Izikhonkwane ze-Intramedullary kwi-Orthopedics yale mihla: Ukutshintsha kweMidlalo kuLungiso lweFracture?

Intshayelelo

Ukhathalelo lwe-Orthopedic trauma luye lwavela ngokuphawulekayo kwiminyaka, kunye ne-intramedullary (IM) izikhonkwane ezidlala indima ebalulekileyo ekulungiseni i-fracture yanamhlanje. Ezi zihlomelo ziye zaba sisisombululo esithandwayo sokuzinzisa ukuphuka kwamathambo amade ngenxa yokungahlaseli kwabo okuncinci, iimpawu eziphezulu ze-biomechanical, kunye namaxesha okubuyisela ngokukhawuleza.

Ngokuhambela phambili kuyilo lokufakelwa, izixhobo, kunye nobuchule botyando, oogqirha botyando bamathambo ngoku banesixhobo esithembekileyo sokunyanga ukwaphuka ngempumelelo ngakumbi. Eli nqaku lijonga ngakumbi indlela izikhonkwane ze-IM ezisebenza ngayo, iingenelo zazo, izicelo eziqhelekileyo, izinto ezintsha zamva nje, kwaye kutheni zifumana ukuthandwa kwimimandla ethetha iSpanish kunye ne-Asia-mpuma ye-Asia.

Ukuqonda Intramedullary Nail s: Zintoni?

Izikhonkwane ze-Intramedullary zinde, iintonga zentsimbi ezomeleleyo ezifakwe kumngxunya wethambo we-medullary ukunceda ukulungelelanisa kunye nokuzinzisa iifractures. Zenziwe nge-titanium okanye intsimbi engatyiwa, zikhuselwe ngezikrufu zokutshixa kuzo zombini iziphelo, zikhusela iintshukumo ezingafunekiyo njengokujikeleza kunye nokunciphisa.

Iintlobo zezikhonkwane ze-Intramedullary

Izikhonkwane ze-IM ziza kwiimilo ezahlukeneyo kunye nobukhulu, nganye yenzelwe amathambo athile kunye neepateni zokuqhekeka:

I-Femoral Reconstruction Nail Intramedullary

-Isetyenziselwa ukuphuka kwe-femoral eyinkimbinkimbi, ngakumbi i-subtrochanteric fractures.

I-Humeral Intramedullary Nail

-Yenzelwe ukuzinzisa i-humerus shaft kunye ne-humerus fractures.

I-PFNA (i-Proximal Femoral Nail Antirotation)

-Ifanelekile kwi-proximal femur fractures, ngakumbi kwizigulane ezikhulileyo ezine-osteoporosis.

I-Femoral Intramedullary Nail

-Inketho eqhelekileyo ye-diaphyseal femur fractures.

I-Tibia Intramedullary Nail

-Ukhetho lokukhetha ukuphuka kwe-tibial shaft, ukunciphisa ixesha lokuphilisa.

UReversed Femoral Intramedullary Nail

-Yenzelwe ukuphuka kwe-distal femoral, ukuqinisekisa ukulungelelaniswa okufanelekileyo.

Multi-Lock Humerus Intramedullary Nail

-Inikezela ngeendlela zokutshixa ngakumbi, ibonelela uzinzo olongezelelweyo kwiifractures ezintsonkothileyo ze-humeral.

Isikhonkwane se-Titanium Elastic (TEN)

- Ngokuqhelekileyo isetyenziswe kwiifractures zabantwana ngenxa yesakhiwo sayo esiguquguqukayo.

