Baarakɛcogo ɲuman ni Plaque de Locking!

KELEN locking plate ye karifɛnw sirilan ye min dingɛ bɛ ni jiri ye. Ni kuru min kun ye ni jiri ye, o sirilen don dingɛ kɔnɔ, o plati bɛ kɛ (kuru) kɛrɛ sirilan ye. Datugulan (angle stable) plati bɛ se ka kɛ ni kuru dingɛw ye minnu bɛ datugu ani minnu tɛ datugu, walasa juru suguya wɛrɛw ka se ka siri u kɔnɔ (a bɛ fɔ fana ko plati faralen ɲɔgɔn kan). Kabini hakilina min ye ka platiw datugu ani k’a waleya kariw furakɛli la, a kɛra baarakɛminɛn ye kosɛbɛ kolotugudaw karilenw sirili la, kolotugudaw karilenw ni kolociw karilenw sirili la k’a sababu kɛ a nafa ye ka dɛmɛ sabatilen di ani ka karilenw siri, kariw kɛnɛyali hakɛ ka ca, farikolo yɔrɔ nɔgɔlenw tiɲɛni dɔgɔyara ani joli sɔrɔli tiɲɛni. Bi sɔgɔmada kalan bɛna daminɛkuma caman di aw ma tabali datugucogo kan, o min nafa ka bon ka kalan sɔrɔ!

(A)Kunnafoni basigilen

1.Locking plate ye mun ye?

Nɛgɛdaga o nɛgɛdaga bɛ se ka siri ka kɛ kɛrɛkili sirili/kɔnɔna sabatili juruw walima pinɛw ye, o ye fɛn ye min bɛ kɛ ka fɛnw datugu.

2. Nafa ni dɛsɛ minnu bɛ sɔrɔ platiw datugucogo la

Nafa minnu b’a la

■ Kɔnɔna sabatili, a bɛ se ka kɔrɔta ani ka wuli

■Screw kunkolo cogoya koni bɛ masinw tilatilali ɲɛ

■Aw bɛ preload radial di, ka kolo seginni bali ani ka kurukuruw lajɔ

■A dilannen don farikolo yɔrɔw la walasa ka farikolo yɔrɔw cogoyaw labɛn

■Templates matching walasa ka sira di fixation percutanée ma diaphyse kɔnɔ (cortical kelen, yɛrɛ-dɔgɔli, yɛrɛ-tapping locking screws)

■Locking screws bɛ anchorage ɲuman di bridging flexible ani absolute stabilization fixation fila bɛɛ ma

■Mako t’a la ka maga kolo yɔrɔ la kosɛbɛ, ka joli sɔrɔli lakana

■Micromotion kɔrɔsilen, min bɛ kari kɛnɛyali dɛmɛ

■A ka c’a la, kolotuguda si man kan ka kɛ

A bɛ se ka kɛ kɛrɛnkɛrɛnnenya la kolotugudaw karilenw na walima kolotugudaw karilenw na minnu tɛ sabati kosɛbɛ.

Nafa minnu bɛ a la

■Locking screws tɛ dɔgɔya ni degun nɔ na, ​​kɛrɛnkɛrɛnnenya la ni bolokɔniw kɔnɔna karilen don walima ni u karilen don ni oblique nɔgɔmanw ye

■Plati tɛ se ka kɛ dɔgɔyali baarakɛminɛn ye walasa ka dɛmɛ don dɔgɔyali la.

■Kurukuruw tɛ diya i n’a fɔ kuru kɔrɔw ni u donna.

■Kurukuruw sira tɛ se ka ladilan (n’a ma kɛ ni juruw ye minnu bɛ datugu ni aksidan caman ye).

■Kurukuruw bɛ bila ka gɛlɛya kojugu, o bɛ se ka kɛ sababu ye ka 'nɛnɛ welding' kɛ.

