Locking plate hman dan dik tak!

ANI Locking plate hi fracture fixation device a ni a, threaded hole a awm bawk. Threaded head nei screw chu hole chhungah screw a nih chuan plate chu (screw) angle fixation device a lo ni ta a ni. Locking (angle stable) plate hian screw hrang hrang screw luh theihna tur locking leh non-locking screw holes a nei thei a (combined plate an ti bawk). Locking plate tih concept hi fracture treatment-ah an rawt a, hman a nih avangin, periarticular fractures, comminuted leh osteoporotic fractures fixation-ah te hman a ni nasa hle a, hei hi a thatna avangin stable support leh fractures fixation, fracture rate sang zawk, soft tissue tihchhiat tlem zawk leh thisen supply tihbuai a nih vang a ni. Vawiin zing chhiarna hian locking plate chungchang chipchiar takin a tarlang ang che, chu chu zir tur a ni!

(a)Basic tlangpui .

1.Locking plate chu eng nge ni?

Steel plate eng pawh angle fixing/angle stabilizing screw emaw pin emaw-a screw theih chu a bul berah chuan locking plate a ni.

2. Locking plate te thatna leh that lohna .

A thatna te .

■ Angular stability, bending leh torsion laka inven theihna .

■Conical shape screw lu hian mechanical distribution a ti tha a ni.

■Radial preload a pe a, ruh resorption leh screw loosening a veng thei bawk.

■Anatomical patterns awm theihna tur atana siam, anatomically shaped .

■Diaphysis-a percutaneous fixation awm theihna tur template siam (single cortical, self-drilling, self-tapping locking screws)

■Locking screws hian flexible bridging leh absolute stabilization fixation pahnih atan anchorage tha tak a pe a ni.

■Bh ruh chung nena inzawmna nghet tak neih a ngai lo, thisen supply humhalh

■Controlled micromotion, ruh tliak tihdamna duhsakna .

■A tlangpuiin ruh grafting a ngai lo .

A bik takin osteoporotic fracture emaw, fracture nghet lo tak tak emaw tan chuan a tangkai hle.

A that lohna .

■Locking screw hian reduction leh compression effect a nei lo a, a bik takin intra-articular fracture emaw simple oblique fractures emaw ah chuan

■Plate hi tihtlem nana pui turin reduction tool atan hman theih a ni lo.

■Screw te hi a dah luh chuan screw pangngai angin a tha lo.

■Screw kal dan tur chu siamrem theih a ni lo (multiaxial locking screw tih loh chu).

■Screw te chu a dah nghet lutuk a, chu chuan 'cold welding' a thlen thei.

■Angle deviation >5°, chakna hloh; >10°, locking effect a hlawk lo

■Plate chu contoured a nih loh chuan subcutaneous protrusion a awm thei ang .

Stiffness chungchangah hian .

Cortical contact tha tak emaw, fracture ends compression tha lo emaw awm lovin, locking splints, a bik takin stainless steel splints hman hian fracture awmna hmuna micromotion tha tak a awm loh avangin fracture chu phase II-a a dam loh nan a veng thei ang

Intraoperative traction hman a nih a, chutah chuan splint fixation locking a nih chuan fracture break gap chu a awm reng ang a, chu chuan fracture healing a ti tlai emaw, a tikhawtlai lo emaw a ni ang

Fracture awlsam tak chu reset leh pressurized a nih loh chuan load chu plate kaltlangin a thawn chhuak a, chu chuan stress concentration a siam a, chu chuan awlsam takin plate breakage a thlen thei a ni.

3. Locking plate leh plate pangngai inkara biomechanical danglamna lian tham .

Conventional plate te hian ruh plate compression tihhlawhtlin nan bone-plate interface-ah friction an ring a.

4. Locking plate leh steel plate pangngaia hman a nih chuan tehkhin theihna a awm .

1.Locking screw te pull-out resistance hi screw pangngai aiin a sang zawk hle.

2. Epiphyseal locking screw te chu an in angle a, chu chuan parallel screw te nena khaikhin chuan screw hian pullout a do theihna a ti sang hle.

(b) Dilna thu bulte .

1. Immobilization chungchanga thu bulte: 1.1.

●Pressurization principle: Osteoporotic diaphysis fracture .

●Neutralization thurin: Osteoporotic diaphysis fracture .