Kutheni izikhonkwane ze-Intramedullary ziguqula ukulungiswa kweFracture

UkuBuyiswa ngokukhawuleza kunye nokuHamba kwangethuba

Enye yeenzuzo ezinkulu zezikhonkwane ze-IM kukukwazi kwabo ukuxhasa ubunzima bokuqala. Uphando lubonisa ukuba izigulane ezibethelela i-IM ngenxa yokuqhekeka zinokuqala ukuthwala ubunzima phakathi kweeveki ze-4-6, xa kuthelekiswa neeveki ze-8-12 kulabo baphathwa ngamacwecwe endabuko. Oku kuhamba kwangoko kukhawuleza ukuphilisa kwaye kunciphisa umngcipheko we-muscle atrophy.

Utyando olungephi

Ngokungafaniyo neendlela zokulungisa zendabuko ezifana neepleyiti, ezihlala zifuna ukutshintshwa okukhulu kunye nokuchithwa kwezicubu ezithambileyo, izikhonkwane ze-IM zinokufakwa ngeendlela ezincinci. Oku kunciphisa umonzakalo wotyando, kwehlisa umngcipheko wosulelo, kwaye kukhokelela ekuhlaleni ixesha elifutshane esibhedlele.

Uzinzo oluPhezulu lwe-Biomechanical

Ngenxa yokuba izikhonkwane ze-IM zifakwe ngaphakathi kwethambo, zilungelelanisa kunye ne-axis yendalo yomzimba, ebonelela ngokuzinza okuqinileyo kunye ne-axial. Olu yilo lulinganisa i-biomechanics yendalo yomzimba, inciphisa imingcipheko yokusilela kokufakelwa.

Umngcipheko ophantsi weengxaki

Xa kuthelekiswa namacwecwe kunye nezilungisi zangaphandle, izikhonkwane ze-IM zinezinga eliphantsi lobunzima. Ukusetyenziswa kwe-screws edibeneyo kuthintela ukunciphisa amathambo kunye nokungahambi kakuhle, ukunciphisa amathuba e-malunion okanye i-nonunion.

Izicelo eziphambili zeeNzipho ze-Intramedullary kwi-Orthopedics

Ukuqhekeka kweFemoral Shaft

Ukuqhekeka kwe-Femoral, ngokukodwa i-diaphyseal fractures, iphathwa kakuhle ngezikhonkwane ze-IM. Uphononongo lubonisa ukuba i-95% yezaphulelo ze-femal eziphathwa ngezikhonkwane ze-IM ziphilisa kwiinyanga ezintandathu xa kulandelwa ukunakekelwa okufanelekileyo emva kokuhlinzwa.

Ukuqhekeka kweTibial Shaft

I-Tibial fractures ixhaphake kwiimeko zokuxhatshazwa kwamandla aphezulu, njengeengozi zemoto kunye nokulimala kwezemidlalo. Ukubethelwa kwe-IM kuvumela ukuthwala ubunzima kwangoko, okubalulekileyo ekuthinteleni iingxaki ezinjenge-compartment syndrome.

Iifractures zeHumeral

Izikhonkwane ze-IM zibonelela ngeziphumo ezingcono zokusebenza kunamacwecwe kwi-humeral shaft fractures, ngakumbi kwizigulane ezisebekhulile ezinamathambo osteoporotic.

I-Geriatric kunye ne-Osteoporotic Fractures

Ngabantu abalupheleyo eMexico, eBrazil, e-Indonesia, nakwiiPhilippines, ukophuka kwe-femur okusondeleyo kuya kusiba rhoqo. Izikhonkwane ze-PFNA zisebenza ngokukodwa ekuphatheni ezi fractures, zinika uzinzo olujikelezayo oluphezulu kwizigulane ezinamathambo abuthathaka.

Utshintsho lwakutsha nje kwi-Intramedullary Nailing

I-Biodegradable kunye ne-Antibiotic-Coated I-IM Izikhonkwane

Uphando olutsha luye lwakhokelela ekuphuhlisweni kwe-IM ye-biodegradable kunye ne-antibiotic-coated-coated, inceda ukunciphisa amazinga okusuleleka kunye nokukhuthaza ukuphulukiswa kwamathambo ngokukhawuleza.