■Angle deviation >5°, fanga bɔnɛ; >10°, locking effect tɛ nafa sɔrɔ

■A bɛ se ka kɛ farikolo jukɔrɔla bɔli ye ni plati ma kɛ contour ye

Gɛlɛya koɲɛw

Ni kɔritiki ma ɲɔgɔn sɔrɔ koɲuman walima ka kari dakunw degun, da tugulanw tali, kɛrɛnkɛrɛnnenya la nɛgɛdaga minnu tɛ sɔgɔ, o bɛna kari kɛnɛya fasa II bali ka a sababu kɛ a gɛlɛya kojugu ye ani ka mikromotion ɲuman bɔ kariyɔrɔ la

Ni opereli kɔnɔ traction kɛra ka sɔrɔ ka locking splint fixation kɛ, kari kari yɔrɔ bɛna mara, o bɛ na ni kari kɛnɛyali bɛ mɛn walima a tɛ kɛnɛya;

Ni kari nɔgɔman ma segin a cogo kɔrɔ la ani ka degun bila a la, doni bɛ tɛmɛ plati fɛ, o bɛ na ni degun hakɛ ye min bɛ se ka kɛ sababu ye ka plati kari nɔgɔya la.

3. Danfaraba minnu bɛ biyomekanikini na, minnu bɛ dakunw ni plati kɔrɔw cɛ

Plati kɔrɔlenw bɛ u jigi da sɔgɔsɔgɔli kan kolo ni plati cɛtigɛyɔrɔ la walasa ka kolo plati degun kɛ.

4. Nafa minnu bɛ sɔrɔ locking plate ni nɛgɛdaga gansan na ni ɲɔgɔn ye

1.Locking screws ka pull-out resistance ka bon kosɛbɛ ka tɛmɛ screw gansanw ta kan.

2. Epiphyseal locking screws bɛ kɛ kɛrɛ fɛ ɲɔgɔn na, o bɛ dɔ fara screw ka se ka bɔli kan kosɛbɛ ni i y’a suma ni parllel screws ye.

(B) Sariyakolo minnu bɛ baara kɛ ni u ye

1. Lamaga-lamagali sariyakolow:

●Degun sariya: koloci diaphyse kari

●Neutralisation principe : kolotugudaw kari

●Bridging principle (Bridging principle): diaphyse comminute walima metaphyse extra-articulaire kari

Jɛkulu ka sariyakolo : kari min bɛ kɛ farikolo kɔnɔ, o karilen don

2. Bridging sariyakolo:

●Fɛɛrɛ min bɛ kɛ ka caya: ka plati fixation minimum invasive percutané (MIPO walima MIPPO fɛɛrɛ) .

●Dɔgɔyali fɛɛrɛ indirect (dɔgɔyali siratigɛ la).

●Walisa ka bɔrɔsi plati siri ka ɲɛ, aw ka kan ka kuru dingɛ 3-4 to da la kariyɔrɔ kɛrɛfɛ.

3.Jɛkulu ka sariyakolow:

● Baara kɛli ni biyomekaniki sariya fila ye minnu ye degun ni bɔrɔ ye plati kelen kɔnɔ - degun plati min bɛ datugu (LCP) .

● Kari nɔgɔmanw karilen yɔrɔ kelen na ani kari tigɛlenw yɔrɔ tɔ kelen na (misali la, karilenw karilenw karilenw, diaphyse) .

●Jɛkulu sariya ka kan ka kɛ dɔrɔn platiw kan minnu bɛ sira di ka kunkolo datugulan fila bɛɛ bila ka fara juruw kan minnu bɛ kɛ ɲɔgɔn fɛ.

Datugulan-platiw tɛ u jigi da sɔgɔsɔgɔninjɛ kan kolo-platiw cɛla wa u bɛ u jigi da fɔlɔ kuru ni plati cɛsira kan min bɛ sabati ni kɛrɛfɛla sabatili ye walasa ka sabatili sabati.

