Usoro ntinye ntu intramedullary 5 na usoro ịwa ahụ!

Ụkpụrụ bụ isi nke intramedullary nailing

1. Akụkọ ihe mere eme nke intramedullary nailing

N'afọ 1910, a na-eji mbọ intramedullary Lilienthal aluminom mee ihe maka mgbaji ọkpụkpụ femoral.

Na 1913, Schone ji ọlaọcha intramedullary mbọ na-agwọ mgbaji mgbaji. 

Kuntscher (1900-1972) nyere nnukwu onyinye maka ntu ntu intramedullary. 

Afọ 1960 na 1970 bụ oge mmepe ngwa ngwa nke mbọ intramedullary. 

obodo m na-eji ha n'ụba kemgbe 1990s.

2. Mepee mbelata na mbelata mechiri emechi

1. Enwere ike ịwa ahụ belata mgbaji ụkwụ n'okpuru anya ma ọ bụ mechie n'okpuru nlekota X-ray.

2. Oghere mbelata mgbaji mgbawa oge ọgwụgwọ dị ogologo, ọbara ọgbụgba intraoperative na-abawanye, na mbelata emeghe na-emebiwanye ọbara na njedebe mgbaji.

3. A na-atụ aro ka iji mbelata mechiri emechi dịka o kwere mee. Enwere ike iji ihe na-ebelata traction, ma ọ bụ obere mbepụ n'elu ụgbọ elu gbajiri agbaji iji pry na ibelata, si otú a na-ebelata nnyonye anya na ntinye ọbara na njedebe mgbaji.

4. Maka ọdịda mbelata mechiri emechi, ntugharị ọkpụkpụ ma ọ bụ mkpọpu anụ ahụ gbara ya gburugburu, yana nnukwu mgbaji gbajiri agbaji, enwere ike iji mbelata oghere ịwa ahụ.

3. Fixation usoro nke ntu intramedullary

1. Usoro nke ntu intramedullary n'ime ime ihe bụ ihe nrịbama nke etiti etiti etiti.

2. Ndozi nke mgbaji site na ntu intramedullary bụ nrụgide na-ekesa nrụzi, ọ bụghị ihe nchekwa nchekwa nchekwa, nke na-eme ka ọkpụkpụ nke callus.

3. Central fixation bụ usoro iwu dị elu karịa nhazi nke mpụga cortical, nke nwere ike ibelata ogwe aka ike, belata ihe omume nke valgus angulation na ọdịda ime ime.

4. Ntuzi ntu intramedullary na-enye ihe ndabere maka mbelata mechiri emechi ma ọ bụ mbelata ghe oghe.

4.Uru nke intramedullary mbọ

1. Nsogbu ole na ole

2. Mgbasawanye ihe ngosi ịwa ahụ

3. Ndozi siri ike

4. Ọzụzụ ọrụ nkwonkwo mbụ

5. Ibu ibu ibu n'oge

6. Enwere ike iji ya mee ihe na ntinye nke ọzọ dị n'ime

Ụdị na usoro ndị bụ isi

1. Mkpọchi na-adịghị akpọchi intramedullary mbọ

2. Dynamic na static mkpọchi intramedullary mbọ

3. Mgbasa medullary na usoro nhazi nke na-abụghị nke medullary

4. Mepee na mechiri emechi usoro ndozi

Na-ejikọta ọnụ na enweghị njikọ

Ntụ ụkwụ intramedullary nkịtị nwere nkwụsi ike axial na-adịghị mma yana ike torsional dị ntakịrị, mana ha nwere ngbanwe ụfọdụ ma nwee ike ịgbake mgbe nrụrụ ahụ gasịrị, na-eme ka ọ bụrụ naanị obere mbanye intrabone.

