Kodi mungapewe bwanji kuyika 'mkati-mkati' kwa zomangira zapakhosi pa nthawi ya opaleshoni?

"Kwa anthu omwe si achikulire omwe amathyoka khosi lachikazi, njira yomwe imagwiritsidwa ntchito kwambiri kuti akhazikitse mkati ndi 'inverted triangle' yokhala ndi zomangira zitatu.Zomangira ziwiri zimayikidwa pafupi ndi khosi lakumbuyo ndi lakumbuyo la khosi lachikazi, ndipo zomangira imodzi imayikidwa pansipa.M'mawonedwe a anteroposterior, zomangira ziwiri zoyandikana zimadutsana, kupanga mawonekedwe a '2-screw', pomwe m'mbali mwake, mawonekedwe a '3-screw' amawonedwa.Masinthidwe awa amawonedwa ngati malo abwino kwambiri opangira zomangira. ”

"Mtsempha wapakati wa circumflex femoral ndiye magazi oyamba kumutu wa chikazi.Zomangira zikayikidwa 'in-out-in' pamwamba pa gawo lakumbuyo la khosi lachikazi, zimakhala ndi chiopsezo cha kuvulala kwa mitsempha ya iatrogenic, zomwe zitha kusokoneza magazi kukhosi lachikazi ndipo, chifukwa chake, kuchiritsa mafupa. "

Pofuna kupewa kuchitika kwa zochitika za 'in-out-in' (IOI), pomwe zomangira zimadutsa pakhosi lakunja la khosi lachikazi, kutuluka fupa la cortical, ndi kulowanso khosi lachikazi ndi mutu, akatswiri a maphunziro a m'mayiko ndi kunja. agwiritsa ntchito njira zosiyanasiyana zowunikira.The acetabulum, yomwe ili pamwamba pa mbali yakunja ya khosi lachikazi, ndi concave depression mu fupa.Pophunzira mgwirizano pakati pa zomangira zomwe zimayikidwa pamwamba pa khosi lachikazi ndi acetabulum m'malingaliro a anteroposterior, munthu akhoza kuneneratu kapena kuyesa kuopsa kwa screw IOI."

▲ Chithunzichi chikuwonetsa chithunzithunzi cha fupa la cortical cha acetabulum mu mawonekedwe a anteroposterior a mgwirizano wa chiuno.

Phunziroli linakhudza odwala 104, ndipo mgwirizano pakati pa fupa la cortical la acetabulum ndi zomangira zam'mbuyo zinayesedwa.Izi zinachitidwa poyerekezera ndi X-rays ndi kuthandizidwa ndi postoperative CT reconstruction kuti aone mgwirizano pakati pa awiriwa.Pakati pa odwala 104, 15 inasonyeza zochitika zomveka za IOI pa X-ray, 6 inali ndi deta yosakwanira yojambula zithunzi, ndipo 10 inali ndi zomangira zomwe zili pafupi kwambiri ndi pakati pa khosi lachikazi, zomwe zimapangitsa kuti kuwunika kusakhale kothandiza.Chifukwa chake, milandu yonse yovomerezeka ya 73 idaphatikizidwa pakuwunikaku.

Pamilandu 73 yomwe yafufuzidwa, pa X-ray, milandu 42 inali ndi zomangira pamwamba pa fupa la cortical acetabulum, pomwe milandu 31 inali ndi zomangira pansipa.Chitsimikizo cha CT chinawulula kuti chodabwitsa cha IOI chinachitika mu 59% ya milandu.Kusanthula deta kumasonyeza kuti pa X-rays, zomangira zomwe zili pamwamba pa fupa la cortical acetabulum zinali ndi chidziwitso cha 90% ndi tsatanetsatane wa 88% polosera zochitika za IOI.

▲ Mlandu Woyamba: X-ray ya Hip mu mawonekedwe a anteroposterior imasonyeza zomangira zomwe zili pamwamba pa fupa la cortical la acetabulum.Mawonedwe a coronal ndi transverse amatsimikizira kukhalapo kwa chochitika cha IOI.

▲Mlandu Wachiwiri: X-ray yolumikizana ndi chiuno pamawonedwe a anteroposterior ikuwonetsa zomangira zomwe zili pansi pa fupa la cortical la acetabulum.Mawonedwe a CT coronal ndi transverse amatsimikizira kuti zomangira zam'mbuyo zili mkati mwa fupa la fupa.