Njengommiselo wangaphakathi, iplate yoxinzelelo ibisoloko idlala indima ebalulekileyo kunyango lwefratshi. Kwiminyaka yakutshanje, umxholo wokungaphantsi kwe-osteosnthesis ohlaselweyo ususwe ngokunzulu kwaye usetyenziswa, ngokuthe ngcembe ukusuka kugxininiso lwangaphakathi kwi-bootor, kodwa igxile ekukhuseleni igazi, kodwa ikwakhuthaza ukuphuculwa kweendlela zangaphakathi.Iplate yokuchonga. Inkqubo yaqala ukusetyenziswa kwikliniki ngoMeyi 2000, yayifezekisile iziphumo ezingcono zekliniki, kwaye iingxelo ezininzi zinike ii-avavares ezikhulu ngayo. Nangona zininzi izibonelelo kulungiso lwayo lokuqhekeka, zineemfuno eziphezulu kwitekhnoloji kunye namava. Ukuba isetyenzisiwe ngokungafanelekanga, kunokuba yinto yokuvuma, kwaye isiphumo kwimiphumo engabinayo.
1. I-biomechacal Imigaqo, uyilo kunye nezibonelelo ze-LCP
Uzinzo lweplate yentsimbi eqhelekileyo isekwe ekuthambekeni phakathi kweplate kunye nethambo. Izikrikhi ziyafuneka ukuba ziqiniswe. Nje ukuba izikrelemnqa zikhululekile, ukuxabana phakathi kweplate kwaye ithambo liya kuncitshiswa, ukuziinza kuya kuncitshiswa, kukhokelela ekungaphumeleli kwi-fall yangaphakathi.LcpIplate yenkxaso entsha ngaphakathi kwi-tishu ethambileyo, ephuhliswa ngokudibanisa iplate yokujonga i-conter Umgaqo wayo wokulungiswa awuxhomekeki kwifreyiti phakathi kweplate kunye nethambo le-bortex, kodwa ixhomekeke kwi-angle yozinzo phakathi kweplate kunye ne-screen cerces kunye ne-bortex, ukuze ufezekise ukulungiswa kwe-phraction. Inzuzo ethe ngqo ilele ekunciphiseni ukuphazamiseka kwegazi le-perpoisterial. Uzinzo lwe-engile phakathi kweplate kunye nezikrelemnqa luphucule kakhulu amandla okuqhuba, ngaloo ndlela amandla eplate enkulu kakhulu, esebenza kumathambo ahlukeneyo. [4-7]
Inqaku elikhethekileyo loyilo lwe-LCP ngulo "umngxunya wokudibanisa", odibanisa imingxunya yokucinezelwa kwamandla (i-DCU) ngemingxunya enoxinzelelo. I-DCU inokuqonda ukuxoxiswa kwe-axial ngokusebenzisa isikalo esiqhelekileyo, okanye iqhekeza elifudusiweyo linokucinezelwa kwaye limiselwe nge-LG SCOW; Umngxunya we-coracal odityanisiweyo unemigca, enokutshixa i-screw kunye ne-latch yenzuzo ye-nati, dlulisela itotshi phakathi kwescrew kunye neplate, kwaye uxinzelelo lwexesha elide lunokutshintshelwa kwicala lokuqhekeka. Ukongeza, i-Groove yokusika iyiyile ngezantsi kweplate, enciphisa indawo yoqhakamshelwano nethambo.
Ngamafutshane, kunezibonelelo ezininzi ngaphezulu kweepleyiti zemveli: ① uzinzisa i-angle: I-engile phakathi kweepleyiti zezipikili zizinzile kwaye ilungisiwe, isebenze kumathambo ahlukileyo; ② Ukunciphisa umngcipheko wokuncitshiswa kwelahleko: Akukho mfuneko yokuqhuba ngokuchanekileyo kwiipleyiti, ukunciphisa umngcipheko welahleko yokuqala yenqanaba lesigaba sokuqala kunye nesigaba sesibini sokulahleka; [8] ③ ukhusela ukuhambisa igazi: eyona ndawo incinci yoqhakamshelwano phakathi kweplate yentsimbi kunye nethambo linciphisa ilahleko yeplate ye-periosteum yegazi, ehambelana nemigaqo engaphantsi kakhulu; ④ inendalo entle yendalo: Isebenza ngokukodwa kwi-OsteoporoOporosis Fracture, inciphisa imeko yokukhwela i-screw nokuphuma; ⑤ ivumela umsebenzi wokuziqhelanisa kwangoko; ⑥ Unoluhlu olubanzi lwezicelo: uhlobo lweplate kunye nobude bagqityiwe, i-Aatomical pre-igcinwe ilungile, enokuqonda ukulungiswa kwamalungu ahlukeneyo kunye neentlobo ezahlukeneyo zefliction.
