kɛnɛma fixateur .

1.Daminɛ .

Kɛnɛma fixation bɛ se ka kɛ ka 'localized damage control' sɔrɔ kariw kama minnu bɛ ni farikolo yɔrɔ nɔgɔlenw tiɲɛni jugumanba ye ani ka kɛ furakɛli dafalen ye kari caman na. Kolow sɔrɔli ye taamasiɲɛba ye ka ɲɛsin kɛnɛya sabatili ma. Kɛnɛma fixation fana bɛ se ka kɛ ka deformité correction ani ka kolo minɛ.

2 .Mun na aw bɛ baara kɛ ni an ye . kɛnɛma fixation . 

2.1 Nafa minnu bɛ sɔrɔ kɛnɛma fixation .

- Joli bɔli ka taa kolo la.

- A bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn nɔgɔlenw datugucogo la.

- A bɛ se ka baara kɛ joona kɔrɔtɔko la.

- ka kari dafalenw ni nɔgɔlenw siri.

- A bɛ sira Di kariw tila-tilacogo kura ni u jɔli sabatili ma ni opereli tɛ.

- Dunan farikolo dɔgɔyali sɔrɔli ni banakisɛ don.

- A bɛ ɲini ka dɔnniya ni opereli seko dɔgɔya ka tɛmɛ incisional reduction and internal fixation (ORIF) kan.

- Kolow ladonni ni u tiɲɛni latilenni bɛ se ka kɛ.

2.2 Taamaʃyɛn minnu bɛ kɛ kɛnɛma fiɲɛbɔli la .

2.2.1 Da wulilenw kari .

Kɛnɛya sabatili bracing ye fɛɛrɛ dɔ ye min bɛ kɛ ka kari dafalenw lamaga waati dɔɔni walima dafalen na, wa a jiralen don kɛrɛnkɛrɛnnenya la ni joginda jugumanbaw bɛ farikolo yɔrɔ nugulamaw la. Kɛnɛyajiw nafa ka bon kariw ma minnu ka bana ka jugu, i n’a fɔ ka taa dɔgɔtɔrɔso la ani/walima joginda nɔgɔli. Kɛnɛya sabatili ye fɛɛrɛ nafamaba ye kabini tuma jan o joginda suguw la, wa hali bi a bɛ jate sanu hakɛ ye.

2.2.2 Kari dagalenw .

Kɛnɛyaji kɛli taamasiɲɛ minnu bɛ kɛ ka bɔ kari dagalenw na, olu ye banabagatɔw ka wulibaliya ye waati dɔɔni kɔnɔ, minnu ka politrauma jugumanba bɛ u la, ani farikolo yɔrɔ nɔgɔlenw ka kirinni jugumanba walima joginni minnu bɛ kɛ ka u bɔ u la. Nin ko ninnu na, waati dɔɔni jɔli ni kɛnɛma fiɲɛbɔlan ye, o bɛ se ka kɛ ka bɔ joginni yɔrɔ la, a ka fisa ka yɔrɔ janya opereli bɛ se ka kɛ yɔrɔ min na, ka farikolo yɔrɔ nɔgɔlen joginni furakɛ ka sɔrɔ ka bolokɔniw labɛn.

2.2.3 Jogin caman .

Kɛnɛyaji labɛnni fɛɛrɛ ka kan ka jateminɛ ni aw bɛ tiɲɛni kunbɛn opereli kɛ banabagatɔw la minnu jogincogo ka ca. Kɛnɛya sabatili nafa kunbabaw ye kari sabatili teliya ye, ka dimi mada, ka joli dɔgɔya, ani ka farikolo funu jaabi syndrome dɔgɔya walasa ka ladonni nɔgɔya.

2.2.4 Banakisɛfagalanw kɔnɔ .

A ka c’a la, fiɲɛ bilali kɔfɛ, o ye waati dɔɔni jateminɛ ye min bɛ farikolo yɔrɔ nɔgɔlenw datugu ka bɔ kari sabatilenw na walima ka fara fɛnɲɛnamafagalanw kan minnu bɛ kɛ ni fɛnɲɛnamafagalanw ye; O fana ye sugandili ye joli-sira-funu walima ligament dilancogo la yɔrɔ minnu na kɔnɔna-fini dafalen-yɔrɔ kelen tɛ Se ka Kɛ. Jogindaw bɛɛ bɛ se ka siri o cogo la, nka a ka ca a la, bolokɔni, gɛnɛgɛnɛ ani senkɔni.

2.2.5 Kolow walima farikolo yɔrɔ nugulamaw tiɲɛni .

Banabagatɔ minnu ka farikolo yɔrɔ nugulen don kosɛbɛ ani minnu kolo ka jugu, kɛnɛma fixation frames bɛ se ka kɛ ka bolokɔniw surunya a kɛcogo kelen na ka sɔrɔ ka bolokɔni janya segin a cogo kɔrɔ la ni distraction osteogenesis ye a kɛcogo filanan na.

