Kubireba imigozi yo mumutwe nijosi, ifata igishushanyo mbonera cya shitingi ya lag screw na screw compression.Guhuriza hamwe guhuza imigozi 2 byongera imbaraga zo kurwanya kuzunguruka umutwe wumugore.
Mugihe cyo kwinjizamo umugozi wo guhunika, kugenda kwa axial ya lag screw itwarwa nu mugozi udasanzwe hagati ya compression ya compression na lag screw, kandi stress yo kurwanya rotation ihindurwamo compression kumurongo kumurongo wacitse, bityo bikazamuka cyane. imbaraga zo kurwanya kuzunguruka za screw.Gabanya imikorere.Imiyoboro 2 irahujwe hamwe kugirango birinde ingaruka "Z".
Igishushanyo cyanyuma cyumusumari wingenzi usa nuwa prothèse ihuriweho ituma umubiri wumusumari uhuza neza nu mwobo wa medullary, nibindi byinshi bijyanye na biomechanical biranga femur yegeranye.
Intambwe zo Kubaga
Umwanya: Umurwayi arashobora guhitamo umwanya cyangwa kuruhande.Hamwe numurwayi mumwanya wa supine, kumeza ikora ya radiolucent cyangwa kumeza ya orthopedic.Uruhande rwiza rwumurwayi rwongewemo kandi rushyizwe kumurongo, kandi uruhande rwanduye rwongewemo 10 ° -15 ° kugirango byorohereze guhuza nu mwobo wa medullary.
Gusubiramo neza: Kurura ingingo zanduye hamwe nigitanda gikurura mbere yo gukora, hanyuma uhindure icyerekezo gikurura munsi ya fluoroscopi kugirango urugingo rwanduye ruri mukuzenguruka gato imbere no kwiyongera.Ivunika ryinshi rirashobora gusubirwamo neza.Gusubiramo mbere yo gutangira ni ngombwa cyane kandi Ingingo ni, ntukagabanye byoroshye niba nta kugabanuka gushimishije.Ibi birashobora kubika igihe cyo gukora no kugabanya ingorane mugihe cyo gukora.Niba kugabanuka bigoye, urashobora gukora incike ntoya mugihe cyo gukora hanyuma ugakoresha inkoni yo gusunika, retrator, kugabanya imbaraga, nibindi kugirango ufashe kugabanuka.Ivunika rito Impande zimbere ninyuma ziratandukanye, kandi nta mpamvu yo guhinduka inshuro nyinshi.Impera yamenetse irashobora guhita isubirwamo mugihe umugozi wo guhunika winjijwe mugihe cyo gukora.
Kugabanuka kwa trocanter ntoya: Igishushanyo cyimisumari yimbere ntigisaba gukomeza cortex yo hagati.Muri rusange, ntabwo bikenewe kugabanya agace kavunitse ka trochanter, kubera ko igikorwa cyo kugabanya gufunga byoroheje ntigishobora kugira ingaruka nke kumaraso yamaraso yamenetse, kandi kuvunika byoroshye gukira.Nyamara, varisi ya coxa igomba gukosorwa mbere yuko shyirwa, kandi igihe cyo kujya hasi nigihe cyo kubyara ibiro nyuma yo gutinda gikwiye gutinda uko bikwiye.
Umwanya wo gutemagura.Umugozi wa Kirschner urashobora gushirwa kuruhande rwinyuma rwigitsina gore cyegeranye, hanyuma ugahinduka kugirango uhuze nu murongo muremure wigitsina gore munsi ya C-arm fluoroscopi, kugirango umwanya wacyo ucye neza.
Menya aho winjirira.Kuruhande rwinyuma, aho imisumari yinjira iherereye kumurongo muremure wa medullary cavit;
Ingingo yo kwinjiramo
InsertGuidePin Fluoroscopy
Byuzuye R.eamed
Kubera ko impera yegeranye yimisumari nkuru ya InterTan iba ifite umubyimba mwinshi, umusumari urashobora kwinjizwa gusa nyuma yo gusubiramo byuzuye mugihe cyo gukora.Kwiyubaka kwa hafi bigomba guhagarikwa mugihe igikoresho cyo kugabanya imyitozo ya reaming ikora ku gikoresho cyinjira.Niba igiti cya kure cyigitsina gore cyahinduwe biterwa nubunini bwa cavit medullary bwaragenwe.Niba X-ray ibanziriza gutangira isanga umwobo wa medullary wigitereko cyigitsina gore cyegeranye bigaragara ko ari muto, reamer ya femorale igomba gutegurwa mbere yo kubagwa.Niba reaming idahagije, bizagora gushyiramo screw.Mugihe cyo guswera, irashobora kunyeganyega murwego ruto Ibice byuruhande rwumusumari wimbere bigomba kwirindwa, ariko hagomba kwirindwa gukomanga gukomeretsa umurizo wumusumari.Uku gukomanga bikabije birashobora gutuma byoroshye gucamo amagufwa mugihe cyo kubaga cyangwa gusimbuza kuvunika nyuma yo kugabanuka.
Shyiramo urutoki rworoshye rwo kurinda imyenda, shyira kumurongo wuyobora hamwe na drill, hanyuma wongere umuyoboro wa femorale wa femorale hafi yimisumari yimbere (hejuru yishusho);niba umwobo wa medullary ari muto, koresha umwitozo woroshye wongeye kwagura umwobo wa medullary mubugari bukwiye;guhuza ubuyobozi shyiramo umusumari mukuru wa InterTAN mumyanya ya medullary (munsi);
ProximalLock
Gushyira umugozi
Gushyira imashini
Kuramo umusumari wa kure
RemoteLock
Igikombe cyanyuma
Kuvura nyuma yo kubagwa
Antibiyotike yakoreshwaga mu gukumira indwara nyuma y'amasaha 48 nyuma yo kubagwa;Kalisiyumu ya heparin ifite uburemere buke na pompe zo mu kirere byakoreshejwe mu gukumira imitsi yimbitse (DVT) mu gice cyo hepfo, kandi indwara z’ibanze z’ubuvuzi zakomeje kuvurwa.Amaradiyo yo mu kibaya ya pelvis na anteroposterior hamwe na radiyo yinyuma yibibuno byafashwe byafashwe kugirango basobanukirwe kugabanuka kuvunika no gukosorwa imbere.
Ku munsi wa mbere nyuma yo kubagwa, umurwayi yashishikarijwe gukora igabanuka rya isometrici ya quadriceps femoris mu gice cya kabiri.Ku munsi wa kabiri, umurwayi yasabwe kwicara ku buriri.Ku munsi wa gatatu, umurwayi yakoraga cyane imyitozo yo mu kibuno no mu ivi ku buriri.Nta buremere bwibihimba byanduye.Shishikariza abarwayi bashoboye kwihanganira igice cy'uburemere ku gihimba cyanduye mu gihe cyo kwihanganira ibyumweru 4 nyuma yo kubagwa.Buhoro buhoro ugendana numugenzi ufite uburemere ukurikije X-ray ikurikirana mubyumweru 6 kugeza 8.Abarwayi badashobora kugenda bigenga kandi bafite ostéoporose ikabije Ku barwayi bafite imikurire ikomeza kumagufwa kuri X-ray, barashobora kugenda buhoro buhoro bafite uburemere buke babifashijwemo.
Menyesha Umuntu: Yoyo (Umuyobozi wibicuruzwa)
TEL / Whatsapp: +86 15682071283
Igihe cyo kohereza: Gicurasi-08-2023
