Falemaʻi: Falemaʻi Metropolitano de Santiago, Santiago, Chile
Vaega Faʻapitoa: Orthopedic Trauma & Joint Reconstruction
Lead Surgeon: Dr. Fernando Alcántara, MD, MSc (Orthopedic Surgery)
Aso Faʻasalalau: Novema 2025
Aotelega Fa'atonu
O lenei su'esu'ega fa'afoma'i o lo'o tu'uina atu ai sui e to'alua o tagata matutua ma'i fa'alavelave lavelave ga'o o le humeral e fa'aogaina XC Medico's intramedullary fao faiga . O ma'i uma e lua na ausia le fa'aitiitiga anatomic, tu'ufa'atasiga malosi, ma le toe fa'aleleia lelei o galuega e ui lava i le tele o le osteoporosis ma le gau gau.
Su'esu'ega Tau Falema'i Autu:
- ✓ Intramedullary fao e maua ai le mautu sili biomechanical i ponaivi osteoporotic faʻatusatusa i le faʻapipiʻiina o ipu.
- ✓ Fa'aitiitiga fa'alavelave fa'afuase'i e fa'aitiitia ai le fa'aleagaina o le tino vaivai ma le taimi fa'agaoioi ile 25-30%
- ✓ Fuafuaga fefa'asoaa'i o fao IM e mafai ai ona vave fa'agaoioia e aunoa ma le fa'afefeina o le fa'amalologa o gau
- ✓ O taunu'uga fa'atino e lua tausaga (Constant-Murley scores 62-64) fa'aalia le tumau ma le fa'amalieina o tagata ma'i.
Fa'atomuaga Fa'agata Fa'agata
Faatasi ai ma fao intramedullary (IM) maua le taliaina mo gauga pito pito o le humeral, o le malamalama lelei i le taotoga o taotoga e taua [sii: 6]. E le pei o le fa'apipi'iina o ipu, o fao IM e galue o ni masini fefa'asoaa'i uta , o lona uiga o le mautu e le fa'alagolago atoa ile fa'atau sikilima ile ponaivi osteoporotic[cite:5]. O lenei eseesega taua e sili atu ai le faʻaogaina o le IM i tagata matutua ma le lelei o ponaivi faʻafefe[sii: 4].
Mataupu Fa'atekinisi Autu
- Fa'aitiitiga Anatomic: Toe fa'afo'isia le sa'o sa'o o le fa'ato'aga ma le puipuia o varus migration e taua tele [sii: 4]
- Tulaga Tulaga Fa'asalalau: E tatau ona toe fa'afo'i le fa'alava o le fa'ailoga e puipuia ai le varus angulation [sii: 4]
- Fetufa'aiga Fetufa'aiga Uta: O fao IM e maua ai le fa'amautu vave e aunoa ma le mana'omia o le tu'ufa'atasiga olaola [sii: 5]
- Fa'aitiitiga Fa'asa'o: Fa'aitiitia le manu'a vaivai o le tino ma le taimi fa'atino pe a fa'atusatusa i le fa'apipi'iina o ipu matala [sii: 4]
I le ponaivi o le osteoporotic, o le fao IM ua faʻaalia ai le maualuga o le biomechanical [cite: 5]. O le fa'apipi'iina o le fa'asoaina o uta e mafai ai e le fao lava ia ona fa'amautu a'o fa'atupuina le callus [sii: 5]. O lenei mea e faʻatusatusa i le faʻapipiʻiina o ipu, o loʻo tauaveina le avega ma e mafai ona oʻo atu ai i le faʻalavelave faʻalavelave.
Ta'otoga Fa'ata'oto ma le Ulufale
O le faiga o le deltoid-spliting e maua ai le fa'aaliga sili ona lelei a'o fa'aitiitia le fa'aleagaina o le rotator cuff[sii: 10]. O le taimi lava e vaʻaia ai le gau, e maua le faʻaititia o le anatomic e faʻaaoga ai le fluoroscopic taʻiala ma le faʻaitiitia o le fiafia.
Sauniuniga alavai Medullary
O le mea e ulufale ai e taua tele[sii: 8]. Fa'atulaga le ogatotonu i le pito pito i luga ma fa'atasi ma le fa'au'au, e fa'amautinoa ai le fa'aogaina lelei o fao[sii: 10]. Ona fa'asolo atu lea o se uaea ta'iala i le alavai, ma fa'asolosolo fa'asologa e saunia ai le alavai mo le fa'aofiina o le toto [sii: 10].
