5 Taken Tarihin Nail na Tari'a na Tari'a da Tarkwani!

Asali na asali na tsakar wasan kwaikwayo

1. Tarihi na Intrayully Nighling

A cikin 1910, Lilental Alumini anyi amfani dashi don kula da fashewar fashewar Femal.

A cikin 1913, Schone yayi amfani da kusoshi na azumin don magance karammiski. 

Kuntsciher (1900-1972) Ya ba da gudummawa mai girma ga fil na ƙusa. 

A shekarun 1960 da 1970 sun kasance tsawon cigaban cigaban kusoshi. 

Kasarata ta kasance tana amfani da su a cikin adadi mai yawa tun daga shekarun 1990s.

2. Bude rage da rage rufewa

1. Karatun lardin reshe na iya zama raguwa a ƙarƙashin wahayi kai tsaye ko kuma rufe ƙarƙashin sa ido na X-RAY.

2. Buɗe lokacin warkar da warkarwa yana da daɗewa, in ji jini yana ƙaruwa, kuma yana buɗe ci gaba da samar da jini ga zubar jini.

3. An ba da shawarar yin amfani da raguwar rufewa gwargwadon iko. Za'a iya amfani da maimaitawa, ko ƙaramin incision za'a iya yin shi a kan jirgin sama mai rauni zuwa pry da rage shi, ta hanyar rage tsangwama tare da wadatar jini.

4. Don Rashin Rashin Rage Rage, guntun kasusuwa, da kuma girman ɓoyayyen ɓoyayyen ruwa, raguwar rauni za'a iya amfani da su.

3. Gyarawar tsarin ƙusa

1. Hanyar intredulyullary ƙusa na cikin gida shine siltmetrical mafi girman kewaye ciki.

2. Kafaffen karaya ta ƙusa-ta rarraba ƙusa-rarraba, ba m jumarcin-danniya-danniya-danniya-danniya-danniya-danniya, wanda ke dacewa da musanyawar Kira.

3. Babban gyararraki shine mafi girman m don cortication na waje, wanda zai iya rage hannun da karfi, ku rage abin da ya faru da gazawar roba.

4. Darajar ƙirar ƙusa tana ba da tushen tsarin rufewa ko iyakance na bude bude.

4. Na'urar farko na kusoshi

1. Karancin rikice-rikice

2.

3. Mawado)

4. A farkon aikin horar da aiki

5. Da farkon nauyi

6. Za'a iya amfani dashi a hade tare da wasu gyaran ciki

Nau'ikan asali da dabaru

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2

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4. Buɗe da rufe dabarun gyara

Kamfanin da ba a ciki ba

Tala'i masu zaman kansu ƙusola na talakawa suna da kwanciyar hankali mara kyau kuma suna da wasu elassional kuma zai iya murmurewa bayan nakasassu, haifar da ƙaramin adadin zamewar motsa jiki.

A rufe kawuna kusoshi da isasshen anti-juyawa da tasirin anti-juyawa, ingantaccen kwanciyar hankali, da kuma bi da ka'idar gyara na halitta. An yi amfani da su sosai cikin ƙasusuwa na gabar jiki. Musamman don yanki da yawa da karaya mai yawa, suna da ingantacciyar kwanciyar hankali fiye da ƙusoshin talakawa.

Agogon karuwa

Matsalar kulle kusurwoyi masu tsoratarwa suna haifar da ƙarancin damuwa kuma a halin yanzu ana ba da shawarar aiwatar da ayyukan rashin daidaituwa.

Don karaya da ba su warkar da a cikin watanni 6 zuwa 8 watanni ba, a cikin kashin kashi grafting ko maye gurbin ƙafar tsifi tare da Dakariya ana amfani da su.

Za'a iya amfani da kuzari azaman hanyar inganta warkar da karaya. Ba da shawarar ba da shawarar yau da kullun saboda yana iya haifar da rage ƙimar lahani da ragi na juyawa.

Marrow fadada da kuma fadada marow

Marrow Fadada na iya saka ƙusoshin da ke da girma tare da mafi girman diamita da ƙarfi, wanda yake dacewa da farkon aikin horo.

Fadada Marrow na iya samar da babban tarkace na kashi tare da sakamako na osteoindwararru, wanda ke da karbar warkarwa.

