Elastic stable intramedullary nailing (ESIN) imhando yekutyoka kwebhonzo refu kunonyanya kushandiswa muvana.Iyo inoratidzirwa nekukuvadzwa kudiki uye kuderera kwekuita zvishoma, izvo zvisingakanganisi kukura kwepfupa remwana, uye hazvina zvazvinoita pakuporesa kwekutyoka uye kukura kwepfupa remangwana remwana.Saka Chipo chaMwari kuVana.
ESIN yakatanga sei?
Iyo classical nzira yekurapa kwekuputsika muvana yainyanya kutarisisa kurapwa kwemapfupa.Iyo pfupa rekugadzirisa simba muvana inogadzirisa zvakasara deformation kuburikidza nekukura, nepo classical nzira dze osteosynthesis dzinogona kusanganisira akawanda matambudziko.Zvisinei, pfungwa idzi hadzisi nguva dzose dzinosimbiswa nechokwadi.Kugadziriswa kwepfupa kunongoerekana kwaitika kune mitemo inoreva nzvimbo yekuputsika, rudzi uye dhigirii rekutamisa, uye zera remurwere.Kana mamiriro aya asina kusangana, osteosynthesis inodiwa.
Maitiro ehunyanzvi aripo iye zvino kurapwa kwevakuru haagone kushandiswa kuvana.Plate osteosynthesis inoda kubviswa kwakawanda kweperiosteal, mumamiriro ezvinhu umo periosteum inoita basa rinokosha mukubatanidzwa kwekuputsika muvana.Intramedullary osteosynthesis, nekupinda kwegorofu yekukura, inokonzera endosteal circulation disorders uye matambudziko makuru ekukura, nekuda kwe epiphysiodesis kana kukura kukurudzirwa kuburikidza nekuvharwa kwakakwana kwemedullary canal.Kuti tibvise zvipingaidzo izvi,elastic intramedullary nailingyakagadzirwa uye yakashandiswa.
Nheyo Yekutanga Nhanganyaya
The kushanda musimboti elastic intramedullary chipikiri (ESIN) kushandisa maviri intramedullary mbambo dzakagadzirwa titanium alloy kana Stainless simbi ine yakanaka elastic recovery kuti vaiswe symmetrically kubva metaphysis.Mumwe nomumweelastic interlocking nailine mapoinzi matatu ekutsigira mukati mebhonzo.Iyo elastic yekudzoreredza simba reiyo elastic mbambo inoshandura kupinza uye kudzvanywa kunodiwa kuderedzwa kwekutyoka kuburikidza ne3 yekusangana mapoinzi e medullary cavity.
Theelastic intramedullarychipikiri chakaita C-chakaita, chinogona kunyatso tsvaga uye kuvaka elastic system inoramba deformation, uye ine kugadzikana kwakakwana kwekufamba kwenzvimbo yekutyoka uye chikamu chekutakura-kutakura.
Huru Kubatsira-Biological Stabilities
1) Flexural kugadzikana
2) Axial kugadzikana
3) Kugadzikana kwepashure
4) Anti-kutenderera kugadzikana.
Kugadzikana kwayo kwebhayoloji ndiyo hwaro hwekuwana iyo inodiwa yekurapa maitiro.Naizvozvo, isarudzo yakanaka kuitaelastic intramedullary misumarifixation.
Zviratidzo zvinoshanda
Zviratidzo zvekiriniki zveESINTENSzvinowanzoenderana nezera remurwere, rudzi rwekutyoka, nenzvimbo.
Zera rezera: Kazhinji, zera revarwere riri pakati pe3 ne15 makore.Muganho wezera repamusoro unogona kuwedzerwa zvakakodzera kune vana vatete, uye zera rezasi rinogona kudzikiswa zvakakodzera kuvana vakafutisa.
Intramedullary chipikiri dhayamita uye kureba kusarudzwa: Kukura kwembambo kunoenderana nedhayamita yemedullary cavity, uye dhayamita yerastiki chipikiri = dhayamita remedullary cavity x 0.4.Kusarudzwa kweakatwasukaelastic intramedullaryzvipikiri zvinowanzotevedzera mitemo inotevera: 3 mm mudhayamita yemakore 6-8, 3.5 mm muhupamhi kwemakore 9-11, uye 4 mm muhupamhi kwemakore 12-14.Panyaya yekutyoka kwediaphyseal, kureba kwembambo elastic = chinhambwe kubva pane inopinza tsono kusvika kune contralateral kukura ndiro + 2 cm.Iyo yakakwana kureba kweiyo elastic tsono inofanirwa kuenzana nenhambwe pakati pemapuleti ekukura pamativi ese, uye 2-3 cm yetsono inofanira kuchengetwa kunze kwebhonzo kuitira kubviswa mune ramangwana.
Anoshanda fracture marudzi: transverse fractures, spiral fractures, multi-segment fractures, bifocal fractures, short oblique or transverse fractures ane zvidimbu zvakaita sewedge, marefu akaputsika ane cortical support, pathological fractures inokonzerwa nevechidiki bone cysts.
Nzvimbo dzinoshandiswa kuputsika: femoral shaft, distal femoral metaphysis, proximal femoral subtrochanteric area, mhuru diaphysis, distal calf metaphysis, humeral diaphysis uye subcapital area, humerus supra-ankle area, ulna uye radius diaphysis, Radial mutsipa uye radial musoro.
Contraindications:
1. Intra-articular fracture;
2.Complex forearm fractures uye kuputika kwepasi kwepasi pasina chero rubatsiro rwekortical, kunyanya avo vanoda kutakura uremu kana vakwegura, havana kukodzera kuESIN.
Nzvimbo dzekuvhiya:
Nhanho yekutanga mukudzikisa kuputsika ndeye kushandisa zvishandiso zvekunze kuti uwane kuvharika kuderedzwa kwekutyoka.
Zvadaro, anelastic intramedullary nailyehurefu hwakakodzera uye dhayamita inosarudzwa uye yakakotama muchimiro chakakodzera.
Pakupedzisira, zvipikiri zve elastic zvakasimwa, kana zvipikiri zviviri zvakanyunguduka zvichishandiswa mupfupa rimwe chete, zvipikiri zvinoputika zvinofanira kuenzaniswa nepurasitiki uye kuiswa kuti zviwane zviri nani zvemagetsi.
Mukupedzisa, elastic intramedullary nailingmushonga unoshanda kwazvo wekutyoka kwevana vezera rechikoro, izvo zvisingakwanisi kungoita biologically zvishoma invasive kugadzirisa uye kuderedzwa kwekutyoka, asiwo hazviwedzere njodzi yematambudziko.
Nguva yekutumira: Mar-18-2022