Kplu La Zazã Nyuie!

A. A locking plate nye mɔ̃ si wotsɔ léa gbagbãƒewo ɖe te si me do si me ka le. Ne wotsɔ gavi si ƒe ta wotsɔ ka blae ɖe doa me la, agbaa zua (screw) ƒe dzogoedzikpɔmɔ̃. Do siwo wotsɔna ƒoa gavi (si woyɔna hã be agbalẽvi si wotsɔ ƒo ƒui) ate ŋu anye do siwo me gavi vovovowo le (si woyɔna hã be agbalẽ si wotsɔ ƒo ƒui) si me woate ŋu axee kple esiwo womexe o siaa. Tso esime wodo susu si nye be woaxe agbalẽviwo ɖe ŋgɔ eye wozãe le ƒu ƒe gbagbã dada me la, wozãe geɖe le ƒunukpeƒe ƒe gbagbãwo, ƒu ƒe gbagbã siwo wogbã kple esiwo me ƒu ƒe gbagbã le ƒe ƒoƒo me le eƒe viɖe siwo nye be enaa kpekpeɖeŋu si li ke eye wòléa ƒu gbagbãwo, gbagbã ƒe dɔyɔyɔ ƒe agbɔsɔsɔ si lolo wu, lãmeka falɛfalɛwo ƒe gbegblẽ kple ʋu ƒe sisi ƒe tɔtɔ si mebɔ o ta. Egbe ƒe ŋdi nuxexlẽa ana nànya ŋgɔdonya tsitotsito tso agba siwo wotsɔ xea nu ŋu, si me wòle be nàsrɔ̃ nu tsoe!

(A)Nyatakaka Gbãtɔ

1.Nukae nye ʋuƒo si wotsɔ xea mɔ na nu?

Ga gbadzɛ ɖesiaɖe si woate ŋu abla ɖe dzogoe ɖɔɖɔɖo/angle stabilizing screws alo pins me la nyea gavi si wotsɔ xea nu koŋ.

2. Viɖe kple kuxi siwo le agbalẽ siwo wotsɔ xea mɔe ŋu

Viɖe siwo le eŋu

■ Dzogoe ƒe liƒo, tsitretsitsi ɖe ƒoƒo kple ʋuʋu ŋu

■Conical nɔnɔme si le screw ta na mɔ̃ɖaŋu mama nyona ɖe edzi

■Na radial preload, xe mɔ na ƒu ƒe resorption kple screw loosening

■Wowɔe le ŋutilã ƒe wɔwɔme nu be wòasɔ ɖe ŋutilã ƒe wɔwɔme ƒe nɔnɔme siwo le teƒe ɖeka nu

■Template siwo sɔ be woaɖe mɔ na percutaneous fixation le diaphysis (ɖeka cortical, ɖokui-ku, wo ɖokui-tapping locking screws)

■Locking screws naa seke nyuitɔ kekeake na siaa flexible bridging kple bliboe stabilization fixation

■Mehiã be woatsɔ kadodo kplikplikpli kple ƒua ƒe gowo o, si ana ʋu nanɔ anyi

■Micromotion si dzi wokpɔna, si doa dzidzɔ na gbagbã ƒe dɔyɔyɔ

■Zi geɖe la, mehiã be woado ƒu aɖeke o

Ewɔa dɔ ŋutɔ na ƒu ƒe gbagbã alo ƒu ƒe gbagbã ɖesiaɖe si meli ke kura o.

Nusiwo gblẽ le eŋu

■Locking screws mekpɔa ŋusẽ ɖe edzi kple nutete o, vevietɔ le intra-articular fractures alo oblique fractures bɔbɔe me

■Womate ŋu azã agbalẽvi la abe dɔwɔnu si dzi ɖena kpɔtɔna ene be wòakpe ɖe eŋu wòaɖe edzi o.

■Kpluawo mesena le wo ɖokui me nyuie abe gavi siwo wozãna ɖaa ene ne wotsɔ wo de eme o.

■Womate ŋu atrɔ asi le gaviawo ƒe mɔfiame ŋu o (negbe gavi siwo xea mɔ na nu geɖe koe mele eme o).