K’a sababu kɛ u ka kelenya sabatili ye, kuru minnu kunkolo bɛ datugu, olu bɔli fanga ka bon kosɛbɛ ka tɛmɛ juruw bɔli kan minnu bɛ kɛ tuma bɛɛ, fo ni kurukuru minnu bɛ u lamini, olu bɛɛ bɔra walima ni u karilen don. A ka c’a la, a ka gɛlɛn ka kuru kelen bɔ walima ka kari a yɛrɛ ma. Kungolo sirilanw tɛ degun di ɲɔgɔn ma. Degun bɛ se ka sɔrɔ ni degunminɛn ye walima ni juru basigilenw bilali ye 'dingɛ ɲagaminenw' kɔnɔ (tansiyɔn juruw fɔlɔ, o kɔfɛ ka nɛgɛw datugu).

1.Ni ni kuru jɔnjɔnw kɛra ka sɔgɔsɔgɔninjɛ siri (misali la 1), kurukuruniw dabɔli bɛ nɔgɔya kosɛbɛ (misali la 2).

2.Ni da tuguli juruw kɛra ka sɔgɔsɔgɔninjɛ ni kolotugudaw siri (misali la, 1), a man ɲi ka jurumugu jɔnjɔnw siri kolotuguda kelen na (misali la, 2) fo ni datugulan juruw lajɔlen don ka u siri kokura (LHS).

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(C) Taamaʃyɛnw ni a taamasiɲɛw

1. Taamaʃyɛnw

Kari minnu furakɛra ni opereli ye, olu fanba tɛ kɛ ni locking plate fixation ye. Ni kolotugudaw opereli sariyakolow tugura, kari fanba bɛ se ka kɛnɛya ni tabali kɔrɔlenw ye walima ni sɔgɔsɔgɔninjɛ ye.

Nka, kari suguya kɛrɛnkɛrɛnnenw bɛ yen minnu bɛ se ka dɔgɔya ka bɔ u la, ka plati walima kuru kari, ani ka fara ɲɔgɔn kan o kɔfɛ, minnu bɛ wele tuma caman na ko 'kari minnu ma ɲɛnabɔ' walima 'gɛlɛya' kari, i n’a fɔ kari minnu bɛ kɛ joli kɔnɔ, kolo karilenw ni kolo misɛnniw karilen don, ani kolo karilenw. Nin kari suguya ninnu bɛ wele tuma caman na ko 'ɲɛnabɔbali' walima 'gɛlɛya' karilenw ani u dɔw ye kariw ye minnu bɛ kɛ joli kɔnɔ, kari minnu bɛ kɛ ni tubabu surun ye ani koloci karilenw. O kari ninnu bɛɛ ye taamasiɲɛw ye minnu bɛ kɛ ka platiw datugu.

Taamaʃyɛn kɔrɔlenw ni minnu ka ɲi kosɛbɛ walasa ka kariw sirili plati la, olu ye bridging principle ye ani union principle ye kariw la minnu bɛ sɔgɔsɔgɔ ka caya - kari minnu fanga ka bon banabagatɔ fitininw na walima koloci karilenw banabagatɔ kɔrɔbaw la.

2. A furakɛcogo minnu bɛ se ka kɛ

Hali ni baara kɛra ni dakunw datugucogo ye kosɛbɛ, wa u taamasiɲɛw ka bon, an ka kan ka dakun caman dɔn ani k’an yɛrɛ tanga da tugulanw ma. Ni dasirilanw kɛra ni danfara tɛ, u sirili dɛsɛ ani kari karilen tɛ ɲɔgɔn na, o bɛ se ka kɛ.

Kari nɔgɔman minnu bɛ farikolo ni ɲɔgɔn cɛ degun wajibiya, i n’a fɔ bolokɔnincinin nɔgɔman minnu furakɛra ni kɔnɔna sirili ye min bɛ datugu, olu ka teli ka kɛ ɲɔgɔndɛmɛbaliya ye.

O cogo kelen na, ka kari nɔgɔmanw datugulanw bila farikolo la ni fɛɛrɛw ye minnu tɛ fɛn caman kɛ, o fana ye bana jugu ye.