Ntu ntu intramedullary na-ejikọta ọnụ nwere mma mgbochi ntụgharị na mmetụta mgbochi mkpakọ, nkwụsi ike dị mma, ma kwekọọ n'ụkpụrụ nke nhazi nke ndu. A na-ejikarị ha eme ihe na ogologo ọkpụkpụ nke akụkụ ahụ. Karịsịa maka akụkụ dị iche iche na mgbaji agbaji, ha nwere nkwụsi ike ka mma karịa mbọ intramedullary nkịtị.

Dynamization nke static fixation

Ntu mkpọchi intramedullary static na-emepụta ntakịrị ihe nkpuchi na-akpata nchekasị ma na-akwado ya ugbu a maka ịmegharị ihe na-adịghị emekarị.

Maka mgbaji ọkpụkpụ nke na-agwọbeghị na ọnwa 6 ruo 8 ka emechara ya, a na-ejikarị dynamization dochie ọkpụkpụ ọkpụkpụ ma ọ bụ ngbanwe nke mbọ intramedullary gbasaa.

Enwere ike iji ngbanwe dị ka ụzọ iji kwalite ọgwụgwọ mgbaji. A naghị atụ aro ya mgbe niile n'ihi na ọ nwere ike ibute mkpụbelata ụkwụ na nrụrụ ntụgharị.

Mgbasa ụmị ọkpụkpụ na mgbasawanye na-abụghị ụmị

Mgbasa ụmị ọkpụkpụ nwere ike ịtinye mbọ intramedullary nwere dayameta buru ibu na ike ka ukwuu, nke na-enyere aka ọzụzụ ọrụ n'oge ma na-ebelata ọnụego ntu agbajiri agbaji.

Mgbasa ụmị ọkpụkpụ nwere ike ịmepụta nnukwu ọkpụkpụ ọkpụkpụ na-enwe mmetụta osteoinductive, nke na-eme ka ọkpụkpụ gbajie.

Mgbasa ụkwara ga-emebi arịa ọbara nke arịa nri na akpụkpọ ahụ endosteal, mana arịa ọbara nwere ike ịmaliteghachi n'akụkụ oghere nke mbọ intramedullary. Mgbasa ụmị ọkpụkpụ nwekwara ike ịbawanye mgbasa ọbara na akwara anụ ahụ dị nro gbara ya gburugburu, si otú a na-akwalite ọgwụgwọ mgbaji.

Mgbasa ụkwara na-abawanye ohere nke ibute ọrịa na embolism, ma ekwesịrị iji nlezianya mee ya maka mgbaji meghere, ọtụtụ mmerụ ahụ, na mmerụ ahụ dị mgbagwoju anya.

Uru nke mgbasawanye medullary

① Mgbe mgbasawanye medullary gasịrị, mpaghara kọntaktị n'etiti ntu intramedullary na ọkpụkpụ na-abawanye, nke na-eme ka nkwụsi ike nke nkwụsi ike. 

② Mgbe mgbasawanye medullary, enwere ike iji ntu intramedullary buru ibu nke ukwuu, nke na-eme ka ike nke ntu intramedullary dịkwuo ike ma na-ebelata ọnụego ntu agbajiri. 

③ Mpekere ọkpụkpụ mgbe mgbasawanye nke medullary nwere ike ime ka ọkpụkpụ ọhụrụ mepụta ọkpụkpụ, nke na-eme ka ọkpụkpụ gbajie.

N'iji ya na mbọ intramedullary ịgbasa medullary, mbọ intramedullary na-agbasaghị nwere uru ndị a.

① Oge ọrụ dị mkpụmkpụ yana obere ọbara ọgbụgba. 

② nnyonye anya dị nta na mgbaba ọbara endosteal n'ọnọdụ nwere mmerụ ahụ dị nro siri ike.

Ngwa nke ntu intramedullary

Humeral interlocking ntu intramedullary

Ngosipụta maka mbọ aka humeral

Ngosipụta maka mbọ aka intramedullary na-ejikọta humeral na ọgwụgwọ nke ọkpụkpụ ọkpụkpụ humeral bụ: mgbaji na-emebi vaskụla na akwara, ọtụtụ mmerụ ahụ, mgbaji na-akwụghị ụgwọ, mgbaji na-akpata ọrịa, na ọkpụkpụ humeral proximal.

