Mprɛte a wɔde to mu no a wɔde di dwuma yiye!

BI Locking plate yɛ afiri a ɛma obi bubu a ɛwɔ tokuru a ɛwɔ asaawa. Sɛ wɔde skru a wɔde asaawa ayɛ no skru hyɛ tokuru no mu a, mprɛte no bɛyɛ (screw) angle fixation device. Mprɛte a wɔde to mu (angle stable) betumi anya locking ne non-locking screw holes a wɔde screw ahorow bɛhyɛ mu (a wɔsan frɛ no mprɛte a wɔaka abom). Esiane sɛ wɔde adwene a ɛne sɛ wɔbɛto mprɛte a wɔde to mu ho nyansahyɛ mae na wɔde dii dwuma wɔ akisikuru ayaresa mu nti, wɔde adi dwuma kɛse wɔ akyi berɛmo mu akisikuru a wɔde si hɔ no mu, commineted ne osteoporotic fractures esiane mfaso horow a ɛwɔ so sɛ ɛde mmoa a ɛyɛ den bɛma ne abubuw a wɔde si hɔ, abubu a ɛkɔ soro, ntini a ɛyɛ mmerɛw a wɔsɛe no kɛse ne mogya a wɔsɛe no. Ɛnnɛ anɔpa akenkan no bɛma woanya nnianim asɛm a ɛkɔ akyiri wɔ mprɛte a wɔde to mu ho, a ɛfata sɛ wusua fi mu!

(a)Basic ho nsɛm a wɔaka abom .

1.Dɛn ne locking mprɛte?

Dade mprɛte biara a wobetumi abɔ mu akɔ anim fixing/angle stabilizing screws anaa pin mu no yɛ mprɛte a wɔde to mu titiriw.

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

Mfaso a ɛwɔ so .

■ Angular stability, resistance a ɛko tia bending ne torsion .

■Conical shape of screw head no ma mfiri kyekyɛ tu mpɔn .

■ma radial preload, siw nnompe a ɛsan yɛ adwuma no ano na skru a ɛyɛ mmerɛw .

■aman .

■matching templates a ɛbɛma kwan ma percutaneous fixation wɔ diaphysis (a ɛyɛ cortical biako, ne ho a ɛtwetwe, ne ho a wɔde hyɛ mu a wɔde to mu) .

■locking screws ma anchorage a ɛkyɛn so ma bridging a ɛyɛ mmerɛw ne nea ɛma ɛyɛ den koraa fixation .

■Ɛho nhia sɛ ɛne nnompe no ani di nkitaho kɛse, na ɛkora mogya so .

■controlled micromotion, a ɛma akisikuru no sa .

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

Ɛyɛ nea etu mpɔn titiriw ma nnompe mu akisikuru anaasɛ akisikuru biara a entumi nnyina koraa.

Mfomso ahorow .

■a ɛtow nkɔnsɔnkɔnsɔn no nni nkɛntɛnso a ɛtew so na ɛyɛ den, titiriw wɔ ntini a ɛwɔ ntini no mu anaasɛ oblique a ɛyɛ mmerɛw a ɛyɛ mmerɛw mu .

■Wɔrentumi mfa mprɛte no nni dwuma sɛ adwinnade a wɔde tew so a ɛbɛboa ma wɔatew so.

■Nkrukyire no nte nka sɛ ɛyɛ papa te sɛ nkɔnsɔnkɔnsɔn a wɔtaa de di dwuma bere a wɔde hyɛ mu no.

■ Wɔrentumi nsiesie baabi a nkɔnsɔnkɔnsɔn no kyerɛ no (gye sɛ screws a wɔde to mu multiaxial locking).

■Wɔde nkɔnsɔnkɔnsɔn no si hɔ denneennen dodo, a ebetumi ama 'awɔw welding'.

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

■a ebetumi aba wɔ honam ani a ɛpuepue mu sɛ wɔanyɛ prɛte no contoured .

Nsɛm a ɛfa stiffness ho .

