Elastic ruaj khov intramedullary nailing (ESIN) yog hom pob txha pob txha ntev tshwj xeeb siv rau cov menyuam yaus.Nws yog tus cwj pwm los ntawm kev raug mob me me thiab kev ua haujlwm me me, uas tsis cuam tshuam rau tus menyuam txoj kev loj hlob ntawm cov pob txha, thiab muaj kev cuam tshuam me ntsis rau kev kho ntawm pob txha thiab tus menyuam txoj kev loj hlob ntawm pob txha yav tom ntej.Yog li ntawd Nws yog Vajtswv lub txiaj ntsim rau menyuam yaus.
ESIN tuaj txog li cas?
Txoj hauv kev classical rau kev kho mob pob txha hauv cov menyuam yaus tau saib xyuas tshwj xeeb rau kev kho mob orthopedic.Lub peev xwm kho pob txha hauv cov menyuam yaus kho qhov seem deformations los ntawm kev loj hlob, thaum cov txheej txheem classical ntawm osteosynthesis tuaj yeem cuam tshuam ntau yam teeb meem.Txawm li cas los xij, cov kev xav no tsis yog ib txwm lees paub los ntawm qhov tseeb.Kev kho pob txha spontaneous yog raws li cov cai hais txog qhov chaw tawg, hom thiab qib ntawm kev hloov pauv, thiab hnub nyoog ntawm tus neeg mob.Thaum cov kev mob no tsis tau raws li, yuav tsum tau osteosynthesis.
Cov txheej txheem thev naus laus zis uas tam sim no muaj rau kev kho cov neeg laus tsis tuaj yeem siv rau cov menyuam yaus.Phaj osteosynthesis yuav tsum tau nthuav dav periosteal stripping, nyob rau hauv tej yam kev mob uas lub periosteum plays lub luag hauj lwm tseem ceeb nyob rau hauv lub consolidation ntawm pob txha nyob rau hauv cov me nyuam.Intramedullary osteosynthesis, nrog rau kev nkag mus ntawm cov pob txha loj hlob, induces endosteal circulation disorders thiab loj hlob teeb meem, vim hais tias ntawm epiphysiodesis los yog kev loj hlob stimulation los ntawm tag nrho cov obstructive medullary kwj dej.Txhawm rau tshem tawm cov kev tsis yooj yim no,elastic intramedullary ntsia thawvtau tsim thiab siv.
Lub Ntsiab Lus Taw Qhia
Lub hauv paus ntsiab lus ntawm kev ua haujlwm ntawm elastic intramedullary ntsia thawv (ESIN) yog siv ob lub rau tes intramedullary ua los ntawm titanium alloy los yog stainless hlau nrog zoo elastic rov qab mus rau symmetrically los ntawm metaphysis.Txhuaelastic interlocking ntsia thawvmuaj peb lub ntsiab lus txhawb rau sab hauv ntawm cov pob txha.Lub elastic rov ua kom lub zog ntawm cov ntsia hlau elastic hloov lub zog thiab lub siab xav tau rau kev txo qis los ntawm 3 lub ntsiab lus ntawm medullary kab noj hniav.
CovIntramedullary elasticCov ntsia hlau yog C-puab, uas tuaj yeem pom tseeb thiab tsim kom muaj lub zog elastic uas tiv thaiv kev deformation, thiab muaj kev ruaj ntseg txaus rau kev txav ntawm qhov chaw tawg thiab ib nrab ntawm cov kabmob.
Qhov Zoo Tshaj Plaws-Txoj Kev Muaj Peev Xwm Loj
1) Flexural stability
2) Axial stability
3) Lateral stability
4) Anti-rotational stability.
Nws txoj kev ruaj ntseg lom yog lub hauv paus kom tau txais cov txiaj ntsig kho mob xav tau.Yog li ntawd, Nws yog qhov kev xaiv zoo los uaelastic intramedullary rau teskho.
