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-na tur locking leh non-locking screw hole a nei thei (combined plate an ti bawk). Locking plate concept hi an rawt a, fracture enkawlna atana hman a nih atang khan periarticular fracture, comminuted leh osteoporotic fracture fixation-ah te hman a ni nasa hle a, a chhan chu a thatna chu stable support leh fracture fixation a pe a, fracture healing rate sang zawk a nei a, soft tissue chhiatna a tlem zawk a, thisen supply a tibuai bawk. Vawiin zing chhiar tur hian locking plate chungchang chipchiar takin a rawn tarlang dawn a, chu chu zir tur a ni!

(A)A bulpui ber thlirletna

1.Locking plate tih hi 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 thatna leh that lohna

A thatna te

■ Angular stability, bending leh torsion laka inven theihna

■Screw head conical shape hian mechanical distribution a ti tha hle

■Radial preload pek, ruh resorption leh screw loosening ven

■Localized anatomical pattern awm thei tur khawpa taksa peng hrang hranga siam

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

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

■Ruh chunglam nena inzawmna hnai tak neih a ngai lo va, thisen supply a humhim

■Micromotion control a ni a, fracture tihdamna a tha hle

■A tlangpuiin ruh grafting a ngai lo

A bik takin osteoporotic fracture emaw, highly unstable fracture emaw tan a tangkai hle.

A that lohna te

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

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

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

■Screw kalna tur chu a inthlak thei lo (multiaxial locking screw tih loh chu).

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

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

■Plate contoured a nih loh chuan subcutaneous protrusion a awm thei

Stiffness chungchang a ni

Cortical contact tha emaw, fracture ends compression emaw awm lo chuan locking splints, a bik takin stainless steel splints hman hian fracture chu a khauh lutuk avangin phase II healing a veng ang a, fracture site-a micromotion tha tak a awm lo ang

Intraoperative traction hman a nih a, chutah locking splint fixation hman a nih chuan fracture break gap chu a humhim ang a, chu chuan fracture damna a tikhawtlai emaw, a dam lo emaw a ni ang

Fracture awlsam tak chu reset leh pressurized a nih loh chuan load chu plate kaltlangin a kal a, chu chuan stress concentration a siam a, awlsam takin plate a ti chhe thei a ni.

3. Locking plate leh conventional plate te biomechanical lama danglamna lian tak tak

Plate pangngai chuan ruh plate compression tihhlawhtlin nan bone-plate interface-a friction an rinchhan a ni.

4. Locking plate leh steel plate pangngai nena khaikhin chuan a thatna

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

2. Epiphyseal locking screw te hi angle in an inzawm a, hei hian parallel screw nena khaikhin chuan screw in pullout a do theihna chu nasa takin a tipung a ni.

(B) Hman dan tur thu bulte

1. Immobilization chungchanga thu bulte:

●Pressurization principle: ruh natna (osteoporotic diaphysis) tihchhiat a ni

●Neutralization principle: ruh natna (osteoporotic diaphysis) tihchhiat a ni

●Bridging principle: diaphysis tihchhiat emaw, extra-articular metaphyseal fracture emaw a awm thei

Union thurin: intra-articular metaphyseal fracture tihchhiat (comminuted) a ni

2. Bridging principle: 1.1.

●A hman dan tlangpui: percutaneous minimally invasive plate fixation (MIPO emaw MIPPO technique) hmanga tih a ni.

●Indirect hmanga tihtlem dan tur

●Bridging plate fixation tha tak neih nan chuan fracture end bulah screw hole 3-4 hawn tur a ni.

3.Inpumkhatna thu bulte: 1.1.

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

● Fracture segment pakhata simple fracture leh a dang a comminuted fractures (eg, metaphysis-a comminuted fractures, diaphysis) .

●Union principle hi locking head screw pahnih bakah common screw dah theihna tur plate-ah chauh hman tur a ni.

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

An inpumkhatna nghet tak avang hian locking head nei screw-te extraction force chu screw pangngai 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, tihchhiat 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'-ah (tension screw hmasa la, nail locking) hmangin emaw hmuh theih a ni.

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

2.Splint leh bone block (eg, 1) secure nan locking screw hman a nih chuan, locking screw te chu tihzauh leh tihkhauh leh (LHS) a nih loh chuan standard screw te chu bone block khatah (eg, 2) screw hi a tha lo.

3.Metaphyseal fracture block chu locking head (LHS) nei screw hmanga secure a nih hnuah, Locking Compression Plate LCP combination-a power compression hole-ah standard screw screw hmangin fracture block inkarah compression fixation a awm thei a ni.

