Mu guhitamo gahunda yo kuvura imvune zo mu gice cyo hagati cy’amagufwa, gufunga inyuma bishobora gukoreshwa nk'uburyo bw'agateganyo bwo gufunga imvune zo mu magufwa zifite imvune zikomeye zo mu ngingo.
Ibimenyetso:
"Kugenzura ibyangiritse" ni ugufata by'agateganyo imvune zivanze n'ibikomere bikomeye by'ingingo zoroshye, nko kuvunika bifunguye cyangwa imvune zifunze hamwe no kubyimba kw'ingingo zoroshye.
Uburyo bwo kuvura burundu imvune zanduye, zanduye, cyangwa imvune zirimo gukomereka gukomeye kw'ingingo zoroshye.
Examine:
Imiterere y'ingingo zoroshye: ①Igisebe gifunguye; ②Imitsi yoroshye irabyimba cyane, inyama zoroshye zirabyimba. Reba uko imitsi y'amaraso ihagaze hanyuma wandike witonze.
Amashusho: Imirasire ya X-rays ya tibia iri imbere n'inyuma, hamwe n'ingingo za acupoints za anterior, lateral na acupoints z'akaguru ku kaguru. Niba hakekwa ko hari imvune ya intra-articular, hakwiye gukorwa CT scan y'agakingirizo ka tibia.
Anatomie:·
"Agace k'umutekano" k'umubiri gashyirwamo agapira ko gushyiramo agapira ko hanze kagenwe hakurikijwe urwego rutandukanye rw'igice.
Metaphysis ya hafi y'agace k'umugongo (tibia) itanga agace k'umutekano gafite ishusho ya arc ya 220° imbere aho imigozi yo gufunga inyuma ishobora gushyirwa.
Ibindi bice bya tibia bitanga ahantu ho gushyira urushinge imbere y'umubiri ku bushyuhe buri hagati ya 120° ~ 140°.
Stekiniki yo kubaga
Uko umurwayi ahagaze: Umurwayi aryamye aryamye ku meza yo kubaga abonerana ya X-ray, kandi ibindi bintu nk'umusego cyangwa agasanduku bishyirwa munsi y'ukuboko kwafashwe kugira ngo bifashe kuguma mu mwanya wabyo. Gushyira agapapuro munsi y'ikibuno cya kabiri bizunguruka ukuguru kwafashwe imbere nta kuzunguruka cyane inyuma.
Auburyo bwo gushyikirana
Kenshi na kenshi, hakorwa uduce duto mu gice cya tibia, calcaneus, na metatarsal ya mbere kugira ngo hashyirweho udupira two gushyiramo inyuma.··
Kuvunika kwa fibula byoroshye gukosorwa uhereye ku ruhande rw'inyuma rw'umubiri rushobora gufatirwa.
Imvune zo mu gice cy'inyuma cy'ingingo zishobora gukosorwa hakoreshejwe icyuma gifata ingingo. Iyo imiterere y'ingingo zoroshye ibyemeye, kandi byaba ngombwa, hashobora gukoreshwa uburyo busanzwe bwo gufata ingingo. Iyo gufata ingingo hanze bikoreshejwe nk'igipimo cy'agateganyo gusa, aho urushinge rw'inyuma ruteganijwe gushyirwa hagomba kuba kure y'aho inzara zifatirwa kugira ngo hirindwe kwanduza ingingo zoroshye. Gufata ingingo mbere y'igihe gito no mu gice cy'inyuma byoroheje byorohereza gufata ingingo neza.
Amabwiriza yo Kwirinda
Witondere inzira yo gushyiramo agakoresho ko hanze kugira ngo ukomeze kubaga neza, kuko ingingo zanduye zizagutera ibibazo nyuma yo kubagwa. Uburyo busanzwe bwo gutera imbere cyangwa hagati y’umubiri hamwe no kubyimba cyane kw’ingingo zoroshye nabyo bishobora gutera ingorane zikomeye mu gukira kw’ibikomere.
Kugabanya no guhagarara kw'amagufwa ya fibula:
Iyo imiterere y'ingingo zoroshye ibaye, imvune ya fibula ibanza kuvurwa. Imvune ya fibula iragabanuka kandi igakosorwa hakoreshejwe uburyo bwo gukata uruziga, akenshi hakoreshejwe vis za 3.5mm za lag na 3.5mm l/3 tube plate, cyangwa vis za 3.5mm LCDC. Nyuma yuko fibula igabanutse kandi igakosorwa, ishobora gukoreshwa nk'ihame ryo gusubiza uburebure bwa tibia no gukosora imiterere y'uruti rw'umugongo.
Amabwiriza yo Kwirinda
Kubyimba cyane kw'ingingo zoroshye cyangwa igisebe gikomeye gishobora no kubuza ko fibula ikomeza gufata. Witondere ko utakosora imvune za fibula zo hafi y'inyuma kandi witondere gukomeretsa imitsi yo mu gice cyo hejuru cy'inyuma cy'inyuma.
Kuvunika kw'amagufwa yo mu gituza: Kugabanya no Gufata neza imbere mu gituza
Kuvunika kw'inyuma y'ingingo y'imbere y'inyuma y'ikirenge bigomba kugabanuka bitewe no kureba neza binyuze mu nzira ya mbere cyangwa iy'imbere y'ikirenge cy'imbere, cyangwa binyuze mu kugabanya intoki mu buryo butaziguye hakoreshejwe fluoroscopy.
