Karyewar yanki na intertrochanteric na femur yana lissafin kashi 50% na ɓarkewar hip kuma sune mafi yawan nau'in fashewa a cikin tsofaffi marasa lafiya.Gyaran ƙusa na intramedullary shine ma'auni na zinariya don maganin fida na karaya ta intertrochanteric.Akwai yarjejeniya tsakanin likitocin kashin baya don guje wa "tasirin gajeren lokaci" ta hanyar amfani da dogon kusoshi ko gajere, amma a halin yanzu babu yarjejeniya kan zabi tsakanin dogon kusoshi da gajere.
A ka’ida, gajerun kusoshi na iya rage lokacin tiyata, rage zubar jini, da kuma gujewa reaming, yayin da dogayen kusoshi ke samar da kwanciyar hankali.A lokacin aikin shigar da ƙusa, hanyar al'ada don auna tsawon dogayen kusoshi shine auna zurfin fil ɗin jagora da aka saka.Duk da haka, wannan hanya yawanci ba ta dace sosai ba, kuma idan akwai tsayin daka, maye gurbin ƙusa na intramedullary zai iya haifar da asarar jini mai yawa, ƙara raunin tiyata, da kuma tsawaita lokacin tiyata.Sabili da haka, idan ana iya tantance tsawon ƙusa na intramedullary da ake buƙata kafin aiki, ana iya cimma burin saka ƙusa a cikin ƙoƙari ɗaya, guje wa haɗarin ciki.
Don magance wannan ƙalubale na asibiti, malaman ƙasashen waje sun yi amfani da akwatin marufi na intramedullary ƙusa (Box) don tantance tsawon ƙusa na intramedullary a ƙarƙashin fluoroscopy, wanda ake kira "Tsarin Akwatin".Tasirin aikace-aikacen asibiti yana da kyau, kamar yadda aka raba a ƙasa:
Na farko, sanya majiyyaci a kan gadon juzu'i kuma yi raguwar rufaffiyar yau da kullun a ƙarƙashin gogayya.Bayan an sami ragi mai gamsarwa, ɗauki ƙusa na intramedullary da ba a buɗe ba (ciki har da akwatin marufi) kuma sanya akwatin marufi sama da femur na gaɓar da abin ya shafa:
Tare da taimakon injin fluoroscopy na C-arm, maƙasudin matsayi na kusa shine daidaitawa kusa da ƙarshen ƙusa na intramedullary tare da cortex sama da wuyan mata kuma sanya shi a kan tsinkayar hanyar shigarwa na ƙusa intramedullary.
Da zarar matsayi na kusa ya gamsu, kula da matsayi na kusa, sa'an nan kuma tura C-arm zuwa ƙarshen nesa kuma yi fluoroscopy don samun ra'ayi na gaskiya na haɗin gwiwa na gwiwa.Matsakaicin matsayi mai nisa shine tsaka-tsaki na femur.Sauya ƙusa na intramedullary tare da tsayi daban-daban, da nufin cimma tazara tsakanin ƙarshen ƙarshen ƙusa na intramedullary na mata da ƙaƙƙarfan ƙima na femur tsakanin diamita 1-3 na ƙusa intramedullary.Wannan yana nuna tsayin da ya dace na ƙusa intramedullary.
Bugu da ƙari, marubutan sun bayyana halayen hoto guda biyu waɗanda zasu iya nuna cewa ƙusa na intramedullary ya yi tsayi sosai:
1. Ƙarshen ƙarshen ƙusa na intramedullary an saka shi a cikin nisa na 1/3 na gefen haɗin gwiwa na patellofemoral (cikin farin layin a cikin hoton da ke ƙasa).
2. An saka ƙarshen ƙusa na intramedullary a cikin triangle da aka kafa ta layin Blumensaat.
Marubutan sun yi amfani da wannan hanyar don auna tsawon kusoshi na intramedullary a cikin marasa lafiya 21 kuma sun sami daidaiton ƙimar 95.2%.Duk da haka, ana iya samun matsala mai yuwuwa tare da wannan hanya: lokacin da aka saka ƙusa na intramedullary a cikin nama mai laushi, za a iya samun sakamako mai girma a lokacin fluoroscopy.Wannan yana nufin cewa ainihin tsawon ƙusa na intramedullary da aka yi amfani da shi na iya buƙatar ɗan gajeren gajere fiye da ma'aunin da aka riga aka yi.Marubutan sun lura da wannan lamari a cikin marasa lafiya masu kiba kuma sun ba da shawarar cewa ga masu fama da matsanancin kiba, ya kamata a rage tsawon ƙusa na intramedullary a matsakaici yayin aunawa ko tabbatar da cewa nisa tsakanin ƙarshen ƙarshen ƙusa na intramedullary da ƙarancin ƙwanƙwasa na femur yana cikin ciki. 2-3 diamita na ƙusa intramedullary.
A wasu ƙasashe, ana iya haɗa kusoshi na intramedullary daban-daban kuma a riga an riga an sanya su, amma a yawancin lokuta, nau'ikan ƙusoshin ciki suna haɗuwa tare da haifuwa tare da masana'antun.Sakamakon haka, bazai yiwu a tantance tsawon ƙusa na intramedullary ba kafin haifuwa.Koyaya, ana iya kammala wannan tsari bayan an yi amfani da ɗigon haifuwa.
Lokacin aikawa: Afrilu-09-2024
