Mprɛte a Wɔde Toto Nneɛma Mu no a Wɔde Di Dwuma Yie!

BI locking plate yɛ afiri a wɔde siw abubuw ano a ɛwɔ tokuru a wɔde nhama ayɛ. Sɛ wɔde nkɔnsɔnkɔnsɔn a ɛwɔ ti a wɔde nhama ayɛ no hyɛ tokuru no mu a, mprɛte no bɛyɛ (skru) afiri a wɔde si anim. Mprɛte a ɛtow (angle stable) betumi anya nkɔnsɔnkɔnsɔn ntokuru a ɛtow ne nea ɛntow nyinaa ama nkɔnsɔnkɔnsɔn ahorow a wɔde nkɔnsɔnkɔnsɔn gu mu (wɔsan frɛ no mprɛte a wɔaka abom). Efi bere a wɔde adwene a ɛne sɛ wɔbɛto mprɛte mu no ho nyansahyɛ mae na wɔde dii dwuma wɔ akisikuru ayaresa mu no, wɔde adi dwuma kɛse wɔ periarticular fractures, comminuted ne osteoporotic fractures a wɔde si hɔ mu esiane mfaso a ɛwɔ so sɛ ɛma mmoa a ɛyɛ den na ɛma abubuw no si hɔ, abubuw no ayaresa dodow a ɛkɔ soro, ntini a ɛyɛ mmerɛw a ɛsɛe kɛse na mogya a wɔde ma no nsɛe nti. Ɛnnɛ anɔpa akenkan bɛma woanya nnianim asɛm a ɛkɔ akyiri a ɛfa mprɛte a wɔto mu ho, na ɛfata sɛ wusua biribi fi mu!

(A)Mfitiaseɛ Nsɛm a Wɔaka abom

1.Dɛn ne lock plate?

Dade mprɛte biara a wobetumi de nkɔnsɔnkɔnsɔn abɔ mu akɔ angle fixing/angle stabilizing screws anaa pins mu no yɛ ne titiriw no, ɛyɛ mprɛte a wɔde to mu.

2. Mfaso ne ɔhaw ahorow a ɛwɔ mprɛte a wɔde to mu so

Mfaso a ɛwɔ so

■ Angular stability, ahoɔden a ɛko tia benkum ne torsion

■Conical shape of screw ti ma mfiri kyekyɛ tu mpɔn

■Ma radial preload, siw nnompe resorption ne screw loosening ano

■Wɔayɛ no sɛnea ɛbɛyɛ a ɛbɛfata nipadua mu nneɛma a ɛwɔ mpɔtam hɔ

■Matching templates ma kwan ma percutaneous fixation wɔ diaphysis (cortical biako, ankasa-drilling, ankasa-tapping locking screws)

■Locking screws ma anchorage a eye kyɛn so ma abien no nyinaa flexible bridging ne koraa stabilization fixation

■Ɛho nhia sɛ ɔne dompe no ani bɛbɔ kɛse, na ama mogya a wɔde ma no akora so

■Micromotion a wɔahyɛ so, a ɛma akisikuru ayaresa

■Mpɛn pii no, ɛho nhia sɛ wɔde nnompe hyɛ mu

Ɛyɛ nea etu mpɔn titiriw ma nnompe a abubu anaasɛ nnompe a abubu biara a entumi nnyina kɛse.

Mfomso ahorow a ɛwom

■Locking screws nni reduction ne compression effect, titiriw wɔ intra-articular fractures anaasɛ oblique fractures a ɛnyɛ den mu

■Wɔrentumi mfa mprɛte no nni dwuma sɛ adwinnade a wɔde tew so mfa mmoa ma wɔtew so.

■Screws no nte nka yiye te sɛ screws a wɔtaa de di dwuma bere a wɔde ahyɛ mu no.

■Wɔntumi nsiesie nkɔnsɔnkɔnsɔn no kwankyerɛ (gye sɛ nkɔnsɔnkɔnsɔn a wɔde to mu a ɛyɛ multiaxial).

■Wɔde nkɔnsɔnkɔnsɔn no si hɔ denneennen dodo, na ebetumi ama 'cold welding'.

