Ivunika ryakarere ka intertrochanteric ya femur rifite 50% byimvune yibibuno kandi nubwoko bukunze kuvunika kubarwayi bageze mu zabukuru.Intramedullary imisumari ikosorwa nigipimo cya zahabu yo kubaga imiti ivura intertrochanteric.Hariho ubwumvikane hagati yabaganga babaga amagufwa kugirango birinde "ingaruka ngufi" ukoresheje imisumari miremire cyangwa ngufi, ariko kuri ubu nta bwumvikane buke bwo guhitamo imisumari miremire na ngufi.
Mubyigisho, imisumari migufi irashobora kugabanya igihe cyo kubaga, kugabanya gutakaza amaraso, no kwirinda gusubiramo, mugihe imisumari miremire itanga ituze ryiza.Mugihe cyo kwinjiza imisumari, uburyo busanzwe bwo gupima uburebure bwimisumari miremire ni ugupima ubujyakuzimu bwinjizwamo pin.Nyamara, ubu buryo mubusanzwe ntabwo busobanutse neza, kandi niba hari gutandukana kurekure, gusimbuza imisumari yimbere bishobora gutera gutakaza amaraso menshi, kongera ihungabana ryo kubaga, no kumara igihe kinini cyo kubagwa.Kubwibyo, niba uburebure bukenewe bwimisumari yimbere bushobora gusuzumwa mbere, intego yo kwinjiza imisumari irashobora kugerwaho mugihe kimwe, wirinda ingaruka ziterwa no gukorana.
Kugira ngo iki kibazo cy’amavuriro gikemuke, intiti z’amahanga zakoresheje agasanduku gapakira imisumari (agasanduku) kugira ngo isuzume mbere na mbere uburebure bw’imisumari yatewe na fluoroscopi, bita "Boxe tekinike".Ingaruka zo kuvura ni nziza, nkuko bisangiwe hepfo:
Ubwa mbere, shyira umurwayi ku buriri bukwega kandi ukore kugabanuka gufunze munsi yikururwa.Nyuma yo kugabanuka kugabanuka gushimishije, fata umusumari udafunguye (harimo agasanduku k'ipaki) hanyuma ushire agasanduku k'ipaki hejuru yigitereko cyanduye:
Hifashishijwe imashini ya C-arm fluoroscopy, icyerekezo cyegeranye ni uguhuza impera yegeranye yimisumari yimbere hamwe na cortex hejuru yijosi ryumugore hanyuma ukayishyira kuri projection yumwanya winjira wumusumari.
Iyo imyanya yegeranye imaze gushimisha, komeza umwanya wegeranye, hanyuma usunike C-ukuboko werekeza kumpera ya kure hanyuma ukore fluoroscopi kugirango ubone ukuri nyako kuruhande rwikivi.Imyanya ya kure yerekanwe ni intercondylar notch ya femur.Simbuza umusumari winjizwamo uburebure butandukanye, ugamije kugera ku ntera iri hagati yimpera ya kure yumusumari wigitsina gore nigitereko hagati ya femur muri diametre 1-3 yumusumari winjiye.Ibi byerekana uburebure bukwiye bwimisumari.
Byongeye kandi, abanditsi basobanuye ibintu bibiri biranga amashusho bishobora kwerekana ko imisumari yimbere ari ndende cyane:
1. Impera ya kure yimisumari yinjizwa mubice bigera kuri 1/3 cyubuso bwa patellofemoral (imbere kumurongo wera mumashusho hepfo).
2. Impera ya kure yimisumari yimbere yinjizwa muri mpandeshatu yakozwe numurongo wa Blumensaat.
Abanditsi bifashishije ubu buryo kugira ngo bapime uburebure bw'imisumari itemewe ku barwayi 21 basanga igipimo cya 95.2%.Nyamara, hashobora kubaho ikibazo gishobora kuvuka muri ubu buryo: mugihe umusumari winjiye winjijwe mumubiri woroshye, hashobora kubaho ingaruka zo gukuza mugihe cya fluoroscopi.Ibi bivuze ko uburebure nyabwo bwimisumari ikoreshwa bushobora gukenera kuba bugufi gato kuruta gupima mbere yo gutangira.Abanditsi babonye iki kibazo ku barwayi bafite umubyibuho ukabije kandi basaba ko ku barwayi bafite umubyibuho ukabije, uburebure bw’imisumari y’imbere bugomba kugabanywa mu buryo butagereranywa mu gihe cyo gupimwa cyangwa bakemeza ko intera iri hagati y’impera ya kure y’imisumari y’imbere n’imbere ya femur iri imbere. Diameter 2-3 z'umusumari winjiye.
Mu bihugu bimwe, imisumari yimbere irashobora gupakirwa kugiti cyayo hanyuma ikabikwa mbere, ariko mubihe byinshi, uburebure butandukanye bwimisumari yimbere bivangwa hamwe kandi bigahinduka hamwe nababikora.Nkigisubizo, ntibishoboka gusuzuma uburebure bwimisumari yimbere mbere yo kuboneza urubyaro.Nyamara, iyi nzira irashobora kurangira nyuma yo gukoreshwa kuri sterilisation.
Igihe cyo kohereza: Apr-09-2024
