Intramedullary nails le egbegbe ƒumeŋuɖuiwo me: fefe-trɔla le gbagbã ƒe fixation me?

Kpɔkplɔyiɖeme

Ƒumeŋuɖui ƒe dɔlélewo gbɔ kpɔkpɔ va trɔ ŋutɔ le ƒeawo me, eye lãkusi siwo le lãkusi me (IM) wɔ akpa vevi aɖe le egbegbe ƒu ƒe gbagbã me. Nusiwo wotsɔ dea lãme na ame siawo va zu atike si wodina wu be woatsɔ ana ƒu ƒe gbagbã didiwo nali ke le woƒe amedzidzedze suetɔ kekeake, biomechanical ƒe nɔnɔme siwo de ŋgɔ wu, kple ɣeyiɣi siwo wohayana kabakaba ta.

Esi wowɔ ŋgɔyiyi le lãkusi ƒe wɔwɔme, nusiwo wotsɔ wɔe, kple amekokomɔnu ŋu ta la, dɔwɔnu si ŋu kakaɖedzi le le ƒumeŋutinunyalawo si fifia be woatsɔ ada ƒu ƒe gbagbã nyuie wu. Nyati sia lé ŋku ɖe alesi IM Nails wɔa dɔe, woƒe viɖewo, wo zazã zi geɖe, nu yeye siwo wowɔ nyitsɔ laa, kple nusita wole amewo ƒe lɔlɔ̃ xɔm le Spaingbedolawo ƒe nutowo kple Anyieheɣedzeƒe Asia ŋu nyuie.

Intramedullary nails gɔmesese: Nukae nye wo?

Aɖatsi siwo le lãkusia me nye gaku siwo le abe ga ene siwo sesẽ eye wotsɔ wo de ƒu me ƒe lãkusi me be wòakpe ɖe wo ŋu woasɔ ɖe wo nɔewo nu ahaɖo wo ɖe teƒe ɖeka. Wotsɔ titanium alo gakpo si mexɔ dzo o wɔe, eye wotsɔ gavi siwo wotsɔna xea mɔ na wo la bla wo ɖe eƒe nugbɔ eveawo, si xea mɔ na ʋuʋu siwo womelɔ̃ o abe tɔtrɔ kple woƒe kpuiƒe ene.

Intramedullary ƒe ɖa ƒomeviwo .

IM Nails ƒe nɔnɔme kple lolome le vovovo, eye wowɔ wo dometɔ ɖesiaɖe na ƒu aɖewo koŋ kple ƒu gbagbã ƒe nɔnɔmewo:

Femoral Reconstruction Intramedullary Nail .

– Wozãnɛ na afɔkpodzi ƒe gbagbã sesẽwo, vevietɔ subtrochanteric ƒe gbagbã.

Humeral Intramedullary Nail .

– Wotrɔ asi le eŋu be wòali ke humerus shaft kple proximal humerus gbagbãwo.

PFNA (afɔkpodzi ƒe ɖa ƒe akpa si te ŋu tsia tre ɖe eŋu) .

– si sɔ nyuie na afɔkpodzi ƒe akpa si te ɖe eŋu, vevietɔ le dɔnɔ tsitsi siwo ŋu ƒunukpeƒetetedɔ le gome.

Femoral Intramedullary Nail .

– Standard tiatia na diaphyseal femur gbagbãwo.

Tibia Intramedullary Nail .

– Yi-na tiatia na tibial shaft fractures, si ɖea dɔyɔyɔ ɣeyiɣi dzi kpɔtɔna.

Reversed Femoral Intramedullary Nail .

– Wotrɔ asi le eŋu na afɔkpodzi ƒe gbagbã le didiƒe, si ana woakpɔ egbɔ be wowɔ ɖeka nyuie.

Multi-lock Humerus Intramedullary Nail .

– Enaa tiatia geɖe wu, si naa liƒo geɖe wu na humeral fractures sesẽwo.

Titanium Elastic Nail (TEN) .

– Wozãnɛ zi geɖe le ɖeviwo ƒe gbagbã me le eƒe wɔwɔme si te ŋu trɔna bɔbɔe ta.

Nusita intramedullary nails le tɔtrɔm le gbagbãƒe ƒe fixation ŋu .

Gbɔdzɔgbɔdzɔ kabakaba kple ʋuʋu kaba .

Viɖe gãtɔ kekeake siwo le IM ɖawo ŋu dometɔ ɖekae nye woƒe ŋutete be woado alɔ kpekpeme dzi kpɔkpɔ kaba. Numekukuwo ɖee fia be dɔnɔ siwo wowɔ IM nailing na gbagbãƒewo ate ŋu adze kpekpeme ƒe akpa aɖe gɔme le kwasiɖa 4-6 me, ne wotsɔe sɔ kple kwasiɖa 8-12 na amesiwo wotsɔ agbalẽ xoxowo da dɔe. Ʋuʋu kabakaba sia nana dɔyɔyɔ kabakaba eye wòɖea lãmekawo ƒe dɔmawɔmawɔ nyuie ƒe afɔkua dzi kpɔtɔna.