Oke enwere ike idozi bụ site na 2cm n'okpuru isi humeral ruo 3cm n'elu fossa olecranon. Ị nwere ike ịhọrọ idozi ya site na ubu na ntu intramedullary antegrade ma ọ bụ site na nku aka na ntu retrograde.

Njirimara nke mbọ aka humeral

Ụzọ nhazi ịwa ahụ maka mgbaji ọkpụkpụ humeral bụ n'ụzọ bụ isi nhazi efere na ntinye ntu intramedullary.

Ndozi efere nwere ihe mgbochi na-agbanwe agbanwe na mgbochi na-agbagọ ma na-edozi ya nke ọma, ma trauma nke ịwa ahụ dị ukwuu, ohere nke ibute ọrịa dị elu, na akwara radial na-emebi ngwa ngwa.

Modern humeral interlocking na onwe mkpọchi mbọ imeri adịghị ike nke nkịtị intramedullary mbọ dị ka axial erughị ala, ogbenye ntughari akara, na mkpa nke ọzọ fixation, nke mere na mgbaji gbajiri agbaji na-ofi, ọbara ọnwụ bụ obere, na nro anụ ahụ ịdọpụ bụ obere, na medullary mgbasa bụ Ẹkot mpaghara ọkpụkpụ transplantation nwere ike malite ọbụna na-arụ ọrụ na-arụ ọrụ, a ga-amalite na-arụ ọrụ n'oge, a na-ekesa ibu ahụ n'oge. ịwa ahụ.

Femoral interlocking ntu intramedullary

Ngosipụta maka mbọ njikọ femoral

Ụdị mgbaji niile dị 2cm n'okpuru vertebra trochanteric na karịa 9cm site na nkwonkwo ikpere.

Agbaji agbaji ochie nke etiti etiti nke femoral aro.

Ndị ọrịa nwere nhazi ime efere dara ada.

Atụmatụ nke ntu na-ejikọta femoral

Mechanical uru

Ogwe aka ike nke femoral interlocking intramedullary ntu maka idozi mgbaji dị ogologo karịa nke efere ígwè, a na-ekesakwa ike ahụ n'otu n'otu na etiti etiti nke ọkpụkpụ dum, nke na-adịghị mfe na-ehulata na deform.

Mkpọchi mkpọchi na nsọtụ abụọ nke ntu intramedullary na-eme ka ọkpụkpụ na-etolite n'ozuzu ya site n'elu ruo na ala, na ntu mkpuchi na njedebe dị anya nwere ike ibelata ogwe aka nke ntu intramedullary n'ime ọkpụkpụ, gbochie mkpụmkpụ na ntụgharị, ma nweta nkwụsi ike kachasị elu na nkwụsi ike maka nkwụsịtụ mgbaji.

Gamma Interlocking Intramedullary Ntu

Ngosipụta ntu Gamma

Ọdabara na ụdị dị iche iche nke peritrochanteric fractures, karịsịa subtrochanteric fractures.

Mgbatị ntu Gamma (ntu nrụgharị) egosi

elu subtrochanteric fractures, trochanteric jikọtara na femoral aro mgbaji.

Uru nke Gamma ntu

Mepụtara site na ijikọta sliding hip ịghasa na intramedullary ntu technology, isi ntu dị nso n'ime nke medullary cavity karịa ike hip efere, otú Gamma ntu na-eduzi ibu onye ọrịa nso na femoral calcar karịa ike hip efere, na-amụba n'ibu ike nke implant. Maka mgbaji mgbaji subtrochanteric gụnyere nbibi medial cortical comminution, ntu Gamma na-ezere mkpa ọ dị maka nrụzigharị anatomy fracture, ya mere ọ bara uru maka mgbaji intertrochanteric ma ọ bụ mgbaji subtrochanteric.