●Bridging principle: Comminuted diaphysis emaw extra-articular metaphyseal fracture emaw a ni.

Union principle: Comminuted intra-articular metaphyseal fracture .

2. Bridging principle: 1.1.

●Typical approach: Percutaneous minimally invasive plate fixation (MIPO emaw MIPPO technique)

●Direct tihtlem dan tur .

●Bridging plate fixation tha tawk tur chuan fracture tawp hnaihah screw holes 3-4 vel hawn tur a ni.

3.Principles of Union: 1.1.

● Plate khata compression leh bridging chungchanga biomechanical principle pahnih hman dun - locking compression plate (LCP)

● A fracture segment pakhatah fracture awlsam tak tak leh a dang a comminuted fractures te (eg, metaphysis comminuted fractures, diaphysis)

●Principle of union hi locking head screw pahnih bakah common screw te dah theihna tur plate-ah chauh hman tur a ni.

Locking plate te hi bone-plate interface inkar friction ah an innghat lo va, stability vawng reng turin screw leh plate inkar interface ah an innghat ber a ni.

An inpumkhatna nghet tak avang hian, locking head nei screw extraction force chu common screw aiin a sang zawk hle a, a chhehvel screw zawng zawng chu lakchhuah emaw, a chhe vek emaw a nih loh chuan. A tlangpuiin, screw pakhat chauh chu a mah chauhva lakchhuah emaw, a chhe emaw a harsa thin. Locking head screw hian inter-fold pressurization a pe lo. Pressurization hi pressurizing device hmangin emaw, regular screw te chu 'mixing holes' (tension screws hmasa ber, chutah nail lock) ah a khalh thei a ni.

1.Splint secure nan standard screw hman a nih chuan (eg 1) locking screw-a screwing chu a awlsam hle ang (eg 2).

2.Splint leh bone block (eg, 1) secure nan locking screw hman a nih chuan, standard screw te chu bone block ang chiah (eg, 2) ah screw a, locking screw te chu a lo chhuak a, a lo retightened leh a nih loh chuan (LHS) a tha lo.

3.Metaphyseal fracture block chu locking head (LHS) nei screw hmanga secure a nih hnuah, fracture block inkar compression fixation chu locking compression plate LCP combination-a power compression hole-a standard screw screw-in a thleng thei a ni.

(c) Thil hriat theihna leh hman loh tur .

1. A lan dan tur .

Surgically treated fracture tam zawkah chuan locking plate fixation a ngai lo. Orthopedic surgery principle te hi zawm a nih chhung chuan fracture tam zawk hi chu conventional plate emaw intramedullary nailing hmangin tihdam theih a ni.

Mahse, fracture chi hrang hrang, tihtlem, plate emaw screw tihchhiatna, leh a hnu lama nonunion, 'unresolved' emaw 'problematic' fracture tia sawi fo thin, intra-articular comnuted fractures, periarticular fractures te pawh ruh fracture te tak te, leh osteoporotic fractures te pawh a awm thei. Heng fracture chi hrang hrangte hi 'unresolved' emaw 'problem' fractures tia sawi an ni fo va, intra-articular comminuted fractures, periarticular short tuberosity fractures leh osteoporotic fractures te pawh an awm bawk. Heng fracture te hi plate lock na tur indication a ni vek.

Classic leh ideal indications for locking plate fixation of fractures chu bridging principle leh union principle for more comminuted fractures - damlo naupang zawkte zingah high-energy fractures emaw, damlo kum upa zawkte osteoporotic fracture emaw a ni.

2. A hman loh tur .

Locking plate hi hman lar tak ni tawh mahse a lantir dan pawh a zau zawk mahse, locking plate-a contraindication engemawzat kan hriat chian a, kan pumpelh a ngai a ni. Locking plate te hi thliar hran loha hman a nih chuan fixation a chhiat leh fracture nonunion a awm thei a ni.

Internal fixation locking hmanga enkawl simple forearm stem fracture ang chi interbody compression mamawh simple fractures te chu non-union a ni tlangpui.

Chutiang bawkin, minimally invasive technique hmanga simple fractures atana locking plate percutaneous placement pawh hi contraindication a ni.

Indirect reduction leh locking plate fixation pawh hi displaced intra-articular fractures atan a tha lo a, chu chu fracture fragments leh firm fixation inkar a open anatomical reduction leh compression a ngai a ni.

