Umba wokukhetha ubukhulu bezipikili ze-intramedullary zamathambo amade e-tubular emilenze engezantsi.

Ukubethela nge-intramedullary yeyona ndlela ibalaseleyo yokunyanga ukwaphuka kwe-diaphyseal kwamathambo amade aneetyhubhu kumalungu asezantsi. Inika iingenelo ezifana nokwenzakala okuncinci kotyando kunye namandla aphezulu e-biomechanical, okwenza ukuba isetyenziswe kakhulu kwiimfanta ze-tibial, femoral, kunye ne-humeral shaft. Ngokwezonyango, ukukhethwa kobubanzi bezinzipho ze-intramedullary kudla ngokuthanda isinzipho esikhulu esinokufakwa ngokulungiswa okuphakathi, ukuqinisekisa uzinzo olukhulu. Nangona kunjalo, nokuba ubukhulu bezinzipho ze-intramedullary buchaphazela ngokuthe ngqo i-fracture prognosis akucaci.

Kwinqaku elingaphambili, sixoxe ngophando oluhlola impembelelo yobubanzi bezinzipho ngaphakathi kwe-medullary ekuphilisweni kwamathambo kwizigulana ezingaphezu kwama-50 ezinamathambo aqhekekileyo phakathi kwe-trochanteric. Iziphumo azibonisanga mahluko kwizibalo kumanqanaba okuphiliswa kwamathambo aqhekekileyo kunye namanqanaba okuphinda asebenze phakathi kweqela le-10mm kunye neqela elinezinzipho ezijiyileyo kune-10mm.

Iphepha elapapashwa ngo-2022 zizazi ezivela kwiPhondo laseTaiwan nalo lafikelela kwisigqibo esifanayo:

Uphononongo olubandakanya izigulana ezingama-257, ezazilungisiwe ngezipikili zangaphakathi ezinobubanzi obuyi-10mm, 11mm, 12mm, kunye ne-13mm, lwahlulahlula izigulana zibe ngamaqela amane ngokusekelwe kububanzi bezipikili. Kufunyaniswe ukuba akukho mahluko kwizibalo kumanqanaba okuphiliswa kwamathambo phakathi kwamaqela amane.

Ngoko ke, ngaba oku kukwanjalo nakwiingxaki ezilula zokuqhekeka kwe-tibial shaft?

Kwisifundo solawulo lweemeko esinokuthi sibandakanye izigulana ezingama-60, abaphandi bahlule izigulana ezingama-60 ngokulinganayo zibe ngamaqela amabini anama-30 ngalinye. Iqela A lalungiswa ngezipikili ezibhityileyo zangaphakathi kwe-medullary (eziyi-9mm kwabasetyhini kunye ne-10mm kumadoda), ngelixa iQela B lalungiswa ngezipikili ezixineneyo zangaphakathi kwe-medullary (eziyi-11mm kwabasetyhini kunye ne-12mm kumadoda):

Iziphumo zibonise ukuba akukho mahluko mkhulu kwiziphumo zeklinikhi okanye imifanekiso phakathi kwezinzipho ezibhityileyo nezityebileyo zangaphakathi kwe-medullary. Ukongeza, izinzipho ezibhityileyo zangaphakathi kwe-medullary zazinxulunyaniswa namaxesha amafutshane otyando kunye ne-fluoroscopy. Nokuba kusetyenziswe isinzipho esityebileyo okanye esincinci, ukuphinda-phinda okuphakathi kwenziwa ngaphambi kokufakwa kwezinzipho. Ababhali bacebisa ukuba kwiintsipho ezilula ze-tibial shaft, izinzipho ezibhityileyo zangaphakathi kwe-medullary zingasetyenziselwa ukuqinisa.