Dɔgɔyali indirect ani locking plate fixation fana man ɲi articular intra-articular fractures displaced, minnu bɛ farikolo yɔrɔw dɔgɔyali da wulilen ni degun de wajibiya kari yɔrɔw ni ferme fixation cɛ.

Fɛn min bɛ se ka kɛ ka platiw datugu, k’a sababu kɛ u musaka ka bon, o ye kariw ye minnu bɛ se ka labɛn ka ɲɛ ni plati kɔrɔw ye. Misali la, bolokɔnincinin karilenw kɛnɛyali hakɛ bɛ tɛmɛ 90% kan ni u furakɛra ni furakisɛ kɔrɔw ye.

(D) Datugulan-plati sigili

1. Aw bɛ drill bit siri ka don plati kuru dingɛw kɔnɔ. Ni >5° bɛ bɔ kuru ni kuru dingɛ cɛ, o bɛ se ka kɛ sababu ye ka kuru da tugu, wa a ka fisa ka baara kɛ ni jiribolo ye walasa ka dingɛw sɔgɔ a ka fisa.

2. Aw bɛ nɛgɛdaga bila kolo sanfɛ ka dingɛw sɔgɔ ka tɛmɛ nɛgɛdaga bolokɔni fɛ.

3. Aw bɛ a juguman suman ni dunnikɛlan ye, aw bɛ aw janto a la ko fɔlikɛlan kunkolo ka don kurukuru dingɛ kɔnɔ.

4. Aw bɛ da tugulan janya bɛnnen sugandi.

5. Degun-kuruw sigili ni nɛgɛdaga gansanw sigili ye kelen ye.

6. A laban na, aw bɛ da tugulanw siri ni girinyalan ye, ni u sirilen don, sɛgɛnlafiɲɛbɔ ni sɔgɔsɔgɔ mankan jɛlen bɛna kɛ, walasa aw kana siri ka siri kojugu, o bɛ na ni bɔli gɛlɛyaw ye.

(E) Locking plate bɔli

Kɛnɛyaso ka da tugu plati juruw bɛ kɛ ka caya, nka u bɔli gɛlɛyaw bɛ sɔrɔ nɔgɔya la, minnu bɛ ye kɛrɛnkɛrɛnnenya la kuru sɔgɔli nɛgɛ ni nɛgɛdaga ni plati nɛgɛ dingɛ juruw la sirilan jugu cɛ.

1. Screw cap groove tiɲɛni

Ni ko bɛnnen don, kuru dawolo dafalen ni kurukuru min bɛ bɛn o ma, olu bɛ bɛn. Kurukuruni ka kan ka bɛn ni kurukuruni dawolo ye sani kurukuruni ka don walima ka a bɔ, n’o tɛ, a ka c’a la, kurukuruni dawololan bɛ tiɲɛ ni a donna walima a bɛ bɔ, o bɛ na ni sɛgɛn ye.

Ka fara o kan, karilen kɛnɛyali kɔfɛ, a ka ca a la, kurukuruni dawolo bɛ siri ni kolotugudaw ye walima ni fɛnɲɛnamafagalanw ye, minnu ka kan ka saniya sani kurukuruni ka bɔ, nka ni aw ma jateminɛ kɛ, kurukuruni dakun ni a kɛrɛfɛla jɔcogo bɛ se ka tiɲɛ ni fɛn dilannenw ye.

Ikomi baarakɛla bolokɔnincinin jiginni sira tɛ bɛn ni fɛnɲɛnamafagalan janya ye, a ka c’a la, kɛrɛ dɔ bɛ yen, ni baarakɛla ye kurukuruni bɔ ni fanga ye, a tɛ se ka bali ko kurukurunin bɛ yɛrɛyɛrɛ, o bɛ na ni jurumugu dawolo tiɲɛni ye fanga bɛnbali fɛ. O la, tiɲɛni min bɛ kɛ kurukuruninw na, o bɛ se ka kɛ sababu ye nɔgɔya la ka kurukuruw sɛgɛn.