■Angle deviation >5°, ahoɔden a ɛyera; >10°, locking effect no nyɛ adwuma yiye

■Ebetumi aba sɛ ɛbɛpue wɔ honam ani sɛ mprɛte no nnyɛ contoured a

Nsɛm a ɛfa stiffness ho

Sɛ ɛnyɛ cortical contact pa anaasɛ compression of the fracture ends a, locking splints, titiriw stainless steel splints, a wɔde bedi dwuma no besiw phase II ayaresa a ɛbɛba wɔ abubuw no mu esiane sɛ ɛyɛ den dodo na wɔayi micromotion a eye wɔ beae a abubu no afi hɔ nti

Sɛ wɔde intraoperative traction di dwuma na afei wɔde locking splint fixation di dwuma a, wɔbɛkora fracture break gap no so, na ɛbɛma abubu no akyɛ anaasɛ ɛrensa;

Sɛ wɔansan ansiesie abubuw a ɛnyɛ den na wɔamfa nhyɛso anhyɛ mu a, adesoa no fa mprɛte no mu, na ɛde nhyɛso a ɛyɛ den a ebetumi ama mprɛte no abubu ntɛm ba.

3. Nsonsonoe atitiriw a ɛwɔ biomechanical mu wɔ mprɛte a wɔde to mu ne mprɛte a wɔtaa de di dwuma ntam

Mprɛte a wɔtaa de di dwuma no de wɔn ho to apereperedi a ɛwɔ dompe ne mprɛte ntam no so na ama wɔatumi amia mprɛte no dompe no.

4. Mfaso a ɛwɔ ntotoho a ɛwɔ locking plate ne dade mprɛte a ɛyɛ mpapahwekwa so

1.The pull-out resistance a locking screws no korɔn kɛse sen nea ɛyɛ mpapahwekwa screws.

2. Epiphyseal locking screws no yɛ angled to each other, a ɛma screw no ahoɔden a ɛko tia twe a ɛbɛtwe no yɛ kɛse kɛse sɛ wɔde toto parallel screws ho a.

(B) Nnyinasosɛm ahorow a wɔde di dwuma

1. Nnyinasosɛm ahorow a ɛfa sɛnea obi ntumi nkɔ baabiara ho:

●Nhyɛso nnyinasosɛm: nnompe mu ntini a ɛyɛ mmerɛw a ɛpaapae

●Neutralization nnyinasosɛm: nnompe mu ntini a ɛyɛ mmerɛw a ɛpaapae

●Bridging nnyinasosɛm: comminuted diaphysis anaasɛ extra-articular metaphyseal a ɛpaapae

Nnyinasosɛm a ɛfa nkabom ho: comminuted intra-articular metaphyseal fracture

2. Bridging nnyinasosɛm:

●Ɔkwan a wɔtaa fa so: wɔde fa honam ani a wɔde hyɛ mprɛte a ɛnyɛ den pii (MIPO anaa MIPPO kwan) .

●Akwan a wɔfa so tew nneɛma so wɔ ɔkwan a ɛnteɛ so

●Sɛnea ɛbɛyɛ a bridging plate fixation a ɛfata a, ɛsɛ sɛ wogyaw screw ntokuru 3-4 bue wɔ baabi a ɛbɛn fracture awiei.

3.Nnyinasosɛm ahorow a ɛfa nkabom ho:

● Biomechanical nnyinasosɛm abien a ɛne compression ne bridging a wɔde di dwuma wɔ mprɛte biako mu a wɔaka abom - locking compression plate (LCP) .

● Abubuw a ɛnyɛ den wɔ abubuw no fã biako ne abubuw a abubu wɔ ɔfã foforo (sɛ nhwɛso no, metaphysis no mu abubuw a abubu, diaphysis) .

●Ɛsɛ sɛ wɔde nnyinasosɛm a ɛne sɛ wɔbɛka abom no di dwuma wɔ mprɛte a ɛma kwan ma wɔde nkɔnsɔnkɔnsɔn a wɔde tow ti abien no nyinaa ne nkɔnsɔnkɔnsɔn a wɔtaa de di dwuma no nyinaa sisi hɔ nkutoo so.