2.2.6 Kɛnɛya sabatili karamɔgɔ min bɛ kɛ baarakɛminɛn ye indirect reset .

Kari dɔgɔyali kɔfɛ, ni kɔnɔna-filɛli-minɛn walima kɔnɔbara basigilen bɛ bila, kariyɔrɔ jɔyɔrɔ bɛ se ka mara ni kɛnɛma-fini-minɛn datuguli ye. Tuma dɔw la, kɛnɛma-fiɲɛbɔlan dɔ bɛ Se ka To waati dɔ kɔnɔ walasa ka fixation wɛrɛw Di ni kɔnɔna-fiɲɛbɔ ma barika Sɔrɔ. A jirala ko kɛnɛma fixateurs walima femoral distractors jɔyɔrɔ ka bon tibial intramedullary nail bilali la. Schnee pin dɔ bɛ siri ka don kɔkolo kɔnɔna na, a bɛ don yɔrɔ min na, o bɛ don a kɔnɔ ani ka a kɛ senkɔni kolo la, ka a siri ni bere jan ye. O bɛ kɛ sababu ye ka yɔrɔlama balannen sama ani fana ka kari janya, ka wuli, ani ka aksidan ladilan sani a ka don a kɔnɔ ni a bɛ don a kɔnɔ a bɛ kɛ gɛnɛgɛnɛ ye min bɛ wuli walima ka janya.

Tibial intramedullary nail bilali ni kɛnɛma fixation bracket retraction .

3.Kɛnɛma fixation brace application sariyaw .

3.1 Biomekaniki fanw .

Aw bɛ pinɛ 2 ni kɔ bila kariyɔrɔba kelen na ka tɛmɛ farikolo tangalan yɔrɔ fɛ, ni pinɛw bɛ yɔrɔ caman na. Ni farikolo yɔrɔ nugulamaw cogoya bɛ se ka kɛ, fixation pins ka kan ka bila ka surunya kari laban na ni a bɛ se ka kɛ, nka a man kan ka don kari laban joli la walima ka don fari tangalan yɔrɔ la. Ni kɔnɔna jɔli janyalen don, fiɲɛ bilali pinɛw ka kan ka u yɛrɛ tanga opereli tigɛcogo ma min bɛ se ka kɛ ani ka opereli kɛ (opereli yɔrɔ). Jɛɲɔgɔnya berew ka kan ka bila kolo la cogo min na walasa ka dɔ fara sabatili kan. Kɛnɛma-fiɲɛbɔlan sabatili bɛ bɔ nin fɛn ninnu na.

- Fixation pins janya ka bɔ kari laban na : ni barika bɛ ka surunya.

- fixation pins (finibɔlanw) janya ka don kari bloki kelen-kelen bɛɛ la : o ka bon.

- janya min bɛ sɔrɔ berew janya la ka bɔ kolo la : a barika ka bon.

- ɲɔgɔndan berew hakɛ : fila barika ka bon ni kelen ye .

- Kɛnɛma fiɲɛbɔlan (ka bɔ fanga dɔgɔman na ka se fanga sanfɛla ma): plan kelen/a cogoya/biplane.

- Kɛnɛma-filɛli-kalan min bɛ fara ɲɔgɔn kan ni kɔnɔna-filɛli danma ye (tension vises) : a man teli ka kɛ bawo fixation élastique ni barikama ɲagaminen ye waati dɔɔnin dɔrɔn ye.

- SCHANZ vises walima schnee pins: 6mm ka flexural fanga ye 5mm ye siɲɛ fila.

kelen. Fɛn kelen-kelen-yɔrɔ kelen-kelen-yɔrɔ-fixation frame. Pinɛ janya ka bɔ kari laban na (x).

Ni a surunyara, a bɛ sabati ka taa a fɛ. Pinɛ suguya caman yɔrɔjan ka bɔ kariyɔrɔba la (Y): Ni a bɛ taa ka taa a fɛ, a bɛ sabati ka taa a fɛ.

Ni a yɔrɔ ka jan, a bɛ sabati ka taa a fɛ. Longitudinal connecting berew janya ka bɔ kolo la (Z): o bɛ surunya ka taa a fɛ.

B. O kɔfɛ, 3-rod faralen ɲɔgɔn kan, o ye fɛn nafama ye min bɛ kɛ ka baara caman kɛ, i n’a fɔ a sigicogo kura.

Modeli bɛ kɛ ka baara caman kɛ, i n’a fɔ segin-ka-bɔnyew.

C. Unilateral uniplanar two-link external fixation frame.

D. Biplane labɛncogo kelen (▲ labɛncogo).

e. Bilateral configuration ni penetrating fixation pins. Sisan, a man teli ka baara kɛ ni o ye.

Kɛnɛya sabatili fiɲɛ tɛ kari kɛnɛyali baara bila kɔfɛ, nka kɛnɛma fiɲɛbɔli karamɔgɔ gɛlɛn kojugu.

