelelanise ulwalathiso lwe-traction phantsi kwe-fluoroscopy ukwenzela ukuba umlenze ochaphazelekayo ube nokujikeleza okuncinci kwangaphakathi kunye ne-adduction position.Uninzi lweefractures zinokusetwa kwakhona kakuhle.Ukusetwa kwakhona kwangaphambili kubaluleke kakhulu kwaye Inqaku lilo, musa ukulisika ngokulula ukuba akukho kuncipha okwanelisayo.Oku kunokugcina ixesha lokusebenza kunye nokunciphisa ubunzima ngexesha lokusebenza.Ukuba ukunciphisa kunzima, unokwenza i-incision encinci ngexesha lokusebenza kwaye usebenzise i-push rod, i-retractor, i-forceps yokunciphisa, njl.Iifractures ezincinci Amacala angaphakathi nangaphandle ahlukaniswe, kwaye akukho mfuneko yokulungelelanisa ngokuphindaphindiweyo.Isiphelo sokuqhekeka sinokusetwa kwakhona ngokuzenzekelayo xa i-screw compression is screwed in ngexesha lomsebenzi.
Ukunciphisa i-trochanter encinci: Uyilo lwesikhonkwane se-intramedullary alufuni ukuqhubeka kwe-cortex ye-medial.Ngokuqhelekileyo, akukho mfuneko yokunciphisa iqhekeza elincinci le-trochanter fracture, ngenxa yokuba umsebenzi wokunciphisa ovaliweyo ovaliweyo unempembelelo encinci ekujikelezeni kwegazi ekupheleni kokuphuka, kwaye ukuphuka kulula ukuphilisa.Nangona kunjalo, i-coxa varus kufuneka ilungiswe ngaphambi kokuba i-screw ibekwe, kwaye ixesha lokuya emhlabeni kunye nexesha lokuthwala ubunzima kufuneka libambezeleke ngokufanelekileyo.
Indawo yokusika: I-3-5 cm ye-longitudinal incision yenziwa ekupheleni kwe-proximal ye-trochanter apex malunga nenqanaba le-anterior superior iliac spine.Ucingo lwe-Kirschner lunokubekwa kwicala langaphandle le-femur esondeleyo, kwaye luhlengahlengiswe ukuba luhambelane ne-axis ende ye-femur phantsi kwe-C-arm fluoroscopy, ukwenzela ukuba ukubekwa kwe-incision kuchaneke ngakumbi.
Qinisekisa indawo yokungena: indawo yokungena iphakathi kancinci kwi-apex ye-trochanter enkulu, ehambelana ne-4 ° ukuphambuka kwecala le-axis ende ye-medullary cavity kwimbono yangaphambili.Kwimbono esecaleni, indawo yokungena yesikhonkwane ifumaneka kwi-axis ende ye-medullary cavity;
Indawo yokuNgena kwinaliti
IngenisaGuidePin Fluoroscopy
Ngokupheleleyo Reamed
Kuba isiphelo esikufuphi sesikhonkwane esiphambili se-InterTan singqindilili, isikhonkwane sinokufakwa kuphela emva kokuvuselelwa ngokupheleleyo ngexesha lokusebenza.I-proximal reming kufuneka iyekwe xa isixhobo sothintelo lwe-reaming drill sichukumisa isixhobo sokungena setshaneli.Ukuba i-distal femoral shaft ibuyiselwe kuxhomekeke kubungakanani be-medullary cavity.Ukuba i-X-reyi yangaphambili ifumanisa ukuba i-medullary cavity ye-proximal femoral shaft ngokucacileyo imxinwa, i-femoral shaft reamer kufuneka ilungiswe phambi kotyando.Ukuba ukubuyisela kwakhona akwanelanga, kuya kwenza kube nzima ukufaka isikrufu.Ngethuba lenkqubo ye-screwing, inokuthi ishukume kuluhlu oluncinci Izixhobo ezisecaleni zesikhonkwane se-intramedullary kufuneka zigwenywe, kodwa ukubetha ngobudlova kumsila we-nail kufuneka kugwenywe.Ukunkqonkqoza rhabaxa kunokubangela lula ukwaphuka kwamathambo ngexesha lomsebenzi okanye ukufuduswa kokwaphuka emva kokuncitshiswa.
Faka umkhono wokukhusela izicubu ezithambileyo, ubhobhoze ngaphakathi ecaleni kocingo lwesikhokelo kunye ne-drill, kwaye wandise umjelo we-femoral osondeleyo wesikhonkwane se-intramedullary (ngasentla komfanekiso);ukuba i-medullary cavity imxinwa, sebenzisa i-reamed soft drill ukwandisa i-medullary cavity kububanzi obufanelekileyo;qhagamshela isikhokelo faka i-InterTAN isikhonkwane esingundoqo kwi-medullary cavity (ngezantsi);
ProximalLok
Lag screw yokubekwa
Ukubekwa kwesikrufu sokucinezela
Krwela isikhonkwane sokutshixa esikude
RimvakaleloLok
INdebe yokuphela
Unyango lwasemva kotyando
Amayeza okubulala iintsholongwane ayesetyenziswa rhoqo ukuthintela usulelo kwiiyure ezingama-48 emva kotyando;I-heparin ye-heparin ye-molecular ephantsi kunye neepompo zomoya zazisetyenziselwa ukukhusela i-vein thrombosis enzulu (DVT) kwiindawo ezisezantsi, kwaye izifo ezisisiseko zonyango zaqhubeka ziphathwa.I-radiographs ecacileyo ye-pelvis kunye ne-anteroposterior kunye ne-radiographs ye-lateral ye-joint hip echaphazelekayo yayithathwa ngokuqhelekileyo ukuze iqonde ukunciphisa ukuphuka kunye nokulungiswa kwangaphakathi.
Ngosuku lokuqala emva kokuhlinzwa, isigulane sakhuthazwa ukuba senze i-isometric contraction ye-quadriceps femoris kwindawo ye-semi-recumbent.Ngosuku lwesibini, isigulane sayalelwa ukuba sihlale ebhedini.Ngosuku lwesithathu, isigulane senziwa ngokusebenzayo i-hip kunye ne-knee flexion exercises phezu kwebhedi.Akukho bunzima kwilungu elichaphazelekayo.Khuthaza izigulane ezikwaziyo ukuba zithwale inxalenye yobunzima kwilungu elichaphazelekayo phakathi kweeveki ezi-4 ezinyamezelekayo emva kokusebenza.Kancinci ukuhamba kunye nomhambi onobunzima obunobunzima ngokulandela i-X-ray kwi-6 kwiiveki ze-8.Izigulane ezingakwazi ukuhamba ngokuzimela kwaye zine-osteoporosis enzima Kwizigulane ezinokukhula kwe-callus yamathambo ngokuqhubekayo kwi-X-ray, ziyakwazi ukuhamba ngokuthe ngcembe kunye nokuthwala ubunzima phantsi kwenkxaso.
Umntu woQhagamshelwano: Yoyo (uMphathi weMveliso)
TEL/Whatsapp: +86 15682071283
Ixesha lokuposa: May-08-2023
