Ƙunƙarar wuyan mata na yau da kullum ne kuma mai yuwuwa rauni ga masu aikin tiyata na orthopedic, saboda rashin isasshen jini, abin da ya faru na raunin da ba na haɗin gwiwa ba da osteonecrosis ya fi girma, mafi kyawun magani ga ƙwayar wuyan mata har yanzu yana da rikici, yawancin malaman sun yi imanin cewa marasa lafiya sun wuce. Ana iya la'akari da shekaru 65 don maganin arthroplasty, kuma marasa lafiya a karkashin shekaru 65 za a iya zaɓar su don aikin gyaran gyare-gyare na ciki, kuma mafi munin tasiri akan jini yana haifar da nau'in nau'in subcapsular na wuyan mata.Karyewar babban birni na wuyan mata yana da mafi girman tasirin haemodynamic, kuma rufaffiyar raguwa da gyare-gyaren ciki har yanzu shine hanyar jiyya ta yau da kullun don karyewar babban birni na wuyan mata.Ragewa mai kyau yana taimakawa wajen tabbatar da karaya, inganta warkar da raunuka da kuma hana necrosis na mata.
Abubuwan da ke biyowa wani lamari ne na al'ada na karaya a wuyan mata don tattauna yadda za a yi gyare-gyare na ciki-rufe tare da dunƙule gwangwani.
Ⅰ Asalin bayanan shari'ar
Bayanin haƙuri: namiji 45 shekaru
Ƙorafi: ciwon hip na hagu da iyakancewar aiki don 6 hours.
Tarihi: Mai haƙuri ya fadi yayin da yake yin wanka, yana haifar da ciwo a cikin hagu na hagu da kuma iyakancewar aiki, wanda ba za a iya sauke shi ta hanyar hutawa ba, kuma an shigar da shi a asibitin mu tare da raunin wuyansa na hagu na hagu a kan rediyo, kuma an kwantar da shi a asibiti a cikin yanayin hankali da rashin tausayi, yana korafin jin zafi a hips na hagu da iyakancewar aiki, kuma bai ci abinci ba kuma bai sauke kansa ba daga hanji na biyu bayan raunin da ya samu.
Ⅱ Jarrabawar Jiki (Duba Dukan Jiki & Duban Kwararru)
T 36.8°C P87 bugun/min R20 bugun/min BP135/85mmHg
Ci gaban al'ada, abinci mai kyau mai kyau, matsayi mara kyau, bayyanannen tunani, haɗin kai a cikin jarrabawa.Launin fata na al'ada ne, na roba, babu edema ko kurji, babu haɓakar nodes na lymph na sama a cikin duka jiki ko yanki na gida.Girman kai, ilimin halittar jiki na yau da kullun, babu zafin matsa lamba, taro, gashi mai sheki.Dukan daliban suna daidai da girmansu da zagaye, tare da haske mai hankali.Wuyan yana da laushi, trachea yana tsakiya, glandon thyroid bai kara girma ba, kirji ya kasance mai daidaitacce, numfashi ya dan rage kadan, babu rashin daidaituwa akan bugun jini na zuciya, iyakokin zuciya sun kasance al'ada akan bugun zuciya, bugun zuciya 87 bugawa/ min, bugun zuciya ya kasance Qi, ciki yana da laushi da laushi, babu ciwon matsi ko jin zafi.Ba a gano hanta da sabulu ba, kuma babu taushi a cikin koda.Ba a bincika diaphragms na gaba da na baya ba, kuma babu nakasar kashin baya, manyan gaɓɓai da ƙananan gaɓoɓin dama, tare da motsi na yau da kullun.Hanyoyin motsa jiki sun kasance a cikin jarrabawar ƙwayar cuta kuma ba a haifar da bayyanar cututtuka ba.
Babu bayyananne kumburin hips na hagu, bayyanannen zafin matsa lamba a tsakiyar makwancin gwal na hagu, gajeriyar nakasar juyi na waje na ƙananan ƙafar hagu, ƙanƙan ƙafar ƙafar ƙafar ƙafar ƙafar ƙafar ƙafar ƙafar hagu (+), tabarbarewar hip na hagu, jin daɗi da aiki na Yatsu biyar na ƙafar hagu sun yi kyau, kuma bugun jijiya na baya na ƙafar daidai ne.
Ⅲ jarrabawar taimako
Fim ɗin X-ray ya nuna: hagu na wuyan mata na hagu na ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan mata, raguwa na ƙarshen karya.
Sauran gwaje-gwajen nazarin halittu, X-ray na kirji, densitometry na kashi, da duban dan tayi na zurfafan jijiyoyi na ƙananan gaɓoɓin ba su nuna wata matsala ta zahiri ba.