■Wotsɔa gaviawo dana ɖe wo nɔewo dzi sesĩe akpa, si ateŋu ana 'cold welding'.

■Angle deviation >5°, ŋusẽ ƒe bu; >10°, locking effect mewɔa dɔ o

■Ate ŋu adzɔ be wòado le ŋutigbalẽ te ne womewɔ agbalẽvi la ƒe nɔnɔme o

Nya siwo ku ɖe sesẽnuwɔwɔ ŋu

Ne cortical kadodo nyui alo compression na gbagbãƒea ƒe nuwuƒewo meli o la, ga si wotsɔ blaa nu, vevietɔ gakpo si mexɔ dzo o ƒe aŋenuwo zazã axe mɔ na akpa II ƒe dɔyɔyɔ le gbagbãƒea ŋu le esi wòsẽ akpa ta eye woaɖe micromotion nyui si le gbagbãƒea ɖa;

Ne wozã intraoperative traction eye emegbe wozã locking splint fixation la, woakpɔ gbagbãƒe ƒe gbagbã ƒe dometsotsoa ta, si ana be gbagbãƒea ƒe dɔyɔyɔ nahe ɖe megbe alo mahaya o;

Ne womegbugbɔ ɖo gbagbã bɔbɔe aɖe eye wotsɔ nyaƒoɖeamenu de eme o la, agbaa toa agbaa dzi, si wɔnɛ be nuteɖeamedzi ƒe agbɔsɔsɔme si ate ŋu ana agbalẽa nagbã bɔbɔe.

3. Vovototo gã siwo le biomechanical dome le locking plates kple plate dzɔdzɔewo dome

Plɛti siwo wozãna ɖaa nɔa te ɖe ʋuʋudedi si le ƒu kple kplu ƒe domedome dzi be woate ŋu awɔ ƒua ƒe agbalẽvi ƒe nutete.

4. Viɖe siwo le ʋuƒoƒo ƒe agbalẽ kple gakpo dzro ƒe agbalẽ si wotsɔ sɔ kple wo nɔewo ŋu

1.The pull-out tsitretsitsi le locking screws kɔ sã wu esi dzro screws.

2. Epiphyseal locking screws la le dzogoe dzi ɖe wo nɔewo ŋu, si dzia screw la ƒe tsitretsitsi ɖe hehe ŋu ɖe edzi ŋutɔ ne wotsɔe sɔ kple parallel screws.

(B) Gɔmeɖose siwo ku ɖe wo ŋudɔwɔwɔ ŋu

1. Gɔmeɖose siwo ku ɖe ame ƒe ʋuʋu ŋu:

●Nyaƒoɖeamenu ƒe gɔmeɖose: ƒumeŋuɖui ƒe ƒumeŋuɖui ƒe gbagbã

●Neutralization gɔmeɖose: ƒumeŋuɖui ƒe ƒumeŋuɖui ƒe gbagbã

●Bridging gɔmeɖose: comminuted diaphysis alo extra-articular metaphyseal gbagbã

Gɔmeɖose si nye union: comminuted intra-articular metaphyseal fracture

2. Gɔmeɖose si woatsɔ awɔ tɔdzisasrã:

●Mɔnu si wozãna ɖaa: to ŋutigbalẽ me tsɔtsɔ bla agbalẽvi si me womezãa nu boo aɖeke le o (MIPO alo MIPPO mɔnu) .

●Aɖaŋu si me woɖea nu le le mɔ si mele tẽ o nu

●Be woalé bridging plate nyuie la, ele be woagblẽ do 3-4 siwo wotsɔ gavi wɔe la ɖi woaʋu le afisi te ɖe gbagbãƒea ŋu.

3.Gɔmeɖose siwo ku ɖe ɖekawɔwɔ ŋu:

● Biomechanical gɔmeɖose eve siwo nye nutete kple tɔdzisasrã zazã ɖekae le agbalẽ ɖeka me - locking compression plate (LCP) .

