Kutseka Plate-Kuletsa Zoletsa ndi Zochepa

Kugwiritsa ntchito zokhoma mbale zakulitsa kukula kwa ntchito mbale mkati fixation wa fractures. Komabe, kugwiritsa ntchito kwawo kuyenera kukhala koyenera komanso kokometsedwa chifukwa cha zovuta zomwe zingakhalepo komanso zoperewera. M'nkhaniyi, tiwona malingaliro ogwiritsira ntchito, zovuta zochotsa, ndi malire, mbali zitatu za ntchito yotseka mbale.

01.Kodi Ndi Zinthu Ziti Zapadera Ndi Zovuta Zomwe Ziyenera Kuzindikirika Poyika Mbale Zotsekera?

Masitepe ndi Zovuta Zochepetsera Zophwanyika Ndi Mbale Zotsekera

Masitepe okhazikitsanso fracture amakhazikika. Ma mbale okhoma samakhazikitsanso fractures. 

Mukayikidwa mu gawo la fupa, kuwonjezera zomangira zambiri sikungasunthe. Ngati mbale yotsekera yomwe imangovomereza misomali yokhoma imagwiritsidwa ntchito, 

izi zikutanthauza kuti mbaleyo ikhoza kutsekedwa pambuyo poti fracture yakhazikitsidwa.

Popeza mbale zokhoma zimalola kuti mafupa achiritsidwe popanda kutayika koyambirira, 

chifukwa chachikulu malunion wa kutseka mbale ndi zolakwika koyamba repositioning. 

Ndipo, kuyikanso molakwika chifukwa cha makina osakwanira kungayambitse machiritso olakwika pamene mbale ya mafupa imasweka chifukwa chachedwa kuchira kapena kusachira.

Kuyikanso popanda kugwiritsa ntchito mbale zokhoma kumakhala kovuta makamaka mukamagwira ntchito movutikira

 ndondomeko chifukwa fupa kukhudzana ndi kochepa kwambiri. Pamafunika njira zosiyanasiyana zokokera (matebulo oyendetsa, ma retractors),

 ma percutaneous repositioning forceps osiyanasiyana, ndi mapini a Kirschner kuti awononge zidutswa za fupa ndi kukonza kwakanthawi. 

Musanagwiritse ntchito mbale zokhoma ndi misomali yotseka, ndikofunikira kuyang'ana kukonzanso ndi fluoroscopy.

Mosiyana ndi izi, mukamagwiritsa ntchito mbale yokhoma yomwe ilinso ndi mabowo okhazikika, 

chomangira chokhazikika chikhoza kuyikidwa mu mabowo okhazikika kuti muyikenso pa mbale.

 Zidutswa za mafupa zimayikidwa pambali pa mbale. Ngati mbaleyo ikugwirizana ndi anatomy, ikhoza kugwiritsidwa ntchito ngati chiwongolero chobwezeretsanso. 

Kutseka misomali kumatsimikizira zotsatira zokhazikika popanda kusintha kukonzanso koyamba. Dongosolo loyikapo (zomangira zokhazikika, kenako zotsekera) ndizofunikira (Chithunzi 4).

Chithunzi 4 Choyamba ikani zomangira muyezo ndi kumangitsa iwo.

Kupanda Tactile Feedback Pamene Mumangitsa Kutseka Zikhomo

Palibe mayankho ogwirika mukamangitsa zomangira zokhoma. Pamenepo, 

Kumangitsa kwa misomali yotseka kumachitika nthawi imodzi mu kortical kapena cancellous fupa ndi chitsulo chokhoma mbale. Pachifukwa ichi,

 n'zosavuta kuti dokotala aganize molakwika kuti msomali wotsekedwa ukugwira bwino mu fupa la cortical kapena cancellous (Chithunzi 3).

Mkuyu. 3 Kugwira ntchito kutalika kwa zomangira zokhoma kutengera mtundu wa fupa ndi kuchuluka kwa ma cortices.

Self-Tapping Locking Screws

Kugwiritsa ntchito zomangira zokhoma pawokha kumatanthawuza kuti palibe mayankho ogwira mtima pakubowola kapena kumangiriza momwe zimachitikira nthawi imodzi.