Mu gihe ukoresha screw ya lag, igice cya fracture kigomba kuba cyarafashwe n'insinga ya Kirschner mbere na mbere.
Kugabanya no gufunga vuba kw'amagufwa yo mu ngingo z'imbere y'inyuma bituma habaho uburyo budatera imbere cyane kandi bigatuma habaho uburyo bworoshye bwo gufunga neza. Indwara mbi zoroshye nko kubyimba cyane cyangwa kwangirika gukomeye kw'ingingo zoroshye zishobora gukumira gufunga vuba kw'uduce two mu ngingo z'imbere y'inyuma.
Kuvunika kw'amagufwa yo mu gituza: Gufata igice cyo hanze cy'inyuma cy'inyuma
Imashini ifatana inyuma ishobora gukoreshwa.
Dukurikije ibisabwa mu buryo bwo gufunga igice cya kabiri, udupira tubiri two gufunga inyuma twa mm 5 tw’umugozi dushyirwamo mu buryo bunyura mu ruhu cyangwa binyuze mu gukata duto ku buso bwo hagati cyangwa imbere bw’umugongo wa tibia ku mpera y’aho imvune yavunitse.
Banza uce igice cy’igufwa ukoresheje agakoresho koroshye gakingira umubiri, hanyuma ucukure, ukandagire, hanyuma unyuremo agakoresho kabigenewe.
Udupira two gushyira inyuma ku mpera y'aho imvune ivunitse dushobora gushyirwa ku gice cy'inyuma cy'umugongo, calcaneus na metatarsal ya mbere, cyangwa ijosi rya talus.
Udupira two gushyiramo imitsi yo mu bwoko bwa Transcalcaneal external tuberosity tugomba gushyirwa ku gice cy’imitsi yo mu bwoko bwa calcaneal tuberosity kuva ku gice cyo hagati kugeza ku gice cyo hagati kugira ngo hirindwe kwangirika kw’imitsi yo mu bwoko bwa medial nervous vascular structures.
Agapira ko gushyiramo inyuma k'agace ka mbere k'umuyoboro kagomba gushyirwa ku buso bwa mbere bw'ishingiro rya gace ka mbere k'umuyoboro.
Hari igihe agapira ko gushyiramo inyuma gashobora gushyirwa imbere y'inyuma binyuze mu gice cya tarsal sinus.
Hanyuma, tibia yo hagati ya tibia yarasubiwemo maze umurongo w'imbaraga uhindurwa binyuze mu kubaga fluoroscopy, maze agakoresho ko gufunga inyuma karateranywa.
Mu gihe uhindura icyuma gifata amashusho inyuma, fungura agakoresho gahuza, kora uburyo bwo gukurura icyuma mu buryo bwihuse, kandi ukoreshe uburyo bworoshye bwo kugabanya icyuma ukoresheje fluoroscopy kugira ngo uhindure aho igice cyacitse giherereye. Hanyuma umukozi agakomeza aho giherereye mu gihe umufasha akomeje udukoresho duhuza.
Maho nta hantu
Niba gufunga inyuma atari uburyo buzwi bwo kuvura, inzira yo gufunga inyuma igomba kugenzurwa kure y’agace gahamye ko gufunga mu gihe cyo gutegura igikorwa, kugira ngo hatazahumanya urwego rw’ibikorwa mu gihe kizaza. Guhagarara kw’ingufu zo gufunga inyuma bishobora kwiyongera binyuze mu kongera intera y’udupira two gufunga kuri buri hantu havunitse, kongera umurambararo w’udupira, kongera umubare w’udupira two gufunga n’imigozi ihuza, kongera ingingo zo gufunga ku kaguru, no kongera urwego rwo gufunga cyangwa gushyiraho agapira ko gufunga inyuma. Gukosora bihagije bigomba kwemezwa binyuze mu byiciro by’imbere n’inyuma n’impande.
Kuvunika kw'amagufwa yo mu gituza: gufatana kw'inyuma ku buryo butari ubw'ubugari
Hari igihe biba byiza gukoresha icyuma gifunga inyuma kidafata ingingo. Niba igice cya tibial cya distal ari kinini bihagije kugira ngo gishyireho udupira two gufunga inyuma tw’igice cy’umugozi, icyuma gifunga inyuma cyoroshye gishobora gukoreshwa. Ku barwayi bafite uduce duto twa metaphyseal fracture, icyuma gifunga inyuma cy’umugozi kigizwe n’agapira ko gufunga inyuma gafite imigozi hafi hamwe n’insinga ya Kirschner iri kure ni ingirakamaro nk'uburyo bw'agateganyo cyangwa buhamye bwo kuvura. Hagomba kwitonderwa iyo ukoresha icyuma gifunga inyuma kidafata ingingo ku mvune zifite ubwandu bw’ingingo zoroshye. Gukuraho uru rugingo rwanduye, gukuraho inzira y’urushinge, no guhagarika kugenda kw’inyuma mu gishishwa kugeza igihe igikomere gikira neza mbere yuko habaho guhagarika kugenda burundu.
Sichuan ChenAnHui Technology Co., Ltd
Umuntu wo kuvugana na we: Yoyo
WhatsApp: +8615682071283
Email: liuyaoyao@medtechcah.com
Igihe cyo kohereza: Gashyantare-10-2023