● Gbagbã bɔbɔe siwo le gbagbãƒea ƒe akpa ɖeka kple gbagbãƒe siwo wogbã le akpa kemɛ (le kpɔɖeŋu me, metaphysis ƒe gbagbã siwo wogbã, diaphysis) .

●Ele be woazã gɔmeɖose si nye union la ɖe agbalẽ siwo ɖea mɔ be woatsɔ ta ƒe gavi siwo wotsɔ xea mɔe kpakple gavi siwo bɔ siaa ɖo la ko dzi.

Kplu siwo wotsɔ xea mɔe meɖoa ŋu ɖe ƒu kple agbalẽvi ƒe ƒomedodo dome ƒe ʋuʋu ŋu o eye woɖoa ŋu ɖe ʋuƒoa kple gbadzɛa dome ƒomedodo si ƒe dzogoe li ke ŋu koŋ be woalé wo ɖe te.

Le woƒe ɖekawɔwɔ si li ke ta la, gavi siwo ƒe ta wotsɔ xea nu ƒe nuɖeɖe ƒe ŋusẽ lolo wu gavi bɔbɔewo tɔ sã, negbe ɖe woɖe gavi siwo katã ƒo xlã wo alo wogbã ko hafi. Zi geɖe la, esesẽna be woaɖe gavi ɖeka alo agbã le eɖokui si. Ta ƒe gavi siwo wotsɔ xea mɔe menaa nyaƒoɖeamenu si wobla ɖe wo nɔewo dome o. Woateŋu akpɔ nyaƒoɖeamenu to nyaƒoɖeamenu ƒe mɔ̃ zazã me alo to gavi siwo wozãna edziedzi tsɔtsɔ yi 'do siwo wotsaka' me (tsɔ gavi siwo tea ɖe wo nɔewo ŋu gbã, emegbe woƒoa ɖa).

1.Ne wozã gavi siwo wozãna ɖaa tsɔ lé ʋuƒoa ɖe te (le kpɔɖeŋu me, 1), gavi siwo wotsɔ xea gaviawo me la ƒoƒo anɔ bɔbɔe ŋutɔ (le kpɔɖeŋu me, 2).

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(C) Dzesiwo kple nusiwo tsi tre ɖe eŋu

1. Nusiwo ɖee fia

Gbagbãƒe akpa gãtɔ siwo wowɔ dɔ na la mehiã be woatsɔ gaƒoɖokui si wotsɔ xea mɔe o. Zi alesi wowɔ ɖe ƒumeŋuɖui ƒe gɔmeɖosewo dzi ko la, woate ŋu ada ƒu gbagbã akpa gãtɔ to agbalẽvi siwo wozãna ɖaa alo ɖaƒoƒo ɖe ƒumeŋuɖui me dzi.

Ke hã, gbagbã ƒomevi aɖewo koŋ li siwo te ŋu buna bɔbɔe, plate alo screw ƒe gbagbã, kple nonunion si kplɔe ɖo, si woyɔna zi geɖe be 'unresolved' alo 'problematic' fractures, siwo dometɔ aɖewoe nye intra-articular comminuted fractures, periarticular fractures with small bone fractures, kple osteoporotic fractures. Woyɔa gbagbã ƒomevi siawo zi geɖe be 'unresolved' alo 'problem' fractures eye wo dometɔ aɖewoe nye intra-articular comminuted fractures, periarticular short tuberosity fractures kple osteoporotic fractures. Gbagbã siawo katã nye dzesi siwo fia be woaxe agbalẽviwo.

Dzesi xoxowo kple nyuitɔwo kekeake na locking plate fixation of fractures nye bridging gɔmeɖose kple union gɔmeɖose na comminuted fractures geɖe wu - ŋusẽ geɖe ƒe gbagbã le dɔnɔ siwo metsi o me alo osteoporotic fractures le dɔnɔ tsitsiwo me.

2. Nusiwo tsi tre ɖe eŋu

Togbɔ be wozã gaƒoɖokuiwo le afisiafi eye woƒe dzesiwo keke ta wu hã la, ele be míade dzesi nu geɖe siwo tsi tre ɖe ʋuƒo siwo wotsɔ xea mɔe ŋu eye míaƒo asa na wo. Ne wozã gaƒoɖokui siwo wotsɔ xea mɔe vovototomademadeameŋutɔe la, ate ŋu adzɔ be womate ŋu atɔ te wo o eye womawɔ ɖeka kple gbagbãƒea o.

