PFNA (Tsarin ƙusa na Femoral na Mata), Ƙaƙƙarfan ƙusa na ƙusa na intramedullary na kusa.Ya dace da nau'i-nau'i daban-daban na fractures intertrochanteric femoral;subtrochanteric fractures;raguwar tushe na wuyan mace;ƙwanƙwasa wuyan mata tare da ɓangarorin mata;ɓangarorin haɗin gwiwa na femoral haɗe tare da faɗuwar shaft na mata.
Babban fasalin ƙirar ƙusa da fa'idodi
(1) An nuna babban ƙirar ƙusa ta fiye da shari'o'in 200,000 na PFNA, kuma ya sami mafi kyawun wasa tare da tsarin jiki na canal medullary;
(2) kusurwar satar digiri 6 na babban ƙusa don sauƙin sakawa daga kololuwar mafi girma;
(3) Farce mara kyau, mai sauƙin sakawa;
(4) Ƙarshen ƙarshen babban ƙusa yana da ƙayyadaddun ƙayyadaddun ƙusa, wanda ke da sauƙin saka babban ƙusa kuma yana guje wa damuwa.
Karkataccen ruwa:
(1) Ɗaya daga cikin gyare-gyare na ciki a lokaci guda ya kammala anti-juyawa da kuma daidaitawar kusurwa;
(2) Ruwan ruwa yana da babban fili kuma yana haɓaka diamita a hankali.Ta hanyar tuki a ciki da matsawa kashin da aka soke, za'a iya inganta ƙarfin ƙwanƙwasa na helical, wanda ya dace da marasa lafiya tare da karaya;
(3) Gilashin helical yana ƙunshe da ƙashi, wanda ke inganta kwanciyar hankali kuma yana tsayayya da juyawa.Ƙarshen karyewar yana da ƙarfi mai ƙarfi na rugujewa da nakasar varus bayan sha.
Ya kamata a ba da hankali ga abubuwan da ke gaba a cikin maganin raunin femoral tare daGyaran ciki na PFNA:
(1) Yawancin majiyyata tsofaffi suna fama da cututtuka na asali kuma suna da rashin haƙuri ga tiyata.Kafin tiyata, ya kamata a yi la'akari da yanayin gaba ɗaya na majiyyaci.Idan majiyyaci zai iya jure wa tiyatar, sai a yi tiyatar da wuri-wuri, sannan a fara motsa jikin da abin ya shafa da wuri bayan tiyatar.Don hana ko rage faruwar matsaloli daban-daban;
(2) Ya kamata a auna nisa na rami na medullary a gaba kafin aiki.Diamita na babban ƙusa intramedullary shine 1-2 mm ƙarami fiye da ainihin rami na medullary, kuma bai dace da wuri mai tashin hankali ba don guje wa faruwar rikice-rikice irin su fashewar femur;
(3) Mai haƙuri yana kwance, ɓangaren da ya shafa yana tsaye, kuma juyawa na ciki shine 15 °, wanda ya dace don shigar da allurar jagora da babban ƙusa.Isasshen gutsitsi da rufaffiyar raguwar karaya a ƙarƙashin fluoroscopy sune maɓallan samun nasarar tiyata;
(4) Rashin aiki mara kyau na wurin shigarwa na babban allurar jagorar dunƙulewa na iya haifar da toshe babban dunƙule na PFNA a cikin rami na medullary ko kuma matsayin ɓangarorin karkace ya kasance mai girman kai, wanda zai iya haifar da karkatacciyar raguwar karyewa ko raguwar damuwa. na wuyan femoral da kan femoral ta hanyar karkace bayan tiyata, rage tasirin tiyata;
(5) Na'urar X-ray na C-arm ya kamata koyaushe kula da zurfin da eccentricity na allurar jagorar dunƙule ruwa a yayin da ake zazzagewa, kuma zurfin saman saman ya kamata ya zama 5-10 mm ƙasa da farfajiyar guringuntsi. kan femoral;
(6) Don haɗe-haɗe-haɗe-haɗe-haɗe-haɗe ko ɓarkewar ɓarna mai tsayi, ana ba da shawarar yin amfani da PFNA mai tsayi, kuma buƙatar buɗaɗɗen buɗewa ya dogara da raguwar raguwa da kwanciyar hankali bayan raguwa.Idan ya cancanta, ana iya amfani da kebul na ƙarfe don ɗaure shingen karaya, amma zai shafi warkar da karaya kuma ya kamata a kauce masa;
(7) Don tsagawar karaya a saman mafi girma trochanter, aikin ya kamata ya kasance mai laushi kamar yadda zai yiwu don kauce wa ƙarin rabuwa da ɓawon burodi.
Abũbuwan amfãni da iyakancewar PFNA
A matsayin sabon nau'inintramedullary fixation na'urar, PFNA na iya canja wurin kaya ta hanyar extrusion, ta yadda ciki da kuma waje na femur za su iya ɗaukar damuwa iri-iri, don haka cimma manufar inganta kwanciyar hankali da tasiri na ƙayyadaddun ciki na fractures.Tasirin da aka gyara yana da kyau da sauransu.
Aikace-aikacen PFNA kuma yana da ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun bayanai, kamar wahalar sanya dunƙule makullin nesa, ƙara haɗarin karaya a kusa da dunƙule makullin, nakasar coxa varus, da kuma jin zafi a yankin cinya na gaba wanda ya haifar da haushin bandungiyar iliotibial.Osteoporosis, hakaintramedullary gyarawasau da yawa yana da yiwuwar gyarawa gazawar da karaya nonunion.
Sabili da haka, ga tsofaffi marasa lafiya tare da raunin intertrochanteric mara ƙarfi tare da osteoporosis mai tsanani, ba a ba da izinin ɗaukar nauyi da wuri ba bayan shan PFNA.
Lokacin aikawa: Satumba-30-2022
