Ku bijyanye n'imisumari yo mu mutwe no mu ijosi, ikoresha imiterere y'imisumari ibiri igizwe n'imisumari yo mu gihe gito n'imisumari yo gukanda. Imisumari ibiri ihuriweho yongera imbaraga zo kudahindukira kw'umutwe w'ijosi.
Mu gihe cyo gushyiramo screw yo gukanda, umuvuduko w'uruziga rwa lag uyoborwa n'umugozi wa occlusal uri hagati ya screw yo gukanda n'uruziga rwa lag, kandi imbaraga zo kurwanya rotation zihinduka umurongo ugororotse ku mpera ya fracture, bityo byongera cyane imbaraga zo kurwanya rotational za screw. Kata imikorere. Utu dupira tubiri dufatanye kugira ngo hirindwe ingaruka za "Z".
Imiterere y'inkombe y'umusumari w'ingenzi isa n'iy'ingingo zikora ku ngingo ituma igice cy'umusumari gihuza neza n'umwobo w'umusumari, kandi bigahuza neza n'imiterere y'umubiri w'umusumari w'umusumari w'umusumari.
Intambwe zo Kubaga
Umwanya: Umurwayi ashobora guhitamo aho ahagaze ku ruhande cyangwa aryamye. Umurwayi ari mu mwanya we aryamye, ku meza yo kubaga afite imirasire cyangwa ku meza yo gukurura amagufwa. Uruhande rwiza rw'umurwayi rushyirwa ku gitereko, kandi uruhande rwafashwe rushyirwa ku bushyuhe bwa 10°-15° kugira ngo byorohereze guhuza n'umwobo wa medullary.
Gusubizaho neza: Kura urwego rw'umubiri rwagize ikibazo ukoresheje agace ko gukurura mbere yo kubagwa, hanyuma uhindure icyerekezo cyo gukurura ukoresheje fluoroscopy kugira ngo urwego rw'umubiri rwagize ikibazo rube mu mwanya wo kuzunguruka gato imbere no mu mwanya wo gukurura. Imvune nyinshi zishobora kongera gukoreshwa neza. Gusubiza inyuma mbere yo kubagwa ni ingenzi cyane kandi Ingingo ni uko, ntugace byoroshye niba nta kugabanya gushimishije kwabayeho. Ibi bishobora kuzigama igihe cyo kubagwa no kugabanya ingorane mu gihe cyo kubagwa. Niba kugabanya bigoranye, ushobora gukata gato mu gihe cyo kubagwa hanyuma ugakoresha agakoresho ko gusunika, retractor, reduction forceps, nibindi kugira ngo bifashe kugabanya. Imvune nto Impande z'imbere n'inyuma ziratandukanye, kandi nta mpamvu yo kuzihindura kenshi. Impera y'imvune ishobora kongera gukoreshwa mu buryo bwikora iyo screw yo gukanda ishyizwemo mu gihe cyo kubagwa.
Kugabanya trochanter ntoya: Imiterere y'inzara zo mu nda ntisaba gukomeza kwa cortex y'imbere. Muri rusange, nta mpamvu yo kugabanya igice cy'ivunika rya trochanter rito, kuko igikorwa cyo kugabanya ivunika rito cyane bigira ingaruka nke ku gutembera kw'amaraso mu gice cyo hasi, kandi ivunika ryoroshye gukira. Ariko, coxa varus igomba gukosorwa mbere yuko ishingwa, kandi igihe cyo kujya hasi no gutwara ibiro nyuma yo kubagwa kigomba gutinda uko bikwiye.
Aho gukata igisebe: Umugozi wa cm 3-5 ukorwa ku mpera y’agace ka trochanter gakomeye hafi ku rwego rw’umugongo wa iliac uruta iyindi. Umugozi wa Kirschner ushobora gushyirwa ku ruhande rw’inyuma rwa femur iteganye, kandi ugahindurwa kugira ngo uhuze n’umurongo muremure wa femur hifashishijwe fluoroscopy ya C-arm, kugira ngo aho agace gaherereye harusheho kuba nyako.