2. Nɛgɛdaga walima wuluwulu dingɛ bɔgɔbɔli

Opereli senfɛ nɛgɛdaga min bɛ datugu farikolo la, o kɛli la, tuma dɔw la ka kɛɲɛ ni nɛgɛdaga kɔrɔtacogo walima a cogoya bɛnnen mago ye, Raja et al. ka da a la ko ni a kɛra ko kurukuruni yɔrɔ kɛra da tuguli kurukuruw kɔnɔ, ni kurukuruni donna datugulanw kɔnɔ, o bɛna kɛ kurukuru da ni nɛgɛ dingɛ bɛnbaliya ye, o min ka teli kosɛbɛ ka kɛ nɛgɛdaga ni nɛgɛdaga nɛgɛ dingɛw sirilenw cɛ buckle jugu, walima kurulen ka surun nɛgɛdaga la ni nɛgɛdaga kɔkolo bɔgɔbɔli sababu bɔra kurukuru barikama fɛ, a ɲɔgɔnnaw, min bɛ se ka kɛ sababu ye ka na ka Gɛlɛya bɔli kɔfɛ.

3. Aw bɛ u yɛrɛ gosi ɲɛgɛnɛsira datugulanw kɛli

Ikomi kɔkolo kolo bɛ bonya ka taa kɔnɔna na wuluwulu dingɛ fɛ, o cogo la a bɛna kurukuru minɛ, o bɛ na ni gɛlɛyaw ye kurukuru bɔli la, kɛrɛnkɛrɛnnenya la, kolotuguda kolo fila minnu bɛ u yɛrɛ gosi, Suzuki et al. aw kana a fɔ ko aw ka kan ka aw yɛrɛ gosi ni kurukuruw ye minnu bɛ kɛ ka ɲɛgɛnɛsira fila siri. Hou Yunfei ni a ɲɔgɔnnaw. a y’a jira ko bicortical fixation kunntan ni juruw ka kan ka ban sanfɛla karilenw na, ani Maehara et al. fana y’a jira ko baara kɛli ni dakunw ye tuma caman na, ni u bɛ baara kɛ ni dakunw ye, wa ko a ka kan ka sariya dɔ sigi senkan diɲɛ bɛɛ kɔnɔ, dakunw sugandili n’u kɛli la.

4. Kurukuruw jɔcogo n’u sigiyɔrɔ

Datugulan kuru bonya, a ɲɛsincogo ani a sigiyɔrɔ bɛ se ka nɔ bila kuru bɔli la. Dɔnnibaa dɔw y’a Sɔrɔ ni kuru ma Sìgi dakun dakun cɛmancɛ la, ni nɛgɛ dingɛ eccentricity (kɛrɛnkɛrɛnnenya la) ka Tɛmɛ 5 ° kan, a bɛ Se ka Kɛ ko kuru sirili lajɔlen don, jiriw sirili jugu walima nɛgɛbere bɔgɔlan bɛ nɔrɔ ani ka Nà ni sirili dɛsɛ ye walima gɛlɛyaw bɔli dakun filanan.

5.Fɔli nɛnɛma

Titaniyɔmu kɔnɔna siriyɔrɔ nɔrɔlen bɛ ni lakanafɛn passivalen ye, kɔnɔna sirili opereli kɛcogo la, ka da a minɛcogo ni a cogoya baarakɛminɛnw kan, walima kuru kunkolo ni nɛgɛdaga ni ɲɔgɔn cɛ sɔgɔsɔgɔninjɛ, a ɲɔgɔnnaw, o bɛ se ka kɛ sababu ye ka lakanalan pasivalen don yɔrɔ la. 2 nɛgɛ jɛgɛn yɔrɔ min bɛ ɲɔgɔn sɔrɔ yɔrɔ min na, o bɛna nɔrɔ, o kɔrɔ ye ko nɛnɛma sɔgɔli.

