Kumayambiriro kwa m'ma 1990, akatswiri akunja adatsogolera pogwiritsa ntchito zingwe zofufumitsa kuti akonzere zojambula monga vatotor cuff pansi pa arthroscopy. Chiphunzitsocho chidachokera ku chinthu pansi panthaka "kumira" ku South Trade Texas, USA, ndiye kuti, nyumba yobisaliratu idakhazikika pa waya wachitsulo.
Mankhwala olimbitsa thupi adachokera ku zotupa za Orthopedic. Ndi njira yofunikira kwambiri komanso yamankhwala yokwanira yamankhwala ndi masewera. Cholinga ndikukwaniritsa kukonza kokwanira ndi zoopsa zochepa, kuphatikizapo kuvulala kochepa, kuvulala kwamphamvu, kuvulaza mapewa, etc. onse ali mkati mwa chithandizo chamankhwala chamankhwala
Nangula ndi chipangizochi chamankhwala chomwe chimagwiritsidwa ntchito kawirikawiri pamankhwala olimbitsa thupi ndi opaleshoni. Zimagwiritsidwa ntchito makamaka kukonza minofu yofewa (monga ma sundon, zingwe, ndi zina) mpaka mafupa olimbikitsa machiritso ndikuchira. Anars nthawi zambiri amapangidwa ndi zida za Biocamlamlandarefied kuti atsimikizire chitetezo komanso kukhazikika m'thupi.
Malinga ndi gulu la anchors, pali magulu awiri akulu: Anchiodergrad chinsalu ndi mangusi okhazikika.
Zipangizo zazikulu za ana osakhazikika ndi Titanium, Nickel-Titanial Clonium, chitsulo chosapanga dzimbiri, titaniaum ndi poly lactic acid; Nthambi zambiri zogwiritsidwa ntchito pochita zachipatala zimapangidwa ndi zida zachitsulo, zomwe zimakhala ndi zabwino zokhala ndi mphamvu, zosavuta kuwunika komanso kuwunika kwa X.
Zipangizo zazikuluzikulu za ansaidergrad chilengedwe ndi poly-lactic acid, polyglyc acid, polyglycolic acid, etc. Kufanizira ndi zingwe zosavuta kubwereza, komanso zotheka. Amathanso kugwiritsidwa ntchito kwa ana.
Zida zazikulu za mangulu
1. Ankhandwe achitsulo
• Zipangizo: Makamaka zida zachitsulo monga Titanium alnoy.
• Makhalidwe: Mphamvu zamphamvu komanso zolimba, zimatha kupereka kusinthasintha. Komabe, kulingalira zakale zitha kuchitika ndipo pamakhala chiopsezo chochokera.
2. Ankhandwe
• Zipangizo: Zomwe zida zopatsa chidwi monga polylactic acid (plalla).
• Maonekedwe: Pang'onopang'ono kuwonongeka m'thupi, palibe opaleshoni yachiwiri yomwe ndiyofunika kuchotsa. Komabe, kuchepa kwa kusakhazikika kumatha kukhala osakhazikika, ndipo mphamvu ya kusintha imachepa pakapita nthawi.
3. Polytheretherone (peek) nangula
• Zipangizo: ma polima-oyendetsa boti monga polytheretherone.
• Mawonekedwe: amapereka mphamvu zapamwamba zamisomali komanso mphamvu zamakina, pomwe kukhala ndi zinthu zabwino komanso zolingalira zabwino.
4. Nangula-sutire
• Kuphatikizidwa: makamaka kupangidwa ndi njerwa, nangula ndi mkwiyo.
• Mawonekedwe: ochepa kwambiri kukula, zofewa pakupanga mawonekedwe, oyenera mikhalidwe yomwe unyinji wa Natime udatayika kapena malo owoneka bwino.
Malinga ndi mawonekedwe a zingwe, amatha kugawidwa m'magulu awiri: mangungu ozungulira komanso osasunthika (monga soture) manguti:
1.
Anchirs ogwedezeka ndi mitundu ya zipembedzo, yodziwika ndi gawo la suture yolumikizidwa ndi mchira wa nangula. Adokotala akuyenera kupititsa minyewa yofewa ndi singano ndikumangirira mfundo kuti akonze minofu yofewa ku nangula, ndiye kuti, fupa.
• Zinthu: Zingwe zomata nthawi zambiri zimapangidwa ndi zida zosayankhidwa (monga Tinium anoy) kapena zida zokongola (monga polylactic acid).
• Imagwiritsira ntchito: Nangur imakhazikika m'fupa kudzera pamapiko ozungulira kapena mapiko okumbika, pomwe kutulutsa kofewa kumalumikizana ndi mawonekedwe a nangula, ndipo mawonekedwe okhazikika amapangidwa pambuyo pomanga mfundo.
• Ubwino ndi zovuta: Ubwino wa mangusi ogwedezeka ndikuti kusintha kosintha kuli kodalirika komanso koyenera kuvulaza mitundu yofewa ya minofu. Komabe, njira yosinthira imatha kuwonjezera zovuta ndi nthawi yogwiritsira ntchito, ndipo kukhalapo kwa mfundoyo kungayambitse kukwiya kwa komweko, kumawonjezera chiopsezo cha kusweka kwa malo kapena ma angur kumasula.
2. Ndenga za Route
Ndenganga zopanda pake, makamaka zikuluzikulu zodzitchinjiriza, ndi mtundu watsopano wa nanyari yemwe wayambitsidwa m'zaka zaposachedwa. Khalidwe lake ndi kuti nangula wonse umapangidwa ndi ma soture, ndipo mawonekedwe ofewa amatha kuwonongeka popanda kukakamiza mfundo.
