Ivunika rya femorale intertrochanteric nigice kinini cyo kuvunika ikibuno mubikorwa byubuvuzi kandi nikimwe mubice bitatu bikunze kuvuka bifitanye isano na osteoporose mubasaza.Kuvura konservateur bisaba kuruhuka igihe kirekire, bigatera ibyago byinshi byo kurwara ibisebe, kwandura ibihaha, embolisme yimpaha, trombose ndende, nibindi bibazo.Ikibazo cyabaforomo kirakomeye, kandi igihe cyo gukira ni kirekire, bitera umutwaro uremereye umuryango ndetse nimiryango.Kubwibyo, kubaga hakiri kare kubaga, igihe cyose byihanganirwa, nibyingenzi kugirango ugere kumusaruro mwiza mubikorwa byo kuvunika ikibuno.
Kugeza ubu, PFNA (sisitemu yo mu bwoko bwa femorale na antirotation ya femorale) ikosorwa imbere ifatwa nkigipimo cya zahabu yo kubaga kuvura kuvunika ikibuno.Kugera ku nkunga nziza mugihe cyo kugabanya kuvunika ikibuno ningirakamaro mu kwemerera imyitozo ikora hakiri kare.Intoroperative fluoroscopy ikubiyemo anteroposterior (AP) hamwe nibitekerezo byo kuruhande kugirango harebwe igabanuka ryimyanya ndangagitsina yimbere yimbere.Nyamara, amakimbirane arashobora kuvuka hagati yuburyo bubiri mugihe cyo kubagwa (ni ukuvuga ibyiza muburyo bwo kuruhande ariko ntibireba anteroposterior view, cyangwa ibinyuranye).Mu bihe nk'ibi, gusuzuma niba kugabanuka byemewe kandi niba hakenewe guhinduka bitera ikibazo kitoroshye kubavuzi.Intiti zo mu bitaro byo mu rugo nk’ibitaro by’iburasirazuba n’ibitaro bya Zhongshan zakemuye iki kibazo zisesenguye neza niba hasuzumwa inkunga nziza n’ibibi biterwa na anteroposterior ndetse n’ibitekerezo byifashishije ibizamini bya CT nyuma y’ibikorwa bitatu bisanzwe.
Igishushanyo cyerekana inkunga nziza (a), inkunga itabogamye (b), hamwe ninkunga itari nziza (c) uburyo bwo kuvunika ikibuno muburyo bwa anteroposterior reba.
Igishushanyo cyerekana inkunga nziza (d), inkunga itabogamye (e), hamwe nubufasha bubi (f) uburyo bwo kuvunika ikibuno muburyo bwo kureba.
Ingingo ikubiyemo amakuru yimibare yabarwayi 128 bavunitse ikibuno.Intraoperative anteroposterior n'amashusho yatanzwe byahawe abaganga babiri (umwe ufite uburambe buke nundi ufite uburambe) kugirango basuzume inkunga nziza cyangwa itari nziza.Nyuma yisuzuma ryambere, reevaluation yakozwe nyuma y amezi 2.Amashusho ya CT nyuma yo guhabwa amashusho yahawe umwarimu w'inararibonye, wemeje niba uru rubanza ari rwiza cyangwa rutari rwiza, rukaba nk'urwego rwo gusuzuma niba isuzumabumenyi ryakozwe n'abaganga babiri ba mbere.Kugereranya kwingenzi mu ngingo ni ibi bikurikira:
（1） Hariho itandukaniro rinini rigaragara mubisubizo by'isuzuma hagati y'abaganga badafite uburambe n'uburambe mu isuzuma rya mbere n'irya kabiri?Ikigeretse kuri ibyo, ingingo iragaragaza guhuza amatsinda hagati yuburambe buke nubunararibonye bwamatsinda kubisuzuma byombi hamwe no guhuza amatsinda hagati yisuzuma ryombi.
2
Ibisubizo byubushakashatsi
1. Mu byiciro bibiri by'isuzuma, hamwe na CT nk'ibipimo ngenderwaho, nta tandukanyirizo rishingiye ku mibare ryagaragaye mu mitekerereze, umwihariko, igipimo cyiza cyiza, igipimo kibi kibi, n'ibindi bipimo bijyanye no gusuzuma ireme ry'igabanuka rishingiye ku bikorwa bya X- imirasire hagati yabaganga bombi bafite uburambe butandukanye.
2.Mu isuzuma ryo kugabanya ubuziranenge, ufata isuzuma ryambere nkurugero:
- Niba hari amasezerano hagati ya anteroposterior nisuzuma ryuruhande (byombi nibyiza cyangwa byombi bitari byiza), kwizerwa muguhanura kugabanuka kuri CT ni 100%.
- Niba hari ukutumvikana hagati ya anteroposterior nisuzuma ryuruhande, ubwizerwe bwibipimo ngenderwaho byo gusuzuma muburyo bwo guhanura kugabanuka kuri CT ni hejuru.
Igishushanyo cyerekana inkunga nziza yerekanwe muburyo bwa anteroposterior mugihe ugaragara nkutari mwiza muburyo bwo kureba.Ibi byerekana kudahuza mubisubizo by'isuzuma hagati ya anteroposterior n'ibitekerezo byuruhande.
▲ Ibice bitatu bya CT kwiyubaka bitanga amashusho menshi yo kureba, bikora nkibipimo byo gusuzuma ubuziranenge bwo kugabanuka.
Mubipimo byabanjirije kugabanya kuvunika kwa intertrochanteric, usibye inkunga nziza kandi itari nziza, hariho kandi igitekerezo cyo "kutabogama", bivuze kugabanuka kwa anatomique.Ariko, kubera ibibazo bijyanye no gukemura fluoroscopi no kutamenya kwijisho ryabantu, "kugabanuka kwa anatomique" kwukuri ntikubaho, kandi burigihe hariho gutandukana gato kugabanura "ibyiza" cyangwa "bibi".Itsinda riyobowe na Zhang Shimin mu bitaro bya Yangpu muri Shanghai ryasohoye impapuro (igitabo cyihariye cyibagiranye, cyashimirwa niba hari ushobora kugitanga) cyerekana ko kugera ku nkunga nziza mu kuvunika hagati y’imvururu bishobora kuvamo umusaruro ushimishije ugereranije no kugabanuka kwa anatomique.Kubwibyo, urebye ubu bushakashatsi, hagomba gushyirwamo ingufu mugihe cyo kubagwa kugirango tugere ku nkunga nziza mu kuvunika hagati y’imyororokere, haba muri anteroposterior ndetse no kuruhande.
Igihe cyo kohereza: Mutarama-19-2024
