ʻO ka elastic stable intramedullary nailing (ESIN) kahi ʻano haʻi iwi lōʻihi i hoʻohana kūikawā ʻia i nā keiki.Hōʻike ʻia ia e ka ʻeha liʻiliʻi a me ka hana liʻiliʻi invasive, ʻaʻole ia e hoʻopilikia i ka ulu ʻana o ka iwi o ke keiki, a he liʻiliʻi ka hopena i ka ho'ōla ʻana i ka haʻihaʻi a me ka ulu ʻana o ka iwi e hiki mai ana.No laila, ʻo ia ka makana a ke Akua i nā keiki.
Pehea i hiki mai ai ka ESIN?
ʻO ke ala maʻamau i ka mālama ʻana i nā haʻihaʻi i nā keiki i uku nui ʻia i ka mālama orthopedic.ʻO ka hiki ke hoʻololi hou i ka iwi i nā keiki ke hoʻoponopono i ke koena deformations ma o ka ulu ʻana, aʻo nā ʻano maʻamau o ka osteosynthesis hiki ke komo i nā pilikia he nui.Eia naʻe, ʻaʻole i hōʻoia mau ʻia kēia mau manaʻo e nā ʻoiaʻiʻo.ʻO ka hoʻoponopono hou ʻana o ka iwi maʻamau e pili ana i nā lula e pili ana i ka wahi haʻihaʻi, ke ʻano a me ke kiʻekiʻe o ka neʻe ʻana, a me ka makahiki o ka mea maʻi.Ke hoʻokō ʻole ʻia kēia mau kūlana, pono ka osteosynthesis.
ʻAʻole hiki ke hoʻohana ʻia nā kaʻina hana ʻenehana i kēia manawa no ka mālama ʻana i nā pākeke.Pono ka papa osteosynthesis i ka wehe ʻana i ka periosteal nui, i nā kūlana e hana nui ai ka periosteum i ka hoʻohui ʻana o nā haʻihaʻi i nā keiki.Intramedullary osteosynthesis, me ke komo ʻana o ka cartilage ulu, hoʻoulu i nā maʻi endosteal circulation a me nā pilikia ulu nui, ma muli o ka epiphysiodesis a i ʻole ka hoʻoulu ʻana i ka ulu ʻana ma o ke keakea piha ʻana o ka canal medullary.I mea e hoopau ai i keia mau pilikia,elastic intramedullary nailingua hoʻolālā ʻia a hoʻohana ʻia.
Hoʻolauna Kumu Kumu
ʻO ke kumu hana o ka elastic intramedullary nail (ESIN) ʻo ia ka hoʻohana ʻana i nā kui intramedullary ʻelua i hana ʻia me ka titanium alloy a i ʻole ke kila kila me ka hoʻihoʻi elastic maikaʻi e hoʻokomo symmetrically mai ka metaphysis.ʻO kēlā me kēiakui kuʻi elasticʻekolu mau kiko kākoʻo ma loko o ka iwi.ʻO ka ikaika hoʻihoʻi elastic o ka nail elastic e hoʻohuli i ka pahu a me ke kaomi i koi ʻia no ka hōʻemi ʻana i ka haʻihaʻi ma o nā wahi pili 3 o ka lua medullary.
ʻO kaelastic intramedullaryʻO ke kui he C-ʻano, hiki ke huli pono a kūkulu i kahi ʻōnaehana elastic e kūʻē i ka deformation, a loaʻa ka paʻa kūpono no ka neʻe ʻana o ka wahi haʻihaʻi a me ka haʻi haʻahaʻa hapa.
Pōmaikaʻi Nui-Bological Stabilities
1) Paʻa flexural
2) Paʻa axial
3) Paʻa ʻaoʻao
4) Anti-rotation paʻa.
ʻO kona kūpaʻa olaola ke kumu no ka loaʻa ʻana o ka hopena therapeutic i makemake ʻia.No laila, He koho maikaʻi e hananā kui intramedullary elastichoʻopaʻa paʻa.