Amekoko si me womezãa nu boo aɖeke le o .

To vovo na mɔnu siwo wozãna tsã abe plate ene, siwo zi geɖe la, ebiaa be woaɖe wo ɖe go gãwo eye woɖea lãkusi falɛfalɛwo ɖea dzesi ŋutɔ la, woate ŋu atsɔ IM ɖawo ade eme to nu suesuesuewo me. Esia ɖea amekoko ƒe nuveviwɔame dzi kpɔtɔna, eɖea dɔlékuiwo xɔxɔ ƒe afɔkua dzi kpɔtɔna, eye wònana kɔdzi nɔnɔ nɔa kpuie wu.

Biomechanical ƒe liƒolili si de ŋgɔ wu .

Esi wotsɔa IM ɖawo dana ɖe ƒu me ta la, wowɔa ɖeka kple ŋutilã ƒe dzɔdzɔme kpekpeme-tsɔtsɔ ƒe axis, si naa torsional kple axial li ke sesĩe. Aɖaŋu sia srɔ̃a ŋutilãa ƒe dzɔdzɔme biomechanics, si ɖea afɔku siwo le ame ƒe ŋutilã ƒe dɔmawɔmawɔ nyuie me dzi kpɔtɔna.

Afɔku si le kuxiwo me dzi ɖena kpɔtɔna .

Ne wotsɔe sɔ kple agbalẽviwo kple gotagome fixators la, IM Nails ƒe kuxiwo ƒe agbɔsɔsɔ le ʋɛ wu. Gavi siwo wotsɔna ƒoa ƒu ɖe wo nɔewo ŋu zazã xea mɔ na ƒu ƒe kpuiƒe kple alesi womewɔa nu ɖe ​​ɖoɖo nu o, si ɖea mɔnukpɔkpɔ si li be woawɔ malunion alo nonunion dzi kpɔtɔna.

Dɔ vevi siwo wowɔna le ƒumeŋuɖui me le ƒumeŋuɖui me .

Femoral shaft fractures .

Afɔkpodzi ƒe gbagbã, vevietɔ diaphyseal fractures, nye nyuitɔ kekeake si wotsɔ IM ɖawo da dɔ na. Numekukuwo ɖee fia be afɔkpodzi ƒe gbagbã 95% siwo wotsɔ IM ɖawo da dɔ na la daa dɔ le ɣleti ade me ne wowɔ ɖe beléle na ame le dɔwɔwɔ vɔ megbe nyuie dzi.

Tibial shaft fractures .

Afɔkpodzi ƒe gbagbã bɔ ɖe nuveviwɔame siwo me ŋusẽ geɖe le, abe ʋufɔkuwo kple kamedefefewo ƒe abixɔxɔ ene me. IM Nailing ɖea mɔ be woatsɔ kpekpeme dzi akpɔtɔ kaba, si le vevie ŋutɔ na mɔxexe ɖe kuxiwo abe compartment syndrome ene nu.

Humeral fractures .

IM Nails naa dɔwɔwɔ me tsonu nyuiwo wu plate siwo le humeral shaft fractures me, vevietɔ na dɔnɔ tsitsi siwo si ƒumeŋuɖui ƒe ƒuwo le.

Ame Tsitsiwo Kple Ƒumeŋuɖui ƒe Akpawo Ƒe Ƒuƒoƒo .

Esi amewo le tsitsim le Mexico, Brazil, Indonesia, kple Philippines ta la, akɔtaƒu siwo te ɖe wo nɔewo ŋu la le dzidzim ɖe edzi. PFNA ƒe ɖawo wɔa dɔ nyuie ŋutɔ le ƒugɔmeƒu siawo dada me, si wɔnɛ be dɔnɔ siwo ƒe ƒuwo mebɔbɔ o la ƒe tɔtrɔ ƒe liƒo si de ŋgɔ wu.

Nu yeye siwo wowɔ nyitsɔ laa le intramedullary nailing .

IM Nails siwo gblẽa nu le nugbagbewo ŋu kple esiwo ŋu dɔlékuiwutikewo le .

Numekuku yeyewo na woto IM ɖa siwo gblẽa nu le nugbagbewo ŋu kple esiwo ŋu dɔlékuiwutikewo le vɛ, si kpe ɖe eŋu be dɔlékuiwo ƒe agbɔsɔsɔ dzi ɖena kpɔtɔna eye wòdoa ƒuwo ƒe dɔyɔyɔ kabakaba ɖe ŋgɔ.

