Amakuru - Isahani ya femoral uburyo bwo gukosora imbere

Hariho ubwoko bubiri bwuburyo bwo kubaga, gushushanya amasahani hamwe nibipano bya Intramedullary, ibyambere birimo imiyoboro rusange ya plaque hamwe na sisitemu yo gutunganya ibibanza bya sisitemu yo gusoza, kandi ibyapa birimo gufunga cyangwa gusubiramo amapine ya retrograde cyangwa retrograde. Guhitamo gushingiye kurubuga runaka nubwoko bwo kuvunika.
Intramedillary PIN ikosora ifite ibyiza byo guhura nibisanzwe, bidahwitse, bidakenewe ko bikosora, nibindi bikwiranye no hagati ya 10/3, kuvunika 1/3 kuvunika igice kinini, kuvunika kwa kabiri. Ku mvurake yo hepfo 1/3, kubera igufwa rinini rya diabullary hamwe nububiko bwinshi bwo guhagarika, biragoye kugenzura kuzunguruka inkuta, kandi gukosora ntabwo bifite umutekano, nubwo bishobora gushimangirwa n'imigozi, ariko birakwiriye imigozi yicyuma.

Ndafungura-imbere kugirango mvunike forcre ya Femur hamwe na IntramediLary Umusumari
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Gucika bugufi bikozwe kumurongo hagati yikiruka kinini na comple ya ferur arinyuma yinyuma yimitsi ya vatus kuruhande rwimitsi ya vatus kuruhande. (Ishusho 3.5.5.2-1,3.5.5.5.2-2).

Ku rundi ruhande, ibinyomoro byashize, bikozwe mu murongo uhereye ku mugongo wo hejuru wa Iliac hejuru ya pateri, kandi bikagera ku mitsi y'imitsi y'inyuma hamwe n'imitsi ya rectus yatunganijwe n'indabyo za femor. 3.5.5.2-3).

. Gabanya periosteum kugirango uhishure impera yo hejuru no hepfo yamenetse yivuza femur, kandi igaragaza urugero kuburyo ishobora kubahirizwa no kugarura, no kwambura imyenda yoroshye bike bishoboka.
. Niba hari umwobo wigituba, cavité yo mu kayira kadullary irashobora gukoreshwa mu gusana neza no kwagura inshinge, kugira ngo kubuza urushinge kudashobora kwinjira kandi kutabasha gukururwa. Kosora iherezo ryamavururo hamwe namagunga, shyiramo inshinge za retramedugradely, winjire hagati yimodoka nyinshi, hanyuma ukomeze gushiramo uruhu, hanyuma ukomeze gushiramo urushinge rwa 3cm kugeza ushyizwe hanze yuruhu. Urushinge rwa Intramedullarlary rwakuweho, rushyikirizwa, rwanyuze mu ruhushya ruva mu ndunduro rukomeye, hanyuma rwinjizwa cyane mu ndege y'umusaraba. Inzibacyuho Intramedullarlary zifite iherezo rito rirangiramo umwobo. Noneho nta mpamvu yo gukuramo no guhindura icyerekezo, kandi urushinge rushobora gukubitwa hanyuma rukubitwa rimwe. Ubundi, inshinge irashobora kwinjizwa muri retrograde hamwe na PIN yubuyobozi kandi igasanga hanze ya trochanter ins trochanterIc, hanyuma intera ya intramediclary irashobora kwinjizwa mubyago bisabwe.
Ibindi Gukuraho Kuvunika. Guhuza Anatomique birashobora kugerwaho mugukoresha ibipimo bya PIN ya Proximal Pin ifatanije n'amagufwa yerekana amagufwa, gukururika, no kuvunika. Gukosora byagezweho hamwe na moto, hamwe na inttttttttttttttttttttttttttollary noneho kugirango umwobo ukuramo inyuma inyuma kugirango uhuze numuyoboro wa femoral. Iherezo ry'urushinge rigomba kugera ku gice gikwiye cyo kumeneka kw'ibice bya kure, ariko bidanyuze mu nzego ya Cartilage, kandi iherezo ry'urushinge rigomba gusigara 2cm rigomba kuvaho 2Cm. (Igishushanyo cya 3.5.2-5).

Nyuma yo gukosorwa, gerageza kugenda neza kw'igikoni no kureba neza. Niba ari ngombwa gusimbuza urushinge rwa Intramedullary, rushobora gukurwaho no gusimburwa. Niba hari kurekuza gato kandi ihungabana, umugozi urashobora kongerwaho kugirango ushimangire gukosorwa. (Ishusho 3.5.5.2-4).
Igikomere cyarangije guhindurwa gifunga mu bice. Inkweto zangiza zo hanze za plaster.
II Plaren Screw Imbere
Gukosora imbere imiyoboro yisahani irashobora gukoreshwa mubice byose byuruti rwumunyabwenge, ariko hepfo 1/3 birakwiriye kuri ubu bwoko bwo gukosora kubera ubumwe bwigituba. Isahani rusange yicyuma cyangwa ao cote ibyuma byicyuma irashobora gukoreshwa. Iheruka irakomeye kandi ihamye neza nta gukosorwa hanze. Ariko, ntanumwe muribo ushobora kwirinda uruhare rwo guhangayika no guhuza n'ihame ryimbaraga zingana, zigomba kunozwa.
Ubu buryo bufite intera nini yo gukuramo, ikosora ryimbere, zibangamiye, kandi zifite amakosa.
Iyo habuze kubura intera ya PIN, Feccramedine Badullary curvature cyangwa igice kinini cyibintu bidafite akamaro kandi hepfo 1/3 cyo hasi birahuza .
(1) femoral ya femoral cyangwa inyuma yinyuma.
(2). Isahani igomba gushyirwa kuruhande rwuruhande, imigozi igomba kunyura kuri cortex kumpande zombi, kandi uburebure bwisahani igomba kuba inshuro 4-5 ya diameter yifano kurubuga. Uburebure bwisahani ni 4 kugeza 8 diameter ya igufwa ryacitse. Ibyapa 6 kugeza 8 bikoreshwa muri femur. Ibice binini byamagufwa birashobora gukosorwa nimigozi yinyongera, kandi umubare munini wamagufwa urashobora gushyirwa mugihe kimwe kuruhande rwumucyo. (Ishusho 3.5.2-5).