Karyewar yankin intertrochanteric na cinyar mace shine ke haifar da kashi 50% na karyewar kugu kuma shine nau'in karyewar da aka fi samu a cikin tsofaffi marasa lafiya. Gyaran farce a cikin intramedullary shine ma'aunin zinare don maganin karaya ta intertrochanteric. Akwai yarjejeniya tsakanin likitocin kashin baya don guje wa "tasirin gajeren gashi" ta hanyar amfani da dogayen farce ko gajeru, amma a halin yanzu babu wata yarjejeniya kan zabi tsakanin dogayen farce da gajeru.
A ka'ida, gajerun farce na iya rage lokacin tiyata, rage zubar jini, da kuma guje wa sake yin gyara, yayin da dogayen farce ke samar da kwanciyar hankali. A lokacin aikin saka farce, hanyar da aka saba amfani da ita don auna tsawon dogon farce ita ce a auna zurfin fil ɗin jagora da aka saka. Duk da haka, wannan hanyar yawanci ba ta da daidaito sosai, kuma idan akwai karkacewar tsayi, maye gurbin farce na intramedullary na iya haifar da asarar jini mai yawa, ƙara raunin tiyata, da tsawaita lokacin tiyata. Saboda haka, idan za a iya tantance tsawon da ake buƙata na farce na intramedullary kafin tiyata, za a iya cimma burin saka farce a ƙoƙari ɗaya, ta hanyar guje wa haɗarin da ke tattare da tiyata.
Domin magance wannan ƙalubalen asibiti, masana ƙasashen waje sun yi amfani da akwatin marufi na farce na intramedullary (Akwati) don tantance tsawon farcen intramedullary kafin tiyata a ƙarƙashin fluoroscopy, wanda aka fi sani da "Dabarar Akwati". Tasirin amfani da farce yana da kyau, kamar yadda aka bayyana a ƙasa:
Da farko, a sanya majiyyacin a kan gadon jan hankali sannan a yi rage girmansa a hankali a ƙarƙashin jan hankali. Bayan an sami raguwa mai kyau, a ɗauki ƙusa ta intramedullary da ba a buɗe ba (gami da akwatin marufi) sannan a sanya akwatin marufi a sama da cinyar gaɓar da abin ya shafa:
Tare da taimakon na'urar C-arm fluoroscopy, ma'aunin matsayi na kusa shine a daidaita ƙarshen kusanci na ƙusa ta intramedullary tare da cortex a saman wuyan femoral sannan a sanya shi a kan hasashen wurin shiga na ƙusa ta intramedullary.
Da zarar wurin da aka yi wa tiyatar ya yi kyau, a ci gaba da ɗaukar matakin kusa, sannan a tura hannun C zuwa ƙarshen nesa sannan a yi amfani da fluoroscopy don samun cikakken hangen nesa na haɗin gwiwa. Ma'aunin matsayi na nesa shine matakin tsakiya na cinyar. A maye gurbin ƙusa ta intramedullary da tsayi daban-daban, da nufin cimma tazara tsakanin ƙarshen ƙarshen ƙusa ta intramedullary na cinyar da kuma matakin tsakiya na cinyar a cikin diamita 1-3 na ƙusa ta intramedullary. Wannan yana nuna tsawon da ya dace na ƙusa ta intramedullary.
Bugu da ƙari, marubutan sun bayyana halaye biyu na hoto waɗanda ka iya nuna cewa ƙusa ta intramedullary ta yi tsayi sosai:
1. An saka ƙarshen ƙusa ta intramedullary a cikin rabin rabin saman haɗin gwiwa na patellofemoral (a cikin layin fari a cikin hoton da ke ƙasa).
2. An saka ƙarshen ƙarshen ƙusa ta intramedullary a cikin alwatika da layin Blumensaat ya samar.
Marubutan sun yi amfani da wannan hanyar don auna tsawon ƙusoshin intramedullary a cikin marasa lafiya 21 kuma sun gano daidaiton kashi 95.2%. Duk da haka, akwai yiwuwar samun matsala game da wannan hanyar: lokacin da aka saka ƙusoshin intramedullary a cikin nama mai laushi, za a iya samun tasirin girma yayin amfani da fluoroscopy. Wannan yana nufin cewa ainihin tsawon ƙusoshin intramedullary da aka yi amfani da su na iya buƙatar ɗan gajarta fiye da ma'aunin kafin tiyata. Marubutan sun lura da wannan lamari a cikin marasa lafiya masu kiba kuma sun ba da shawarar cewa ga marasa lafiya masu kiba sosai, ya kamata a rage tsawon ƙusoshin intramedullary a matsakaici yayin aunawa ko kuma a tabbatar da cewa nisan da ke tsakanin ƙarshen ƙusoshin intramedullary da kuma tsakiyar condylar na femur yana cikin diamita 2-3 na ƙusoshin intramedullary.
A wasu ƙasashe, ana iya naɗe farce na intramedullary daban-daban sannan a yi musu najasa kafin a yi musu najasa, amma a lokuta da yawa, ana haɗa tsawon farce na intramedullary daban-daban tare kuma masana'antun suna yin najasa tare. Sakamakon haka, ba zai yiwu a tantance tsawon farce na intramedullary ba kafin a yi najasa. Duk da haka, ana iya kammala wannan tsari bayan an yi amfani da labulen najasa.
Lokacin Saƙo: Afrilu-09-2024