Sɛ wɔannya cortical contact pa anaasɛ compression of the fracture ends a, locking splints a wɔde di dwuma, titiriw stainless steel splints, besiw phase II ayaresa a ɛfa fracture no ho esiane stiffness a ɛboro so ne micromotion a eye wɔ fracture site no a woyi fi hɔ nti;

Sɛ wɔde intraoperative traction di dwuma na afei wɔde locking splint fixation di dwuma a, wɔbɛkora fracture break gap no so, na ɛde a ɛkyɛ anaasɛ enni fracture ayaresa;

Sɛ wɔansan anhyehyɛ mpaapaemu a ɛnyɛ den na wɔahyɛ no den a, adesoa no fa mprɛte no so, na ɛde nhyɛso a ɛyɛ mmerɛw sɛ ɛbɛma mprɛte no abubu aba.

3. Nsonsonoe atitiriw a ɛwɔ biomechanical mu wɔ mprɛte a wɔde to mu ne mprɛte a wɔtaa de di dwuma no ntam .

Mprɛte a wɔtaa de di dwuma no de ne ho to akasakasa so wɔ nnompe-prɛte ntam kwan so na ama mprɛte no ayɛ mprɛte a wɔde mia no.

4. Mfaso a ɛwɔ so sɛ wɔde toto mprɛte a wɔde to mu ne dade mprɛte a ɛyɛ mmerɛw ho .

1.The pull-out resistance of locking screws no korɔn koraa sen nea ɛwɔ screws a ɛyɛ mmerɛw no mu.

2. Epiphyseal locking screws no yɛ angled ma wɔn ho wɔn ho, a ɛma screw no resistance to pullout no yɛ kɛse kɛse sɛ wɔde toto parallel screws ho a.

(b) Nnyinasosɛm ahorow a wɔde di dwuma .

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

●Nhyɛso Nnyinasosɛm: Nnompe mu yare a ɛma obi ho kyere no .

●Nnyinasosɛm a ɛwɔ neutralization mu: nnompe mu yare a ɛma obi ho kyere no .

●Nnyinasosɛm a ɛyɛ den: diaphysis a wɔayɛ no comminit anaasɛ metaphyseal a ɛyɛ articular fracture .

Nnyinasosɛm a ɛfa nkabom ho: Commined intra-articular metaphyseal fracture .

2. Nnyinasosɛm a wɔde di dwuma:

●Akwan a wɔtaa fa so: mprɛte a wɔde hyɛ nipadua no mu kakraa bi (MIPO anaa MIPPO kwan) .

●Akwan a wɔfa so tew so a ɛnteɛ .

●Sɛ wopɛ bridging plate fixation a ɛfata a, ɛsɛ sɛ wogyae skru ho ntokuru 3-4 bue wɔ baabi a ɛbɛn fracture awiei.

3.Nnyinasosɛm a ɛfa nkabom ho:

● Biomechanical nnyinasosɛm abien a ɛfa nhyɛso ne bridging ho a wɔaka abom wɔ mprɛte biako mu - locking compression plate (LCP) .

● Mmubui a ɛnyɛ den a ɛwɔ abubuw no fã biako mu na ɛyɛ comminit abubu wɔ ɔfã foforo no mu (sɛ nhwɛso no, metaphysis, diaphysis no mu akisikuru a wɔabom ayɛ no mu abubuw) .

●Ɛsɛ sɛ wɔde nkabom nnyinasosɛm no di dwuma wɔ mprɛte a ɛma wotumi de nkɔnsɔnkɔnsɔn a ɛtow ti no nyinaa ne nkɔnsɔnkɔnsɔn a wɔtaa de di dwuma no nyinaa so nkutoo.

Mprɛte a wɔde to mu no mfa ne ho nto akasakasa a ɛda nnompe-prɛte ntam no ntam na ɛde ne ho to ntamgyinafo a ɛda skru ne mprɛte no ntam no so titiriw na ama angular stability akɔ so agyina.

