Abɔnten Fixator ma Nan & Kotodwe Spanning Ex Fix

1. Nnianim asɛm

Abɔnten so a wɔde si hɔ yɛ ɔkwan a wotumi de di dwuma pii, a ɛnyɛ nea wɔde hyɛ nipadua no mu kɛse a wɔfa so ma akisikuru no gyina na wodi ntini a ɛyɛ mmerɛw a ɛyɛ den apirakuru ho dwuma. Wɔtaa de di dwuma ma abubuw a ɛda hɔ , nonunions a ɔyare mmoawa wom, ɔsɛe a wɔhyɛ wɔ polytrauma mu, deformity correction, ne akwaa a ɛtrɛw.

2. Dɛn nti na wɔde abɔnten so fixation di dwuma?

2.1 Mfasoɔ a ɛwɔ so

• Ɛmma nnompe mu mogya a wɔde ma ne ntini a ɛyɛ mmerɛw a ɛkata so no nsɛe.

• Wɔde di dwuma ntɛmntɛm wɔ tebea horow a egye ntɛmpɛ anaasɛ ɔsɛe ano aduru mu.

• Mfaso wɔ so ma dompe a abubu/a efĩ wom ne dompe a ɔyare mmoawa wom wɔ baabi a asiane wɔ mu sɛ wɔde bɛhyɛ mu.

• Ma kwan ma wɔsan si no wɔ staged (bere tiaa mu stabilization → definitive fixation).

• Ɛma nnompe ho dwuma a wodi, nnompe a ɛtwetwe adwene, ne dɛmdi a wɔteɛteɛ no yɛ mmerɛw.

2.2 Nkyerεkyerεmu

Ayaresa mu tebea horow a ɛtaa ba a wɔkyerɛ sɛ wɔmfa abɔnten so nsie:

• Open fractures a ntini a ɛyɛ mmerɛw asɛe kɛse anaasɛ efĩ wom.

• Akisikuru a wɔatoto mu wɔ ayarefo a wɔanya polytrauma mu a ɛhwehwɛ sɛ wɔma ɛyɛ den bere tiaa bi.

• Intra-articular fractures bere a ntini a ɛyɛ mmerɛw ntumi nnyina emu fixation ano (nsateaa, . kotodwe , nansoaa).

• Nnompe a ɛyera anaasɛ ntini a ɛyɛ mmerɛw a ɛtɔ sin a wɔde tiawa a wɔde yɛ tiaa ne nea ɛtwetwe adwene a wɔde di dwuma wɔ ɔkwan a ɛkɔ akyiri so.

• Infection / infected nonunion — wobetumi de pins asi baabi a ɛwɔ akyirikyiri fi mmeae a ɔyare no wɔ.

• Joint spanning (bridging) constructs ma peri-articular opira a emu yɛ den anaasɛ nkwaa a entumi nnyina.

3. Nnyinasosɛm ahorow a ɛfa abɔnten so fixation application ho

3.1 Biomechanical nsafe

• Anyɛ yiye koraa no, fa pin abien di dwuma wɔ asinasin titiriw biara a wɔde ahyɛ nipadua mu mmeae a ahobammɔ wɔ.

• Fa pin ahorow gu baabi a ɛbɛn baabi a abubu no (nanso wɔ hematoma/honam ani abubuw akyi) na ama atumi agyina pintinn kɛse.

• Ma nhama a ɛka bom no bɛn dompe na ma pin no ntrɛw kɛse wɔ asinasin biara mu.

• Poma pii ne multi-plane constructs ma stiffness yɛ kɛse.

4. Components — ntɛm reference

5. Nnwuma titiriw a wɔde di dwuma

5.1 Nkwaa fusion & nkwaa a ɛtrɛw

Wobetumi de abɔnten so afiri adi dwuma de ayɛ nkwaa a wɔde bɛka abom anaasɛ wɔde ayɛ nkwaa a ɛtrɛw de abɔ ntini a ɛyɛ mmerɛw ho ban bere a wɔkora akwaa a ɛne ne ho hyia so (sɛ nhwɛso no, nansoaa a ɛpaapae kɛse).

6. Dwumadi, Nsɛnkyerɛnne & Oprehyɛn Akyi Ɔhwɛ

6.1 Sεdeε εbεyε na fixator  na wɔde di dwuma

1. Yɛ pin/wire akwan ho nhyehyɛe denam mmeae a ahobammɔ wɔ so.

2. Fa pin anaa nhama hyɛ mfonini akwankyerɛ ase.

3. Fa abaa ne nhama a wɔde kyekyere nneɛma ho bata ho; yɛ nsakrae wɔ sɛnea ɛne ne ho hyia no mu.

4. Ma ayarefo nkyerɛkyerɛ fa pin tract hwɛ ho.

6.2 Nkyerεkyerεmu a εtaa ba

• Tibial fractures — mpɛn pii no wɔde tibial pins di dwuma.

• Ankle fractures ne soft tissue opira — ebia ebehia joint spanning fixation.

• Peri-articular fractures bere a emu ntumi nhyɛ mu.

6.3 Oprehyɛn akyi hwɛ

• Pin tract cleaning: fi ase da a edi oprehyɛn no akyi . Hohoro pin tract biara ho mpɛn 1–2 da biara.

• Ɛyaw ano aduru: nnuru a wɔde kum ɛyaw a ɛnyɛ den ne nnuru a wɔde kyekyere ɛyaw a ɛyɛ dry.

• Hwɛ: hwɛ sɛ ɛyɛ kɔkɔɔ, ɛyaw, nsu a ɛretu, anaa atiridiinini anaa.

• Mobilization: wɔtaa ma kwan ma wɔsoa emu duru fã bi.

• Nhyehyɛe a wɔde di akyi: ayaresabea nhwehwɛmu a wɔyɛ no daa.

7. Bere tenten a abɔnten so fixation ne nsakrae

• Ayaresa a edi mũ kosi sɛ abubuw no bɛkɔ so ayɛ den.

• Nsakrae ntɛm kɔ emu fixation so bere a ntini a ɛyɛ mmerɛw ma kwan no.

• Nsakrae kɔ plaster/orthosis so wɔ baabi a ɛfata.