Ivunika rya femorale hafi ya yose rigaragara ibikomere byamavuriro bituruka ku ihahamuka ryinshi.Bitewe na anatomique iranga femur yegeranye, umurongo wavunitse akenshi uba hafi yubuso bwa arctular kandi ushobora kwaguka mubice, bigatuma bidakwiriye gukosorwa imisumari.Kubera iyo mpamvu, igice kinini cyimanza kiracyashingira kubikosorwa ukoresheje isahani na sisitemu.Nubwo bimeze bityo ariko, ibinyabuzima biranga isahani itunganijwe neza bitera ibyago byinshi byingaruka nko kunanirwa gukosora ibyapa, guturika imbere, no gukuramo imigozi.Gukoresha ubufasha bwa plaque yo hagati kugirango bikosorwe, nubwo bifite akamaro, bizana imbogamizi zatewe nihungabana ryinshi, igihe kinini cyo kubagwa, ibyago byinshi byo kwandura nyuma yo kubagwa, kandi byongera abarwayi amafaranga yumutungo.
Urebye ibyo bitekerezo, kugirango tugere ku buringanire bushyize mu gaciro hagati y’ibinyabuzima bikoreshwa mu isahani imwe hamwe n’ihungabana ryo kubaga bifitanye isano no gukoresha amasahani abiri yo hagati ndetse n’uruhande, intiti z’amahanga zakoresheje tekinike ijyanye no gukosora isahani y’inyongera hamwe no gukosora ibyuma bya percutaneous. kuruhande.Ubu buryo bwerekanye ibisubizo byiza byubuvuzi.
Nyuma ya anesthesia, umurwayi ashyirwa mumwanya mwiza.
Intambwe ya 1: Kugabanya kuvunika.Shyiramo urushinge rwa 2.0mm ya Kocher muri tibial tuberosity, gukurura kugirango ugarure uburebure bwigihimba, kandi ukoreshe ikivi kugirango ukosore iyimurwa ryindege ya sagittal.
Intambwe ya 2: Gushyira icyapa cyuruhande.Nyuma yo kugabanuka kwibanze gukwega, wegera mu buryo butaziguye femur ya kure, hitamo icyapa gikwiye cyo gufunga kugirango ukomeze kugabanuka, hanyuma ushyiremo imigozi ibiri kumpera yegeranye kandi ya kure yimvune kugirango ukomeze kugabanuka.Kuri iyi ngingo, ni ngombwa kumenya ko imigozi ibiri ya kure igomba gushyirwa hafi yimbere hashoboka kugirango birinde kugira ingaruka kumyanya yo hagati.
Intambwe ya 3: Gushyira inkingi yo hagati.Nyuma yo guhagarika kuvunika hamwe nicyapa cyuruhande, koresha umwitozo wa 2.8mm uyobowe na screw kugirango winjire unyuze hagati, hamwe nurushinge ruherereye hagati cyangwa inyuma yumwanya wa femorale ya kure, hejuru cyane no hejuru, winjira muburyo bunyuranye. amagufwa ya cortical.Nyuma yo kugabanuka kwa fluoroscopi ishimishije, koresha umwitozo wa 5.0mm kugirango ukore umwobo hanyuma ushyiremo 7.3mm ya kanseri.
Igishushanyo cyerekana inzira yo kugabanya kuvunika no gukosorwa.Umukecuru w'imyaka 74 ufite imvune ya femorale intera intera-articular (AO 33C1)..(C) Nyuma yo kugabanuka kuvunika, isahani yinyuma yinyuma yinjizwamo imigozi ikingira impande zombi zegeranye kandi ziri kure;(D) Ishusho ya Fluoroscopy yerekana umwanya ushimishije wumugozi wo kuyobora;.
Mugihe cyo kugabanya, ni ngombwa gusuzuma ingingo zikurikira:
(1) Koresha insinga iyobora hamwe na screw.Kwinjiza imigozi yo hagati yinkingi iragutse cyane, kandi gukoresha umugozi uyobora udafite umugozi birashobora kuganisha kumpande ndende mugihe cyo gucukura unyuze hagati, bigatuma bikunda kunyerera.
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(4) Imiyoboro ku mpera yisahani irashobora kubuza kwinjiza imigozi yo hagati.Niba inzitizi ya screw ihuye nigihe cyo kwinjiza inkingi yo hagati, tekereza gukuramo cyangwa gusimbuza imigozi ya kure ya plaque kuruhande, utange umwanya wambere wo gushyira imigozi yo hagati.
Ikiburanwa 2. Umurwayi wumugore, imyaka 76, hamwe no kuvunika kure kwumugore udasanzwe....
Ikiburanwa 3. Umurwayi wumugore, ufite imyaka 70, hamwe no kuvunika periprosthetic ikikije igitsina gore....
Igihe cyo kohereza: Mutarama-10-2024