Makina awo amafanana ndi zomangira za single cortex locking panthawi imodzi ya cortex. Ngati atalika kwambiri, 

adzalumikizana ndi kotekisi yachiwiri yosabowoleza, zomwe zimapangitsa kuti msomali wotsekera ukhale wolakwika mu mbale yotsekera.

Pakugwiritsa ntchito ma bicortical, amatha kukhala amfupi kwambiri, zomwe zimawapangitsa kukhala ofanana ndi misomali yotsekera yokhala ndi kotekisi imodzi. 

Ngati ali otalika kwambiri, amatha kupitirira cortex ndipo akhoza kuwononga zinthu zovuta kumbali ina ya mbale.

Utali wolondola wokhoma msomali ukhoza kupezedwa poyesa kutalika komwe mukufuna pambuyo pobowola kapena kutsimikizira ndi fluoroscopy.

Mawonekedwe a Uniaxial Locking Screw

Choyipa chachikulu cha misomali yotsekera uniaxial ndikuti mawonekedwe awo adakonzedweratu. 

Atha kukhala ndi implant kapena tsinde la prosthetic panjira yawo, zomwe zimapangitsa kuyika kosatheka kapena kumalepheretsa kukhazikika kwa unicortical.

Kwa mbale zotsekera za anatomical zomwe zimagwiritsidwa ntchito m'miyendo yokhala ndi misomali yotseka ya uniaxial yokhala ndi mawonekedwe okhazikika, 

wokometsedwa pazifukwa za anatomical ndi biomechanical, pali chiopsezo cha intra-articular locking misomali kuyika. 

Chitsanzo chodziwika bwino ndi kuphulika kwa distal radius. Chiwopsezochi chimakhala chokulirapo ngati mbale yotsekera ili pafupi ndi olowa kapena ngati thupi silikuyenda bwino. 

Kusapezeka kwa fracture ya intra-articular kuyenera kutsimikiziridwa ndi fluoroscopy.

Malingaliro a kampani MIPO Technologies

Njira ya minimally invasive percutaneous osteosynthesis (MIPO) imaphatikizapo subcutaneous ndi/kapena submuscular. 

ndi extraperiosteal kulowetsa mbale ya fupa kudzera pa kabowo kakang'ono m'fupa pambuyo potsetsereka, popanda kuwonetsa

 malo ophwanyika. Izi zimalola kuti tizicheka ting'onoting'ono, kuchepa kwa malo opangira opaleshoni, ndikupangitsa kuti njirayi ikhale '' biologic ''

 chifukwa palibe chifukwa chowonetsera chidutswa chilichonse cha fupa ndipo palibe kusokoneza minofu yofewa, periosteal vascularization, kapena fracture hematoma.

Ikhoza kukwaniritsidwa ndi mbale yotsekera ndi chida chopangidwa mwapadera chomwe chimalola mbale 

kugwiritsiridwa ntchito ndi kudutsa pakhungu kuti apeze mosavuta mabowo okhoma msomali mu mbale. 

Zithunzi za fluoroscopic ziyenera kutengedwa pa sitepe iliyonse kuti zitsimikizire momwe zikuyendera. Gawo lirilonse la njira iyi ndi yovuta. Vuto loyamba ndikukhazikitsanso fracture isanayambe kukonza.

 Chotsekera mbaleyo chiyenera kukhala chokhazikika motsatira kutalika kwa fupa, apo ayi kuyanjanitsa kwa mbale yotsekera kudzakhala asymmetric (Chithunzi 5). Kuphatikiza apo, 

mbale yotsekera iyenera kukhala yofananira bwino ndi kotekisi ya fupa yomwe idapangidwa kuti itsatire komanso pafupi ndi fupa ngati 

zotheka popanda kuchepetsa kwambiri kuuma kwa dongosolo. Pakutseka komaliza, zimakhala zovuta kutsimikizira kuti

 zomangira za zomangira zimagwirizana bwino pa mbale yokhoma komanso kuti misomali yotsekera imalumikizidwa bwino pakumizidwa.

Chithunzi 5 Kuyika kwapakati kwa mbale yotsekera komanso kusowa kwa mayankho a haptic panthawi yomizidwa.