Retrograde intramedullary femoral ntu

Ngosipụta nke mbọ femoral retrograde

A na-eji ya eme ihe maka mgbaji mgbaji femoral supracondylar, gụnyere mgbaji ọkpụkpụ nke supracondylar na intercondylar 'T' na 'Y' gbajiri agbaji nke metụtara elu akwara.

Enwere ike iji ya maka mgbaji femoral n'okpuru isthmus nke femur.

Osisi femoral, femoral supracondylar, na intercondylar fractures n'ime 20CM site na nkwonkwo ikpere.

Ndị dara efere efere.

Àmà nke retrograde femoral nailing

Ọkpụkpụ femoral supracondylar bụ mgbaji siri ike na-esiri ike na nke mbụ, mbelata na nke abụọ, nrụzi dị n'ime. Enwere nnukwu nsogbu nke nsogbu dị ka mgbaji na-abụghị njikọ na ọgwụgwọ na-egbu oge.

Retrograde interlocking intramedullary nailing bụ usoro a na-ejikarị na-emeso mgbaji femur distal na afọ ndị na-adịbeghị anya, nke nwere ezigbo nkwụsi ike n'ibu, nwere ike ịchịkwa nkwụsị azụ na ntụgharị ntụgharị nke njedebe njedebe nke mgbaji ahụ, ma na-enyere aka na mmegharị nkwonkwo mbụ.

A na-edozi mgbaji ụkwụ femoral jikọtara nke supracondylar na ntu ogologo nke intramedullary supracondylar, nke na-edozi nsogbu ahụ siri ike idozi site na ịgbanye nku intramedullary nke femur. Ngwá ọrụ dị mfe iji rụọ ọrụ, nke ziri ezi na ọnọdụ, a pụrụ ịdabere na ya na nhazi, na onye ọrịa nwere ike ịrụ ọrụ ikpere ikpere n'oge mgbe ịwachara ahụ.

Tibial interlocking ntu intramedullary

Ihe ngosi maka ntu tibial

Mgbaji kwụsiri ike n'etiti 1/3 nke tibia: mgbaji na-agbaji agbaji, obere mgbaji oblique, pseudarthrosis.

Ọkpụkpụ na-adịghị eguzosi ike n'ihe n'ime 60% nke ogologo nke etiti etiti tibia: mgbaji dị nso na metaphysis, ogologo ọkpụkpụ gbajiri agbaji, ọkpụkpụ nke akụkụ, nkwụsị nke ọkpụkpụ, ọkpụkpụ na ọkpụkpụ ọkpụkpụ.

Njirimara nke ntu tibial

A na-ejikarị ntu ntu intramedullary nke tibia eme ihe maka mgbaji n'etiti tibia.

Ọ bụ ezie na a pụkwara iji ya mee ihe maka mgbaji tibia dị nso na nke dị anya, ọnụ ọgụgụ mgbagwoju anya dị elu, malunion na-emekarị ugboro ugboro, njedebe mgbawa nwere ≧1cm nke mmegharị na 1/2 nke ikpe, na 1/4 nke nhazi ahụ ada ada.

Edemede kọrọ nsonaazụ kacha mma nke mgbaji tibia distal karịa mgbaji tibia dị nso mgbe edozichara fibula oge niile.

Usoro ịwa ahụ

Preoperative nkwadebe nke pụrụ iche akụrụngwa

Orthopedic bed (akwa traction) ma ọ bụ ọkọlọtọ fluoroscopic bed ịwa ahụ; onye na-eweghachi azụ; ihe oyiyi ike.

Nhọrọ ziri ezi nke ogologo ntu intramedullary maka endoprostheses tupu ịwa ahụ

Radiograph

nha ogologo ụkwụ na-emegiderịta onwe ya

Dayameta ntu intramedullary

x-ray isthmus obosara

Ntụ ogologo ntu intramedullary

1.Translucent mkpebi siri ike n'okpuru igwe C-arm

Ebe dị anya na nke dị nso nke ọkpụkpụ dị na etiti nke ray; onye na-achị ahụ yiri diaphysis.

