Gukosora K-wire ni bumwe muburyo bwinshi bwakoreshejwe mukugabanya kugabanuka kwa radiyo yatandukanijwe. Byitwa kandi gufunga no gufunga percutaneous, tekinike ikoresha insinga za Kirschner kugirango ihagarike ibice byavunitse nyuma yo guhuza byagaruwe.
Ntabwo ari igisubizo rusange kuri buri kuboko kuvunitse. Uburyo bwo kuvunika, kugabanya ituze, uruhare rwamagambo, ubwiza bwamagufwa, imiterere yoroheje-tissue, ibyo abarwayi bashira imbere hamwe nuburyo bwo gukosora byose bigira ingaruka kumahitamo yo kuvura. Aka gatabo gasobanura amahame n'imbogamizi za radiyo ya kure ya K-wire itabanje gusimbuza amahugurwa yo kubaga cyangwa ibikoresho byihariye bya tekinike.
Ibyingenzi
Gukosora K-wire mubisanzwe bifatwa nyuma yo kugabanya kuvunika mugihe hagikenewe izindi stabilisation kandi ibice bishobora kugenzurwa ninsinga.
Imiterere ya radiyoyumu, dorsal, ibice-byihariye kandi ibishushanyo mbonera bisobanura amahame atandukanye aho kuba pin imwe iteganijwe.
Umubare winsinga, diameter, trayectory na immobilisation ingamba ni ibintu- nibikoresho byihariye; ntibagomba gutoranywa mu ngingo rusange yo kwamamaza.
Impungenge zishobora kuba zirimo gutakaza kugabanuka, kwandura pin-tract, kwimuka kwinsinga, kurakara-tissue tissue, kurakara cyangwa gukomeretsa imitsi no gukomera kwamaboko.
K-insinga, plaque plaque hamwe no gukosora hanze buriwese afite ubucuruzi butandukanye. Ibimenyetso byubu ntabwo bishyigikira uburyo bumwe bwo gukosora nkuko bisumba isi yose kuri buri kuvunika kudahindagurika cyangwa kuzuye.
Niki K-Wire Ikosora Kubice bya Radiyo Yitaruye?
Ivunika rya radiyo ya kure riboneka hafi yintoki za radiyo. Iyo kuvunika kwimuwe, abaganga basuzuma niba guhuza byemewe bishobora kugarurwa no gukomeza. Kugabanuka gufunga bivuga kugarura guhuza udafunguye urubuga rwacitse. Gucumita neza noneho ushire insinga imwe cyangwa nyinshi zoroshye binyuze mumwanya muto winjira uruhu kugirango ufate ibice byatoranijwe mugihe gukira gutera imbere.
Ijambo ryubuvuzi ryatoranijwe ni ukugabanya kugabanya no gukomeretsa , ntabwo 'gufunga inshinge. ' Umugozi wa Kirschner nigikoresho cyo gukosora aho kuba inshinge. Ingingo igomba rero gukoresha K-wire, wire, pinning na fixation terminology buri gihe.
Uburyo K-Insinga Zigabanya Kugabanuka
Insinga zirashobora kurenga kuvunika no kunguka kugura mugice gihamye cya radiyo, cyangwa zirashobora gushyigikira ibice kugiti cyihariye muburyo bwatoranijwe bwo kuvunika. Imashini itekanye biterwa numubare winsinga. Gutandukana, kugenzura ibice, kugura cortical, diameter ya wire, ubwiza bwamagufwa hamwe na immobilisation yinyongera byose bishobora kugira ingaruka kumyubakire.
K-Umugozi Gukosora Nuburyo bumwe bwo kuvura
Ivunika rya radiyo ya kure irashobora gucungwa hatabayeho kubagwa, mugihe izindi zishobora kuvurwa hamwe nudusimba twa percutaneous, volar cyangwa plaque dorsal, fixer yo hanze cyangwa ingamba hamwe. Kubisobanuro birambuye, reba ubuyobozi bwa XC Medico kuri gusuzuma, gutondeka no kuvura ivunika rya radiyo ya kure .
Aho Ipine ya Percutaneous ikwiranye no kuvura
Ubuyobozi budakora
Byatoranijwe kuvunika cyangwa kuvunika bikomeza guhuzwa byemewe nyuma yo kugabanuka birashobora gucungwa hamwe nabakinnyi cyangwa ibice hamwe no gukurikirana amashusho. Imyaka y'abarwayi yonyine ntabwo igena ubuvuzi.