Locking plate-a relative contraindication, an man to em avangin, fractures a ni a, chu chu plate pangngai nena inmil taka fix theih a ni. Entirnan, forearm symphysis-a ruh tliakte hian plate pangngai hmanga enkawl a nih chuan 90% aia tam an dam thei a ni.

(d) Locking plate dahna tur .

1. Drill bit chu plate-a screw holes-ah screw rawh. Screw leh screw hole inkar deviation >5° deviation chuan screw locking a tichhia thei a, drill bit hmangin hole te chu drill tha zawk turin a tha.

2. Steel plate chu ruh chung lamah dah la, drill sleeve hmangin khur te chu drill rawh.

3. Depth sounder hmangin depth chu teh la, sounder lu chu screw hole-ah dah a nih leh nih loh ngaihtuah rawh.

4. Locking screw sei zawng dik tak thlang rawh.

5. Pressurized screw te chu steel plate pangngai ang bawkin dah a ni.

6. A tawpah chuan locking screw te chu torque wrench hmangin tight la, tight a nih chuan sliding feeling leh snapping sound chiang tak a awm ang a, chu chuan screw in a tight lutuk loh nan, removal harsatna a thlen ang.

(e) Plate lakchhuahna tur locking .

Clinical locking plate screw te hi hman a ni nasa hle a, mahse awlsam takin removal harsatna an tawk a, a bik takin screw slipping wire leh nail cap leh plate nail hole thread te chu buckle dik lo inkar ah an lang chhuak thin.

1. Screw cap groove a chhiat .

Thil awmdan pangngaiah chuan screw cap groove kimchang leh a inmil screwdriver chu a inmil a ni. Screwdriver chu screw insertion emaw removal emaw hmain screw cap groove nen align tur a ni a, chutiang a nih loh chuan screw cap groove chu screw in emaw screw out emaw laiin a inthlak danglam thei a, chu chuan slippage a thlen thei a ni.

Chu bakah, fracture dam hnuah screw cap notch chu ruh crust emaw fibrous tissue emaw hmanga phuar a ni tlangpui a, chu chu screw lakchhuah hmain tihfai hmasak tur a ni a, mahse ngaihven a nih loh chuan screw cap notch leh angular structure chu artificial-in a chhia thei bawk.

Operator forearm rotation axis chu screwdriver-a long axis nen a inmil loh avangin angle engemaw zat a awm fo thin a, operator chuan screw chu forcefully screwed out a nih chuan screwdriver chuan a wobbles a, chu chuan uneven force vangin screw cap groove a tichhia a ni. Chuvangin, screw groove a chhiat chuan awlsam takin screw slippage a thlen thei a ni.

2. Nail cap emaw nail hole deformation emaw .

Anatomical locking steel plate chu intraoperative-a hman a nih lai hian, a chang chuan steel plate-a bending emaw, shaping emaw ha tak mamawh ang zelin, Raja et al. Locking screw holes-a bending part a awm palh a nih chuan, locking screw-a screw-a screw-a screw-a screw-a screw leh nail hole inmil lo chu nail cap leh steel plate nail holes thread dik lo, a nih loh leh steel plate hnaih taka screw-a screwing chak tak avanga nail deformation tail, etc., a hnu lama paih chhuah a nih chuan a awm thei hle ang tih ring rawh.

3. Self-tapping cortical locking nail hman dan tur .

A chhan chu cortical bone chu nail hole-ah a chhung lam hawiin a lo thang a, chutiang chuan screw chu a chelh tlat ang a, chu chuan screw lakchhuahna kawngah harsatna a thlen ang a, a bik takin self-tapping double cortical bone screws hman a nih chuan, Suzuki et al. Double cortical fixation atan self-tapping screw hman a rawt lo. Hou Yunfei leh a thawhpuiten an zirchiannaah chuan. Upper extremity fractures tan chuan screw hmanga bicortical fixation tul lo tak tak tih loh tur an ti a, Maehara et al. Tin, locking plate hman hunah locking screw hman fo loh tur a ni tih a rawt bawk a, locking screw thlan leh hman dan tur universal standard din a ngai tih a rawt bawk.

