Jiri Efere Mkpọchi nke ọma!

A Mkpọchi efere bụ ngwaọrụ ndozi mgbaji nwere oghere eri. Mgbe a na-agbanye ihe nkedo nwere isi eri n'ime oghere ahụ, efere ahụ na-aghọ ngwaọrụ nhazi akụkụ (screw). Efere akpọchi (n'akuku kwụsiri ike) nwere ike ịnwe ma oghere na-ekpochi ma na-adịghị ekpochi maka skru dị iche iche a ga-agbanye n'ime (nke a na-akpọkwa efere jikọtara). Ebe ọ bụ na a tụpụtara echiche nke ikpochi efere ma tinye ya na ọgwụgwọ mgbawa, a na-eji ya eme ihe n'ọtụtụ ebe na nhazi nke ọkpụkpụ periarticular, comminuted na osteoporotic fractures n'ihi uru ya nke inye nkwado kwụsiri ike na nkwụsị nke ọkpụkpụ, ọnụ ọgụgụ dị elu na-agwọ ọrịa, obere mmebi anụ ahụ dị nro na nkwụsị nke ọbara. Ọgụgụ ụtụtụ nke taa ga-enye gị nkọwapụta zuru oke maka ikpochi efere, nke kwesịrị ịmụta na ya!

(A) Nlebanya bụ isi

1.Gịnị bụ efere mkpọchi?

Efere ọla ọ bụla enwere ike ịgbanye n'ime ndozi akụkụ / akụkụ na-eme ka skru ma ọ bụ ntụtụ guzosie ike bụ n'ezie efere mkpọchi.

2. Uru na ọghọm nke efere mkpọchi

Uru

■ Nkwụsi ike n'akụkụ, iguzogide nhulata na nhụsianya

■Conical udi nke ịghasa isi mma n'ibu nkesa

∎ Wepụta radial preload, gbochie ntugharị ọkpụkpụ na ịghasa ịtọpụ

■Ebere ọdịdị ahụ ka ọ nabata usoro anatomical mpaghara

∎ Ndebiri dakọtara iji nye ohere idozi percutaneous na diaphysis (otu cortical, ịkwọ ụgbọ ala, skru nke onwe)

■ Mkpọchi skru na-enye ezigbo arịlịka maka njikọ na-agbanwe agbanwe yana nkwụsi ike zuru oke.

■Ọ dịghị mkpa maka njikọ chiri anya na elu ọkpụkpụ, na-echekwa ọbara

■ Micromotion na-achịkwa, na-akwado ọgwụgwọ mgbaji

■N'ozuzu, ọ dịghị mkpado ọkpụkpụ a chọrọ

Ọ na-adị irè karịsịa maka mgbaji ọkpụkpụ osteoporotic ma ọ bụ ọkpụkpụ ọ bụla na-adịghị akwụsi ike.

Ọdịmma

■ Ihe mkpuchi mkpuchi anaghị enwe mmetụta mbelata na mkpakọ, ọkachasị n'ime mgbawa intra-articular ma ọ bụ mgbaji oblique dị mfe.

∎ Enweghị ike iji efere ahụ dị ka ngwá ọrụ mbelata iji nyere aka n'ibelata.

∎ Ihe nkedo ahụ anaghị adị mma dị ka skru ndị a na-emekarị mgbe etinyere ya.

∎ Enweghị ike ịhazigharị ntụziaka nke kposara (ma e wezụga skru multiaxial).

■A na-etinye skru ndị ahụ nke ọma, nke nwere ike iduga na 'ịgbado ọkụ oyi'.