Mprɛte a wɔde to mu no mfa wɔn ho nto akasakasa a ɛda dompe ne mprɛte ntam no so na wɔde wɔn ho to ntam a ɛda skru ne mprɛte no ntam a ɛwɔ ahinanan a ɛyɛ den no so titiriw na ama atumi agyina pintinn.

Esiane sɛ ɛyɛ biako a ɛyɛ den nti, tumi a nkɔnsɔnkɔnsɔn a ɛwɔ ti a ɛtow mu no yi fi mu no dɔɔso sen nkɔnsɔnkɔnsɔn a wɔtaa de di dwuma no, gye sɛ wɔayi nkɔnsɔnkɔnsɔn a atwa ho ahyia no nyinaa anaasɛ wɔabubu. Mpɛn pii no, ɛyɛ den sɛ wobeyi skru biako pɛ anaasɛ n’ankasa abubu. Locking head screws mma inter-fold nhyɛso. Wobetumi anya nhyɛso denam afiri a wɔde hyɛ nhyɛso a wɔde bedi dwuma so anaasɛ wɔde nkɔnsɔnkɔnsɔn a wɔde di dwuma daa akɔ 'tokuru a wɔde frafra' mu (nkɔnsɔnkɔnsɔn a wɔde nhyɛso di kan, afei nnadewa a wɔbɛto mu).

1.Sɛ wɔde standard screws adi dwuma de abɔ splint no ho ban (sɛ nhwɛso no 1), screwing wɔ locking screws no bɛyɛ mmerɛw yiye (sɛ nhwɛso no 2).

2.Sɛ wɔde locking screws adi dwuma de abɔ splint ne bone block (sɛ nhwɛso no, 1) a, ɛnsɛ sɛ wɔde standard screws bɛhyɛ bone block koro no ara mu (sɛ nhwɛso no, 2) gye sɛ wɔasansan locking screws no na wɔasan akyekye (LHS).

.

(C) Nneɛma a wɔde kyerɛ ne nea ɛne ne ho nhyia

1. Nneɛma a wɔde kyerɛ

Abubuw dodow no ara a wɔde oprehyɛn ayɛ no nhia sɛ wɔde locking plate fixation. Bere tenten a wodi nnyinasosɛm ahorow a ɛfa nnompe oprehyɛn ho akyi no, wobetumi de mprɛte a wɔtaa de di dwuma anaasɛ nnadewa a wɔde hyɛ ntini mu asa akisikuru dodow no ara.

Nanso, akisikuru ahorow pɔtee bi wɔ hɔ a ɛyɛ mmerɛw sɛ ɛbɛhwere nea ɛso tew, mprɛte anaa skru a ɛpaapae, ne nea edi hɔ a ɛnyɛ nkabom, a wɔtaa frɛ no 'unresolved' anaa 'ɔhaw' abubu, a nea ɛka ho ne intra-articular comminuted fractures, periarticular fractures a nnompe nketenkete asinasin, ne osteoporotic fractures. Wɔtaa frɛ saa akisikuru ahorow yi 'unresolved' anaa 'problem' abubuw na nea ɛka ho ne intra-articular comminuted fractures, periarticular short tuberosity fractures ne osteoporotic fractures. Saa mpaapaemu yi nyinaa yɛ nsɛnkyerɛnne a ɛkyerɛ sɛ wɔato mprɛte mu.

Nsɛnkyerɛnne a ɛyɛ tete ne nea eye ma locking plate fixation of fractures ne bridging nnyinasosɛm ne union nnyinasosɛm ma comminuted fractures pii - ahoɔden kɛse abubu wɔ ayarefo nkumaa mu anaasɛ osteoporotic fractures wɔ ayarefo a wɔn mfe akɔ anim mu.

2. Nneɛma a wɔde siw ano

Ɛwom sɛ wɔde mprɛte a wɔde to mu adi dwuma kɛse na nea ɛkyerɛ no trɛw de, nanso ɛsɛ sɛ yehu na yɛkwati nneɛma pii a ɛne mprɛte a wɔde to mu no nhyia. Sɛ wɔde mprɛte a wɔde to nneɛma mu di dwuma a wɔnyɛ nyiyim a, ebetumi aba sɛ nea wɔde besi hɔ no adi nkogu na ɛnyɛ nea ɛka bom wɔ abubuw no mu.

