I-Elastic stable intramedullary nailing (ESIN) uhlobo olude lokuphuka kwethambo olusetshenziswa ngokukhethekile ezinganeni.Ibonakala ngokuhlukumezeka okuncane kanye nokusebenza okuncane okungaphazamisi, okungaphazamisi ukukhula kwamathambo engane, futhi kunomthelela omncane ekwelapheni ukuphuka kanye nokuthuthukiswa kwamathambo engane yesikhathi esizayo.Ngakho Kuyisipho sikaNkulunkulu kuBantwana.
I-ESIN yavela kanjani?
Indlela ye-classical yokwelapha ama-fractures ezinganeni inake ngokukhethekile ukwelashwa kwamathambo.Amandla okulungisa amathambo ezinganeni alungisa ukonakala okusalela ngokukhula, kuyilapho izindlela zakudala ze-osteosynthesis zingase zihlanganise izinkinga eziningi.Nokho, le mibono ayiqinisekiswa njalo amaqiniso.Ukulungiswa kabusha kwamathambo okuzenzakalelayo kungaphansi kwemithetho ebhekisela endaweni yokuphuka, uhlobo nezinga lokufuduka, kanye neminyaka yesiguli.Uma lezi zimo zingahlangatshezwana nazo, i-osteosynthesis iyadingeka.
Izinqubo zobuchwepheshe ezikhona njengamanje zokwelashwa kwabantu abadala azikwazi ukusetshenziswa ezinganeni.I-Plate osteosynthesis idinga ukuchithwa okubanzi kwe-periosteal, ezimweni lapho i-periosteum idlala indima ebalulekile ekuhlanganisweni kokuphuka kwezingane.I-Intramedullary osteosynthesis, ngokungena kwe-cartilage yokukhula, idala ukuphazamiseka kwe-endosteal circulation kanye nezinkinga ezinzima zokukhula, ngenxa ye-epiphysiodesis noma ukukhuthaza ukukhula ngokusebenzisa ukuvinjelwa okuphelele komsele we-medullary.Ukuze kuqedwe lezi ziphazamiso,i-elastic intramedullary nailingyakhelwe futhi yasetshenziswa.
Isimiso Esiyisisekelo Isingeniso
Umgomo wokusebenza we-elastic intramedullary nail (ESIN) ukusebenzisa izinzipho ezimbili ze-intramedullary ezenziwe nge-titanium alloy noma insimbi engagqwali enokubuyiselwa okuhle nokunwebeka ukuze kufakwe ngokulinganayo ku-metaphysis.Ngamunyei-elastic interlocking nailinamaphuzu amathathu okusekela ngaphakathi kwethambo.Amandla okubuyisela okunwebekayo ezinzipho ezinwebekayo aguqula ukusunduza nokucindezela okudingekayo ukuze kuncishiswe ukuphuka ngokusebenzisa amaphuzu okuthinta angu-3 we-medullary cavity.
Ii-elastic intramedullaryisikhonkwane sinomumo ongu-C, ongakwazi ukuthola ngokunembile futhi akhe uhlelo olunwebekayo olumelana nokuguquguquka, futhi linozinzo olwanele lokuhamba kwendawo yokuphuka kanye nokuthwala ingxenye ethile.
I-Advantage-Biological Stabilities Enkulu
1) Ukuzinza kwe-Flexural
2) Ukuzinza kwe-axial
I-3) Ukuzinza kwe-lateral
I-4) Ukuzinza kwe-Anti-rotational.
Ukuzinza kwayo kwezinto eziphilayo kuyisisekelo sokuthola umphumela wokwelapha oyifunayo.Ngakho-ke, ukukhetha okuhle ukukwenzaizipikili ezinwebekayo ze-intramedullaryukulungiswa.
Izimpawu ezisebenzayo
Izinkomba zomtholampilo ze-ESINI-TENSngokuvamile zisekelwe eminyakeni yesiguli, uhlobo lokuphuka, nendawo.
