Kumeneka kw'ijosi ry'umugore ni igikomere gisanzwe kandi gishobora kwangiza cyane kubaga amagufwa, kubera amaraso make, indwara zo kuvunika zidahuje ubumwe na osteonecrosis ni nyinshi, uburyo bwiza bwo kuvunika ijosi ry'umugore buracyavuguruzanya, intiti nyinshi zemeza ko abarwayi barangiye Imyaka 65 y'amavuko irashobora gutekerezwa kuri arthroplastique, kandi abarwayi bari munsi yimyaka 65 y'amavuko barashobora gutoranyirizwa kubagwa imbere, kandi ingaruka zikomeye kumaraso aterwa no kuvunika ubwoko bwa subcapsular kuvunika ijosi ryumugore.Kuvunika kwijosi ryijosi ryigitsina gore bifite ingaruka zikomeye za haemodinamike, kandi kugabanya gufunga no gukosora imbere biracyari uburyo busanzwe bwo kuvura kuvunika subcapital kwijosi ryumugore.Kugabanuka neza bifasha guhagarika kuvunika, guteza imbere gukira kuvunika no kwirinda umutwe wa femorale femorale.
Ibikurikira nuburyo busanzwe bwo kuvunika ijosi ryigitsina gore kuvunika kugirango baganire uburyo bwo gukora gufunga-kwimura imbere imbere hamwe na screw.
Amakuru y'ibanze y'urubanza
Amakuru y'abarwayi: umugabo ufite imyaka 45
Ikirego: kubabara ikibuno cyibumoso no kugabanya ibikorwa kumasaha 6.
Amateka: Umurwayi yaguye arimo kwiyuhagira, bitera ububabare mu kibero cy’ibumoso no kugabanya ibikorwa, bidashobora koroherwa no kuruhuka, maze yinjira mu bitaro byacu avunika ijosi ry’igitsina cy’ibumoso kuri radiyo, kandi yinjiye mu bitaro ameze neza kandi afite umutima mubi, yinubira ububabare bwo mu kibuno cy’ibumoso no kugabanya ibikorwa, kandi ntiyariye kandi ntiyigeze yikuramo amara ya kabiri nyuma y’imvune.
Examination Ikizamini cyumubiri (Kugenzura umubiri wose & Kugenzura inzobere)
T 36.8 ° C P87 gukubita / min R20 gukubita / min BP135 / 85mmHg
Iterambere risanzwe, imirire myiza, imyanya idahwitse, imitekerereze isobanutse, koperative mugupima.Ibara ryuruhu nibisanzwe, byoroshye, nta edema cyangwa guhubuka, nta kwaguka kwa lymph node yimbere mumubiri wose cyangwa mukarere.Ingano yumutwe, morphologie isanzwe, nta bubabare bwumuvuduko, misa, umusatsi urabagirana.Abanyeshuri bombi bangana mubunini no kuzenguruka, hamwe nurumuri rworoshye.Ijosi ryari ryoroshye, trachea yari hagati, glande ya tiroyide ntiyagutse, igituza cyari gifite uburinganire, guhumeka byagabanutseho gato, nta bidasanzwe byari bifite auscultation yumutima, imipaka yumutima yari isanzwe kuri percussion, umuvuduko wumutima ni 87 gukubita / min, injyana yumutima yari Qi, inda yari iringaniye kandi yoroshye, nta bubabare bwumuvuduko cyangwa ububabare bwongeye kugaruka.Umwijima n'impyiko ntibyamenyekanye, kandi nta mpuhwe zari mu mpyiko.Diaphragms y'imbere n'inyuma ntiyigeze isuzumwa, kandi nta bumuga bw'umugongo, ingingo zo hejuru n'amaguru yo hepfo y'iburyo, hamwe no kugenda bisanzwe.Imiterere ya physiologique yari ihari mugupima imitsi kandi refleks ya pathologiya ntabwo yatanzwe.
Nta kubyimba kugaragara kw'ikibuno cy'ibumoso, ububabare bugaragara bwagaragaye hagati yigitereko cyibumoso, kugabanya ububi bwo kuzunguruka bwo hanze bwibumoso bwibumoso, ibumoso bwo hepfo ingingo ndende (+), gukora ikibuno cyibumoso, kumva no gukora bya amano atanu yamaguru yibumoso yari meza, kandi dorsal arterial pulsation yikirenge yari isanzwe.
Ibizamini by'abafasha
Filime X-ray yerekanaga: kuvunika ijosi ryigitsina gore subcapital kuvunika, kwimura impera yamenetse.
Ibindi bisuzumwa bya biohimiki, igituza X-ray, densitometrie yamagufa, hamwe na ultrasound yamabara yimitsi yimbitse yibihimba byo hepfo ntago byagaragaye ko bidasanzwe.
