Femoral Intramedullary Nailing - Aw bɛ se ka don yɔrɔ ɲuman sugandi cogo di?

Daminɛ kuma

Senkɔni kari furakɛli yiriwali bɛ se ka bɔ san 1940 waatiw la, waati min na Kuntscher ye sɔgɔsɔgɔninjɛ kɛcogo datugulen don senkɔniw kɔnɔ. Nɛgɛw kɛli senkɔniw kɔnɔ (IMN) senkɔniw karilenw na, o kɛra ladonni sariya ye san tan tɛmɛnenw kɔnɔ, ani sisan ɲɛtaa minnu kɛra senkɔniw na sɔgɔsɔgɔninjɛ ni opereli fɛɛrɛw ɲɛtaa kɛra sababu ye ka dɔ fara senkɔniw sɔgɔli kɛcogo kan kosɛbɛ.

Senkɔniw karilenw furakɛli min bɛ kɛ ni kɔrɔlen ye, o bɛ kɛ banabagatɔ damadɔ dɔrɔn de la minnu ka bana jugumanba bɛ anestezi ni opereli la, wa furakɛli kunba bɛ to opereli jɔli la. Nin kari ninnu furakɛli opereli siratigɛ la, fɛɛrɛ caman bɛ se ka kɛ, i n’a fɔ ka sɔgɔsɔgɔninjɛ kɛ senkɔniw kɔnɔ, ka plati kuru siri, ani ka kɛnɛma siri. Ni aw ye a suma ni opereli suguya wɛrɛw ye, sɔgɔsɔgɔninjɛ min bɛ kɛ senkɔniw kɔnɔ, o ye fɛɛrɛ ye min ka gɛlɛyaw ka dɔgɔn ani min karilenw kɛnɛyali hakɛ ka ca, wa a bɛ ka kɛ ka caya kɛnɛyaso la.

Ni aw ye senkɔni gɛrɛgɛrɛ farikololabɔcogo faamuya ka ɲɛ, joli min bɛ taa senkɔni kunkolo la ani kɔkiliw farikololabɔcogo, o bɛ se ka dɔ fara senkɔniw sɔgɔli ɲɛtaa kan kosɛbɛ senkɔniw karilenw na. O ni dondaw sugandili bɛ bɔ fɛn caman na, i n’a fɔ wuluwulu dilanni, a kariyɔrɔ, a kariyɔrɔ, ani banabagatɔ ka fɛnw (misali la, joginda caman, kɔnɔmaya, ani fasa). Donda yɔrɔ min sugandira, o mana kɛ min o min ye, dondaw ɲuman sɔrɔli nafa ka bon walasa ka dɔgɔyali bɛrɛbɛrɛ mara wulu dontuma na ka sɔrɔ ka gɛlɛyaw farati dɔgɔya.

Senkɔni Anatomie (Anatomie femoral).

1.Joli bɛ don senkɔni kun na

Senkɔni kunkolo bɛ joli siraw sɔrɔ ka bɔ joli siraba 3 la. Senkɔni sira min bɛ wuli kɛrɛfɛ (ni bolo 3-4 bɛ a la), obturator artery, min bɛ ligament bulama di, ani senkɔni rotator medial (ja 1), o fana bɛ wuli ka wuli ka taa sanfɛ min bɛ anastomose ni lateral rotator femoral artery ye ani ka trochanteric region belebeleba di.

2.Anatomie De La Muscles De Hip

Ni aw bɛ senkɔni sɔgɔli kɛ senkɔni kɔnɔ, farikolo yɔrɔw faamuyali ɲuman nafa ka bon walasa ka joginda kunntanw bali. Gluteus medius farikolo bɛ bɔ sɔgɔsɔgɔninjɛ la ka laban sɔgɔsɔgɔninjɛ belebeleba kɛrɛfɛla la, ka sɔrɔ gluteus minimus farikolo fana bɛ bɔ kɔkolo la ka tɛmɛ kɔkolo kɔkanna fan fɛ ka laban sɔgɔsɔgɔninjɛ belebele kɔfɛla la (Ja 2 & 3). O farikolo fila bɛɛ bɛ baara kɛ i n’a fɔ cɛya adductors ani kɔkolo kɔnɔna wulilanw. O la, ni tiɲɛni kɛra o farikolo yɔrɔw la senkɔni senkɔniw donni senfɛ, o bɛna kɛ sababu ye ka adductor barika dɔgɔya ani ka Trendelenburg taama, o bɛ nɔ jugu bila banabagatɔ ka kɛnɛyali ni a kɔlɔlɔw la.