Esiane wɔn biakoyɛ a ɛyɛ den nti, tumi a wɔde yi nkɔnsɔnkɔnsɔn a ɛwɔ ti a ɛto mu no korɔn sen nkɔnsɔnkɔnsɔn a wɔtaa de di dwuma no, gye sɛ woyi nkɔnsɔnkɔnsɔn a atwa ho ahyia no nyinaa anaasɛ wɔpaapae mu. Mpɛn pii no, ɛyɛ den sɛ wobeyi skru biako anaasɛ ɛbɛpaapae wɔ n’ankasa mu. Ti a ɛtow ti no mma pressurization a ɛwɔ ntam no mma. Wobetumi anya pressurization denam pressurizing device a wode bedi dwuma anaasɛ wode skru a wɔde di dwuma daa akɔ 'mixing holes' (Tension screws a edi kan, afei wobɛto nnadewa mu) mu.

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

2.Sɛ wɔde screws a wɔde to mu adi dwuma de ahyɛ splint ne bone block no mu den (sɛ nhwɛso no, 1) a, wɔkamfo kyerɛ sɛ wɔmfa screws standard screws no nkɔ dompe block koro no ara mu (sɛ nhwɛso no, 2) gye sɛ locking screws no sansan na wɔsan siesie (LHS).

3.Sɛ wɔde skru a ɛwɔ locking head (LHS) abɔ metaphyseal fracture block no ho wie a, wɔde screwing a ɛyɛ standard screw a wɔde hyɛ locking compression plate LCP nkabom no mu no na ɛyɛ compression fixation a ɛwɔ fracture blocks no ntam.

(c) Nsɛnkyerɛnne ne nea ɛkyerɛ sɛ ɛyɛ nokware .

1. Nsɛnkyerɛnne .

Ntini a wɔayɛ no oprehyɛn no mu dodow no ara nhwehwɛ sɛ wɔde mprɛte a wɔde bɛto mu no si hɔ. Bere tenten a wodi nnompe mu oprehyɛn ho nnyinasosɛm ahorow akyi no, wobetumi de mprɛte a wɔtaa de di dwuma anaasɛ nnadewa a wɔde hyɛ ntini no mu no asa akisikuru no mu dodow no ara.

Nanso, mpaapaemu ahorow pɔtee bi wɔ hɔ a ɛyɛ mmerɛw sɛ ɛbɛhwere nea ɛtew so, mprɛte anaasɛ screw a ɛpaapae, ne nea edi hɔ a ɛnyɛ kuw, a wɔtaa frɛ no 'unsolved' anaa 'problematic' abubuw, a nea ɛka ho ne intra-articular comminited fractures, periarticular fractures, ne nnompe mu ntini nketenkete. Wɔtaa frɛ saa mpaapaemu ahorow yi sɛ 'unresolved' anaa 'ɔhaw no mu abubu na ɛka intra-articular comminited fractures, periarticular short tuberosity fractures ne osteoporotic fractures ho. Saa mpaapaemu yi nyinaa yɛ mprɛte a wɔde to mu ho nsɛnkyerɛnne.

Nneɛma a ɛyɛ tete de na eye a ɛkyerɛ sɛ mprɛte a wɔde hyɛ mu a wɔde hyɛ mu no yɛ bridging nnyinasosɛm ne Union nnyinasosɛm a ɛma comminited fractures kɛse - ahoɔden a ɛkorɔn a ɛma ayarefo nkumaa anaasɛ nnompe mu akisikuru wɔ ayarefo a wɔn mfe akɔ anim mu.

2. Nneɛma a wɔde bɔ abira .

Ɛwom sɛ wɔde mprɛte a wɔde to mu adi dwuma kɛse na nea ɛkyerɛ no trɛw de, nanso ɛsɛ sɛ yehu na yɛkwati mpɛn pii a ɛne mprɛte a wɔde to mu no nhyia. Sɛ wɔde mprɛte a wɔde to mu di dwuma wɔ ɔkwan a ɛnyɛ nyiyim so a, fixation a entumi nyɛ adwuma yiye ne nea ɛnyɛ nkabom no betumi aba.