Mpaapaemu a ɛnyɛ den a ɛhwehwɛ sɛ wɔhyɛ nipadua no ntam, te sɛ nsateaa dua a ɛpaapae a ɛnyɛ den a wɔde nneɛma a wɔde hyɛ mu a wɔde to mu ayɛ ho adwuma no taa yɛ nea ɛnyɛ biako.

Saa ara nso na mprɛte a wɔde to honam ani a wɔde si hɔ ma akisikuru a ɛnyɛ den a wɔde akwan a ɛnyɛ den pii bedi dwuma nso yɛ nea ɛne no bɔ abira.

Indirect reduction ne locking plate fixation nso mfata mma displaced intra-articular fractures, a ɛhwehwɛ sɛ wɔtew nipadua mu a wɔabue ano na wɔhyɛ abubu asinasin no ntam ne firm fixation.

Ade a ɛne mprɛte a wɔde to mu no nhyia kakra, esiane ne bo a ɛkɔ soro nti, ne mpaapaemu a wobetumi de mprɛte a wɔtaa de di dwuma asiesie no yiye. Sɛ nhwɛso no, nsateaa a ɛbubu symphysis no sa yare bɛboro 90% bere a wɔde mprɛte a wɔtaa de di dwuma saa no.

(D) Mprɛte a wɔde tow nneɛma mu a wɔde besisi hɔ

1. Fa drill bit no hyɛ skru ntokuru a ɛwɔ mprɛte no mu no mu. Sɛ ɛkɔ akyiri >5° wɔ skru ne skru tokuru no ntam a, ebetumi ama skru no a wɔbɛto mu no adi nkogu, na wɔkamfo kyerɛ sɛ wɔde drill bit no tutu ntokuru no sɛnea ɛbɛyɛ yiye.

2. Fa dade mprɛte no to dompe no ani na tow ntokuru no fa drill sleeve no mu.

3. Fa depth sounder susuw bun no, na hwɛ yiye sɛ wɔde sounder no ti bɛhyɛ skru tokuru no mu.

4. Paw skru a wɔde to mu no tenten a ɛfata.

5. Nneɛma a wɔde hyɛ nkɔnsɔnkɔnsɔn a wɔahyɛ no den no mu no te sɛ nea wɔde hyehyɛ dade mprɛte a ɛyɛ mpapahwekwa no.

6. Awiei koraa no, fa torque safe kyekyere nkɔnsɔnkɔnsɔn a wɔde to mu no mu den, sɛ wɔkyekyere no denneennen a, ɛbɛda adi sɛ wobɛte nka sɛ ɛtwetwe ne nnyigyei a ɛtwetwe, na woakwati sɛ wobɛbɔ nkɔnsɔnkɔnsɔn mu denneennen dodo, na ɛde ɔhaw ahorow aba wɔ yiyi mu.

(E) Locking plate a woyi fi hɔ

Wɔde nnuru a wɔde tow mprɛte nkɔnsɔnkɔnsɔn di dwuma kɛse, nanso ɛnyɛ den sɛ wobehyia ɔhaw ahorow a wɔde yi fi hɔ, a ɛda adi titiriw wɔ skru no nhama a ɛtwetwe ne nnadewa kyɛw ne mprɛte nnadewa tokuru nhama a ɛwɔ abɔso a ɛnteɛ no ntam no mu.

1. Screw cap groove asɛe

Wɔ tebea horow a ɛfata mu no, screw cap groove a edi mũ ne screwdriver a ɛne no hyia no hyia. Ɛsɛ sɛ wɔde skru draiver no ne skru no ano aduru no hyia ansa na wɔde skru no ahyɛ mu anaasɛ wɔayi afi mu, anyɛ saa a ɛda adi sɛ skru draiver no asɛe bere a wɔde skru no bɛhyɛ mu anaasɛ wɔrebɔ no, na ɛde ahwease aba.