Izikhonkwane ze-IM ze-3D eziprintiweyo

Abavelisi ngoku basebenzisa itekhnoloji yoshicilelo ye-3D ukuvelisa izikhonkwane ze-IM ezilungelelanisiweyo, ziqinisekisa umdlalo ongcono we-anatomical kwisigulane ngasinye.

IiNdlela zokuTshixa eziPhezulu

Ukuqaliswa kweenkqubo ezininzi zokutshixa izikhonkwane kuye kwaphucula ukuzinza kwiimeko ezinzima zokuqhekeka, ukubonelela oogqirha botyando ngeendlela ezininzi zokwenza ngokwezifiso ukulungiswa.

Iindlela zeMarike: Kutheni iMfuno ikhula kwiMimandla ethetha iSpanish kunye nakuMzantsi-mpuma weAsia

Ukwandiswa kwaMatyala okuNzakala

I-Latin America kunye ne-Southeast Asia zinawona mazinga aphezulu eengozi zendlela kwihlabathi jikelele. Ngokutsho koMbutho wezeMpilo weHlabathi (i-WHO), ngaphezu kwe-1.35 yezigidi zokufa kwenzeka ngonyaka ngenxa yeengozi zendlela, nto leyo eyenza unyango lwezaphulelo lube yeyona nto iphambili.

Ukwandiswa kweZibonelelo zezeMpilo

Amazwe afana neMexico, iThailand, ne-Indonesia atyala imali eninzi ekuphuculeni ukhathalelo lwempilo, nto leyo ekhokelela ekwamkelweni okwandisiweyo kofakelo lwamathambo olufana nezikhonkwane ze-IM.

Ukukhula okuKhethekileyo kwi-Titanium IM Izikhonkwane

Izikhonkwane ze-Titanium zifumana ukutsaleka ngenxa ye-biocompatibility yazo, indalo ekhaphukhaphu, kunye nokuxhathisa ukubola. Izizwe ezifana neColombia kunye neVietnam zitshintshela kwizikhonkwane ze-titanium IM kwizibhedlele ezikhokelayo zentlungu.

Indlela abasasazi abanokwenza ngayo imali kwiMarike ye-IM yezikhonkwane ekhulayo

Imingeni ekusasazeni

Iimvume ezilawulayo (umzekelo, i-COFEPRIS eMexico, i-BPOM e-Indonesia).

Imisebenzi evela kumazwe angaphandle kunye nolawulo lwekhonkco lokubonelela.

Amathuba kuBasasazi

Ukusebenzisana nezibhedlele zamathambo kunye namaziko okwenzakala.

Ukunikezela ngeenkqubo zoqeqesho lweengcibi kwiiteknoloji ezintsha zokufakelwa.

Ukubonelela nge-FDA- kunye nokufakelwa kwe-CE-eqinisekisiweyo ukuhlangabezana nemigangatho yokuthengwa kwesibhedlele.

Ukuqukumbela

Izikhonkwane ze-Intramedullary ziguqule ukulungiswa kwe-fracture ngokunika izinto ezincinci ezihlaselayo, ezomeleleyo ze-biomechanically, kunye nezisombululo zokuqala ezinobunzima. Njengoko imfuno yabo iqhubeka nokunyuka kwimimandla ethetha iSpanishi kunye ne-Asia-mpuma ye-Asia, abasasazi kunye nababoneleli bezempilo kufuneka bahlale benolwazi malunga nobuchwepheshe bamuva kunye neendlela zemarike.

Koogqirha botyando, ukuqonda ezona ndlela zilungileyo zokubethelela i-IM kuqinisekisa iziphumo ezingcono zesigulana. Kubabasasazi, utyalo-mali kwizikhonkwane ze-IM ezikumgangatho ophezulu kunye neenkqubo zemfundo zinokunceda ukwandisa ukufikelela kwiimarike kunye nokuseka intsebenziswano eqinile kwishishini lamathambo.