2. Iphawu le-LCP
I-LCP inokusetyenziswa nokuba njengeplate ehlanganisiweyo okanye njengenkxaso yangaphakathi. Ugqirha ugqirha unokudibanisa zombini, ukuze akhulise kakhulu iimboniselo zawo kwaye afake iintlobo ezahlukeneyo zeepatheni zokuqhekeza.
2.1 I-Fratures elula ye-diaphysis okanye i-metaphysis: Ukuba umonakalo wezicubu ezithambileyo awunamgangatho ofanelekileyo, i-quature elula ifuna ukunciphisa, kwaye iqhekeza elilula le-FARE lingasetyenziswa njengeplate yokunyanzelwa kunye neplate okanye iplate yokungathathi cala.
2.2 I-Traction Fratures ye-diaphysis okanye iMetaphyseal: I-LCP inokusetyenziswa njengeplate yebhulorho, eyamnika umntu ophumla ngokungathanga ngqo kunye ne-bridge osteosyenthesis. Ayidingi ukuncitshiswa kwe-anatomical, kodwa uphinda iphinde ibuyise ubude bomzimba, ukujikeleza kunye nomgca we-axial. Ukuqhekeka kweradiyo kunye ne-Ulna kukodwa, kuba ukusebenza kokujikeleza kuxhomekeke kakhulu kwi-anatomy eqhelekileyo ye-radius kunye ne-ulna, efana ne-intra-quariculs. Ngaphandle koko, ukuncitshiswa kwe-anatomical kufuneka kwenziwe, kwaye kuya kumiselwa kakuhle kwiipleyiti ..
2.3 I-Intra-Acra-Articular iqhekeza kunye nefreyimu phakathi kobugcisa: Kwintshukumo ye-intra ye-intra, akufuneki ukuba sinciphise amathambo, kodwa kufuneka sicofe amathambo ukuze sifezekise impilo, kwaye ivumela umsebenzi wokuphumelela kwangoko, kwaye uvumela umsebenzi wokuphiliswa kwethambo, kwaye uvumela umsebenzi wokuphikisana kwethambo, kwaye uvumela umsebenzi wokuphikisana kwasekuqaleni. Ukuba amaqhekeza abuhlungu aneempembelelo emathanjeni, i-LCP inokulungisa idibanisaphakathi kwe-articlar encitshisiweyo kunye ne-diaphsesis. Kwaye akukho sidingo sokwakha iplate kwi utyando, echithile ixesha lotyando.
2.4 Ukulibaziseka kwe-Union okanye ukunganikezeli.
I-2.5 ivaliwe okanye ivuliwe i-osteotomy.
2.6 Ayisebenzi ekungeneniI-Intramellary saisingukwaphuka, kwaye i-LCP yindlela efanelekileyo. Umzekelo, i-LCP ayinakwenzeka kumonakalo womongo wokuqhekezwa kwabantwana okanye ulutsha, abantu abanemingxunya yabo incinci kakhulu okanye kakhulu okanye engalunganga.