Jaa 2. Farikolo minnu bɛ kɔkolo lamini na, olu farikolo cogoya

Jaa 3. senkɔni farikolo yɔrɔ min bɛ a kɛrɛfɛ

Nail intramedullaire femoral parallèle

Kɔsa in na, sɛgɛsɛgɛli caman kɛra ka don yɔrɔ ɲuman sɛgɛsɛgɛ senkɔni parakirini na. Nɛgɛ dondaw suganditaw ye trochanter belebeleba ni piriform fossa ye, u kelen-kelen bɛɛ n’u ka taamasiɲɛw ni gɛlɛya minnu bɛ tali kɛ o la (Taabolo 1).

Tablo 1.Daminɛyɔrɔw ni farati minnu bɛ se ka sɔrɔ parakirini ni senkɔniw sɔgɔli kɔfɛ
variant (dafalen) ye	nail intramedullaire parallèle (banakisɛ min bɛ kɛ ni ɲɛgɛnɛsira kɔnɔ) ye		wuluwulu min bɛ kɔsegin kɔkolo kɔnɔ
	rotor (rotor) ye	piriform fossa (banakisɛfagalan) .
korona awiyɔn	Trochanter belebeleba kunkolo ani a bɛ tali kɛ cɛmancɛ la ka taa ɲɛgɛnɛsira la	trochanter belebele ni senkɔni kɔ ka ɲɔgɔn sɔrɔ	cɛmancɛ yɔrɔ min bɛ wele ko intercondylaire fossa (anatomie) .
plan sagittal (jatebɔ) .	Layini bɛ senkɔni belebele cɛmancɛ ni senkɔni ɲɛgɛnɛsira cɛmancɛ cɛ	piriform fossa (banakisɛfagalan) .	PCL santimɛtɛrɛ 1,2 bɛ senkɔni daminɛyɔrɔ ɲɛfɛ, a bɛ a ɲɛsin senkɔniw ma.
fɛnw jirali	Hip abductor kulu jɔli yɔrɔ jogin	Joli sɔrɔli dɔgɔyali senkɔni kunkolo ni kɔkili kɛnɛma wulilan farikolo la	A minɛcogo jugu bɛ se ka kɛ sababu ye ka PCL sɔrɔ
PCL: kɔfɛla sɔgɔsɔgɔninjɛ

1.Rotor pikirijikɛlan don yɔrɔba

A ɲɛfɔra ko trochanter belebeleba ye kolotuguda kɛnɛman ye min bɛ sɔrɔ senkɔni kɔkanna fan fɛ, a sanfɛla bɛ nɔrɔli kɛ kɛrɛfɛla sɔgɔsɔgɔninjɛ cɛmancɛ ni ɲɛfɛla sɔgɔsɔgɔninjɛ minimus farikolow la (Jaa 2 ni 3). Hali ni nin ye kolo taamasiɲɛ fitinin ye, ka daminɛyɔrɔ ɲuman sigi sen kan ni aw bɛ senkɔni IMN kɛ, o bɛ se ka kɛ danfara ye min bɛ sɔrɔ wasa walima nɔ jugu sɔrɔli cɛ ni aw bɛ senkɔniw karilen ɲɛnabɔ.

Ni an ye sɛbɛnw lajɛ sisan senkɔniw dondaw ɲɛfɔli kan, an y’a ye ko farikololabɔlan dɔ tɛ yen min ɲɛfɔlen don ka jɛya senkɔni rotor IMN dondaw la.Bharti et al. a ye donyɔrɔ ɲɛfɔ ka bɔ sɔgɔsɔgɔninjɛba kuncɛyɔrɔ la ko a bɛ cɛmancɛ la ka taa ɲɛgɛnɛsira ɲɛfɛla la orthostatique jɔyɔrɔ la, ani ko a bɛ kɛ sɔgɔsɔgɔninjɛba cɛmancɛ ye min bɛ bɛn senkɔniw cɛmancɛ cɛmancɛ ma kɛrɛfɛyɔrɔ la (Ja 4), ani sɔgɔsɔgɔninjɛba dondaw ɲɛfɔli wɛrɛ min bɛ kɔkili kɛrɛfɛla lajɛ la, o bɛ rotor kɔnɔ ɲɛfɛla cɛ ɲɛfɛla ni ɲɔgɔn cɛ tila sabanan kelen ani kɔfɛla tila sabanan fila ye rotor.Georgiadis et al. ye pikirijikɛlan don yɔrɔ ɲɛfɔ i n’a fɔ rotor (rotor) sanfɛla sanfɛla dakun kɔfɛla fanba.