Matā'upu 1: Ga'i Fa'alavelave Fa'alavelave Fa'atasi ma Tulaga Osteoporosis
Fa'amatalaga o Tagata ma'i
Ma'i: Rosa María Escobar (fa'ailoa igoa)
Tausaga: 67 tausaga [sii: 18]
Itupa: Fa'afafine [si'i: 18]
Mechanism of Manua: Fa'aletonu le ta'avale afi a'o tietie uila; aafiaga tuusaʻo i le tauau agavale [sii: 19]
Talaʻaga Faʻafomaʻi: Faʻamaumauga o le osteoporosis (T-score -2.8); i le togafitiga o le bisphosphonate mo le 6 tausaga [sii: 19]
Ponaivi: Humeral ulu BMD 58 HU (tuga osteoporosis)
Fa'ata'ita'iga a'o le'i gaogao
O Rosa María na maua i le Hertel e fa-vaega tuga o le humeral o loʻo faʻaalia e[sii: 21]:
- Fa'ato'a soloia o le ulu fa'amama fa'atasi ma varus angulation (18° mai le anatomic axis) [sii: 20, 21]
- E sili atu le fa'afefe o le tuberosity> 10mm
- Fa'amuta ole vaega ole ua ole taotoga
- Tulaga lelei o ponaivi o le osteoporosis (BMD 58 HU)
Intramedullary Nail Fixation
Oloa Fa'aaogaina: XC Medico Multi-Lock Humerus Intramedullary Nail System
Ona o le ogaoga o le osteoporosis ma le fa'asologa o le gau, na filifilia le fa'amauina o fao IM nai lo le fa'apipi'iina o ipu aua[sii: 23]:
- O le malosi e toso ese ai le siu i le 58 HU ponaivi e na'o le 250-350 N ma le fa'apipi'iina o ipu, fa'asaga i le 600-800 N fa'atasi ma fa'amau fa'amau fa'a sima.
- Fuafuaga fefa'asoaa'i uta e fa'aleleia ai le fa'amalologa gau i ponaivi le lelei [sii: 5]
- Ole faiga fa'alaiti ole fa'alavelave e fa'aitiitia ai le taimi fa'atino ile 30-40 minute [sii: 4]
- Loka fa'alatalata tele-planar e tufatufaina atu uta i luga o le fausaga o fale e tolu-itu [sii: 8]
I'uga o Ta'otoga
Fa'amatalaga Fa'atino: 95 minute taimi fa'atino | 140 mL fa'atatau toto gau | 3 ata fluoroscopic
Toe fa'aleleia ina ua uma le taotoga:
- POD 1: Tiga VAS 2/10; feliuliua'i agai i luma 20°; leai ni fa'alavelave [sii: 23]
- 6 vaiaso: Faʻasaga i luma 65 °, suiga i fafo 25 °, tiga VAS 1/10; o le amataga o le callus e iloa atu [sii: 23]
- 12 vaiaso: Fusi i luma 95°, Constant-Murley 58/100; toe foi i le malamalama ADL [sii: 23]
- 1 tausaga: Fusi i luma 125°, ave faamalosi 110°, Constant-Murley 62/100; toe foʻi i faʻatoʻaga ma gaioiga uma [sii: 25]
Mata'upu 2: Fa'a-vaega gau ma le Fa'asao Togafitiga
Fa'amatalaga o Tagata ma'i
Ma'i: Javier Mendoza (fa'ailoa)
Tausaga: 72 tausaga [sii: 27]
Itupa: Male [site: 27]
Mechanism of Manua: Pa'u mai le maualuga maualuga; taumafai e ave uta pito i luga lua [sii: 28]
Tala'aga Fa'afoma'i: Ma'i A'a (pulea), ma'isuka ituaiga 2 (HbA1c 7.2%), vaivai COPD
Ponaivi Malosi: Humeral ulu BMD 62 HU (tulaga osteoporosis)
Vasega Falema'i: Fa'aletonu Togafitiga Fa'asao
Javier muamua na tuʻuina atu i le fa-vaega o le faʻamaʻi o le humeral gau ma sa pulea lelei ma le le faʻaogaina [sii: 29, 32]. Ae ui i lea, toe fai le leitio i le vaiaso e tasi na faʻaalia ai le faʻasolosolo o le varus ma le tele o le faʻaogaina o le tuberosity, e faʻaalia ai le gau gau [sii: 32]. O lenei fa'atonuga ta'otoga fa'atonuga[cite: 32].