■ Ntugharị akụkụ> 5 °, ike ọnwụ; >10°, mmetụta mkpọchi adịghị arụ ọrụ

■Enwere ike ịpụta n'okpuru anụ ahụ ma ọ bụrụ na emeghị efere ahụ

Okwu isi ike

Na-enweghị ezigbo kọntaktị cortical ma ọ bụ mkpakọ nke njedebe nke mgbawa ahụ, iji mkpuchi mkpuchi, karịsịa igwe anaghị agba nchara, ga-egbochi usoro nke II ọgwụgwọ nke mgbawa n'ihi oke isi ike na ikpochapụ micromotion dị mma na saịtị mgbawa;

Ọ bụrụ na a na-etinye traction intraoperative na mgbe ahụ, a na-etinye ihe nrụnye splint na-ekpochi, a ga-echekwa oghere nkwụsịtụ ahụ, na-eme ka ọ dị ogologo oge ma ọ bụ na-adịghị agwọ ọrịa;

Ọ bụrụ na agbajighị nkenke dị mfe ma na-agbanye ya, a na-ebufe ibu ahụ site na efere ahụ, na-ebute nrụgide nrụgide nke nwere ike iduga n'ụzọ dị mfe na nkwụsịtụ efere.

3. Nnukwu ọdịiche biomechanical dị n'etiti efere mkpọchi na efere a na-ahụkarị

Efere a na-emekarị na-adabere na esemokwu dị na nhụta nke ọkpụkpụ iji mezuo mkpakọ efere nke ọkpụkpụ.

4. Uru atụnyere nke efere mkpọchi na efere ígwè nkịtị

1.The sere-esi na-eguzogide nke kpochiri kposara bụ nnọọ elu karịa nke nkịtị kposara.

2. The epiphyseal kposara kposara na-angled ibe ya, nke ukwuu na-eme ka ịghasa na-eguzogide pullout tụnyere yiri kposara.

(B) Ụkpụrụ ntinye

1. Ụkpụrụ nke imegharị ihe:

● Ụkpụrụ nrụgide: osteoporotic diaphysis fracture

● Ụkpụrụ na-anọpụ iche: osteoporotic diaphysis fracture

●Bridging ụkpụrụ: comminuted diaphysis ma ọ bụ extra-articular metaphyseal mgbaji.

Ụkpụrụ nke ịdị n'otu: nbibi mgbawa intra-articular metaphyseal

2. Usoro nhazi:

● Usoro a na-ahụkarị: nhazi efere dị ntakịrị na-emerụ ahụ (MIPO ma ọ bụ usoro MIPPO)

● Usoro mbelata na-apụtaghị ìhè

● Maka nhazi efere efere zuru oke, oghere 3-4 kwesịrị ịhapụ oghere n'akụkụ njedebe mgbaji.

3. Ụkpụrụ nke otu:

● Ejikọta ụkpụrụ abụọ biomechanical nke mkpakọ na ịchịkọta n'otu efere - mkpọchi mkpakọ efere (LCP)

● Mgbaji dị mfe n'otu akụkụ nke mgbaji ahụ na mgbaji agbaji na nke ọzọ (dịka ọmụmaatụ, mgbaji agbaji nke metaphysis, diaphysis)

●Ekwesịrị itinye ụkpụrụ nke otu n'ọrụ na efere ndị na-enye ohere maka ntinye nke skru nke isi mkpọchi yana skru nkịtị.

Efere akpọchi anaghị adabere na esemokwu dị n'etiti ihu efere ọkpụkpụ ma na-adabere n'ụzọ bụ isi na interface dị n'etiti ịghasa na efere nwere nkwụsi ike angular iji kwado nkwụsi ike.

N'ihi ịdị n'otu ha kwụsiri ike, ike mmịpụta nke kposara nwere isi mkpọchi dị elu karịa nke skru nkịtị, ọ gwụla ma ewepụtara ma ọ bụ gbajie skru niile gbara ya gburugburu. Dị ka ọ na-adịkarị, ọ na-esiri otu ịghasa ike ịwepụta ma ọ bụ gbajie ya n'onwe ya. Ihe mkpuchi isi anaghị enye nrụgide n'etiti. Enwere ike nweta nrụgide site na iji ngwa nrụgide ma ọ bụ site na ịkwọba skru mgbe niile n'ime 'oghere na-agwakọta' (mkpọsa ahụ na-ebu ụzọ, wee kpochie mbọ).

1.Ọ bụrụ na ejirila skru ọkọlọtọ mee ihe iji chekwaa splint (dịka ọmụmaatụ 1), ịmegharị na kposara mkpọchi ga-adị mfe (dịka ọmụmaatụ 2).

