Melemo ea likotlo tse 5 tsa intradullary le mekhoa ea ho buoa!

Melao-motheo ea Bohlokoa ea ho Itšireletsa Haila

1. Nalane ea ho attradellary nailing

Ka 1910, Lilienthal Anuminum Intramperellary Keils li sebelisetsoa ho phekola li-shift tsa smoral lila.

Ka 1913, schone o sebelisitse lipekere tsa silevera tsa silevera ho phethola limela. 

Cuntssched (1900-1972) e entse menehelo e meholo ho ea ho li-atralimillary tsa ho itšilafatsa. 

Lilemong tsa bo-1960 le bo-1970 e ne e le nako ea nts'etsopele e potlakileng ea lipekere tsa intramedhalar. 

Naha ea heso e ntse e li sebelisa ka bongata ho tloha ka bo-1990.

2. Phokotso e bulehileng le phokotso e koetsoeng

1. Li-bractures tse bobebe li ka fokotsoa ka mokhoa o potitsoeng tlasa pono e tobileng kapa tse koetsoeng tlasa pono ea X-ray.

2. Nako e bulehileng ea ho fokotsa pholiso e robehileng e le telele, ho tsoa ka mokhoa o sa tsotelleng.

3. Ho khothalletsoa ho sebelisa phokotso e koaletsoeng ka hohle kamoo ho ka khonehang. Polisano ea mohlala e ka sebelisoa, kapa ho itlosa joala hanyane ho ka etsoa lifotong tse robehileng ho etsa le ho fokotsa, ka ho etsa thibelo ea ho kena-kenana le pherekano e felile.

4. Bakeng sa ho fokotsa phokotso e koetsoeng, ho fofa ha masapo kapa ho phunya lisele tse haufi le lisele tse robehileng, tse bulehileng tse bulehileng, li ka sebelisoa.

3. Mechanism ea lisebelisoa tsa intrathellary nail

1. Mokhoa oa ho itšireletsa oa ho itšireletsa ka hare ke sesebelisoa sa symmetri le se nang le maemo a tloaelehileng a spelint.

2. Mokhoa oa ho robeha ke nail ea ho ameha haholo ke thepa ea ho aba ha khatello ea maikutlo, eseng lisebelisoa tse sirelletsang maikutlong, tse e sitisang ho Calus.

3. Ho hlophisoa ha lisebelisoa tsa bohareng ke ho phahama ka mokhoa o phahameng ho fumana matla a kantle, a ka fokotsang letsoho, fokotsa maemo a ho halaloa ha pelo ea valgas le ho atleha.

4.

Mahlaseli a li-standullary nails

1. Litšobotsi tse fokolang

2. Ho atolosoa ka sesupo sa matšoao a bulule

3. TLHOKOMELISO E Phahameng

4. Koetliso ea ts'ebetso ea pele

5. Tsebiso ea boima ba pele

6. E ka sebelisoa hammoho le thepa e 'ngoe ea ka hare

Mefuta ea mantlha le mekhoa ea mantlha

1.

2. Matla a khopehileng a matla a sejoale-joale

3. Katoloso ea medulary le mekhoa e seng ea medulary

4. E bulehile le mekhoa ea ho lokisa

Ho kena-kenana le ho se fetohele

Lihlahisoa tse tloaelehileng tsa ho se sebetse hantle li na le botsitso bo bobe ba moea le matla a fokolang, empa ba khona ho fola, ho etsa hore palo e nyane e thellise.

Mefuta e metenya ea ho se sebetse hantle e na le litlamorao tse ntle tsa ho potoloha le litlamorao, botsitso bo botle le ho latela melao-motheo ea ho lokisa. Li sebelisoa haholo masapo a malelele a maoto le matsoho. Haholo-holo bakeng sa karolo e mengata le ho fokola, ho na le botsitso bo botle ho na le lipekere tse tloaelehileng tsa ho intramed.