2.Length nha dịka akara elu ahụ si dị

Femur: n'ọnụ nke ukwuu trochanter → mpụta ikpere oghere ma ọ bụ elu osisi patella; tibia: oghere ikpere etiti na mpụta → akụkụ azụ nke nkwonkwo nkwonkwo ụkwụ n'azụ ụkwụ.

Usoro ntinye ntu intramedullary - Ụzọ ntinye aka

Ogologo ogologo oghere nke oghere medullary n'ahịrị kwụ ọtọ

Ọ bụghị nso nso ebe ntinye

Ogologo kwesịrị ekwesị: gbasaa - ogologo; undilated - mkpụmkpụ

(Nkwenye na-apụtaghị ìhè nke ebe ntinye; ọ dịghị dilation pulp, ọ dịghị ihe nchebe anụ ahụ dị nro chọrọ)

Ndekota femoral intramedullary ntu ntu

Nkwadebe nke ntinye ntinye maka ntu intramedullary femoral yiri ya

Mgbanwe hip na ntinye

Mberibe ogologo ogologo dị nso na trochanter ka ukwuu

Ọ dịbeghị anya azụ

Ndokwa ntụtụ ntuziaka

Ndokwa nke ọta anụ ahụ dị nro

Ebe ntinye ntu intramedullary femoral retrograde

30° ngbanwe ikpere

Ogologo axis nke pin ndu n'otu ụzọ ahụ dị ka oghere medullary nke isi femoral dị anya.

Ntinye nke Kirschner pin n'ime femur distal site na ligamenti patellar site na uwe nchebe: orthogonal - etiti intercondylar fossa nke femur; akuku - ahịrị Blumensaat

Ebe mmalite nke PCL na-enweghị mmerụ ahụ

Ọnụ ụzọ ntinye ntu intramedullary tibial yiri ya

Na centerline nke oghere medullary

Ogbe ihu nke tibial plateau

Dị elu dị ka o kwere mee na-emebighị ala dị larịị

Mgbanwe ikpere kachasị

mbepụ tibial tuberosity-osisi dị ala nke patella n'akụkụ oghere medullary.

Mepee oghere medullary: pin ndu na 15° gaa n'ụgbọelu sagittal nke ogologo axis nke tibial stem.

Ọnọdụ nke ihe na-emewanye ihe oyiyi

Usoro ịgha mkpụrụ

Mbelata ike eletrik

ọkpụkpụ ọhụrụ

Mbelata akwụkwọ ntuziaka

agbaji agbaji na pseudoarthrosis, sclerosis na oghere medullary

Enweghị njem nlegharị anya n'okpuru onu oriri

mgbasa ọbara bụ ihe kacha mma coolant

Usoro nhazigharị

Ndekota femoral intramedullary ntu

Ihe kpatara ihe isi ike na iweghachi ọkpụkpụ femoral

Mkpuchi anụ ahụ dị nro anaghị ekwe ka ịnweta ọkpụkpụ ozugbo

Enweghị ike ịhụ ebe ntinye agịga anya ozugbo

Mgbakwunye nkwonkwo hip → iliac fascia esemokwu → mbelata mgbaji

Mbelata mgbaji tibial

Ntughari

Ọtụtụ n'ime subcutaneous ma dị mfe palpate

Mgbaji agbaji agbaji - etiti ma ọ bụ distal A na B ụdị mgbaji

Ọkpụkpụ oblique - oke oke

Intramedullary nailing→ ngwaọrụ mbugharị

Usoro mbelata enyemaka

Ike mbelata ntụpọ

tibia; percutaneous ma ọ bụ ọnya were

Nnukwu retractors (ihe nkwado)

mbelata egbu oge; mkpirisi ụkwụ

skru Schanz nwa oge

① Femur, tibia

② Dị ka nso ahịrị mgbaji dị ka o kwere mee

③ Njiji dị nso otu cortical ojiji

④ Jiri chuck zuru ụwa ọnụ nwere T-handle maka ịmegharị ngwa ngwa

Ntu ntu

① Metaphyseal mgbawa (na-edozi ahịrị ike, na-eme ka mweghachi ahụ guzosie ike, iweghachi ọrụ ahụ)