(C) Indication leh contraindication te

1. Thil hriattirna

Surgery hmanga enkawl fracture tam zawk hi chu locking plate fixation a ngai lo. Orthopaedic surgery principle zawm a nih chhung chuan, ruh tliak tam zawk chu plate pangngai emaw, intramedullary nailing emaw hmangin tihdam theih a ni.

Mahse, fracture chi hrang hrang, reduction hloh, plate emaw screw breakage, leh a hnu lama nonunion awm thei, 'unresolved' emaw 'problematic' fracture tia sawi fo thin, intra-articular comminuted fractures, periarticular fracture ruh tliak te te, leh osteoporotic fracture te pawh a awm. Heng fracture chi hrang hrangte hi 'unresolved' emaw 'problem' fracture tia sawi a ni fo a, intra-articular comminuted fracture, periarticular short tuberosity fracture leh osteoporotic fracture te pawh a tel. Heng fracture te hi locking plate awm theihna tur indication vek a ni.

Fracture locking plate fixation atana classic leh ideal indications chu bridging principle leh union principle a ni a, comminuted fracture tam zawk - damlo naupang zawkah high-energy fracture emaw, damlo kum upa zawkah osteoporotic fracture emaw a awm thei.

2. A hman lohna tur

Locking plate hi hman lar tak a ni tawh a, a indication pawh zau zawk mahse, locking plate dodalna engemaw zat kan hriat a ngai a, kan pumpelh a ngai bawk. Locking plate te hi thliar hran loha hman a nih chuan fixation failure leh nonunion of the fracture a awm thei.

Fracture awlsam tak tak, interbody compression mamawh, forearm stem fracture awlsam tak, locking internal fixation hmanga enkawl te hi non-union a awm duh hle.

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

Indirect reduction leh locking plate fixation hi displaced intra-articular fracture tan pawh a tha lo hle a, hei hian open anatomical reduction leh fracture fragment inkara compression leh firm fixation a mamawh a ni.

Locking plate-a relative contraindication, a man to lutuk avangin, a fracture chu plate pangngai hmanga lungawithlak taka tihfel theih a ni. Entirnan, forearm symphysis fracture hi plate pangngai hmanga enkawl a nih chuan healing rate 90% aia tam a ni.

(D) Locking plate dahna tur

1. Drill bit chu plate chhunga screw holes chhungah screw la. Screw leh screw hole inkar >5° deviation chuan screw locking a tichhia thei a, drill bit hmanga holes drill a tha ber.

2. Steel plate chu ruh chung lamah dah la, drill sleeve hmangin a zungte chu drill rawh.

3. Depth sounder hmangin a thuk zawng teh la, sounder lu chu screw hole chhungah a lut ngei ngei tur a ni.

4. Locking screw sei zawng tur dik tak thlang rawh.

5. Pressurized screw dah dan hi steel plate pangngaia dah dan ang chiah a ni.

6. A tawpah chuan locking screw te chu torque wrench hmangin khauh takin khih la, i khauh chuan sliding feeling leh snapping sound chiang tak a awm ang a, chu chu screw in tight lutuk lo turin, chu chuan lakchhuah harsatna a thlen ang.

(E) Locking plate lakchhuahna

Clinical locking plate screw hi hman a ni nasa hle a, mahse awlsam taka lakchhuah harsatna a tawk a, a langsar ber chu screw slipping wire leh nail cap leh plate nail hole threads buckle dik lo inkar ah a langsar hle.

1. Screw cap groove tihchhiat a ni

Thil awmdan pangngaiah chuan screw cap groove kimchang leh a kaihhnawih screwdriver chu a inmil vek a ni. Screw dah luh emaw, lak chhuah emaw hmain screwdriver chu screw cap groove nen a inmil tur a ni a, chutiang a nih loh chuan screw cap groove chu screw in emaw screw out emaw laiin a deform a rinawm a, chu chuan slippage a thlen thei a ni.

Tin, fracture a dam hnuah screw cap notch hi bone crust emaw fibrous tissue emaw hmanga khuh 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 te chu artificial takin a chhe thei a ni.

