I-Elastic stable intramedullary nailing (ESIN) luhlobo lokwaphuka kwethambo elide elisetyenziswa ngokukodwa ebantwaneni.Ibonakaliswa yintlupheko encinci kunye nokusebenza okuncinci, okungachaphazeli ukuphuhliswa kwamathambo omntwana, kwaye kunempembelelo encinci ekuphulukiseni ukuphuka kunye nokuphuhliswa kwamathambo omntwana kwixesha elizayo.Ngoko sisipho sikaThixo kuBantwana.
Yabakho njani i-ESIN?
Indlela ye-classical yokunyangwa kweefractures ebantwaneni yanikela ingqalelo ekhethekileyo kunyango lwamathambo.Amandla okuhlaziya amathambo kubantwana alungisa ukuguqulwa okushiyekileyo ngokukhula, ngelixa iindlela zakudala ze-osteosynthesis zingabandakanya iingxaki ezininzi.Noko ke, ezi mbono azisoloko zingqinwa zizibakala.Ukulungiswa kwamathambo okuzenzekelayo kuxhomekeke kwimithetho ebhekiselele kwindawo yokuphuka, uhlobo kunye neqondo lokufuduka, kunye nobudala besigulane.Xa ezi meko zingafezekiswanga, i-osteosynthesis iyafuneka.
Iinkqubo zobugcisa ezikhoyo ngoku kunyango lwabantu abadala azikwazi ukusetyenziswa kubantwana.I-Plate osteosynthesis idinga i-periosteal stripping ebanzi, kwiimeko apho i-periosteum idlala indima ebalulekileyo ekuhlanganiseni ukuphuka kwabantwana.I-Intramedullary osteosynthesis, kunye nokungena kwe-cartilage yokukhula, ibangela ukuphazamiseka kwe-endosteal circulation kunye neengxaki ezinzulu zokukhula, ngenxa ye-epiphysiodesis okanye ukuvuselela ukukhula ngokuphazamiseka okupheleleyo kwe-medullary canal.Ukuze kupheliswe ezi ziphazamisi,nailing intramedullary nailingiyilwe kwaye yasetyenziswa.
Intshayelelo yoMgaqo oSisiseko
Umgaqo osebenzayo we-elastic intramedullary nail (ESIN) kukusebenzisa izikhonkwane ezimbini ze-intramedullary ezenziwe nge-titanium alloy okanye insimbi engenasici kunye nokubuyisela okuhle kwe-elastic ukuba ifakwe ngokulinganayo kwi-metaphysis.Ngamnyei-elastic interlocking nailinamanqaku amathathu axhasayo ngaphakathi kwethambo.Amandla okubuyisela i-elastic ye-elastic nail iguqula i-thrust kunye noxinzelelo olufunekayo ekunciphiseni i-fracture ngokusebenzisa iindawo ezi-3 zoqhagamshelwano ze-medullary cavity.
Ii-elastic intramedullaryisikhonkwane sinobume be-C, esinokufumana ngokuchanekileyo kunye nokwakha inkqubo ye-elastic echasene ne-deformation, kwaye inozinzo olwaneleyo lokuhamba kwendawo yokuphuka kunye nomthwalo wokuthwala inxalenye.
I-Advantage enkulu-Uzinzo lwebhayoloji
1) Ukuzinza kwe-Flexural
2) Ukuzinza kwe-axial
3) Uzinzo lwasemva
4) Ukuzinza okuchasene nokujikeleza.
Ukuzinza kwayo kwezinto eziphilayo sisiseko sokufumana umphumo ofunekayo wonyango.Ngoko ke, lukhetho oluhle ukwenzaiinzipho elastic intramedullaryukulungiswa.
Iimpawu ezisebenzayo
Iimpawu zeklinikhi ze-ESINIZISHUMIzidla ngokusekelwe kwiminyaka yesigulana, uhlobo lokwaphuka, nendawo.
Uluhlu lobudala: Ngokuqhelekileyo, ubudala bezigulane buphakathi kwe-3 kunye ne-15 iminyaka ubudala.Umda weminyaka ephezulu unokunyuswa ngokufanelekileyo kubantwana abancinci, kwaye umda weminyaka ephantsi unokuthotywa ngokufanelekileyo kubantwana abatyebe kakhulu.
I-Intramedullary nail diameter kunye nokukhetha ubude: Ubungakanani besikhonkwane buxhomekeke kwidayamitha ye-medullary cavity, kunye nobubanzi besikhonkwane esilastiki = idiameter ye-medullary cavity x 0.4.Ukukhetha ngokuthe ngqoi-elastic intramedullaryiinzipho ngokubanzi zilandela le migaqo ilandelayo: 3 mm ububanzi iminyaka 6-8 ubudala, 3.5 mm ububanzi iminyaka 9-11 ubudala, kwaye 4 mm ububanzi iminyaka 12-14 ubudala.Kwimeko ye-diaphyseal fracture, ubude be-nail elastic = umgama ukusuka kwindawo yokufaka inaliti ukuya kwiplani yokukhula ye-contralateral + 2 cm.Ubude obufanelekileyo benaliti e-elastic kufuneka bulingane nomgama phakathi kwamacwecwe okukhula kumacala omabini, kwaye i-2-3 cm yenaliti kufuneka igcinwe ngaphandle kwethambo ukwenzela ukukhutshwa kwexesha elizayo.
Iindidi zokuqhawula ezisebenzayo: iifractures ezinqamlezileyo, i-spiral fractures, i-multi-segment fractures, i-bifocal fractures, i-oblique emfutshane okanye i-transverse fractures enamaqhekeza amise okwe-wedge, iifractures ezide kunye nenkxaso ye-cortical, i-pathological fractures ebangelwa ngamathambo aselula.
Iindawo ezisebenzayo zokuphuka: i-femoral shaft, i-distal femoral metaphysis, i-proximal femoral subtrochanteric area, ithole i-diaphysis, i-distal calf metaphysis, i-humeral diaphysis kunye ne-subcapital area, indawo ye-humerus supra-ankle, i-ulna kunye ne-radius diaphysis, i-radial neck kunye nentloko ye-radial.
Contraindications:
1. Ukuqhekeka kwe-intra-articular;
2.I-Complex forearm fractures kunye ne-low extremt fractures ngaphandle kwenkxaso ye-cortical, ngakumbi abo bafuna ukuthwala ubunzima okanye abadala, abafanelekanga kwi-ESIN.
Iindawo zokusebenza:
Isinyathelo sokuqala ekunciphiseni ukuphuka kukusebenzisa izixhobo zangaphandle ukufezekisa ukunciphisa okuvaliweyo kokuphuka.
Emva koko, inail elastic intramedullaryubude obufanelekileyo kunye nedayamitha ikhethiwe kwaye igotywe kwimilo efanelekileyo.
Ekugqibeleni, izikhonkwane ezi-elastic zihlonyelwe, xa izikhonkwane ezimbini ze-elastic zisetyenziswe kwithambo elifanayo, izikhonkwane ze-elastic kufuneka zixutywe ngeplastiki kwaye zibekwe ukuze zifumane ibhalansi engcono yomatshini.
Ukuququmbela, nailing intramedullary nailinglunyango olusebenzayo kakhulu lokuphuka kwabantwana abakwiminyaka yesikolo, abangenakwenza kuphela ukulungiswa kwe-biologically minimally invasive kunye nokunciphisa i-fractures, kodwa ayinyusi ingozi yeengxaki.
Ixesha lokuposa: Mar-18-2022