JIGISƐN 4. Opereli kɔfɛ, kɔkolo lajɛcogo ni a kɛrɛfɛla lajɛw bɛ donyɔrɔ ɲuman jira senkɔni paramedian intramedullary nailing of the greater trochanter. '*' bɛ wuluwulu dondaw jira.

Kɔsa in na, sɛgɛsɛgɛli minnu kɛra sɛbɛnw kɔnɔ, olu y’a jira ko jirisunba kuncɛyɔrɔ ye daminɛyɔrɔ ɲuman ye fanga sira ɲuman sɔrɔli kama, wa ko ɲɔgɔndan jugu min bɛ sɔrɔ inversion deformity fɛ, o bɛ kɛ tuma caman na ni donyɔrɔ bɛ wuli ka tɛmɛ milimɛtɛrɛ 2 kan kɛrɛfɛ ka taa trochanter belebeleba la. Nin kalan in y’a sinsin fana ko dondaw min bɛ kɔfɛ kosɛbɛ, o bɛ na ni ɲɛfɛla jiginni ye yɔrɔjan, k’a sɔrɔ dondaw cɛmancɛ bɛ se ka kɛ sababu ye ka yɔrɔjan kariyɔrɔ bloki wuli ka taa kɔfɛ. O ni ɲɔgɔn cɛ, sɛgɛsɛgɛli wɛrɛ y’a jira ko senkɔniw karilenw na, wuluwuluw sɔgɔli hakɛ ka ca kosɛbɛ ni pinɛyɔrɔ ye min bɛ ɲɛfɛla fan fɛ ka tɛmɛ pinɛyɔrɔ kan min ka surun cɛmancɛ ni kɔfɛ fan fɛ.

Trochanteric apex pinning point min ka bon, o ka teli ka kɛ banabagatɔ fasalenw na, wa o kɛcogo tɛ fɛɛrɛko siratigɛ la, o bɛ opereli waati dɔgɔya ani ka gɛlɛyaw farati dɔgɔya ka tɛmɛ piriform fossa pinning point kan.

GƐLƐYAW: Opereli kɔfɛ ani opereli kɔfɛ gɛlɛya minnu bɛ sɔrɔ senkɔniw sɔgɔsɔgɔli la ni u ka taamayɔrɔ ka bon ni trochantérique ye, olu ɲɛfɔra sɛbɛn caman kɔnɔ. Olu dɔ la kelen, a ka c’a la, a bɛ tali kɛ sɔgɔsɔgɔninjɛ fɛɛrɛ la, o ye kariw ye minnu bɛ sɔrɔ furakɛli fɛ. Senkɔniw karilenw na, dondaw min bɛ senkɔni belebeleba kɛrɛfɛ ani ɲɛfɛ, o ka teli ka kɛ sababu ye ka cɛmancɛ kari ka tɛmɛ dondaw kan min ka surun cɛmancɛ fan fɛ.

Gɛlɛya wɛrɛ min bɛ tali kɛ o la, o bɛ sɔrɔ farikolo yɔrɔ nɔgɔlenw joginw fɛ, kɛrɛnkɛrɛnnenya la senkɔni joli sira cɛmancɛ la ani senkɔni fasaw bolow, nka o joginw man teli ka kɛ ni u ni piriform fossa dondaw ye. Ka fara o kan, senkɔni kunkolo sɔgɔsɔgɔninjɛ ni sɔgɔsɔgɔninjɛba kuncɛyɔrɔ ye i n’a fɔ a donyɔrɔ, a bɛ miiri ko o ka dɔgɔn kosɛbɛ, ni sɛgɛsɛgɛliw y’a jira ko a ka dɔgɔn fo ka se 0,3% ma.