Mpaapaemu a ɛnyɛ den a ɛhwehwɛ sɛ wɔde nipadua no ntam ntini no hyɛ mu, te sɛ nsateaa a ɛyɛ mmerɛw a wɔde ayɛ nsateaa a wɔde hyɛ mu a wɔde afiri a wɔde hyɛ mu a wɔde hyɛ mu no yɛ no, na ɛnyɛ nea ɛnyɛ biako.

Saa ara nso na mprɛte a wɔde to mu a wɔde fa nipadua no mu ma ɛyɛ mmerɛw sɛ wɔde akwan a ɛnyɛ den pii bedi dwuma no nso yɛ nea ɛne no bɔ abira.

Indirect reduction ne locking plate fixation nso mfata ma displaced intra-articular fractures, a ɛhwehwɛ sɛ ɛbue nipadua no so tew ne compression ntam fracture asinasin ne firm fixation.

Nea ɛne mprɛte a wɔde to mu no bɔ abira kakra, esiane sɛ ɛho ka yɛ den nti, ne mpaapaemu a wobetumi de mprɛte a wɔtaa de di dwuma no ahyɛ mu ma wɔ ɔkwan a ɛma abotɔyam so. Sɛ nhwɛso no, nsa anim symphysis no mu a ɛpaapae no boro 90% bere a wɔde mprɛte a wɔtaa de di dwuma no sa no.

(d) mprɛte a wɔde to mu a wɔde besisi hɔ .

1. Screw drill bit no kɔ skru no ntokuru a ɛwɔ mprɛte no mu no mu. Deviations a ɛyɛ >5° wɔ screw ne screw hole no ntam no betumi ama screw locking no adi nkogu, na wɔkamfo kyerɛ sɛ fa drill bit no di dwuma na fa tole no tutu tokuru no yiye.

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

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

4. Paw locking screw no tenten a ɛfata.

5. Nhama a wɔde nhyɛso ayɛ no a wɔde besisi hɔ no yɛ nea ɛte sɛ nea wɔde yɛ dade mprɛte a ɛyɛ mmerɛw no ara pɛ.

6. Awiei koraa no, fa torque wrench kyekyere nkɔnsɔnkɔnsɔn a wɔde to mu no mu den, bere a wɔahyɛ no den no, nkate a ɛda adi pefee ne nnyigyei a ɛrebɔ no bɛba, na amma wɔansɛe no denneennen dodo, na ɛde nsɛnnennen a ɛyɛ den ama sɛ wobeyi afi hɔ.

(e) Mprɛte a wɔde to mu .

Wɔde clinical locking plate screws di dwuma kɛse, nanso ɛnyɛ den sɛ wobehyia no sɛ wobeyi afi hɔ, titiriw no ɛda adi wɔ screw slipping wire ne nail cap ne plate nail hole threads a ɛwɔ buckle a ɛnteɛ 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 screwdriver no ne screw cap groove no hyia ansa na wɔde skru no ahyɛ mu anaasɛ wɔayi afi mu, anyɛ saa a ɛda adi sɛ screw cap groove no bɛyɛ deformed bere a screwing no wɔ anaasɛ screwing out, na ɛde slippage aba.

Afei nso, sɛ wɔsa akisikuru no wie a, mpɛn pii no, wɔde nnompe a ɛyɛ mmerɛw anaasɛ ntini a ɛyɛ nhama a ɛyɛ den na ɛkata screw cap notch no so, na ɛsɛ sɛ wɔtew ho ansa na wɔayi skru no afi hɔ, nanso sɛ wɔannye adwene biara a, screw no ano notch ne angular structure no betumi asɛe no wɔ ɔkwan a wɔayɛ so.