Ibanga lobudala: Ngokuvamile, iminyaka yeziguli iphakathi kweminyaka emi-3 neyi-15 ubudala.Umkhawulo weminyaka engaphezulu ungakhuliswa ngokufanelekile ezinganeni ezizacile, futhi umkhawulo weminyaka ephansi ungehliswa ngokufanelekile ezinganeni ezikhuluphele.
Ububanzi bezinzipho ze-Intramedullary kanye nokukhetha ubude: Ubukhulu bozipho buncike kububanzi bomgodi we-medullary, kanye nobubanzi bozipho olunwebekayo = ububanzi bomgodi we-medullary x 0.4.Ukukhetha okuqondilei-elastic intramedullaryizinzipho ngokuvamile zilandela le mithetho elandelayo: 3 mm ububanzi iminyaka 6-8 ubudala, 3.5 mm ububanzi iminyaka 9-11 ubudala, futhi 4 mm ububanzi iminyaka 12-14 ubudala.Endabeni ye-diaphyseal fracture, ubude be-nail elastic = ibanga ukusuka endaweni yokufaka inaliti kuya ku-contralateral ukukhula ipuleti + 2 cm.Ubude obufanele benaliti yokunwebeka kufanele bulingane nebanga phakathi kwamapuleti okukhula nhlangothi zombili, futhi u-2-3 cm yenaliti kufanele ugcinwe ngaphandle kwethambo ukuze ukhishwe esikhathini esizayo.
Izinhlobo zokuphuka ezisebenzayo: ukuphuka okuphambene, ukuphuka okuvunguzayo, ukuhlukana kwezingxenye eziningi, ukuhlukana kwe-bifocal, ukuhlukana okufushane okutshekile noma okuphambene nezicucu ezimise okwe-wedge, ukuphuka okude okusekelwe i-cortical, ukuphuka kwe-pathological okubangelwa ama-cysts amathambo ezingane.
Izindawo zokuphuka ezisebenzayo: i-femoral shaft, i-distal femoral metaphysis, i-proximal femoral subtrochanteric area, i-calf diaphysis, i-distal calf metaphysis, i-humeral diaphysis kanye ne-subcapital area, indawo ye-humerus supra-ankle, i-ulna ne-radius diaphysis, i-radial neck kanye nekhanda elikhanyayo.
Contraindications:
1. Ukuphuka kwe-intra-articular;
2.Ukuphuka kwengalo yengalo eyinkimbinkimbi kanye nokuqhekeka komkhawulo ongezansi ngaphandle kokusekelwa kwe-cortical, ikakhulukazi labo abadinga ukuthwala isisindo noma abadala, akufanelekile i-ESIN.
Amaphuzu okusebenza:
Isinyathelo sokuqala sokunciphisa ukuphuka ukusebenzisa izisetshenziswa zangaphandle ukuze kuzuzwe ukunciphisa okuvaliwe kokuphuka.
Ngemva kwalokho, ii-elastic intramedullary nailubude nobubanzi obufanele kukhethwa futhi kugotshwe kube yisimo esifanele.
Okokugcina, izipikili ezinwebekayo zifakwe, lapho izipikili ezimbili ezinwebekayo zisetshenziswa ethanjeni elifanayo, izipikili ezinwebekayo kufanele zenziwe ngepulasitiki ngokulinganayo futhi zibekwe ukuze zithole ibhalansi engcono yemishini.
Ekuphetheni, i-elastic intramedullary nailingkuyindlela yokwelapha ephumelela kakhulu yokuphuka kwezingane ezisafunda isikole, ezingakwazi nje kuphela ukwenza ukulungisa okungavamile kwebhayoloji kanye nokunciphisa ukuphuka, kodwa futhi akubandisi ubungozi bezinkinga.
Isikhathi sokuthumela: Mar-18-2022