Gutandukanya K-Umuyoboro
Gushushanya birashobora gutanga ibice byinyongera nyuma yo kugabanuka muburyo bwatoranijwe. Mubisanzwe bisaba kwitondera urubuga rwa pin, immobilisation no gucunga insinga nyuma.
Ikibaho
Isahani ya volar cyangwa dorsal itanga gukosora imbere kandi irashobora gutoranywa kubishushanyo bisaba kugenzura ibice bitaziguye. XC Medico itanga byinshi intera ya radiyo ifunga isahani .
Gukosora hanze
Ikadiri izunguruka cyangwa idasobanutse irashobora gufasha kugumana uburebure no guhuza ibice byatoranijwe bidahungabana, harimo nigihe ibintu byoroshye-tissue bigira ingaruka kumigambi yo gukosora imbere.
Amabwiriza ngenderwaho ya AAOS / ASSH yerekana ko nta tandukaniro rinini riri hagati y’ibisubizo bya radiografiya cyangwa by’abarwayi hagati yubuhanga bwo gukosora ibice bya radiyo yuzuye ya arctular cyangwa idahindagurika, nubwo plaque zifunze zishobora gutanga imikorere yambere mugihe gito. Ibi bishyigikira guhitamo kugiti cyawe aho kuvuga ko K-insinga cyangwa amasahani buri gihe ari byiza.
Ni ryari hashobora gutekerezwa K-Wire Ikosora?
Gufata ibyemezo bya Clinical bitangirana no gusuzuma no gufata amashusho. Ibintu bikurikira birashobora gusuzumwa nababigize umwuga babishoboye, ariko ntabwo ari urutonde rwerekana ibimenyetso byonyine.
Uburyo bwo kuvunika no kugabanya guhagarara
Gushushanya birashoboka cyane mugihe ibice byingenzi bishobora kugabanuka no kugenzurwa ninsinga zihagaze neza. Ikimenyetso cya metafhyseal comminution, uduce duto twa arctular cyangwa impengamiro yo gusenyuka birashobora kugabanya kwizerwa kwubaka insinga yoroshye no gutekereza byihuse ubundi buryo cyangwa inyongera.
Ubunini bwamagufwa nubunini bwibice
Amagufwa ya Osteoporotic arashobora gutanga kugura insinga zizewe. Ongeraho insinga ntabwo zihita zihagije kugirango gikemuke nabi, kandi nta tegeko rusange rivuga ko kuvunika osteoporotic bisaba amapine ane cyangwa atanu. Guhitamo kubaka bigomba gukurikiza uburyo bwo kuvunika, gushushanya, tekinike yemewe hamwe no kubaga abaganga.
Ibintu byihangana kandi byoroshye-Tissue
Imiterere y'uruhu, kubyimba, gukomeretsa kumugaragaro, ingaruka zubuvuzi, ibisabwa mubikorwa, ubushobozi bwo gukurikiza pin-site hamwe n’amabwiriza y’ubudahangarwa hamwe n’imyitozo ngororamubiri iteganijwe byose bigira uruhare mu guhitamo imiti.
Imyaka n'ibisabwa
Ibimenyetso bigomba gusobanurwa hamwe nimpamvu zo murwego rwabarwayi. Amabwiriza ngenderwaho ya AAOS / ASSH avuga ko kuvura ibikorwa by’abaturage bakuze bidakunze guteza imbere ibisubizo by’igihe kirekire by’abarwayi ugereranije no kutita ku bikorwa, kabone niyo guhuza radiyo bitandukanye. Gusangira gufata ibyemezo bisigaye ari ngombwa.
Imipaka yubuvuzi: ingingo rusange yuburezi ntishobora kumenya niba kuvunika byihariye bisaba K-insinga, isahani, gukosora hanze cyangwa kuvura bidakorewe. Icyo cyemezo gisaba gusuzuma abarwayi, gufata amashusho no kubuvuzi bujuje ibisabwa.
Amahame asanzwe ya K-Wire
Ibitekerezo byinshi byo gusobanura bisobanurwa mubikorwa bya orthopedic. Amazina akurikira yerekana ingamba nini; ntibagomba gusobanurwa nkibintu byinjira byinjira, inguni cyangwa kubara insinga ziteganijwe.
