Itekhnoloji ye-Intramedullary nailing iyindlela eqhelekileyo yokulungiswa kwamathambo yangaphakathi.Imbali yayo inokulandwa ukusukela kwiminyaka yoo-1940.Isetyenziswe ngokubanzi kunyango lwamathambo amade, i-nonunions, njl., ngokubeka i-intramedullary nail kumbindi we-medullary cavity.Lungisa indawo yokwaphuka.Kule miba, siya kukwazisa umxholo ofanelekileyo kuwe malunga nezikhonkwane ze-intramedullary.
Ukubeka ngokulula, isikhonkwane se-intramedullary sisakhiwo eside esinemingxuma emininzi yokutshixa isikhonkwane kuzo zombini iziphelo ukulungisa iziphelo ezisondele kunye nezikude zokuqhekeka.Ngokwezakhiwo ezahlukeneyo, zinokuthi zihlulwe zibe ziqinileyo, i-tubular, i-open-section, njl., ezifanelekileyo kwizigulane ezahlukeneyo.Umzekelo, iinzipho eziqinileyo ze-intramedullary ziyakwazi ukumelana nosulelo ngenxa yokuba azinayo indawo efileyo yangaphakathi.Isakhono esingcono.
Ukuthatha i-tibia njengomzekelo, ububanzi be-medullary cavity buhluka kakhulu kwizigulane ezahlukeneyo.Ngokuhambelana nokuba ukuphinda kuphinde kufuneke, izikhonkwane ze-intramedullary zinokwahlulwa zibe zizikhonkwane eziphinda-phindayo nezingaphindiweyo.Umahluko ulele ekubeni iireamers kufuneka zisetyenziselwe ukuvuselela i-medullary, kubandakanywa izixhobo zezandla okanye zombane, njl.
Nangona kunjalo, inkqubo yokwandiswa komongo yonakalisa i-endosteum, njengoko kubonisiwe kulo mfanekiso, kwaye ichaphazela inxalenye yomthombo wegazi wethambo, nto leyo enokukhokelela kwi-necrosis ye-avascular yesikhashana yamathambo asekuhlaleni kunye nokwandisa umngcipheko wosulelo.Nangona kunjalo, inxulumene nezifundo zeklinikhi ziyaphika ukuba kukho umahluko omkhulu.Kukho neembono eziqinisekisa ixabiso le-medullary reaming.Kwelinye icala, iinzipho ze-intramedullary ezinobukhulu obukhulu zingasetyenziselwa ukubuyisela i-medullary.Amandla kunye nokuqina kwanda ngokunyuka kobubanzi, kwaye indawo yoqhagamshelwano kunye ne-medullary cavity iyanda.Kukho nombono wokuba iitshiphusi zamathambo ezincinci eziveliswe ngexesha lenkqubo yokwandiswa komongo nazo zidlala indima ethile kwi-autologous bone transplantation.
Ingxoxo ephambili exhasa indlela engasebenziyo kukuba inokunciphisa umngcipheko wosulelo kunye ne-pulmonary embolism, kodwa into engenakuhoywa kukuba i-diameter yayo encinci izisa iimpawu ezibuthathaka zoomatshini, okukhokelela kwisantya esiphezulu sokusebenza kwakhona.Okwangoku, iinzipho ezininzi ze-tibial intramedullary zivame ukusebenzisa izikhonkwane ezandisiweyo ze-intramedullary, kodwa i-pros and cons zisafuna ukulinganiswa ngokusekelwe kubukhulu be-medullary cavity kunye neemeko zokuphuka.Imfuno ye-reamer kukunciphisa ukungqubuzana ngexesha lokusika kwaye ube ne-flute enzulu kunye ne-shaft encinci ye-diameter, ngaloo ndlela unciphisa uxinzelelo kwi-medullary cavity kunye nokuphepha ukugqithiswa kwamathambo kunye nezicubu ezithambileyo ezibangelwa ukukhuhlana.Necrosis.
Emva kokuba isikhonkwane se-intramedullary sifakwe, ukulungiswa kwe-screw kuyafuneka.Ukulungiswa kwesikruphu semveli kubizwa ngokuba kukutshixa okumileyo, kwaye abanye abantu bakholelwa ukuba kunokubangela ukulibaziseka kokuphiliswa.Njengophuculo, eminye imingxunya yezikrufu yokutshixa iyilwe ibe yimilo embhoxo, ebizwa ngokuba yi-dynamic locking.
Oku ngasentla sisingeniso kumacandelo e-intramedullary nailing.Kushicilelo olulandelayo, siza kwabelana nawe ngenkqubo emfutshane yotyando lwezikhonkwane kwi-intramedullary.
Ixesha lokuposa: Sep-16-2023