Matla a ho tlisa thepa ea kelello

Lijana tsa ho notlela li-straticholontery li hlahisa litšupiso tse nyane haholo tsa khatello ea maikutlo ebile li buelletsoe hangata bakeng sa ketso e seng e le tloaelo ea ho senya.

Bakeng sa matsaranka ho isa likhoeling tse 6 ho isa ho tse 8 lik'hilojing, masapo a grafting kapa a ho nkeloa ke lipekere tse nang le motlakase.

Ho etsa tlhahiso ho ka sebelisoa e le mokhoa oa ho khothaletsa phollo e robehileng. Ha e khothalletsoe khafetsa hobane e ka lebisa ho khutsufatsa le ho tsitsipana le ho potoloha.

Katoloso ea Cenreka le Katoloso e seng ea Maran

Kameho ea Porarow e ka kenya lipekere tse kenngoeng ka bophara le matla a maholo, e leng matla a ho koetlisa a sebetsang pele le ho fokotsa sekhahla sa lipekere tse robehileng.

Katoloso ea Hararow e ka hlahisa maloanlahla a masapo a nang le tšusumetso e fokolang, e kenang ho pholiso ea mali.

Katoloso ea Hararow e tla senya phepelo ea mali ea lijana tsa mali le membrane ea mamello, empa methapo ea mali e ka nchafatsa lesika la lipekere tsa ho itšilafatsa. Katoloso ea hae e ka boela ea eketsa ho potoloha ha mali le eena ka har'a mesifa e bonolo ea lisele, ka tsela eo e khothalletsa pholiso e robehileng.

Ho ts'oaroa ke ts'oaetso e ngata e eketsa monyetla oa tšoaetso le bo-ramohela, 'me e lokela ho sebelisoa ka tlhokomeliso, likotsi tse ngata le likotsi tse rarahaneng le likotsi tse ngata le likotsi tse rarahaneng.

Melemo ea keketseho e medulary

① Kamora kholo ea medullary, sebaka sa ho ikopanya pakeng tsa nail ea ho senyeha le lesapo la kelello, se ntlafatsang botsitso ba tokiso. 

② Kamora kholo ea medullary, lehaha e khōlō ea sebopeho e ka sebelisoa, e eketsang matla a mabtrallary le fokotsa sekhahla sa lipekere tse robehileng. 

③ Defulbes ea masapo kamora hore meronya e meholo e ka hohela foromo ea bone ea bone, e kenang pholiso ea ho lematsa.

Lijana tse ling tse nang le metsoako e metetso ea ho intrathelullary, lipekere tse sa thekeseleng li na le melemo e latelang

① Nako e khuts'oanyane ea ts'ebetso le ho tsoa mali hanyane. 

Ha ho na thuso e tlase ea mali e nang le mali a felisitsoeng ka linyeoe ka likotsi tse matla tsa sesepa.

Kopo ea IndtraMullary nail

Kopanya litumelo tsa intrathellary nail

Matšoao a lipekere tsa humeral

Matšoao a lipekere tsa bolulo tse kenang ka katleho le mathata a phekolo ea makotla a phete

Mefuta e ka lokisoang e tsoa ho 2CM ka tlase ho hlooho ea sehlooho ho 3CM kaholimo ho Olecranon Fossan Fossan Fossan Fossason Fossan Fossan Fossan Fossan Fossan Fossan Fossan Fossan Fossan Fossan Fossan Fossan Fossa. U ka khetha ho e lokisa ho mahetla a nang le nail ea antegrade ea antegrade

Litšobotsi tsa lipekere tsa humeral

Mekhoa ea ho lokisa e sa buuoeng ea li-hutheral shaft malapeng le ha e le hantle ea ho fumana thepa ea lipekere le hol e kenang.

Tokisetso ea poleiti e na le thepa e thata ea ho potoloha le e thibelang 'me e tsitsitse e kholo, empa ho na le lebaka la tšoaetso e phahame haholo.

