Elastic stable intramedullary nailing (ESIN) bụ ụdị mgbaji ọkpụkpụ dị ogologo nke a na-eji na ụmụaka.A na-eji obere trauma mara ya na obere ọrụ na-emerụ ahụ, nke na-adịghị emetụta ọganihu ọkpụkpụ nke nwatakịrị ahụ, ọ na-enwekwa mmetụta dị nta na ọgwụgwọ nke mgbaji na ọganihu ọkpụkpụ nwa n'ọdịnihu.Ya mere, ọ bụ onyinye Chineke nyere ụmụaka.
Kedu ka ESIN siri bịa?
Usoro oge gboo maka ọgwụgwọ mgbaji na ụmụaka na-elebara anya na ọgwụgwọ orthopedic.Ike imegharị ọkpụkpụ na ụmụaka na-edozi nrụrụ ndị fọdụrụ site na uto, ebe usoro oge ochie nke osteosynthesis nwere ike ịkpata ọtụtụ nsogbu.Agbanyeghị, ọ bụghị mgbe niile ka eziokwu na-akwado echiche ndị a.Mgbanwe ọkpụkpụ ozugbo na-adabere n'iwu na-ezo aka na saịtị mgbawa, ụdị na ogo nke nchụpụ, na afọ onye ọrịa.Mgbe ọnọdụ ndị a na-emezughị, osteosynthesis dị mkpa.
Usoro teknụzụ nke dị ugbu a maka ọgwụgwọ ndị okenye enweghị ike itinye aka na ụmụaka.Efere osteosynthesis na-achọ ịwepụ ihe dị ukwuu nke periosteal, n'ọnọdụ ebe periosteum na-arụ ọrụ dị mkpa n'ịkwalite mgbaji n'ime ụmụaka.Osteosynthesis nke intramedullary, na ntinye nke cartilage nke na-eto eto, na-ebute nsogbu mgbasa nke endosteal na nsogbu oke ibu, n'ihi epiphysiodesis ma ọ bụ mkpali uto site na nkwụsị zuru oke nke oghere medullary.Iji kpochapụ nsogbu ndị a.ntu intramedullary na-agbanweemebela ma jiri ya mee ihe.
Okwu mmalite nke ụkpụrụ
Ụkpụrụ na-arụ ọrụ nke ntu intramedullary elastic (ESIN) bụ iji ntu intramedullary abụọ nke titanium alloy ma ọ bụ igwe anaghị agba nchara nwere mgbake dị mma nke a ga-etinye na symmetrically site na metaphysis.Nke ọ bụlantu na-agbanwe agbanwenwere ihe nkwado atọ n'ime ọkpụkpụ.Ike mweghachi nke ntu na-agbanwe agbanwe na-agbanwe mkpali na nrụgide achọrọ maka mbelata mgbaji site na kọntaktị 3 nke oghere medullary.
Nkena-agbanwe intramedullaryntu bụ ụdị C, nke nwere ike ịchọta n'ụzọ ziri ezi ma wuo usoro na-agbanwe agbanwe nke na-eguzogide nrụrụ, ma nwee nkwụsi ike zuru oke maka mmegharị nke saịtị mgbaji na ibu ibu.
Nnukwu Uru- Nkwụsi Ike Ndụ
1) Nkwụsi ike na-agbanwe agbanwe
2) Nkwụsi ike axial
3) Nkwụsi ike n'akụkụ
4) Mgbochi na-agbanwe agbanwe.
Nkwụsi ike nke ndu ya bụ ihe ndabere maka inweta mmetụta ọgwụgwọ a chọrọ.Ya mere, ọ dị mma nhọrọ imembọ intramedullary na-agbanwendozi.
Mgbaàmà ndị ọdabara
Ihe ngosi ụlọ ọgwụ maka ESINTENSna-adaberekarị na afọ onye ọrịa, ụdị mgbaji, na ebe ọ nọ.
Ogologo afọ: N'ozuzu, afọ ndị ọrịa dị n'etiti 3 na 15 afọ.Enwere ike ịbawanye oke afọ n'ụzọ kwesịrị ekwesị maka ụmụaka dị gịrịgịrị, yana obere afọ nwere ike wedata nke ọma maka ụmụaka buru oke ibu.
Ogologo ntu intramedullary na nhọrọ ogologo: Ogo nke ntu na-adabere na dayameta nke oghere medullary, na dayameta nke ntu na-agbanwe = dayameta nke oghere medullary x 0.4.Nhọrọ nke ogologona-agbanwe intramedullarymbọ n'ozuzu na-agbaso iwu ndị a: 3 mm na dayameta maka 6-8 afọ, 3.5 mm na dayameta maka 9-11 afọ, na 4 mm na dayameta maka 12-14 afọ.N'ihe banyere mgbaji diaphyseal, ogologo ntu na-agbanwe = ebe dị anya site na ntinye agịga na-adabere na efere uto na-emegiderịta onwe + 2 cm.Ogologo kachasị mma nke agịga na-agbanwe kwesịrị ịdị ka anya dị n'etiti efere ndị na-eto eto n'akụkụ abụọ, na 2-3 cm nke agịga kwesịrị idobere n'èzí ọkpụkpụ maka mmịpụta n'ọdịnihu.
Ụdị mgbaji dị na ya: ọkpụkpụ transverse, spiral fractures, multi-segment fractures, bifocal fractures, short oblique or transverse fractures with wedge-shaped fragtures, ogologo mgbaji na nkwado cortical, pathological fractures kpatara site na ọkpụkpụ ọkpụkpụ nke ụmụaka.
Ebe mgbawa ọdabara: ogwe femoral, femoral metaphysis distal, mpaghara subtrochanteric femoral proximal, nwa ehi diaphysis, distal nwa ehi metaphysis, humeral diaphysis na subcapital mpaghara, humerus supra-ikwa ụkwụ, ulna na radius diaphysis, Radial olu na radial isi.
Contraindications:
1. mgbaji n'ime-articular;
2.Mgbagwoju anya nke mgbagwoju anya na mgbaji ọkpụkpụ dị ala na-enweghị nkwado cortical ọ bụla, karịsịa ndị chọrọ ibu ibu ma ọ bụ ndị toro eto, adịghị mma maka ESIN.
Atụmatụ ọrụ:
Nzọụkwụ mbụ na mbelata mgbawa bụ iji ngwaọrụ mpụga iji nweta mbelata mgbaji ahụ mechiri emechi.
N'ikpeazụ, antu intramedullary na-agbanweA na-ahọrọ ogologo ogologo na dayameta kwesịrị ekwesị ma gbadaa n'ụdị kwesịrị ekwesị.
N'ikpeazụ, a na-akụnye mbọ na-agbanwe agbanwe, mgbe a na-eji ntu abụọ na-agbanwe agbanwe n'otu ọkpụkpụ ahụ, a ga-etinye mbọ na-agbanwe agbanwe nke ọma ma tinye ya iji nweta nguzozi n'ụzọ dị mma.
Na ngwụcha, ntu intramedullary na-agbanwebụ ọgwụgwọ dị irè maka mgbaji ụmụaka na-erule akwụkwọ, nke nwere ike ọ bụghị nanị na-eme ka ọkpụkpụ dị ntakịrị na-emerụ ahụ na mbelata mgbaji, ma ọ dịghịkwa eme ka ihe ize ndụ nke nsogbu dịkwuo elu.
Oge nzipu: Mar-18-2022