Chotsekera mbale ndi chipangizo chokhazikika chophwanyika chokhala ndi dzenje la ulusi.Pamene wononga ndi mutu wa ulusi ikulungidwa mu dzenje, mbaleyo imakhala (screw) angle fixation device.Zitsulo zokhoma (zokhazikika) zimatha kukhala ndi zibowo zotsekera komanso zosatsekera zomangira zomangira zosiyanasiyana (zomwe zimatchedwanso zitsulo zophatikizika).
1.Mbiri ndi chitukuko
Ma mbale otsekera adayambitsidwa pafupifupi zaka 20 zapitazo kuti agwiritsidwe ntchito pa maopaleshoni a msana ndi maxillofacial.Chakumapeto kwa zaka za m'ma 1980 ndi 1990, kafukufuku woyesera pamitundu yosiyanasiyana ya zida zopangira mkati adayambitsa mbale zokhoma pochiza fractures.Njira yokhazikika yotetezedwayi idapangidwa poyambirira kuti ipewe kufalikira kwa minofu yofewa.
Zinthu zingapo zalimbikitsa kugwiritsa ntchito mbale iyi, kuphatikiza:
Chiwopsezo cha fractures comminuted chikupitiriza kuwonjezeka pamene chiwerengero cha kupulumuka chikuwonjezeka kwa odwala omwe ali ndi kuvulala kwamphamvu kwambiri ndipo chiwerengero cha odwala okalamba omwe ali ndi matenda a mafupa akuwonjezeka ku Western Europe ndi North America.
Madokotala ndi odwala sakhutira ndi zotsatira za chithandizo cha fractures zina za periarticular.
Zina zomwe sizili zolimbikitsa zachipatala zingaphatikizepo: kulimbikitsa kwamakampani kwa matekinoloje atsopano ndi misika yatsopano;kutchuka kwapang'onopang'ono kwa maopaleshoni ochepa kwambiri, ndi zina zotero.
2.Makhalidwe ndi mfundo zokhazikika
Kusiyana kwakukulu kwa biomechanical pakati pa mbale zokhoma ndi mbale zachikhalidwe ndikuti zotsirizirazi zimadalira kukangana kwa fupa-mbale mawonekedwe kuti amalize kukanikizana kwa fupa ndi mbale.
Zowonongeka za biomechanical za mbale zachitsulo zachikhalidwe: compress periosteum ndikukhudza magazi mpaka kumapeto kwa fracture.Choncho, chikhalidwe chokhazikika mbale osteosynthesis (monga interfragmentary psinjika ndi zomangira lag) ali ndi mlingo wovuta kwambiri, kuphatikizapo matenda, mbale kuthyoka, kuchedwa mgwirizano, ndi nonunion.
Pamene axial load cycle ikuchulukirachulukira, zomangira zimayamba kumasuka ndikupangitsa kuti kukangana kuchepe, ndikupangitsa kuti mbaleyo isungunuke.Ngati mbaleyo imamasula chipolopolocho chisanachiritse, mapeto ake amatha kukhala osakhazikika ndipo pamapeto pake mbaleyo idzasweka.Chomwe chimakhala chovuta kwambiri kupeza ndi kusunga zitsulo zolimba (monga metaphysis ndi osteoporotic bone ends), zimakhala zovuta kwambiri kuti mukhalebe okhazikika kumapeto kwa fracture.
Mfundo yokhazikika:
Zotsekera mbale sizidalira kukangana pakati pa mawonekedwe a mafupa-mbale.Kukhazikika kumasungidwa ndi mawonekedwe aang'ono okhazikika pakati pa wononga ndi mbale yachitsulo.Chifukwa chokhoma chotsekera chamkati chotere chimakhala ndi kukhulupirika kokhazikika, mphamvu yokoka ya zomangira zotsekera ndizokwera kwambiri kuposa zomangira wamba.Pokhapokha ngati zomangira zonse zozungulira zitatulutsidwa kapena kuthyoledwa, zimakhala zovuta kuti wononga kapena kuthyoka chokha.
3. Zizindikiro
Ma fractures ambiri omwe amachitidwa opaleshoni safuna kukonza mbale zokhoma.Malingana ngati mfundo za opaleshoni ya mafupa zimatsatiridwa, fractures zambiri zimatha kuchiritsidwa ndi mbale zachikhalidwe kapena misomali ya intramedullary.
Komabe, palinso mitundu ina yapadera ya fractures yomwe imakonda kuchepetsedwa, kusweka kwa mbale kapena kusweka, ndi kusagwirizana kwa mafupa.Mitundu iyi, yomwe nthawi zambiri imatchedwa "zosasinthika" kapena "vuto" zosweka, zimaphatikizapo fractures ya intra-articular comminuted, periarticular short bone fractures, ndi osteoporotic fractures.Kuthyoka koteroko ndizizindikiro zokhoma mbale.
4. Ntchito
Kuchulukirachulukira kwa opanga akuperekanso mbale za anatomical zokhala ndi mabowo otsekera.Mwachitsanzo, mbale zowoneka bwino za anatomic za proximal ndi distal femurs, proximal ndi distal tibias, proximal ndi distal humerus, ndi calcaneus.Mapangidwe a mbale yachitsulo amachepetsa kukhudzana pakati pa mbale yachitsulo ndi fupa nthawi zambiri, potero kusunga magazi a periosteal ndi kutsekemera kwa mapeto a fracture.
LCP (kutsekera mbale yopondera)
Pulatifomu yotsekera yotsekera imaphatikiza matekinoloje awiri osiyana kwambiri amkati kukhala implant imodzi.
LCP itha kugwiritsidwa ntchito ngati mbale yopondereza, chotsekera chamkati, kapena kuphatikiza ziwirizi
Zosokoneza pang'ono:
Kuchulukirachulukira kwa mbale zokhoma kumakhala ndi zogwirira zakunja, zogwirizira, ndi mapangidwe osamveka bwino omwe amalola madokotala kuyika mbaleyo mocheperako kapena mocheperapo kuti angowononga pang'ono.
Ngati mukufuna kudziwa zamalonda athu, lemberani:
Yoyo
Whatsapp/Tel: +86 15682071283
Nthawi yotumiza: Sep-25-2023