2.7 Izigulana ze-osteororooporousis: Oko ithambo lethambo licekeceke, kunzima kwiplate yesiqhelo ukufumana uzinzo oluthembekileyo, kwaye luphume kubunzima bokukhula ngokulula kunye nokuphuma kokulungiswa ngokulula. I-LCP yokutshixa i-screw kunye ne-ankile yeplate yenza uzinzo lwe-engile, kwaye iiplate zeplate ziyadityaniswa. Ukongeza, ububanzi be-mandrel ye-screw yokutshixa bukhulu, ukwandisa amandla athambileyo ethambo. Ke ngoko, ukuba imeko yokukhululwa kwesibhakabhaka incitshisiwe ngokufanelekileyo. Imithambo yomzimba yangaphambi kwexesha ivunyelwe kwintsebenziswano. Isifo se-osteoporousis luphawu oluluqilima lwe-LCP, kwaye iingxelo ezininzi zilunike ingqalelo ephezulu.
2.8 I-Peripprosthetic Fractures: I-Peripprosthetic Procraral Procrals ihlala ihamba kunye ne-osteopororousis, izifo ezidala kunye nezifo ezikhulileyo. Iipleyiti zemveli ziphantsi kwengqumbo ebanzi, ebangela imitya enokubakho ekunikezelweni kwegazi kwetyheli. Ngaphandle koko, izikrikhi eziqhelekileyo zifuna ukulungiswa kwe-bicuortical, kubangela ukonakaliswa kwethambo, kwaye i-osteoporoOporousis ihlwempuzekile. I-LCP kunye neepleyiti ze-liss zisombulula iingxaki ezinjalo. Oko kukuthi, bamkele itekhnoloji ye-MIP ukuba banciphise ukusebenza ngokudibeneyo, banciphise oomonakalo banikezele ngegazi, kwaye ke isikhafu esitshixwayo esitshitshisiweyo sinokubonelela ngozinzo olwaneleyo, olungenakubangela i-fune. Le ndlela iboniswe ngokulula, ixesha elifutshane lokusebenza, ukopha okungaphezulu, kuluhlu oluncinci, kuluhlu lokuqhekeza ukuphiliswa. Ke ngoko, i-peripprostheiting themoral iqhekeza lelona phawu lubalulekileyo lwe-LCP. [1, 10, 11]
3
3.1 Itekhnoloji yokuXelwa kweMveli yeMveli Iindlela zokucinezelwa zezi: ② njengendawo yokhuselo, i-LCP isebenzisa isikhafu sokulungisa i-quarique inde; ③ ngokwamkela umgaqo-siseko weTyhini, ipleyiti ibekwe kwicala lethambo lethambo, liya kubekwa phantsi kwengxabano, kunye nethambo leqela elinokufumana uxinzelelo; Iplati ye-butress, i-LCP isetyenziswa ngokudibeneyo kunye nezikrelemnqa ze-lag zokulungiswa kwamathambo.
3.2 Itekhnoloji yokulungisa iBridge: Okokuqala, yamkela indlela yokunciphisa ngokungathanga ngqo ukuseta kwakhona i-phractore, indawo engalinganiyo kwi-frieds ngebhulorho kwaye ulungise amacala omabini enzaliseko. Ukuncitshiswa kwe-Aatomic akunyanzelekanga, kodwa kufuna kuphela ukubuyela kwakhona kobude be-diaphysis, ukujikeleza kunye nokunyanzeliswa komgca. Ngeli xesha, ukulungiswa kwethambo kunokwenziwa ukukhuthaza ukwenziwa kweCawus kunye nokukhuthaza ukuphiliswa kweqhekeza. Nangona kunjalo, ukulungiswa kwebhulorho kunokufezekisa uzinzo ngokuhambelana, ukuphilisa ukuphiliswa kufezekiswa kwii-calls ezimbini ngenjongo yesibini, ngenxa yoko isebenza kuphela ekuphuculweni.
