"Pa kusweka kwa khosi la femoral komwe sikuli kwa okalamba, njira yodziwika kwambiri yolumikizira mkati ndi kasinthidwe ka 'inverted triangle' yokhala ndi zomangira zitatu. Zomangira ziwiri zimayikidwa pafupi ndi ma cortices akunja ndi kumbuyo kwa khosi la femoral, ndipo screw imodzi imayikidwa pansi. Pakuwonera kutsogolo, zomangira ziwiri zoyandikana zimalumikizana, ndikupanga mawonekedwe a '2-screw', pomwe pakuwona mbali, mawonekedwe a '3-screw' amawonedwa. Kapangidwe kameneka kamaonedwa kuti ndi malo abwino kwambiri opangira zomangira."
"Medial circumflex femoral artery ndiye magazi oyamba kupita ku mutu wa femoral. Pamene zomangira zimayikidwa 'in-out-in' pamwamba pa mbali yakumbuyo ya khosi la femoral, zimayambitsa chiopsezo cha kuvulala kwa mitsempha ya iatrogenic, zomwe zingasokoneze magazi kupita ku khosi la femoral ndipo, motero, zimakhudza kuchira kwa mafupa."
"Pofuna kupewa kuchitika kwa vuto la 'in-out-in' (IOI), pomwe ma screw amadutsa mu cortex yakunja ya khosi la femoral, kutuluka mu fupa la cortical, ndikulowanso mu khosi la femoral ndi mutu, akatswiri akudziko lonse lapansi komanso apadziko lonse lapansi agwiritsa ntchito njira zosiyanasiyana zowunikira. Acetabulum, yomwe ili pamwamba pa khosi la femoral, ndi concave depression m'fupa. Mwa kuphunzira ubale pakati pa ma screw omwe ali pamwamba pa khosi la femoral ndi acetabulum powonekera kumbuyo, munthu akhoza kulosera kapena kuwunika chiopsezo cha screw IOI."
▲ Chithunzichi chikuwonetsa chithunzi cha mafupa a cortical a acetabulum mu mawonekedwe a anteroposterior a cholumikizira cha m'chiuno.
Kafukufukuyu adakhudza odwala 104, ndipo ubale pakati pa fupa la cortical la acetabulum ndi zomangira zapambuyo unafufuzidwa. Izi zidachitika poyerekezera pa X-ray ndipo zinawonjezeredwa ndi kukonzanso kwa CT pambuyo pa opaleshoni kuti aone ubale pakati pa awiriwa. Pakati pa odwala 104, 15 adawonetsa vuto la IOI lomveka bwino pa X-ray, 6 anali ndi deta yosakwanira yojambula, ndipo 10 anali ndi zomangira zomwe zinali pafupi kwambiri ndi pakati pa khosi la femoral, zomwe zidapangitsa kuti kuwunika kusagwire ntchito. Chifukwa chake, milandu yonse 73 yovomerezeka idaphatikizidwa mu kusanthula.
Mu milandu 73 yomwe inafufuzidwa, pa X-ray, milandu 42 inali ndi zomangira pamwamba pa fupa la cortical la acetabulum, pomwe milandu 31 inali ndi zomangira pansi. Kutsimikizika kwa CT kunawonetsa kuti chochitika cha IOI chinachitika mu 59% ya milandu. Kusanthula deta kukuwonetsa kuti pa X-ray, zomangira zomwe zinali pamwamba pa fupa la cortical la acetabulum zinali ndi mphamvu ya 90% komanso 88% yeniyeni poneneratu chochitika cha IOI.
▲ Nkhani Yoyamba: X-ray ya chiuno cha m'chiuno yomwe ili kutsogolo kwa chiwalo imasonyeza zomangira zomwe zili pamwamba pa fupa la cortical la acetabulum. Mawonekedwe a CT coronal ndi transverse amatsimikizira kukhalapo kwa IOI.
▲Mlandu Wachiwiri: X-ray ya chiuno cha m'chiuno poyang'ana kutsogolo kwa thupi imasonyeza zomangira zomwe zili pansi pa fupa la cortical la acetabulum. Mawonekedwe a CT coronal ndi transverse amatsimikizira kuti zomangira zakumbuyo zili mkati mwa fupa la cortex.
Nthawi yotumizira: Novembala-23-2023