Gbagbã bɔbɔe siwo hiã be woazi ametia dome, abe abɔta ƒe ke ƒe gbagbã bɔbɔe siwo ŋu wotsɔa nutrenu ememetɔ da dɔe ene, te ŋu mewɔa ɖeka o bɔbɔe.

Nenema ke ne wotsɔ mɔnu siwo me womewɔa nu boo aɖeke le o zazã to lãgbalẽgoe siwo wotsɔ xea nu na ƒu gbagbã bɔbɔewo hã nye nusi tsi tre ɖe eŋu.

Indirect reduction kple locking plate fixation hã mesɔ na displaced intra-articular fractures, si bia be woaɖe ŋutilã ƒe wɔwɔme dzi akpɔtɔ le gaglãgbe eye woate ɖe gbagbãƒea ƒe kakɛawo dome kple fixation sesẽwo dome o.

Nusi tsi tre ɖe agbalẽvi siwo wotsɔ xea mɔe ŋu vie, le woƒe asixɔxɔ gã ta, enye gbagbãƒe siwo woate ŋu atsɔ agbalẽvi siwo wozãna ɖaa aɖɔe ɖo wòadze ame ŋu. Le kpɔɖeŋu me, abɔta ƒe ƒunukpeƒe ƒe gbagbãwo ƒe dɔyɔyɔ wu 90% ne wotsɔ agbalẽvi siwo wozãna ɖaa da dɔe.

(D) Ga si wotsɔ xea mɔ na nu la dede

1. Klɔ drill bit la ɖe gavi ƒe do siwo le agbaa me la me. Ne wotra >5° le gavi la kple gavi ƒe doa dome la, ate ŋu ana gavi ƒe ʋuʋu nado kpo nu, eye wokafui be woazã drill bit la atsɔ aku doawo ne enyo wu.

2. Da gakpoa ɖe ƒua dzi eye nàku doawo to doa ƒe abɔta.

3. Tsɔ goglome ƒe gbeɖiɖimɔ̃ dzidze goglomea, eye nàkpɔ egbɔ be wotsɔ gbeɖiɖimɔ̃a ƒe ta de do si me wotsɔa gaviwo ƒoa nui la me.

4. Tia ʋuƒoa ƒe didime si sɔ.

5. Gavi siwo wotsɔ nyaƒoɖeamenu wɔe la dede sɔ kple gakpo dzrowo.

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(E) Locking plate ɖeɖeɖa

Wozãa atikewɔƒewo ƒe ʋuƒo siwo wotsɔ xea mɔ na nu ƒe gavi geɖe, gake wodoa go kuxi sesẽwo le wo ɖeɖeɖa me bɔbɔe, eye wodzena vevietɔ le gavi ƒe ka si le glidzaglidza kple ɖa ƒe nutrenu kple agbalẽa ƒe ɖa ƒe do ka siwo le ka si mesɔ o dome.

1. Screw cap groove ƒe gbegblẽ

Le nɔnɔme siwo sɔ me la, gavi ƒe nutrenu ƒe ʋuƒo bliboa kple gavi si sɔ kplii la sɔ. Ele be woatsɔ gavi la nasɔ kple gavi ƒe nugbɔ ƒe do hafi woatsɔ gavi la ade eme alo aɖee ɖa, ne menye nenema o la, anɔ eme be gavi la ƒe ʋuƒoa agblẽ ne wole gavi la ge ɖe eme alo le eɖem do goe, si ana wòadze.

Tsɔ kpe ɖe eŋu la, le ƒu ƒe gbagbã ƒe dɔyɔyɔ vɔ megbe la, zi geɖe la, wotsɔa ƒu ƒe ƒuƒu alo ka siwo me ka le blaa gavi ƒe nugbɔ, si wòle be woakɔ hafi aɖe gavi la ɖa, gake ne womelé ŋku ɖe eŋu o la, gavi ƒe nugbɔ ƒe nugbɔ kple dzogoe ƒe wɔwɔme ate ŋu agblẽ le mɔ si wowɔ nu.