Zomwe Zingachitike Pakhungu Mukamagwiritsa Ntchito Zotsekera Zakunja za Ankle

Kugwiritsiridwa ntchito kwa mbale zokhoma kukonza fractures zakunja za akakolo zakhala zikugwirizana ndi kuchuluka kwachilendo kwa khungu la necrosis. 

The makulidwe a subcutaneous zokhoma mbale amaika kupsyinjika pa khungu ndi kusokoneza ake mtima kugawa ndi machiritso. 

Chinachake chofananacho chingachitike pamene mbale zokhoma zikugwiritsidwa ntchito pothyoka ma hawksbill.

Chiwopsezo cha Osteoporosis Ndi Kutulutsa Zingwe

Mu mafupa a osteoporotic, misomali yotseka imathandizira kuchepetsa chiwopsezo chokoka kapena kuchotsa. 

Kumangako sikuli kolimba mokwanira chifukwa cha fupa la fupa lochepa kwambiri komanso kuchepa kwa trabeculae.

Pamenepa, kuyika mbale zokhoma kumakhala kolimba komanso kumangika bwino mukamagwiritsa ntchito chomangira chozungulira kapena cholumikizira monolithic (Chithunzi 3).

Chidule:

1. zomangira zotsekera sizimalola kuti kusweka kwa mbale ya mafupa kukhazikitsidwenso.

2. fracture iyenera kukhazikitsidwanso musanawonjezere zotsekera zotsekera.

3. percutaneous fixation kuti fracture kuchepetsa kumafuna kutseka mbale zida. njira ya MIPO ndiyofunika kwambiri.

02. Zovuta Zochotsa Mbale Zotsekera

Kuchotsa mbale yokhomayo ikatha kusweka ndizovuta komanso zosayembekezereka, 

koma mkhalidwewo ukhoza kuthetsedwa. Vuto lalikulu ndikumasula zotsekera zotsekera.

Nthawi zina, ulusi womwe uli pamutu wa msomali wokhoma umawonongeka pakuyika 

(kulimbitsa kangapo ndi kumasula, mawonekedwe a screwdriver awonongeka ndipo osati a hexagonal, kuyika kwa screw kumapangidwa ndi kubowola mphamvu), 

kutanthauza kuti sangathe kumasulidwa. Chifukwa chake, ndikwabwino kupewa zovuta izi mwakusintha nthawi yomweyo wononga ndi a 

kuonongeka mutu patani panthawi yoikamo, pogwiritsa ntchito screwdriver wathunthu ndikumangitsa wononga ndi dzanja (osati ndi kubowola magetsi).

 Kugwiritsa ntchito zomangira zopangidwa ndi zinthu zolimba kungathandize kuchepetsa vutoli.

Nthawi zambiri, pamakhala kutseka kwa makina kapena kupanikizana pakati pa ulusi wokhoma wa misomali ndi bowo lotsekera mu mbale yokhoma. 

Izi zimawonedwa nthawi zambiri ndi 3.5mm mainchesi a titaniyamu hex patani imodzi yokhoma shaft. Palibe makina amodzi

 kusokoneza. Zomangira nthawi zambiri zimakhala zolimba kwambiri chifukwa cholephera kugwiritsa ntchito wrench ya torque yomwe ili mu zida za zida, 

zomwe zimatha kusintha ulusi pa chikhomo chokhoma ndi mbale yotsekera. Nthawi zina, 

kulephera kugwiritsa ntchito kapena kugwiritsa ntchito kalozera wobowola molakwika kumapangitsa kuti zomangira zisagwirizane zikamangidwa, 

zomwe zidapangitsa kuti zomangira zisokonezeke. Kuti muchepetse chiopsezo cha kupanikizana panthawi yokonzekera koyambirira,

 ndikofunikira kugwiritsa ntchito zida zonse zomwe zilipo: maupangiri obowola ndi ma sockets, ma torque wrenches mumayendedwe amphumphu pomangitsa misomali yotseka.