Gusuzuma no gusuzuma bitandukanye
Ukurikije amateka yumurwayi w’ihungabana, ububabare bwibibero byibumoso, kugabanya ibikorwa, kwisuzumisha kumubiri wibumoso bwo hepfo bigabanya ubumuga bwo kuzenguruka hanze, ubwuzu bwikibuno bugaragara, ibumoso bwibumoso bwiburyo bwa longitudinal axis kowtow ububabare (+), imikorere yibibuno byibumoso, ifatanije na firime X-ray irashobora gupimwa neza.Kuvunika kwa trochanter birashobora kandi kugira ububabare bwibibuno no kugabanya ibikorwa, ariko mubisanzwe kubyimba kwaho biragaragara, aho igitutu giherereye muri trochanter, kandi impande zizunguruka zo hanze ni nini, kuburyo ishobora gutandukana nayo.
Umuti
Kugabanya gufunga no gufunga imisumari yimbere byakozwe nyuma yo gusuzuma neza.
Filime ibanziriza gutangira niyi ikurikira
Maneuver hamwe no kuzunguruka imbere no gukurura ingingo zanduye hamwe no gushimuta gato ingingo zanduye nyuma yo gusana na fluoroscopi byagaragaje gusana neza.
Igipapuro cya Kirschner cyashyizwe hejuru yumubiri mu cyerekezo cy ijosi ryigitsina gore kuri fluoroscopi, hanyuma hakozwe uruhu ruto ruto ukurikije aho iherezo rya pin riherereye.
Imiyoboro ngenderwaho yinjizwa mu ijosi ryigitsina gore ibangikanye nubuso bwumubiri mu cyerekezo cya pin ya Kirschner mugihe ikomeza kugana imbere ya dogere zigera kuri 15 hanyuma hakorwa fluoroscopi
Igice cya kabiri kiyobora pin cyinjijwe binyuze muri femorale spur ukoresheje icyerekezo kibangikanye nu munsi wicyerekezo cyambere pin.
Urushinge rwa gatatu rwinjijwemo rusa ninyuma yinshinge yambere ukoresheje ubuyobozi.
Ukoresheje ishusho yibikeri fluoroscopic kuruhande, pin zose uko ari eshatu za Kirschner zagaragaye ko ziri mwijosi ryumugore
Gucukura umwobo werekeza ku cyerekezo cya pin, ugapima ubujyakuzimu hanyuma uhitemo uburebure bukwiye bwumusumari utoboye wasunitswe ku cyerekezo kiyobora, birasabwa gusunika umugongo wigitsina gore wumusumari wimbere, bishobora kubuza gutakaza. gusubiramo.
Shyira mu zindi ebyiri zashizwemo umugozi umwe umwe hanyuma urebe unyuze muri
Imiterere y'uruhu
Filime isubiramo
Ufatanije nimyaka yumurwayi, ubwoko bwavunitse, hamwe nubwiza bwamagufwa, kugabanuka gufunga ubusa imisumari yimbere byakosowe, bifite ibyiza byihungabana rito, byanze bikunze gukosorwa, imikorere yoroshye kandi byoroshye kubyitwaramo, birashobora gukoreshwa na compression, imiterere yubusa irafasha kuri decompression internacranial, kandi igipimo cyo gukira kuvunika ni kinini.
Incamake
1 Gushyira inshinge za Kirschner hejuru yumubiri hamwe na fluoroscopi bifasha kumenya ingingo nicyerekezo cyo kwinjiza inshinge hamwe nurwego rwo gutema uruhu;
2 Amapine atatu ya Kirschner agomba kuba aringaniye, zigzag ihindagurika, kandi yegereye inkombe zishoboka, ibyo bikaba byafasha kuvunika no guhagarika kunyerera;
3 Hasi ya Kirschner pin yinjira igomba gutoranywa kumurongo wigitsina gore ugaragara cyane kugirango umenye neza ko pin iri hagati yijosi ryigitsina gore, mugihe inama yibipapuro bibiri byambere ishobora kunyerera imbere no gusubira inyuma kuruhande rukomeye. koroshya kubahiriza;
4 Ntugatware pin ya Kirschner icyarimwe icyarimwe kugirango wirinde kwinjira mubutaka bwa arctular, biti ya drill irashobora gucukurwa mumurongo wavunitse, kimwe nukwirinda gucukura mumutwe wumugore, ikindi kikaba gifasha imisumari yubusa. kwikuramo;
5 Imiyoboro idafite umwobo yinjiye hafi ya hafi hanyuma unyuze muri bike, suzuma uburebure bw'imigozi ihanamye ni ukuri, niba uburebure butari kure cyane, gerageza wirinde gusimbuza inshuro nyinshi, niba osteoporose, gusimbuza imigozi ahanini bihinduka gukosorwa bitemewe. ya screw, kubimenyesha umurwayi wo gutunganya neza imigozi, ariko uburebure bwuburebure bwimigozi ni bubi gato kurenza uburebure bwo gukosora bidafite akamaro nibyiza cyane!
Igihe cyo kohereza: Mutarama-15-2024