2.Ọ bụrụ na ejirila kpochie mkpọchi iji chekwaa splint na ọkpụkpụ ọkpụkpụ (dịka ọmụmaatụ, 1), a naghị atụ aro ka screws ọkọlọtọ n'ime otu ọkpụkpụ ọkpụkpụ (dịka ọmụmaatụ, 2) ma ọ bụrụ na a na-atọpụ skru na-ekpuchi ma na-atụgharị (LHS).

3.O mgbe ejiri m nkedo na-ekpuchi isi (LHS) mee ka metaphyseal fracture block kpuchiri ya, a na-enweta ntinye mkpakọ n'etiti ngọngọ mgbawa site na ịpịnye ọkọlọtọ ọkọlọtọ n'ime oghere mkpakọ ike nke Nchikota Mkpọchi Mkpuchi Plate LCP.

(C) Ngosipụta na contraindications

1. Ngosipụta

Ọtụtụ mgbaji a na-agwọ ọrịa anaghị achọ ndozi efere mkpọchi. Ọ bụrụhaala na a na-agbaso ụkpụrụ nke ịwa ahụ ọkpụkpụ, a pụrụ ịgwọta ọtụtụ mgbaji site na efere omenala ma ọ bụ ntu intramedullary.

Otú ọ dị, e nwere ụdị mgbaji a kapịrị ọnụ nke na-enwe ike ịnwụ nke mbelata, efere ma ọ bụ nkwụsị nke screw, na enweghị njikọ na-esote, nke a na-akpọkarị 'nkwụsịghị edozi' ma ọ bụ 'nsogbu' mgbaji, gụnyere mgbaji nke intra-articular comminuted fractures, periarticular fractures with small steopogments. A na-akpọkarị ụdị mgbaji a dị ka 'mgbajie a na-edozighị' ma ọ bụ 'nsogbu' ma na-agụnye mgbaji n'ime-articular comminuted, mgbaji obere tuberosity periarticular na ọkpụkpụ osteoporotic. Ọkpụkpụ ndị a bụ ihe ngosipụta maka ikpochi efere.

Omuma na ihe ngosi dị mma maka ikpochi efere efere nke mgbaji bụ ụkpụrụ na-achịkọta na ụkpụrụ nke otu maka mgbaji agbaji agbaji - ike dị elu na ndị ọrịa na-eto eto ma ọ bụ ọkpụkpụ ọkpụkpụ osteoporotic na ndị ọrịa meworo agadi.

2. Contraindications

Ọ bụ ezie na ejirila efere mkpọchi eme ihe n'ọtụtụ ebe yana ihe ngosi ha ka sara mbara, anyị ga-amata ma zere ọtụtụ ihe mgbochi na mkpọchi mkpọchi. Ọ bụrụ na a na-eji efere mkpọchi eme ihe n'enweghị ihe ọ bụla, ọdịda nke nhazi na enweghị njikọ nke mgbaji nwere ike ime.

Ọkpụkpụ dị mfe nke chọrọ mkpakọ n'etiti mmadụ, dị ka mgbaji ụkwụ dị mfe a na-emeso ya na mkpọchi ime ime, na-adịkarị mfe na-abụghị njikọ.

N'otu aka ahụ, idobe efere mkpọchi maka mgbaji dị mfe site na iji usoro mkpasu iwe dị ntakịrị bụkwa ihe mgbochi.

Mbelata na-apụtaghị ìhè na mgbachi efere adịghịkwa adabara maka mgbaji dị n'ime akwara, nke chọrọ mbelata anatomical mepere emepe na mkpakọ n'etiti iberibe mgbawa na ndozi siri ike.

Ihe mgbochi maka ikpochi efere, n'ihi oke ọnụ ahịa ha, bụ mgbaji nke nwere ike idozi nke ọma na efere omenala. Dịka ọmụmaatụ, mgbaji nke aka mgbaji symphysis nwere ọnụ ọgụgụ ọgwụgwọ karịa 90% mgbe ejiri efere omenala agwọ ya.