Esiane sɛ nea ɔde di dwuma no nsateaa a ɛkyinkyini no ne screwdriver no kwan tenten no nhyia nti, mpɛn pii no, anim pɔtee bi wɔ hɔ, bere a nea ɔde di dwuma no de ahoɔden twitwa skru no mu no, ɛyɛ nea wontumi nkwati sɛ screwdriver no wosow, na ɛde ɔsɛe a ɛba cap groove a ɛwɔ screw no mu no ba esiane tumi a ɛnyɛ pɛpɛɛpɛ nti. Enti, ɛnyɛ den sɛ screw groove no sɛe no betumi ama screw slippage akɔ so.

2. Nail cap anaa nnade tokuru deformation .

Wɔ nhyehyɛe a wɔde di dwuma wɔ oprehyɛn mu a wɔde fa dade mprɛte so, bere ne bere mu sɛnea ɛho hia sɛ wɔde dade mprɛte no bɔ anaasɛ wɔyɛ no sɛnea ɛfata no, Raja ne ne mfɛfo. Gye di sɛ sɛ ɛba sɛ benkum fã no ba wɔ locking screw holes no mu a, bere a screwing wɔ locking screws no mu no bɛyɛ screw cap ne nail hole mismatch, a ɛda adi kɛse sɛ ɛbɛba nnadewa cap ne steel plate no nnadewa ntokuru no ntam no a ɛnam buckle a ɛnteɛ so, anaasɛ screwed bɛn dade mprɛte no bere a dua no dua deformation a ɛnam strong screwing, etc., a ebetumi ama ne ho ayɛ den no so.

3. Nnadewa a wɔde hyɛ cortical locking mu a wɔde di dwuma .

Esiane sɛ cortical dompe no nyin kɔ mu wɔ nnadewa tokuru no ho na ɛnam so akura skru no mu, na ɛde nsɛnnennen aba wɔ screw a woyi fi hɔ no mu, titiriw no, cortical bone screws a ɛyɛ ne ho a wɔde di dwuma no a wɔde di dwuma no, Suzuki et al. Nkamfo sɛ wɔmfa screws a wɔde wɔn ho hyɛ mu nni dwuma mma cortical a wɔde hyɛ mu abien. Hou Yunfei ne afoforo. no kyerɛe sɛ ɛsɛ sɛ wɔkwati bicortical fixation a ɛho nhia a wɔde screws ayɛ no ma upper extremity fractures, na Maehara ne ne mfɛfo. nso kyerɛe sɛ ɛsɛ sɛ wɔkwati nkɔnsɔnkɔnsɔn a wɔde to mu a wɔtaa de di dwuma bere a wɔde mprɛte a wɔde to mu di dwuma no, na ɛho hia sɛ wɔde amansan gyinapɛn bi si hɔ ma nkɔnsɔnkɔnsɔn a wɔde to mu a wɔpaw na wɔde di dwuma no.

4. Nhyehyɛe ne beae a ɛwɔ screws .

Screw a wɔde to mu no kɛse, sɛnea ɛkyerɛ kwan, ne faako a ɛwɔ no betumi aka sɛnea woyi skru no fi hɔ. Nhomanimfo binom ahu sɛ sɛ skru no nni tokuru a ɛtow no mfinimfini a, bere a nnadewa tokuru no mu duru a ɛboro 5 ° no betumi ayɛ nea ɛyɛ mmerɛw a wɔde hyɛ mu, nhama a ɛnteɛ a wɔde kyekyere wɔn ho anaasɛ nnadewa dua a ɛyɛ mmerɛw no asisi na ɛde fixation anaasɛ ɔfã a ɛto so abien a ɛne sɛ wobeyi nsɛnnennen afi hɔ no aba.

5.Awɔw welding .

Titanium a ɛwɔ mu a ɛyɛ daa no wɔ afã bi a ɛyɛ passivated protective layer, wɔ oprehyɛn a wɔde si mu fixation mu, esiane nnwinnade a wɔde soa na wɔde yɛ ade, anaasɛ skru no ti ne friction a ɛda dade mprɛte no ntam, ne nea ɛkeka ho no, betumi ama passivated protective layer wear area. 2 Dadeɛ nkitahodiɛ a ɛda contact point a ɛwɔ hɔ no ntam no, wɔbɛdi so, kyerɛ sɛ, cold welding a ɛyɛ no.