Ni aw ye opereli waati ni fluoroscopie tali jateminɛ, opereli waati cɛmancɛ tun ye miniti 90,7 ye trochanterie don yɔrɔba la ni i ye a suma ni miniti 112,7 ye fosa donyɔrɔ kulu la min bɛ i n’a fɔ peer, k’a sɔrɔ fluoroscopie waati tun ye segin 5,88 ye trochanterie don yɔrɔba kulu la ani segin 10,08 ye pear cogoya la fosa dondaw kulu, n’i y’a suma ni fosa dondaw ye minnu bɛ i n’a fɔ pere.

Banabagatɔw ka ɲɛnamaya ɲɛfɔcogo fana tun ye ko nafama ye ni u tun bɛ wulu doncogo latigɛ, barisa baarakɛcogo kɛnɛyali joona (i n’a fɔ a jateminɛna cogo min na sigilan-sigilan sɛgɛsɛgɛli fɛ ani kɔrɔtacogo sɛgɛsɛgɛli fɛ waati latigɛlen fɛ) tun ka fisa kosɛbɛ banabagatɔw ma kalo 6 kɔnɔ opereli kɔfɛ ka ɲɛsin trochanteriki don yɔrɔba ma ni i ye a suma ni piriform fossa dondaw ye, nka o danfara tun tɛ kosɛbɛ kalo 12 opereli kɔfɛ. Hali ni a ka c’a la, trochanteric donyɔrɔba bɛ tali kɛ farikolo yɔrɔ nɔgɔlenw bɔli dɔgɔyali la k’a sababu kɛ a sigiyɔrɔ ye, a bɛ se ka kɛ sababu ye ka joginni bila mɔgɔ minɛbaga farikolo kulu la hali bi, i n’a fɔ Ergiş ni a ɲɔgɔnnaw y’a jira cogo min na. U y’a ye ko balansi fangama ni kɔkili minɛcogo fanga dɔgɔyara banabagatɔw la minnu ka trochanteric entry peg ka bon ni i ye a suma ni kɛnɛyabaarakɛlaw ye. Ka fara o kan, u ka sɛgɛsɛgɛli y’a jira ko kɔkolo minɛbagaw, kɔkiliw ani kɔnɔna/kɛnɛma wulilanw fanga dɔgɔyara kosɛbɛ ni i y’a suma ni fan ye min ma opere.

2. Perle fossa dondaw

Piriformis farikolo fosa ye farikolo yɔrɔw taamasiyɛn nafama ye min dɔnna ko a donna yɔrɔ dɔ ye paracentesis femoral intramedullary nail.U ka autopsy cadaveric study kɔnɔ, Lakhwani et al. a kɔlɔsira ko piriformis farikolo fosa tun tɛ 'pere' cogoya ye, wa a tun tɛ piriformis farikolo nɔrɔlen ye. Farikolo bɛ nɔrɔ yɔrɔ fitinin dɔ la sɔgɔsɔgɔninjɛba kuncɛ la, k’a sɔrɔ piriform fossa ye degun ye sɔgɔsɔgɔninjɛ belebele cɛmancɛ fan fɛ ani a ye extensor carpi radialis brevis farikolo nɔrɔlen ye. Sɛbɛnnikɛlaw y’a Jira ko pirifɔmu farikolo ni pirifɔmu fosa ye fɛn fla ye minnu tɛ kelen ye wa ko min bɛ Weele ko pirifɔmu fosi, o ka kan ka Weele ko 'rotor' walima 'occlusal' fosa walasa ka jɛya ani ka farikolo-ɲɛnajɛ kɛcogo ɲuman Sɔrɔ. U y'a jira ko cis-femoral kalanni kɔfɛ U y'a jira ko 'rotor fossa' daɲɛ fɔlɔ ka don sɛbɛnw kɔnɔ kokura 'pyriform fossa' nɔ na, ​​parafemoral dondaw daɲɛw kalanni kɔfɛ. Hali n’a y’a sɔrɔ nin kalan fila in hakilinaw bɛ bonya kosɛbɛ, walasa ka ɲɛfɔli nɔgɔya ani ka ɲagami bali ni trochanteric dondaw belebeleba ye, an bɛna o dondaw wele hali bi ko pyriform fossa dondaw.

