Inama 5 zo Gufata Imisumari Intramedullary ku Byacitse mu Giti cy'Ibumoso

Imirongo ibiri y'umuvugo "gukata no gushyiraho uburyo bwo gufunga imbere, gushyira ibyuma bifunganye mu misumari" igaragaza neza imyumvire y'abaganga b'amagufwa ku kuvura imvune za tibia zo mu gice cya kure. Kugeza n'uyu munsi, biracyari ikibazo cy'ibitekerezo niba ibyuma byo mu gikoni cyangwa inzara zo mu gice cya kure ari byo byiza kurushaho. Uko byaba bimeze kose, uyu munsi tugiye gutanga incamake y'inama zo kubaga ibyuma byo mu gice cya kure cy'imisumari.

Seti y'ipine y'inyongera mbere yo kubagwa

Nubwo gutegura mbere yo kubagwa bisanzwe atari ngombwa, ni byiza kugira izindi vis n'amasahani mu gihe habayeho ibintu bitunguranye (urugero: umurongo uhishe w'imvune ubuza vis gufunga, cyangwa amakosa y'abantu akongera imvune ikabuza guhagarara, n'ibindi) bishobora guterwa no gukoresha imisumari yo mu nda.

Ishingiro 4 zo guhindura imiterere y'aho hantu neza

Bitewe n'imiterere y'uturemangingo tw'ingingo zo mu gice cy'imbere cy'inyuma, gukurura byoroshye bishobora kudatuma buri gihe bigabanuka neza. Ingingo zikurikira zizafasha kunoza igipimo cyo kwiyubaka:

1. gufata orthopantomogram mbere yo kubagwa cyangwa mu gihe cyo kubagwa kugira ngo ugereranye kandi umenye ingano y'imvune ku ruhande rwafashwe.

2. Koresha uburyo bwo gukaraba ivi kugira ngo worohereze gushyira inzara no kuziba amenyo

3.koresha agakoresho ko kugarura urugingo kugira ngo ukomeze kuguma mu mwanya warwo no mu burebure bwarwo

4. Shyira vis za Schanz mu gice cyo hagati n'icya hafi y'umugongo kugira ngo bifashe kugabanya kuvunika.

Ibisobanuro 7 ku bijyanye no gufasha mu kugabanya no guhagarika imikorere

1. Shyira agapira k'ubuyobozi neza mu gice cy'imbere cy'umutwe w'amaguru ukoresheje igikoresho gifasha cyangwa ubanje kugonda umutwe w'agapira k'ubuyobozi mbere yo gushyiramo.

2. Koresha forceps zo kongeramo uruhu kugira ngo ushyire inzara zo mu nda mu mvune zizunguruka n'izigoranye (Ishusho ya 1)

3. Koresha icyuma gikomeye gifite uburyo bwo gufatana (tableau cyangwa compression plate) mu buryo bwo kugabanya kugira ngo ukomeze kugabanya kugeza igihe inzara zo mu nda zishyizwemo

4. kugabanya umuyoboro w'inzara mu gice cy'imbere cy'umugongo hakoreshejwe utugozi two gufunga kugira ngo hakosorwe uburyo bwo gufunga inzara n'umuyoboro kugira ngo hongerwe uburyo bwo gushyira inzara mu gice cy'imbere cy'umugongo (Ishusho ya 2)

5. bitewe n'ubwoko bw'aho imvune yavunitse, hitamo niba ukoresha vis zo gufunga no gufunga by'agateganyo ukoresheje Schnee cyangwa Kirschner pins.

6. kwirinda kuvunika gushya mu gihe ukoresha vis zo kuziba ku barwayi bafite indwara yo mu magufwa

7. Banza ushyire fibula hanyuma ushyire tibia mu gihe habaye imvune ya fibula kugira ngo worohereze ihinduka ry'inyuma ry'inyuma ry'inyuma

Ishusho ya 1 Guhindura urwego rw'inyuma ...

Ishusho ya 2 Gukoresha vis zo gufunga Ishusho ya A igaragaza kuvunika cyane kwa metaphysis ya tibial iri kure hagakurikiraho ubumuga bwo gufunga inyuma, hamwe n'ubumuga bwo guhindukira nyuma yo gufunga fibular nubwo hakosowe ubumuga bwo gufunga inyuma ya sagittal (Ishusho ya C) (Ishusho ya B), hamwe n'vis imwe yo gufunga ishyirwa inyuma n'indi ku ruhande rw'inyuma rw'ivunitse (Ishusho ya B na C), hamwe no kwaguka kwa medullary nyuma yo gushyiramo udupira two kuyobora kugira ngo hakosorwe ubumuga bwo gufunga mu mpande (Ishusho ya D), mu gihe hagumana uburinganire bwo gufunga mu mpande (E)
Amanota 6 yo gufata neza intramedullary

1. Iyo igufwa rya kure ry'aho ryavunitse rifite amagufwa ahagije, inzara zo mu gice cy'imbere cy'umugongo zishobora gukomezwa hakoreshejwe vis 4 mu mfuruka nyinshi (kugira ngo hongerwe uburyo bwo kugumana imigozi myinshi), kugira ngo hongerwe uburyo bwo gukomera kw'imiterere.
2. Koresha inzara zo mu nda zituma vis zishyirwamo zinyuramo kandi zigakora imiterere ifunganye kandi ifite inguni ihamye.
3. Koresha vis nini, vis nyinshi, n'imirongo myinshi yo gushyira vis kugira ngo ukwirakwize vis hagati y'impande za kure n'iza hafi z'aho imvune ivunitse kugira ngo wongere imbaraga zo gufata inzara zo mu nda.
4. Iyo umusumari wo mu nda ushyizwe kure cyane ku buryo umugozi uyobora mbere ubuza kwaguka kwa tibial iri kure, noneho umugozi uyobora mbere utari uri kure cyangwa umugozi utari uri kure ushobora gukoreshwa.
5. Bika umusumari n'isahani bifunga kugeza igihe imvune igabanutse, keretse iyo umusumari ufunga ubuza umusumari gukwirakwira mu igufwa cyangwa isahani imwe y'ingobyi yangiza ingingo zoroshye.
6. Iyo inzara n'imisumari byo mu nda ya medullary bidatanga uburyo buhagije bwo kugabanya no gufata neza inzara, hashobora kongerwamo agapira cyangwa vis kugira ngo inzara zo mu nda ya medullary zikomeze gukomera.

Ibyibutswa

Ibirenga 1/3 by'imvune za tibia yo mu gice cy'inyuma zifata ingingo. By'umwihariko, imvune za stem ya tibia yo mu gice cy'inyuma, imvune za tibia yo mu gice cy'inyuma, cyangwa imvune za fibula yo mu gice cy'inyuma zigomba gusuzumwa kugira ngo harebwe imvune za intra-articular. Niba ari uko bimeze, imvune ya intra-articular igomba gucungwa ukwayo mbere yo gushyiramo umunyu wa intramedullary.