3.3 Ngokuphindaphindiweyo ipleyiti ye-Osteosynthesis (i-MIPO) Itekhnoloji yase-1990, umbutho we-1970, i-AO uMbutho we-AO ubeke imigaqo yonyango Imigaqo iqatshelwe ngokubanzi kwihlabathi, kwaye iziphumo zekliniki zingcono kunendlela yonyango lwangaphambili. Nangona kunjalo, ukufumana ukuncitshiswa kwe-anatomic kunye ne-fall yangaphakathi, ihlala ifuna ukuncitshiswa okukhulu, okukhokelela kwithambo lethambo elincitshisiweyo, ukunciphisa ukuhanjiswa kwegazi kusulelo kunye nemingcipheko eyandayo yosulelo. Kwiminyaka yakutshanje, abaphengululi basekhaya nabaphesheya banikela ingqalelo engakumbi kwaye bagxininisa ngakumbi kubuchwephesha begazi elithambileyo, bekhusela i-tisterity ye-tisteral kunye nezicubu ze-piestem kunye ne-tissure ethambileyo, enganyanzeli ukuncitshiswa kwesandisi. Ke ngoko, kukhusela ubume be-biby of bimolocal, oko kukuthi, i-osteolont ye-osteosynthesis (Bo). Ngo-1990s, uKrettek wacela i-MUP Technologx, eyona inkqubela phambili entsha yokuqhekeka okuqhelekileyo kwiminyaka yakutshanje. Ijolise ekukhuseleni ukubonelelwa kwegazi kunye nezicubu ezithambileyo kunye nomonakalo omncinci ukuya kwinqanaba elikhulu. Indlela kukwakha umun ococekileyo ngokutsha, beka iipleyiti, kwaye yamkele ubuchule bokunciphisa ngokungathanga ngqo kunciphiso lwe-Fraction kunye ne-fallyur yangaphakathi. I-angle phakathi kweepleyiti ze-LCP zizinzile. Nangona iipleyiti aziyiboni ngokupheleleyo i-aalotomicals, ukuncitshiswa kwesandla kunokugcinwa, ngoko ke izibonelelo zoTekhnoloji zeMipo zivelele kakhulu, kwaye kukungafakwanga iteknoloji ye-MUP.
4. Izizathu kunye nezithintelo zokusilela kwesicelo se-LCP
4.1 ukusilela kwe-fall Arpitor yangaphakathi
Konke ukufakelwa kukhulula, ukufuduswa, ukwaphuka kunye neminye imingcipheko yokusilela, ipleyiti yokutshixa kunye ne-LCP ayikho kwaphela. Ngokweengxelo zoncwadi, ukusilela kwe-fall yangaphakathi ayibangelwanga yiplate ngokwayo, kodwa ngenxa yokuba imigaqo esisiseko yonyango iphulwe ngenxa yokuqonda okwaneleyo kunye nolwazi lokulungiswa kwe-LCP.
4.1.1. Iiplate ezikhethiweyo zimfutshane kakhulu. Ubude beplate kunye nokuhanjiswa kwesibhakabhaka kubalulekile kwizinto eziphambili ezichaphazela ulungiso. Ngaphambi kokuvela kweTekhnoloji ye-IIPO, iipleyiti ezifutshane zinokunciphisa ubude be-ition kunye nokwahlulahlula izicubu ezithambileyo. Iipleyiti ezimfutshane kakhulu ziya kunciphisa amandla e-axial kunye namandla okutolisha ngenxa yesakhiwo esipheleleyo sesonke, okukhokelela ekungaphumeleli kwi-fall yangaphakathi. Ngokuphuhliswa kwetekhnoloji yokuncitshiswa ngokungathanga ngqo kunye netekhnoloji engahlaseli encinci, iipleyiti ezinde aziyi kunyusa ukubekwa kwezicubu ezithambileyo. Ugqirha utyando kufuneka akhethe ubude beplate ngokungqinelana ne-biomechanics yokuqhekeka. Ngomgangatho olula wokuqhekeka, umyinge wobude beplate efanelekileyo kwaye ubude bendawo yokuqhekeka kufuneka bube ngaphezulu kwe-8-10 amaxesha, ngelixa i-quion yokuqhekeka, lo mlinganiselo kufuneka uphakame ngaphezu kwamaxesha ama-2-3. . Ngokweziphumo zohlalutyo lwezinto ze-LCP fitmen, xa umsantsa phakathi kwamacala aqhekezayo yi-1mm, icala le-phraure lishiya i-Plate yoxinzelelo lwePlates, uxinzelelo kwiplate yoxinzelelo lunciphisa i-6% yezikrelemnqa; Xa icala leqhekeza lishiya imingxunya emibini, uxinzelelo kwiplate yoxinzelelo lunciphisa ukuncitshiswa kwe-45%, kwaye uxinzelelo kwizikrelemnqa kunciphisa i-78%. Ke ngoko, ukuthintela uxinzelelo loxinzelelo, kuba iqhekeza elilula, imingxunya eli-1-2 kufutshane namacala aqhekekileyo aya kushiywa, kuyacetyiswa ukuba isetyenziswe kwicala ngalinye le-phlity kunye nesikrelemnqa ngasinye siya kusondela kwiqhekeza ngalinye.