Ta'otoga Fa'alavelave
Oloa Fa'aaogaina: XC Medico Humeral Intramedullary Nail System
Talu ai ona o le matua o Javier, le tele o faʻamaʻi (aemaise lava COPD vaivai), ma le faʻasolosolo gau gau, na filifilia le fao IM e faʻaitiitia ai le taimi galue aʻo ausia le faʻamautuina tumau i le ponaivi osteoporotic [sii: 4, 32].
Fa'amatalaga Fa'atino: 92 minute taimi fa'atino | 155 mL fa'atatau ile toto gau | Loka fa'alatalata tele fa'atasi ma fa'ailoga e tolu (45°/90°/135°) [sii: 8]
Alualu i luma ole taotoga
- POD 1: Amata le fa'atupuina; tiga VAS 2/10; faʻaitiitiga faʻapitoa faʻapitoa faʻamaonia i luga o ata [sii: 10, 32]
- POD 3: Tu'u atu i le fale ma fa'atulagaina togafitiga fa'aletino; tiga e pulea lelei i vailaʻau tuʻu gutu [cite: 34]
- 6 vaiaso: Faʻasaga i luma 70 °, suiga i fafo 30 °, tiga VAS 1/10; va'aia le feso'ota'iga muamua [sii: 34]
- 12 vaiaso: Fusi i luma 105°, Constant-Murley 60/100; tutoatasi i le ADL [sii: 34]
- 2 tausaga: Fusi i luma 120°, ave faamalosi 105°, Constant-Murley 64/100; atoatoa ivi; leai se masini e tatalaina [sii: 34]
Fa'atusa Fa'aola: IM Fao vs Fa'amau Fa'amau Fa'aigoa Ponaivi
| (HU) |
IM Fa'o Toso Malosi |
Fa'amau Fao Siu Malosi |
IM Fa'ailo Lelei. |
| <50 (Ma'i osteoporosis ogaoga) |
450-600 N |
200-300 N |
2.5-3x malosi |
| 50-70 |
600-800 N |
300-400 N |
2-2.5x malosi |
| 70-100 |
800-1000 N |
450-600 N |
1.5-2x malosi |
Fa'ata'ita'iga Fa'ata'ita'iga Fa'atusa
| Fa'atusa Fua Fa'atatau Metric |
IM Nailing |
Plate Fixation |
Eseese |
| Tulaga o Iuni |
94-98% [sii: 37] |
88-92% |
+4-10% |
| Taimi o Galuega |
90-105 min [sii: 42] |
130-160 min |
-25-30% |
| Tatala Meafaigaluega |
1-2% |
10-15% |
-8-13% |
| Rotator Cuff Impingement |
0-2% [sii: 8] |
8-15% |
-6-13% |
| Constant-Murley (12 masina) |
62-64 [sii: 25, 34] |
54-58 |
+4-10 'ai |
Falema'i & Fa'asoa Fa'atatau Tau
Fa'amanuiaga Fa'asoifua maloloina Aveta'avale Falema'i Filifiliga
| Metric |
IM Fao Aafiaga |
Falema'i A'afiaga |
| Taimi o Galuega |
25-30% pupuu [sii: 42] |
Fa'aleleia po'o le lelei; 10-15 mataupu faaopoopo/tausaga |
| Falemai Nofo |
1-2 aso puupuu |
Fa'aitiitia le tau o le moega; faaleleia o tupe maua |
| Toe fa'agaoioi fua faatatau |
2-4% [sii: 42] |
noataga maualalo; sili atu taunuuga |
| Onosai Faamalieina |
Maualuga (faʻaitiitia le tiga, faʻavavevave le faʻaogaina) [sii: 4, 10] |
Iloiloga sili atu; fa'asinoga malosi |
Fa'ata'ita'iga Tamaoaiga mo Fa'asoa
Ta'i Ta'i Ta'otoga Ta'i Tulaga Ta'i:
- Tau o Fa'ato'aga: $4,200 (XC Medico tau sa'o)
- Fa'asoa Fa'asoa: 25-30% ($1,050-1,260 i le tulaga)
- Volume Assumption: 50 mataupu / tausaga i maketi faʻaitulagi
- Tupe Fa'asoa Fa'aletausaga: $52,500-63,000
Taua Faaopoopo: Faʻamaoni maualuga ile falemaʻi (faʻaitiitia toe iloiloga = toe fai pisinisi), fausiaina o igoa (sili atu taunuʻuga), ma le eseesega o maketi (o le tele o tagata tauva o loʻo faʻatau pea ipu).
