Karyewar ƙashi a cikin cinya (intertrochanteric) na haifar da kashi 50% na karyewar ƙashi a cikin ƙugu ga tsofaffi. Maganin da aka saba yi yana da saurin kamuwa da matsaloli kamar su thrombosis na jijiyoyin jini mai zurfi, embolism na huhu, ciwon matsi, da kuma kamuwa da cututtukan huhu. Yawan mace-mace a cikin shekara guda ya wuce kashi 20%. Saboda haka, a lokuta inda yanayin lafiyar majiyyaci ya ba da damar yin tiyata da wuri, gyaran ciki na tiyata da wuri shine maganin da aka fi so don karyewar ƙashi a cikin cinya.
Gyaran farce a cikin farce a cikin medullary a halin yanzu shine ma'aunin zinare don magance karyewar intertrochanteric. A cikin bincike kan abubuwan da ke shafar gyaran farce a cikin PFNA, an ruwaito abubuwa kamar tsawon farce na PFNA, kusurwar varus, da ƙira a cikin bincike da yawa da suka gabata. Duk da haka, har yanzu ba a san ko kauri na babban farce yana shafar sakamakon aiki ba. Don magance wannan, masana ƙasashen waje sun yi amfani da farce a cikin medullary masu tsayi iri ɗaya amma kauri daban-daban don gyara karyewar intertrochanteric a cikin tsofaffi (shekaru sama da 50), da nufin kwatanta ko akwai bambance-bambance a cikin sakamakon aiki.
Binciken ya haɗa da shari'o'i 191 na karyewar haɗin gwiwa tsakanin ƙwayoyin halitta, waɗanda aka yi musu magani da PFNA-II fixation na ciki. Lokacin da aka karye ƙaramar ƙwayar cuta kuma aka cire ta, an yi amfani da gajeren ƙusa mai tsawon mm 200; lokacin da ƙaramin ƙwayar cuta ba ta da matsala ko kuma ba ta rabu ba, an yi amfani da ƙusa mai tsawon mm 170. Diamita na babban ƙusa ya kasance daga mm 9-12. Babban kwatancen da aka yi a cikin binciken ya mayar da hankali kan waɗannan alamu:
1. Faɗin trochanter kaɗan, don tantance ko wurin da aka sanya shi daidai ne;
2. Alaƙa tsakanin tsakiyar kwakwalwa na ɓangaren kai da wuya da kuma ɓangaren nesa, don tantance ingancin raguwar;
3. Nisa tsakanin Tip-Apex (TAD);
4. Rabon ƙusa zuwa magudanar ruwa (NCR). NCR shine rabon babban diamita na ƙusa zuwa diamita na magudanar ruwa a kan jirgin sukurori na nesa.
Daga cikin marasa lafiya 191 da aka haɗa, an nuna rarrabawar shari'o'in bisa ga tsayi da diamita na babban ƙusa a cikin hoto mai zuwa:
Matsakaicin NCR shine kashi 68.7% ta hanyar amfani da wannan matsakaicin a matsayin iyaka, an yi la'akari da shari'o'in da suka fi matsakaicin girma da girman babban farce mai kauri, yayin da shari'o'in da suka fi ƙasa da matsakaicin girma da girman babban farce mai siriri. Wannan ya haifar da rarrabuwar marasa lafiya zuwa rukunin Thick Main Farce (masu cutar 90) da rukunin Thin Main Farce (masu cutar 101).
Sakamakon ya nuna cewa babu wani bambanci mai mahimmanci a kididdiga tsakanin ƙungiyar Thick Main Nail da ƙungiyar Thin Main Nail dangane da Distance na Tip-Apex, maki na Koval, jinkirin warkarwa, ƙimar sake yin tiyata, da kuma matsalolin ƙashi.
Kamar wannan binciken, an buga wani kasida a cikin "Journal of Orthopaedic Trauma" a cikin 2021: [Taken Labarin].
Binciken ya haɗa da tsofaffi 168 (masu shekaru sama da 60) waɗanda ke da karyewar farce ta intertrochanteric, waɗanda aka yi musu magani da farce na cephalomedullary. Dangane da diamita na babban farce, an raba marasa lafiya zuwa rukuni na 10mm da rukuni mai diamita fiye da 10mm. Sakamakon ya kuma nuna cewa babu wani bambanci mai mahimmanci a kididdiga a cikin adadin sake yin tiyata (ko dai gabaɗaya ko ba ya yaɗuwa) tsakanin ƙungiyoyin biyu. Marubutan binciken sun nuna cewa, a cikin tsofaffi marasa lafiya da ke da karyewar farce ta intertrochanteric, amfani da babban farce mai diamita 10mm ya isa, kuma babu buƙatar yin gyaran fuska fiye da kima, domin har yanzu yana iya samun sakamako mai kyau na aiki.
Lokacin Saƙo: Fabrairu-23-2024