4.1.2 Umsantsa phakathi kweepleyiti kunye nethambo lomphezulu ligqithisile. Xa i-LCP yamkela itekhnoloji yokulungisa ibhulorho, iipleyiti akufuneki ziqhagamshelane ne-periosteum ukukhusela ukubonelelwa kwegazi kwendawo yokuqhekeka. Yeyodidi lokuCwangciswa kwe-Elastic, ukukhuthaza ukumiselwa kwesibini kokukhula kwe-cayius. Ngokufunda uzinzo lwe-biomechanical, ahmad m, uNanda R [16] et al bafumanisa ukuba xa umsantsa phakathi kwe-LCP kunye ne-Amial kunye namandla e-Axial kunye noThengiso lweepleyiti zinciphile kakhulu; Xa umsantsa ungaphantsi kwe-2mm, akukho lula. Ke ngoko, umsantsa uyacetyiswa ukuba ungaphantsi kwe-2mm.
4.1.3 Iplate iphambuka kwi-diaphysis axis, kwaye isikrikhi sisebenza. Xa i-LCP idityanisiwe i-MUP, iipleyiti ziyimfuneko ukufaka i-percutaneal, kwaye ngamanye amaxesha kunzima ukulawula isikhundla seplate. Ukuba ithambo le-axis alifani neplate ye-axis, ipleyiti ye-vistal inokuphambuka kwi-bone axis, eya kukhokelela ekulungiseleleni i-eccentric criction yezikrelemnqa kwaye ilungiswe kakuhle. [9,15]. Kucetyiswa ukuba uthathe i-action efanelekileyo, kunye noviwo lwe-X-ray luya kwenziwa emva kokuba isikhokelo seSikhokelo sokuBamba ngoManwe kukulungiswa kwePini efanelekileyo kwaye intonga.
4.1.4 Ukusilela ukulandela imigaqo esisiseko yonyango lwefraure kwaye ukhethe i-Ator yangaphakathi yokulungisa kunye netekhnoloji yokulungisa. Kwiziqwenga ze-intra-factures, i-diaphysis yedraftis, i-LCP inokusetyenziswa njengeplate yoxinzelelo ukulungisa imeko yokuqhekeka, kunye nokukhuthaza ukuphiliswa kokuqheliselwa kwamanzi; Kwi-metaphyseseSheal okanye i-disctions, itekhnoloji yokulungisa i-bridge kufuneka isetyenziswe, inikele ingqalelo ekunikezelweni kwegazi kunye nezicubu ezithambileyo, zivumele ukulungiswa okuzinzileyo, khuthaza ukulungiswa okuzinzileyo, khuthaza ukukhula kwesiqhelo. Ngokwahlukileyo koko, ukusetyenziswa kwetekhnoloji yokulungisa ibhulorho ukunyanga ukwaphulwa ngokulula kunokubangela ububi obungazinzanga, bunokubangela ukulibaziseka kokuphiliswa; .