Esi wònye be dɔwɔla la ƒe abɔta ƒe tɔtrɔ ƒe axadzi mewɔ ɖeka kple gavi la ƒe axa didi o ta la, zi geɖe la, dzogoe aɖe nɔa anyi, ne dɔwɔla la tsɔ gavi la do goe sesĩe la, godoo be gavi la naʋuʋu, si ana gavi la ƒe nutrenu ƒe do nagblẽ le ŋusẽ si mesɔ o ta. Eyata nusiwo gblẽ le gavi ƒe ʋuƒoa ŋu ate ŋu ana gavi la nadze bɔbɔe.

2. Nail cap alo ɖa ƒe do ƒe tɔtrɔ

Le gakpo gbadzɛ si wotu ɖe ŋutilã ƒe dɔwɔwɔ me zazã me, ɣeaɖewoɣi le alesi wòhiã be woabɔbɔ alo awɔ gakpoa ƒe nɔnɔme wòasɔ nu la, Raja et al. xɔe se be ne edzɔ be akpa si wobɔbɔ la dzɔ le gavi siwo wotsɔ xea nu me la, ne wole gavi siwo wotsɔ xea nu me la, gavi ƒe nutrenu kple gavi ƒe do masɔmasɔ, si ate ŋu adzɔ ŋutɔ le ɖa ƒe nutrenu kple gakpoa ƒe ʋuƒoa dome nail does threads wrong buckle, alo screwed close to the steel plate when the tail of the nail deformation caused by the strong screwing, etc., which may lead na Sesẽa ɖeɖeɖa emegbe.

3. Wozãa wo ɖokui-tapping cortical locking nails

Esi wònye be ƒu si le lãkusia me tsina yia eme le ɖaa ƒe doa me eye to esia me la, alé gavi la, si ana wòasesẽ le gavi la ɖeɖe me, vevietɔ lãkusi eve siwo wotsɔna ƒoa ƒui siwo ƒoa wo ɖokui ta la, Suzuki et al. meɖo aɖaŋu be woazã gavi siwo ƒoa wo ɖokui ɖe lãkusi eve ŋu o. Hou Yunfei kple exɔlɔ̃wo. do susua ɖa be ele be woaƒo asa na bicortical fixation si mehiã o kple screws na eƒe akpa si le etame ƒe gbagbã, eye Maehara et al. do susua ɖa hã be ele be woaƒo asa na gavi siwo wotsɔ xea mɔe zazã enuenu ne wole gavi siwo wotsɔ xea mɔe zãm, eye be ehiã be woaɖo dzidzenu si sɔ na xexeame katã ƒe gavi siwo wotsɔ xea nu ƒe tiatia kple wo zazã.

4. Gaviawo ƒe wɔwɔme kple teƒe si wole

Gavi si wotsɔ xea mɔe ƒe lolome, afisi wòle, kple afisi wòle ate ŋu akpɔ ŋusẽ ɖe gavi la ɖeɖeɖa dzi. Agbalẽnyala aɖewo kpɔe be ne gavi la mele do si wotu ƒe titina o la, ne nya ƒe doa ƒe eccentricity wu 5 ° ko la, ate ŋu anye be gavi si me mekɔ o ƒe tsɔtsɔ, ka siwo mesɔ o ƒe asike alo ɖa ƒe asike ƒe tɔtrɔ atɔ eye wòahe fixation ƒe kpododonu alo kuxi sesẽwo ɖeɖeɖa ƒe akpa evelia vɛ.

5.Fafɛ welding

Normal titanium ememe fixation anyigba layer nye pasivated ametakpɔnu ƒuƒoƒo, le amekoko ƒe ɖoɖo si me ememe fixation ɖoɖo, le dɔwɔnu siwo léa nu kple nɔnɔme, alo ta ƒe screw kple friction le gakpo gbadzɛa dome, kple bubuawo, ate ŋu ahe pasivated ametakpɔnu layer do teƒe. 2 ga kadodo anyigba dome substantive kadodo teƒea alé ɖe eŋu, si fia be, vuvɔ welding ƒe wɔwɔme.