Ⅳ Bincike da ganewar asali
Dangane da tarihin mai haƙuri na rauni, ciwon hip na hagu, ƙayyadaddun aiki, nazarin jiki na ƙananan ƙafar ƙafar hagu yana rage jujjuyawar nakasar waje, rashin tausayi a fili, ƙananan ƙafar ƙafar ƙafar ƙafar ƙafar ƙafar ƙafar ƙafa kowtow zafi (+), rashin aiki na hagu na hagu, haɗe tare da. Ana iya gano fim ɗin X-ray a fili.Har ila yau, karaya na trochanter na iya samun ciwon hip da iyakancewar aiki, amma yawanci kumburin gida yana bayyana a fili, wurin matsa lamba yana cikin trochanter, kuma kusurwar juyawa na waje ya fi girma, saboda haka ana iya bambanta shi da shi.
Ⅴ Magani
Rufewar ragewa da ƙusa ƙusa na ciki an yi shi bayan cikakken bincike.
Fim ɗin kafin a fara aiki shine kamar haka
Maneuver tare da jujjuyawar ciki da jujjuya gaɓoɓin da abin ya shafa tare da ɗan satar abin da ya shafa bayan an dawo da shi da kuma fluoroscopy ya nuna kyakkyawan farfadowa.
An sanya fil ɗin Kirschner a saman jiki ta hanyar wuyan femoral don fluoroscopy, kuma an yi ɗan ƙaramin fata daidai da wurin da ƙarshen fil ɗin yake.
Ana saka fil ɗin jagora a cikin wuyan femoral daidai da saman jiki a cikin jagorar fil ɗin Kirschner yayin kiyaye karkatar gaba na kusan digiri 15 kuma ana yin fluoroscopy.
Ana shigar da fil ɗin jagora na biyu ta hanyar ɗigon mata ta hanyar amfani da jagora mai layi ɗaya zuwa ƙarƙashin jagorancin fil ɗin jagora na farko.
Ana saka allura ta uku daidai da bayan allurar farko ta jagorar.
Yin amfani da hoton gefen kwaɗo, an ga dukkan fitilun Kirschner guda uku suna cikin wuyan femoral.
Drill ramuka a cikin shugabanci na jagora fil, auna zurfin sa'an nan zaži dace tsawon na m ƙusa dunƙule tare da jagora fil, shi bada shawarar zuwa dunƙule a cikin femoral kashin baya na m ƙusa da farko, wanda zai iya hana asarar daga sake saiti.
Matsa a cikin sauran biyu gwangwani dunƙule daya bayan daya da kuma gani ta cikin
Yanayin yankan fata
Fim ɗin bita bayan tiyata
Haɗe tare da shekarun mai haƙuri, nau'in karaya, da ingancin kashi, an fi son rage raguwar ƙusa mai zurfi na ciki, wanda yana da fa'idodin ƙananan rauni, tabbataccen sakamako mai gyare-gyare, aiki mai sauƙi da sauƙi don ƙwarewa, za a iya ƙarfafa matsawa, tsari mara kyau yana da kyau. zuwa intracranial decompression, kuma raguwar waraka yana da yawa.
Takaitawa
1 Sanya alluran Kirschner a jikin jiki tare da fluoroscopy yana da amfani don ƙayyade ma'ana da jagorancin shigar da allura da kewayon raunin fata;
2 Fil ɗin Kirschner guda uku yakamata su kasance daidai da juna, jujjuyawar zigzag, kuma kusa da gefen kamar yadda zai yiwu, wanda zai iya haifar da karyewar kwanciyar hankali kuma daga baya zamewa matsawa;
3 Ya kamata a zaɓi wurin shigar fil ɗin Kirschner na ƙasa a mafi girman fitacciyar ƙirjin femoral na gefe don tabbatar da cewa fil ɗin yana tsakiyar wuyan mace, yayin da tukwici na saman fil biyu za a iya zamewa gaba da baya tare da fitacciyar ƙirjin. don sauƙaƙe riko;
4 Kada ku tuƙi fil ɗin Kirschner da zurfi a lokaci ɗaya don guje wa shiga cikin bangon articular, za a iya hako bit ɗin ta cikin layin karaya, ɗayan shine don hana hakowa ta kan femoral, ɗayan kuma yana dacewa da ƙusa mara kyau. matsawa;
5 The m sukurori dunƙule a cikin kusan, sa'an nan ta hanyar kadan, yi hukunci da tsawon m dunƙule daidai, idan tsawon bai yi nisa ba, kokarin kauce wa akai-akai maye sukurori, idan osteoporosis, maye sukurori m zama mara inganci gyarawa. na sukurori, don tsinkayar mai haƙuri na ingantaccen gyaran gyare-gyare na screws, amma tsayin tsayin sukurori ya ɗan fi muni fiye da tsayin gyare-gyare mara inganci na screws ya fi kyau!
Lokacin aikawa: Janairu-15-2024