Bio nso, galvanic coupling a ɛda metal ions, inflammatory reactions, ne nea ɛkeka ho ntam no nso betumi ama cold welds a ɛba no anya nkɔso. Wɔn a wɔyɛ mfiri a wɔde si dan mu 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 no so wɔ nnadewa ntokuru ne screw contact surfaces ntam, a ɛno nso botae ne sɛ ebesiw ionization ne adsorption a ɛwɔ protein mu wɔ nipadua no mu no ano na ɛtew cold welds a ɛba no so.

(f) akwan a wɔfa so yi nneɛma fi hɔ .

Wobetumi akyekyɛ akwan a wɔfa so yi nneɛma fi hɔ a wɔbɔ ho amanneɛ wɔ ɔman ne amanaman ntam nhoma ahorow mu no mu akuw 2, a ɛne sɛ, nea ɛyɛ mmerɛw na ɛyɛ adwuma na ɛyɛ den, nea edi kan no yɛ nea ɛyɛ mmerɛw sɛ wobenya, nea mfaso wɔ so, ntini a ɛyɛ mmerɛw a ɛba fam, ahokokwaw a ɛba fam ne nea ɛho nhia sɛ wɔde nnwinnade soronko di dwuma, na nea etwa to no hwehwɛ sɛ wɔde nnwinnade soronko ne nnwinnade titiriw na ɛyɛ.

Maehara ne afoforo. Fa nyansahyɛ ma sɛ fa torque-limiting screwdrivers a shank akɛse wom di dwuma bere biara a ɛbɛyɛ yiye. Bere a wohyia nkɔnsɔnkɔnsɔn a ahwe ase no, Pattison ne ne mfɛfo. bɔɔ amanneɛ sɛ ɔkwan a ɛyɛ mmerɛw a wɔfa so yi nkɔnsɔnkɔnsɔn a ahwe ase no denam platinum dade a wɔde kyekyere skru-draebɔ no ti so na wɔde hyɛ nkɔnsɔnkɔnsɔn no ano no mu no so. Saa kwan yi yɛ anifere sɛ wɔde dade krataa bɛhyɛ screw cap groove no ma na ama contact area ne friction no ayɛ kɛse wɔ screwdriver ne groove no ntam, a ɛma ɛyɛ mmerɛw sɛ wɔde nhama a ahwe ase beyi screws no afi hɔ. Wɔ saa kwan yi so no, ɛda so ara yɛ den sɛ wobeyi asɛm no afi hɔ, sɛ screw cap ne steel plate nail hole threads no da so ara yɛ nea ɛwɔ hɔ a, wubetumi abɔ mmɔden sɛ wode conical reverse tapping screw remover no bedi dwuma, kyerɛ sɛ, efi screw cap groove a wɔde ahyɛ reverse tapping no mu na ahyɛ groove no ma, wɔ adeyɛ a ɛne sɛ wobɛdannan na wore pressurizing skru no mu.

Nea enye wɔ ho no, ɛda so ara yɛ den sɛ wɔde conical reverse tapping screw extractor bedi dwuma de ayɛ screws bi a wɔde to mu no yiye, te sɛ Ehlinger ne ne mfɛfo. Na Bae ne afoforo. a wohui sɛ saa kwan yi taa yɛ nea etu mpɔn ma 3.5 mm screw slippage, nanso mpɛn pii no entumi nyɛ adwuma mma 4.5 mm screw slippage. Wɔ eyi mu no, ɛnyɛ ayaresabea nnompe ho fã biara na wɔde dade a wɔde twitwiw nneɛma titiriw te sɛ carbide drills, diamond drills, anaasɛ speed grinding wheels ahyɛ mu.

