Kubyerekeranye numutwe wimitwe nicyuma, ifata igishushanyo cya kabiri-gishushanyo cya screw lag na screst. Guhuza imitekerereze 2 yongera kurwanya kuzunguruka umutwe.
Mugihe cyo kwinjiza ibicuruzwa bya compression, urujya n'uruza rw'umugozi uteganijwe hagati y'imigozi ya compression, bityo tugatera imigozi yo kuzenguruka. Noneho imitekerereze yo kuzunguruka yashizwemo umurongo urangiye, kandi imbaraga zo kurwanya imirongo. Gabanya imikorere. Imiyoboro 2 irahujwe kugirango yirinde "Z".
Igishushanyo mbonera cyambere cyumusumari nyamukuru gisa nubwa prostrasi ihuriweho gabanya imisumari bihujwe nubusambanyi, nibindi byinshi bijyanye nibiranga ibinyabuzima bya femur.
Intambwe yo kubaga
Umwanya: Umurwayi arashobora guhitamo umwanya wuruhande cyangwa utanga. Hamwe n'umurwayi mumwanya utanga suppine, kumeza ya Radiyo cyangwa Imbonerahamwe ya orthopedic. Uruhande rwiza rwumurwayi ruri rwiyeguwe kandi rushyirwa ku mugozi, kandi uruhande rwibasiwe rwatewe 10 ° -15 ° korohereza guhuza hamwe na cavity.
Gusubiramo neza: Gukurikirana igihimba cyatewe nigitanda cya traction mbere yo gukora, hanyuma uhindure icyerekezo cya clatus munsi ya flaroscopy kugirango igikome cyibasiwe kiri mumurongo muto wo kuzunguruka no kwiyegurira. Kuvunika byinshi birashobora gusubirwamo neza. Gusubiramo mbere nibyingenzi cyane kandi ingingo ni, ntugabanye byoroshye niba nta kugabanuka gashimishije. Ibi birashobora kuzigama umwanya wo gukora no kugabanya ingorane mugihe cyo gukora. Niba kugabanuka bigoye, urashobora gukora akantu gato mugihe cyo gukora no gukoresha inkoni yo gusunika, retractor, kugabanya imbaraga, nibindi kugirango ufashe kugabanuka. Hakoronye gato impande zose ninyuma ziratandukanye, kandi nta mpamvu yo guhinduka inshuro nyinshi. Kuvunika iherezo birashobora guhita bisubiramo mugihe umugozi wo kwikuramo washwanyaguwe mugihe cyo gukora.
Kugabanya umuto: Igishushanyo cyimisumari intramedullary ntibisaba gukomeza cortex medial. Muri rusange, nta mpamvu yo kugabanya igice gito cyo kuvunika igituba, kuko ikibara gifunze gifunze gifunze kidafite ingaruka ku gukwirakwiza amaraso kurangiza, kandi kuvunika biroroshye gukira. Ariko, valusi ya coxa igomba gukosorwa mbere yuko umurongo ushyirwa, kandi igihe cyo kujya mu butaka nigihe cyo gutanga ibirori bigomba gutinda bikwiye
Umwanya: Gucibwa CM 3-5 bimaze gutegurwa mugihe cyambere cya apex nini ya trochantere nkuru nkuru nkuru nkuru yumugongo wo hejuru wa iliac. Inkonzi ya kirscner irashobora gushyirwa kuruhande rwa femur yinyuma ya femur ya proximil, kandi yahinduwe kugirango ihuze na ch-arm fluoroscopy, kugirango imyanya ya cluoscopy, kugirango imyanya yihagarike isobanutse neza.
Menya aho binjira: Ingingo yinjira irahuza gato kuri apex yimodoka nini, ihuye na 4 ° gutandukana kuruhande rwimirongo miremire ya gicururizwa kumurongo. Kumwanya wuruhande, aho byinjira mu misumari biherereye kuri axis ndende yubusambanyi;
Ingingo yinjira
InsekeGuePin Fluoroscopy
Risomeri
Kubera ko iherezo ryimisumari nyamukuru nibyimbye cyane, umusumari arashobora kwinjizwa gusa nyuma yo kongera gusubirwamo mugihe cyibikorwa. Kwiyongera kwa Proximan bigomba guhagarikwa mugihe igikoresho cyo kugabanya imyitozo yo gusubira inyuma ikora ku cyiciro cyo kwinjira. Niba igiti cya kure cyane gisubirwamo giterwa nubunini bwubukorikori bwagati bwiyemeje. Niba X-ray ya mbere yasanze umwobo wigituba cya femoral ya proximas biragaragara ko bigufi, shaft ya reamer igomba gutegurwa mbere yo kubagwa. Niba reamud idahagije, bizagora kwinjiza screw. Mugihe cyo guswera, birashobora kunyeganyega ahantu hato gato gato k'imisumari ikwiye kwirindwa, ariko gukomanga urugomo bigomba kwirindwa. Gukomanze gukomanga birashobora gutera amagufwa gutandukana mugihe cyo gukora cyangwa gutanga umusaruro nyuma yo kugabanya.
Shyiramo uburinzi bworoshye bwo kurinda ibinyabiziga, ukunda insinga uyobora hamwe na drill, kandi wagure umuyoboro wa femoral wa intramedillar (hejuru); Niba ubuvumo bukabije bufunganye, koresha imyitozo yoroshye yo kwagura ubumwe bwigituba ku bugari bukwiye; Huza umuyobozi shyiramo imisumari nyamukuru mumivurungano (hepfo);
ProximalLock
Gushyira Gushyira
Kwikuramo
Screw mu gufunga cyane
RemoteLock
Igikombe cyanyuma
Kuvurwa nyuma yo kuvurwa
Antibiyotike yari isanzwe ikoreshwa mu gukumira kwandura amasaha 48 nyuma yo kubagwa; Hasi-uburemere bwa molekin calcium na pompe yikirere yakoreshejwe mu gukumira umuganga wimbitse (DVT) mu mpande zo hepfo, n'indwara z'ibanze zakomeje kuvurwa. Radiyo isanzwe ya pelvis na radiyo ya anteroposter hamwe na radiyo yibasiwe byafashwe bisanzwe byafashwe kugirango bagabanye kugabanuka no gukosorwa imbere.
Ku munsi wa mbere nyuma yo kubagwa, umurwayi yashishikarijwe gukora isometric gutumiza kwa quadriceps femoris mumwanya wa kabiri. Ku munsi wa kabiri, umurwayi yahawe amabwiriza yo kwicara ku buriri. Ku munsi wa gatatu, umurwayi yakoraga imyitozo yo mu kibuno n'ivi mu buriri. Nta kirego-gifite imiti yibasiwe. Shishikariza abarwayi bashoboye kwihanganira uburemere ku gice cyibasiwe mubyihanganira ibyumweru 4 nyuma yo gukora. Buhoro buhoro ugenda ugenda ufite ibiro bifatika ukurikije x-ray gukurikirana ibyumweru 6 kugeza 8. Abarwayi badashobora kugenda bigenga kandi bafite osteopororo ikomeye kubarwayi bafite amagufwa akomeza kwiyongera kuri x-ray, barashobora kugenda buhoro buhoro bafite uburemere bufite uburemere.
Umubonano Umuntu: Yoyo (Umuyobozi wibicuruzwa)
Tel / WhatsApp: +86 15682071283
Igihe cya nyuma: Gicurasi-08-2023
