A cikin 'yan shekarun da suka gabata, da fitowar ƙwayoyin cuta mai zurfi (phfs) ya karu da sama da 28%, da kuma ragi ta karu sama da 10% a cikin marasa lafiya masu shekaru 65 da haihuwa. Babu shakka, rage yawan kashi kuma ya karu da yawa na faduwa shine manyan abubuwan haɗari a cikin ƙararrawa maza. Kodayake ana samun jiyya iri daban-daban don sarrafa masu gudun hijira ko ba da izini ba, babu wani yarjejeniya game da mafi kyawun hanyar tiyata don tsofaffi. Ci gaban kusurwar faranti ya samar da zaɓin magani don maganin tiyata, amma dole ne a yi la'akari da babban abubuwan har zuwa 40%. Mafi yawan da aka fi sani da aka ruwaito sune rushewar rushe tare da dunƙulewar iska da kuma necrosis (AVN) na Hura.
Rage ragewar ƙwayar cuta, maido da lokacin humadal, da kuma ingantaccen gyaran subcutaneotiotes na dunƙule zai iya rage irin wannan rikice-rikice. Gruction fictiation galibi yana da wuyar cuci saboda ingancin ingancin kashi na wakili ya haifar da osteoporosis. Don magance wannan matsalar, ƙarfafa ƙwararrun keɓaɓɓiyar keɓewa tare da ƙarancin ƙwayar cuta ta hanyar amfani da ƙwayar cuta don inganta ƙarfin ƙarfin.
Binciken na yanzu da nufin kimanta da kuma bincika sakamakon radiographic na phfs da aka bi da faranti da kuma ƙarin ƙwanƙolin sikelin.
Ⅰ.Abu da hanya
Jimlar marasa lafiya 49 suna lalata kwana da kuma ƙarin matsakaicin ciminti don Phfs, kuma an haɗa da marasa lafiya a cikin binciken dangane da haɗa da ƙa'idodi da keɓaɓɓun ƙayyadaddun abubuwa.
An tsara duk phfs 24 ta amfani da tsarin rarrabuwa na HGLS wanda aka gabatar daga Sukthankar da Hertel ta amfani da samfuran Ct wanda ya fi dacewa. Abubuwan da ke bayarwa da hasken ruwa da kuma bayanan radioogram ɗin da ke bayyane. An yi la'akari da isticancin ragin karaya da aka ɗauka lokacin da tuberorarfin kai wanda aka sake rage kuma ya nuna ƙasa da 5 mm na rata ko fitarwa. An bayyana nakasar dadewa a matsayin karkatar da Humemeral kai dangi zuwa ga tsattsauran tsattsauran ra'ayi na ƙasa da 145 ° da nakasar nakasar da aka ayyana fiye da 145 °.
An ayyana firstration penetration kamar yadda murfin tarko ya wuce iyakar medullary cortex na kai. Sakandare na sakandare an ayyana shi azaman gudun hijira na rage karar fiye da 5 mm da / ko canji fiye da 15 ° a kusurwar fageograograograography na kai.
Dukkanin harkar da aka yi ta hanyar babban tsarin gudanarwa. Rage ragin karaya da farantin suna ne a cikin daidaitaccen tsari. Club-CERENment tuki wanda aka yi amfani da 0.5 ml na ciminti don ƙwanƙwasa ƙirar dunƙule.
An yi impritilation da ba shi da izini a cikin swing na raba mutum don kafada na makonni 3. A farkon m motsi da kuma taimaka m motsi tare da zafi turulation an fara kwanaki 2 don cimma cikakken kewayon motsi (ROM).
Ⅱ.Sakamakon.
Sakamako: An hada marasa lafiya ashirin, tare da shekaru 77.5 shekaru (Range, shekaru 62-96). Ashirin da ɗaya sun kasance mata da uku namiji. Rarraba guda biyu, 12-sashen rabuwa, 12 3-sashen rabuwa, da bakwai-sashi na bakwai an bi da farfadowa da sikila da kuma ƙarin haɓaka sikelin. Uku daga cikin karar 24 na tsummoki na humeral mai rauni. Rage Anatomic ya samu a cikin shekaru 12 na 24; Cikakken rage ragin medial cortex an samu a cikin 15 na marasa lafiya 24 (62.5%). A watanni 3 bayan tiyata, 20 daga cikin marassaaya 21 (95.2%) sun sami haɗin karaya, ban da marasa lafiya guda 3 waɗanda suke buƙatar tiyata da aka bi da su.
Isaya daga cikin mai haƙuri ya haɓaka fitowar simintin sati na farko) yanki mai humeral) 7 makonni bayan tiyata. An yi bita tare da sake juyawa kafada kafada 3 watanni bayan tiyata. Farkon tsinkayen da ya kunshi saboda karancin sumunti ciminti (ba tare da manyan lalacewa na haɗin gwiwa ba) yayin yin ajiyar zuciya na ciki. An gano shigarwar ido a cikin C Layer na kusancin farantin a cikin marasa lafiya 2 da kuma a cikin e na Layer a wani (fig. 3). 2 daga cikin waɗannan marasa lafiya na gaba ɗaya daga baya haɓaka necrosis na Avascrosis na Avascrosis (AVN). Marasa lafiya sunada zagi bi da tiyata saboda ci gaban AVN (Tables 1, 2).