• Zipangizo: zingwe zokwanira nthawi zambiri zimagwiritsa ntchito zida zofewa komanso zamphamvu, monga kulemera kwamphamvu kwa polyethylene (ulusi wa UHMWPE).
• Imagwiritsira ntchito: zingwe zodzaza ndi zotupa zimatha kuphatikizidwa mwachindunji mu mafupa a mafupa kudzera mwa njira zawo zapadera ndi njira yolowera, pomwe mukugwiritsa ntchito kusamvana kwa zofewa mpaka pamafupa. Popeza palibe chifukwa chomangirira mfundo, zovuta ndi nthawi yochita opareshoni imachepetsedwa, ndipo chiopsezo choletsa kuswa ndi ma nangula kumasulira kumachepetsedwanso.
• Ubwino ndi zovuta: Ubwino wa mangulu athunthu ndi osavuta opaleshoni, kusintha kodalirika komanso kuwonongeka pang'ono kwa minofu yofewa. Komabe, chifukwa cha kapangidwe kake chapadera, zimakhala ndi njira zapamwamba zamaukadaulo ndi malo osokoneza bongo. Kuphatikiza apo, mtengo wa zingwe zokwanira kungakhale wokwera kwambiri, zomwe zimawonjezera katundu wazachuma kwa odwala.
Anthambi amagwiritsidwa ntchito kwambiri pamasewera osiyanasiyana, monga vatitor cuff, tendon, malo oyambiranso ku opaleshoni pogwiritsa ntchito mbivators kukonza cuff cuff kukonza,
• Masitepe Opaleshoni: Choyamba, adotolo adzayeretsa ndikukonza malo ovulala; Kenako, ikani nangula pamalo oyenera; Kenako, gwiritsani ntchito kusakhazikika kukonza vatitor cuff minofu kupita ku nangula; Pomaliza, sutire ndi bandeji.
• Zochita Zochita Zochita: Kuyambira pakukhazikika kwa nangula, kukhazikika ndi ntchito ya cuttor cuff minofu ikhoza kubwezeretsedwa, kulimbikitsa wodwalayo.
Ubwino, Zovuta ndi Zosintha za Anchors
Ubwino
• Kukhazikitsa kokhazikika.
• Imagwira ntchito pamitundu yofewa ya minofu.
• Nyungulu ina imatha ndipo safuna kuchitidwa opaleshoni yachiwiri yochotsa.
Zovuta
• Ananthwe achitsulo amatha kubweretsa zojambulajambula.
Kuwonongeka kwa zingwe zotsekemera kumakhala kosakhazikika.
• Pali chiopsezo cha kusinthika kwa nangula kapena kuphwanya kosungunuka.
Zingwe zamankhwala zimagwiritsidwa ntchito pazochita izi:
1.
2. Misozi yama dikals imang'ambika: misozi yoyambitsidwa ndi mayendedwe osiyanasiyana, thirakiti, zokhudza, etc. zitha kuthandizidwa ndi ma angula. Ndezi ziwiri zimayikidwa m'manda okwereza, ndipo waya wa mchira umasinthidwa ku chitsa cha biceps.
3.. Chifukwa cha kuvulala kophatikizika, akatswiri ena ambiri amakonda chithandizo choyambirira. Njira ya waya inchor imagwiritsidwa ntchito popukutira fupa pomwe izi zimaphatikizidwa. Pambuyo potuluka magazi atsopano, nangulayo amasambitsidwa mu fupa pomwe pomwe ligi imaphatikizidwa, ndipo waya wokwiririka kumapeto kwa msomali umagwiritsidwa ntchito kuluka ku chitsa cha kufinya ndikuungulitsa singano.
4. Kuwonongeka kwa chophatikizika cha ligamenting Ligamer: ACLOOR CRUCUNCHORING (ACL) Tibial Lovement Studion fracture ndi kuvulala kwapadera kwa ACL ndipo iyenera kukonzedwa molawirira. Kugwiritsa ntchito njira ya waya ku Anchor kuli ndi zisonyezo zingapo ndipo sikungokhala ndi kukula kwa kachidutswa kakang'ono. Sizimafuna kuti ma fluoroscopy a fluoroscopy kuti asinthe malangizo a screw. Opaleshoniyo ndi yosavuta komanso nthawi ya opareshoni imafupikitsidwa.
5.Patellar kusakhazikika: kumachitika chifukwa cha zonyansa komanso zosakwanira zoletsa minofu. Ophunzira ambiri amalimbikitsa othandizira opaleshoni pogwiritsa ntchito zingwe za waya.
6. Poika patellar inrir torcrature ndi kuluka ndi kukweza miyendo ya pa Patror, kukhulupirika kwa bondo kumatha kubwezeretsedwa komanso kothandiza kutalika kwa mabowo owonjezera mphamvu.
7..
Kusamalitsa
• Mphamvu ya wodwalayo komanso kapangidwe ka opaleshoni yopangira opaleshoni iyenera kuyesedwa kwathunthu asanachitidwe.
• Sankhani mtundu woyenera wa nangula ndi zolembera kuti zitsimikizire zowawa.
• Kuchita masewera olimbitsa thupi koyenera kuyenera kuchitidwa pambuyo pa opaleshoni yolimbikitsa machiritso ndikubwezeretsa ntchito.
Mwachidule, anchors amatenga gawo lofunikira mu zamasewera zamasewera. Posankha mtundu woyenera wa nangula ndi zolembera ndi kutsatira njira zopangira zopangira opaleshoni ndi kusamala, zopangira opaleshoni zitha kutsimikiziridwa kutsimikizika ndipo kulephera kwa wodwalayo kungalimbikitsidwe.
Post Nthawi: Disembala-17-2024