4. Screw siam dan leh a awmna hmun .

Locking screw lian leh te, a awmna hmun leh a awmna hmun hian screw lakchhuahna a nghawng thei a ni. Mithiam thenkhat chuan screw chu locking hole lai takah a awm loh chuan, nail hole 5 ° aia tam a awm tawh chuan screw fixation loose a awm thei a, threads wrong buckle emaw nail tail deformation stuck a awm thei a, fixation failure emaw, harsatna tihbo a nih vawi hnihna emaw a awm thei tih an hmuchhuak bawk.

5.Cold Welding .

Normal titanium internal fixation surface hian passivated protective layer layer a nei a, chu chu surgical placement of internal fixation kalpui mek a ni a, chu chu grasping leh shaping hmanrua avang emaw, screw lu leh steel plate inkar friction, etc., chuan passivated protective layer wear area a thlen thei a ni. 2 Substantive contact point inkar a metal contact surface chu adhered a ni ang a, chu chu cold welding siam a ni ang.

Chu bakah, metal ion, inflammatory reaction, etc. inkara galvanic coupling hian cold weld siam a tichak thei bawk. Internal fixation device siamtu tam zawk pawhin he harsatna hi an hre chiang hle a, chuvangin hman loh steel plate te chu nail holes leh screw contact surface inkar ah oxide film technology hmangin an khuh a, hei hian taksaa proteins ionization leh adsorption te tihtawp a tum bawk a, cold welds lo awm thin te pawh a ti tlem bawk.

(f) Hmuhchhuah dan tur .

Ram pum leh ram pawna literature-a report-a removal technique report chu category 2-ah then theih a ni a, chu chu simple leh practical leh complex, a hmasa zawk chu simple accessibility, practicality, low soft tissue damage, low skill leh special instruments mamawh lo leh specialized instrumentation leh equipment bik mamawh a ni.

Maehara leh a thawhpuiten an zirchiannaah chuan. A theih phawt chuan torque-limiting screwdrivers shank lian tak tak hmanga siam rawt ang che. Slipped screws an hmachhawn chuan Pattison et al. report dan awlsam tak chuan slipped screw te chu platinum metal hmanga screwdriver lu chu phuarin screw cap groove-ah a thun a, a chhuah dan awlsam tak a ni. Hetiang method hi screw cap groove chu metal foil hmanga fill leh screwdriver leh groove inkar contact area leh friction tihpun nan a fing a, hei hian slipped thread hmanga screw lakchhuah a awlsam phah a ni. Hetiang method-ah hian case lakchhuah a la harsa hle a, screw cap leh steel plate nail hole thread te chu a la awm reng a nih chuan, conical reverse tapping screw remover, chu chu reverse tapping-a screw cap groove dah aangin, screw out leh pressurize-na atan hman tum theih a ni.

A chhe lam erawh chu locking screw thenkhat chu conical reverse tapping screw extractor hmanga hlawkpui a la harsa hle a, chu chu Ehlinger et al. leh Bae et al. He method hi 3.5 mm screw slippage atan a tangkai fo tih hmutu chuan a hmu a, mahse 4.5 mm screw slippage atan chuan a hlawk lo fo thin. Chutiang a nih chuan hospital orthopedics tier tin hian specialized metal grinding equipment, carbide drills, diamond drills, high-speed grinding wheels te an nei vek lo.

Gopinathan-a leh a thawhpuiten an zirchiannaah chuan. Clavicular reconstruction plate atanga screw lakchhuah harsa tak report-na hmanga heng specialized equipment mamawh lo method rawn luhtir, chu chu reconstruction plate cutout hniam tak hmangin, plate nail holes inkar a plate nail hole inkar a portion tawi zawk chu shear turin wire cutter lian tak hmangin, chutiang chuan screw leh nail hole portion chu awlsam takin unit te tak te, leh screw te chu a chhuak thei a ni. He technique hi titanium reconstruction locking plate te, forearm locking plate te chu low notchs nalh zawk nei, leh 1/3 tube-type plate te tan chauh hman theih a ni a, a hnuai lam extremity-a plate zau zawk emaw, thick zawk emaw tan pawh hman theih a ni lo.

Thil awlsam tak sawi a ni bawk a, chutah chuan drill bit lian deuh deuh hmangin slipped locking screw bula common hole-ah chuan khur pakhat drill a ni a, chutah chuan plate leh screw chu common hole drilled thar lam hawiin an tap a, chutah chuan plate leh screw chu a chhuah chuan plate hnuaia bone cutter dahin prying out hmangin an la chhuak a ni.