Nā hōʻailona kūpono
ʻO nā hōʻailona hōʻailona no ESINUMIʻO ka mea maʻamau e pili ana i ka makahiki o ka mea maʻi, ke ʻano haʻi, a me kahi.
Nā makahiki: ʻO ka maʻamau, ʻo ka makahiki o nā maʻi ma waena o 3 a me 15 mau makahiki.Hiki ke hoʻonui ʻia ka palena makahiki kiʻekiʻe no nā keiki wiwi, a hiki ke hoʻohaʻahaʻa ʻia ka palena makahiki haʻahaʻa no nā keiki momona.
Intramedullary nail anawaena a me ka lōʻihi koho: ʻO ka nui o ke kui e pili ana i ke anawaena o ka medullary cavity, a me ke anawaena o ka elastic nail = ke anawaena o ka medullary cavity x 0.4.ʻO ke koho pololeielastic intramedullaryE hahai ana na kui i keia mau rula: 3 mm anawaena no 6-8 makahiki, 3.5 mm anawaena no 9-11 makahiki, a 4 mm anawaena no 12-14 makahiki.I ka hihia o ka haʻihaʻi diaphyseal, ka lōʻihi o ka nail elastic = ka mamao mai ka helu hoʻokomo o ka nila i ka pā ulu contralateral + 2 knm.ʻO ka lōʻihi maikaʻi loa o ka nila elastic e like me ka mamao ma waena o nā papa ulu ma nā ʻaoʻao ʻelua, a ʻo 2-3 cm o ka nila e mālama ʻia ma waho o ka iwi no ka unuhi ʻana e hiki mai ana.
Nā ʻano haʻi pili: nā haʻi kuamoʻo, nā haʻi spiral, nā ʻāpana ʻāpana he nui, nā ʻāpana bifocal, nā ʻāpana oblique pōkole a i ʻole nā ʻāpana ʻāpana me nā ʻāpana like ʻole, nā haki lōʻihi me ke kākoʻo cortical, nā haʻi pathological i hoʻokumu ʻia e nā iwi ʻōpio.
ʻO nā wahi haʻihaʻi kūpono: femoral shaft, distal femoral metaphysis, proximal femoral subtrochanteric area, calf diaphysis, distal calf metaphysis, humeral diaphysis a me subcapital area, humerus supra-ankle area, ulna a me radius diaphysis, Radial neck and radial head.
Contraindications:
1. ʻO ka haʻihaʻi intra-articular;
2.Complex forearm fractures a me ka haʻihaʻi haʻahaʻa haʻihaʻi me ka cortical kākoʻo, o ka oi aku ka poe pono e amo kaumaha a oi aku paha, aole pono no ESIN.
Nā helu hana:
ʻO ka hana mua i ka hōʻemi haʻihaʻi ʻana, ʻo ia ka hoʻohana ʻana i nā mea waho e hoʻokō i ka hoʻemi pani ʻia o ka haʻihaʻi.
Mahope iho, henail elastic intramedullarykoho ʻia ka lōʻihi a me ke anawaena kūpono a hoʻopaʻa ʻia i ke ʻano kūpono.
ʻO ka hope, hoʻokomo ʻia nā kui elastic, ke hoʻohana ʻia ʻelua mau kui elastic i ka iwi hoʻokahi, pono e hoʻopalike ʻia nā kui elastic a hoʻonoho ʻia i mea e loaʻa ai ka ʻoi aku ka maikaʻi o ke kaulike mechanical.
I ka hopena, elastic intramedullary nailinghe lāʻau maikaʻi loa ia no nā haʻihaʻi o nā keiki o ke kula, ʻaʻole hiki ke hana i ka biologically minimally invasive fixation a me ka hoʻohaʻahaʻa ʻana i nā haʻihaʻi, akā ʻaʻole hoʻi e hoʻonui i ka pilikia o nā pilikia.
Ka manawa hoʻouna: Mar-18-2022