Njira ya MIPO imakhala ndi chiwopsezo chachikulu cha kuyika kolakwika kwa kalozera wamalumikizidwe, 

popeza palibe mawonekedwe achindunji a mbale yotsekera. Kuwongolera kolakwika kwa kalozera wobowola kumatanthauza kuti dzenje lobowola 

msomali wotsekera ndi kulowetsa msomali wotseka nawonso adzakhala wolakwika. Palinso chiopsezo chowononga mutu wa mutu wa

 kutseka msomali pamene screwdriver sichinagwirizane bwino ndi screw.

Pazifukwa izi, asanachotse mbale yotsekera, dokotala wa opaleshoni ayenera kudziwa kuti sizingakhale choncho 

zotheka kumasula misomali yokhoma, motero pamafunika kugwiritsa ntchito screwdriver yapamwamba kwambiri ya hexagonal ndi zida zowonjezera.

Pamene msomali wokhoma sungathe kumasulidwa, kapena mutu wawonongeka, 

sitepe yoyamba ndi kuika wononga screwdriver (tapered screwdriver ndi inverted ulusi) mu mutu wa wononga;

 izi zikhoza kukhala zokwanira kumasula wononga. Njira ina ndikudula mbale yokhoma mbali zonse za msomali wokhoma ndikugwiritsa ntchito

 ngati screwdriver kumasula dongosolo lonse. Ngati wononga sichingamasulidwebe, mbale yotsekerayo imatha kumasulidwa 

kubowola ndi kubowola, kuwononga mutu wa msomali wokhoma, kapena kudula mozungulira mbale kuti amasule msomali wokhoma. Pambuyo pake, 

vise ikhoza kugwiritsidwa ntchito kuchotsa zikhomo za zikhomo zokhoma. Ngati sichingamasulidwebe (chifukwa chimaphatikizidwa mu fupa kapena sichimatuluka mokwanira), 

ikhoza kuchotsedwa ndi kubowola mphete (mkuyu 6).

Chithunzi 6 Malangizo ndi malangizo ochotsera zomangira zotsekera zomwe zakhala pa bolodi.

Mavuto onsewa amatha kutalikitsa opaleshoniyo, angayambitse kupweteka kwa minofu yofewa chifukwa cha zidutswa zachitsulo zomwe zimatulutsidwa, ndipo zimakhala ndi chiopsezo chotenga matenda. 

Kugwiritsa ntchito kubowola mphete kumawonjezera chiopsezo cha fractures ya perioperative.

Chidule:

1. Vuto lochotsa misomali yotseka limachitika makamaka ndi zomangira za titaniyamu za 3.5mm hex.

2.Njira yabwino yopewera vutoli ndikugwiritsa ntchito zida zonse zoperekedwa poika screw. Mavutowa angathetsedwe pogwiritsa ntchito zipangizo zoyenera.

03. Kodi Zolepheretsa Kugwiritsa Ntchito Pakhomo Lotsekera Ndi Chiyani?

Clavicle mbale fracture ndi osseous nonunion

Poonetsetsa kuti dongosololi silili lolimba mopitirira muyeso chifukwa chosakwanira kugwira ntchito kwa mbale yotsekera kapena kuchuluka kwa misomali yotseka (mkuyu 7), chiopsezo cha mbale yotsekera kusweka pansi pa mabowo a screw kapena pamphambano ya screw / fupa akhoza kuchepetsedwa.

Chithunzi 7 Machiritso a mafupa adakwaniritsidwa patatha masiku 60 posintha kuchuluka ndi malo a zomangira zotsekera ndikuwonjezera kukhazikika kwa zolimba zolimba kwambiri.

Matenda a mafupa nonunion nthawi zambiri amatsimikiziridwa ndi kusweka kwa mbale. 

Kusweka mochedwa kwa mbale yotsekera kapena msomali wotseka ndi nthawi yake chifukwa micromotion imatha kuchitika ndikupangitsa kuchira kwa mafupa.

M'mafupa osavuta omwe amafunikira kupanikizana, komwe kumadalira mtundu wa fracture osati fupa lomwe likukhudzidwa, 

dongosolo lolimba lomwe zidutswa ziwirizo sizimakhudza zingayambitse kusachiritsa ndi kutopa kwa mbale. 