Ⅲ.Tattaunawa.
Mafi yawan abubuwan da aka fi sani a cikin karaya na Proximal (PHFs), banda karkatar da necrosis na AVASCrosis tare da gurbataccen karye mai zuwa na humeral. Wannan binciken ya gano cewa girke-girke na ciminti ya haifar da ƙimar ƙungiyar 95.2% a cikin watanni 3.7%, da adadin 16.7% na lissafin 16.7%. CEMINTINMENTSATIHAR RUWAN SULUSHE CIKIN CIKIN SAUKI NA 4.2% Ba tare da rushewar karaya ba, wanda yake kadan ne idan aka kwatanta da na al'ada farantin farantin al'ada. Muna bayar da shawarar karfi cewa za a yi kokarin don cimma isasshen isasshen ragi, musamman na medial cortex a cikin farantin farantin phfs. Ko da ana amfani da ƙarin ƙwanƙen ƙwanƙwasawa ta dunƙulen dunƙulen dunƙulen dunƙule, an san sananniyar ƙa'idodin gajiyayyu.
Matsakaicin bita na 16.7% ta amfani da Tukwarin Tukwalinta na dunƙule a cikin yankin da aka buga a cikin tsofaffin yawan al'adu daga cikin 13% zuwa 28%. Babu jira. Mai yiwuwa, binciken da aka ba da izini, wanda Hengg Et et al. bai nuna amfanin ciminti ba. Daga cikin dukkan marasa lafiya 65 waɗanda suka kammala biyun na shekaru 1, gazawar injiniyan ya faru a cikin marasa lafiya 9 da kuma rukunin keɓaɓɓun. Avn an lura a cikin marasa lafiya 2 (10.3%) kuma a cikin marasa lafiya 2 (5.6%) a cikin rukunin da ba su inganta ba. Gabaɗaya, babu wani mahimman bambance-bambance a cikin abin da ya faru na mummunan abin aukuwa da kuma sakamakon asibiti tsakanin rukunoni biyu. Kodayake waɗannan nazarin da aka mayar da hankali kan cutar asibiti da rediyo, ba su kimanta radiographs a cikin cikakken bayani kamar wannan binciken ba. Gabaɗaya, rikice-rikice na radioolically sun yi kama da waɗanda suke cikin wannan binciken. Babu wani daga cikin wadannan binciken da aka ruwaito yaduwar siminti na cutar kansa, ban da binciken ta hanyar Hengg et al., Wa ya lura da wannan mummunar aukuwa a cikin haƙuri ɗaya. A cikin binciken yanzu, an lura da famare ta farko a matakin c da sau ɗaya a matakin E, tare da zurfin sarkin E, tare da zurfin sarkin E, tare da jerin gwanon hankali na e, tare da makasudin bincike mai zuwa ba tare da wani mahimmancin asibiti ba. Bambancin kayan da aka allura ƙarƙashin ikon sarrafa wutar lantarki kafin a shafi ƙarin tsintsaguni a kowace dunƙule. Koyaya, ra'ayoyi na rediyo daban-daban a mukamai daban-daban daban-daban ya kamata a yi kuma kimanta a hankali don yin mulkin kowane firam na farko da aikace-aikacen. Bugu da ƙari, maganin ciminti a matakan c (Slo Dandalin Digorration na C (Slo Dandalin Dubawa) ya kamata a guji saboda haɗarin babban dunƙule da shigar kunnen kunshin wuta da kuma masu zuwa ciminti. Cement dunƙule tip tanti ba a bada shawarar a cikin marasa lafiya da humader kai mai rauni don intraarticular zurfafawa lura a cikin cutar karaya (lura a cikin marasa lafiya).
Vi. Kammalawa.
A cikin lura da phfs tare da faranti na kusurwa ta amfani da dabarar PMMA ta amfani da dabarar tanki mai ban sha'awa ga kashi 4.2% a cikin marasa lafiyar secleoporotic. Idan aka kwatanta da abubuwan da ake ciki, ana ƙara fitar da ƙwayar cututtukan avascular necrosis na AVASCURESS mai tsananin rauni kuma wannan dole ne a la'akari da shi. Kafin aikace-aikacen sumunti, dole ne a cire kowane ƙwayar ciminti na ciki ta hanyar bambanci da ƙanƙantar yanayi. Saboda babban hadarin da ke cikin tsinkaye a cikin humama rauni, ba mu bayar da shawarar ciminti dunƙu da girma a wannan karaya.
Lokaci: Aug-06-2024