Ka fara o kan, nɛgɛ ionw ni ɲɔgɔn cɛ galvanic coupling, inflammatory reactions, a ɲɔgɔnnaw fana bɛ se ka kɛ sababu ye ka welds nɛnɛmaw dilan. Kɔnɔna sirilanw dilannikɛla fanba fana bɛ o gɛlɛya in dɔn, o de kama, nɛgɛdaga minnu tɛ baara kɛ ni u ye, olu datugulen don ni ɔkisizɛni filimu fɛɛrɛ ye wulu dingɛw ni kurukuruw ɲɔgɔndan yɔrɔw cɛ, o fana laɲini ye ka farikolo kɔnɔ farikolojɔlifɛnw ionize ni u tali bali ani ka dɔ bɔ nɛnɛ sɔgɔli sɔrɔli la.

(F) A bɔli fɛɛrɛw

Fɛɛrɛ minnu fɔra jamana ni diɲɛ sɛbɛnw kɔnɔ, olu bɛ se ka tila kulu 2 ye, n’olu ye, minnu ka nɔgɔn ani minnu bɛ se ka kɛ ani minnu ka gɛlɛn, fɔlɔw bɛ dɔn ni sɔrɔli nɔgɔman ye, baarakɛcogo ɲuman, farikolo yɔrɔ nɔgɔlenw tiɲɛni dɔgɔyali, seko dɔgɔyalen ani mago tɛ minɛn kɛrɛnkɛrɛnnenw na, ani filananw bɛ minɛn kɛrɛnkɛrɛnnenw ni minɛn kɛrɛnkɛrɛnnenw de wajibiya.

Maehara ni a ɲɔgɔnnaw. aw bɛ a fɔ ko aw ka baara kɛ ni fɛnɲɛnamafagalanw ye minnu bɛ girinya dantigɛ, ni u senw ka bon ni aw bɛ se ka kɛ tuma o tuma. Ni u ye ɲɔgɔn sɔrɔ ni juruw sɔgɔlenw ye, Pattison et al. ye fɛɛrɛ nɔgɔman dɔ lakali min bɛ se ka kɛ ka juruw bɔ minnu sɛgɛnnen don, n’u ye kurukuru kunkolo siri ni nɛgɛ platini ye, k’a don jurumugu dawolo kɔnɔ. Nin fɛɛrɛ in ye hakilitigiya ye walasa ka nɛgɛdaga dawolo fa ni nɛgɛfugulan ye ani ka dɔ fara ɲɔgɔnkanu yɔrɔ ni sɔgɔsɔgɔninjɛ kan kurukuruni ni jiribolo cɛ, o bɛ juruw bɔli nɔgɔya ni jiriw sɔgɔlenw ye. O fɛɛrɛ in na a ka gɛlɛn hali bi ka ko in bɔ, ni kuru dawolo ni nɛgɛdaga nɛgɛ dingɛ juruw bɛ u cogo la hali bi, aw bɛ se k’a ɲini ka baara kɛ ni kurukuru bɔlan ye min bɛ wele ko conical reverse tapping screw remover, o kɔrɔ ye ko ka bɔ kuru dawolo la min donna kɔfɛ tapping kɔnɔ ani ka jiribolo fa, o kɛcogo la ka kurukuru wuli ani ka a digidigi ka bɔ.

A dɔgɔyalenba la, dakun dɔw bɛ gɛlɛya hali bi ka baara kɛ ni conical reverse tapping screw extractor ye, i n’a fɔ Ehlinger et al. ani Bae ni a ɲɔgɔnnaw. minnu y’a ye ko nin fɛɛrɛ in ka teli ka kɛ milimɛtɛrɛ 3,5 kuru sɔgɔli la, nka tuma caman na, a tɛ nafa sɔrɔ milimɛtɛrɛ 4,5 kuru sɔgɔli la. O cogo la, dɔgɔtɔrɔso kolociw ka kulu bɛɛ tɛ ni nɛgɛ sɔgɔlan kɛrɛnkɛrɛnnenw ye i n’a fɔ karɔti sɔgɔlanw, diamant sɔgɔlanw, walima nɛgɛ sɔgɔlanw minnu bɛ teliya kosɛbɛ.

