Intertrochanteric fractures na femur lissafi na 50% na raunin hip a cikin tsofaffi.Maganin ra'ayin mazan jiya yana da wuyar haifar da rikitarwa irin su thrombosis mai zurfi, ciwon huhu, ciwon huhu, da cututtuka na huhu.Adadin mace-mace a cikin shekara guda ya wuce kashi 20%.Sabili da haka, a cikin lokuta inda yanayin jiki na mai haƙuri ya ba da izini, ƙaddamarwa na farko na tiyata na ciki shine mafi kyawun magani don fractures intertrochanteric.
Intramedullary ƙusa na ciki a halin yanzu shine ma'aunin zinare don maganin karaya ta intertrochanteric.A cikin nazarin abubuwan da ke tasiri gyare-gyaren ciki na PFNA, an ba da rahoton abubuwa kamar tsayin ƙusa na PFNA, kusurwar ɓarna, da ƙira a cikin yawancin binciken da suka gabata.Duk da haka, har yanzu ba a san ko kauri na babban ƙusa ya shafi sakamakon aiki ba.Don magance wannan, malaman kasashen waje sun yi amfani da kusoshi na intramedullary tare da tsayi daidai amma kauri daban-daban don gyara raunin intertrochanteric a cikin tsofaffi (shekaru> 50), da nufin kwatanta ko akwai bambance-bambance a cikin sakamakon aiki.
Binciken ya haɗa da shari'o'i 191 na raunin intertrochanteric guda ɗaya, duk an bi da su tare da gyaran ciki na PFNA-II.Lokacin da ƙaramin trochanter ya karye kuma ya ware, an yi amfani da ɗan gajeren ƙusa 200mm;lokacin da ƙaramin mashin ɗin ya kasance cikakke ko bai ware ba, an yi amfani da ƙusa gajere 170mm.Diamita na babban ƙusa ya kasance daga 9-12mm.Babban kwatancen da aka yi a cikin binciken ya mayar da hankali kan abubuwa masu zuwa:
1. Ƙananan nisa, don tantance ko matsayi daidai ne;
2. Dangantaka tsakanin tsaka-tsakin tsaka-tsakin tsaka-tsaki na guntun wuyan kai da raguwa mai nisa, don kimanta ingancin raguwa;
3. Tip-Apex Distance (TAD);
4.Nail-to-canal ratio (NCR).NCR shine rabon babban diamita na ƙusa zuwa diamita na canal na medullary akan jirgin dunƙule na nesa.
Daga cikin marasa lafiya 191 da aka haɗa, an nuna rarraba lokuta dangane da tsayi da diamita na babban ƙusa a cikin adadi mai zuwa:
Matsakaicin NCR ya kasance 68.7%.Amfani da wannan matsakaita a matsayin bakin kofa, an yi la'akari da shari'o'in da ke da NCR mafi girma fiye da matsakaicin matsakaicin babban diamita mai kauri, yayin da masu NCR kasa da matsakaita ana la'akari da su suna da mafi girman diamita na ƙusa.Wannan ya haifar da rarrabuwa na marasa lafiya a cikin rukunin Babban Nail na Thick (harsashi 90) da kuma rukunin ƙusa na bakin ciki (101 lokuta).
Sakamakon ya nuna cewa babu wani bambance-bambance a cikin ƙididdiga tsakanin ƙungiyar Babban ƙusa mai kauri da kuma rukunin Babban Nail na bakin ciki dangane da Tip-Apex Distance, maki Koval, jinkirin adadin waraka, ƙimar sake aiki, da rikice-rikice na orthopedic.
Mai kama da wannan binciken, an buga labarin a cikin "Journal of Orthopedic Trauma" a cikin 2021: [Title of the Article].
Binciken ya haɗa da 168 tsofaffi marasa lafiya (shekaru> 60) tare da raunin intertrochanteric, duk an bi da su tare da kusoshi na cephalomedullary.Dangane da diamita na babban ƙusa, an raba marasa lafiya zuwa rukuni na 10mm da rukuni tare da diamita fiye da 10mm.Sakamakon ya kuma nuna cewa babu wani bambance-bambance na ƙididdiga a cikin ƙimar sake aiki (ko dai gabaɗaya ko mara cutar) tsakanin ƙungiyoyin biyu.Marubutan binciken sun ba da shawarar cewa, a cikin tsofaffi marasa lafiya tare da fashewar intertrochanteric, yin amfani da ƙusa babba na diamita na 10mm ya isa, kuma babu buƙatar wuce gona da iri, saboda har yanzu yana iya samun kyakkyawan sakamako na aiki.
Lokacin aikawa: Fabrairu-23-2024