Kuphatikizika kwa splint yolimba + yokhoma msomali + kukoka pamalo ophwanyika kumapangitsa kuti mafupa asagwirizane.

Kusiyanasiyana kwa izi ndi kung'ambika kwa nthawi yomweyo kwa msomali wokhoma pansi pa chomangira chake ku mbale, 

zomwe zimachitikanso chifukwa cholimba kwambiri. Izi zimapangitsa kuti mbali imodzi ya mbale ituluke 'm'chidutswa chimodzi' ndipo kuchiritsa sikutheka (Chithunzi 8).

Chithunzi 8 Kulephera kwachiwiri kwa chomangira cholimba kwambiri komanso chosakhazikika: zomangira zotsekera zambiri zidagwiritsidwa ntchito kutali ndipo mbale yolumikizirana siinali yayitali.

Chifukwa chake, kukonza kwa intracapsular fractures ya ntchafu yokhala ndi mbale zotsekera kungayambitse kusagwirizana kwa fupa chifukwa kapangidwe kake ndi kolimba kwambiri kuti zisasokoneze malo ophwanyika. 

Popanda ma micromotion ofunikira kuti machiritso, katundu wonse amanyamulidwa ndi implant ndipo pamapeto pake amalephera.

asymmetric kuchiritsa minofu

Mafupa a Periosteal amatha kukhala asymmetric, 

makamaka m'mitsempha ya distal 1/3 ya femur. Kuthamanga kwa micromotion chifukwa cha elasticity kumalola 

Kukula kofanana kwa minyewa yochiritsa ya fracture yomwe imapezeka kokha pamalo ofananira ndi chotsekera mbale / kupanga misomali.

 Pofuna kuthana ndi ngoziyi, kutalika kwa ntchito ya mbale yotsekerayo iyenera kuonjezedwa, mwina pogwiritsa ntchito mbale za titaniyamu zosinthika kwambiri kapena kugwiritsa ntchito misomali yotsekera yatsopano. 

Mosiyana ndi zimenezi, mapangidwe osinthika kwambiri angayambitse hypertrophic bone nonunion.

Pulasitiki deformation wa mbale zitsulo

Kuyika mbale pafupi ndi kotekisi momwe zingathere kumachepetsa chiopsezo cha kusinthika kwa pulasitiki pakati pa mbale;

 pamene mtunda pakati pa mbale ndi kotekisi uposa 5 mm,

 mphamvu zamapangidwe zimachepetsedwa kwambiri ndipo chiwopsezo cha mapindikidwe apulasitiki a mbale ndi kulephera kwa mbale ya titaniyamu ndi yayikulu.

Kuphulika mochedwa kwa diaphysis kapena metaphysis kumapeto kwa mbale yotseka

Chiwopsezo cha kuthyoka mochedwa kumapeto kwa mbale yotseka diaphysis kapena metaphysis, 

makamaka mu mafupa osteoporotic, akhoza kuchepetsedwa mwa kulowetsa msomali umodzi wa cortical locking kapena standard bicortical screw kumapeto kwa mbale kuti muchepetse kupsinjika kwa dera lino.

Kulephera Kwamakina

Zinthu zotsatirazi zimachulukitsa chiwopsezo cha kulephera kwamakina kwa mbale yotsekera:

1. Kukonzekera kwa humeral diaphysis fractures kumafuna kugwiritsa ntchito misomali yotsekera inayi kumbali zonse za malo ophwanyika kuti asagwedezeke ndikuwonjezera kulephera kwa makina; ndi

2. Kukonzekera kwa epiphyseal fractures kumakhala kovuta chifukwa nthawi zambiri kumakhala kosakhazikika, 

makamaka chifukwa malo ophwanyidwa sangathe kupanikizidwa ndi misomali yotseka ndipo fupa ndi osteoporotic;

3. Kuphatikizika kwa intra-articular ndi extra-articular comminuted fractures ya epiphysis ndi yosakhazikika

 (mwachitsanzo, distal femur fractures, bicondylar tibial plateau fractures, distal radius fractures);

4. Kupititsa patsogolo kwapakati kwa metaphyseal fractures yomwe imakonda kuchoka ku inversion (mwachitsanzo, proximal humerus, proximal femur, ndi proximal tibia fractures).