(D) Nwụnye efere mkpọchi

1. Kpochie ihe nkedo ahụ n'ime oghere ndị dị na efere ahụ. Ngbanwe nke>5° n'etiti ihe nkedo na oghere nke skru nwere ike ibute ọdịda nke mkpọchi mkpuchi, yana a na-atụ aro ka iji obere mgbịrịgba gwuo oghere ndị ahụ ọkacha mma.

2. Debe efere ígwè n'elu ọkpụkpụ ahụ ma gbanye oghere site na uwe mwụda.

3. Jiri ụda olu dị omimi tụọ omimi, na-elezi anya na isi nke ụda na-etinye n'ime oghere nkedo.

4. Họrọ ogologo kwesịrị ekwesị nke kpochie mkpọchi.

5. Ntinye nke kposara nrụgide bụ otu maka efere ígwè nkịtị.

6. N'ikpeazụ mee ka kpochie mkpọchi ahụ jiri eriri torque dị ike, mgbe a na-eme ka ọ dị ike, a ga-enwe mmetụta mmịfe doro anya na ụda ụda, ka ịzere ịghasa nke ọma, na-ebute nsogbu nkwụsị.

(E) Mwepụ efere mkpọchi

Clinical kpochidoro efere kposara na-ọtụtụ ebe, ma mfe zutere mwepụ ihe isi ike, tumadi pụtara na ịghasa slipping waya na ntu okpu na efere ntu oghere eri n'etiti na-ezighị ezi ikechi.

1. Ịghasa okpu uzo mmebi

N'okpuru ọnọdụ nkịtị, oghere mkpuchi mkpuchi zuru oke na screwdriver dabara adaba. Ekwesịrị ịkwado screwdriver na oghere mkpuchi mkpuchi tupu ntinye ma ọ bụ wepụ ihe mkpuchi ahụ, ma ọ bụghị ya, ọ ga-abụ na ọ ga-eme ka ọkpụkpụ screwdriver ahụ gbanwee n'oge ị na-agbanye ma ọ bụ na-apụ apụ, na-ebute nkwụsị.

Tụkwasị na nke ahụ, mgbe ọgwụgwọ gbajiri agbaji gasịrị, a na-ejikarị ọkpụkpụ ọkpụkpụ ma ọ bụ anụ ahụ fibrous kechie ihe nkedo ahụ, nke a ga-ehichapụ tupu wepụ ihe nkedo ahụ, ma ọ bụrụ na a naghị elebara ya anya, ọkpụkpụ mkpuchi mkpuchi na ihe owuwu angular nwere ike imebi ya.

N'ihi na ntụgharị ntụgharị nke ogwe aka nke onye na-arụ ọrụ adịghị adabere na ogologo ogologo nke screwdriver, a na-enwekarị akụkụ ụfọdụ, mgbe onye ọrụ na-eji ike kpochapụ ihe nkedo ahụ, ọ bụ ihe a na-apụghị izere ezere na screwdriver na-ama jijiji, na-akpata mmebi na oghere okpu nke ịghasa n'ihi ike na-enweghị isi. Ya mere, mmebi nke screw groove nwere ike iduga n'ụzọ dị mfe na ịghasa.

2. Ntu ntu ma ọ bụ ntu oghere nrụrụ

N'ime usoro intraoperative ngwa nke anatomical mkpọchi ígwè efere, mgbe ụfọdụ dị ka mkpa kwesịrị ekwesị ekwe ma ọ bụ ịkpụzi efere ígwè, Raja et al. kwere na ọ bụrụ na ehulata akụkụ na-eme eme na kpochidoro ịghasa oghere, mgbe screwing na kpochiri kposara ga-ịghasa okpu na ntu oghere mismatch, nke dị nnọọ yiri ka ime n'etiti ntu okpu na ígwè efere ntu oghere eri na-ezighị ezi eriri, ma ọ bụ screwed nso ígwè efere mgbe ọdụ nke ntu deformation mere site na ike na-edu ndú, wdg. Ihe isi ike.