Spellension fadakarwa zai lalata samar da jinin da jijiyoyin lantarki da membrane na endostal, amma hanyoyin jini na iya sake farfadowa tare da ramin kusoshi. Hakanan karin magana ta barrow kuma zai iya ƙara yawan kewayawar jini a cikin tsokoki na nama mai taushi, don inganta warkarwa da warkarwa.

Marrow Expanoon in mun gwada da damar damar kamuwa da cuta da kuma fitowar ta embolism, kuma ya kamata ayi amfani da shi da taka tsantsan don buɗewa, da yawa raunuka, da raunin da ya faru.

Abvantbuwan amfãni na yaduwar medullary

① Bayan faɗaɗa Medullary, yankin Lambobin Tsakanin ƙusa da ƙwararraki da kasusuwa yana ƙaruwa, wanda ke inganta kwanciyar hankali. 

Bayan faɗaɗa Medullary, mafi girma diamita mai saurin amfani da ƙusa na ƙusa na Intraadullary ƙusa da rage ragin na ƙusoshi. 

③ tarkace kashi bayan fadada Medullary zai iya haifar da sabon tsari na kashi, wanda ke da karbar warkarwa.

Idan aka kwatanta da kusancin tsararraki na Medulyullary ƙusoshin, marasa-fadada kusoshi suna da waɗannan fa'idodin

Lokaci na guntu da ƙasa da ƙasa. 

② Karami mai tsangwama tare da jini na endostal a lokuta tare da raunin nama mai taushi.

Aikace-aikacen farji

Humeral intracking neh

Alamar don kusoshi na Humeral

Abubuwan da ke nuna alamun Humemalal sun mamaye kusurwoyi masu tsaka-tsaki a cikin karaya da jijiya da jijiya da jijiya, raunin raunin da suka faru, da kuma karaya mai zurfi.

Yankin da za'a iya gyara shi ne daga 2cm a ƙasa da Humeral kai zuwa 3cm sama da elecron fossa. Zaka iya zaɓar gyara shi daga kafada tare da ƙusa na antgredully ko daga gwiwar hannu tare da ƙusa mai retogrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrugrade.

Halaye na kusoshi na mugaye

Hanyoyin adantawar na tiyata don tsararren tsararren humeral sune m farantin farantin farfadowa da ƙwararren ƙusa.

Masana zane mai karfi yana da karfi anti-juyawa da maganin anti-lanƙwasa kuma an daidaita shi da tabbaci, amma yiwuwar kamuwa da cuta yana da girma, kuma yiwuwar kamuwa da cuta yana da sauƙin lalacewa.

Na zamani humeral a cikin kusurwata na zamani sun shawo kan kasawar kusoshi masu laushi kamar karami mai taushi, da kuma buƙatar ƙarin ƙayyadadden ƙasa, da kuma ɗaukar nauyin nama, da kuma ɗaukar nauyin naƙasassu ya zama da wuri, kuma ana iya fara motsa jiki na aiki bayan tiyata.

Femoral ta rufe ƙusa mai shiga ciki

Alamu don ayyukan da ke kewaye da kusoshi

Duk nau'ikan fashewar 2cm a ƙasa da trertebra kuma fiye da 9cm daga gwiwa hadin gwiwa.

Tsohon karar na tsakiyar tsakiyar shaskewa.

Marasa lafiya tare da farantin farantin ciki na cikin gida.

Fasali na ƙusa ƙusa

Abvantenting fa'idodi

Hannun da aka tilasta wa mafakokin motsa jiki na tsinkaye na ƙusa ya fi tsayayye na faranti, kuma an rarraba ƙarfi a kan tsakiyar kashi, wanda ba shi da sauƙi don lanƙwasa da lalata.

Kulla kusurwoyi a duka iyakar tsallake na ƙusa na samar da kashi ɗaya daga sama, da ƙusoshin da kulle da juyawa da juyawa, kuma cimma matsakaicin kwanciyar hankali.

Gamma

Gamma Nail

Zartar da nau'ikan cututtukan cututtukan cututtukan fata, musamman subtrochansic karar sashen.

Nail Nail na Gamma

Babban subtrochandicarcarcies, trichansca hade tare da fashewar shakin da ke cike da ƙarfi.