3D-tata ɖe ɖoɖo nu im ɖawo .

Fifia la, adzɔnuwo wɔlawo le 3D tata mɔ̃ɖaŋununya zãm tsɔ le IM ɖa siwo wowɔ ɖe ɖoɖo nu la wɔm, si le egbɔ kpɔm be dɔnɔ ɖesiaɖe ƒe ŋutilã ƒe wɔwɔme sɔ nyuie wu.

Mɔ̃ siwo wotsɔna xea mɔ̃ deŋgɔwo .

Aɖatsimɔ̃ siwo wotsɔa ʋuƒo geɖe ƒoa ƒui ƒe dodo ɖe ŋgɔ na be woli ke nyuie wu le gbagbãƒe siwo me nu sesẽwo le me, si naa tiatia geɖe amekolawo be woatsɔ atrɔ asi le fixation ŋu.

Asitsatsa ƒe Nɔnɔmewo: Nusitae didi le dzidzim ɖe edzi le Spaingbedolawo ƒe nutowo me & Anyieheɣedzeƒe Asia .

Nuveviwɔame ƒe nya siwo le dzidzim ɖe edzi .

Mɔfɔkuwo ƒe agbɔsɔsɔ gãtɔ kekeake le Latin Amerika kple Anyieheɣedzeƒe Asia dometɔ aɖewo le xexeame katã. Xexeame ƒe Lãmesẽ Habɔbɔ (WHO) gblɔ be ame miliɔn 1.35 kple edzivɔ kuna ƒe sia ƒe le ʋufɔkuwo ta, si wɔe be atikewɔwɔ na ame ƒe gbagbã nye nu vevitɔ kekeake.

Lãmesẽnyawo gbɔ kpɔkpɔ ƒe xɔtuɖoɖowo keke ɖe enu .

Dukɔwo abe Mexico, Thailand, kple Indonesia ene le ga geɖe dem lãmesẽnyawo gbɔ kpɔkpɔ ƒe ŋgɔyiyi me, si na be woxɔa ƒunukpeƒewo abe IM ɖa ene ɖe edzi.

Titanium im ƒe ɖawo ƒe didi si le dzidzim ɖe edzi .

Titanium-tiwo le ŋusẽ kpɔm ɖe edzi le woƒe biocompatibility, woƒe kpekpeme le bɔbɔe, kple corrosion resistance ta. Dukɔwo abe Colombia kple Vietnam ene le tɔtrɔm ɖo ta titanium im ɖawo gbɔ le kɔdzi siwo xɔ ŋgɔ le nuveviwɔame me.

Alesi mamalawo ate ŋu awɔ IM Nail ƒe asi si le dzidzim ɖe edzi la ŋudɔ nyuie .

Kuxi siwo le mama me .

Sededewo ƒe mɔɖeɖewo (le kpɔɖeŋu me, cofepris le Mexico, BPOM le Indonesia).

Adzɔ siwo woxena ɖe nusiwo wotsɔ tso duta vɛ kple nuzazãwo ƒe kɔsɔkɔsɔwo dzi kpɔkpɔ ta.

Mɔnukpɔkpɔwo na mamalawo .

Hadede kple ƒumeŋuɖui ƒe kɔdziwo kple nuveviwɔamedɔwɔƒewo.

Amekolawo ƒe hehenana ƒe ɖoɖowo nana na mɔ̃ɖaŋununya yeye siwo wotsɔ dea ame me.

FDA- kple CE-ɖaseɖigbalẽ ƒe atikewo nana be woawɔ ɖe kɔdzi ƒe nuƒle ƒe dzidzenuwo dzi.

Nyanuwuwuw

Intramedullary nails trɔ asi le gbagbã ƒe fixation ŋu to nusiwo me womezãa nu boo aɖeke le o, siwo ŋu ŋusẽ le le biomechanically, kple esiwo wotsɔna tsɔa kpekpeme kabae la nana me. Esi woƒe didi yi edzi le dzidzim ɖe edzi le Spaingbedolawo ƒe nutowo kple Anyieheɣedzeƒe Asia me la, ele be numãlawo kple lãmesẽdɔwɔlawo nanya nu tso mɔ̃ɖaŋununya yeyewo kple asitsatsa ƒe nɔnɔmewo ŋu.

Le amekolawo gome la, nu nyuitɔ kekeake siwo wowɔna na IM ƒe atitsotso gɔmesese nana dɔnɔa ƒe dɔwɔwɔ me tsonu nyuiwo nyona ɖe edzi. Le mamalawo gome la, gadede asi na IM ɖa kple hehenana ƒe ɖoɖo deŋgɔwo ate ŋu akpe ɖe asi ƒe asiɖoɖo anyi ŋu eye woaɖo hadomeɖoɖo sesẽwo ɖe ƒumeŋuɖui dɔwɔƒea.