3. Ngwa nke mbọ mkpọchi cortical na-ejide onwe ya

N'ihi na ọkpụkpụ cortical na-etolite n'ime ya tinyere oghere ntu ahụ ma si otú ahụ ga-ejide ihe nkedo ahụ, na-eduga n'ihe isi ike na mwepụ nke ịghasa, karịsịa ngwa nke ịkụnye onwe ya okpukpu abụọ cortical ọkpụkpụ kposara, Suzuki et al. akwadola ka iji skru nke onwe ya maka nhazi cortical okpukpu abụọ. Hou Yunfei et al. tụrụ aro na a ga-ezere ndozi bicortical na-enweghị isi na kposara maka mgbaji dị elu, na Maehara et al. tụkwara aro na a ga-ezere iji skru mkpọchi ugboro ugboro mgbe ị na-eji efere mkpọchi, na ọ dị mkpa ka e guzobe ụkpụrụ zuru ụwa ọnụ maka nhọrọ na itinye skru mkpọchi.

4. Ọdịdị na ọnọdụ nke kposara

Nha, nghazi, na ọnọdụ nke kpochidoro mkpọchi nwere ike imetụta mwepụ nke skru. Ụfọdụ ndị ọkà mmụta achọpụtala na ọ bụrụ na ịghasa na-adịghị dị n'etiti nke mkpọchi oghere, ozugbo ntu oghere eccentricity nke ihe karịrị 5 Celsius nwere ike a rụrụ ịghasa fixation, eri na-ezighị ezi kechie ma ọ bụ ntu ọdụ deformation rapaara na-eduga ọdịda nke fixation ma ọ bụ nke abụọ na-adọ nke mwepụ nke ihe isi ike.

5.Oyi ịgbado ọkụ

Nkịtị titanium esịtidem fixation elu nwere oyi akwa nke passivated nchebe oyi akwa, na usoro nke ịwa ahụ ọnyịnye nke esịtidem fixation, n'ihi na ngwá ọrụ nke aghọta na ịkpụzi, ma ọ bụ isi nke ịghasa na esemokwu n'etiti ígwè efere, wdg, nwere ike iduga passivated nchebe oyi akwa eyi ebe. 2 metal kọntaktị elu n'etiti substantive kọntaktị ebe ga-rubere na, ya bụ, guzobe nke oyi ịgbado ọkụ.

Tụkwasị na nke ahụ, njikọ galvanic n'etiti ion metal, mmeghachi omume mkpali, wdg nwekwara ike ịkwalite nhazi nke welds oyi. Ọtụtụ emepụta nke esịtidem fixation ngwaọrụ nwekwara maara nke a nsogbu, ya mere ejibeghi akpọchi ígwè efere na-kpuchie oxide film technology n'etiti ntu oghere na ịghasa kọntaktị na-ebupụta, nke nwekwara aims inhibit ionization na adsorption nke ndị na-edozi ahụ na ahụ na-ebelata omume nke oyi welds.

(F) Usoro mwepụ

Usoro mwepụ nke a na-akọ na akwụkwọ mba na mba ụwa nwere ike kewaa n'ime 2 edemede, ya bụ, dị mfe na nke bara uru na mgbagwoju anya, nke mbụ e ji mara mfe ịnweta, ihe bara uru, mmebi anụ ahụ dị nro dị ala, nkà dị ala na ọ dịghị mkpa maka ngwá ọrụ pụrụ iche, na nke ikpeazụ chọrọ ngwá ọrụ pụrụ iche na ngwá ọrụ.

Maehara et al. na-atụ aro iji screwdrivers na-amachi torque nwere nnukwu shank mgbe ọ bụla enwere ike. Mgbe chere skru ndị na-ada ada, Pattison et al. kọrọ usoro dị mfe iji wepụ kposara skru site na iji ọla platinum kechie isi nke screwdriver ma tinye ya n'ime oghere nke okpu ịghasa. Usoro a bụ ihe amamihe dị na ya iji mejupụta oghere mkpuchi ihe nkedo na mpempe ígwè ma mee ka mpaghara kọntaktị na esemokwu dị n'etiti screwdriver na uzo, nke na-eme ka mwepụ nke kposara na eri na-amị amị. Na usoro a ka siri ike wepụ ikpe, ma ọ bụrụ na ịghasa okpu na ígwè efere ntu oghere eri ka na-emebibeghị, ị nwere ike na-agbalị iji conical reverse tapping ịghasa remover, ya bụ, si ịghasa okpu uzo ịtinye n'ime reverse tapping na jupụta uzo, na usoro n'usoro n'usoro na-atụgharị na pressurizing ịghasa si.

