Kusweka kwa khosi la femoral ndi vuto lofala kwambiri komanso lomwe lingayambitse mavuto kwa madokotala a mafupa, ndipo nthawi zambiri matendawa samachitika chifukwa cha magazi osalimba. Kuchepetsa bwino komanso molondola kusweka kwa khosi la femoral ndiye chinsinsi cha kukhazikika bwino kwa mkati.
Kuwunika Kuchepetsa
Malinga ndi Garden, muyezo wochepetsera kusweka kwa khosi la femoral lomwe lasunthika ndi 160° mu filimu ya mafupa ndi 180° mu filimu ya lateral. Zimaonedwa kuti ndizovomerezeka ngati Garden index ili pakati pa 155° ndi 180° m'malo apakati ndi a lateral pambuyo pochepetsa.
Kuwunika kwa X-ray: pambuyo pochepetsa motsekedwa, kuchuluka kwa kukhutitsidwa kwa kuchepetsa kuyenera kudziwika pogwiritsa ntchito zithunzi zapamwamba za X-ray. Simon ndi Wyman adachita ma angles osiyanasiyana a X-ray pambuyo pochepetsa kusweka kwa khosi la femoral, ndipo adapeza kuti mafilimu abwino ndi ambali okha a X-ray amawonetsa kuchepa kwa thupi, koma osati kuchepa kwenikweni kwa thupi. Lowell adanenanso kuti pamwamba pa mutu wa femoral ndi pamwamba pa khosi la femoral zitha kulumikizidwa ndi S-curve mu mkhalidwe wabwinobwino wa thupi. Lowell adati pamwamba pa mutu wa femoral ndi pamwamba pa khosi la femoral zitha kupanga mawonekedwe ofanana ndi S pansi pa mikhalidwe yabwinobwino ya thupi, ndipo ngati mawonekedwe ofanana ndi S sali osalala kapena osakanikirana pamalo aliwonse pa X-ray, zikutanthauza kuti kusintha kwa thupi sikunakwaniritsidwe.
Katatu kotembenuzidwa kali ndi ubwino woonekeratu wa biomechanical
Mwachitsanzo, pachithunzi chili pansipa, khosi la femur litasweka, mbali yosweka imakumana ndi mavuto omwe nthawi zambiri amakhala omangika kumtunda komanso omangika kumunsi.
Cholinga cha kukonza fracture ndi: 1. kusunga bwino mgwirizano ndi 2. kuthana ndi kupsinjika kwa tensile momwe zingathere, kapena kusintha kupsinjika kwa tensile kukhala kupsinjika kwa pressure, zomwe zikugwirizana ndi mfundo ya tension banding. Chifukwa chake, inverted triangle solution yokhala ndi screws ziwiri pamwambapa ndi yabwino kwambiri kuposa orthotic triangle solution yokhala ndi screw imodzi yokha pamwamba kuti ithane ndi kupsinjika kwa tensile.
Ndondomeko yomwe zomangira zitatu zimayikidwa mu khosi losweka la femoral ndi yofunika:
Chokulungira choyamba chiyenera kukhala nsonga ya katatu kotembenukira, motsatira mphindi ya femoral;
Chokulungira chachiwiri chiyenera kuyikidwa kumbuyo kwa pansi pa kansalu kozungulira, motsatira khosi la femoral;
Sikuluu yachitatu iyenera kukhala kutsogolo kwa m'mphepete mwa pansi pa kansalu kozungulira, kumbali yolimba ya fupa losweka.
Popeza kusweka kwa khosi la femoral nthawi zambiri kumagwirizanitsidwa ndi matenda a osteoporosis, zomangira zimakhala ndi screw grip yochepa ngati sizimangiriridwa m'mphepete ndipo mafupa ndi ochepa pakati, kotero kumangirira m'mphepete pafupi ndi subcortex kumapereka kukhazikika bwino.
Mfundo zitatu zomangira misomali yopanda kanthu: pafupi ndi m'mphepete, mozungulira, zinthu zozungulira
Pafupi ndi khosi, screw zitatu zili mkati mwa khosi la femur, pafupi ndi peripheral cortex momwe zingathere. Mwanjira imeneyi, screw zitatu zonse zimapangitsa kuti pamwamba pa fracture pakhale kupanikizika, pomwe ngati screw zitatuzo sizili zogawanika mokwanira, kupanikizika kumakhala kofanana ndi mfundo, kosakhazikika komanso kosagonja ku torsion ndi shear.
Zochita Zolimbitsa Thupi Pambuyo pa Opaleshoni
Maseŵero olimbitsa thupi okweza zala amatha kuchitidwa kwa milungu 12 mutathyoka fupa, ndipo maseŵero olimbitsa thupi pang'ono amatha kuyambitsidwa patatha milungu 12. Mosiyana ndi zimenezi, pa ma fracture a mtundu wa Pauwels III, kukonza DHS kapena PFNA n'kofunikira.
Nthawi yotumizira: Januwale-26-2024