Afei nso, sɛ abubu no sa a, wɔtaa de nnompe mu ntini anaa nhama a ɛyɛ nhama kyekyere skru no ano, na ɛsɛ sɛ wɔtew ho ansa na wɔayi skru no, nanso sɛ wɔamfa wɔn adwene ansi so a, ebia skru no ano notch ne ahinanan no betumi asɛe.

Esiane sɛ nea ɔde di dwuma no anim nsa a ɛkyinkyini no ne skru draiver no kwan tenten no nhyia nti, mpɛn pii no, anim pɔtee bi wɔ hɔ, bere a nea ɔde di dwuma no de ahoɔden twitwaa skru no mu no, ɛyɛ nea wontumi nkwati sɛ skru draiver no wosow, na ɛde skru no kyɛw no ahina no sɛe esiane ahoɔden a ɛnteɛ nti. Enti, ɛnyɛ den sɛ skru no asɛe no betumi ama skru no ahwe ase.

2. Nail cap anaa nnadewa tokuru deformation

Wɔ adeyɛ a wɔde di dwuma wɔ oprehyɛn mu a wɔde anatomical locking dade mprɛte, ɛtɔ mmere bi a sɛnea hia a ehia sɛ wɔkotow anaasɛ wɔyɛ dade mprɛte no sɛnea ɛfata no, Raja ne afoforo. gye di sɛ sɛ ɛba sɛ bending fã no ba wɔ locking screw ntokuru no mu, bere a screwing wɔ locking screws no bɛyɛ screw cap ne nnadewa tokuru mismatch, a ɛda adi kɛse sɛ ɛbɛba ntam nnadewa cap ne dade mprɛte nnadewa ntokuru nhama ntam buckle bɔne, anaasɛ screwed bɛn dade mprɛte bere a dua no nnadewa deformation de ba denam strong screwing, ne nea ɛkeka ho, a ebetumi akɔ de kɔ akyiri yi a wobeyi Ɔhaw no afi hɔ no so.

3. Nnadewa a wɔde tow cortical locking a ɛyɛ ne ho a wɔde di dwuma

Esiane sɛ cortical bone no nyin kɔ mu wɔ nnadewa tokuru no mu na ɛnam so bɛkura skru no mu, na ɛde ɔhaw aba wɔ skru no a wobeyi mu, titiriw sɛ wɔde wɔn ho bɔ cortical bone screws abien a wɔde bedi dwuma nti, Suzuki ne afoforo. nkamfo nkyerɛ sɛ wɔmfa nkɔnsɔnkɔnsɔn a ɛbɔ ankasa nni dwuma mma cortical fixation abien. Hou Yunfei ne afoforo. kyerɛe sɛ ɛsɛ sɛ wɔkwati bicortical fixation a ɛho nhia a wɔde nkɔnsɔnkɔnsɔn bɛhyɛ mu ma atifi fam abubu, na Maehara ne ne mfɛfo. nso hyɛɛ nyansa sɛ ɛsɛ sɛ wɔkwati sɛ wɔtaa de nkɔnsɔnkɔnsɔn a wɔde tow mu di dwuma bere a wɔde mprɛte a wɔde tow nneɛma redi dwuma no, na ɛho hia sɛ wɔde amansan gyinapɛn bi si hɔ ma nkɔnsɔnkɔnsɔn a wɔde tow nneɛma a wɔpaw na wɔde di dwuma no.

4. Nhyehyɛe ne beae a wɔde nkɔnsɔnkɔnsɔn gu

Sɛnea skru a wɔde to mu no kɛse, sɛnea ɛkɔ, ne beae a ɛwɔ no betumi aka sɛnea wobeyi skru no afi hɔ. Nhomanimfo binom ahu sɛ sɛ skru no nni mfinimfini tokuru a wɔde to mu no a, sɛ nnadewa tokuru no eccentricity bɛboro 5 ° pɛ a, ebetumi aba sɛ nkɔnsɔnkɔnsɔn a ɛyɛ loose fixation, nhama a ɛnteɛ buckle anaasɛ nnadewa dua deformation abata na ɛde fixation no huammɔdi anaasɛ ɔfã a ɛto so abien a wobeyi nsɛnnennen no aba.