Lipekere tsa sejoale-palo tsa sejoale-joale li hlola mefokolo e tloaelehileng, taolo ea mali e nyane, moloi o hlasimolla ka thata, 'me boikoetliso bo sebetsang bo ka etsa joalo. ho qala ka mor'a ho buuoa.

Feallicking Intraker

Matšoao a Nails

Mefuta eohle ea bosholu ba 2cm ka tlase ho Vertebra ea Trochanteric le tse fetang 9cm ho tloha mongobo o le mong.

Maqaqailana ea khale ea karolo e bohareng ea moqomo oa li-femoral.

Bakuli ba nang le tokiso e sa atleheng ea ka hare.

Litšobotsi tsa nail ea sejoale-joale

Melemo ea Mechani

Leqhubu la matla a ho sekana le ho lokisa makhathenyane a ho lokisa matsala, mme matla a be bonolo a ho khumama le ho apa.

Mechine e merollang liphethong tse peli tsa lipekere tse tsoang holimo ho tloha holimo le tlase ho ka fokotsa ho khutsufatsa le ho tiea, le ho tiea le ho potoloha bakeng sa ho ts'oaroa ha metsi.

Gamma Interlocking Histellary Nail

Letšoao la Nail

E sebetsa ho mefuta e fapaneng ea li-perdidechanteric, haholo-holo likhechana tsa li-subtroctactivic.

E atolositsoeng ea gamma lamma (abuil.

Liphoso tse phahameng tsa subtrochanteic, Trochanteric e kopantsoe le likhechana tsa li-femoral.

Melemo ea Gamma Nail

E ntlafalitsoe ka ho kopanya screw ea hae ea noka e nang le intrasteryllary nail, lehamane o ea ka har'a poleiti ea mothapo ho feta ponate ea serethehi, a eketsa matla a mathomo, ka hona, alo ea papali ea mafura a haufi le ho kenella. Bakeng sa likhechana tsa subtrochanteric tse amanang le mosebetsi oa boikhathollo, maoatle a Gamma a qoba ho aha hampe, kahoo ho molemo bakeng sa mano a marang-rang kapa actrachanteric.

Retromodery Itradellary Femoral Nailing

Matšoao a Mechine ea Feligrade

Haholo-holo e sebelisoa bakeng sa maqeba a supracondur, ho kenyeletsa le lifofane tsa Supracondyyweng hantle

E ka sebelisoa hape bakeng sa likhechana tsa Femoral ka tlas'a sehlekehleke sa femper.

Shaft ea Femoral, Shaft ea Femoral, Shaft, Supracondylar Fmoral

Ba atlehileng sa ho beleha.

Litšobotsi tsa ho khutlisetsoa morao

Ho senyeha ha _Pracondylar ke ho robeha ka tsela e kotsi ka ho thatafala pele, phokotso le bobeli ba tokiso e matla. Ho na le mahlomola a mangata a mathata a kang ho robeha eseng bonngoe le ho fokotsa pholiso.

Ho ikhula hape ho se sebetse hantle ho sebelisa mokhoa o tloaelehileng ho sebetsana le pheletso ea bofelohi le ho potoloha ha pheletso ea pheletso ea phallo ea bophelo, 'me e thusa motsamao o kopaneng oa ho robeha.

Supracondyyywlar e kopaneng e le lerootho e lokiselitsoeng ka ho leleka li-supracondylaylar ho lelefatsa ho rarolloa ke ho fetoloa ha motho ea sa keneleng. Sesebelisoa se bonolo ho se sebetse, se nepahetse, se ka tšeptjoang, 'me mokuli a ka etsa mohono oa mokokotlo oa pele.

Malinyane a manganga a ho kenella

Matšoao a Letlole la Maqhubu

Lintoa tse tsitsitseng bohareng ba 1/3 ea Tibia: Likhechana tse feto-fetohang, likhechana tse khutšoane, li-pseudarthrosis.