Imirasire ya radiyo
Umugozi wa radiyo styloide urashobora kwerekezwa kumeneka kugirango ubone kugura muri radiyo yegeranye. Ishami ryunvikana ryimyakura ya radial, imitsi, hejuru yuburinganire hamwe numwanya winsinga bisaba kwitabwaho. Inzira nyayo iterwa na anatomy, kuvunika morphologie hamwe na tekinike yatoranijwe.
Ishusho ya kure ya radiyo yerekana iboneza. Gushyira insinga zanyuma bigomba gushingira kuri anatomie yamenetse, gusuzuma fluoroscopique hamwe nubuhanga bwemewe bwo kubaga.
Dorsal na Fragment-Byihariye
Intsinga ya Dorsal cyangwa insinga zerekejwe kumurongo wamahirwe arashobora gukoreshwa mugihe ibyo bice bisaba kugenzura. Dorsal anatomy ikubiyemo ibice byagutse hamwe na tendon zishobora kurakara cyangwa gukomeretsa aho zinjirira zidakwiye, insinga zikomeye cyangwa kwimuka.
Urugero rwibice-bigizwe na wire ikosora. Ikigereranyo gisobanura ihame, ntabwo ari inyandikorugero-itatu yisi yose.
Kapandji
Muri tekinike ya Kapandji, insinga zinjizwa ahavunitse kandi zikoreshwa mugufasha kugabanya no gushyigikira igice cya kure mbere yo gutera imbere kugirango gikomeze kubaka. Uburyo butandukanye no kurenga gusa kuvunika kuva kure yinjira. Ibikwiye biterwa nuburyo bwavunitse hamwe nubwiza bwamagufwa.
Kapandji intrafocal pinning igitekerezo. Ingano yinsinga yihariye, umubare nicyerekezo bigomba kuva mubuhanga bwemewe na gahunda yihariye.
Inyongera yinyongera hamwe hamwe
Kuvunika bigoye birashobora gusaba ibice byihariye kugenzura cyangwa kubaka hamwe. Nyamara, insinga nyinshi ntabwo zihita zitanga umutekano mwiza. Guhuza insinga, gukwirakwira bidahagije, kugura nabi cortical cyangwa kutabasha kugenzura igice cyingenzi birashobora kuvamo gutakaza kugabanuka.
Gutanga ibitekerezo birashobora gutuma pinning yoroshye itizewe. Inyongera cyangwa ubundi buryo bwo gukosora burashobora gusuzumwa ukurikije amashusho nimpamvu zabarwayi.
Isuzuma no Gusuzuma
Kugabanya no Guhuza Ibice
Kwerekana amashusho bikoreshwa mugusuzuma uburebure bwa radiyo, guhindagurika, kugoreka, guhuza imitsi hamwe na radioulnar ya kure. Intego yemewe iterwa numurwayi no kuvunika. Umugozi ushyizwe mubuhanga ntabwo wishyura kugabanuka bitemewe.
Umwanya winsinga hamwe no kugura Cortical
Ibitekerezo bya Fluoroscopique bifasha gusuzuma niba insinga zigenzura ibice byateganijwe, irinde radiocarpal hamwe na radioulnar intera ihuriweho hamwe aho bikenewe, kandi ubone kugura bikwiye nta kibazo gikomeye. Ibitekerezo byinshi birashobora gukenerwa kuko insinga igaragara yemewe muri projection imwe ntishobora kwemerwa mubindi.
Kubaka Ihamye
Isuzuma rihamye ryerekana kuvunika, iboneza ryinsinga hamwe na gahunda yo kwimuka hamwe. Intsinga zegeranye mukarere kamwe zirashobora gutanga igenzura rito ugereranije nubwubatsi bwagabanijwe neza, ariko itegeko ryumwanya rusange ntirishobora gusimbuza ibinyabuzima na clinique.
Kugenzura insinga no kuvunika bigomba gusuzumwa muburyo bukwiye bwo gufata amashusho mbere yo kubaka byemewe.
Ibishobora kugorana no gutekereza kubibazo
Ingorane ntizishobora gukumirwa rwose nurutonde. Intego ni ukumenya ingaruka zingirakamaro no gukurikiza amabwiriza yihariye yatewe, protocole sterile na gahunda ya nyuma yibikorwa.