Shyiraho aho winjirira: aho umuntu yinjira ni hagati gato n'agasongero k'umutwe munini wa trochanter, bihuye no kunyuranaho kwa 4° k'umurongo muremure w'umwobo wa medullary ku ruhande rw'imbere. Ku ruhande rw'imbere, aho umuntu yinjira mu nzara ni ku murongo muremure w'umwobo wa medullary;
Aho winjirira urushinge
InsertGuidePin Fluoroscopy
R yuzuyeyashyizweho
Kubera ko impera y’umusumari w’ingenzi wa InterTan ari nini cyane, umusumari ushobora gushyirwamo gusa nyuma yo kuwushyiramo neza mu gihe cyo kuwukora. Gushyiramo neza bigomba guhagarikwa iyo igikoresho cyo kugabanya umusumari cyakoze ku gikoresho cyo kwinjira. Niba umusumari w’imbere warasubitswe biterwa n’ingano y’umusumari. Iyo X-ray mbere yo kubagwa isanze umusumari w’umusumari w’imbere warasubitswe ari muto cyane, umusumari w’imbere warasubitswe mbere yo kuwukora. Niba kuwushyiramo bidahagije, bizatuma bigorana kuwushyiramo. Mu gihe cyo kuwushyiramo, ushobora kunyeganyega mu rugero ruto. Ibice by’inyuma by’umusumari w’imbere bigomba kwirindwa, ariko gukubita umusumari cyane ku murizo bigomba kwirindwa. Uko gukubita cyane bishobora gutuma amagufwa acikamo ibice mu gihe cyo kubagwa cyangwa kongera gusimbuza imvune nyuma yo kugabanuka.
Shyiramo agakoresho ko kurinda umubiri koroshye, ucukure ukoresheje igikoresho cyo gucukura, hanyuma wongere umuyoboro w’imbere w’umusumari w’imbere mu kanwa (ifoto iri hejuru); niba umwobo w’umusumari ari muto, koresha igikoresho cyo gucukura cyoroshye cyahinduwe kugira ngo wongere umwobo w’umusumari ku bugari bukwiye; shyira igikoresho cyo gucukura icyuma cyo gucukura umusumari wa InterTAN mu mwobo w’umusumari (hepfo);
Picyiciro cya kabiriLikirenge
Gushyira vis mu mwanya wa lag
Gushyira vis yo gukanda
Shyira umusumari ufunga kure
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Igikombe cya nyuma
Ubuvuzi nyuma yo kubagwa
Imiti igabanya ubukana bw'indwara yakoreshejwe mu kwirinda kwandura amasaha 48 nyuma yo kubagwa; hakoreshejwe kalisiyumu ya heparini ifite uburemere buke n'imashini zitanga umwuka mu gukumira indwara ya DVT mu bice byo hasi by'umubiri, kandi hakomeje kuvurwa indwara z'ibanze. Hafashwe ingamba zo gupima imitsi yo mu kibuno n'iy'imbere mu kibuno cyangiritse kugira ngo hasobanurwe uburyo bwo kugabanya imvune no gufata neza imbere mu mubiri.
Ku munsi wa mbere nyuma yo kubagwa, umurwayi yashishikarijwe gukora imyitozo ngororamubiri ya quadriceps femoris mu mwanya wo kuruhuka gato. Ku munsi wa kabiri, umurwayi yasabwe kwicara ku buriri. Ku munsi wa gatatu, umurwayi yakorewe imyitozo yo gukaraba ikibuno n'amavi ku buriri. Nta gukaraba ibiro ku kuguru kwafashwe. Shishikariza abarwayi bashoboye gutwara igice cy'ibiro ku kuguru kwafashwe mu gihe cyo kwihanganira ibyumweru 4 nyuma yo kubagwa. Genda buhoro buhoro n'icyuma gitwara ibiro nk'uko byagaragajwe na X-ray nyuma y'ibyumweru 6 kugeza kuri 8. Abarwayi badashobora kugenda bonyine kandi bafite indwara ikomeye ya osteoporosis Ku barwayi bakomeza gukura kw'amagufwa kuri X-ray, bashobora kugenda buhoro buhoro bafite ibiro munsi y'inkunga.
Umuntu wo kuvugana na we: Yoyo (Umuyobozi w'Ibicuruzwa)
Terefone/Whatsapp: +86 15682071283
Igihe cyo kohereza: Gicurasi-08-2023
