Amsar wannan tambayar ita ce babu wani karyewar diddige da ke buƙatar dashen ƙashi yayin da ake gyara ciki.
Sanders ya ce
A shekarar 1993, Sanders da abokan aikinsa [1] sun buga wani muhimmin tarihi a tarihin maganin tiyata na karyewar kashin baya a cikin CORR tare da rarrabuwar kashin baya bisa tushen CT. Kwanan nan, Sanders da abokan aikinsa [2] sun kammala da cewa babu buƙatar dashen ƙashi ko faranti na kullewa a cikin karyewar diddige 120 tare da dogon lokaci na shekaru 10-20.
Nau'in CT na karyewar diddige wanda Sanders da abokan aikinsa suka buga a cikin CORR a shekarar 1993.
Dashen ƙashi yana da manyan manufofi guda biyu: dashen tsarin don tallafawa injina, kamar a cikin fibula, da kuma dashen granular don cikewa da haifar da osteogenesis.
Sanders ya ambaci cewa kashin diddige ya ƙunshi babban harsashin cortical wanda ke rufe ƙashin cancellous, kuma cewa karyewar ƙashin diddige da aka canza daga cikin ƙashin diddige za a iya sake gina shi da sauri ta hanyar ƙashin cancellous tare da tsarin trabecular idan za a iya sake saita harsashin cortical. Palmer et al [3] su ne farkon waɗanda suka ba da rahoto game da dashen ƙashi a 1948 saboda rashin na'urorin gyara na ciki masu dacewa don kiyaye karyewar saman ƙashi a wurin a wancan lokacin. Tare da ci gaba da haɓaka na'urorin gyara na ciki kamar faranti da sukurori na baya, tallafin kula da ragewa ta hanyar dashen ƙashi ya zama ba dole ba. Nazarin asibiti na dogon lokaci ya tabbatar da wannan ra'ayi.
Binciken da aka gudanar a asibiti ya kammala da cewa dashen ƙashi ba dole ba ne
Longino da abokan aikinsa [4] da sauransu sun gudanar da wani bincike mai zurfi kan karyewar diddige guda 40 da suka ɓace tare da aƙalla shekaru 2 na bin diddiginsu kuma ba su sami wani bambanci mai mahimmanci tsakanin dashen ƙashi da rashin dashen ƙashi dangane da hoton ko sakamakon aiki ba. Gusic da abokan aikinsa [5] sun gudanar da wani bincike mai zurfi kan karyewar diddige guda 143 da suka ɓace tare da sakamako iri ɗaya.
Singh da abokan aikinsa [6] daga Mayo Clinic sun gudanar da wani bincike na baya-bayan nan kan marasa lafiya 202 kuma duk da cewa dashen ƙashi ya fi kyau dangane da kusurwar Bohler da lokacin ɗaukar nauyinsa, babu wani bambanci mai mahimmanci a cikin sakamakon aiki da rikitarwa.
Dashen ƙashi a matsayin abin da ke haifar da rikice-rikicen rauni
Farfesa Pan Zhijun da tawagarsa a Asibitin Likita na Biyu na Zhejiang sun gudanar da wani bincike mai tsari da kuma nazarin meta-analysis a shekarar 2015 [7], wanda ya haɗa da dukkan littattafan da za a iya samowa daga bayanan lantarki kamar na shekarar 2014, ciki har da karaya 1651 a cikin marasa lafiya 1559, kuma sun kammala da cewa dashen ƙashi, ciwon suga, rashin sanya magudanar ruwa, da kuma karaya mai tsanani yana ƙara haɗarin rikitarwa bayan tiyata.
A ƙarshe, ba lallai ba ne a dasa ƙashi yayin gyara karyewar diddige a cikin jiki kuma baya taimakawa ga aiki ko sakamako na ƙarshe, amma yana ƙara haɗarin rikitarwa masu rauni.
1.Sanders R, Fortin P, DiPasquale T, da sauransu. Maganin tiyata a cikin karaya 120 da aka cire daga cikin ƙashin ƙashi. Sakamakon amfani da tsarin tantancewar hoto mai ƙididdigewa. Clin Orthop Relat Res. 1993;(290):87-95.
2.Sanders R, Vaupel ZM, Erdogan M, da sauransu. Maganin tiyata na karyewar ƙashin ƙashi a cikin jijiyoyin jini: na dogon lokaci (Shekaru 10-20) yana haifar da karyewar ƙashi 108 ta amfani da tsarin CT na hasashen yanayi. J Orthop Trauma. 2014;28(10):551-63.
3. Palmer I. Tsarin da kuma maganin karyewar ƙashin ƙashi. J Bone Joint Surg Am. 1948;30A:2–8.
4.Longino D, Buckley RE. Dashen ƙashi a cikin maganin tiyata na karyewar ƙashin ƙashi a cikin jijiyoyin jini: shin yana da amfani? J Orthop Trauma. 2001;15(4):280-6.
5.Gusic N, Fedel I, Darabos N, da sauransu. Maganin tiyata na karyewar ƙashin ƙashi a cikin ƙashin ƙugu: Sakamakon jiki da aiki na dabarun tiyata guda uku daban-daban. Raunin. 2015;46 Kayayyaki 6:S130-3.
6.Singh AK, Vinay K. Maganin tiyata na karyewar ƙashi a cikin ƙashin ƙugu: Shin dashen ƙashi ya zama dole? J Orthop Traumatol. 2013;14(4):299-305.
7. Zhang W, Chen E, Xue D, da sauransu. Abubuwan da ke haifar da matsalolin rauni na karyewar kashin baya bayan tiyata: bita mai tsari da kuma nazarin meta-analysis. Scand J Trauma Resusc Emerg Med. 2015;23:18.
Lokacin Saƙo: Disamba-07-2023