Siv tau cov tsos mob
Cov lus qhia kho mob rau ESINTENSfeem ntau yog nyob ntawm tus neeg mob lub hnub nyoog, hom pob txha, thiab qhov chaw.
Hnub nyoog ntau: Feem ntau, hnub nyoog ntawm cov neeg mob yog nyob nruab nrab ntawm 3 thiab 15 xyoo.Lub hnub nyoog qis tshaj tuaj yeem tsim nyog ntxiv rau cov menyuam yaus nyias, thiab cov hnub nyoog qis dua tuaj yeem tsim nyog rau cov menyuam rog rog.
Intramedullary ntsia thawv txoj kab uas hla thiab ntev xaiv: Qhov loj ntawm tus ntsia thawv nyob ntawm txoj kab uas hla ntawm lub medullary kab noj hniav, thiab txoj kab uas hla ntawm tus ntsia thawv elastic = txoj kab uas hla ntawm medullary kab noj hniav x 0.4.Kev xaiv ntawm ncajIntramedullary elasticCov ntsia hlau feem ntau ua raws li cov cai hauv qab no: 3 hli inch rau 6-8 xyoo, 3.5 hli inch rau 9-11 xyoo, thiab 4 hli inch rau 12-14 xyoo.Nyob rau hauv cov ntaub ntawv ntawm diaphyseal puas, qhov ntev ntawm tus ntsia thawv elastic = qhov kev ncua deb ntawm lub koob ntxig taw tes rau lub contralateral loj hlob phaj + 2 cm.Qhov ntev ntev ntawm txoj hlua elastic yuav tsum sib npaug rau qhov kev ncua deb ntawm daim phiaj loj hlob ntawm ob sab, thiab 2-3 cm ntawm rab koob yuav tsum tau tshwj tseg sab nraum cov pob txha rau yav tom ntej.
Muaj feem cuam tshuam cov pob txha: transverse fractures, kauv fractures, ntau ntu pob txha, bifocal fractures, luv oblique los yog transverse fractures nrog wedge-shaped fragments, ntev fractures nrog cortical kev them nyiaj yug, pathological fractures tshwm sim los ntawm cov me nyuam mos pob txha cysts.
Cov chaw muaj feem cuam tshuam: femoral ncej, distal femoral metaphysis, proximal femoral subtrochanteric area, calf diaphysis, distal calf metaphysis, humeral diaphysis and subcapital area, humerus supra-ankle area, ulna thiab radius diaphysis, Radial neck.
Contraindications:
1. Intra-articular puas;
2.Complex forearm fractures thiab qis extremity fractures tsis muaj kev txhawb nqa cortical, tshwj xeeb tshaj yog cov neeg uas yuav tsum tau ris hnyav los yog laus dua, tsis haum rau ESIN.
Cov ntsiab lus ua haujlwm:
Thawj kauj ruam hauv kev txo cov pob txha yog siv cov khoom siv sab nraud kom ua tiav qhov kev txo qis ntawm cov pob txha.
Tom qab ntawd, ibelastic intramedullary ntsia thawvntawm qhov tsim nyog ntev thiab txoj kab uas hla yog xaiv thiab khoov rau hauv cov duab tsim nyog.
Thaum kawg, cov ntsia hlau elastic yog cog, thaum ob lub rau tes elastic siv nyob rau hauv tib lub pob txha, cov ntsia hlau elastic yuav tsum tau symmetrically plasticized thiab muab tso rau kom tau zoo dua txhua yam sib npaug.
Hauv kev xaus, elastic intramedullary ntsia thawvyog ib qho kev kho mob zoo heev rau cov pob txha ntawm cov menyuam yaus hnub nyoog kawm ntawv, uas tuaj yeem ua tsis tau tsuas yog ua kom muaj cov kab mob sib kis tsawg tsawg thiab txo cov pob txha, tab sis kuj tsis ua rau muaj kev pheej hmoo ntawm cov teeb meem.
Lub sij hawm xa tuaj: Mar-18-2022