5.Awɔw welding

Normal titanium mu fixation soro wɔ layer a pasivated ahobammɔ layer, wɔ adeyɛ a oprehyɛn placement of mu fixation, esiane nnwinnade a ɛfa grasping ne shaping, anaasɛ ti no skru ne friction ntam dade mprɛte, ne nea ɛkeka ho, betumi ama passivated ahobammɔ layer wear beae. 2 dade contact surface ntam substantive contact point no bɛbata, kyerɛ sɛ, formation of awɔw welding.

Afei nso, galvanic coupling a ɛda dade ions ntam, inflammatory reactions, ne nea ɛkeka ho nso betumi ama wɔayɛ welds a ɛyɛ nwini. Wɔn a wɔyɛ mfiri a wɔde hyɛ nipadua no mu dodow no ara nso nim ɔhaw yi, na enti wɔde oxide film mfiridwuma akata dade mprɛte a wɔde to mu a wɔmfa nni dwuma so wɔ nnadewa ntokuru ne screw contact surfaces ntam, a ɛno nso botae ne sɛ ebesiw ionization ne adsorption a protein ahorow a ɛwɔ nipadua no mu no ano na ɛtew weld a ɛyɛ nwini a ɛba no so.

(F) Akwan a wɔfa so yi fi hɔ

Wobetumi akyekyɛ akwan a wɔfa so yi fi hɔ a wɔbɔɔ ho amanneɛ wɔ ɔman ne amanaman ntam nhoma ahorow mu no mu akuw 2, a ɛne, ɛnyɛ den na mfaso wɔ so na ɛyɛ den, kan no yɛ nea ɛyɛ mmerɛw sɛ wobetumi anya, mfaso, ntini a ɛyɛ mmerɛw a ɛsɛe kɛse, ahokokwaw a ɛba fam na enhia nnwinnade titiriw, na nea etwa to no hwehwɛ sɛ wɔde nnwinnade ne nnwinnade titiriw titiriw bi di dwuma.

Maehara ne afoforo. hyɛ nyansa sɛ fa skrudraiver a ɛto torque ano hye a ɛwɔ shanks akɛse nni dwuma bere biara a ɛbɛyɛ yiye. Sɛ wohyia nkɔnsɔnkɔnsɔn a ahwe ase a, Pattison ne afoforo. bɔɔ ɔkwan tiawa bi a wɔfa so yi nkɔnsɔnkɔnsɔn a ahwe ase denam platinum dade a wɔde kyekyere skrudraever no ti na wɔde hyɛ nkɔnsɔnkɔnsɔn no ano no mu ho amanneɛ. Saa kwan yi yɛ anifere sɛ wɔde dade krataa bɛhyɛ skru no ano aduru no ma na ama baabi a skru draiver no ne afiri no ntam no di nkitaho ne akasakasa no ayɛ kɛse, na ɛma ɛyɛ mmerɛw sɛ wobeyi nkɔnsɔnkɔnsɔn a nhama a ahwe ase wom no afi hɔ. Wɔ saa kwan yi mu no ɛda so ara yɛ den sɛ wobeyi asɛm no afi hɔ, sɛ skru no ano ne dade mprɛte nnadewa tokuru nhama no da so ara yɛ nea enni dɛm a, wubetumi abɔ mmɔden sɛ wode conical reverse tapping screw remover no bedi dwuma, kyerɛ sɛ, efi screw cap groove a wɔde ahyɛ akyi tapping no mu na ahyɛ groove no ma, wɔ adeyɛ a ɛne sɛ wobɛdannan na woahyɛ skru no mu ma.

Nea enye wɔ so no, ɛda so ara yɛ den sɛ wɔbɛma nkɔnsɔnkɔnsɔn a wɔde to mu no bi ayɛ adwuma yiye denam conical reverse tapping screw extractor te sɛ Ehlinger ne ne mfɛfo so. ne Bae ne afoforo. a wohui sɛ saa kwan yi taa yɛ adwuma yiye ma 3.5 mm skru a ɛtwetwe, nanso mpɛn pii no ɛnyɛ nea etu mpɔn wɔ 4.5 mm skru a ɛtwetwe no ho. Wɔ eyi mu no, ɛnyɛ ayaresabea nnompe ho aduruyɛ kuw biara na wɔde mfiri titiriw a wɔde twitwiw dade te sɛ carbide drills, diamond drills, anaa ntwahonan a wɔde twitwiw nneɛma ntɛmntɛm ahyɛ mu.