4.1.5 Khetha iintlobo ze-screw ezingalunganga. Umngxunya we-LCP unokukrazula kwiindidi ezine zesikrweqe: Izikrelem eziqhelekileyo eziqhelekileyo, isikrelemnqa sethambo esiqhelekileyo, isikrelemnqa esisebenzayo Ukuziqhelanisa nokuziqhelanisa nokuzithambisa kuhlala kusetyenziswa njengesikrelemnqa ongenakulungisa ukulungisa amathambo aqhelekileyo amathambo. Ingcebiso ye-Nail inoyilo lwendlela yokuqhuba, ekulula ukuyidlulisela kwi-cortex rhoqo ngaphandle kwemfuneko yokulinganisa ubunzulu. Ukuba i-Diaphyseleal Cavity inqabile, i-screw net ye-scress ayinakho ngokupheleleyo i-screw, kwaye i-screw chic ichukumisa i-cortex, emva koko komonakalo we-whows offit ichaphazela ngeli xesha. Izikrelemnqa ezimsulwa zinelungelo lokufumana amathambo aqhelekileyo ukuya kumathambo aqhelekileyo, kodwa i-Osteoporosis Bone idla ngokuba ne-cortex ebuthathaka. Kuba ixesha lokusebenza le-screws linciphise, umzuzu wokungaxhathisi besikroba ukugoba ukwehla, nto leyo ekhokelela ngokulula kwi-Screw CORTEX, i-Screw ukukhululwa nokuqhekeka kokuqhekeka kwesahlulo senqanaba lesibini. [18] Njengoko isikrikhi se-bicurnition sonyuse ubude bokusebenza, amandla athambileyo amathambo ayanda. Ngaphezu kwako konke, ithambo eliqhelekileyo linokusebenzisa isikrolo esingenakucociwe ukulungisa, kodwa ithambo le-Osteoporosis liyacetyiswa ukuba basebenzise isikrelemnqa. Ukongeza, i-humerus Bone Cortex incinci, ngokulula ibangela i-ityumy, ke izikrelemnqa ziyafuneka ukuze zilungiswe ukunyanga ukwaphuka kwamakhaya.
4.1.6 Ukuhanjiswa kwesibhakabhaka kuncinci kakhulu okanye kancinci. Ukulungiswa kwesibhakabhaka kuyafuneka ukuba uthobele i-biomechanics ye-bibramere. Ukuhanjiswa kwe-Creat Special kuya kukhokelela ekugxinisweni koxinzelelo lwasekhaya kunye nokuqhekeka kwe-fall yangaphakathi; I-scews encinci kakhulu kwaye amandla okulungisa angonelanga kuya kubangela ukungaphumeleli kwe-fall Andrator yangaphakathi. Xa itekhnoloji yebhulorho isetyenziswa kulungiso lwe-phraction, ukuxinana okucetyiswayo kufuneka kube ngaphantsi kwe-40% -50% okanye ngaphantsi. [7,13,15] Ke ngoko, iipleyiti zide, ukuze kwandise ibhalansi yoomatshini; Imingxunya emi-2-3 kufuneka ishiywe kumacala aqhekekileyo, ukuze avumele ubume obukhulu, ukuthintela uxinzelelo loxinzelelo kwaye unciphise izehlo zoqhawulo-mgama wangaphakathi. I-Gautier kunye ne-Sommer [15] bacinga ukuba ubuncinci izikrelemnqa ezimbini ziya kumiselwa kumacala omabini e-quetis, i-cortex eyongezelelekileyo ayiyi kunciphisa izinga lokungaphumeleli, oko ubuncinci kucetyiswa ukuba ifakwe kumacala omabini aqhekezwe. Ubuncinci ii-3-4s ziyimfuneko kumacala omabini e-humerus kunye ne-Wallorm uqhekezo, imithwalo engaphezulu kufuneka ithwalwe.
4.1.7 Izixhobo zokulungisa zisetyenziswa ngokuchanekileyo, zikhokelela ekungaphumeleli kwi-fall yangaphakathi. I-SOMER c [9] ityelele izigulana ezili-127 ezinamatyala ali-151 asebenzise i-LCP unyaka omnye, iziphumo zohlalutyo zibonisa ukuba izikrelem ezifunekileyo ezingama-700, zimbalwa kakhulu ubukhulu be-3.5mm ukhululwe. Isizathu kukusetyenziswa okushiyiweyo kwisixhobo sokujonga isikreqo. Ngapha koko, isikhafu sokutshixa kwaye iplate ayikho nkqo, kodwa bonisa ama-50 ama-50 e-angle. Olu luyilo lujolise ekunciphiseni uxinzelelo lovavanyo olutshintshileyo. Ukusetyenziswa kwesixhobo sokubona kunokutshintsha isicatshulwa seenwele kwaye ke kubangele ukonakala kwamandla okulungisa. [20] Wayeqhubele isifundo sovavanyo, wafumana i-angle phakathi kwesikrweqe kunye neeplate ze-LCP inkulu kakhulu, kwaye ke amandla okuphelisa izikrikhi anciphile kakhulu.