Operator-a kut hmawr rotation axis chu screwdriver-a axis sei tak nen a inmil loh avangin angle engemaw zat a awm fo thin a, operator-in screw chu chak taka a screw chhuah chuan screwdriver chu a inthlak danglam a, chu chuan chakna inang lo tak avangin screw-a 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 emaw tihdanglam

Anatomical locking steel plate intraoperative application kalpui danah, a chang chuan steel plate chu a dik taka bending emaw shaping emaw a mamawh dan azirin Raja et al. rin dan chuan bending part chu locking screw holes-ah a thleng palh a nih chuan, locking screw-a screw-naah screw cap leh nail hole inmil lohna a ni ang a, hei hi nail cap leh steel plate nail holes threads threads wrong buckle inkarah a thleng thei hle a, emaw, steel plate hnaih taka screwed a nih chuan nail deformation tail chu screwing chak tak, etc., a thlen chuan a thlen thei a ni a hnua Harsatna tihbo a nih theih nan.

3. Self-tapping cortical locking nail hman dan tur

Cortical bone chu nail hole zawhin chhung lam hawiin a lo thang lian a, chutiang chuan screw chu a chelh tlat ang a, screw lakchhuahna kawngah harsatna a thlen a, a bik takin self-tapping double cortical bone screw hmannaah Suzuki et al. double cortical fixation atan self-tapping screw hman a rawt lo. Hou Yunfei leh a thawhpuiten an sawi. upper extremity fracture-ah chuan screw hmanga bicortical fixation tul lo taka tih loh tur thu an rawt a, Maehara et al. tin, locking plate hman hunah locking screw hman fo loh tur thu leh, locking screw thlan leh hman dan tur universal standard siam a ngai tih a rawt bawk.

4. Screw awm dan leh a awmna hmun

Locking screw lian leh te, a orientation 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 vawi khat nail hole eccentricity 5 ° aia tam a awm chuan loose screw fixation a awm thei a, threads wrong buckle emaw nail tail deformation emaw a stuck thei a, fixation a hlawhchham emaw, harsatna tihbona phase hnihna emaw a thlen thei tih an hmuchhuak.

5.Cold welding hmanga tih a ni

Normal titanium internal fixation surface hian passivated protective layer layer a nei a, internal fixation surgical placement process-ah, grasping leh shaping hmanrua avang te, emaw, screw lu leh steel plate inkara friction, etc. avang hian passivated protective layer wear area a awm thei a ni. 2 metal contact surface inkar substantive contact point chu adhered ang a, chu chu cold welding siamna a ni.

Chu bakah, metal ion inkara galvanic coupling, inflammatory reaction, etc. te hian cold weld siamna a tichak thei bawk. Internal fixation device siamtu tam zawk pawhin he harsatna hi an hre chiang hle a, chuvangin locking steel plate hman lohte chu nail hole leh screw contact surface inkarah oxide film technology hmanga khuh a ni a, hei hian taksaa proteins ionization leh adsorption tihtawp leh cold weld awm lohna tihtlem a tum bawk.

(F) Hrilhfiahna hmanrua

National leh international literature-a report-te removal technique-te chu category 2-ah then theih a ni a, chungte chu, simple leh practical leh complex te an ni a, a hmasa zawk chu simple accessibility, practicality, soft tissue chhiatna tlem, skill hniam leh instrument bik mamawh lohna a ni a, a hnuhnung zawk chu specialized instrumentation leh equipment mamawhna a ni.

Maehara leh a thawhpuiten an sawi. a theih phawt chuan torque-limiting screwdriver, shank lian tak tak nei hman turin rawtna siam rawh. Screw sliped an hmachhawn chuan Pattison et al. report chuan screwdriver lu chu platinum metal hmanga khuh a, screw cap groove-a dah hmanga slipped screw lakchhuah dan awlsam tak a ni. Hetiang method hian screw cap groove chu metal foil-in a khat a, screwdriver leh groove inkara contact area leh friction a tipung a, hei hian slipped thread nei screw te chu lakchhuah a ti awlsam hle. Hetiang method-ah hian case lakchhuah a la harsa a, screw cap leh steel plate nail hole threads te chu a la awm reng a nih chuan conical reverse tapping screw remover hmangin i tum thei a, chu chu screw cap groove reverse tapping-a dah atang chuan groove chu fill la, screw chu rotating leh pressurizing out process-ah.

A chhe lam erawh chu locking screw thenkhat chu conical reverse tapping screw extractor hmanga hman tangkai a la harsa hle a, Ehlinger et al. leh Bae leh a thawhpuiten an sawi bawk. an hmuh dan chuan he method hi 3.5 mm screw slippage atan a tangkai fo a, 4.5 mm screw slippage tan erawh a hlawk lo fo thung. Chutiang a nih chuan hospital orthopaedic tier zawng zawngah hian specialized metal grinding equipment, carbide drills, diamond drills, emaw high-speed grinding wheels te dah vek a ni lo.

