External Fixator yeGumbo & Knee Spanning Ex Fix

1. Nhanganyaya

Kugadziriswa kwekunze inzira inochinja-chinja, ine zvishoma inopindira yekudzikamisa mafractures uye kugadzirisa yakaoma kukuvara kwetishu. Inowanzoshandiswa kuvhurika kuputsika , hutachiona husina hutachiona, kudzora kukuvara mu polytrauma, kuremara kururamisa, uye kureba kwemakumbo.

2. Sei kushandisa kunze kwekugadzirisa?

2.1 Zvakanakira

• Inoderedza kukanganiswa kweropa remapfupa uye kuvharika kwenyama yakapfava.

• Kurumidza kushandisa mune emergency kana kukuvara kudzora mamiriro.

• Inobatsira kune yakavhurika / yakasvibiswa fractures uye ine hutachiona bhonzo uko mukati mekudyara kune njodzi.

• Inobvumira kuvaka patsva (kudzikamisa kwechinguvana → definitive fixation).

• Inofambisa kubata kwepfupa, kuvhiringidza osteogenesis, uye kuremara kugadzirisa.

2.2 Zviratidzo

Mamiriro emakiriniki akajairika apo kugadziriswa kwekunze kunoratidzwa:

• Vhura mafractures ane kukuvara kwakanyanya kwenyama yakapfava kana kusvibiswa.

• Yakavharwa kuputsika muvarwere vepolytrauma vanoda kugadzikana kwenguva pfupi.

• Intra-articular fractures kana zvinyoro zvinyoro zvisingakwanisi kushivirira kugadziriswa kwemukati (wrist, wrist, ibvi , gumbo).

• Kurasika kwebhonzo kana kuremara kwenyama yakapfava inogadziriswa nekupfupisa uye kukanganisa.

• Infection / utachiona nonunion - mapini anogona kuiswa kure nenzvimbo dzine hutachiona.

• Joint spanning (bridging) inovaka kukuvara kwakanyanya kweperi-articular kana majoini asina kugadzikana.

3. Nheyo dzekunze kwekugadzirisa kushandiswa

3.1 Biomechanical kiyi

• Shandisa anokwana mapini maviri pachidimbu chikuru chakaiswa munzvimbo dzakachengeteka dzeanatomic.

• Isa mapini ari pedyo nekutsemuka (asi kunze kwehematoma / kuparara kweganda) kuwedzera kugadzikana.

• Ramba uchibatanidza tsvimbo padyo nebhonzo uye wedzera pini inopararira mukati mechikamu chimwe nechimwe.

• Matanda akawanda uye akawanda-ndege anovaka anowedzera kuoma.

4. Zvikamu - kukurumidza kunongedzera

5. Zvikumbiro zvakakosha

5.1 Joint fusion & kubatana kutenderera

Kugadziriswa kwekunze kunogona kushandiswa kusanganisa majoini kana semubatanidzwa wekutenderera furemu kuti udzivirire zvinyoro zvinyoro uchichengetedza kurongeka kwemakumbo (semuenzaniso, kutsemuka kwegumbo).

6. Kushandisa, Zviratidzo & Post-operative Care

6.1 sei fixator  inoshandiswa

1. Ronga pini/waya trajectories uchishandisa nzvimbo dzakachengeteka.

2. Isa mapini kana waya pasi pekutungamira kwemufananidzo.

3. Batanidza tsvimbo uye simbi; gadzirisa kurongeka.

4. Ipa dzidziso yemurwere nezve pin tract care.

6.2 Zviratidzo zvakajairika

• Tibial fractures - kazhinji kushandisa tibial pini.

• Ankle fractures nekukuvara kwenyama yakapfava - inogona kuda kubatana kwepakati pekugadzirisa .

• Peri-articular fractures apo kugadziriswa kwemukati hakugoneki.

6.3 Kuchengeta mushure mekuvhiyiwa

• Pini turakiti kuchenesa: tanga zuva mushure mekuvhiyiwa . Geza imwe neimwe yepini turakiti 1-2 kanomwe pazuva.

• Pain control: nyore analgesia uye yakaoma kupfeka.

• Kucherekedza: tarisa kutsvuka, kurwadziwa, mvura, kana fivha.

• Kuunganidza: kutakura uremu kunowanzobvumidzwa.

• Purogiramu yekutevera: kuongororwa kwekiriniki nguva dzose.

7. Nguva yekunze kwekugadzirisa uye kutendeuka

• Definitive kurapa kusvikira kuputsika kusimbiswa.

• Kushandurwa kwekutanga kune kugadzirisa kwemukati kana zvinyoro zvinyoro zvichibvumira.

• Shanduko yekupurasita/orthosis pazvinenge zvakakodzera.