Dangane da screws kai da wuyansa, yana ɗaukar ƙirar dunƙule biyu na lag screws da skru na matsawa.Haɗin haɗin kai na 2 sukurori yana haɓaka juriya ga jujjuya kan femoral.
A lokacin aiwatar da shigar da dunƙule matsawa, motsi na axial na lag dunƙule yana motsawa ta hanyar zaren occlusal tsakanin ɗigon matsawa da lag screw, kuma damuwa na jujjuyawar yana jujjuya zuwa matsa lamba na madaidaiciya akan ƙarshen karaya, ta haka yana haɓakawa sosai. da anti-juyawa ƙarfi na dunƙule.Yanke aikin.Sukullun 2 an haɗa su tare don guje wa tasirin "Z".
Tsarin ƙusa na kusa da babban ƙusa mai kama da na haɗin gwiwa yana sa jikin ƙusa ya fi dacewa tare da rami na medullary, kuma ya fi dacewa da halayen kwayoyin halitta na proximal femur.
Matakan Tiyata
Matsayi: Mai haƙuri zai iya zaɓar matsayi na gefe ko na baya.Tare da majiyyaci a cikin madaidaicin matsayi, akan tebur mai aiki na rediyolucent ko tebur gogayya na orthopedic.An ɗora gefen lafiya na majiyyaci kuma an gyara shi a kan madaidaicin, kuma an sanya gefen da ya shafa 10 ° -15 ° don sauƙaƙe daidaitawa tare da rami na medullary.
Madaidaicin sake saiti: Juya gaɓoɓin da abin ya shafa tare da gadon juzu'i kafin a fara aiki, kuma daidaita hanyar juzu'i a ƙarƙashin fluoroscopy ta yadda ɓangaren da ya shafa ya kasance cikin ɗan jujjuyawar ciki da matsayi.Yawancin karaya za a iya sake saita su da kyau.Sake saitin kafin aiki yana da matukar mahimmanci kuma abin nufi shine, kar a yanke shi cikin sauƙi idan babu ragi mai gamsarwa.Wannan zai iya adana lokacin aiki kuma ya rage wahala yayin aikin.Idan raguwa yana da wuyar gaske, za ku iya yin ɗan ƙarami yayin aiki kuma kuyi amfani da sandar turawa, retractor, raguwa mai ƙarfi, da dai sauransu don taimakawa ragewa.Ƙananan karaya An raba ɓangarorin ciki da na waje, kuma babu buƙatar daidaitawa akai-akai.Za'a iya sake saita ƙarshen karayar ta atomatik lokacin da aka dunƙule dunƙule matsi yayin aiki.
Rage ƙananan maɗaukaki: Tsarin ƙusa na intramedullary baya buƙatar ci gaba da ƙwayar tsakiya.Gabaɗaya magana, babu buƙatar rage ƙaramin ɓarna ƙwanƙwasa, saboda ƙarancin aikin rage ɓoyayyen ɓoyayyiyar ɓarna yana da ƙarancin tasiri akan zagawar jini na ƙarshen karaya, kuma raunin yana da sauƙin warkarwa.Koyaya, yakamata a gyara coxa varus kafin a sanya dunƙule, kuma lokacin zuwa ƙasa da lokacin ɗaukar nauyi ya kamata a jinkirta shi yadda ya kamata.
Matsayin ƙaddamarwa: Ana yin katsewar tsayi na 3-5 cm a kusa da ƙarshen mafi girma na trochanter kusan a matakin babban kashin baya na iliac na gaba.Za a iya sanya waya ta Kirschner a gefen waje na mata na kusa, kuma a daidaita shi don dacewa da tsayin daka na femur a karkashin C-arm fluoroscopy, don haka matsayi na incision ya fi daidai.
