Indlela yokulungisa ngaphakathi ye-PFNA
I-PFNA (Ukuthintela ukujikeleziswa kweenzipho ze-Proximal Femoral), uzipho oluchasene nokujikeleza kwe-intramedullary ye-proximal femoral. Ifanelekile kwiintlobo ezahlukeneyo zokuqhekeka kwe-femoral intertrochanteric; ukwaphuka kwe-subtrochanteric; ukwaphuka kwesiseko sentamo ye-femoral; ukwaphuka kwentamo ye-femoral kunye nokuqhekeka kwe-femoral shaft; ukwaphuka kwe-femoral intertrochanteric kunye nokuqhekeka kwe-femoral shaft.
Iimpawu eziphambili zoyilo lwezipikili kunye neenzuzo
（1） Uyilo oluphambili lwezipikili lubonakaliswe ziimeko ezingaphezu kwama-200,000 ze-PFNA, kwaye lufikelele kwinqanaba elifanelekileyo lokuhambelana nokwakheka komsele we-medullary;
（2） I-engile yokuhluthwa kweenzipho eziphambili ye-6-degree ukuze kube lula ukuyifaka kwincopho ye-trochanter enkulu；
（3）Izikhonkwane ezingenanto, kulula ukuzifaka；
（4）Isiphelo esikude senzipho esiphambili sinobungqingqwa obuthile, okulula ukuyifaka isikhonkwane esiphambili kwaye siphephe ukuxinwa koxinzelelo.
I-Spiral blade:
(1) Ukulungiswa kwangaphakathi ngaxeshanye kugqiba ukuqina kokungajikelezi kunye ne-angular;
(2) I-blade inendawo enkulu yomphezulu kunye nobubanzi obuphakathi obukhula kancinci kancinci. Ngokungena ngaphakathi nangokucinezela ithambo elirhoxisayo, amandla okubambelela e-helical blade anokuphuculwa, nto leyo efanelekileyo ngakumbi kwizigulane ezinezaphuko ezikhululekileyo;
(3) I-helical blade ifakwe ngokuqinileyo kwithambo, nto leyo eyomeleza uzinzo kwaye imelane nokujikeleza. Isiphelo sokuqhekeka sinamandla amakhulu okuwa kunye nokukhubazeka kwe-varus emva kokufunxwa.
La manqaku alandelayo kufuneka aqwalaselwe xa kunyangwa ukwaphuka kwe-femoral nge:Ukulungiswa kwangaphakathi kwe-PFNA:
(1) Uninzi lwezigulane ezindala zihlushwa zizifo ezisisiseko kwaye azikwazi ukumelana notyando. Ngaphambi kotyando, imeko iyonke yesigulana kufuneka ihlolwe ngokupheleleyo. Ukuba isigulana sinokunyamezela utyando, utyando kufuneka lwenziwe kwangethuba, kwaye ilungu elichaphazelekayo kufuneka lisetyenziswe kwangethuba emva kotyando. Ukuthintela okanye ukunciphisa ukuvela kweengxaki ezahlukeneyo;
(2) Ububanzi bomngxuma we-medullary kufuneka bulinganiswe kwangaphambili ngaphambi kokuba kwenziwe utyando. Ububanzi besikhonkwane esiphambili sangaphakathi kwe-medullary buncinci nge-1-2 mm kunomngxuma we-medullary wokwenyani, kwaye akufanelekanga ukuba kubekwe ngendlela enobudlova ukuze kuthintelwe ukuvela kweengxaki ezifana nokuqhekeka kwe-femur ye-distal;
(3) Isigulana silele, ilungu elichaphazelekayo lithe tye, kwaye ukujikeleza kwangaphakathi yi-15°, nto leyo elula ukufakwa kwenaliti yesikhokelo kunye neenzipho eziphambili. Ukubambelela okwaneleyo kunye nokunciphisa ukwaphuka okuvaliweyo phantsi kwe-fluoroscopy zizinto ezibalulekileyo zotyando oluphumelelayo;
(4) Ukusebenza okungafanelekanga kwendawo yokungena yenaliti yesikhokelo sesikrufu esiphambili kunokubangela ukuba isikrufu esiphambili sePFNA sivalwe kwi-medullary cavity okanye indawo ye-spiral blade ibe yinto engaqhelekanga, nto leyo enokubangela ukuphambuka kokunciphisa ukwaphuka okanye ukuchetywa koxinzelelo lwentamo ye-femoral kunye nentloko ye-femoral yi-spiral blade emva kotyando, okunciphisa isiphumo sotyando;
(5) Umatshini we-X-ray we-C-arm kufuneka uhlale unika ingqalelo kubunzulu kunye nokungangqinelani kwenaliti yesikhokelo se-screw blade xa uyifaka, kwaye ubunzulu bentloko ye-screw blade kufuneka bube yi-5-10 mm ngaphantsi komphezulu we-cartilage yentloko ye-femoral;
(6) Kwii-combined subtrochanteric fractures okanye ii-long oblique fracture fracture fractures, kucetyiswa ukuba kusetyenziswe i-PFNA eyandisiweyo, kwaye imfuneko yokunciphisa okuvulekileyo ixhomekeke ekunciphiseni ukwaphuka kunye nokuzinza emva kokunciphisa. Ukuba kuyimfuneko, intambo yentsimbi ingasetyenziselwa ukubopha ibhloko yokuqhekeka, kodwa iya kuchaphazela ukuphiliswa kokuqhekeka kwaye kufuneka ithintelwe;
(7) Kwiingozi eziqhekekileyo phezulu kwetrochanter enkulu, utyando kufuneka lube mnene kangangoko kunokwenzeka ukuze kuthintelwe ukwahlukana ngakumbi kweziqwenga eziqhekekileyo.
Iingenelo kunye nemida ye-PFNA
Njengohlobo olutsha lweisixhobo sokulungisa ngaphakathi kwe-medullary, i-PFNA inokudlulisa umthwalo nge-extrusion, ukuze amacala angaphakathi nangaphandle e-femur akwazi ukuthwala uxinzelelo olufanayo, ngaloo ndlela kufezekiswa injongo yokuphucula uzinzo kunye nokusebenza kakuhle kokulungiswa kwangaphakathi kwee-fractures. Isiphumo esimiselweyo silungile njalo njalo.
Ukusetyenziswa kwe-PFNA kukwanemida ethile, njengobunzima bokubeka isikrufu sokutshixa esikude, umngcipheko owandileyo wokuqhekeka ojikeleze isikrufu sokutshixa, ukukhubazeka kwe-coxa varus, kunye nentlungu kwindawo engaphambili yethanga ebangelwa kukurhawuzelelwa kwebhendi ye-iliotibial.ukulungiswa kwe-intramedullaryidla ngokuba nokwenzeka ukuba i-fixation failure kunye ne-fracture non-unit ingasebenzi.
Ngoko ke, kwizigulane ezindala ezine-intertrochanteric fractures ezingazinzanga kunye ne-osteoporosis enzima, ukuthwala ubunzima kwasekuqaleni akuvumelekanga kwaphela emva kokuthatha i-PFNA.
Ixesha lokuthumela: Septemba-30-2022