A ka kan tuma dɔw la ka fixation stable (fixation stable) kɛ ka doni bonya ni girinya hakɛ dɔ walima a dafalen ye ani/walima ka kɛnɛma fixation frame labɛncogo Changer.

3.2 A bɛ kɛ ni furakisɛ bilali fɛɛrɛw ye .

- Aw bɛ aw yɛrɛ dɔn farikolo yɔrɔw la walasa aw kana joginni kɛ farikolo yɔrɔw la, joli siraw ani senkɔniw na.

- Aw kana a to fixation pins walima screws ka don joli la.

- Aw bɛ aw yɛrɛ tanga kari dakunw ni joli-sira-funu ma.

- Aw bɛ aw yɛrɛ tanga farikolo yɔrɔw ma minnu bɛ bɔ farikolo la walima minnu bɛ kɛ ka mɔgɔw bila u ka u yɛrɛ tanga.

- Aw bɛ kolosinsinnanw kɛ ka kɔn ka u wuli walasa u kana tiɲɛni kɛ funteni na (a bɛ bɔ ring necrose la).

- Fixation pins ka kan ka janya bɛnnen na walasa ka frame bɛnnen dɔ jɔ.

3.2.1 Backbone .

Ni drill walima fixation pin ka nɔgɔn, funteni bɛna dɔgɔya. Ni kurukuruw bɛ teliya, funteni bɛna bonya. Kolow tiɲɛni funteni na, o ye haminankoba ye bawo o bɛ se ka kɛ sababu ye ka kolo salenw sɔrɔ minnu bɛ kɛ ni bolo ye, o min bɛ se ka kɛ sababu ye ka a lajɔ joona ani/walima ka banakisɛ sɔrɔ. Fixation pins minnu bilalen don ka ɲɛ, olu ka kan ka minɛ koɲuman kɔri fila bɛɛ kan, ka sɔrɔ a kun man kan ka don yɔrɔ jan.

3.2.2 Diaphyse .

Epifisi kɔnɔ, funteni sɔrɔli tɛ gɛlɛya ye. A bɛ se ka kɛ ko a ka fisa ka baara kɛ ni yɛrɛlabɛnni juruw ye nin yɔrɔ in na, barisa a ka nɔgɔn ka tɛmɛ dingɛw kan minnu bɛ sɔgɔ ka kɔn ni u bɛ siri ni kuruw ye. Fixation pin donli joli la, o ka kan ka bali barisa farati bɛ pikirijikɛlan na ka don joli la.

3.2.3 Lakanali yɔrɔw .

Walasa ka aw tanga joginda ma, joli siraw, senkɔniw, ani farikolo yɔrɔw, operelikɛla ka kan ka a bolokɔniw farikololabɔcogo dɔn kurukuruw bɛɛ la ani ka baara kɛ ni lakana yɔrɔ ye walasa ka fixation pins bila.

Jaa 3.3.3-2 Yɔrɔ lakananen don kɛnɛma fixation pin bilali la.

a senkɔni.

Jaa 3.3.3-2 (a bɛ taa ɲɛ) .

B tibia.

Jaa 3.3.3-2 (a bɛ taa ɲɛ) .

C Humerus, kɔfɛla lajɛ.

Ni a bɛ kɛ awiyɔn kelen kɔnɔ, a man kan ka Schanz buruburu don ka don ɲɛgɛnɛsira ɲɛfɛla la. Tibial crest ɲɛfɛla kolo ni a sɔgɔli bɛ funteni caman bɔ, o bɛ se ka kɛ sababu ye ka kolotuguda filanan kɛ. Tibia distal la, farati bɛ a la ka senkɔni ɲɛfɛla ni extensor digitorum muscles jogin.

4. A yɔrɔw .

4.1 Tubabu-Rod ka sigida .

4.1.1 SCHANZ BAMAKO ƝƐNAJƐW . 

Schanz visw ye fixation pins dɔw ye minnu bɛ siri ni jiri ye. U bɛ Sɔrɔ u cɛmancɛ la, u janya tɛ kelen ye (kɔrɔta janya, jiri janya) ani tipiw danfaralenw. Schanz ka jurukisɛ jɔnjɔn kun ye trocar-shaped tip ye (Ja 3.3.3-3A) wa a ka ca a la a bɛ kɛ ka kɔn ka a kɛ.

Jaa 3.3.3-3 SCHANZ ƝƐFƆLIW.

A standard socket pin-shaped tip.

b Yɛrɛ-yɛrɛ-yɛrɛ-yɛrɛ-yɛrɛ-ko.

Yɛrɛlabɛnni ni yɛrɛdɔn pinɛw bɛ ni tip kɛrɛnkɛrɛnnen ye min bɛ se ka jiriw sɔgɔ ani ka u tigɛ waati kelen na ni u sirilen don. U dabɔra ka baara kɛ ni u ye metafizi la (Ja 333-3b).