Abvantbuwan amfãni na gamma

An inganta ta hanyar haɗuwa da fasahar hijabi tare da Fasahar Nail ta kusa da farantin hijabi, don haka ƙusa ta hanyar gamma fiye da farantin hip, mai ƙara yawan kayan shafa. Don subtrochantic hadadden rudani, ƙwararren gamma ta guji buƙatar karar ƙwayar cuta ta hanzari ko karaya na hanzari.

Nightungiyar Retrogredullary Femal

Alamomin retroggrade femoral kusoshi

Gaba ɗaya don cinyewar rauni, gami da cinyeylar compinuted karaya da intercondyyyyyyyyyyyyyyyylar compinuted. 'Kuma ' kuma 'da kuma karar karaya da ya shafi yanayin fasaha.

Hakanan za'a iya amfani dashi don karban karaya da ke ƙasa da isthmus na femur.

Shafface mai ban sha'awa, da barcinnondyyyyyylar, da kuma karawar da ke tsakanin 20cm daga gwiwa a gwiwa.

Waɗanda suka gaza m

Halayen na Retrograde na Night

Sunkillonondyylar Femalcalcalcoral shine mummunan rauni tare da wahala a cikin farko, raguwa kuma na biyu, ƙara ficewa cikin gida. Akwai wani babban abin da ya faru na rikitarwa kamar juriya mara amfani da shi da jinkirin waraka.

Retrograry wanda aka yi amfani da kai tsaye shine hanyar da za a saba don magance karaya na cikin 'yan gudun hijira, wanda ke da kwanciyar hankali na zamani, kuma yana taimakawa wajen hadadden hadin gwiwa.

Supracondynllar hade da karawar kara da aka tsallakewa tare da tsawaita matsalar cinikin da ke da wuya a magance ta ta hanyar rufewa da ke cikin rawar jiki. Kayan aiki yana da sauki don aiki, daidai a wurin, amintacce a cikin gyara, kuma mai haƙuri zai iya yin farkon aiki mai aiki bayan tiyata.

Tibial ya rufe kawuna

Alamar don Night Nighing

Tsayar da karaya a tsakiya 1/3 na Tibia: transber rabuwa, Short obliqurosis.

Abubuwan da ba a iya ba da izini a cikin 60% na tsawon tsakiyar Tibia: karaya kusa da comphysis, karaya na kashi, karaya tare da lahani na kashi.

Halayen tibial

An yi amfani da tsaka tsakar zango na Tiba galibi don tsakiyar tibia karar.

Kodayake ana iya amfani dashi don kusancin da kuma kusancin Tibiya, farashin ya fi ƙaruwa sau da yawa, ƙarshen tashin hankali yana da motsi a cikin 1/2 na lokuta da ke ƙasa.

Littattafan wallafe-wallafen sun fi dacewa sakamakon distal tibia ribia fiye da wakili tibia karce bayan gyara na fibula.

Tukwarin tiyata

Shirye-shiryen kayan aiki na musamman

Orthopedic gado (gado gado) ko daidaitaccen gado mai laushi; injin; hoto mai ƙarfafawa.

Daidai zaɓi na tsifin ƙusa don entoprastes

Badigram

Matsakaicin Limbor Losbalment

Diami mai narkewa

x-ray isthmus nisa

Matsakaicin tsayin daka na nesa

1. Matattara mai yanke hukunci a ƙarƙashin injin C-ayoyin

Distal da kusancin kashi sun kasance a kan layi na Ray; Mai mulkin ya kasance daidai da diaphysis.

2.Laƙƙarfan auna gwargwadon ma'aunin jikin mutum

Femur: tip na mafi girma TroLALTER → A labarun gwiwa sarari ko mafi girman patella; Tibiya: Sararin gwiwa na gwanonin lastster → yanayin gwiwa na gwiwa hadin gwiwa a cikin dorriflexion na kafa.

