Ubuhanga bwo gutera imisumari nuburyo bukoreshwa muburyo bwimikorere ya orthopedic imbere.Amateka yacyo arashobora guhera mu myaka ya za 40.Irakoreshwa cyane mukuvura kuvunika amagufwa maremare, kudahuza, nibindi, mugushira umusumari winjiye hagati mu cyuho cya medullary.Kosora urubuga rwacitse.Muri ibi bibazo, tuzabagezaho ibikubiyemo bijyanye n'imisumari idasanzwe.
Muri make, imisumari yimbere ni imiterere ndende ifite imyobo myinshi ifunga imyobo kumpande zombi kugirango ikosore impera yegeranye kandi ya kure.Ukurikije imiterere itandukanye, irashobora kugabanywamo ibice bikomeye, tubular, gufungura-igice, nibindi, bibereye abarwayi batandukanye.Kurugero, imisumari ikomeye yimbere irwanya kwandura kuko idafite umwanya wimbere.Ubushobozi bwiza.
Dufashe tibia nk'urugero, diameter ya cavit medullary iratandukanye cyane kubarwayi batandukanye.Ukurikije niba reaming ikenewe, imisumari yimbere irashobora kugabanywamo imisumari isubirwamo kandi imisumari idasubirwaho.Itandukaniro riri hagati yo kumenya niba reamers igomba gukoreshwa muguhindura medullary, harimo ibikoresho byamaboko cyangwa amashanyarazi, nibindi, kandi bigenda binini bigenda byifashishwa mu kwagura umwobo wa medullary kugirango habeho imisumari minini ya diameter.
Nyamara, inzira yo kwaguka ya marrow yangiza endosteum, nkuko bigaragara ku gishushanyo, kandi ikagira ingaruka ku gice gitanga amaraso yo mu magufwa, gishobora gutera indwara ya nérosose y'amaraso y'agateganyo y'amagufwa yaho kandi ikongera ibyago byo kwandura.Ariko, bifitanye isano nubushakashatsi bwa Clinical buhakana ko hari itandukaniro rikomeye.Hariho n'ibitekerezo byemeza agaciro ka medullary reaming.Ku ruhande rumwe, imisumari yimbere ifite diametero nini irashobora gukoreshwa muburyo bwa medullary.Imbaraga nigihe kirekire byiyongera hamwe no kwiyongera kwa diameter, kandi aho uhurira na cavit medullary iriyongera.Hariho kandi kubona ko uduce duto twamagufwa yakozwe mugihe cyo kwaguka kwa marrow nayo agira uruhare runini muguhindura amagufwa ya autologique.
Impamvu nyamukuru ishyigikira uburyo budasubirwaho ni uko ishobora kugabanya ibyago byo kwandura na embolisme y’impyiko, ariko ikidashobora kwirengagizwa ni uko diameter yayo yoroheje izana imiterere y’imashini idakomeye, bikaviramo umuvuduko mwinshi.Kugeza ubu, imisumari myinshi ya tibial intramedullary ikunda gukoresha imisumari yagutse, ariko ibyiza n'ibibi biracyakenewe gupimwa hashingiwe ku bunini bw'umurwayi wa medullary hamwe no kuvunika.Ibisabwa kuri reamer ni ukugabanya ubushyamirane mugihe cyo gukata no kugira umwironge wimbitse hamwe nigitereko gito cya diameter, bityo bikagabanya umuvuduko uri mu cyuho cya medullary kandi ukirinda gushyuha cyane amagufwa nuduce tworoheje biterwa no guterana amagambo.Necrosis.
Nyuma yo gushiramo imisumari yimbere, birakenewe gukosorwa.Gukosora imyanya gakondo byitwa static gufunga, kandi abantu bamwe bizera ko bishobora gutera gukira gutinze.Nukuzamura, bimwe byo gufunga imiyoboro yabugenewe byakozwe muburyo bwa oval, ibyo bita dinamike ifunga.
Ibyavuzwe haruguru ni intangiriro yibigize imisumari yimbere.Mu nomero itaha, tuzabagezaho inzira ngufi yo kubaga imisumari.
Igihe cyo kohereza: Nzeri-16-2023