Schanz buruburuw bɛ sɔrɔ nɛgɛ, titaniyɔmu walima idɔrɔsiyapatiti la. Hydroxyapatite pinɛw bɛ se ka minɛ ka ɲɛ kolo la, o bɛ a to kolo bɛ don joona ani ka a yɛrɛ tanga lajɔli ma. Nin pin suguya in bɛnnen don banabagatɔw ma minnu bɛ kɛnɛma fiɲɛ bila u nɔ na waati jan kɔnɔ.

4.1.2 Steiner Pins .

Steiner pinw bɛ kɛ ka caya i n’a fɔ fixation pins minnu bɛ don kolo la. U kunw bɛ kɛ drill bolokɔniw cogo la wa u ka kan ka kɔn ka u bila ka ɲɛ kolosinsinnan kolo la sani u ka don a kɔnɔ.

4.1.3 Tubabu/Rodw .

Ka kɛɲɛ ni tubabu/jiriw ka fɛnsɛbɛnniw ye, modɛli 4 bɛ yen minnu tɛ kelen ye:

• A ka bon: 11 mm tube/rod, Schanz vises ye 4~6 mm ye.

• Medium: 8 mm tube/rod, Schanz vis ye 3~6 mm ye.

• A ka dɔgɔn: 4 mm tube/rod, schanz buruburuw ye milimɛtɛrɛ 1,8 fo 4 ye.

• Mini: 2 mm sitɛmu bolokɔniw kama, dilancogo kɔrɔlen, ni pin caman sirilan ye K-wiriw ni 2 mm berew labɛnni na.

Nin sigida in ka moduluw bɛ fara ɲɔgɔn kan ni berew ye minnu bɛ kɛ ka ɲɛ, minnu bɛ kɛ ni karɔbɔni ye. Walasa ka fiɲɛ bila yɔrɔ gɛlɛnw na i n’a fɔ bolokɔni, T-joint modules fana bɛ sɔrɔ.

4.1.4 Kɔlɔnw .

A sirilanw bɛ kɛ ka tubabu/rod ni fixation pins siri ɲɔgɔn na. Tubuw/jiriw fana bɛ se ka siri ɲɔgɔn na ni sirilan bɛnnen ye (tube-tube).

Jaa 3.3.3-5 .

A yɛrɛ datugulan min bɛ kɛ ka Schanz juruw ni tubabukanw/jiriw siri ɲɔgɔn na.

B Aw bɛ bere walima tubabufura fila siri ɲɔgɔn na.

c Universel multi-pin clamp.

D tube-tube clamp ka tubabukan fila siri ɲɔgɔn na.

4.2 Kɛnɛya sabatili karamɔgɔya siratigɛ la .

Kari bloki bɛ se ka kunbɛn ni sirilan fila ye walima ka a siri ni fɛn ye min bɛ kɛ ka kɛɲɛ ni mɔgɔw sago ye. Cɛmancɛ-yɔrɔ-yɔrɔ dɔ bɛ Se ka Dòn a la walasa a ka Se ka 'fɛn Bɔ a la walima ka a degun walasa ka kolo janya ani/walima kolo-taama.

A kelen-kelen bɛɛ ka kɛnɛma-filɛli-minɛn min bɛ kɛ ka kolo-taama kɛ .

4.3 Kɛnɛya sabatili faralen ɲɔgɔn kan .

Kɛnɛyaji faralen ɲɔgɔn kan, o bɛ kɛ kariw la minnu bɛ kolotuguda kɛrɛfɛ ani a bɛ Kirschner Pin tensionnée ɲini walasa ka ring fixation kɛ ani ka schanz screw conventionnel kɛ diaphyse la. A ka c’a la, a ka ca a la, a bɛ kɛ ni lamini ye. Ring fixators faralen ɲɔgɔn kan, olu bɛ kɛ fɔlɔ senkɔniw na minnu ka surun ani minnu bɛ yɔrɔjan.

Aw bɛ kɛnɛyaji sirilan faralen ɲɔgɔn kan ka ɲɛsin tibial plateau fractures ma. A bɛ se ka kɛ fana ka ɲɛgɛnɛsiralabanaw ka kariw kɛ. V-cogo la , a bɛ sabatili ɲuman di edics .

4.4 Lamini fixation de fixation extérieur .

Nafa min bɛ kɛnɛma-fini-yɔrɔ-ko la min bɛ Kɛ ni lamini ye pewu, o ye ko doni-ta-minɛn ni kolotuguda-yɔrɔ-yɔrɔ-yɔrɔ bɛ Tɛmɛ kɛnɛma-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ cɛmancɛ la ka Fàra kolo janya-yɔrɔ janya kan. Lamini na, kɛnɛma fiɲɛbɔlan bɛ se ka kɛ ka kolo janya, ka kolo minɛ, ani ka kari nɔgɔmanw ni kari gɛlɛnw furakɛ.

Tibial ring kɛnɛma fixation brace .

Ja min bɛ kɛ ka ɲɛgɛnɛ kɛ, o ye tibial ring external fixation system ye .

