Ubuchule bokulungiswa kwangaphakathi kwePFNA
I-PFNA (i-Proximal Femoral Nail Antirotation), i-proximal femoral anti-rotation intramedullary nail.Ifanelekile kwiindidi ezahlukeneyo ze-femoral intertrochanteric fractures;i-subtrochanteric fractures;i-femoral neck fractures;iifractures zentamo ye-femal edibeneyo kunye nokuphulwa kwe-femoral shaft;iifractures ze-femoral intertrochanteric ezidityaniswe ne-femoral shaft fractures.
Iimpawu eziphambili zokuyila iinzipho kunye neenzuzo
(1) Uyilo oluphambili lwezikhonkwane lubonakaliswe ngamatyala angaphezu kwe-200,000 yePFNA, kwaye iphumelele umdlalo ogqwesileyo kunye ne-anatomy ye-medullary canal;
(2) i-angle yokuhlutha i-6-degree yesikhonkwane esingundoqo ukuze ufakwe lula ukusuka kwi-pex ye-trochanter enkulu;
(3) Isikhonkwane esivulekileyo, kulula ukusifaka;
(4) Isiphelo se-distal yesikhonkwane esiphambili sine-elasticity ethile, elula ukufaka isikhonkwane esiphambili kwaye sigweme ukugxilwa kwengcinezelo.
I-Spiral blade:
(1) Ukulungiswa okukodwa kwangaphakathi ngaxeshanye kugqiba ukuchasana nokujikeleza kunye nokuzinzisa kwe-angular;
(2) Iblade inomhlaba omkhulu kunye nokwanda kwedayamitha engundoqo ngokuthe ngcembe.Ngokuqhuba kunye nokunyanzeliswa kwethambo lokukhansela, amandla okubambelela kwi-helical blade inokuphuculwa, efanelekileyo kakhulu kwizigulane ezineefractures ezikhululekile;
(3) I-helical blade ifakwe ngokuqinileyo kwithambo, ephucula ukuzinza kwaye imelane nokujikeleza.Isiphelo sokuqhekeka sinamandla amakhulu okuwa kunye ne-varus deformity emva kokufunxa.
La manqaku alandelayo kufuneka athathelwe ingqalelo kunyango lwezahlulo ze-femoral ngePFNA ukulungiswa kwangaphakathi:
(1) Uninzi lwabaguli abalupheleyo luthwaxwa zizifo ezisisiseko zonyango yaye alunyamezeli utyando.Ngaphambi kokuhlinzwa, imeko jikelele yesigulane kufuneka ihlolwe ngokubanzi.Ukuba isigulana sinokulunyamezela utyando, utyando kufuneka lwenziwe kwangethuba, yaye ilungu elichaphazelekayo lifanele lenziwe kwangethuba emva kotyando.Ukuthintela okanye ukunciphisa ukwenzeka kweengxaki ezahlukeneyo;
(2) Ububanzi bomgodi wemedulari kufuneka bulinganiswe kwangaphambili phambi kotyando.Ububanzi besikhonkwane esiphambili se-intramedullary yi-1-2 mm encinci kune-medullary cavity yangempela, kwaye ayifanelekanga ukubekwa ngobundlobongela ukuphepha ukuvela kweengxaki ezifana ne-distal femur fracture;
(3) Isigulane siphezulu, ilungu elichaphazelekayo lithe tye, kwaye ukujikeleza kwangaphakathi yi-15 °, ekulungele ukufakwa kwenaliti yesikhokelo kunye nesikhonkwane esikhulu.Ukutsalwa okwaneleyo kunye nokunciphisa okuvaliweyo kweefractures phantsi kwe-fluoroscopy yizitshixo zokuhlinzwa okuphumelelayo;
(4) Ukungasebenzi ngendlela engafanelekanga kwendawo yokungena yenaliti yesikhokelo sokujija kunokubangela ukuba isikrufu esikhulu sePFNA sivalwe kwi-medullary cavity okanye indawo ye-spiral blade i-eccentric, enokubangela ukutenxa kokunciphisa ukwaphuka okanye ukucheba uxinzelelo. yentamo yowesifazane kunye nentloko ye-femoral nge-spiral blade emva kokuhlinzwa, ukunciphisa umphumo wotyando;
(5) Umatshini weX-reyi ye-C-arm kufuneka usoloko unikel’ ingqalelo kubunzulu kunye ne-eccentricity yenaliti ye-screw blade yesikhokelo xa ujija, kwaye ubunzulu bentloko ye-screw blade kufuneka bube yi-5-10 mm ngaphantsi kwe-cartilage surface intloko yowesifazane;
(6) Ukudibanisa i-subtrochanteric fractures okanye i-oblique fracture fracture fractures, kucetyiswa ukuba kusetyenziswe i-PFNA eyandisiweyo, kunye nesidingo sokunciphisa okuvulekileyo kuxhomekeke ekunciphiseni ukuphuka kunye nokuzinza emva kokunciphisa.Ukuba kuyimfuneko, intambo yensimbi ingasetyenziselwa ukubopha ibhloko yokuphuka, kodwa iya kuchaphazela ukuphulukiswa kokuphuka kwaye kufuneka igwenywe;
(7) Ukuqhekeka kwezahlulo phezulu kwi-trochanter enkulu, umsebenzi kufuneka ube mnene kangangoko ukuphepha ukuhlukana okungaphezulu kweeqhekeza.
Izinto eziluncedo kunye neMida yePFNA
Njengohlobo olutsha lweisixhobo sokulungiswa kwe-intramedullary, I-PFNA inokudlulisa umthwalo ngokusebenzisa i-extrusion, ukwenzela ukuba amacala angaphakathi nangaphandle e-femur angakwazi ukuthwala uxinzelelo olufanayo, ngaloo ndlela afezekise injongo yokuphucula ukuzinza kunye nokusebenza kokulungiswa kwangaphakathi kweefractures.Umphumo omiselweyo ulungile kwaye njalo njalo.
Ukusetyenziswa kwe-PFNA kukwanazo nemida ethile, enjengobunzima ekubekeni i-screw yokutshixa i-distal, ukonyuka komngcipheko wokwaphuka kwi-screw yokutshixa, i-coxa varus deformity, kunye nentlungu kwindawo yethanga yangaphambili ebangelwa kukucaphuka kwebhendi ye-aliotibial.I-Osteoporosis, ngokoukulungiswa kwe-intramedullaryihlala inethuba lokusilela ukulungisa kunye nokuqhekeka kwe-nonnunion.
Ke ngoko, kwizigulana ezisele zikhulile ezine-intertrochanteric fractures ezingazinzanga ezine-osteoporosis enzima, ukuthwala ubunzima kwangoko akuvumelekanga ngokupheleleyo emva kokuthatha i-PFNA.
Ixesha lokuposa: Sep-30-2022