Ƙayyade wurin shigarwa: wurin shiga yana ɗan tsaka-tsaki kaɗan zuwa koli na mafi girma trochanter, wanda yayi daidai da 4 ° ɓacin lokaci na tsayin daka na medullary cavity a kan kallon gaba.A kan ra'ayi na gefe, wurin shigar ƙusa yana kan tsayin tsayin daka na medullary cavity;
Wurin Shigar Allura
IsakaGuidePin Fluoroscopy
Cikakken Reamed
Tun da kusancin ƙusa na babban ƙusa na InterTan yana da ɗan kauri, ƙusa za a iya saka shi kawai bayan an gama gama aikin.Ya kamata a dakatar da reaming na kusa lokacin da na'urar ƙuntatawa na rawar motsa jiki ta taɓa kayan aikin tashar shigarwa.Ko an sake gyara ramin femoral na mata ya dogara da girman girman kogon medullary an ƙaddara.Idan X-ray da aka riga aka yi aikin ya gano cewa rami mai zurfi na ramin femoral na kusa yana da kunkuntar, ya kamata a shirya madaidaicin ramin femoral kafin a fara aiki.Idan reaming bai isa ba, zai yi wahala a saka dunƙulewa.A lokacin aiwatar da screwing, yana iya girgiza a cikin ƙaramin kewayon Ya kamata a guji abubuwan da ke gefen ƙusa na intramedullary, amma ya kamata a guji bugun ƙusa mai ƙarfi.Irin wannan ƙwanƙwasawa mai sauƙi na iya haifar da rarrabuwar kashi yayin aiki ko maye gurbin karaya bayan raguwa.
Saka hannun rigar kariyar nama mai laushi, rawar jiki tare da waya mai jagora tare da rawar jiki, da kuma fadada tashar femoral na kusa don ƙusa na intramedullary (a sama hoto);idan rami mai zurfi ya kasance kunkuntar, yi amfani da rawar motsa jiki da aka sake gyara don faɗaɗa kogon medullary zuwa faɗin da ya dace;haɗa jagorar saka babban ƙusa na InterTAN a cikin rami medullary (a ƙasa);
ProximalLokay
Lag dunƙule jeri
Matsi dunƙule jeri
Kulle a cikin ƙusa mai kulle nesa
RzazzagewaLokay
Ƙarshen Kofin
Magani bayan tiyata
An yi amfani da maganin rigakafi akai-akai don hana kamuwa da cuta sa'o'i 48 bayan aikin;An yi amfani da calcium mai ƙananan ƙwayoyin heparin da famfo na iska don hana thrombosis mai zurfi (DVT) a cikin ƙananan sassan, kuma an ci gaba da kula da cututtuka na asali.Hotunan radiyo na fili na ƙashin ƙugu da na baya da na baya da na gefe na haɗin gwiwar hip da aka shafa an dauki su akai-akai don fahimtar raguwar raguwa da gyaran ciki.
A rana ta farko bayan tiyata, an ƙarfafa majiyyaci don yin ƙayyadaddun isometric na quadriceps femoris a cikin matsayi na gaba.A rana ta biyu, an umurci mai haƙuri ya zauna a kan gado.A rana ta uku, mai haƙuri ya yi rawar jiki da motsa jiki a kan gado.Babu wani nau'i mai ɗaukar nauyi akan sashin da abin ya shafa.Ƙarfafa majiyyata masu iya ɗaukar wani ɓangare na nauyi akan gaɓar abin da ya shafa a cikin kewayon jurewa makonni 4 bayan aiki.A hankali tafiya tare da mai tafiya tare da ɗaukar nauyi bisa ga bin X-ray a makonni 6 zuwa 8.Marasa lafiya waɗanda ba za su iya tafiya da kansu ba kuma suna da ciwon osteoporosis mai tsanani Ga marasa lafiya tare da ci gaba da haɓakar ƙira na ƙasusuwa akan X-ray, a hankali za su iya tafiya tare da ɗaukar nauyi a ƙarƙashin tallafi.
Abokin Tuntuɓa: Yoyo (Mai sarrafa samfur)
TEL/Whatsapp: +86 15682071283
Lokacin aikawa: Mayu-08-2023