N'akụkụ ala, ụfọdụ skru mkpọchi ka siri ike ịdị irè site na iji conical reverse tapping screw extractor, dị ka Ehlinger et al. na Bae et al. onye chọpụtara na usoro a na-emekarị ka ọ dị irè maka 3.5 mm screw slippage, ma ọ naghị adị irè maka nkwụsị nke 4.5 mm. N'okwu a, ọ bụghị ọkwa ọ bụla nke orthopedics ụlọ ọgwụ na-eji ngwá ọrụ egweri pụrụ iche dị ka carbide drills, diamond drills, ma ọ bụ wiil egweri dị elu.

Gopinathan et al. ewebata usoro nke na-adịghị achọ ndị a pụrụ iche ngwá site n'ịkọ a ikpe nke siri ike ịghasa mwepụ si a clavicular nwughari efere, ya bụ, na-eji a ala cutout nke nwughari efere, a nnukwu waya cutter na-eji ịkwachaa narrower akụkụ nke efere n'etiti efere ntu oghere, nke mere na kposara na ntu oghere òkè nke efere na-etolite a obere unit, na-adị mfe wepụ. Usoro a na-adabara naanị na efere mkpọchi nwughari nke titanium, efere mkpuchi ihu na obere obere ọkwa dị warara, yana 1/3 ụdị tube, enweghị ike iji ya mee ihe maka efere obosara ma ọ bụ buru ibu na nsọtụ ala.

A kọwakwara usoro dị mfe nke a na-eji obere ihe nkedo buru ibu na-eme ka oghere dị n'ime oghere nkịtị na-esote n'akụkụ screw nke a na-ekpuchi ekpuchi, mgbe ahụ, a na-agbanye efere na screw na ntụziaka nke oghere ọhụrụ a kpụrụ ọhụrụ, mgbe ahụ, a na-ewepụ efere ahụ na ịghasa site na iji ọkpụkpụ ọkpụkpụ na-etinye n'okpuru efere ahụ ma jiri ụkpụrụ nke leverage pụta mgbe a na-atọpụ ya.

N'ezie, enwere ike imebi ọkpụkpụ site na usoro a, ya mere, a na-atụ aro nchebe ibu ibu mgbe arụchara ọrụ gasịrị. Na mgbakwunye, ọ dịkwa mkpa ịkwadebe ụfọdụ ngwa ọkachamara ndị a na-ejikarị tupu ịwa ahụ nrụzi nke ime ime, dị ka onye na-ewepụta bolt, oghere reamer, screw extract pliers, T-type pressurized soket na ndị ọzọ.

N'ihu mkpọchi ịghasa na-amị amị waya siri ike iwepụ, ụfọdụ ndị ọkà mmụta ụlọ tụrụ aro ka ịgbanwe uzo uzo, ya bụ, iji eze Micro-egweri igwe ígwè mpempe ịgbanwe ịghasa okpu groove hexagonal ma ọ bụ quadrangular groove maka 'otu' ma ọ bụ 'iri' uzo, ma ọ bụ mie nke mbụ groove.

Ehlinger et al. kọrọ na n'ọnọdụ ebe conical reverse tapping ịghasa extractor ka na-esiri ike iwepụ ihe nkedo ahụ, a na-atụ aro na enwere ike iwepụ efere ígwè ahụ site n'ibibi isi nke ịghasa site na tungsten drilling na-amụba oghere ntu na efere ígwè, mgbe ahụ, enwere ike iwepụ ahụ nke ịghasa ahụ site na iji mgbanaka mgbanaka.