4.1.8 I-Light ye-Limb yokuGqibela kusasa kakhulu. Iingxelo ezimnandi kakhulu zikhokele oogqirha abaninzi ukuba bakholelwa kakhulu amaqhinga okutshixa kunye nezikrelemnqa kunye nokuzinza, bakholelwa ukuba amandla okutsala akwazi ukulayisha ubunzima bomzimba, kukhokelela kwiplate okanye i-screw gwenxa. Xa usebenzisa i-bridge yokulungiswa kwe-blorhoji, i-LCP iZinzayo, kwaye iyafuneka ukuba yenze i-cangus ukuze ibone ukuphiliswa komtshato wesibini. Ukuba abaguli baphumile ebhedini kwangethuba kwaye balayisha ubunzima obukhulu, iplate kunye ne-screw iya kwaphulwa okanye ityhilwe. Ukutshixwa kweplate yeplate kukhuthaza umsebenzi wangaphambili, kodwa ukugcwalisa kancinci kancinci kuya kuba ziiveki ezintandathu kamva, kwaye iifilimu ze-X-ray zibonisa ukuba icala eliqhekezayo libonisa i-callus ebonakalayo. [9]
4.2 I-tendon kunye ne-neurovascular ye-neurovascular:
I-MOPO Tendech ifuna ukufaka okungapheliyo kwaye ibekwe phantsi kwemisipha, ke xa i-screws ifakwe, oogqirha bangenakusibona isakhiwo seplate, kwaye ngaloo tendon kunye ne-neurovascular yomonakalo iyanda. UVan Hensbroek pb [21] uxele ityala lokusebenzisa itekhnoloji ye-LICS ukuba isebenzise i-LCP, ekhokelele kwi-rateri yangaphandle ye-tibial pseudoineaneaneaneaneaneaneaneaneaneaneaneaneaneaneaneaneaneaneaneanenesms. I-AI-rashid m. [22] ETA ixeliwe ukuba iphathe ukulibaziseka kwe-osson thendon feat firch rackeres nge-lcp. Esona sizathu siphambili somonakalo yi-IATRELICC. Eyokuqala yomonakalo ngqo oswe zizikrelem okanye iPIN yeKirschner. Okwesibini ngumonakalo obangelwe ngumkhono. Kwaye eyesithathu ingumonakalo we-thermal oveliswe ngokuqhuba izikrelemnqa. 9 Ke ngoko, iinotyando ziyafuneka ukuze ziqhelane ne-amommuniting ye-anatomy, zinikele ingqalelo ekukhuseleni i-nerkus vasksi kunye nezinye izinto ezibalulekileyo, ukuziphangela ngokupheleleyo ekubekeni imikhono, ukunqanda ukucinezelwa okanye itrayi yokucinezelwa okanye itrayi. Ukongeza, xa udla izikrelemnqa, sebenzisa amanzi ukunciphisa imveliso yobushushu kwaye unciphise ukwenziwa kobushushu.