② mgbaji oblique nke distal tibia ma ọ bụ femur (nrụgide nrụgide → nrụgide)

③ Ntu intramedullary na-adịghị mma na-abanye na ọwa medullary ochie n'oge ịwa ahụ nke abụọ

④ Ebe mbata na-adịghị mma, ndakọrịta mgbaji dị nso na-adịghị mma (a na-etinye ya n'akụkụ ebe enwere ike ịkwaga endplant)

Njem nlegharị anya sara mbara

① tibia

② agbakwunyere site na traction ma ọ bụ retractor

③ Jiri nlezianya mee ihe na mmerụ ahụ dị nro siri ike

④ Debe ya nkenke

⑤ Machibido mgbasawanye nke medullary na steeti ebugoro ọkụ

Usoro mkpọchi ntu: distal wee bụrụ nso

Uru

mfe nke knockback, mkpakọ nke gbajiri agbaji; mkpochapu nkewa; Mbelata arụmọrụ.

Usoro mbelata maka ịwa ahụ na-egbu oge & enweghị otu

Nsogbu ndị nwere ike izute na ịwa ahụ egbu oge

Nrụrụ axial (mkpụkpụ, angulation na ma ọ bụ mbugharị)

Uto nke granulation anụ ahụ

Ọkpụkpụ mbụ

Sclerosis nke mgbaji na-agbaji na mmechi nke oghere medullary

Osteoporosis

Nsogbu intraoperative enwere ike

Ntughari nke expander na ntu intramedullary → ntinye ntu intramedullary nke cortex

Nrụrụ akụkụ → retractor

Mwepụ nke nsọtụ ndị gbawara agbawa → Ntu poller, ndozi efere

Ụzọ iji gbochie ahịrị ike na-adịghị mma

Proximal - ebe ntinye ziri ezi

Distal - ntu intramedullary n'etiti oghere medullary

Mgbagwoju anya nke ntu intramedullary

★ ọrịa

★ mmebi akwara

★ agwọ ọrịa gbajiri agbaji

★ mgbaji ahụike

Ntugharị mpụga, torsion, valgus, ntụgharị ime, angulation

★ mgbu nkwonkwo n'akụkụ

★ Abụba embolism

★ Heterotopic ossification

★ pulmonary embolism

★Re-agbajikwa

★ Thrombosis

★ nkwonkwo isi ike

★Na-adịghị n'otu nke mgbaji, ọkpụkpụ adịghị n'otu

★ Internal fixation ọdịda

★ mkpirisi aka

★ Ndị ọzọ

Mgbagwoju anya -- ọrịa

1.N'oge na-adịbeghị anya, a na-ewere mgbaji na-emeghe ka ọ bụrụ ihe na-emegide ntu intramedullary.

2.The ọnọdụ nke postoperative ọrịa na-emeghe fractures na-adabere na ọnọdụ nke anụ ahụ dị nro mmerụ na mmetọ.

Mmetụta nke ọrịa mgbe ọkpụkpụ gbawara agbawa na-adabere na ọnọdụ nke mmerụ ahụ dị nro na mmetọ yana otu esi ejikwa anụ ahụ dị nro.

3.Thinner intramedullary mbọ na-abawanye ohere nke ọrịa; na-agbasaghị akpọchi intramedullary mbọ fixation bụ dịtụ ogbenye, na ọkpụkpụ nsọtụ nwere

Ndozi ntu intramedullary na-adịghị agbasawanye adịghị agbasawanye, na-enwe mmegharị microscopic nke njedebe gbajiri agbaji nke ọkpụkpụ yana oghere fọdụrụnụ, nke dị mfe maka uto nje.