Kalan caman minnu kɛra sisan sɛbɛnw kɔnɔ, olu bɛ perle fossa don yɔrɔ tigitigi ɲɛfɔ ka ɲɛ senkɔniw kɔnɔ.Georgiadis et al. aw bɛ perle fossa don yɔrɔ ɲɛfɔ i n’a fɔ extenseur carpi radialis brevis farikolo nɔrɔyɔrɔ min bɛ degun na senkɔni kɔ da la (ja 5). Sɛbɛnnikɛlaw y’u sinsin fana a kan ko dondaw min ka jan kojugu walima ni a yɔrɔ ka jan kojugu kɔnɔ, o bɛ se ka dɔ fara senkɔni kɔ karicogo kan, wa ni dondaw yɔrɔ ka jan kɔfɛ, faratiba bɛ se ka kɛ joli-sira-funu-banakisɛ la, o min ka ca banabagatɔ funankɛninw na.

Jaa 5. Opereli kɔfɛ ɲɛda lajɛ min bɛ donyɔrɔ ɲuman jira senkɔni kɔnɔbara la min bɛ wele ko pyriform fossa retrograde femoral intramedullary nail. '*' bɛ sɔgɔsɔgɔninjɛ daminɛyɔrɔ jira.

Harper ni a ɲɔgɔnnaw. ye sɛgɛsɛgɛli dɔ bɔ hadamadenw ka cɛya suw kulu 14 kan san 1987, u ye ɲɛgɛnɛsira ɲɛminɛlan yɔrɔ jateminɛ ani ɲɛgɛnɛsira kɔnɔ nɛgɛ bɔyɔrɔ min donna yɔrɔjan ni kɛrɛfɛ cogo la min bɛ kɔsegin ka bɔ senkɔniw cɛmancɛ la. U y’a jira ko piriformis paramedian intramedullary nail don yɔrɔ bɛ sɔrɔ trochanter belebele ni senkɔni kɔ cɛtigɛyɔrɔ la, piriformis occulta ɲɛfɛ dɔɔni.A donna yɔrɔ in dafara kokura Gausepohl ni a ɲɔgɔnnaw fɛ. Kadaveric kalan wɛrɛ la, u ye donyɔrɔ ɲuman sigi senkɔni kɔnɔbara la, ka kɛɲɛ ni trochanter belebele cɛmancɛ da la min bɛ pyriformis tendon kan. O tɛmɛnen kɔ, Labronici ni a ɲɔgɔnnaw ka suw sɛgɛsɛgɛli la. piriformis farikolo fosa ɲɛfɔra i n’a fɔ luminal yɔrɔ min bɛ i n’a fɔ peer, min bɛ bɛn senkɔniw cɛmancɛ-yɔrɔ ma koronawirisi-yɔrɔ la.

Piriform fossa sɔrɔyɔrɔ nafa kɛrɛnkɛrɛnnen dɔw bɛ a la barisa a ka gɛlɛn fɛɛrɛko siratigɛ la ni i ye a suma ni trochanter sɔrɔyɔrɔba ye, kɛrɛnkɛrɛnnenya la banabagatɔ fasalenw na. Ka fara o kan, donyɔrɔ ɲuman min bɛ kɛ fosa pikirijikɛlan dondaw la min bɛ i n’a fɔ pere, o ye yɔrɔ fitinin ye, o b’a to a ka gɛlɛn ka sigida lamini. Misali la, ni ɲɛfɛla daminɛyɔrɔ tɛmɛna senkɔni kɔ kan, o bɛna kɛ sababu ye ka lamini degun kojugu ani ka dɔ fara ɲɛda ɲɛfɛla pɛrɛnni farati kan, kɛrɛnkɛrɛnnenya la ni daminɛyɔrɔ ka ca ni milimɛtɛrɛ 6 ye senkɔni ɲɛfɛ. Ka fara o kan, cogoya danfara bɛ se ka donyɔrɔ ɲuman bali, kɛrɛnkɛrɛnnenya la ni kɛnɛma wulilan surun ka bon walima ni wulilan bɛ bɔ kɛnɛma, o bɛ na ni dondaw ye min bɛ cɛmancɛ la kojugu ani ni farati bɛ senkɔni kɔ kari.

GƐLƐYAW : Ni u ye trochantérique don yɔrɔ belebele 38 ni perle fossa don yɔrɔ 53 suma senkɔniw kɔnɔ, Ricci ni a ɲɔgɔnnaw y’a ye ko perle fossa kulu ka opereli waati ka jan 30% ani fluoroscopie waati ka jan 73%. O sɔrɔlenw Sɛmɛntiya Bhatti ni a ɲɔgɔnnaw fɛ. ni aw bɛ pikirijikɛlan dondaw 2 suma ɲɔgɔn na.

