Kumvetsetsa Intramedullary Misomali

Ukadaulo wa intramedullary nailing ndi njira yomwe imagwiritsidwa ntchito kwambiri ndi mafupa amkati.Mbiri yake imatha kutsatiridwa mpaka m'ma 1940.Amagwiritsidwa ntchito kwambiri pochiza mafupa aatali, osagwirizana, ndi zina zotero, poyika msomali wa intramedullary pakati pa medullary cavity.Konzani malo ophwanyika.M'nkhani izi, tidzakudziwitsani zoyenera zokhudzana ndi misomali ya intramedullary.

Mwachidule, msomali wa intramedullary ndi mawonekedwe aatali okhala ndi mabowo otsekera angapo kumapeto onse awiri kuti akonze nsonga zapakatikati ndi zakutali za fracture.Malingana ndi mapangidwe osiyanasiyana, amatha kugawidwa kukhala olimba, tubular, otseguka, ndi zina zotero, zomwe zili zoyenera kwa odwala osiyanasiyana.Mwachitsanzo, misomali yolimba ya intramedullary imalimbana ndi matenda chifukwa ilibe danga lakufa mkati.Kukhoza bwinoko.

Kutengera tibia monga chitsanzo, kukula kwa nthiti za medullary kumasiyanasiyana kwambiri mwa odwala osiyanasiyana.Kutengera ngati kukonzanso ndikofunikira, misomali ya intramedullary imatha kugawidwa kukhala misomali yokhazikika komanso yosasinthika.Kusiyanaku kuli ngati ma reamers akuyenera kugwiritsidwa ntchito pokonzanso medula, kuphatikiza zida zamanja kapena zamagetsi, ndi zina zambiri, ndipo tizibowo tating'ono tokulirapo timagwiritsidwa ntchito kukulitsa minyewa ya medulla kuti ipeze misomali yokulirapo ya intramedullary.

Komabe, m`kati kukula m`mafupa kuwononga endosteum, monga momwe chithunzicho, ndi zimakhudza mbali ya magazi gwero la fupa, zomwe zingachititse osakhalitsa avascular necrosis wa mafupa am`deralo ndi kuonjezera chiopsezo cha matenda.Komabe, zokhudzana ndi maphunziro a Zachipatala amakana kuti pali kusiyana kwakukulu.Palinso malingaliro omwe amatsimikizira kufunika kwa kukonzanso kwa medulla.Kumbali imodzi, misomali ya intramedullary yokhala ndi mainchesi akulu ingagwiritsidwe ntchito pokonzanso medula.Mphamvu ndi kulimba kumawonjezeka ndi kukula kwake, ndipo malo okhudzana ndi medullary cavity amawonjezeka.Palinso lingaliro lakuti timinofu tating'onoting'ono timene timapangidwa panthawi ya kukula kwa m'mafupa amakhalanso ndi gawo lina la autologous bone transplantation.

Mtsutso waukulu womwe umachirikiza njira yosasinthika ndikuti ukhoza kuchepetsa chiopsezo cha matenda ndi pulmonary embolism, koma zomwe sizinganyalanyazidwe ndikuti m'mimba mwake wowonda kwambiri umabweretsa zinthu zofooka zamakina, zomwe zimapangitsa kuti pakhale kuyambiranso.Pakalipano, misomali yambiri ya tibial intramedullary imakonda kugwiritsa ntchito misomali yowonjezereka, koma ubwino ndi kuipa kwake kumafunikabe kuyesedwa malinga ndi kukula kwa medullary cavity ndi fracture ya wodwalayo.Chofunikira pa reamer ndikuchepetsa kukangana panthawi yodula ndikukhala ndi chitoliro chakuya ndi shaft yaying'ono, potero kuchepetsa kupanikizika kwa medullary cavity ndikupewa kutenthedwa kwa mafupa ndi minyewa yofewa yomwe imayambitsidwa ndi kukangana.Necrosis.

Pambuyo pakuyika msomali wa intramedullary, kukhazikika kwa screw ndikofunikira.Traditional screw position fixation amatchedwa static locking, ndipo anthu ena amakhulupirira kuti kungayambitse kuchedwa kuchira.Monga kusintha, mabowo ena otsekera amapangidwa kukhala oval, omwe amatchedwa dynamic locking.

Zomwe zili pamwambazi ndizofotokozera za zigawo za intramedullary nailing.M'magazini yotsatira, tidzagawana nanu mwachidule ndondomeko ya opaleshoni ya intramedullary.