4. Ojiji nke ịgbasawanye na njedebe na-agbatị medullary ọ bụghị nanị na-eme ka nkwụsi ike nke mgbawa ahụ dịkwuo mma, ma na-ezerekwa ịmepụta oghere nwụrụ anwụ.

Ọrịa embolism nke abụba

1.The omume nke FES nke ogologo tubular ọkpụkpụ mgbaji bụ 0,5% ka 2%.

2. Mgbasawanye nke medulla na enweghị mgbasawanye nke medulla enweghị mmetụta dị ịrịba ama na ventilashion pulmonary.

3.Mgbe ị na-agbasa medulla, usoro ahụ kwesịrị ịdị nwayọọ nwayọọ na-agbaze, na-ezere ike dị ukwuu na arụ ọrụ siri ike.

4.nke ugbu a nchoputa nke FES ka nakweere njirisi tụrụ aro site Gurd na 1974, na ọgwụgwọ mgbe nchoputa ga-egbu oge kacha mma maka ọgwụgwọ na nwere ike inwe oké njọ.

Ngwọta mgbaji na-egbu oge na enweghị njikọ ọkpụkpụ

Ihe dị iche iche na-emetụta ọgwụgwọ mgbaji mgbe emechara ntu intramedullary, na enwere ike nyochaa ihe kpatara ya dị ka ndị a.

1. anụ ahụ dị nro agbakwunyere na njedebe mgbaji

2. Nkewa nke transverse mgbaji agwụ

3. Oke agadi nke onye ọrịa

4. Mgbaji meghere, mmerụ ahụ dị nro dị njọ, nnukwu hemodialysis mpaghara ma ọ bụ ọrịa.

5. Ndozi ntu intramedullary na-adịghị mma

6. Ejikọtara ọrịa shuga mellitus ma ọ bụ ọrịa ndị ọzọ na-eri nri.

Ọkpụkpụ ahụike

Ọkpụkpụ a na-ebute site n'ịgwọ ọrịa na-abụkarị mgbaji ụkwụ nke abụọ kpatara site na nhịahụ na-ezighi ezi n'oge nhazi ntu intramedullary.

Ekwesịrị itinye nlebara anya intraoperative

1. Nhọrọ na-ezighi ezi nke ntinye ntinye ntu nwere ike ibute mgbaji dị nso.

2. Akwụsịla ike na mgbasawanye nke medulla.

3. Ọnụ ụzọ nke mgbasawanye pulp kwesịrị ịdị n'otu ntụziaka ahụ dị ka ntụziaka nke ntinye ntu.

4. Ejila ike mgbe ị na-etinye mbọ intramedullary n'ime njedebe dị anya.

Mgbu na nkwonkwo agbata obi

1. Ntinye nke ntu intramedullary gụnyere anụ ahụ dị nro na ọbụna capsule nkwonkwo na gburugburu ma ọ dịkarịa ala 1 nkwonkwo.

2. A na-ejikọta ọnụ ala nke tibial na ihu ihu nke meniscus medial site na eriri ikpere na-atụgharị ma na-eme ka mpaghara nchekwa dị n'elu tuberosity tibial ruo ebe a. Ọ bụrụ na ebe ntu ahụ dị nso n'elu ma ọ bụ dayameta nke ntu intramedullary buru ibu, ọ nwere ike imebi akụkụ ahụ nke intra-articular, na-ebute mgbu ikpere mgbe ọ gasịrị.

3. Proximal protrusion nke intramedullary ntu na heterotopic ossification bụ isi ihe na-akpata mgbu hip mgbe femoral intramedullary mbọ ịwa ahụ.

4. Proximal protrusion nke intramedullary mbọ, proximal mkpọchi ntu iyatesịt na rotator cuff nnyonye anya bụ isi ihe na-akpata mgbu ubu mgbe humeral intramedullary nailing.