 Kutsekera mbale zomangika ku mbali ya fupa la fupa kumapereka dongosolo lolimba lomwe nthawi zambiri limakhala lokwanira 

kuti akhazikitse fractures izi popanda kufunikira kowonjezera mbale zamtundu wa console pakati kapena kuwonjezera fupa ndikusunga malo ophwanyika. 

Kukhazikika kumangodalira mbale yotsekera / kutsekera msomali mawonekedwe, 

zomwe zimatsindika kwambiri pambuyo pokonzanso pamene epiphysis imakhalabe inverted kapena pamene medial console sinamangidwenso. Chotsekera mbale chikhoza kulephera chachiwiri ndi kutopa.

Choncho, kukonza kwa bicondylar tibial plateau fractures pogwiritsa ntchito mbale zokhoma pambali yokhayo iyenera kuganiziridwa malinga ndi mtunduwo.

 Kwa ma fractures a proximal humerus, kuchuluka kwa ma fracture blocks, kutayika kwa chithandizo chapakati,

 ndi kutembenuka kwa epiphysis kwa fixation ndizomwe zimadziwika kuti ndizoopsa. Kuchepetsa chiopsezo cha kulephera kupanga, 

misomali ina yotsekera idzathandizidwa ndi makina kuti athe kubweza kusowa kwa chithandizo chapakati pakuchepetsa fractures zomasuliridwa kunja.

Kulephera Kwachilengedwe Kwa Zokhoma Mbale

Kulephera kwachilengedwe kwa mbale zokhoma ndikudula ndi kuthyoka kapena kulowetsa msomali wokhoma. 

Zowopsa izi zimakhala zazikulu ngati mafupa osteoporosis amapezeka m'mafupa, 

zomwe zikutanthauza kuti kukonzanso koyambirira ndi kubwereranso kulemera kuyenera kuchitidwa mosamala musanayambe kuchiritsa mafupa.

(1) Kuchotsa Zokhoma Zokhoma

Kutulutsa screw kumafanana ndi 'total' ndikuchotsa munthawi yomweyo msomali wokhoma kuchokera pafupa pa mbali imodzi kapena zonse ziwiri za mbale. Nthawi zina, 

msomali wokhomayo amachotsedwa ndi chidutswa cha fupa mozungulira.

M'chigawo cha epiphyseal, mbale yotsekera yokhala ndi chidutswa chimodzi nthawi zambiri imapereka kukhazikika kokwanira chifukwa chomizidwa kapena kutsekeka kwa msomali, 

ndi mawonekedwe atatu azithunzi amawonjezera kukana kwa wononga m'zigawo kuchokera ku cancellous fupa.

M'chigawo cha diaphyseal, misomali yotsekera komanso yomwazika yokhala ndi mbale zokhoma zazitali imakhala ndi mphamvu zokoka bwino. 

Kumanga kotereku ndi koyenera kwa fractures ya periprosthetic. Mu mafupa a osteoporotic, 

bicortical stem screw fixation ndipamwamba kuposa monocortical screw fixation. Kwa fractures ya periprosthetic, zomangira za flat-head unicortical zimathandizira kupewa kukhudzana ndi ma implants a intramedullary.

Zolephera zokhazikikazi zimagwirizanitsidwa ndi kuperewera kwa mafupa, ngakhale kapangidwe kake kamakhala kokhazikika.

(2) Kudula kapena kulowetsa zomangira zokhoma

Kudula kapena kutsekeka kwa misomali yotseka yokhala ndi kulowa mkati mwa intra-articular kumatha kuchitika mdera la epiphyseal.

Kusamutsidwa kumeneku ndikusuntha kwa zidutswa za epiphyseal za mafupa otsika omwe amachoka mozungulira msomali wokhoma.

 Izi zimabweretsa kuwonongeka kwa epiphyseal fracture kuchepetsa. Nthawi yabwino, epiphyseal locking misomali imasokoneza ndi

 Chimalowa m'fupa la cancellous. Zikafika poipa kwambiri, msomali wotseka epiphyseal umatuluka mu epiphysis ndikuyenda molumikizana.

