Dangane da sukurori na kai da wuya, yana amfani da tsarin sukurori biyu na lag da sukurori masu matsewa. Haɗin haɗakar sukurori guda biyu yana ƙara juriya ga juyawar kan femoral.
A lokacin da ake saka sukurin matsewa, motsin axial na sukurin lag yana motsawa ta hanyar zaren da ke tsakanin sukurin matsewa da sukurin lag, kuma matsin hana juyawa yana canzawa zuwa matsi mai layi a ƙarshen karyewa, wanda hakan ke ƙara ƙarfin hana juyawa na sukurin sosai. Yanke aikin. Sukurin guda biyu suna haɗe tare don guje wa tasirin "Z".
Tsarin ƙarshen babban ƙusa mai kama da na haɗin gwiwa yana sa jikin ƙusa ya fi dacewa da ramin medullary, kuma ya fi dacewa da halayen biomechanical na proximal femur.
Matakan Tiyata
Matsayi: Marasa lafiya zai iya zaɓar matsayin gefe ko na baya. Da mara lafiya a kwance, a kan teburin aiki mai amfani da rediyo ko teburin jan hankali na orthopedic. Ana ɗaura gefen lafiya na mara lafiya a kan maƙallin, sannan a ɗaura gefen da abin ya shafa a 10°-15° don sauƙaƙe daidaitawa da ramin medullary.
Sake saitin daidai: Rufe gaɓɓan da abin ya shafa da gadon jan ƙarfe kafin a yi aiki, sannan a daidaita alkiblar jan ƙarfe a ƙarƙashin fluoroscopy don haka gaɓɓan da abin ya shafa su kasance cikin ɗan juyawa na ciki da matsayi na juyawa. Yawancin karyewar za a iya sake saita su da kyau. Sake saitawa kafin tiyata yana da matukar muhimmanci kuma Ma'anar ita ce, kada a yanke shi cikin sauƙi idan babu raguwa mai gamsarwa. Wannan zai iya adana lokacin aiki da rage wahalar yayin aikin. Idan ragewar ta yi wahala, za ku iya yin ƙaramin yankewa yayin aikin kuma ku yi amfani da sandar turawa, mai ja da baya, mai rage ƙarfi, da sauransu don taimakawa ragewar. Ƙananan karyewar an raba ɓangarorin ciki da na waje, kuma babu buƙatar daidaitawa akai-akai. Ana iya sake saita ƙarshen karyewar ta atomatik lokacin da aka murƙushe sukurori na matsewa yayin aikin.
Rage ƙarancin trochanter: Tsarin ƙusa na intramedullary ba ya buƙatar ci gaba da tsakiyar kwakwalwa. Gabaɗaya, babu buƙatar rage ƙaramin ɓangaren karyewar trochanter, saboda aikin rage raguwar da ba ta da tasiri sosai yana da ƙarancin tasiri ga zagayawar jini na ƙarshen karyewar, kuma karyewar tana da sauƙin warkewa. Duk da haka, ya kamata a gyara coxa varus kafin a sanya sukurori, kuma ya kamata a jinkirta lokacin zuwa ƙasa da lokacin ɗaukar nauyi bayan tiyata yadda ya kamata.
Matsayin yankewa: Ana yin yanke mai tsayin santimita 3-5 a ƙarshen babban trochanter a kusa da saman trochanter kusan a matakin kashin baya na gaba. Ana iya sanya wayar Kirschner a gefen waje na mafitar femur, sannan a daidaita ta don ta yi daidai da tsayin axis na femur a ƙarƙashin fluoroscopy na C-arm, don haka wurin da aka yanke ya fi daidai.