Dik tak chuan he method hmang hian ruh a tichhia thei a, chuvangin postoperative weight-bearing protection neih a tha. Chu bakah, internal fixation removal surgery hmaa professional tools hman tlanglawn thenkhat, bolt extractor, hole reamer, screw extraction pliers, T-type pressurized socket leh a dangte buatsaih a ngai bawk.

Locking screw slippery wire removal harsatna hmachhawn hian ram chhunga mithiam thenkhat chuan groove method thlak an rawt a, chu chu dental micro-grinding machine steel sand piece hmanga screw cap groove hexagonal emaw quadrangular groove emaw thlak nan 'one' emaw 'ten' groove emaw, original groove thuk zawk emaw a ni.

Ehlinger leh a thawhpuiten an zirchiannaah chuan, Report-te chuan conical reverse tapping screw extractor-in screw lakchhuah a la harsat em em a nih chuan, tungsten drill grinding hmanga screw lu chu tihchhiat a, steel plate-a nail holes te chu ti lianin, chuta tang chuan screw taksa chu ring saw hmangin a la chhuak thei tih an rawt a ni.

Georgiadis leh a thawhpuiten an zirchiannaah chuan, leh Raia et al. Screw leh steel plate combination-a proposed chu a tight lutuk a, lakchhuah harsa a ni a, hmanraw bik (pneumatic high-speed cutting drills, carbide drills, diamond wheels, etc. ang chi) steel plate cutting method vel nail hole-ah, steel plate-ah chuan screw chu a lo chhuah theih nan an tan a, screw pawh hi a pianphungah chuan lak chhuah awlsam a ni bawk.

Kumar leh Dunlopl-a te chuan distal femur locking steel plate screw system internal fixation removal process-ah, standard self-limiting torque screwdriver, conical screw extractor hmannaah an hlawhchham a, mahse, method thar an rawn luhtir bawk a, chu chu, high-speed thin-flake abrasive wheels hman a ni a, chu chu steel plate kil sir a steel plate kil khata awm, leh chutah chuan bone irradial-a insert a ni. Steel plate nail hole chu cap chu a hahdam theih nan hawng suh la, chutiang chuan locking screws te chu a tha taka paih chhuah theih a ni ang.

A chunga kan sawi tak te hi a theih ang anga zawi zawia hmasawn tur a ni a, chu chu high-speed cutting disk hmanga plate cut emaw grinding emaw a nih laiin screw lu chhungah a tan loh nan leh ruh leh soft tissue te a tichhia lo tur a ni. Chu bakah, heng technique te hian temperature sang leh metal debris a siam thei a, chu chuan medically induced re-fracture, tissue thermal necrosis, leh infection te a thlen theihna a sang thei bawk.

(g) Thuhmahruai .

■ Periosteum nen plate inhnaih tawk lo turin phalsak rawh .

■Plate chu lock hmain dah leh tur a ni a, a chhan chu fracture chu lock hnuah reposition a awm thei lo.

■Locking plate chu pressurized theih a ni lo va, union hole-a pressurizer emaw centrifugal screwing emaw chu screw pangngaiah hman a ngai a, a hmasa berah pressurized a ngai a, chutah chuan locking a ngai a ni.

■ Fracture site 3~4 screw holes screw awm lovin stress thehdarh; ■ Fracture site 3~4 screw holes screw awm lovin stress thehdarh; leh

■ Diaphysis emaw bone cortex thick emaw monocortical fixation, leh ruh quality tha tak awmna hmun; leh

■Vawikhat locked a nih chuan back out theih a ni lo a, screw pangngai chu back out theih a nih laiin .

■Fixation chak tak leh screw tam lutuk hian nonunion a thlen thei a; Principle chu plate te hi a sei tur a ni a, screw tlem zawk hman tur a ni a; Periarticular fractures enkawlnaah chuan stem-ah screw tlem zawk dah tur a ni a, articular surface laka fixation atan screw tam zawk hman tur a ni

■ Bridging plate sei zawng chu fracture area sei zawng aiin a let hnih a sei tur a ni a, screw te chu a ruala sem tur a ni a, ideal fixation chu through-the-aperture fixation a ni tur a ni

■ Force hi plate sei takah a insem darh vek a, screw tlem zawk hmanga fixation hian scab siam a tichak a, ruh damna a tichak bawk.