Ukuqhekeka kwentamo ye-femoral kukwenzakala okuqhelekileyo nokunokuba yingozi kakhulu koogqirha bamathambo, kunye nenani elikhulu lokungadibani kunye ne-osteonecrosis ngenxa yokunikezelwa kwegazi okubuthathaka. Ukunciphisa ngokuchanekileyo nokulungileyo kokuqhekeka kwentamo ye-femoral ngundoqo wokulungiswa kwangaphakathi okuphumelelayo.
Uvavanyo lokuNcitshiswa
Ngokutsho kukaGarden, umgangatho wokunciphisa ukwaphuka kwentamo ye-femoral esusiweyo yi-160° kwifilimu yamathambo kunye ne-180° kwifilimu esecaleni. Kuthathwa njengokufanelekileyo ukuba i-Garden index iphakathi kwe-155° kunye ne-180° kwiindawo eziphakathi kunye nezisecaleni emva kokunciphisa.
Uvavanyo lwe-X-reyi: emva kokunciphisa okuvaliweyo, izinga lokwaneliseka kokunciphisa kufuneka limiselwe ngokusebenzisa imifanekiso ye-X-reyi ekumgangatho ophezulu. USimom noWyman benze ii-engile ezahlukeneyo ze-X-reyi emva kokunciphisa okuvaliweyo kokuqhekeka kwentamo ye-femoral, baza bafumanisa ukuba kuphela iifilimu ze-X-reyi ezilungileyo nezisecaleni ezibonisa ukunciphisa komzimba, kodwa hayi ukunciphisa komzimba okwenyani. ULowell ucebise ukuba umphezulu ongqukuva wentloko ye-femoral kunye nomphezulu ongqukuva wentamo ye-femoral zinokudityaniswa ne-S-curve kwimeko eqhelekileyo yomzimba. ULowell ucebise ukuba umphezulu ongqukuva wentloko ye-femoral kunye nomphezulu ongqukuva wentamo ye-femoral zinokwenza i-curve efana ne-S phantsi kweemeko eziqhelekileyo zomzimba, kwaye xa i-curve efana ne-S ingagudi okanye ingaguquki nakweyiphi na indawo kwi-X-reyi, oko kuthetha ukuba ukutshintshwa kwe-anatomical akukafezekiswa.
Unxantathu oguqulweyo unezibonelelo ezicacileyo ze-biomechanical
Umzekelo, kumfanekiso ongezantsi, emva kokuphuka kwentamo ye-femur, isiphelo sokuqhekeka siphantsi koxinzelelo oluxineneyo kakhulu kwicandelo eliphezulu kwaye oluxinzelelekileyo kwicandelo elingaphantsi.
Iinjongo zokulungisa ukwaphuka zezi: 1. ukugcina ulungelelwano oluhle kunye 2. nokumelana noxinzelelo loxinzelelo kangangoko kunokwenzeka, okanye ukuguqula uxinzelelo loxinzelelo lube luxinzelelo loxinzelelo, oluhambelana nomgaqo wokubopha uxinzelelo. Ke ngoko, isisombululo sonxantathu oguqulweyo esinezikrufu ezi-2 ngasentla ngokucacileyo singcono kunesisombululo sonxantathu olungiselelweyo esinesikrufu esinye kuphela ngaphezulu ukuze silwe noxinzelelo loxinzelelo.
Kubalulekile ukuba ulandelelwano olubekwe ngalo izikrufu ezi-3 kwi-femoral neck fracture:
Isikrufu sokuqala kufuneka sibe yincam yenxantathu eguqulweyo, ecaleni kwexesha le-femoral;
Isikrufu sesibini masibekwe ngasemva kwisiseko senxantathu eguqulweyo, ecaleni kwentamo ye-femoral;
Isikrufu sesithathu masibe ngaphambili kumphetho ongezantsi wenxantathu eguqulweyo, kwicala loxinzelelo lwendawo eqhekekileyo.
Ekubeni ukwaphuka kwentamo ye-femoral kudla ngokunxulunyaniswa ne-osteoporosis, izikrufu zine-screw grip elinganiselweyo ukuba azinamatheliswanga emphethweni kwaye ubunzima bethambo buncinci kwindawo ephakathi, ngoko ke ukunamathelisa umphetho kufutshane kangangoko kunokwenzeka kwi-subcortex kunika uzinzo olungcono. Indawo efanelekileyo:
Imigaqo emithathu yokulungisa izikhonkwane ezingenanto: kufutshane nomphetho, izinto ezihambelanayo, eziguquliweyo
I-Adjacent ithetha ukuba izikrufu ezi-3 zingaphakathi kwentamo ye-femur, zisondele kakhulu kwi-peripheral cortex. Ngale ndlela, izikrufu ezi-3 zizonke zenza uxinzelelo lomphezulu kuwo wonke umphezulu owaphukileyo, ngelixa ukuba izikrufu ezi-3 azihlukani ngokwaneleyo, uxinzelelo ludla ngokuba ngathi lune-point-like, aluzinzanga kwaye aluxhathisi kakhulu kwi-torsion kunye ne-shear.
Ukuzivocavoca emva kotyando
Ukuzilolonga ngokubeka iintsimbi ezibukhali ezijonge unyawo kunokwenziwa iiveki ezili-12 emva kokulungiswa kweentlungu, kwaye ukuzilolonga ngokubeka iintsimbi ezibukhali kungaqalwa emva kweeveki ezili-12. Ngokwahlukileyo koko, kwiintlungu zohlobo lwesithathu lwePauwels, kucetyiswa ukulungiswa nge-DHS okanye i-PFNA.
Ixesha leposi: Jan-26-2024
