Elastic Intramedullary Nail – Mphatso ya Mulungu kwa Ana

Elastic stable intramedullary nailing (ESIN) ndi mtundu wa mafupa othyoka aatali omwe amagwiritsidwa ntchito mwa ana.Iwo yodziwika ndi yaing`ono zoopsa ndi minimally invasive ntchito, zomwe sizimakhudza fupa chitukuko cha mwanayo, ndipo ali ndi zotsatira zochepa pa machiritso fracture ndi tsogolo la mwanayo chitukuko cha mafupa.Choncho ndi mphatso ya Mulungu kwa Ana.

Kodi ESIN inabwera bwanji?

The tingachipeze powerenga njira zochizira fractures ana analabadira makamaka mankhwala mafupa.Mphamvu yokonzanso mafupa mwa ana imakonza zotsalira zotsalira mwa kukula, pamene njira zachikale za osteosynthesis zikhoza kukhala ndi zovuta zambiri.Komabe, maganizo amenewa satsimikiziridwa nthawi zonse ndi zowona.Kukonzekera kwa mafupa modzidzimutsa kumatsatira malamulo okhudza malo ophwanyika, mtundu ndi mlingo wa kusamuka, ndi zaka za wodwalayo.Ngati izi sizikwaniritsidwa, osteosynthesis imafunika.

Njira zamakono zomwe zilipo panopa zothandizira anthu akuluakulu sizingagwiritsidwe ntchito kwa ana.Plate osteosynthesis imafuna kudulidwa kwakukulu kwa periosteal, m'mikhalidwe yomwe periosteum imagwira ntchito yofunika kwambiri pakuphatikizana kwa fractures mwa ana.Intramedullary osteosynthesis, ndi kulowa kwa cartilage ya kukula, imayambitsa kusokonezeka kwa endosteal circulation ndi mavuto aakulu akukula, chifukwa cha epiphysiodesis kapena kukula kolimbikitsana kupyolera mwa kutsekereza kwathunthu kwa ngalande ya medullary.Pofuna kuthetsa zosokonezazi,zotanuka intramedullary kukhomereraidapangidwa ndikugwiritsidwa ntchito.

Mfundo Yoyamba Yoyambira

Mfundo yogwirira ntchito ya misomali yotanuka intramedullary (ESIN) ndiyo kugwiritsa ntchito misomali iwiri ya intramedullary yopangidwa ndi titaniyamu alloy kapena chitsulo chosapanga dzimbiri chokhala ndi kuchira bwino kuti alowetsedwe molingana ndi metaphysis.Aliyensezotanuka interlocking msomaliali ndi mfundo zitatu zothandizira mkati mwa fupa.Mphamvu yobwezeretsa zotanuka za misomali yotanuka imatembenuza kukankhira ndi kukakamiza komwe kumafunikira kuti muchepetse fracture kudzera m'malo olumikizana a 3 a medullary cavity.

Thezotanuka intramedullarymsomali ndi wooneka ngati C, umene ukhoza kupeza molondola ndi kumanga dongosolo zotanuka zomwe zimakana kusinthika, ndipo zimakhala ndi kukhazikika kokwanira kwa kayendedwe ka malo ophwanyika ndi kunyamula pang'ono.

Ubwino Waikulu-Kukhazikika Kwachilengedwe

1) Kukhazikika kwa Flexural
2) Kukhazikika kwa axial
3) Kukhazikika kwapakati
4) Anti-rotational bata.
Kukhazikika kwake kwachilengedwe ndiko maziko opezera chithandizo chomwe mukufuna.Choncho, Ndi bwino kusankha kuchitazotanuka intramedullary misomalikukonza.

Zizindikiro zogwirika

Zizindikiro zachipatala za ESINTENSkaŵirikaŵiri zimatengera zaka za wodwala, mtundu wosweka, ndi malo.

Mtundu wa zaka: Nthawi zambiri, zaka za odwala zimakhala pakati pa 3 ndi 15 zaka.Msinkhu wapamwamba ukhoza kuwonjezeredwa moyenerera kwa ana owonda, ndipo malire a zaka zotsika akhoza kuchepetsedwa moyenera kwa ana onenepa kwambiri.

Kukula kwa msomali kumadalira kukula kwa msomali wa medullary, komanso kukula kwa msomali = m'mimba mwake wa medullary cavity x 0.4.Kusankhidwa kwa molunjikazotanuka intramedullarymisomali zambiri amatsatira malamulo otsatirawa: 3 mm m'mimba mwake kwa zaka 6-8, 3.5 mm m'mimba mwake kwa zaka 9-11, ndi 4 mm m'mimba mwake kwa zaka 12-14.Pankhani ya fracture ya diaphyseal, kutalika kwa msomali wotanuka = ​​mtunda wochokera kumalo olowetsa singano kupita ku mbale ya kukula kwa contralateral + 2 cm.Kutalika koyenera kwa singano zotanuka kuyenera kukhala kofanana ndi mtunda wapakati pa mbale zakukula kumbali zonse ziwiri, ndipo 2-3 cm ya singano iyenera kusungidwa kunja kwa fupa kuti ichotse m'tsogolo.

Mitundu yogwiritsira ntchito yothyoka: fractures yopingasa, fractures yozungulira, fractures yamagulu ambiri, bifocal fractures, yochepa oblique kapena transverse fractures yokhala ndi zidutswa zooneka ngati mphero, fractures yaitali ndi chithandizo cha cortical, pathological fractures chifukwa cha mafupa aang'ono a mafupa.

Malo ogwiritsidwa ntchito ophwanyidwa: femoral shaft, distal femoral metaphysis, proximal femoral subtrochanteric area, ng'ombe diaphysis, distal ng'ombe metaphysis, humeral diaphysis ndi subcapital area, humerus supra-ankle area, ulna ndi radius diaphysis, Radial khosi ndi radial mutu.

Contraindications:

1. Kuphulika kwapakati-articular;

2.Kuphwanyidwa kovutirapo kwa mkono wam'mbuyo ndi fractures m'munsi popanda chithandizo cha cortical, makamaka omwe amafunikira kulemera kapena okalamba, sali oyenerera EIN.

Zopangira ntchito:

Njira yoyamba yochepetsera fracture ndiyo kugwiritsa ntchito zipangizo zakunja kuti mukwaniritse kuchepetsa kutsekedwa kwa fracture.

Pambuyo pake, anzotanuka intramedullary msomalikutalika ndi m'mimba mwake koyenera kumasankhidwa ndikupindika mu mawonekedwe oyenera.

Potsirizira pake, misomali yotanuka imayikidwa, pamene misomali iwiri yotanuka imagwiritsidwa ntchito mu fupa lomwelo, misomali yotanuka iyenera kukhala symmetrically plasticized ndi kuikidwa kuti ipeze bwino makina.

Pomaliza, zotanuka intramedullary kukhomererandi othandiza kwambiri mankhwala fractures ana a sukulu, amene sangakhoze kuchita biologically minimally invasive fixation ndi kuchepetsa fractures, komanso sizimawonjezera chiopsezo cha mavuto.