Gopinathan ne afoforo. de ɔkwan bi a enhia saa nnwinnade titiriw yi ba denam asɛm bi a ɛyɛ den sɛ wobeyi nkɔnsɔnkɔnsɔn afi clavicular reconstruction plate so ho amanneɛbɔ a wɔbɛbɔ ho amanneɛ so, kyerɛ sɛ, sɛ wɔde waya a wɔatwa no ketewaa bi a ɛwɔ reconstruction plate no so di dwuma a, wɔde waya twitwafo kɛse bi twitwa mprɛte no fã a ɛyɛ teateaa no wɔ mprɛte no nnadewa ntokuru ntam, sɛnea ɛbɛyɛ a nkɔnsɔnkɔnsɔn no ne nnadewa tokuru fã a ɛwɔ mprɛte no mu no bɛyɛ ade ketewaa bi, na ɛnyɛ den sɛ wobeyi nkɔnsɔnkɔnsɔn no afi hɔ. Saa kwan yi fa titanium reconstruction locking plates, forearm locking plates a ɛwɔ notches a ɛba fam teateaa, ne 1/3 tube-type plates nkutoo ho, na wontumi mfa nni dwuma mma mprɛte a ɛtrɛw anaa ɛyɛ den wɔ ase ano.

Wɔaka ɔkwan tiawa bi nso ho asɛm a wɔde drill bit a ɛsõ kakra tutu tokuru wɔ common tokuru no mu wɔ locking screw a ahwe ase no nkyɛn, na afei wɔde tokuru mprɛte ne screw no kɔ common tokuru a wɔatu no foforo no kwan so, na afei wɔde bone cutter a wɔde ahyɛ mprɛte no ase na wɔde nnyinasosɛm a ɛne leverage twitwa mu bere a ɛte saa no so wɔasansan ayɛ no.

Nokwarem no, ebetumi ama nnompe asɛe denam saa kwan yi so, enti wɔkamfo kyerɛ sɛ wɔmfa ahobammɔ a wɔde bɛbɔ wɔn mu duru ho ban wɔ oprehyɛn akyi. Afei nso, ɛho hia nso sɛ wosiesie adwumayɛfo nnwinnade bi a wɔtaa de di dwuma ansa na wɔayɛ oprehyɛn a wɔde yi fixation a ɛwɔ mu no, te sɛ bolt extractor, hole reamer, screw extraction pliers, T-type pressurized socket ne nea ɛkeka ho.

Wɔ locking screw slippery wire yiyi nsɛnnennen anim no, afie mu nhomanimfo binom hyɛɛ nyansa sɛ wɔnsesa groove kwan no, kyerɛ sɛ, wɔde dental micro-grinding machine dade anhwea asinasin bedi dwuma de asesa screw cap groove no hexagonal anaa quadrangular groove no ama 'one' anaa 'ten' groove no, anaasɛ wɔbɛma mfitiase groove no mu dɔ.

Ehlinger ne afoforo. bɔɔ amanneɛ sɛ wɔ tebea horow a na ɛyɛ den ma conical reverse tapping screw extractor no da so ara sɛ obeyi skru no, wɔhyɛɛ nyansa sɛ wobetumi ayi dade mprɛte no denam tungsten drill a wɔde twitwiw skru no ti a wɔbɛsɛe no so na wɔama nnade ntokuru a ɛwɔ dade mprɛte no mu no ayɛ kɛse, na afei wobetumi ayi skru no nipadua denam ring saw a wɔde bedi dwuma so.

Georgiadis ne afoforo. ne Raia ne afoforo. wɔahyɛ ho nyansa wɔ skru ne dade mprɛte nkabom no mu yɛ den dodo na ɛyɛ den sɛ wobeyi afi hɔ, nnwinnade titiriw (te sɛ mframa ahoɔhare kɛse twa drills, carbide drills, diamond ntwahonan, ne nea ɛkeka ho) wɔ nnadewa tokuru a atwa dade mprɛte twa kwan no ho ahyia, wɔ dade mprɛte no mu no wɔatwa de ayɛ loosen skru no, skru no nso fi awosu mu mmerɛw sɛ wobeyi afi hɔ.