Impungenge zishobora kuba zirimo:
Gutakaza kugabanuka cyangwa kunanirwa gukosorwa
Indwara ya pin-tract cyangwa kwandura byimbitse
Kurekura insinga, kwimuka, kumeneka cyangwa kurwara uruhu
Gukomeretsa cyangwa kurakara birimo imitsi yagutse, imitsi yumutima cyangwa izindi ngingo zoroshye
Kwinjira hamwe cyangwa kutamenyekana kwa cortical
Ukuboko n'intoki
Malunion, arthrite nyuma yo guhahamuka cyangwa syndrome yububabare yo mukarere
Gutakaza Kugabanuka
Gukwirakwiza, kutagira amagufwa mabi, kugenzura ibice bidahagije, kugena insinga zidakwiriye cyangwa immobilisation idahagije birashobora kugira uruhare mukwimuka kwa kabiri. Gukurikirana amashusho birashobora gukoreshwa ukurikije protocole yitsinda rivura hamwe no guhagarara kuvunika.
Indwara ya pin
Imiterere ya pin-site igomba gukurikiranwa ukurikije amabwiriza yinzego zokubaga. Kongera umutuku, gutemba, kubyimba, kubabara, umuriro cyangwa ibindi bijyanye nibimenyetso bisaba kwisuzumisha kwa muganga. Iyi ngingo ntisobanura gahunda rusange ya pin-care.
Tendon, Nervu na Soft-Tissue Gukomeretsa
Ahantu hinjirira, inzira yinzira, kumenyekana no kwimuka birashobora gushyira ibyubatswe hafi mukaga. Igituntu cya Lister hamwe nuduce twagutse twa dorsal ni ibimenyetso byerekana ibimenyetso bifatika, mugihe imitsi yumutima yumutima isaba kwitabwaho hafi yumwanya winjira.
Gukomeretsa Ubushyuhe nubushyuhe
Gucukura inshuro nyinshi, ubushyuhe bukabije, ibikoresho bidakwiriye cyangwa tekinike mbi irashobora kwangiza amagufwa cyangwa imyenda yoroshye. Abakoresha bujuje ibisabwa bagomba gukurikiza tekinike yemewe, amabwiriza yibikoresho hamwe na protocole yinzego aho gukurikiza intambwe rusange yo kumurongo.
Nyuma yo gukosorwa Gukurikirana-Ibitekerezo
Gukurikirana biratandukana hamwe no gucika intege, uburyo bwo gukosora nibintu byabarwayi. Ibice bikunze gusuzumwa birimo ibikomere cyangwa pin-site, imiterere yimitsi yumutima, kugenda urutoki, kubyimba, kubabara, guhuza amaradiyo nibimenyetso byo kurekura insinga cyangwa kwimuka.
Igihe cya immobilisation igihe, gusubiza mu buzima busanzwe, gukuraho insinga no gusubira mu bikorwa byihariye. Abarwayi ntibagomba guhindura ibice, gukora imyitozo cyangwa gucunga insinga igaragara ishingiye gusa kumakuru yo kumurongo.
Urutoki hamwe nuburyo bworoshye-tissue birashobora gusubirwamo mugihe cyo kubikurikirana, mugihe kuvugurura intoki biterwa no kubaka umutekano hamwe na gahunda yo kuvura.
K-Wires vs Volar Plates vs Fixation yo hanze
Uburyo
Rusange Ibiranga
Ibitekerezo Byingenzi
Gukosora K-wire
Koresha ugereranije ntoya ntoya kugirango ugumane ibice byatoranijwe.
Kugenzura ibice, imbuga za pin, kwimuka, immobilisation no gucunga insinga nyuma.
Icyapa cya plaque cyangwa dorsal
Itanga imbere imbere kandi irashobora kwemerera kugenzura ibice byatoranijwe.
Kubaga kubagwa, umwanya wa screw, kurakara kwa tendon, gushira umwirondoro no gutekereza kubitekerezo.
Gukosora hanze
Koresha ikadiri yo hanze kugirango igumane uburebure no guhuza; irashobora kuba izunguruka cyangwa idasobanutse.
Imbuga za pin, gucunga ikadiri, imyenda yoroheje, gukomera hamwe no kwihanganira abarwayi.
Gukosora hamwe
Koresha uburyo burenze bumwe mugihe inyubako imwe idakemura bihagije kuvunika.
Ibindi bigoye hamwe nuburyo bwihariye ingaruka; bigomba gutegurwa kuvunika kugiti cye.
Gukosora hanze nuburyo bumwe cyangwa ubundi buryo bwinyongera kubintu byatoranijwe bidahindagurika bya radiyo. Ntabwo isimburana hamwe no gutondeka kuri buri kintu.