Georgiadis et al. na Raia et al. tụrụ aro na ịghasa na nchara efere Nchikota bụ oke siri ike na-esi ike wepụ, pụrụ iche ngwá (dị ka pneumatic elu-ọsọ ọnwụ drills, carbide drills, diamond wiil, wdg) na ntu oghere gburugburu ígwè efere ọnwụ usoro, na ígwè efere na-ebipụ ka atọghe nke ịghasa, na ịghasa bụkwa ndammana mfe wepụ.

Kumar na Dunlopl kọrọ na distal femur kpochidoro ígwè efere ịghasa usoro esịtidem fixation mwepụ usoro, na ojiji nke ọkọlọtọ onwe-mmachi torque screwdriver, conical ịghasa extractor na-emezughị, ma na-ewebata a ọhụrụ usoro, ya bụ, ojiji nke elu-ọsọ mkpa-flake abrasive wiil n'akụkụ nsọtụ nke ígwè efere ruo n'ọnụ nke ọkpụkpụ n'ime radiji nke ọkpụkpụ, mgbe ahụ, anyị na-etinye n'ime oghere nchara nchara n'ime oghere nchara n'ime oghere nchara n'ime oghere nchara n'ime oghere nchara n'ime oghere nchara n'ime radish. mbepụ ahụ, emeghela oghere ntu efere ígwè iji mee ka okpu ahụ dị jụụ, nke mere na mwepụ dị irè nke kposara mkpọchi.

Ọ dị mkpa iburu n'obi na ụzọ ndị a dị n'elu kwesịrị ịkwalite nwayọọ nwayọọ dị ka o kwere mee n'oge ịkpụ ma ọ bụ na-egweri efere na-eji diski na-agba ọsọ dị elu iji zere ịkụnye n'ime isi nke ịghasa ma mebie ọkpụkpụ na anụ ahụ dị nro. Tụkwasị na nke a, usoro ndị a nwere ike ịmepụta okpomọkụ dị elu na ihe mkpofu ígwè, nke nwere ike ịkpata ihe ize ndụ dị ukwuu nke ịmaliteghachi ọgwụgwọ ahụike, necrosis thermal necrosis, na ọrịa.

(G) Nchịkọta

∎ Kwe ka ikpokọta efere ezughị ezu na periosteum

■A ga-emegharị efere ahụ tupu akpọchie ya, n'ihi na enweghị ike ịmegharị mgbaji ahụ mgbe akpọchiri ya.

■ Enweghị ike ịgbanye efere mkpọchi, ịkwesịrị iji pressurizer ma ọ bụ centrifugal screwing n'ime oghere otu n'ime ịghasa nkịtị, buru ụzọ pịa, wee kpochie.

■ Ebe mgbawa 3 ~ 4 kpochie oghere na-enweghị ihe nkedo iji gbasaa nrụgide; ■ Ebe mgbawa 3 ~ 4 kpochie oghere na-enweghị ihe nkedo iji gbasaa nrụgide; na

■ monocortical fixation nke diaphysis ma ọ bụ oké ọkpụkpụ cortex, na ebe àgwà nke ọkpụkpụ dị mma; na

∎ Ozugbo akpọchiri ya, enweghị ike ịghachite ya, ebe skru nkịtị nwere ike ịweghachi

■ Ndozi siri ike na ọtụtụ kposara nwere ike iduga n'enweghị njikọ; ụkpụrụ bụ na efere kwesịrị ịdị ogologo ma jiri obere skru mee ihe; na ọgwụgwọ nke periarticular fractures, a ga-etinye obere skru na azuokokoosisi ma jiri screws ọzọ mee ihe maka nhazi megide elu articular.

■ Ogologo efere nkedo kwesịrị ịbụ okpukpu abụọ n'ogologo nke ebe mgbaji, a ga-ekesa screws nke ọma, na nhazi dị mma kwesịrị ịbụ site na nkwụsịtụ oghere.

∎ A na-ekesa ike n'otu ntabi anya n'elu efere dị ogologo, na idozi ya na skru ole na ole nwere ike ịkpalite skaab ma kwalite ọgwụgwọ ọkpụkpụ.