Me pēhea te whiriwhiri i te mea e tika anaWhao I roto i te Medullary Femoral?
Te whiriwhiri i tētahi mea e tika anafwairuanmateme arotake whānuitia te momo whati o te tūroro, te hanganga tinana, te kounga o te wheua, te huarahi pokanga, me ngā manakohanga hangarau a te taote pokanga, ka hua ake he whakatau takitahi. Ko ngā paearu aromatawai matua e whai ake nei:
I. Kōwhiringa i runga i te wāhi me te momo whati (Ngā tohu)
Ngā whati o te femur tata (intertrochanteric me transcervical):
Paerewaroto i te medullary whao(pērā i te PFNA paerewa): E tohuhia ana mō ngā whati i waenga i ngā wheua (pērā i te momo 31-A1, 31-A2), ngā whati i waenga i ngā wheua whakamuri (momo 31-A3), me ngā whati taumata-tiketike (32-A1). Kāore te tauira paerewa i te whakatikatikahia, ā, he pai mō ngā tūroro he pai te kounga o te wheua me ngā whati pumau.
Whao toronga intramedullary (pērā i te PFNA toronga): E tohuhia ana mō ngā whati iti subtrochanteric, ngā whati me te rārangi whati e toro atu ana i tua atu i te pito distal o te acetabulum iti neke atu i te 3 cm, ngā whati acetabular ipsilateral, ngā whati maha, ngā whati pathological, ngā tūroro osteoporosis rānei. Ko ngā momo toronga me cannulation, ā, ka taea te whakarato i te whakapiri roa-katoa me te pumau anti-hurihuri.
Ētahi atu momo (pērā i a InterTan,Whao kamma): He pai te InterTan (whao takirua me te taura) mō ngā whati pakaru tino pakaru e hiahia ana kia pēhia; e tohu ana te whao Gamma mō ngā whati ngāwari, pumau, ngā whati subtrochanteric rānei.
Ngā whati o te kakau femur (waenganui): Ko te mea pai ko te whao intramedullary locking anterograde. Me whiriwhiri te diameter me te roa e tika ana o te whao intramedullary i runga i te whānui o te kōhao medullary me te nui o te pakaru o te whati.
Ngā whati o te femur distal (ngā whati o te condylar o runga/ngā whati i waenganui i ngā condylar): Ko te maimoatanga pai ko ngā whao intramedullary reverse locking, e tika ana mō ngā whati kopa o te condylar o runga, ngā whati i waenganui i ngā condylar e pā ana ki te mata o te hononga, ngā whati rānei i raro i te trochanter femur.
II. I runga i te Pūwāhi Tomokanga me te Huarahi Pokanga
Te wāhi tomo ki te tihi o te trochanter nui (huarahi mua): He pai mō ngā tūroro momona (tikanga māmā noa, wā pokanga poto ake, iti ake te fluoroscopy) me ngā whati intertrochanteric noa. Heoi, me tūpato kia kore ai e whara ngā uaua abductor.
Te pūwāhi werohanga o te sinus pyriform (te ahunga whakamua): He pai mō ngā whati intertrochanteric noa, engari he whaiti te tūnga. He uaua ake te mahi mō ngā tūroro momona, ā, me tūpato kia kore ai e pakaru te rere o te toto ki te kaki femur, ki te pane femur rānei.
Te pū werohanga whakamuri (mā roto i te fossa intercondylar): He pai mō ngā whati o te femur distal. Me tūpato kia kore ai e kino te pūtake o te hononga cruciate o muri.
III. I runga i te roa o ngā whao o te Titanium Femor
Whao poto (170–200 mm): E taunakitia ana mō ngā tūroro he kuiti te awaawa o te femur, he whati pumau, ā, kāore anō kia pakaru te cortex femur proximal taha. Ka whakapoto i te wā pokanga, engari me tūpato kia kore ai e kore e pumau te hurihanga o ngā tūroro he whānui ngā awaawa o te medullary.
Whao roa-waenga (235–240 mm): He pai hei whakakapi mō ngā whao poto, mō ngā whati iti rānei i waenganui i ngā uaua, ina hiahiatia kia mau tonu ngā kōhao raka o te pito engari kāore e taea te whakamahi i ngā whao roa.
Whao roa (260–480 mm): He pai mō ngā tūroro he whānui ngā awaawa o te femur, he osteoporosis, he whati pathological, he hapa cortical proximal, he rārangi whati tawhiti, he hunga rānei e hiahia ana kia whakapirihia te roa katoa. Heoi, ka piki ake te wā pokanga me te toto e ngaro ana.
IV. I runga i te whānui, te matotoru rānei o te whao hanga anō
Te mātāpono kōwhiringa diameter: Me taurite kia rite ki te wāhanga whaiti rawa o te kōhao medullary o te tūroro (te kōhao medullary rānei i whakatauhia) kia nui ai te kaha pupuri (press-fit fixation) me te karo i ngā whati iatrogenic.
Whao kāore anō kia whānui: Kōwhiria he whao he 1mm te iti iho i te diameter o te kōhao medullary (hei tauira, mēnā he 10mm te diameter o te kōhao medullary, whiriwhiria he whao 9mm).
Whao whānui (hei tauira, mēnā he 11mm te whānui o te awaawa whānui, whiriwhiria he whao he 9-10mm te whānui).
Awhe paerewa: Ko te diameter e whakamahia whānuitia ana mō ngā pakeke ko te 9-11mm, mō ngā tamariki ko te 4-6mm.
V. Kōwhiringa i runga i te āhua o te wheua me te āhua o te tūroro
Ngā tūroro e pāngia ana e te osteoporosis: He mea tika kia whiriwhiria he matotoru akeOrthopedic Whao (whakapiri pēhi-taumata) ngā mea roa rānei hei karo i te motu o ngā whao o te mahunga, i te kore rānei e ranea te whakapiri o roto nā te kore e ranea te kaha pupuri.
Ngā taiohi/tūroro he pai te āhua o te wheua: Ka taea te whiriwhiri i ngā whao intramedullary angiangi ake hei tiaki i te rere o te toto ki te kōhao medullary me te whakaiti i te tūponotanga o te necrosis ischemic wera i puta mai i te whānui o te hinu wheua.
Tuhipoka: Ko te kōwhiringa whakamutunga oTe Hanga Anō i ngā Whao Femurme whai whakatau whānui i runga i ngā inenga whakaahua i mua i te pokanga (X-ray/CT), ngā āhuatanga o te fluoroscopy i te wā o te pokanga, me te pūkenga o te kaiwhakahaere.
Wā tuku: Hepetema-16-2026