Tsɔ kpe ɖe eŋu la, galvanic coupling le ga ions, inflammatory reactions, kple bubuawo dome hã ate ŋu ado welds fafɛwo wɔwɔ ɖe ŋgɔ. Mɔ̃ siwo wotsɔ léa ememenuwoe ƒe akpa gãtɔ hã nya kuxi sia, eye le esia ta wotsɔa oxide film mɔ̃ɖaŋununya tsyɔa gakpo siwo wotsɔ xea mɔ na nu siwo womezã o la dzi le ɖa ƒe dowo kple gavi ƒe kadodo ƒe anyigbawo dome, si hã ƒe taɖodzinue nye be yeaxe mɔ ɖe protein siwo le ŋutilãa me ƒe ionization kple adsorption nu eye wòaɖe weld fafɛ ƒe dzɔdzɔ dzi akpɔtɔ.

(F) Mɔnu siwo wozãna tsɔ ɖea nu ɖa

Woate ŋu ama aɖaŋu siwo woɖena ɖa siwo ŋu woka nya ta le le dukɔa kple dukɔwo dome agbalẽwo me ɖe hatsotso 2 me, siwo nye, bɔbɔe kple esiwo ŋudɔ woate ŋu awɔ eye wosesẽ, gbãtɔa ƒe dzesi enye be woate ŋu aɖo wo bɔbɔe, woate ŋu awɔ dɔ nyuie, wogblẽa nu le lãmeka falɛfalɛwo ŋu boo o, aɖaŋu si mebɔ o eye womehiãa dɔwɔnu tɔxɛwo o, eye evelia bia be woawɔ dɔwɔnu kple dɔwɔnu tɔxɛ tɔxɛwo.

Maehara kple exɔlɔ̃wo. do susua ɖa be nàzã gavi siwo ƒe afɔkpodzi lolo siwo sea torque-seɖoƒe li na ɣesiaɣi si wòanya wɔ. Ne wodze ŋgɔ gavi siwo ƒu la, Pattison et al. ka nya ta tso mɔnu bɔbɔe aɖe si dzi woato aɖe gavi siwo ge la ɖa to ga si wotsɔ platinum-ga xatsa gavi la ƒe ta eye wotsɔe de gavi la ƒe nugbɔ ƒe do me. Mɔnu sia nye aɖaŋudzedze be woatsɔ ga gbadzɛ ayɔ gavi ƒe nutrenu ƒe doa me eye wòana afisi gavi la kple ʋuƒoa ƒe kadodo kple ʋuʋudedi le ɖe edzi, si wɔnɛ be woate ŋu aɖe gavi siwo ŋu ka siwo ge ɖo la ɖa bɔbɔe. Le mɔnu sia me la, egasesẽna kokoko be woaɖe nya la ɖa, ne gavi ƒe nutrenu kple gakpo gbadzɛ ƒe ɖa ƒe do kawo gakpɔtɔ li la, àte ŋu adze agbagba azã conical reverse tapping screw remover, si fia be, tso screw cap groove si wotsɔ de megbe tapping me eye nàyɔ groove la me, le tɔtrɔ kple nyaƒoɖeamenu screw la ƒe ɖoɖoa me.

Le nusi gblẽ le eŋu gome la, egasesẽna kokoko be woawɔ gavi aɖewo siwo wotsɔ xea mɔe to conical reverse tapping screw extractor zazã me, abe Ehlinger et al. kple Bae kple exɔlɔ̃wo. amesiwo kpɔe be mɔnu sia wɔa dɔ zi geɖe le 3.5 mm ƒe gavi ƒe ʋuʋu me, gake zi geɖe la, mewɔa dɔ le 4.5 mm ƒe gavi ƒe ʋuʋu me o. Le go sia me la, menye kɔdzi ƒe ƒuŋutinunyalawo ƒe hatsotso ɖesiaɖee wotsɔa ga tutu dɔwɔnu tɔxɛwo abe carbide drills, diamond drills, alo grinding wheels siwo zɔna kabakaba ene o.