Nin fɛɛrɛ in kɛli bɛ a to girinya jiginni joona. Walasa ka kari kura sɔrɔ, an bɛ kɛnɛma fixation frame nɔgɔman dɔ fɛ furakɛli kama. Kolow minɛcogo n’u janya bɛ se ka furakɛ ni kɛnɛma fixation system ye min bɛ kɛ fan kelen fɛ, nka a bɛ se ka gɛlɛya ka tiɲɛniw latilenni gɛlɛnw kɛ, minnu bɛ sabati, minnu bɛ kɛ ni fɛn caman ye, minnu kama, kɛnɛma fixateur lamininen bɛ fɔ. Ni a kɛra kɛnɛma fiɲɛ ye, kɛnɛma-filɛli lamini bɛ sabatili danfaralen di. Ni pikirijikɛlan tɛmɛna awiyɔn suguya caman fɛ walasa ka fiɲɛ caman bila, o jɔcogo bɛ sabatiliba di. A jɔcogo fanga bɛ danfara ka kɛɲɛ ni fiɲɛ sigicogo ye, bololanɛgɛ hakɛ min bɛ kɛ, ani pini suguya min bɛ kɛ, i n’a fɔ Kirschner pinɛw walima Schanz juruw. Ka kɛɲɛ ni ɲɔgɔnkanu ye, kari bɛ se ka kɔsegin walima ka degun, wa a tiɲɛni fana bɛ se ka latilen. A ka ca a la, ɲɛgɛnɛsiralabanaw bɛ kɛ ka kolosinsinnanw dila ka kolo gɛlɛya, ka surunya ani ka fɛn dɔw tiɲɛ.

4.5 Aw bɛ fɛnɲɛnamafagalanw (Brace de fixation extérieur) .

A bɛ kɛ ka kolotugudaw jiginni walima u kariyɔrɔw jiginni sabati ani ka joli lamagacogo dɔw (kunnafoni) di u ma walasa u ka se ka kolotugudaw gɛlɛyali bali. A bɛ kɛ ka caya kɔkili joli la.

5 Kalansenw jɔli ka ɲɛsin kɛnɛma fixation braces ma .

5.1 Tɔgɔdacogo min bɛ kɛ karamɔgɔya la .

Fɛɛrɛw bɛ yen minnu bɛ kɛ ka ɲɛsin karamɔgɔya sigicogo ma, kɛrɛnkɛrɛnnenya la, minnu sinsinnen bɛ:

- Baarakunda.

- Kalansenw dilanni.

- plan de application.

- Karamɔgɔya.

5.1.1 Kalansen kelen .

A fan kelen-kelen bɛɛ ye kɛnɛma fixator frame modality ye min bɛ kɛ ka caya diaphyseal fractures kura furakɛli la. Kalansen bɛ kɛ plan kelen kɔnɔ, misali la, anteromedial walima medial to the tibia and anterolateral walima lateral to the femur. Fixation pins bɛ don fari la fan kelen fɛ ka don double cortex kɔnɔ. Pinɛ ka kan ka bila yɔrɔ la ka bɔ joli la, ka bɔ joli la ka bɔ joli la, walasa joli ka sepsis kana kɛ. O bere fila bɛ sigi awiyɔn kelen kɔnɔ walima awiyɔn fila wɛrɛw kɔnɔ o kɔfɛ u bɛ fara ɲɔgɔn kan.

5.1.2 Kalansen fila .

Szczecin pin bɛ tɛmɛ fari fɛ a fan kelen fɛ, ka don bilaminar cortex kɔnɔ, o kɔfɛ a bɛ tɛmɛ fari fɛ a fan dɔ fɛ. fila-fila-kalanw man ɲi kariw furakɛli dafalen na, nka u bɛ se ka kɛ ka u siri waati dɔɔni kɔnɔ.

5.1.3 Kɔnɔnafiliw tigɛlenw .

A bɛ kɛ ka tiɲɛniw kunbɛn fɛɛrɛw la ka se yɔrɔw ma minnu joginni jugumanba bɛ u la walima ka u karili gɛlɛnw kɛ u la ani ka kariw bɔ ɲɔgɔn na.

▲Pelvic fractures, proximal femur fractures, ani proximal tibia fractures tun bɛ lamaga ni waati dɔɔnin kɛnɛma fixation braces ye gɛnɛgɛnɛ ni senkɔniw cɛ.

Kɛnɛya sabatili karamɔgɔ bɛ sabatili min di, o bɛ sira di farikolo yɔrɔ nɔgɔlenw kɛnɛyali ma ka fara CT scanner ani ka kɔn operasiyɔn ɲɛ. A ka ca a la, a ka ca a la, a ka kan ka kɛ ni fɛnw ye minnu bɛ kɛ ka fɛnw siri, ani ka opereli dafalenw kɛ joginni yɔrɔ kɔfɛ ani ka baara kɛ ni u ye sini.