Ho haola ha 60% ea bolelele ba boholo ba bohareng: ho fokola haufi le metaphysis, maqeba a mangata, maqeba a ho robeha, a robehile ka masapo a ho etsa joalo.

Litšobotsi tsa nali ea mapholi

Khoebo e sa sebetseng ea ho itšireletsa ea Tibia e sebelisoa haholo bakeng sa bohareng ba Tibia.

Le ha e ka sebelisoa bakeng sa likhechana tsa proximal le lialdal tibia

Lingoliloeng li tlaleha sephetho se setle le se robehileng hantle ho feta proximal tibia e robehileng kamora ho hlophisa khafetsa

Mekhoa ea ho buoa

Ho hlophisoa ha lisebelisoa tse khethehileng

Bethe ea masapo (bethe ea mapheoana) kapa bethe e tloaelehileng ea fluoroscopic reptrarator; setšoantšo se tsitsitseng.

Khetho e nepahetseng ea bolelele ba manyatsi a ho itlosa bolutu bakeng sa maikutlo a pele ho pōptros

Seballo sa seea-le-moea

Tekanyo ea maoto ea li-lemba tsa letsopa

Simempellary nail

X-Ray Asthmus bophara

Tekanyo ea makoloi ea Indtrallery ea Nail

1.Tean Khopolo ea 'Mè Tlas'a Mochini oa C-Arm

Lipheletso tse hole le tse nang le lesapo la lesapo li ne li le haufi le ray; 'Musi o ne a tšoana le liphaephe.

Mekhabiso ea 2.Longth ho latela matšoao a 'mele oa' mele

Femur: Ke ntlha ea Trochanter e kholo ea Trochanter → Sebaka sa morao-rao kapa Poleor Poleor ea Patella; tibia: medial-lateral knee space → anterior aspect of ankle joint in dorsiflexion of foot.

Techtrallary nail Conrrion thekhon - mokhoa oa ho kena oa ho kena

Li-axis tse telele tsa mokokotlo oa medullary ka mola o otlolohileng

Eseng haufi haholo le ntlha ea ho kena

Bolelele bo loketseng: Ba hapile - Nako e telele; e sa fetoheng - e khuts'oane

(Netefatso ea ho kena ho eona

Parallel Femoral FisterThalary Nail

Ho hlophisoa ha sebaka sa ho kena bakeng sa sebaka se tšoanang sa feshene sa maikutlo sa feshene sa strapellary

Litefiso tsa litefo le ho eketsa

Nako e telele ea tlhaho ea Trontimal ho Trochanner e kholo

Eseng hole haholo

Ho beoa PIN ea Tataiso

Ho beoa ha the the the the soft sesere

Retrograde Feligrade Felimmed Horn Point

Litefiso tse 30 ° Knee

Li-axis tse telele tsa Tataiso ea Tataiso ka lehlakoreng le le leng ha e le mongobo o medulary oa stem e fapaneng

Ho kenngoa ha Kirschner Pin ka hole ka sekheo se sirelelitsoeng ka letsoho la sirelelitsoeng: Orthogonal - bohareng ba toropo ea Borena; lateral - mola oa Blumensaat

Polelo ea ho qala ha PRC ntle le ho tsoa likotsi

Tibiallel Tibiamelllary oa ho kena ha nail

Bohareng ba cavillary cavitylary

Moeli oa kantle oa naha ea Tibial

E phahameng ka hohle kamoo ho ka khonehang ntle le ho senya sekala

Boholo ba mangole

Insic Tirol Tubigity-e tlase-tlase ea patello haufi le mongobo o medulary

Bula sekoti sa medullary: Tataisi ea tataiso ho 15 ° ho sefofane sa saguittal sa axis ea malelele a matangoana