Gopinathan kple exɔlɔ̃wo. to mɔnu aɖe si mehiã dɔwɔnu tɔxɛ siawo o vɛ to nyatakaka nana be esesẽ be woaɖe gavi ɖa le akɔta gbugbɔgatu ƒe agbalẽvi dzi, si fia be, wozãa gbugbɔgatu gbadzɛa ƒe lãɖeɖe si le bɔbɔe la, wozãa kaƒomɔ̃ gã aɖe tsɔ lãa gavi la ƒe akpa si le kpuie wu le agbalẽa ƒe ʋuƒoa ƒe dowo dome, ale be gaviawo kple gavi la ƒe akpa si me ʋuƒoa le la nazu nu sue aɖe, eye woate ŋu aɖe gaviawo ɖa bɔbɔe. Mɔnu sia sɔ na titanium gbugbɔgatu ƒe nutrenu gbadzɛwo, abɔta ƒe ʋuƒo siwo ƒe ʋuƒo siwo le kpuie wu, kple 1/3 tube-ƒomevi gbadzɛwo, eye womate ŋu azãe na agbalẽ siwo keke alo esiwo le kpekpem wu le eƒe akpa si le ete o.

Woƒo nu tso mɔnu bɔbɔe aɖe hã ŋu si me wozãa do si lolo vie tsɔ kua do ɖe do si bɔ la me le gavi si wotsɔ xea mɔe si ge la xa, eye emegbe woƒoa agbalẽvi la kple gavi la ɖe do bɔbɔe si woɖe yeyee la ƒe mɔ nu, eye emegbe woɖea gbadzɛa kple gavi la ɖa to ƒutsotsoe si woda ɖe agbaa te zazã me eye wotsɔa gɔmeɖose si nye be woaɖee ɖa ne ele eme woɖe asi le eŋu.

Nyateƒee, mɔnu sia ate ŋu agblẽ nu le ƒu ŋu, eyata wokafui be woakpɔ ame ta le kpekpeme tsɔtsɔ me le dɔwɔwɔ vɔ megbe. Tsɔ kpe ɖe eŋu la, ehiã hã be woadzra dɔnyala ƒe dɔwɔnu aɖewo siwo wozãna zi geɖe ɖo hafi woawɔ dɔ na wo le ememe fixation ɖeɖeɖa, abe bolt extractor, hole reamer, screw extraction pliers, T-type pressurized socket kple bubuawo ene.

Le locking screw slippery wire ɖeɖeɖa ƒe kuxiwo me la, aƒeme nunyala aɖewo do susua ɖa be woatrɔ groove mɔnu, si fia be woazã aɖu ƒe micro-grinding machine steel sand piece atsɔ atrɔ screw cap groove hexagonal alo quadrangular groove na 'one' alo 'ten' groove, alo ade goglome gbãtɔ groove.

Ehlinger kple exɔlɔ̃wo. ka nya ta be le nɔnɔme siwo me wògasesẽna na conical reverse tapping screw extractor la be wòaɖe gavi la ɖa la, wodo susua ɖa be woate ŋu aɖe gakpoa ƒe ta ɖa to tungsten drill tutu kple gavi ƒe do siwo le gakpoa me ƒe lolome dzi ɖeɖe kpɔtɔ me, eye emegbe woate ŋu aɖe gakpoa ƒe ŋutilã ɖa to asigɛ si wotsɔ lãgbalẽ wɔe zazã me.

Georgiadis kple exɔlɔ̃wo. kple Raia kple exɔlɔ̃wo. wodoe ɖa le gakpo kple gakpo gbadzɛ ƒe ƒuƒoƒoa me la sesẽ akpa eye wòsesẽ be woaɖee ɖa, dɔwɔnu tɔxɛwo (abe ya ƒe duƒuƒu sesẽ ƒe lãɖeɖe ƒe ʋuƒo, carbide drills, diamond wheels, kple bubuawo) le nail do si ƒo xlã gakpo gbadzɛ lãɖeɖe mɔnu la dzi, le gakpo gbadzɛa me la, wotsoe be wòaɖe gavi la ɖa, gavi la hã le dzɔdzɔme nu be woaɖe ɖa.

