Gutera imisumari mu ndani uburyo bukoreshwa cyane mu kuvura amagufwa maremare, butangira mu myaka ya 1940. Bukoreshwa cyane mu kuvura amagufwa maremare, imvune zitari iz’amagufwa, n’izindi mvune zifitanye isano. Ubu buryo burimo gushyira umusumari wo mu nda mu muyoboro wo hagati w’igufwa kugira ngo uhamye aho imvune yavunitse. Mu magambo make, umusumari wo mu nda ni imiterere miremire ifite byinshivis yo gufungaUmwobo ku mpera zombi, ukoreshwa mu gusana impera zo hafi n'izo hagati y'aho imvune yavunitse. Bitewe n'imiterere yazo, inzara zo mu gice cya kabiri zishobora gushyirwa mu byiciro bikomeye, iby'imiyoboro, cyangwa iby'igice gifunguye, kandi zikoreshwa mu kuvura ubwoko butandukanye bw'abarwayi. Urugero, inzara zo mu gice cya kabiri cya kabiri cya kabiri zangiritse cyane bitewe n'uko nta mwanya wazo wo mu gice cya kabiri cyapfuye.
Ni ubuhe bwoko bw'imvune bukwiriye inzara zo mu nda?
Urusumari rwo mu ndani uburyo bwiza bwo kuvura imvune za diaphyseal, cyane cyane mu gice cy'imbere cy'umugongo n'ikibuno. Binyuze mu buryo budatera imvune, inzara zo mu gice cy'imbere cy'umugongo zishobora gutanga ituze ryiza mu gihe zigabanya kwangirika kw'ingingo zoroshye mu gice cy'umugongo.
Kubaga inzara zo mu nda no kuziba inyunganiramirire bifite akamaro kakurikira:
Gufunga no gukata imisumari mu nda (CRIN) bifite akamaro ko kwirinda gukata aho imvune yavunitse no kugabanya ibyago byo kwandura. Iyo hakozwe akantu gato, birinda gukata cyane ingingo zoroshye no kwangiza amaraso aho imvune yavunitse, bityo bikongera umuvuduko wo gukira. Ku bwoko bwihariye bwakuvunika kw'amagufwa hafi, CRIN ishobora gutanga ubushobozi buhagije bwo gutangira, bigatuma abarwayi batangira gukora imyitozo ngororamubiri hakiri kare; kandi ni ingirakamaro cyane mu bijyanye no kwihanganira stress y’ingingo ugereranije n’ubundi buryo bwo gufata ingingo mu buryo budasanzwe mu bijyanye na biomechanics. Ishobora gukumira kurekura imikorere y’imbere nyuma yo kubagwa binyuze mu kongera aho igice kiri hagati y’igitereko n’amagufwa, bigatuma kiba cyiza ku barwayi ba osteoporosis.
Ikoreshwa ku gice cy'umugongo:
Nkuko bigaragara ku ishusho, uburyo bwo kubaga bukubiyemo gukata gato ka cm 3-5 hejuru y’ikibuno cya tibial gusa, no gushyiramo vis 2-3 zo gufunga binyuze mu gukata biri munsi ya cm 1 ku mpera z’ukuguru no ku mpera z’ukuguru ko hasi. Ugereranyije n’uburyo busanzwe bwo kugabanya no gufunga imbere hakoreshejwe icyuma cy’icyuma, ubu buryo bushobora kwitwa uburyo buto cyane bwo kugabanya.
Ikoreshwa ku gice cy'imbere cy'umugore:
1. Imikorere yo guhuza urusyo rw'imbere mu nda rw'umugongo rufunganye:
Bivuga ubushobozi bwayo bwo kurwanya kuzenguruka binyuze mu buryo bwo gufunga umusumari wo mu nda.
2. Gushyira mu byiciro inzara zo mu nda zifunze:
Ku bijyanye n'imikorere: inzara zisanzwe zifunze neza mu nda no kongera kubaka inzara zifunze neza mu nda; ahanini bigaragazwa n'uburyo stress ikwirakwira mu nda iva mu kibuno ijya mu ivi, ndetse niba ibice byo hejuru n'ibyo hasi biri hagati y'ibizunguruka (muri cm 5) bihamye. Iyo bidakomeye, kongera kubaka stress yo mu kibuno birakenewe.
Ku bijyanye n'uburebure: ubwoko bugufi, bugufi, n'ubugari, ahanini butoranywa hashingiwe ku burebure bw'aho havunitse iyo uhisemo uburebure bw'umusumari wo mu nda.
2.1 Umunyu usanzwe uhuza amenyo y'imbere mu nda
Inshingano nyamukuru: gutuza umuvuduko w'imitsi.
Ibimenyetso: Kuvunika kw'umugongo w'inyuma (ntibikoreshwa ku kuvunika kwa subtrochanteric)
2.2 Ivugurura ry'umusumari uhuza imbere mu nda
Inshingano nyamukuru: Ihererekanya ry'imihangayiko kuva mu kibuno kugera ku gice cy'imbere cy'umugongo ntirihamye, kandi ihererekanya ry'imihangayiko muri iki gice rigomba kongera kubakwa.
Ibimenyetso: 1. Gucika intege kw'ijosi ry'inyuma; 2. Gucika intege kw'ijosi ry'inyuma hamwe n'ugucika intege kw'inyuma ku ruhande rumwe (gucika intege kw'inyuma ku ruhande rumwe).
PFNA kandi ni ubwoko bw'inzara zo mu nda zimeze nk'izishya!
2.3 Uburyo bwo gufunga imisumari yo mu nda y'umugongo
Uburyo bwo gufunga imisumari ya intramedullary buhinduka bitewe n'uwayikoze. Muri rusange, screw imwe ifunga imisumari ya intramedullary ikoreshwa ku nzara za intramedullary, ariko ku nzara za intramedullary zavunitse cyangwa inzara za intramedullary zaregutse, screw ebyiri cyangwa eshatu zifunga imisumari ya static zifite dynamic locking zikunze gukoreshwa kugira ngo zongere uburimbane bwo kuzenguruka. Inzoga za intramedullary za femoral na tibial zaregutse zishyirwaho screw ebyiri zifunga.
Igihe cyo kohereza: Werurwe-29-2023





