Kuvunika kw'inyuma y'ikibuno bigizwe na 50% by'imvune zo mu kibuno ku bageze mu za bukuru. Ubuvuzi busanzwe bushobora gutera ingorane nko kuvura imitsi yo mu bwonko, kuvura ibihaha, kubabara igitutu, no kwandura indwara zo mu bihaha. Igipimo cy'impfu mu gihe cy'umwaka umwe kirenga 20%. Kubwibyo, mu gihe imiterere y'umubiri w'umurwayi yemerera, kubagwa hakiri kare ni bwo buryo bwiza bwo kuvura imvune zo mu gice cy'ikibuno.
Gufata inzara imbere mu mitsi ni cyo gipimo cy’ingenzi mu kuvura imvune hagati y’imitsi. Mu bushakashatsi ku bintu bigira ingaruka ku gufata inzara imbere mu mitsi, ibintu nk'uburebure bw'inzara za PFNA, inguni ya varus, n'imiterere byagaragaye mu bushakashatsi bwinshi bwabanje. Ariko, ntibiramenyekana neza niba ubunini bw'inzara nyamukuru bugira ingaruka ku mikorere y'umubiri. Kugira ngo bagire icyo bavuga, intiti z'abanyamahanga zakoresheje inzara imbere mu mitsi zifite uburebure bungana ariko bunyuranye kugira ngo zikosore imvune hagati y'imitsi ku bantu bageze mu za bukuru (bafite imyaka irenga 50), bagamije kugereranya niba hari itandukaniro mu mikorere y'umubiri.
Ubushakashatsi bwakozwe ku bantu 191 bavunitse hagati y’uruti rw’umugongo, bose bavuwe hakoreshejwe uburyo bwa PFNA-II internal fixation. Iyo trochanter ntoya yavunitse ikanavanwaho, hakoreshejwe umunyu ngufi wa mm 200; iyo trochanter ntoya yari yuzuye cyangwa itaravanwaho, hakoreshejwe umunyu ngufi wa mm 170. Umurambararo w’umunyu munini wari hagati ya mm 9-12. Igereranya ry’ingenzi muri ubu bushakashatsi ryibanze ku bimenyetso bikurikira:
1. Ubugari buke bwa trochanter, kugira ngo harebwe niba aho ishyirwa ari ho hasanzwe;
2. Isano iri hagati y'agace k'umutwe n'ijosi n'agace ka kure, kugira ngo harebwe ubwiza bw'igabanuka;
3. Intera yo kugabanya uburebure bw'ikirenge (TAD);
4. Igipimo cy'umusumari n'umuyoboro w'amazi (NCR). NCR ni igipimo cy'umurambararo w'umusumari w'ingenzi n'umurambararo w'umuyoboro w'amazi ku gice cyo hagati cy'umuyoboro w'amazi.
Mu barwayi 191 barimo, uko umubare w'abarwayi banduye ukwirakwira hashingiwe ku burebure n'umurambararo w'umusumari mukuru ugaragara ku ishusho ikurikira:
Impuzandengo ya NCR yari 68.7%. Dukoresheje iyi mpuzandengo nk'igipimo, abarwayi bafite NCR irenga impuzandengo bafatwaga nk'abafite umurambararo munini w'inzara, mu gihe abarwayi bafite NCR iri munsi y'impuzandengo bafatwaga nk'abafite umurambararo muto w'inzara. Ibi byatumye abarwayi bashyirwa mu byiciro by'itsinda ry'inzara nini (90) n'itsinda ry'inzara nini (101).
Ibisubizo bigaragaza ko nta tandukaniro rikomeye ryagaragaye hagati y’itsinda ry’inzara nini n’itsinda ry’inzara nini rigizwe n’imisumari ingana na Tip-Apex Distance, amanota ya Koval, igipimo cyo gukira cyatinze, igipimo cyo kongera kubagwa, n’ibibazo by’amagufwa.
Kimwe n'ubu bushakashatsi, hari inkuru yasohotse mu "Journal of Orthopaedic Trauma" mu 2021: [Umutwe w'iyi nkuru].
Ubushakashatsi bwakorewe ku barwayi 168 bageze mu zabukuru (bafite imyaka irenga 60) bafite imvune hagati y’imitsi, bose bavuwe n’inzara zo mu bwoko bwa cephalomedullary. Hashingiwe ku murambararo w’inzara nyamukuru, abarwayi bagabanyijwemo itsinda rya 10mm n’itsinda rifite umurambararo urenze 10mm. Ibisubizo byagaragaje kandi ko nta tandukaniro rikomeye ryagaragaye mu mibare mu kongera kubagwa (haba muri rusange cyangwa mu buryo budatera indwara) hagati y’ayo matsinda yombi. Abanditsi b’ubu bushakashatsi bavuga ko, ku barwayi bageze mu zabukuru bafite imvune hagati y’imitsi, gukoresha inzara nini ifite umurambararo wa 10mm birahagije, kandi nta mpamvu yo kuyisukura cyane, kuko ishobora kugera ku musaruro mwiza mu mikorere.
Igihe cyo kohereza: 23 Gashyantare 2024