Gopinathan leh a thawhpuiten an sawi. clavicular reconstruction plate atanga screw lakchhuah harsa tak tak report-in heng specialized equipment mamawh lo method introduce a, chu chu reconstruction plate cutout hniam tak hmangin wire cutter lian tak hmangin plate nail holes inkar a plate a tawi zawk chu shear a ni a, chutiang chuan screw leh plate nail hole portion chu unit tenau tak a siam a, screw te chu awlsam takin lakchhuah theih a ni. He technique hi titanium reconstruction locking plate, forearm locking plate notch hniam zawk nei, leh 1/3 tube-type plate-ah chauh hman theih a ni a, a hnuai lam a plate zau zawk leh thuk zawk tan pawh hman theih a ni lo.

Thil tih dan awlsam tak pawh sawi a ni tawh a, chu chu slipped locking screw bula common hole-ah chuan drill bit lian deuh hmangin hole an drill a, chutah chuan plate leh screw chu common hole drill thar lam hawiin an tap a, chutah chuan plate leh screw chu plate hnuaia bone cutter dahin a awm hunah leverage principle hmangin prying out hmangin an la chhuak a ni tihzauh a ni.

Hetiang method hmang hian ruh tihchhiat theihna a awm tih chu a chiang a, chuvangin postoperative weight-bearing protection hi a tha hle. Chu bakah, internal fixation lakchhuahna surgery hmaa professional hmanrua hman tlanglawn thenkhat, bolt extractor, hole reamer, screw extraction pliers, T-type pressurized socket leh a dangte pawh buatsaih a ngai bawk.

Locking screw slippery wire lakchhuah harsatna karah, domestic scholar thenkhat chuan groove method thlak danglam an rawt a, chu chu dental micro-grinding machine steel sand piece hmanga screw cap groove hexagonal emaw quadrangular groove chu 'one' emaw 'ten' groove atan thlak emaw, original groove deepen emaw a ni.

Ehlinger leh a thawhpuiten an sawi. report chuan conical reverse tapping screw extractor-in screw lakchhuah harsatna a la neih chuan, steel plate chu tungsten drill grinding hmanga screw lu tihchhiat leh steel plate-a nail holes tihzauh hmanga lak chhuah theih a nih thu an rawt a, chutah chuan screw taksa chu ring saw hmanga lakchhuah theih a nih thu an rawt a ni.

Georgiadis leh a thawhpuiten an ziak a ni. leh Raia leh a thawhpuiten an sawi bawk. proposed in the screw and steel plate combination is too tight and hard to remove, special equipment (such as pneumatic high-speed cutting drills, carbide drills, diamond wheels, etc.) chu nail hole vel steel plate cutting method vel ah, steel plate ah chuan screw loosen turin cut a ni a, screw pawh hi natural takin lakchhuah awlsam a ni.

Kumar leh Dunlopl te chuan distal femur locking steel plate screw system internal fixation removal process-ah an report a, standard self-limiting torque screwdriver hmannaah conical screw extractor an hlawhchham a, mahse method thar an rawn hmang bawk a, chu chu steel plate kil sir atanga screw hole sir thlenga high-speed thin-flake abrasive wheel hman a ni radial incision, chutah chuan incision chhunga bone knife dah chu wedge la, cap relax theih nan steel plate nail hole chu hawng suh, chutiang chuan Locking screws te effective removal.

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

(G) Thupui tawi

■ Plate chu periosteum nena inzawm kim lo turin phalsak rawh

■Plate chu lock hmain a hmun dangah dah leh tur a ni a, a chhan chu lock hnuah pawh a fracture chu dah leh theih a ni lo.

■Locking plate chu pressurized theih a ni lo, union hole-a pressurizer emaw centrifugal screwing emaw hmanga screw pangngaiah luh a ngai a, pressurized hmasak a ngai a, chutah chuan locking

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

■ diaphysis emaw thick bone cortex emaw monocortical fixation, leh ruh quality tha awmna hmunah; leh

■Vawikhat lock a nih chuan back out theih a ni lo va, screw pangngai erawh chu back out theih a ni thung

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

■ bridging plate sei zawng chu fracture area sei zawng aiin a let hnih a ni tur a ni a, screw te chu a ruala sem darh tur a ni a, fixation tha ber chu through-the-aperture fixation a ni tur a ni

■ Force hi plate sei takah inang tlang taka sem darh a ni a, screw tlem zawk hmanga fixation hian scab siam a tichak thei a, ruh damna a tichak thei bawk.