Boemo ba setšoantšo se tsitsitseng

Mekhoa ea ho tsamaisa

Phokotso e tsamaeang ka motlakase

Frattures e ncha

Phokotso ea Buka

Ho robeha ha pseudorthrostrosis, sclerosis ho cavity e medullary

Ha ho na mofuta oa toroni tlasa inflation

Ho potoloha ha mali ke phoo e ntle ka ho fetisisa

Mekhoa ea ho qaptjoa

Pale ea ENRALLELL FEMOLLEDLALLARLARLLARLE

Mabaka a ho thatafalloa ho khutlisa likhechana

Phoka e boreleli e bonolo ha e lumelle phihlello e tobileng le lesapo

Ntlha ea ho kena e ke ke ea bonoa ka kotloloho

Ts'ebetso ea Jonain ea Qalo ea Hip

Phokotso ea Tibial e robehileng

Qhekella

Haholo-holo e sa tloaelehang ebile e bonolo ho ea matsatsing

Ho senyeha - bohareng ba bohareng ba mofuta oa a le hold

Oblique Fractures - Ho feta

Entrastellary nailing →

Mehato ea Phokotso ea Actillary

Matla a ho fokotsa litšenyehelo

Tibia; tšebeliso e fapaneng kapa ea maqeba

Bareki ba bangata (braces)

Phokotso e liehang; Li-showte ea maoto

Scann ea nakoana ea Scanz

① Femur, Tibia

② Haufi le mohala o robehileng ka hohle kamoo ho ka khonehang

③ Proximal Fracture

④use chuck ea bokahohleng e nang le sethala sa ho tsamaisa thepa e bonolo

Poller Nail

①metaphyseaal (lokisa mola oa matla, o tsikitlanya tsosoloso, khutlisetsa ts'ebetso)

② ofihlela o le mong oa lintho tse ling tse fapaneng kapa femur (shear khatello ea maikutlo → khatello)

③ Matsoho a sa sebetseng hantle a kena setsing sa khale sa medullary nakong ea ho buuoa ka bobeli

Bohlale bo bobe ba ho kena-kenana

Mochini o mongata o pharalletseng

① Tibia

② e tlatselletsoa ka mokhoa oa ho ts'oaroa kapa ho khutlisa

③ Sebelisa ka tlhokomeliso ho tse mpe tse mpe tse bonolo tse bonolo

④ E boloke e khuts'oanyane

Ho thibela katoloso ea medullary maemong a phahameng

Lerata la ho notlela '

Melemo

nolofalloa ke kokomplack, compress ea ho robeha ho robeha; ho tlola karohano; ts'ebetso ea ho fokotsa.

Mekhoa ea phokotso ea ho fokotsa le ho lieha ho buuoa le ho buleha

Mathata a ka kopaneng le ho buuoa hape

Bofokoli ba Axal (ho khutsufatsa, ho qhekella le ho fallisoa)

Keketseho ea Tissunulation Granution

Maqhubu a masapo a pele

Sclerosis ea ho robeha ha phomolo ka ho koaloa ha medullary medullary

Osteoporosis

Mathata a ka amang

Ho hatella ha e mong le atolotsi le nail ea ho intradellary oa intrastellary nail penetitery ea Cortex

Ho se sebetse hantle → Repctortor

Ho phatloha ha litefiso tse senyehileng →

Mekhoa ea ho thibela mela e sa tloaelehang ea matla

Proximal - sebaka se nepahetseng sa ho kena

Distal - Stramedelary nail bohareng ba cavity e medullary

Mathata a ho atterrallary nailing

★ Tšoaetso

★ Ho senya litšila

★ Pholiso e Khopotsoeng ea Fractures

★ fractures ea bongaka

Ho Rota Kantle, Torsions, Valgus, ho potoloha ha motho ka hare, ho qhekella

★ haufi le bohloko bo kopaneng

★ E-ba mafura a mafura

★ Ho Opollo ea Heterotop

★ Fulmonary embolism

★ start

★ thrombosis

★ Ho satalla ho Tisitsa

★ Ha ho kopano e robehileng, masapo

★ Ho sitoa ha kahare

Н chrick Shorteling

★

Liphephetso - Tšoaetso

1.ETELA ho, ho ne ho nkuoa li-bractures tse bulehileng ho contrandullal nail.