Kumar kple Dunlopl ka nya ta le distal femur locking steel plate screw system ememe fixation ɖeɖeɖa ƒe ɖoɖoa me, le standard self-limiting torque screwdriver zazã me la, conical screw extractor do kpo nu, gake woto mɔnu yeye aɖe hã vɛ, si nye, wozãa duƒuƒu sesẽ thin-flake abrasive wheels le gakpo gbadzɛa ƒe nugbɔ vaseɖe screw doa ƒe go kemɛ dzi radial incision, eye emegbe wedge ƒu hɛ si wotsɔ de incision la me, mègaʋu gakpo gbadzɛ ƒe ɖa doa be wòaɖe dzi ɖi le nutsyɔnu la me o, ale be Locking screws la ɖeɖeɖa nyuie.

Ele vevie be míade dzesii be ele be woado mɔnu siwo le etame ɖe ŋgɔ blewu alesi woate ŋui le agbaa lãɖeɖe alo etutu me to lãɖeɖe ƒe disk si zɔna kabakaba zazã me be woaƒo asa na lãɖeɖe ɖe gavi la ƒe ta me eye wòagblẽ nu le ƒu kple lãkusi falɛfalɛawo ŋu. Tsɔ kpe ɖe eŋu la, mɔnu siawo ate ŋu ana dzoxɔxɔ si nu sẽ eye ga gbagbãwo nado mo ɖa, si ate ŋu ana afɔku nadzi ɖe edzi be atikewɔwɔ na gbugbɔgagbã, lãmekawo ƒe dzoxɔxɔ ƒe kuku, kple dɔlékuiwo xɔxɔ.

(G) Kpuie ko la

■ Ðe mɔ na agbalẽa ƒe kadodo si mede blibo o kple akɔtaƒua

■Ele be woagbugbɔ agbalẽvia aɖo teƒe bubu hafi axee, elabena womate ŋu agbugbɔ aŋea aɖo teƒe bubu le etutu vɔ megbe o.

■Locking plate mate ŋu aƒoe o, ehiã be woazã pressurizer alo centrifugal screwing le union doa me ɖe screw dzroa me, gbã nyaƒoɖeamenu, emegbe ʋu

■ Fracture teƒe 3 ~ 4 screw dowo ma screws be woakaka nuteɖeamedzia; ■ Fracture teƒe 3 ~ 4 screw dowo ma screws be woakaka nuteɖeamedzia; kple

■ ƒu ƒe lãkusi alo ƒu ƒe lãkusi si le ɣie ƒe ʋuʋu ɖekae, kple afisi ƒua ƒe nyonyome nyo le; kple

■Ne wonya tu ko la, womate ŋu agbugbɔe ado goe o, evɔ woate ŋu agbugbɔ gavi dzrowo agbugbɔ ado goe

■Ne woblae sesĩe kple gavi geɖe akpa ate ŋu ana woagawɔ ɖeka o; gɔmeɖoseae nye be ele be agbalẽviwo nadidi eye woazã gavi ʋɛ aɖewo ko; le ƒunukpeƒetetedɔ ƒe gbagbãwo dada me la, ele be woatsɔ gavi ʋɛ aɖewo ade atikutsetsea ŋu eye woazã gavi geɖe atsɔ ablae ɖe ƒunukpeƒea ƒe anyime

■ ele be tɔdzisasrãa ƒe didime nadidi teƒe si wogbãe ƒe teƒe eve, ele be woama gaviawo ɖe wo nɔewo nu sɔsɔe, eye ele be nusi woatsɔ alée ɖe te nyuie nanye nusi woatsɔ ablae to ʋuƒoa me

■ Woma ŋusẽ ɖe agba didi aɖe dzi sɔsɔe, eye ne wotsɔ gavi ʋɛ aɖewo blae la, ate ŋu ana ƒuwo nawɔ eye wòana ƒu nahaya.