Gopinathan ne afoforo. Fa ɔkwan bi a enhia saa nnwinnade titiriw yi ba denam amanneɛbɔ a ɛfa asɛm bi a ɛfa screw a ɛyɛ den a woyi fi clavicular reconstruction mprɛte so, kyerɛ sɛ, wɔde low cutout of the reconstruction plate, large wire cutter di dwuma de twitwa mprɛte no fã teateaa a ɛda mprɛte nnadewa ntokuru ntam no so, sɛnea ɛbɛyɛ a screws ne mprɛte no fã a ɛwɔ mprɛte no fã no betumi ayɛ mmerɛw sɛ wobeyi afi mu, na wɔayi nkɔnsɔnkɔnsɔn no. Saa kwan yi fa titanium a wɔsan de si mprɛte a wɔde to mu, mprɛte a wɔde to anim a ɛwɔ anim a ɛyɛ teateaa a ɛba fam, ne mprɛte a ɛte sɛ tube 1/3, na wontumi mfa nyɛ mprɛte a ɛtrɛw anaasɛ ɛyɛ den wɔ ase hɔ.

Wɔaka ɔkwan a ɛyɛ mmerɛw nso ho asɛm a wɔde drill bit a ɛsõ kakra di dwuma de tutu tokuru wɔ tokuru a wɔtaa de to mu a ɛwɔ slick locking screw no nkyɛn no mu, na afei wɔde mprɛte ne skru no abɔ tokuru a wɔtaa tu no foforo no kwan so, na afei wɔayi mprɛte ne skru no denam nnompe a wɔde twitwa so a wɔde si mprɛte no ase na wɔde twetwe no fi mu na wɔde nnyinasosɛm a ɛne sɛ wɔbɛma afiri a wɔde twitwiw nneɛma no ayɛ mmerɛw bere a wɔde bere a wɔde wɔn ho ahyɛ mu no.

Nokwarem no, tumi a ɛwɔ hɔ sɛ nnompe bɛsɛe wɔ ɔkwan yi so no, enti wɔkamfo kyerɛ sɛ wɔmfa oprehyɛn akyi mu duru a wɔde soa nneɛma ho ban. Nea ɛka ho no, ɛho hia nso sɛ wosiesie adwumayɛfo nnwinnade bi a wɔtaa de di dwuma ansa na wɔayɛ oprehyɛn a wɔde yi fi mu, te sɛ bolt extractor, hole reamer, screw extraction pliers, T-type pressurized socket ne nea ɛkeka ho.

Wɔ locking screw slippery wire removal nsɛnnennen anim no, afie mu nhomanimfo binom hyɛɛ nyansa sɛ wɔbɛsesa groove kwan no, kyerɛ sɛ, dental micro-grinding machine steel sand piece a wɔde bedi dwuma de asesa screw cap groove hexagonal anaa quadrangular groove no ama 'one' anaa 'Ten' groove, anaasɛ deepen the original groove.

Ehlinger ne afoforo. bɔɔ amanneɛ sɛ wɔ nsɛm a conical reverse tapping screw extractor no da so ara yɛ den sɛ wobeyi skru no mu no, wɔkyerɛe sɛ wobetumi ayi dade mprɛte no denam screw no ti a wɔbɛsɛe no denam tungsten drill grinding so na wɔama nnadewa ntokuru a ɛwɔ dade mprɛte no mu no ayɛ kɛse, na afei wobetumi ayi skru no nipadua no afi hɔ denam ring saw a wɔde bedi dwuma so.

Georgiafo ne afoforo. ne Raia ne afoforo. Wɔahyɛ ho nyansa wɔ screw ne dadeɛ mprɛte a wɔaka abom no mu no yɛ den dodo na ɛyɛ den sɛ wɔbɛyi afiri hɔ, nnwinnadeɛ soronko (te sɛ pneumatic high-speed cutting drills, carbide drills, diamond wheels, ne nea ɛkeka ho) wɔ nnadewa tokuru a atwa dadeɛ mprɛte twitwa kwan no ho ahyia no, wɔ dadeɛ mprɛte no mu no, wɔatwitwa skru no, skru no nso yɛ adeɛ a ɛnyɛ den sɛ wɔbɛyi.