Gopinathan ni a ɲɔgɔnnaw. ka fɛɛrɛ dɔ daminɛ min tɛ nin minɛn kɛrɛnkɛrɛnnen ninnu wajibiya ni kurukuru bɔli gɛlɛn dɔ fɔli ye ka bɔ sɔgɔsɔgɔninjɛ seginni plati la, o kɔrɔ ye ko ni baara kɛra ni seginkanni plati tigɛcogo dɔgɔman ye, nɛgɛ tigɛlan belebele dɔ bɛ kɛ ka plati yɔrɔ fitinin tigɛ plati nɛgɛ dingɛw cɛ, walasa kurukuruw ni nɛgɛ dingɛ yɔrɔ min bɛ plati kɔnɔ ka kɛ fɛn fitinin ye, ani kurukuruw ka se ka bɔ nɔgɔya la. Nin fɛɛrɛ in bɛ kɛ dɔrɔn titaniyɔmu jɔli seginni dakunw na, bolokɔni ɲɛfɛla datugulanw minnu ka dɔgɔn, ani tubabu suguya 1/3, wa a tɛ se ka kɛ talanw ye minnu ka bon walima minnu ka bon duguma dakunw na.

Fɛɛrɛ nɔgɔman dɔ fana ɲɛfɔra, n’o ye ko jirisunba dɔ bɛ kɛ ka dingɛ dɔ sɔgɔ dingɛ jɛlen kɔnɔ min bɛ da tugulan sɔgɔlen kɛrɛfɛ, o kɔfɛ, plati ni juru bɛ gosi dingɛ jɛlen kura sɔgɔlen sira fɛ, o kɔfɛ, plati ni kuru bɛ bɔ ni kolo tigɛlan ye min bilalen don bɔgɔdaga jukɔrɔ k’a sɔgɔ ni leverage sariya ye n’a kɛra a lajɔlen don.

Tiɲɛ don, kolo tiɲɛni bɛ se ka kɛ ni nin fɛɛrɛ in ye, o la opereli kɔfɛ girinya tacogo ka ɲi. Ka fara o kan, a ka kan fana ka baarakɛlaw ka baarakɛminɛn dɔw labɛn minnu bɛ kɛ ka caya sani kɔnɔnatumuw bɔli opereli ka kɛ, i n’a fɔ bololanɛgɛ bɔlan, dingɛw bɔlan, burusi bɔli pince, T-type pressurized socket ani o ɲɔgɔnnaw.

Kɔrɔsili kuru sɔgɔlen bɔli gɛlɛyaw ɲɛkɔrɔ, sokɔnɔ dɔnnikɛla dɔw y’a jira ko ka jirisunw kɛcogo Changer, o kɔrɔ ye ka ɲinw ka mikro-grinding machine nɛgɛ cɛncɛn yɔrɔ kɛ ka kuru dawolo sɔgɔlen hexagonal walima quadrangular groove Changer for the 'one' or 'ten' groove, walima ka groove fɔlɔ juguya.

Ehlinger ni a ɲɔgɔnnaw. a fɔra ko ni ko minnu na, ni conical reverse tapping screw extractor tun bɛ gɛlɛya sɔrɔ hali bi ka burusi bɔ, a jirala ko nɛgɛdaga bɛ se ka bɔ ni nɛgɛdaga kunkolo tiɲɛni ye ni tungsten drill grinding ye ani ka nɛgɛ dingɛw bonya nɛgɛdaga kɔnɔ, o kɔfɛ, nɛgɛso farikolo bɛ se ka bɔ ni ring saw ye.

