I.Kodi ndi cholinga chanji chopangira phula chokhala ndi bowo?
Kodi ma screw system a cannulated amagwira ntchito bwanji? Kugwiritsa ntchito mawaya opyapyala a Kirschner (K-waya) omwe adabowoleredwa mu fupa kuti awongolere zomangira m'mafupa ang'onoang'ono.
Kugwiritsa ntchito mawaya a K kumapewa kubowola kwambiri mabowo oyendetsa ndikulola kukhazikika kwa zidutswa za mafupa zomwe zatsala pang'ono kuyikapo phula. Zida zopanda pake ndi zomangira zopanda pake zimayikidwa mu fupa pamwamba pa mawaya a K. Cannulated screw fixation ndi yothandiza pa khomo lachiberekero kuti akhazikike odontoid fractures komanso kuchiza kusakhazikika kwa atlantoaxial.
Zomangira zam'madzi zili ndi zabwino zingapo poyerekeza ndi zomangira zopanda mafuta: 1) mawaya a K amawongolera malo opangira fupa;
2) K-waya trajectory imapangitsa kuyikanso mosavuta ngati njira yoyambirira sinali yabwino;
3) ma K-waya amalola kukhazikika kosalekeza kwa zidutswa za mafupa osakhazikika;
4) Mawaya a K amalepheretsa kusuntha kwa zidutswa za mafupa osakhazikika pakuyika wononga.
Zovuta zomwe zimagwirizanitsidwa ndi K-waya (kusweka, kuyikanso, ndi kupita patsogolo) zitha kuchepetsedwa pogwiritsa ntchito njira zenizeni zogwirira ntchito. Dongosolo la zida zapadera zomangira zomangira zidapangidwa makamaka kuti khomo lachiberekero lizikhazikike kuti lilole kubowola kopitilira muyeso pogwiritsa ntchito zida zazitali zomangira, ma sheath a minofu, maupangiri obowola, ndi ma K-waya aatali. Zida izi zimalola kubweretsa zomangira zamzitini motsika pang'ono kupita ku msana kudzera munjira zazitali zofewa. Zomangira zam'kanizi zimakhala ndi zabwino zambiri poyerekeza ndi zomangira zosapangana kuti zikhazikitse khosi la khomo lachiberekero losakhazikika pa dongosolo.
II.Ndi ziti zomwe zili bwino zomangira kapena misomali ya intrameduallary?
Misomali yonse ya intramedullary ndi misomali ya cannulated ndi zida zamankhwala zomwe zimagwiritsidwa ntchito kukonza mkati mwa fractures. Aliyense ali ndi ubwino wake ndipo ali oyenera mitundu yosiyanasiyana ya fractures ndi chithandizo chamankhwala.
| Mtundu | Ubwino |
| Msomali wa Intramedullary | Kukhazikika kwa msomali wa intramedullary pamafupa okhazikika a mafupa aatali ndi abwino, osavulazidwa pang'ono komanso magazi ochepa. Intramedullary misomali fixation ndi chapakati fixation. Poyerekeza ndi mbale zachitsulo, misomali ya intramedullary imathanso kuteteza kukhulupirika kwa nembanemba ya extraosseous, kupewa kuchedwa kuchira kwa fracture, ndikuthandizira kupewa matenda. |
| Cannulated Screw | Amagwiritsidwa ntchito makamaka m'madera monga femoral khosi fractures, ndi fixation wapadera ndi psinjika zotsatira. Komanso, zowonongekazo ndizochepa kwambiri ndipo palibe mbale zachitsulo zomwe zimafunikira. |
III.Mungagwiritse ntchito liti zomangira za cancellous vs kortical?
Zomangira zomangira zomangira ndi zomangira zapakhosi ndi mitundu yonse ya zoyika mafupa zomwe zimagwiritsidwa ntchito pokonza fupa, koma zidapangidwira mitundu yosiyanasiyana ya mafupa ndipo zimakhala ndi ntchito zosiyanasiyana:
Cancellous Screws Amapangidwa Mwachindunji kuti agwiritsidwe ntchito mu minofu ya spongy, yochepa kwambiri, komanso ya trabecular, yomwe imapezeka kumapeto kwa mafupa aatali, monga femur ndi tibia.Amagwiritsidwa ntchito m'madera omwe fupa limakhala lopweteka kwambiri komanso lochepa kwambiri, monga madera a metaphyseal a mafupa aatali. Nthawi zambiri amagwiritsidwa ntchito pochiza msana, chiuno, ndi mbali zina za phewa ndi chiuno.
Ma Cortical Screws adapangidwa kuti azigwiritsidwa ntchito mu fupa la deser, cortical, lomwe limapanga gawo lakunja la mafupa ambiri ndipo ndi lolimba komanso lamphamvu kuposa fupa lolephera. Nthawi zambiri amagwiritsidwa ntchito pamene mphamvu zazikulu ndi kukhazikika zimafunikira, monga kukonza zosweka mu diaphysis (tsinde) la mafupa aatali. Amagwiritsidwanso ntchito pazida zina zamkati ndi mbale.
Mwachidule, kusankha pakati pa zomangira za cancellous ndi cortical zimadalira mtundu wa fupa lomwe likukhazikika komanso zofunikira zenizeni za njira ya mafupa. Zomangira zomangira n'zoyenera fupa lofewa, lokhala ndi pobowo, pomwe zomangira za kortical ndizoyenera fupa lolimba, lonyamula katundu.
Nthawi yotumiza: May-09-2025