Ka ɲɛsin farikolo yɔrɔ nɔgɔlenw joginni ma, farikolo yɔrɔ nɔgɔlenw joginni farati tun ka bon piriformis dondaw la ni i ye a suma ni kolotugudaw cɛsiraw ye minnu bɛ trochanteriki pikirijikɛlan don yɔrɔba la. Dora ni a ɲɔgɔnnaw. ye baliku su 16 jateminɛ ni farikolo yɔrɔ nɔgɔlen joginw ye piriformis farikolo ni rotor dondaw pinɛ la. U y’a ye ko hali ni piriformis fossa tun bɛ jateminɛ kɛcogo ɲuman na, a ye tiɲɛniba kɛ joli siraw la minnu bɛ taa senkɔni kunkolo la ani a lamini fasaw ni senkɔniw na. O sɔrɔlen ninnu sinsinnen don kokura ni suw sɛgɛsɛgɛli ye Ansari Moin ni a ɲɔgɔnnaw fɛ. OMS fana ye dondaw fila suma ɲɔgɔn na. U y’a jira ko nɛgɛ kɔnɔna jɔli k’a daminɛ piriformis farikolo la, o ka teli ka kɔkili minɛfɛnw ni kɛnɛma wulilanw tiɲɛ. Ka fara o kan, tiɲɛni kɛra senkɔni joli sira cɛmancɛ la, o kɛra ko bɛɛ la (Taabolo 2).

Tablo 2. Farikolo nɔgɔlen joginw kuncɛlen pikirijikɛlan dondaw danfaralenw na
variant (dafalen) min bɛ wele ko variant	Piriform fossa dondaw (n=5) .	Rotor baloyɔrɔba (n=5) .
farikolo yɔrɔ nɔgɔlenw
gluteus medius farikolo (anatomie) .	5	1
gluteus medius sɔgɔsɔgɔninjɛ	0	4
sɔgɔsɔgɔninjɛ joginni
gluteus minimus (banakisɛfagalan) .	3	0
piriformis farikolo (kɔkolo sanfɛla sanfɛ) .	3	3
obturateur internus (banakisɛfagalan) .	1	0
latissimus dorsi farikolo yɔrɔ (anatomie) .	3	0
Joli siraw ni kolotugudaw
MFCA bolofara jugumanw	4	0
MFCA bolofara min ka surun	4	0
articulaire capsule (joli min bɛ kɛ i n’a fɔ gɛnɛgɛnɛ farikolo yɔrɔw la) .	1	0
MFCA: senkɔni joli sira cɛmancɛ lamini.

Kɔsa in na, Bharti ni a ɲɔgɔnnaw ye sɛgɛsɛgɛli kɛ. ye gɛlɛya farati sɛgɛsɛgɛ senkɔniw kɔnɔ sɔgɔsɔgɔninjɛ la sɔgɔsɔgɔninjɛ don yɔrɔba la ani perle fossa don yɔrɔ la ani ka gɛlɛya faratiw sɔrɔ i n’a fɔ kari kɛnɛya hakɛ ani k’u lajɛ nin cogo la (Taabolo 3).

Tablo 3. Piriform fossa dondaw ni trochanter belebele dondaw senkɔni kolotugudaw
gɛlɛya min bɛ sɔrɔ a la	Piriformis sinus pikirijikɛlan yɔrɔ	Trochanter doncogo yɔrɔ min ka bon
Banakisɛw don a la	6.7	3.3
Malunion (Maliyɔn) ye	20	13.3
Kɛnɛya min bɛ mɛn sen na	20	13.3
Kɔnɔbara lamagacogo danma	20	33.3
Gɛnɛgɛnɛ lamagacogo danma	6.7	6.7
Senkɔniw janya danfara	13.3	20
Kɔnɔbara dawolo bɛ Bɔ kolotuguda sanfɛ	13.3	20
Opereli senfɛ senkɔni kɔ kari	10	0
Trochanter karilenba (trochanter) karilenba	0	3.4
Senkɔni kunkolo nekɔrɔsi	6.7	0