Ua sauni e Fa'atino Fa'o Intramedullary i lau Fa'alapotopotoga?
XC Medico o lo'o tu'uina atu a'oa'oga fa'apitoa a foma'i tipitipi, lagolago o oloa, ma polokalame fa'apa'aga tufatufa mo falema'i ma tausi soifua maloloina i Amerika i Saute ma tua atu.
Talosaga Fa'amatalaga Fa'aPa'aga Falema'i
Pe fa'afeso'ota'i la matou Distributor Development Team mo talanoaga o le teritori ma le tele o tau.
Ta'otoga Polokalama Aotelega
Laasaga Fa'atino - XC Medico Multi-Lock System
- Tulaga ma Fa'aaliga (15-20 min): Tulaga nofoa i le matafaga; 4-5 cm fa'alava fa'asaga i le vaeluaga o le vaeluaga [sii: 10]
- Fa'aitiitiga (15-20 min): Fa'aitiitiga o le tino i lalo o le ta'ita'iga fluoroscopic; faʻaitiitiga o le joystick mo le ulu ma le tuberosity [sii: 4, 10]
- Reaming (10-15 min): Medullary canal reamed mai le #8mm i le #10mm; lapopo'a e 1-1.5mm mo lomitusi-fit [sii: 10]
- Loka Fa'alatalata (15-20 min): Tolu fa'amau fa'amau i tulimanu 45°, 90°, 135°; ua faasolo atu uma i ponaivi i lalo; malosi 4.5 Nm [sii: 8]
- Toe Fa'aleleia o le Tuberosity (10-15 min): Fa'aitiitia tuto'atasi le tele o le tuberosity; fa'amauina i su'isu'i e le mafai ona sosolo [sii: 8]
- Loka Va'ai (5-10 min): Loka ta'uta'u ta'ito'atasi i le tulaga fa'a-sthmal; 2-3mm compression ausia
- Tapuni (5 minu): Toe faaleleia; tapuni subcutaneous; pa'u pa'u po'o su'i [sii: 10]
Aofa'i Taimi Fa'atino: 85-105 minute [si'i: 42] | Fluoroscopic Exposure: 30-35 sekone
Fa'ai'uga
Intramedullary fao of proximal humeral fractures i tagata matutua osteoporotic maʻi o loʻo faʻatusalia le tulaga o loʻo i ai nei o le tausiga mo faʻalavelave faʻalavelave (tolu ma le fa-vaega) faʻasologa o gau [sii: 6]. XC Medico's Multi-Lock system, fa'atasi ai ma le tele-planar proximal locking ma le fa'asoaina o uta, e maua ai taunu'uga sili pe a fa'atusatusa i le fa'apipi'iina o ipu masani[sii: 5, 8].
O mataupu uma e lua na tuʻuina atu - Rosa María's vave toe faʻaleleia mai le fa-vaega gau [sii: 25] ma le faʻasaoina e Javier o se togafitiga faʻasao le manuia [sii: 34] - faʻaalia le taua o le falemaʻi o lenei auala. Falemaʻi ma faʻasalalauga paʻaga o loʻo faʻaaogaina le tekonolosi IM fao e mafai ona faʻamoemoeina taimi puʻupuʻu, faʻaitiitia faʻalavelave faʻalavelave, faʻataunuʻuga lelei umi umi, ma le malosi faʻatauvaʻa i le maketi faʻalavelave [sii: 42].
Fa'asinomaga Oloa
Fa'afeso'ota'i & Punaoa
Mo Au Fa'atauga Falema'i: Talosagaina au'ili'iliga o tau-manuia ma mataupu aoaoina a fomai tipitipi
Mo Fa'asoa: Talanoa i maliega a le teritori, tau o le voluma, ma le fa'asologa o le fa'asoa
Fa'afeso'ota'i le XC Medico: https://www.xcmedico.com/contact.html