Kumar ne Dunlopl bɔɔ amanneɛ wɔ distal femur locking dade mprɛte screw nhyehyɛe mu fixation yiyi kwan no mu, wɔ standard self-limiting torque screwdriver a wɔde di dwuma mu no, conical screw extractor no adi nkogu, nanso wɔde ɔkwan foforo nso bae, kyerɛ sɛ, wɔde ahoɔhare kɛse thin-flake abrasive wheels di dwuma wɔ dade mprɛte no ano kosi screw tokuru no ano radial incision, na afei wedge dompe sekan a wɔde ahyɛ incision no mu, mmue dade mprɛte nnadewa tokuru no sɛnea ɛbɛyɛ a wobɛhome cap no, sɛnea ɛbɛyɛ a etu mpɔn yi Locking screws.

Ɛho hia sɛ yɛhyɛ no nsow sɛ ɛsɛ sɛ wɔma akwan a ɛwɔ atifi hɔ no kɔ anim nkakrankakra sɛnea wobetumi bere a wɔretwitwa anaa wɔreyam prɛte no denam diski a wɔde twa ade a ɛyɛ ntɛmntɛm so na wɔakwati sɛ wobetwitwa akɔ skru no ti mu na wɔasɛe dompe ne ntini a ɛyɛ mmerɛw no. Nea ɛka ho no, saa akwan yi betumi ama ɔhyew a ɛkɔ soro ne dade a asɛe, na ebetumi ama asiane a ɛwɔ hɔ sɛ aduruyɛ mu no bɛsan abubu, ntini a ɛyɛ hyew a ɛbɛwuwu, ne ɔyare mmoawa no akɔ soro.

(G) Nsɛm a wɔaboaboa ano

■ Ma mprɛte a enni mũ nkɔ periosteum no ho

■Ɛsɛ sɛ wɔsan de mprɛte no si hɔ ansa na wɔatoto mu, efisɛ wontumi nsan mfa nea abubu no nsi baabi foforo bere a wɔatoto mu awie no.

■Locking mprɛte ntumi pressurized, hia sɛ wɔde pressurizer anaa centrifugal screwing wɔ union tokuru no mu kɔ skru a ɛyɛ mmerɛw no mu, di kan pressurized, afei locking

■ Fracture site 3 ~ 4 screw ntokuru a enni screws a ɛtrɛw adwennwen no; ■ Fracture site 3 ~ 4 screw ntokuru a enni screws a ɛtrɛw adwennwen no; ne

■ monocortical fixation of the diaphysis anaa thick bone cortex, ne baabi a dompe no su ye; ne

■Sɛ wɔato mu pɛ a, wontumi nsan nkɔ akyi, bere a wobetumi asan akɔ nkɔnsɔnkɔnsɔn a ɛnyɛ den no akyi

■Strong fixation ne screws pii betumi ama nonunion; nnyinasosɛm no ne sɛ ɛsɛ sɛ mprɛte yɛ tenten na wɔmfa nkɔnsɔnkɔnsɔn kakraa bi na edi dwuma; wɔ akisikuru a ɛwɔ akyi no ayaresa mu no, ɛsɛ sɛ wɔde nkɔnsɔnkɔnsɔn kakraa bi gu dua no so na wɔde nkɔnsɔnkɔnsɔn pii di dwuma de si ntini no ani

■ ɛsɛ sɛ bridging plate no tenten yɛ beae a abubu no mmɔho abien, ɛsɛ sɛ wɔkyekyɛ nkɔnsɔnkɔnsɔn no mu pɛpɛɛpɛ, na ɛsɛ sɛ nea eye sen biara a wɔde besi hɔ no yɛ nea wɔde fa aperture no mu

■ Wɔkyekyɛ ahoɔden mu pɛpɛɛpɛ wɔ prɛte tenten bi so, na sɛ wɔde nkɔnsɔnkɔnsɔn kakraa bi si so a, ebetumi akanyan akisikuru na ama nnompe no ayɛ yiye.