Kɔnɔbara basigilen kɔfɛla sɔgɔsɔgɔninjɛ

Ni aw ye donyɔrɔ bɛnnen dɔn senkɔni kɔfɛla sɔgɔsɔgɔninjɛ la, o bɛna dɛmɛ ka kariw labɛncogo ɲuman, a janya ani a jiginni kɛcogo ɲuman segin a cogo kɔrɔ la ka sɔrɔ ka joli siraw tiɲɛni dɔgɔya, ɲɛdawolo ɲɛfɛla sɔgɔsɔgɔninjɛ (ACL), kɔfɛla sɔgɔsɔgɔninjɛ (ACL), ani farikolo yɔrɔ nɔgɔlen joginni (Taabolo 1). Kɔsa in na, nafa bɛ ka bonya senkɔni kɔfɛla sɔgɔli la ni laɲini ye ka gɛlɛyaw dɔgɔya minnu bɛ sɔrɔ paracromial nailing fɛ, i n’a fɔ kɔdimi, koloci hɛtɛrotopiki, adductor barika dɔgɔyali, ani pudendal nerve palsy, o min jatera ko a tɛ fɛn caman kɛ ni a bɛ tali kɛ tigɛda dɔgɔyali ni locking femoral plating for internal fixation, kɛrɛnkɛrɛnnenya la senkɔni jiribolo tila sabanan yɔrɔjan karilenw na. Ka fara o kan, dalilu minnu sɔrɔla kɔsa in na, olu b’a jira ko ni nin wuluwulu minnu bɛ segin kɔfɛ, olu bonya bɛnnen don, a bɛ se ka kɛ ko wulu minnu bɛ datugu kɛrɛfɛ, olu tɛ mako ɲɛ.Danfara si tun tɛ kɛnɛya hakɛ la, kɛnɛya waati la, walima banabagatɔw ka kɔlɔlɔw la minnu fɔra Meccariello ni a ɲɔgɔnnaw cɛ. ani Bisaccia ni a ɲɔgɔnnaw. senkɔni jiribolo karilenw tila sabanan yɔrɔjan furakɛli la ni wuluwuluw ye minnu bɛ kɔsegin, minnu bɛ datugu ani minnu tɛ datugu. O la, senkɔniw sɔgɔli kɔfɛ, o kɛra fɛn ye min diyara mɔgɔw ye, wa a sɔnna a ma kosɛbɛ.

Ɲɛfɔli caman bɛ se ka sɔrɔ sɛbɛnw kɔnɔ, minnu bɛ se ka kɛ sababu ye ka senkɔni kɔnɔnatumuw doncogo ɲuman sɔrɔ. Kalan fanba b’a jira ko donyɔrɔ ɲuman don senkɔni kɔfɛla la, o ye 1,2 ye kɔfɛla kurukuruni bɔyɔrɔ ɲɛfɛ

santimɛtɛrɛ (a bɛ bɛn medullary cavity ma) ani intercondylar fossa cɛmancɛ (ja 6).

JIGISƐN 6. Gɛnɛgɛnɛ jɔcogo ni a kɛrɛfɛla lajɛ opereli senfɛ, o bɛ donyɔrɔ ɲuman jira senkɔni kɔfɛla kɔnɔbara la. '*' bɛ ɲɛgɛnɛsira kɔnɔna na daminɛyɔrɔ jira.

Hali ni taamasiɲɛ dafalen si tɛ senkɔni kɔfɛla sɔgɔsɔgɔninjɛ la, taamasiɲɛ caman ɲɛfɔra minnu bɛ tali kɛ ɲɔgɔn na. Olu ye joli-sira-funu-banabagatɔw ye, banabagatɔ minnu fasalen don kosɛbɛ, banabagatɔ kɔnɔmaw, senkɔni jiribolo fila karilenw, senkɔniw ni senkɔniw karilenw walima senkɔniw karilenw walima senkɔniw karilenw, ani senkɔniw ni senkɔniw karilenw. Nin taamasiɲɛ ninnu fanba bɛ tali kɛ banabagatɔ jɔyɔrɔ nɔgɔyali la ani opereli joginda caman kunbɛnni na u kɛrɛfɛ.

