Ukuqhekeka kwentamo ye-Femoral yinto eqhelekileyo kunye nokulimala okunokubangela ukwenzakala koogqirha bamathambo, kunye neziganeko eziphezulu zokungahlanganisi kunye ne-osteonecrosis ngenxa yonikezelo lwegazi olubuthathaka. Ukunciphisa ngokuchanekileyo kunye nokunciphisa kakuhle i-femoral neck fractures kuyisitshixo sokulungiswa okuphumelelayo kwangaphakathi.
Uvavanyo lokuNcitshiswa
Ngokutsho kweGadi, umgangatho wokunciphisa i-femoral neck fracture yi-160 ° kwifilimu ye-orthopedic kunye ne-180 ° kwifilimu esecaleni. Kuthathwa njengeyamkelekileyo ukuba isalathisi seGarden siphakathi kwe-155 ° kunye ne-180 ° kwiindawo eziphakathi kunye neendawo ezisecaleni emva kokunciphisa.
Uvavanyo lwe-X-ray: emva kokunciphisa okuvaliweyo, iqondo lokwaneliseka lokunciphisa kufuneka ligqitywe ngokusebenzisa imifanekiso ye-X-ray ephezulu. USimom kunye no-Wyman baye benza ii-angles ezahlukeneyo ze-X-ray emva kokunciphisa okuvaliweyo kwe-femoral neck fracture, kwaye bafumanisa ukuba kuphela iifilimu ze-X-ray ezintle kunye ne-lateral zibonisa ukunciphisa i-anatomical, kodwa kungekhona i-conduction ye-anatomical yokwenyani kunye nokunciphisa i-anatomical ebusweni. i-concave surface yentamo ye-femoral inokudibaniswa ne-S-curve kwimeko ye-anatomical eqhelekileyo. U-Lowell ucebise ukuba umphezulu we-convex wentloko ye-femoral kunye ne-concave surface yentamo ye-femoral unokwenza i-curve emise okwe-S phantsi kweemeko eziqhelekileyo ze-anatomical, kwaye xa i-curve enemilo ye-S ayigudi okanye i-tangent nakweyiphi na indawo kwi-X-reyi, iphakamisa ukuba ukulungiswa kwe-anatomical akuzange kuphunyezwe.
Unxantathu oguqulweyo uneengenelo ezicacileyo zebhayomechanical
Njengomzekelo, kumzobo ongezantsi, emva kokuqhekeka kwentamo ye-femur, isiphelo se-fracture sixhomekeke kuxinzelelo oluxhomekeke kakhulu kwindawo ephezulu kunye noxinzelelo kwindawo engezantsi.
Iinjongo zokulungiswa kokwaphuka zezi:1. ukugcina ulungelelwaniso olululo kunye 2. nokuchasana noxinzelelo lwe-tensile kangangoko kunokwenzeka, okanye ukuguqula uxinezeleko lube luxinzelelo olucinezelayo, oluhambelana nomgaqo-siseko webhendi yoxinzelelo. Ngoko ke, isisombululo sikanxantathu ojikisiweyo kunye nezikhonkwane ezi-2 ngasentla zingaphezulu ngokucacileyo kwisisombululo se-orthotic esingunxantathu kunye nesikrufu esinye ngaphezulu ukuchasana noxinzelelo lwe-tensile.
Umyalelo apho izikrufu ezi-3 zibekwe khona ekuqhekekeni kwentamo ye-femal kubalulekile:
I-screw yokuqala kufuneka ibe yincam yonxantathu oguqulweyo, kunye nomzuzu we-femoral;
I-screw yesibini kufuneka ibekwe ngasemva kwisiseko sonxantathu oguqulweyo, ecaleni kwentamo ye-femal;
I-screw yesithathu kufuneka ibe ngaphambili ukuya kumda ophantsi wonxantathu oguqulweyo, kwicala loxinzelelo lokuphuka.
Ekubeni i-femoral neck fractures idla ngokunxulunyaniswa ne-osteoporosis, izikrufu zine-screw grip elinganiselweyo ukuba aziqhotyoshelwanga emphethweni kwaye ubunzima bethambo bunqabile kwindawo ephakathi, ngoko ke ukuncamathela umda ngokusondeleyo kunokwenzeka kwi-subcortex kunika uzinzo olungcono. Indawo efanelekileyo:
Imigaqo emithathu yokulungisa izikhonkwane ezingenanto: kufuphi nomda, i-parallel, iimveliso eziguquliweyo
Okuyamelwana kuthetha ukuba izikrufu ezi-3 zingaphakathi kwentamo ye-femur, kufutshane ne-peripheral cortex kangangoko kunokwenzeka. Ngale ndlela, i-screws ezi-3 zizonke zenza uxinzelelo oluphezulu kwindawo yonke yokuphuka, kanti ukuba i-screws ezi-3 azikho ngokwaneleyo ngokwaneleyo, uxinzelelo luvame ukuba lufana nenqaku, luzinzile kwaye luncinci ukumelana ne-torsion kunye ne-shear.
ImiSebenzi yokuSebenza emva kokuSebenza
Ukuzivocavoca kwe-toe-bearing weight-bearing exercises kungenziwa kwiiveki ze-12 emva kokulungiswa kwe-fracture, kunye ne-partial weight-bearing exercises inokuqaliswa emva kweeveki ze-12. Ngokwahlukileyo, kwi-Pauwels uhlobo lwe-III fractures, ukulungiswa nge-DHS okanye i-PFNA kuyacetyiswa.
Ixesha lokuposa: Jan-26-2024