Kumar ne DunloPL bɔɔ amanneɛ wɔ distal femur locking steel plate screw nhyehyɛe no mu fixation removal adeyɛ 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 aba, kyerɛ sɛ, wɔde ahoɔhare kɛse a ɛyɛ tratraa a ɛyɛ tratraa a wɔde di dwuma no di dwuma Mma mmue dade mprɛte nnadewa tokuru no sɛnea ɛbɛyɛ a wobɛma akataso no ayɛ mmerɛw, sɛnea ɛbɛyɛ a sɛ woyi nkɔnsɔnkɔnsɔn a wɔde to mu no fi hɔ yiye.

Ɛho hia sɛ yɛhyɛ no nsow sɛ ɛsɛ sɛ wɔma akwan a ɛwɔ atifi hɔ no kɔ anim nkakrankakra sɛnea ɛbɛyɛ yiye bere a wɔretwitwa anaa wɔreyam mprɛte no denam disk a wɔde twa ntɛmntɛm a wɔde twa ade so na amma wɔantwitwa akɔ skru no ti mu na wɔasɛe dompe no ne ntini a ɛyɛ mmerɛw no. Nea ɛka ho no, saa akwan yi betumi ama ɔhyew a ɛkɔ soro ne dade mu nneɛma a asɛe aba, na ebetumi ama asiane a ɛwɔ hɔ sɛ wɔbɛsan ayɛ adwuma wɔ aduruyɛ mu no akɔ soro, ntini a ɛma ntini no mu yɛ hyew, ne ɔyare mmoawa.

(g) Nsɛm a wɔaboaboa ano .

■ Ma kwan ma mprɛte a enni mũ no ne periosteum no di nkitaho .

■Ɛsɛ sɛ wɔsan de mprɛte no si baabi foforo ansa na wɔatoto mu, efisɛ wontumi nsan nsi fracture no ananmu bere a wɔatoto mu awie no.

■Wɔrentumi nhyɛ mprɛte a wɔde to mu no mu den, ehia sɛ wɔde pressurizer anaa centrifugal screwing di dwuma wɔ Union Hole no mu kɔ skru a ɛyɛ mmerɛw no mu, na wodi kan de nhyɛso ba, afei wɔtow mu .

■ fracture site 3~4 screw holes a enni screws a ɛbɛtrɛw nhyɛso no mu; ■ fracture site 3~4 screw holes a enni screws a ɛbɛtrɛw nhyɛso no mu; ne

■ Monocortical fixation a ɛwɔ diaphysis anaa dompe cortex a ɛyɛ den mu, ne baabi a dompe no su ye; ne

■bere a wɔatoto mu no, wontumi nhyɛ no akyi, bere a wobetumi asan abɔ nkɔnsɔnkɔnsɔn a ɛyɛ mmerɛw no akyi .

■Strong fixation ne screws pii betumi ama nonion aba; Nnyinasosɛm no ne sɛ ɛsɛ sɛ mprɛte yɛ tenten na ɛsɛ sɛ wɔde nkɔnsɔnkɔnsɔn kakraa bi di dwuma; Wɔ periarticular fractures ayaresa mu no, ɛsɛ sɛ wɔde nkɔnsɔnkɔnsɔn kakraa bi gu dua no so na wɔde nkɔnsɔnkɔnsɔn pii di dwuma ma wɔde si articular no ani so .

■ Ɛsɛ sɛ bridging mprɛte no tenten yɛ beae a abubu no tenten mmɔho abien, ɛsɛ sɛ wɔkyekyɛ nkɔnsɔnkɔnsɔn no mu pɛpɛɛpɛ, na ɛsɛ sɛ fixation a eye sen biara no yɛ nea ɛfa-afiri a wɔde hyɛ mu no ho .

■ Wɔkyekyɛ ahoɔden mu pɛpɛɛpɛ wɔ mprɛte tenten bi so, na sɛ wɔde nkɔnsɔnkɔnsɔn kakraa bi si hɔ a, ebetumi akanyan akisikuru na ama nnompe ayɛ yiye.