2. Tsela ea tšoaetso ea postoperatice ho tse bulehileng li ipapisitse le boemo ba likotsi tse bonolo tsa mokokotlo le tšilafalo

Keketseho ea tšoaetso kamora ho bula ho ipapisitse le ho lemala ha moea le tšilafalo hammoho le mokhoa oo lisele tse bonolo li laoloang.

3. Marusi a h pele a ho sirelletsang a eketsa monyetla oa ts'oaetso; Lits'enyehelo tse sa thekeseleng tsa nala tse sa amanyehileng li futsanehile, 'me lesapo le fela

Sesebelisoa se sa ntseng se thekesela se atileng se hlobotseng ke mafutsana.

4. Ts'ebeliso ea phepelo e atolositsoeng le e fokolang e ekelitsoeng e sa ekelehang feela ho ntlafatsa feela botsitso ba sebaka, empa hape o qoba ho bōptjoa sebaka.

Emlilism dyndrome

1.Ke liketsahalo tsa FES tsa masapo a masea a masapo a 0.5% ho 2%.

2. Katoloso ea medulla le ha e theole medulla ha e na tšusumetso e kholo ho phobo ea pulmony.

3.Koloaholi a ntse a lematsa medulla, mokhoa o lokela ho khumama ka bonolo, ho qoba ho qobelloa haholo le ts'ebetso e mpe.

4. Mokhoa oa ho enpa oa hona joale o ntse o amohela mokhoa o reriloeng ke Gurd ka 1974, 'me kalafo ka mor'a hore tlhahlobo ea HIV e tla lieha ho kalafo.

Ho foqoha ha pholiso le ho putlama ha masapo

Ho na le lintlha tse fapaneng tse amang pholiso e robehileng ka mor'a ho kenella ha litšila tsa moea, 'me lisosa li ka hlahlojoa ka tsela e latelang.

1.soft lithaelese li kenelletse ka ho senyeha

2. Karohano ea ho arohana le maemo

3. Lilemo tse tsofetseng tsa mokuli

4. Ho robeha ho bulehileng, ho lemala hampe le ho lemala hoa lithane, hemediansis e tebileng kapa tšoaetso.

5. LITLHAKISO TSE KHOLO TSA BOPHELO

6. Li-daebute tsa daebrates kapa maloetse a mang a ho tšoaroang.

Frattures ea bongaka

Ho robeha ha matloana ke boholo bo bakoang ke maqeba a bakoang ke ho qhekella ka mokhoa o sa lokang nakong ea ho kenella ha sekepe.

Tsebiso e sa sebetseng e lokela ho lefuoa ho

1. Khetho ea ho kena ha motho ea iseng e ka lebisa bofokoli ba pele.

2. Se ke oa sutumetsa ka matla keketseho ea medulla.

3. Ho kenella ha keketseho ea makhasi ho lokela ho ba ka lehlakoreng le leng la ho kenngoa ha likepe.

4. Se ke oa sebelisa matla ha u kenya lipekere tsa intradellary qetellong.

Bohloko ba manonyeletso a boahisani

1. Ho beoa ha nail ea intradullary ho kenyelletsa linama tse bonolo esita le k'hampone e kopaneng ea bonyane bonyane ba 1.

2. Pula ea Tibia e hokahane le moeli o ka ntle oa mensiscus ka ligae tse ngata tsa mangole le ho theha sebaka se sireletsehileng ka holim'a mokokotlo o kaholimo ho ntlha ena. Haeba ntlha ea ho kula e haufi haholo le bophahamo ba nail ea ho itšireletsa e ka ba kholo haholo, e ka baka tšenyo ea methapo ea methapo ea kutlo.

3. Khokahano ea bokhabane ba nail le lisosa tsa '

4.