Tsarin Kullan IntReDullay

Longituditiinal a cikin rami na Meduly a cikin layi madaidaiciya

Ba ma kusa da wurin shigarwa

Tsawon da ya dace: daskararre - dogon; Undered - Short

(Tabbatarwar Shigar da Shiga; Babu Dilation Mobp, Babu Mai Tsaro mai taushi)

Daidaici Fimoral Strafedullory Nail Point

Shiri na shigarwar wurin shigar da kusanar da aka fi sani da ƙusa na ɗaya

Hip m da kari

LongituSinal Incimal Exximal zuwa mafi girman Trocharter

Ba ma nisa sosai

Sanya fil mai jagorar

Sanya garkuwar garken mai laushi mai taushi

An sake shigar da retrograry

30 ° Clighon

Filin mai jagorar fil a daidai allo a matsayin koguwar medullary na tsararraki na girma

Saka cikin Kirschner Pin cikin Distal Femur ta hanyar Salellar Fasellar ta hanyar Supeve: Orthogonal Fosa na Femur; a baya - layin Bluentaat

Farawa daga PCL ba tare da rauni ba

A layi daya na tibial tibial

A kan layi na layin tsinkaye

Karkatar da tibial Fileau

Gwargwadon iko ba tare da lalata Filato ba

Iyakar gwiwa

Karkatar da tabial tubercial-infior pound na polella tare da kogin Meduly

Bude murfin Meduly: Jagora Pin a 15 ° zuwa jirgin saman Sagittal na Tsabtace na Tubias

Matsayin hoto mai ƙarfafawa

Fasahar maraba

Ragewar da aka rage

Fresh karaya

Raguwa da aka yi aiki

Tsohon karaya tare da pseudothrosis, sclerosis a cikin kogin Medullary

Babu yawon shakatawa a karkashin hauhawar farashin kaya

jini mai dauke da jini shine mafi kyawun sanyaya

Fasahohin sake biya

Daidaici Fimoryulory Nighing

Dalilai na wahala wajen dawo da karaya

Lokacin farin ciki nama rufe baya barin damar kai tsaye ga kashi

Ba za a iya hango inda shigarwa ba

Marain gwiwa na Hip Itiaida → Iliac fascia tashin hankali → Itiacstation

Rage karaya

Magini

Mafi yawa subcutaneous kuma mai sauƙin palpate

Tsinkaye karaya - tsakiya ko kuma karkatar da rauni

Karatun oblique - overkill

Tsararren tsallakewar → → kayan aiki

Matakan Rage matakan raguwa

Motoci na maki

tibia; Percutaneous ko amfani da rauni

Manyan masu jan hankali (takalmi)

rage ragi; limb gajeren

Schanz schanz sukurori

① Feemur, Tibiya

② kusa da layin karaya kamar yadda zai yiwu

③ ③ ③imal karfin karaya guda ɗaya

④e kowane yanki na duniya tare da t-rike don sauƙin motsawa

Ƙusa ƙusa

①memephyseal karaya (gyara layin ƙarfi, yana karbar sabuntawa, yana dawo da aikin)

② oblique karfin rami na distal tibia ko femur (karfi damuwa → matsa lamba)

③ talauci ya rage kusoshi mai kauri a kan tsoffin tashoshin medullary yayin tiyata na sakandare

④ talauci

Karin balaguron

① tibia

② up anyara shi ta hanyar gogewa ko mai aikawa

Yi amfani da tsanantawa a cikin raunin nama mai taushi

Kiyaye shi gajere

⑤ ya hana fadada medullary a cikin jihar

Tsarin Kulle na ƙusa: Distal to Topximal

Yan fa'idohu

sauƙin kwankwasawa, matsawa na karya. kawar da rabuwa; ayyukan rage.

Abubuwan rage kebantawar da aka jinkirta & ba a sanya su ba

Matsalolin da za a iya ci karo da tiyata

Nakasar nakasar (rage girman kai, andang da ko gudun hijira)