5.1.4 Kalansenw .

Ilizarov ye nin fɛɛrɛ in don sen kan ni kɛnɛma fixation frame circumferentiel ye. Tubabukan na, kɛnɛma-filɛli-kalanw ni kɛnɛma-filɛli-kalan-minɛnw bɛ Se ka Kɛ ka nin sariya in Tà dɔɔnin dɔɔnin, n’o ye ko nafa tɛ a la ko kɛrɛ ni 'yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-ko-ɲɛnabɔli-cogow latilenni tɛ Se ka Kɛ waati kelen na fo n'a Kɛra ko janya bɛ Kɛ ni 'kɔnɔna-yɔrɔ-ko ye.

5.2 Labɛncogo kura kɛcogo misali .

Nafa min bɛ kɛnɛma fixation frame faralen ɲɔgɔn kan, o ye ko a bɛ se ka kɛ ka kolo janw bɛɛ dɔgɔya, ka u siri, ani ka u siri, yɔrɔ minnu bɛ kolotuguda kɛrɛfɛ, ani joli yɛrɛ (transarticulaire).

Schanz kuruw bilali bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ sababu ye ka fɛn dɔw kɛ ka a kɛ ka kɛɲɛ ni a ka fɛn ye min bɛ se ka kɛ sababu ye ka fɛn dɔ kɛ min bɛ se ka kɛ ka fɛnw siri. Kari yɔrɔbaw dɔgɔyali bɛ se ka kɛ ni levier ni reduction techniques indirects ye, ka sɔrɔ ka joli bɔli mara ka taa kolo ni farikolo yɔrɔ nɔgɔlenw na. Nin fɛɛrɛ in kɛli bɛ sira di ka kari dɔgɔyali ladilan kokura waati o waati.

Reduction technique faralen ɲɔgɔn kan.

A suguya b tibial jiri kari.

B Kari bloki belebele kelen-kelen bɛɛ la, fixation pins 2 bɛ siri jogin yɔrɔ kɔkan.

C fixation pins bɛ siri connection berew la ni universel clamps ye, o bɛ kɛ sababu ye u 2 bololanɛgɛw ka fara kari dɔgɔyali kan.

D Kariyɔrɔ seginnen kɔ, 3nan ɲɔgɔndan bere sirilen bɛ ɲɔgɔndan 2 fɔlɔw la minnu bɛ ɲɔgɔn cɛ ni tubabu-tuba sirilan ye.

▲ Kɛnɛya sabatili brace faralen ɲɔgɔn kan. A tibia. B femur. C Trans-Knee.

6 Sɛbɛnni kɛrɛnkɛrɛnnenw .

6.1 Jogindaw ka ɲɔgɔn falen .

Baara kɛrɛnkɛrɛnnen min bɛ Kɛ ni kɛnɛma-figaw ye, o ye jogindaw faralen ye ɲɔgɔn kan ni degun ye ni kɛnɛma-fiɲɛbɔlanw ye. O sariyakolo bɛ kɛ tuma dɔw la senkɔniw, gɛnɛgɛnɛw ani kɔkiliw faralen ɲɔgɔn kan, kɛrɛnkɛrɛnnenya la ni banakisɛ bɛ u la .

6.2 Banakisɛfagalanw .

Kɛnɛya sabatili ye furakɛli laban ye min bɛ kɛ ka karibana jugumanba sɔrɔ walima ka farikolo yɔrɔ dɔ sɔrɔ, barisa a ka ca a la, fixation pins bɛ se ka bila ka bɔ banakisɛ yɔrɔ la.

6.3 kolotugudaw latilenni .

Osteotomie minnu bɛ kɛ ka fɛnɲɛnamafagalanw latilen ni farikolo yɔrɔ nugulamaw cogoyaw man ɲi walima ni u bɛ tiɲɛ ani ni u bɛ se ka kɛ ka kɔnɔna fiɲɛ bila u la, o ka bon, o cogo la, kɛnɛma fixation brackets bɛ se ka kɛ ka fiɲɛ bila. Fɛn wɛrɛ min bɛ a jira ko koloci ni kolo minɛcogo bɛ kɛ waati kelen na. A ka c’a la, o bɛ a ɲini ka latilenni kɛ ni kɛnɛma fixation frame lamini ye.

6.4 Kolow tali - Distraction osteogenesis .

Kolow tigɛli sinsinnen bɛ Ilizarov ka sariyakolo kan min ye ka kɔnɔbara basigilen mara walasa kolo tigɛlen ka ɲɛ ka se ka bɔ a la dɔɔni dɔɔni (0,5-1 mm/d), ani kolo kura bɛ sɔrɔ o yɔrɔ la. Distraction (distraction) hakɛ dɔgɔyali bɛ na ni kolo kɛnɛyali ye, k’a sɔrɔ distraction (distraction) teliya hakɛ minnu bɛ tɛmɛ farikolo yɔrɔ tolerance (sɔgɔsɔgɔninjɛ) muɲuni kan, olu tɛ kɛ sababu ye ka kolow dilan. Kolow sɔgɔli walima u hakili ɲagaminen, i n’a fɔ kariw ta, olu fana bɛ tɛmɛ sɔgɔsɔgɔninjɛ furakɛli taabolo bɛɛ fɛ fo ka se kolotuguda kɛnɛyali ma. Nin fɛɛrɛ in tali taamasiɲɛ 3 bɛ yen, wa tuma dɔw la, o taamasiɲɛ ninnu bɛ se ka kɛ ɲɔgɔn fɛ:

- farikolo yɔrɔ janya.

