Ƙusoshi a cikin intramedullarywata dabara ce da aka saba amfani da ita wajen gyara ƙashi ta jiki wadda ta samo asali tun daga shekarun 1940. Ana amfani da ita sosai wajen magance karyewar ƙashi mai tsawo, rashin haɗuwa, da sauran raunuka masu alaƙa. Wannan dabarar ta ƙunshi saka ƙusa ta ciki a cikin tsakiyar magudanar ƙashi don daidaita wurin karyewar. A taƙaice dai, ƙusa ta ciki wani dogon tsari ne mai matakai da yawa.sukurori na kullewaramuka a ƙarshen biyu, waɗanda ake amfani da su don gyara ƙarshen karyewar da ke kusa da ta nesa. Dangane da tsarinsu, ana iya rarraba kusoshin intramedullary zuwa sassa masu ƙarfi, tubular, ko kuma sassan da ba a buɗe ba, kuma ana amfani da su don magance nau'ikan marasa lafiya daban-daban. Misali, kusoshin intramedullary masu ƙarfi suna da juriya mafi kyau ga kamuwa da cuta saboda rashin sararin ciki da ba a iya gani ba.
Waɗanne irin karaya ne suka dace da kusoshin intramedullary?
Kusa ta ciki ta tsakiyashine dashen da ya dace don magance karyewar diaphyseal, musamman a cikin femur da tibia. Ta hanyar dabarun da ba su da yawa, ƙusa ta intramedullary na iya samar da kyakkyawan kwanciyar hankali yayin da take rage lalacewar nama mai laushi a yankin karyewar.
Tiyatar rage ƙusa da kuma gyaran ƙusa ta intramedullary tana da fa'idodi masu zuwa:
Rufe raguwa da ƙusa a cikin medullary (CRIN) yana da fa'idodin guje wa yanke wurin karyewar da kuma rage haɗarin kamuwa da cuta. Da ƙaramin yankewa, yana guje wa yaɗuwar nama mai laushi da lalacewar jini a wurin karyewar, don haka yana inganta saurin warkar da karyewar. Ga takamaiman nau'ikankaryewar ƙashi na kusaCRIN na iya samar da isasshen kwanciyar hankali na farko, wanda ke ba marasa lafiya damar fara motsi na haɗin gwiwa da wuri; kuma yana da fa'ida sosai dangane da ɗaukar damuwa ta axial idan aka kwatanta da sauran hanyoyin gyarawa na eccentric dangane da biomechanics. Zai iya hana sassauta gyaran ciki bayan tiyata ta hanyar ƙara yankin hulɗa tsakanin dashen da ƙashi, wanda hakan ya sa ya fi dacewa da marasa lafiya da ke fama da osteoporosis.
An yi amfani da shi ga tibia:
Kamar yadda aka nuna a cikin hoton, aikin tiyatar ya ƙunshi yin ƙaramin yankewa na 3-5 cm kawai a saman tibial tubercle, da kuma saka sukurori 2-3 masu kullewa ta hanyar yankewa ƙasa da 1 cm a ƙarshen kusa da nesa na ƙasan ƙafa. Idan aka kwatanta da rage buɗewa na gargajiya da kuma ɗaurewa na ciki tare da farantin ƙarfe, ana iya kiran wannan dabarar da ba ta da tasiri sosai.
An shafa a kan cinyar:
1. Aikin haɗa ƙusa a cikin medullary da aka kulle a cikin femoral:
Yana nufin ikonsa na tsayayya da juyawa ta hanyar hanyar kulle ƙusa ta intramedullary.
2. Rarraba ƙusa ta intramedullary da aka kulle:
Dangane da aiki: ƙusa mai kullewa ta hanyar intramedullary da aka kulle da kuma sake gina ƙusa mai kullewa ta intramedullary; galibi ana tantance ta hanyar watsa damuwa daga haɗin gwiwa zuwa haɗin gwiwa, da kuma ko sassan sama da na ƙasa tsakanin masu juyawa (cikin 5cm) sun tabbata. Idan babu kwanciyar hankali, ana buƙatar sake gina watsa damuwa ta kugu.
Dangane da tsayi: gajeru, kusanci, da kuma nau'ikan da suka faɗaɗa, galibi ana zaɓa su ne bisa tsayin wurin da ya karye lokacin zaɓar tsawon ƙusa a cikin medullary.
2.1 Kusa mai haɗa kai ta intramedullary
Babban aiki: daidaita damuwa ta axial.
Alamomi: Karyewar shaft ɗin femoral (ba a yi amfani da shi ga karaya ta ƙasa ba)
2.2 Sake gina ƙusa mai haɗa kai a cikin medullary
Babban aiki: Yaɗuwar damuwa daga kwatangwalo zuwa shaft ɗin femoral ba ta da tabbas, kuma ana buƙatar sake gina kwanciyar hankali na yaɗa damuwa a wannan ɓangaren.
Alamomi: 1. Karyewar ƙashin ƙugu; 2. Karyewar wuyan ƙugu tare da karyewar shaft ɗin ƙugu a gefe ɗaya (karyewar ɓangarorin biyu a gefe ɗaya).
PFNA kuma wani nau'in ƙusa ne na intramedullary irin na sake ginawa!
2.3 Tsarin kullewa na nesa na ƙusa ta intramedullary
Tsarin kullewa na nesa na kusoshin intramedullary ya bambanta dangane da masana'anta. Gabaɗaya, ana amfani da sukurori guda ɗaya mai tsauri don kusoshin intramedullary na kusa da femoral, amma ga karyewar shaft na femoral ko kusoshin intramedullary masu tsayi, ana amfani da sukurori biyu ko uku masu tsauri tare da kullewa mai ƙarfi don haɓaka kwanciyar hankali na juyawa. Dukansu kusoshin intramedullary masu tsayi na femoral da tibial ana ɗaure su da sukurori biyu masu kullewa.
Lokacin Saƙo: Maris-29-2023