Georgiadis ni a ɲɔgɔnnaw. ani Raia ni a ɲɔgɔnnaw. proposed in the screw and steel plate combination is too tight and difficult to remove, minɛn kɛrɛnkɛrɛnnenw (i n’a fɔ pneumatic high-speed cutting drills, carbide drills, diamant wheels, wdfl) kan nail dingɛ lamini na steel plate tigɛcogo, in the steel plate is cut to loosen the screw, the screw is naturally easy to remove.

Kumar ni Dunlopl ye kunnafoni di distal femur locking steel plate screw system kɔnɔna fixation removal process kɔnɔ, standard self-limiting torque screwdriver baara la, conical screw extractor bɛ dɛsɛ, nka u ye fɛɛrɛ kura dɔ fana don sen kan, o kɔrɔ ye ko teliyaba finman-flake abrasive wheels baara kɛli nɛgɛ plate da la ka se screw hole da la radial incision, ka sɔrɔ ka kolo muru donna tigɛda la, aw kana nɛgɛdaga da wuli walasa ka fini lafiya, walasa Locking screws bɔli nafama.

A nafa ka bon ka a dɔn ko nin fɛɛrɛ minnu fɔra sanfɛ, olu ka kan ka taa ɲɛ dɔɔni dɔɔni ni a bɛ se ka kɛ, tasa tigɛ walima a sɔgɔli waati ni tigɛlan teliyaba ye walasa a kana tigɛ ka don kurukuru kun na ani ka kolo ni farikolo yɔrɔ nɔgɔlenw tiɲɛ. Ka fara o kan, o fɛɛrɛ ninnu bɛ se ka funteni caman ni nɛgɛw tiɲɛ, o bɛ se ka kɛ sababu ye ka faratiba lase furakɛli ma ka segin ka kari, ka farikolo yɔrɔw sɔgɔsɔgɔ, ani ka banakisɛw sɔrɔ.

(G) Kuma surun

■ Aw bɛ a to plati dafalen kana maga ɲɛgɛnɛsira la

■A ka kan ka plati bila yɔrɔ wɛrɛ la sani a ka datugu, barisa a karilen tɛ se ka bila yɔrɔ wɛrɛ la a datugulen kɔfɛ.

■Locking plate tɛ se ka degun, a ka kan ka degun walima centrifugal screwing kɛ union dingɛ kɔnɔ ka don kuru gansan kɔnɔ, fɔlɔ ka degun, o kɔfɛ ka a datugu

■ Kariyɔrɔ 3~4 kurukuruw dingɛ minnu tɛ jurumuw ye walasa ka degun jɛnsɛn; ■ Kariyɔrɔ 3~4 kurukuruw dingɛ minnu tɛ jurumuw ye walasa ka degun jɛnsɛn; ani

■ kolotuguda walima kolotuguda sirili kelen na, ani kolo jogo ka ɲi yɔrɔ minnu na; ani

■Ni a datugulen don, a tɛ se ka kɔsegin ka bɔ, k’a sɔrɔ jurumu gansanw bɛ se ka kɔsegin ka bɔ

■Fixation barikama ni kuru caman bɛ se ka kɛ sababu ye ka nonunion; sariyakolo ye ko platiw ka kan ka janya ani ka baara kɛ ni juruw ye minnu ka dɔgɔn; ɲɛda lamini karilenw furakɛli la, jurukisɛ damadɔ ka kan ka kɛ jiribolo la ani kuru caman ka kan ka kɛ ka a siri kolotuguda yɔrɔ la

■ bɔrɔ janya ka kan ka kɛ kariyɔrɔ janya siɲɛ fila ye, juruw ka kan ka tila ɲɔgɔn na, wa a siricogo ɲuman ka kan ka kɛ da wulicogo ye

■ Fanga bɛ tila-tila cogo kelen na tabali jan dɔ kan, wa ni a sirilen don ni juru damadɔ ye, o bɛ se ka sɔgɔsɔgɔninjɛ bila mɔgɔ la ani ka kolo kɛnɛyali sabati.