Ivunika hagati ya femur igizwe na 50% yo kuvunika ikibuno kubasaza.Ubuvuzi bwa conservateur bukunze guhura nibibazo nka trombose ndende, embolisme yimpyisi, ibisebe byumuvuduko, n'indwara zifata ibihaha.Umubare w'abapfa mu mwaka umwe urenga 20%.Kubwibyo, mugihe aho umubiri wumurwayi ubyemerera, kubaga hakiri kare kubagwa imbere nubuvuzi bwatoranijwe kuvunika intertrochanteric.
Intramedullary imisumari yimbere ni igipimo cyizahabu cyo kuvura imvune hagati.Mu bushakashatsi ku bintu bigira ingaruka kuri PFNA ikosora imbere, ibintu nkuburebure bwa PFNA, imisumari ya varus, nigishushanyo byagaragaye mubushakashatsi bwinshi bwabanje.Nubwo bimeze bityo ariko, ntibirasobanuka neza niba ubunini bw’imisumari nyamukuru bugira ingaruka ku mikorere.Kugira ngo iki kibazo gikemuke, intiti z’amahanga zakoresheje imisumari idasanzwe ifite uburebure bungana ariko ubunini butandukanye kugira ngo ikosore imvune hagati y’abantu bageze mu zabukuru (imyaka> 50), bagamije kugereranya niba hari itandukaniro mu mikorere.
Ubushakashatsi bwarimo ibibazo 191 byo kuvunika hagati y’uruhande rumwe, byose bivurwa hamwe na PFNA-II byakosowe imbere.Iyo trocanter ntoya yavunitse kandi itandukanijwe, hakoreshejwe umusumari muto wa 200mm;mugihe Trochanter ntoya yari idahwitse cyangwa idatandukanijwe, hakoreshejwe umusumari wa ultramm-170mm.Diameter yumusumari nyamukuru yari hagati ya 9-12mm.Kugereranya kwingenzi mubushakashatsi byibanze ku bipimo bikurikira:
1. Ubugari buto bwa trochanter, kugirango tumenye niba imyanya yari isanzwe;
2. Isano iri hagati ya cortex yo hagati yigice cyumutwe-ijosi nigice cya kure, kugirango isuzume ubwiza bwo kugabanuka;
3. Intera-Apex Intera (TAD);
4.Ikigereranyo cyo kutagira umuyoboro (NCR).NCR ni igipimo cya diameter nyamukuru yimisumari na diametre ya medullary ya diameter kumurongo wa kure.
Mu barwayi 191 barimo, ikwirakwizwa ry'imanza zishingiye ku burebure na diametre y'umusumari mukuru bigaragara ku gishushanyo gikurikira:
Ikigereranyo cya NCR cyari 68.7%.Ukoresheje iyi mpuzandengo nkurugero, imanza zifite NCR zirenze izisanzwe zafatwaga nkizifite umubyimba munini wa diameter nini, mugihe imanza zifite NCR zitari munsi yikigereranyo zafatwaga nkizifite umurambararo muto.Ibi byatumye abarwayi bashyirwa mu itsinda rya Thick Main Nail (90) hamwe na Thin Main Nail group (101).
Ibisubizo byerekana ko nta tandukanyirizo rishingiye ku mibare ryari hagati yitsinda rya Thick Main Nail na Groupe Thin Main Nail ukurikije intera ya Tip-Apex, amanota ya Koval, gutinda gukira, igipimo cyo kongera gufungura, hamwe ningorane zamagufwa.
Kimwe nubu bushakashatsi, ingingo yasohotse muri "Ikinyamakuru cy’amagufwa ya orthopedic" mu 2021: [Umutwe w’ingingo].
Ubushakashatsi bwarimo abarwayi 168 bageze mu zabukuru (imyaka> 60) bafite imvune za intertrochanteric, bose bavuwe imisumari ya cephalomedullary.Ukurikije diameter yumusumari mukuru, abarwayi bagabanyijwemo itsinda rya 10mm nitsinda rifite diameter irenga 10mm.Ibisubizo byerekanye kandi ko nta tandukanyirizo rishingiye ku mibare ryagaragaye mu bipimo byo kongera gufungura (haba muri rusange cyangwa bitanduye) hagati y'ayo matsinda yombi.Abanditsi b'ubwo bushakashatsi bavuga ko, ku barwayi bageze mu za bukuru bafite imvune za intertrochanteric, gukoresha umusumari mukuru wa diametero 10mm birahagije, kandi nta mpamvu yo gusubiramo cyane, kuko bishobora kugera ku musaruro ushimishije.
Igihe cyo kohereza: Gashyantare-23-2024