- Segmental kolo minɛcogo walasa ka kolo tiɲɛniw furakɛ.

- kolotugudaw latilenni.

Fixation frames minnu bɛnnen don kosɛbɛ o baara kama olu ye lamini fixation frame circumferentiel ye (ni kɛnɛma fixation frame semi-circumferentiel ye walima ni a tɛ yen) ani kɛnɛma fixation frame kelen.

6.5 Jogindaw seginni ani lamaga sabatili .

Kɛnɛyajibɔlan min bɛ kɛ ka a sɔgɔ, o ye farali nafama ye kɔkili joginni gɛlɛn damadɔw kan minnu tɛ sabati, i n’a fɔ kɔkiliw bɔli basigilen walima a ɲɛnabɔbali kɔfɛ, ka da a kan a sigicogo kura ni a ligament dilancogo. A bɛ bɔ kɛnɛma fixateur (finibɔlan) la min bɛ kɔkiliw lasegin ni mobilasiyɔn kɔrɔsilen ye. Repositioning (yɔrɔ-yɔrɔ-ko) marali ye fɔlɔ ye. Basigibaliya ɲɛnabɔli ka gɛlɛn ka tɛmɛ lamagabaliya kan. Aksidan ka kan ka bila tigitigi fluoroskopi jukɔrɔ. Deviations dɔɔnin minnu bɛ sɔrɔ charnière jɔyɔrɔ la, olu bɛ se ka nɔba bila a ka baara la.

▲ Aw bɛ kɛnɛma fiɲɛbɔlan dɔ bila a kɔkili la.

7 furakɛli kɔfɛ furakɛli .

7.1 Pin Tract Care .

Pin tract reaction bɛ bɔ fixation pin jɔyɔrɔ n’a sabatili la, opereli kɔfɛ furakɛli jɛkulu ni banabagatɔ. Dɔgɔyali fɛɛrɛ faralen ɲɔgɔn kan, o nafa ka bon kosɛbɛ bawo a bɛ sira di farikolo jɔyɔrɔ ɲuman sugandili ma fixation pin na ka kɛɲɛ ni kari suguya ye. Dɔgɔtɔrɔso ka kan ka kɛ ni pin tractw ladoncogo jɛlen ye, ani dɔgɔtɔrɔso baarakɛlaw minnu bɛ se kosɛbɛ, olu ka kan ka banabagatɔw kalan u yɛrɛ ka pin furakɛli la. Ni aw bɛ aw yɛrɛ tanga joginni funteni ma ani joli bɔli ma sigida la pin dontuma na, ani ka dɔlɔ banakisɛfagalanw kɛ ka pin yɔrɔ saniya furakɛli kɔfɛ, ani ka baara kɛ ni degun dagalenw ye, ka PIN banakisɛ sɔrɔ ani ka a lajɔ, o bɛ se ka dɔgɔya kosɛbɛ.

7.2 Pin Tract banakisɛ . 

Pin Tract Care ka kan ka fɔlɔ ka pinɛ doncogo ɲuman sɔrɔ. Schanz buruburu kɔrɔlenw kama, a ka c’a la, a ka kan ka kɛ ko PIN bɛ kɛ ni bolo ye walasa ka funteni nekɔrɔsi dɔgɔya. A ka kan ka bɔ pin lamini na opereli senfɛ. Pin Tract ladonni ɲuman nafa ka bon walasa ka dɔ bɔ pinɛw ka gɛlɛyaw sɔrɔli la. Pin Tract infection ani screw lajɔli bɛ se ka ɲɛnabɔ ni pinɛ lafiyalen bɔli ye ani ka pini dɔ wuli kokura yɔrɔ wɛrɛ la.

7.3 Mobilizasiyɔn .

N’a ma kɛ ko kɛrɛnkɛrɛnnen damadɔw ye (fixation bridgement, baara kɛcogo kɔrɔtɔlen, tension adjustment), a bɛ se ka kɛ ko girinya yɔrɔ dɔ bɛ se ka kɛ kɛnɛma fixator daminɛ na. Ni kɛnɛya bɛ taa ɲɛ, girinya dafalen bɛ se ka caya dɔɔni dɔɔni. Wajibi tɛ ka fanga-da-minɛn wɛrɛw Fàra kɛnɛma-fiɲɛbɔlan kan. Kisɛya yɔrɔ dɔ walima a dafalen ye fanga sɔrɔcogo ɲuman ye ani a bɛ se ka kɛ.

8 Kɛnɛma fiɲɛbɔli kuntaala .

8.1 Furakɛli caman cili .

Furakɛcogo jɔnjɔn 3 bɛ yen:

• Aw bɛ kɛnɛma fiyɛlan kɛ furakɛli dafalen ye fo ka se ka kari ka kɛnɛya.