Faan wɛrɛ fɛ, senkɔni kɔkanna sɔgɔsɔgɔninjɛ kɔlɔlɔ dafalenw ye senkɔni kɔfɛla sira datuguli ye senkɔni kɔnɔfɛn min maralen don ani senkɔni yɔrɔjan karilenw dabɔlen. Banakisɛfagalan minnu bɛ tali kɛ ɲɔgɔn na, olu ye kariw ye minnu bɛ sɔrɔ santimɛtɛrɛ 5 kɔnɔ ka bɔ sɔgɔsɔgɔninjɛ fitinin na, gɛlɛya ka don donyɔrɔ ɲuman na ka a sababu kɛ gɛnɛgɛnɛ kɔrɔtalen ye min tɛ degere 45 bɔ, gɛnɛgɛnɛ banakisɛ sɔrɔli ka kɔn o ɲɛ min bɛ se ka kɛ sababu ye ka farati lase a ma ka jɛnsɛn senkɔnibara la, joginni jugumanba minnu bɛ sɔrɔ gɛnɛgɛnɛ lamini na, ani gɛnɛgɛnɛ duguma yɔrɔ karilen intra-articular patella ani pole distal extreme.

Gɛlɛyaw : Senkɔniw sɔgɔli kɔfɛ gɛlɛya fanba bɛ tali kɛ a minɛcogo jugu la, kɛrɛnkɛrɛnnenya la dondaw bilali cogo jugu la. Sagittal plane kɔnɔ, don yɔrɔ min ka ca ni ɲɛfɛla ye, o bɛna kɛ sababu ye ka kɔfɛla kari bamanankan na, ka bolokɔniw ɲɛ tiɲɛ, ani a bɛ se ka kɛ ko nɛgɛ bɛ se ka gosi senkɔni na ni gɛnɛgɛnɛ kurulen don. Faan wɛrɛ fɛ, ni dondaw ma sigi ka ɲɛ kɔfɛla la, o bɛ se ka kɛ sababu ye ka joginni faratiba lase kɔfɛla kurukuru bɔyɔrɔ ma ani ka kariyɔrɔ ɲɛfɛla wuli.

Hutchinson ni a ɲɔgɔnnaw. gɛlɛya minnu bɛ sɔrɔ koronawirisi pankurun dondaw la minnu tɛ bɛn, olu ɲɛfɔra. U y’a ye ko don yɔrɔ min bɛ cɛmancɛ la kojugu, o bɛ na ni kɔfɛla tiɲɛni ye ni kɔfɛla karilen bamanankan ye, k’a sɔrɔ kɛrɛfɛla min ka ca kojugu, o bɛ na ni cɛmancɛla tiɲɛni ye ani cɛmancɛ bamanankan na.Sanders et al. a y’a jira ko ni u ye cɛmancɛ daminɛyɔrɔ sugandi min bɛ santimɛtɛrɛ 2 walima ka tɛmɛ o kan ka bɔ cɛmancɛla yɔrɔ la, o bɛ na ni cɛmancɛ ɲɛda karilen ye min malunited ka da kari kɔfɛ isthmic bending moment kan min bɛ na ni kɔfɛla dɔgɔyali jugu ye.

Gɛlɛya wɛrɛ minnu bɛ sɔrɔ senkɔni kɔfɛla sɔgɔli la, olu ye gɛnɛgɛnɛ dimi ye, a gɛlɛyali, gɛnɛgɛnɛ koloci hɛtɛrotopiki, ani gɛnɛgɛnɛ kɔnɔ farikolo min tɛ kɛ.

A ka kuma kuncɛ

Hali ni sɔgɔsɔgɔninjɛ kɛcogo kelen-kelen bɛɛ bɛ ni taamasiɲɛ ye min bɛ bɛn o ma, a ka c’a la, ɲɛgɛnɛsira sɔgɔli fɛɛrɛ min bɛ kɛ senkɔniw karilen furakɛli la, o sugandili bɛ bɔ operelikɛla ka fɛɛrɛ la. Ni aw bɛ senkɔni sɔgɔli kɛ senkɔni kɔnɔ, ka don yɔrɔ ɲuman sɔrɔ nɛgɛ suguya la min bɛ kɛ ka a siri, o de ka kan walasa ka se ka kɛ ka ɲɛ. Sigida farikololabɔli ni ja lajɛcogo dɔnni bɛna operelikɛla dɛmɛ ka fɛɛrɛ dɔ kɛ min bɛ se ka kɛ fɛɛrɛko siratigɛ la, ka sɔrɔ ka dɔ bɔ gɛlɛyaw la minnu bɛ sɔrɔ o la. Ka fara o kan, sɔgɔsɔgɔninjɛ kɛcogo la, dɔgɔyali sabatili ye fɛn nafamaba ye min bɛ se ka kɛ sababu ye ka ɲɔgɔndɛmɛbaliya ni ɲɔgɔndɛmɛbaliya walima kariw faralibaliya bali.