Ibicuruzwa bya radiyo bitandukanijwe
Kubakwirakwiza hamwe nitsinda ryamagufwa risuzuma intera ya radiyo ya kure, ibicuruzwa bisabwa birashobora gutandukana nuburyo bwo kuvura. XC Medico itanga ibikoresho bya radiyo ya kure , gufunga ibyapa nibigari orthopedic ihahamuka ryatewe ibisubizo .
Kubisabwa byo gukosora hanze ,. intoki yo hanze ikosora ya radiyo ya kure na ulna ivunika ikubiyemo ibice byinshi. Ibicuruzwa biboneka, ibipimo, imikoreshereze yabigenewe, imiterere itajenjetse kandi byemewe bigomba kwemezwa ku isoko ryerekeza mbere yo gutumiza.
Menyesha XC Medico kubicuruzwa byihariye, iboneza ry'ibikoresho, amakuru ya catalog hamwe nisoko ryihariye ryisoko ryibicuruzwa bya radiyo ya kure.
Menyesha XC Medico
Ibibazo Bikunze Kubazwa
Niki K-wire ikosora?
Nuburyo bwo guhagarika ibice byatoranijwe byavunitse hamwe ninsinga za Kirschner zinjijwe mumwanya muto winjira uruhu, mubisanzwe nyuma yo kuvunika kugabanuka.
Gukosora K-wire birakwiriye kumeneka ya radiyo ya kure?
No.
Nangahe K-insinga zikoreshwa mukuvunika kwa radiyo kure?
Nta mubare rusange. Kubara insinga no kuboneza byatoranijwe kuburyo bwo kuvunika hamwe na tekinike yemewe. Ibimenyetso ntibishyigikira kwerekana ibyateganijwe bitatu-byateganijwe kuri buri rubanza.
Ubuhanga bwa Kapandji ni ubuhe?
Kapandji pinning nuburyo butagaragara aho insinga zinjizwa ahavunitse kugirango zifashe kugabanya no gushyigikira igice cya kure. Nuburyo bumwe bwa tekinike, ntabwo aribisanzwe.
Ni izihe ngaruka zisanzwe zo gukosora K-wire?
Ingaruka zishobora kubaho zirimo gutakaza kugabanuka, kwandura pin-tract, kurekura insinga cyangwa kwimuka, kurakara byoroshye-tissue, gukomeretsa imitsi cyangwa imitsi, kwinjirira hamwe no gukomera.
Ese K-insinga ziruta icyuma gifunga volar?
Nta buryo na bumwe ari bwiza kuri bose. Amabwiriza agezweho ashyigikira guhitamo gukosorwa ukurikije kuvunika numurwayi. Isahani ya Volar irashobora gutanga igihe gito cyo gukira mugihe gito cyo kuvunika kutajegajega cyangwa kuvunika, mugihe ibisubizo birebire bishobora kuba bisa muburyo bwo gukosora.
Reba
Ishuri Rikuru ry’Abanyamerika babaga amagufwa hamwe na societe y'Abanyamerika ishinzwe kubaga ukuboko. Imicungire ya Radiyo Yacitse Ivunika Amabwiriza yubuvuzi. Reba umurongo ngenderwaho .
Kamal RN, Shapiro LM. AAOS / ASSH Amavuriro Yubuvuzi Amabwiriza Incamake: Gucunga ibice bya radiyo ya kure. Reba incamake yuzuye .
Shapiro LM, Kamal RN, n'abandi. Amabwiriza ya Radius Yavunitse Amabwiriza yubuvuzi-Kuvugurura hamwe nubuvuzi bwa Clinical. Reba inyandiko yatangajwe .
Ishuri Rikuru ry’Abanyamerika babaga amagufwa. Gukoresha Ibikwiye: Kuvura Imvune ya Radiyo Yitaruye. Reba inyandiko yuzuye .
Kumenyesha-gukoresha umwuga: Iyi ngingo itanga uburezi rusange kubashinzwe ubuzima, ibitaro nabatanga ibikoresho byubuvuzi. Ntabwo ari inama zubuvuzi, protocole yo kubaga cyangwa umusimbura wamahugurwa asanzwe, isuzuma ryihariye ry’abarwayi, ibyemezo bya tekinike yo kubaga byemewe cyangwa amabwiriza yo gukoresha. Ibicuruzwa byerekana nuburyo bugenzurwa biratandukanye ku isoko.