• Yɛlɛma joona ka kɛ kɔnɔna labɛnni ye.

• Aw bɛ wuli ka taa furakɛli la min tɛ opereli ye, i n’a fɔ plaster, orthose, a ɲɔgɔnnaw.

Ni jiginni ka kɛ kɔnɔna na, o bɛ makɔnɔ, a ka kan ka kɛ joona (dɔgɔkun 2 kɔnɔ) bawo gɛlɛya hakɛ bɛ dɔgɔya kosɛbɛ ka tɛmɛ jiginni kɔfɛta kan.

Nin sariya ninnu ka kan ka labato ni aw bɛ opereli suguya o suguya labɛn sani u ka sigi waati dɔɔni kɔnɔ, walima u kɔfɛ:

• Ni fɛn kura donna kɛnɛma fixation yɔrɔ fɔlɔ lamini na, pinɛw bɛɛ ka kan ka saniya. Tuma dɔw la, o kɛcogo bɛ kɛ taabolo fila la, ni dakun kelen ye walasa ka pin sira fɔlɔ saniya ani ka taabolo filanan kɛ walasa ka fiɲɛbɔli dafalen kɛ.

• Pin sira o yɔrɔ min kɔrɔla ka tɛmɛ tile 10 fo tile 14 kan, o bɛ jate koloni ye, wa a ka kan ka saniya ani ka a bɔ a la aseptiki la sani a ka fiɲɛ bila a la.

• Ni siga bɛ nin pinɛw walima pinɛw ka fɛnɲɛnamafagalanw ka fɛnɲɛnamafagalanw na kaban, 'Pin lafiɲɛbɔ waati' min bɛ tile 10 la dɔgɔmannin, o bɛ kɛ pinɛw ka sɛgɛsɛgɛli kɔfɛ sani fɛn dɔ ka don a kɔnɔ.

• Banakisɛfagalanw ka kan ka kɛ banakisɛfagalanw tali la ni banakisɛfagalanw ye minnu bɛ banakisɛw datugu ka bɔ pin sira tɛmɛnenw na.

• Aw bɛ tugu-tugu-ɲɔgɔn kɔ dɔgɔkun 6 fɔlɔw la, kɔnɔna-fiɲɛbɔlan caman cili kɔfɛ.

Ni dalilu bɛ yen min b’a jira ko gɛlɛya dɔ bɛ pini sira kan, a ka fisa ka banakisɛ suguya dɔn, ka banakisɛfagalanw kɛ, ka pini caman Changer ani ka a bila a nɔ na, ka taa a fɛ ka furakɛli kɛ ni kɛnɛma fixateur ye. Pin Tract ladonni ka kan ka kɛ banabagatɔ la walasa ka a ka ɲɛtaa ɲuman sɔrɔ. Ni kɛnɛma fiɲɛbɔlan ka kan ka wuli ni kɔnɔna fixation ye a laban na, a ka ɲi ka 'Pin lafiɲɛbɔ waati' sɔrɔ min ka dɔgɔn tile 10, o kɔrɔ ye ko kɛnɛma fiɲɛbɔlan bɔlen kɔfɛ, pin sira ka kan ka saniya ani ka bɔ a la fɔlɔ, ka sɔrɔ ka a siri ni sɔgɔlilan ye fo ka se ka kɔnɔna labɛnni gɛlɛya ɲɛnabɔ. Banakisɛfagalanw bɛ se ka kɛ ka ɲɛ o waati kɔnɔ.

8.2 Fixation laban .

Kɔrɔtɔko la, kɛnɛma fiɲɛ bilali bɛ se ka farikolo yɔrɔ bɛɛ sabati waati dɔɔni kɔnɔ ani ka sira di farikolo yɔrɔ nugulamaw kɛnɛyali ma. Ni farikolo yɔrɔ nɔgɔlenw cogoyaw bɛ sabati, kɛnɛma fiɲɛbɔlan bɛ se ka wuli ka bila a nɔ na ni kɔnɔna fiɲɛ laban ye. A ka fisa, a ka kan ka bila a nɔ na kɔnɔna na tile 10 kɔnɔ.

Ni kɛnɛma fiɲɛ bɛ sabati hali bi ani ni gɛlɛya taamasiɲɛw tɛ yen, fiɲɛ bilali a nɔ na, o man kan. Ni fari datugucogo man ɲi, walima ni hami bɛ farikolo yɔrɔ nugulamaw tiɲɛni jugumanba la ani ni u bɛ se ka sɔrɔ da wulilenw na, o farati ka bon, kɛnɛma fiyɛlilan bɛ se ka mara i n’a fɔ kari furakɛli laban.

Kari kɛnɛyali ɲɛtaa ka kan ka kɔlɔsi kosɛbɛ, wa ni ɲɛtaa ma sɔrɔ, furakɛli wɛrɛw ka kan ka jateminɛ.