Ƙayyade wurin shiga: wurin shiga yana da ɗan tsakiya zuwa saman babban trochanter, wanda yayi daidai da karkacewar gefe 4° na dogon axis na medullary rami akan gaban gani. A gefen gani, wurin shigar ƙusa yana kan dogon axis na medullary rami;
Wurin Shiga Allura
IsakaGuidePin Fduban duban dan tayi
Cikakken Reamed
Tunda ƙarshen ƙusa na InterTan mai kusanci yana da kauri sosai, ana iya saka ƙusa ne kawai bayan an gama gyarawa sosai yayin aikin. Ya kamata a dakatar da gyaran ƙusa lokacin da na'urar takaita aikin haƙa ramin reaming ta taɓa kayan aikin tashar shiga. Ko an gyara ramin femoral na nesa ya dogara da girman ramin medullary. Idan X-ray kafin tiyata ya gano cewa ramin medullary na shaft ɗin femoral mai kusanci a bayyane yake kunkuntar, ya kamata a shirya reamer ɗin shaft ɗin femoral kafin aikin. Idan gyaran bai isa ba, zai sa ya yi wuya a saka sukurori. A lokacin aikin sukurori, yana iya girgiza a cikin ƙaramin kewayon. Ya kamata a guji abubuwan gefe na ƙusa na intramedullary, amma ya kamata a guji buga wutsiyar ƙusa mai ƙarfi. Irin wannan bugun mai ƙarfi na iya haifar da rabuwar ƙashi cikin sauƙi yayin aikin ko sake canza karyewar bayan raguwa.
Saka hannun riga mai laushi na nama, haƙa ramin tare da wayar jagora, sannan a faɗaɗa hanyar kusanci ta femoral don ƙusa ta intramedullary (hoton da ke sama); idan ramin medullary kunkuntar ne, yi amfani da rawar laushi da aka sake gyarawa don faɗaɗa ramin medullary zuwa faɗin da ya dace; haɗa jagorar saka babban ƙusa na InterTAN cikin ramin medullary (a ƙasa);
Pmafi girmaLakwatin gawa
Sanya sukurori na lag
Sanya sukurori na matsawa
Sukule a cikin ƙusa mai kullewa ta nesa
Rmotsin raiLakwatin gawa
Kofin Ƙarshe
Maganin Bayan Tiyata
An yi amfani da magungunan rigakafi akai-akai don hana kamuwa da cuta awanni 48 bayan tiyata; an yi amfani da sinadarin calcium na heparin mai ƙarancin ƙwayoyin halitta da famfunan iska don hana thrombosis na jijiyoyin jini (DVT) a ƙananan gaɓoɓi, kuma an ci gaba da magance cututtukan lafiya na asali. An yi amfani da hotunan rediyo na ƙashin ƙugu da hotunan rediyo na gefen haɗin kugu da abin ya shafa akai-akai don fahimtar rage karyewa da gyara ciki.
A rana ta farko bayan tiyata, an ƙarfafa wa majiyyacin gwiwa ya yi ƙanƙantar quadriceps femoris a matsayin mai lanƙwasa. A rana ta biyu, an umurci majiyyacin ya zauna a kan gado. A rana ta uku, an yi wa majiyyacin motsa jiki na lanƙwasa kugu da gwiwa a kan gado. Babu ɗaukar nauyi a kan gaɓɓan da abin ya shafa. A ƙarfafa majiyyacin da za su iya ɗaukar wani ɓangare na nauyin a kan gaɓɓan da abin ya shafa a cikin tsawon makonni 4 bayan tiyata. A hankali a yi tafiya tare da mai tafiya da mai ɗaukar nauyi bisa ga bin diddigin X-ray a makonni 6 zuwa 8. Marasa lafiya waɗanda ba za su iya tafiya da kansu ba kuma suna da mummunan osteoporosis Ga marasa lafiya da ke ci gaba da girma a ƙashi a kan X-ray, a hankali za su iya tafiya da ɗaukar nauyi a ƙarƙashin tallafi.
Mutumin da ake tuntuɓa: Yoyo (Manajan Samfura)
TEL/Whatsapp: +86 15682071283
Lokacin Saƙo: Mayu-08-2023