4.3 Usulelo lwendawo yokutya kunye nokuvezwa kweplate:
I-LCP yinkqubo yangaphakathi ye-cwatator yenzekile phantsi kwemvelaphi yokukhuthaza umxholo ohlaselwa kancinci, ojolise ekunciphiseni ukonakala, ukunciphisa usulelo, izinto ezingezizo kunye nezinye iingxaki. Ngotyando, kufuneka sinikele ingqalelo ngokukodwa kukhuseleko oluthambileyo lokukhusela, ngakumbi iinxalenye ezibuthathaka zezicubu ezithambileyo. Xa kuthelekiswa ne-DCP, i-LCP inobunzima obukhulu kunye nobuninzi obukhulu. Xa usebenzisa i-MOPIT ye-MIP ye-IPOcutaneous okanye i-intramuscular famp, inokubangela i-thession ye-tissuon ethambileyo okanye umonakalo we-aviulsion kwaye ukhokele kusulelo olunenxeba. I-Phineit P [23] yanika ingxelo yokuba inkqubo ye-LILS inyangwe ngamatyala angama-37 e-proximal tibial tibia, kwaye imeko yosulelo olunzulu yayiye kwi-22%. UNamazi H [24] Uxele ukuba i-LCP ithwaxwa ngamatyala angama-34 e-tibiality ye-34 yosulelo lwe-metaphyseal gesisul osulelo lwe-tibia, kunye nokuvezwa kwepleyiti kwe-23,5%. Ke ngoko, ngaphambi kokusebenza, amathuba kunye nomnxeba wangaphakathi uya kuthathelwa kancinane ngokungqinelana nomonakalo wezicubu ezithambileyo kunye nenqanaba elinzima lokuqhekeka.
4.4 I-Boily yentsimbi engenakukhathaza isifo sezicubu ezithambileyo:
I-Phineit P [23] yanika ingxelo yokuba inkqubo ye-LILS ithwalile iimeko ezingama-37 ze-proximal fibires, iimeko ezingama-4 zeplate ye-tistoped (iintlungu zeplate ze-5mm ukusuka kumphezulu wethambo kunye ne-1mm ukusuka kumgangatho wethambo. I-HasenboeHler.e [17] ET Al ichaze i-LCP yamatyala angama-32 atyhafileyo, kubandakanya amatyala angama-29 e-Medial Malleous engalunganga. Isizathu kukuba i-play inkulu kakhulu okanye ipleyiti ibekwe ngokungalunganga kwaye izicubu ezithambileyo zithambile kwiMedial Malleous, ngenxa yoko izigulana ziya kuziva zingonwabanga xa zicinezela izikhumba eziphezulu kwaye zicinezela ulusu. Iindaba ezimnandi zezokuba iplate ye-metaphyseal entsha ephuhliswe ngemilinganiselo icekeceke kwaye inamathelele kwithambo ngemiphetho egudileyo, eyenza icombulule ngempumelelo le ngxaki.
4.5 ubunzima ekususeni izikrelem ezitshixayo:
Izinto ze-LCP zezomandla eziphezulu ze-Titanium, zihambelana nomzimba womntu, ekulula ukupakishwa nguComus. Ukususa, ukususa okokuqala kwe-cawus kukhokelela kubunzima obukhungelayo. Esinye isizathu sokususa ubunzima kubunzima obungaphezulu kokuqiniswa kwesikrelemnqa okanye ukonakala kwe-Nut, okuhlala kubangelwa kukutshintsha isixhobo sokujonga esishiyiweyo. Ke ngoko, isixhobo sokubona siya kusetyenziswa ekwenzeni izikrelem ezitshixwayo, ukuze imisonto ye-screw inokuthi ihlawulwe ngokuchanekileyo ngemisonto yeplate. .
Ngaphezulu kwako konke, njengeplate yokunyanzelwa kophuhliso lwakutshanje, i-LCP ibonelele ukhetho olutsha lonyango lwanamhlanje lwe-subgical. Ukudityaniswa kunye ne-MUP Technology, i-LCP yokudibanisa igcina ubonelelo lwegazi kumacala amakhulu, ikhuthaza ukuphiliswa kosulelo, kunciphisa ukuqhekeka kosulelo, ngenxa yoko igcina amathemba okusebenza kwonyango. Kuba isicelo, i-LCP ifumene iziphumo zekliniki ezimfutshane, ukanti ezinye iingxaki ziyabhencwa. Utyando lufuna ucwangciso oluneenkcukacha zokuthengisa ngokukodwa kweklinikhi, ukhetha iingcali zangaphakathi zezonyango kunye neetekhnoloji zesiseko semigaqo-nkqubo esisiseko yonyango, ukuze isebenzise izilungiso ngokuchanekileyo, ukuze zithintele iziphumo kwaye zifumane iziphumo ezilungileyo zonyango.
IXESHA LOKUQALA: JUNI-02-2022