Girma a cikin ƙwayar ƙwayar cuta

Scabs na farko

Sclerosis na fashewar fashewa tare da rufe kogon Meduly

Osteoporosis

Matsaloli masu yiwuwa

Dabarar fadada da Intredullary Nail Interredulyulyulary Nail shigar da Cortex

Nakasar rashin daidaituwa → Medractor

Bayyanar iyakar ƙusa → ƙusa ƙusa, farantin farantin

Hanyoyi don hana layin da ba su da ƙarfi

Taken - daidaitaccen shigarwa

Distal - ƙusa na Intramedullary ƙusa a tsakiyar kogon Medullary

Rikitarwa na tsatsowar tsinkaye

★ kamuwa da cuta

★ jure jijiya

★ gurbatar da aka gurbata karaya

★ karabbin likita

Juyawa na waje, trission, valgus, juyawa ciki, rasuwar ciki

★ subcent hadin gwiwa

★ Fat Proctism

★ heterotopic

★ urmonary commolism

★ sake karuwa

★ Trisombosis

★ guftarfin haɗin gwiwa

★ Non-Union na karaya, nangunion kasusuwa

★ gyaran cikin gida

★ Limb gajere

★ Sa

Haƙiƙa - kamuwa da cuta

1. A cikin, an yi la'akari da fashewar busassun wata hanya ce ta hanyar tsinkaye ta hanyar tsinkaye.

2.Ta dace da cutar kamuwa da cuta a bude karaya ya dogara da matsayin raunin nama da kuma gurbatawa

Abin da ya faru na kamuwa da cuta bayan buɗewa ya dogara da jihar rauni na laushi da gurbatawa da yadda ake sarrafawa ta taushi.

3.Na ƙusoshin da ke kusa da ƙusoshin kamuwa da cuta; Abubuwan da ba a faɗaɗa ba na ɓoye ƙayyadaddun ƙayyadadden ƙayyadaddun ƙwayar cuta ba ne, kuma sun ƙare kashi yana da

Ingancin da ba a faɗaɗa ba na ƙwararrun ƙwararrun ƙwararraki ne mai kyau, tare da motsi na microscopic na ƙarshen ƙashin kashi kamar yadda ragowar ci gaba, wanda yake mai sauƙi don haɓakar ƙwayar cuta.

4. Amfani da fadada da iyakance fizge na fadada ba kawai inganta kwanciyar hankali na karaya ba, amma kuma yana nisantar halittar sararin samaniya.

Mai ciwon zakarya syndrom

1.The abin da ya faru na fes na dogon karaya tubular shine 0.5% zuwa 2%.

2. Fadada da medulla da kuma fadada da ba fadada daga medulla ba shi da mahimmanci a kan iska ta damisa.

3.Wana faɗaɗa medulla, dabarar ya kamata ya zama a hankali a hankali, yana gujewa karfi da yawa da aiki mai wahala.

4.The yanayin binciken Fes na yanzu har yanzu yana ɗaukar ka'idodin da Gurd a 1974, da kuma magani bayan ganewar asali zai yi jinkirin da mafi kyawun lokacin don magani kuma yana iya samun mummunan sakamako.

Jinkirta karfin warkar da kasusuwa

Abubuwan da yawa suna shafar haɓakar karaya bayan tsallake na ƙusa, kuma ana iya bincika abubuwan da ake amfani dasu kamar haka.

1.soft nama saka a cikin karaya

2. Kashe na jujjuyawa

3. Tsohon zamanin mai haƙuri

4. Buɗe rauni, mummunan rauni mai laushi, babban heodialysis ko kamuwa da cuta.

5. Darajar da ƙwararraki

6. Hada ciwon sukari mellitus ko wasu cututtukan masu cin abinci.

Karatun likita

A cikin karaya da aka haifar da sakandare na sakandare wanda ya haifar ta hanyar magidanar da ba a cika shi ba yayin shigarwar ƙusa.

Ya kamata a biya hankalinsa da hankali

1. Zaɓuɓɓukan shigar da aikin nisan na iya haifar da karaya mai zurfi.

2. Kada ku tilasta tura a cikin fadada Medulla.

3. Harshen fadada ya zama daidai da shugabanci na ƙusa.

4. Karka yi amfani da karfi lokacin shigar da kusoshi masu shiga cikin ƙarshen ƙarshen.

Zafi a cikin makwabta makwabta

1. Sanya ƙusa mai ban tsoro ya ƙunshi nama mai taushi kuma har ma da gidan haɗin gwiwa a kusurwar akalla 1 hadin gwiwa.

2. Filin Tibe an haɗa shi da gefen matsanancin meniscus ta hanyar transrae jiji da kuma siffofin amintaccen yanki sama da tibial ba da izini a kan wannan batun. Idan nunin faifai ya kusa kusa da saman ko diamita na ƙusa na farfajiya ya yi yawa, yana iya haifar da lalacewar tsarin da ke cikin intra-articular, wanda ya haifar da ciwon ciki na gwiwa.

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