Zovuta ziwirizi zimachitika nthawi zambiri mu proximal humers ndi distal radius fractures. 

Pakuti lokhoma mbale fixation wa proximal humerus fractures tikulimbikitsidwa kuti kutalika kwa 

epiphyseal locking msomali ukhale wocheperako kuti uchepetse chiopsezo cha ingrowth ndi kulowa kwachiwiri.

Kulephera kokhazikika kumeneku kumachitika chifukwa cha kusakwanira kwa mafupa komanso kusamuka kwakukulu kwa zidutswa zosweka zisanachepetse, 

ngakhale kapangidwe kake kamakhala kolimba.

Kubwezeretsa Mgwirizano ndi Kulemera Mwamsanga

Kukonzanso ndi kulemera kumaloledwa kokha pambuyo pokhazikika bwino ndikutsimikiziridwa pa X-rays ya postoperative.

Maphunziro a biomechanical awonetsa kuti m'mafupa abwinobwino, ngati kusiyana pakati pa zidutswazo kuli kochepera 1 mm, 

kulemera kumatheka popanda chiopsezo. pambuyo pa kuzungulira kwa 1 miliyoni, kuuma kwake kumakhala kofanana ndi mafupa abwinobwino, omwe ndi okwanira kuti machiritso achitike.

Zikamveka bwino, mbale zokhoma ndi misomali yotsekera yokhazikika zimalola kubwereranso koyambirira 

zolemetsa chifukwa katunduyo amasamutsidwa mwachindunji kuchokera ku misomali yotsekera kupita ku mbale yotsekera, popanda chiopsezo cha kulephera kukonza pamphambano ya msomali.

Komabe, pamene olamulira a multiaxial locking msomali si perpendicular kwa mbale lokhoma, oyambirira kulemera kunyamula sikuloledwa.

Kwa MIPO, kulemera koyambirira kumaloledwa kuti pakhale ma fractures owonjezera, osavuta komanso / kapena osavuta. 

Zomanga zazitali kwambiri zimasinthasintha mokwanira ndi misomali yotsekera ya bicortical ndi mipata yoyamwitsa ndi kugawa.

Pomaliza:

Maphunziro a 1.Biomechanical adayesa mitundu yosiyanasiyana ya zomangamanga ndi makina awo.

Zolemba zimathandizira kutsimikizira ziyembekezo zamalingaliro zomwe zimagwirizanitsidwa ndi kukonzanso kwamtunduwu. 

Komabe, zolembedwa zaposachedwa zikuwonetsanso zovuta zaukadaulo ndi zolephera zomwe zimagwirizanitsidwa ndi zotsekera mbale.

2. Chifukwa chachikulu chakulephera ndikusakonzekera bwino kwa njira ya opaleshoni, 

zomwe ndizovuta kwambiri, makamaka pochita njira zochepetsera pang'ono.

3.Kuthyokako kumayenera kukonzedwanso poyamba, osatseka zomangira ku mbale,

monga kubwezeretsanso mwachindunji mbale mwa kutseka zomangira sikutheka.

4.Kapangidwe kake kayenera kukhala koyenera kutalika ndi mphamvu, 

zomwe zikutanthauza kuti dokotalayo ayenera kudziwa bwino mfundo ndi malamulo omwe amatsogolera kugwiritsa ntchito mbalezi. 

Chomangiracho chiyenera kukhala chotanuka, chokhala ndi zomangira zotsekera zokhala ndi mipata zomwe zimasinthana ndi mabowo opanda kanthu.

5.Ngakhale kukhazikika kwamalingaliro koyambirira kwa mbale zokhoma, 

kukonzanso kapangidwe kake kumachepa ndi zovuta za fracture, ubwino wa kuchepetsa, ndi khalidwe lachilengedwe la fupa.

6.Ngati kapangidwe kake kamakhala kosasinthika, mtundu wa fupa ndi wabwino ndipo kusweka kwake kumakhala kowonjezera, 

wodwala wokhala ndi ufulu wokwanira akhoza kuloledwa kulemera pa mwendo wosweka. Nthawi zambiri, kukonza mbale zokhoma kumathandizira kukonzanso koyambirira.