Ịkekọrịta ihe ọmụmụ |Ntuziaka Osteotomy Ebipụtara 3D yana Prosthesis ahaziri ahazi maka ịwa ahụ ngbanwe nke ubu “nhazi nkeonwe”

A na-akọ na ngalaba Orthopedics na Tumor nke ụlọ ọgwụ Wuhan Union emechaala ịwa ahụ nke mbụ "3D-ebipụta ahaziri atụgharị ubu arthroplasty na hemi-scapula reconstruction".Ịrụ ọrụ na-aga nke ọma na-egosi ọkwa dị elu n'ime ụlọ ọgwụ na-eme ka ọkpụkpụ nkwonkwo ụbụrụ na-arụ ọrụ na nkà na ụzụ nwughari, na-ebute ozi ọma nye ndị ọrịa nwere nsogbu siri ike.
nwanne mama Liu, onye dị afọ 56 n'afọ a, nwere mgbu ubu aka nri ọtụtụ afọ gara aga.Ọ ka njọ nke ukwuu n'ime ọnwa anọ gara aga, ọkachasị n'abalị.Ụlọ ọgwụ dị n'ógbè ahụ hụrụ "ọnya ụbụrụ cortical akụkụ aka nri" na fim ahụ.Ọ bịara na ngalaba Orthopedics na Tumor nke ụlọ ọgwụ Wuhan Union maka ọgwụgwọ.Mgbe ndị otu Prọfesọ Liu Jianxiang natara onye ọrịa ahụ, a na-eme nyocha CT na MR nkwonkwo ubu, na etuto ahụ gụnyere humerus proximal na scapula, nke nwere ụdị dị iche iche.Nke mbụ, a na-eme biopsy nke mpaghara mpaghara maka onye ọrịa, na achọpụtara ọrịa pathological dị ka "biphasic synovial sarcoma nke ubu aka nri".N'iburu n'uche na ụbụrụ ahụ bụ ụbụrụ na-adịghị mma na onye ọrịa nwere ugbu a na-elekwasị anya n'ime ahụ dum, ndị otu ahụ chepụtara usoro ọgwụgwọ onwe onye maka onye ọrịa-mwepụ zuru oke nke njedebe nso nke humerus na ọkara nke scapula, na 3D- e biri ebi artificial reverse ubu nkwonkwo nnọchi.Ebumnobi a bụ iji nweta ntughari akpụ na nrụzigharị prosthesis, si otú ahụ weghachi nhazi na ọrụ nkwonkwo ubu nke onye ọrịa.

Mgbe ha kwusasịrị ọnọdụ onye ọrịa ahụ, atụmatụ ọgwụgwọ, na mmetụta ọgwụgwọ a na-atụ anya ya na onye ọrịa na ezinụlọ ha, na ịnweta nkwenye ha, ndị otu ahụ malitere ịkwado maka ịwa ahụ nke onye ọrịa nke ukwuu.Iji hụ na nchịkọta tumor zuru oke, ọkara nke scapula kwesịrị iwepụ na ọrụ a, na nrụghachi nke nkwonkwo ubu bụ ihe siri ike.Mgbe nyochachara nke ọma nke ihe nkiri ahụ, nyocha anụ ahụ, na mkparịta ụka, Prọfesọ Liu Jianxiang, Dr. Zhao Lei, na Dr. Zhong Binlong chepụtara atụmatụ ịwa ahụ nke ọma ma soro onye injinia kwurịta banyere nhazi na nhazi nke prosthesis ọtụtụ ugboro.Ha simulated tumor osteotomy na prosthesis echichi na 3D e biri ebi nlereanya, na-eke a "onwe customization" maka onye ọrịa - ihe artificial reverse ubu nkwonkwo prosthesis nke dakọtara ha autologous ọkpụkpụ na a 1: 1 ruru.

A. Tulee oke osteotomy.B. Chepụta prosthesis 3D.C. 3D bipụta prosthesis.D. Buru ụzọ wụnye prosthesis.
The reverse ubu nkwonkwo dị iche na omenala wuru ubu nkwonkwo, na gburugburu gburugburu nkwonkwo elu enịm ke scapular n'akụkụ nke glenoid na iko enịm na proximal ọkara amachibidoro humerus na ọkara mgbochi ngụkọta ubu nkwonkwo prosthesis.Ịwa ahụ a nwere uru ndị a: 1. Ọ nwere ike dakọtara nke ukwuu n'ọkpụkpụ ọkpụkpụ buru ibu nke na-eme ka ụbụrụ tumor;2. Oghere nwughari ligament nke e mere tupu emee nwere ike idozi anụ ahụ dị nro gbara ya gburugburu ma zere nkwonkwo nkwonkwo na-akpata site na resection rotator cuff;3. Ọdịdị trabecular bio-mimetic dị n'elu nke prosthesis nwere ike ịkwalite nsị nke ọkpụkpụ gbara ya gburugburu na anụ ahụ dị nro;4. The ahaziri reverse ubu nkwonkwo nwere ike n'ụzọ dị irè ibelata postoperative dislocation ọnụego nke prosthesis.N'adịghị ka mgbanwe ubu a na-emekarị, ịwa ahụ a na-achọkwa iwepụ isi niile nke humeral na ọkara nke iko scapular, na mwughachi isi humeral na iko scapular dị ka ngọngọ dum, nke chọrọ nhazi ziri ezi na usoro ịwa ahụ mara mma.
Mgbe nhazi na nkwadebe nke ọma n'oge oge mgbatị ahụ, a na-arụ ọrụ ahụ nke ọma na onye ọrịa n'oge na-adịbeghị anya, n'okpuru nduzi nke Prọfesọ Liu Jianxiang.Ndị otu ahụ na-arụkọ ọrụ ọnụ ma rụọ ọrụ ziri ezi iji mezue mkpochapụ zuru oke nke etuto ahụ, osteotomy ziri ezi nke humerus na scapula, ntinye na mgbakọ nke prosthesis artificial, nke were awa 2 iji wuchaa.

D: Kpochapụ kpọmkwem humerus na scapula na efere ndu ọkpụkpụ iji wepụ etuto ahụ (H: fluoroscopy intraoperative maka iwepụ tumor)
Mgbe emechara ya, ọnọdụ onye ọrịa ahụ dị mma, ha wee nwee ike iji nkwado nkwado na akụkụ ahụ emetụtara gaa n'ụbọchị nke abụọ ma mee mmegharị nkwonkwo ubu na-agafe agafe.Nyocha X-ray na-esochi gosipụtara ọnọdụ dị mma nke prosthesis nkwonkwo ubu na mgbake na-arụ ọrụ nke ọma.

Ịwa ahụ ugbu a bụ ikpe mbụ na ngalaba ụlọ ọgwụ nke Wuhan Union nke na-anakwere ntuziaka ịkpụ akwụkwọ 3D na prostheses ahaziri maka nkwonkwo ubu ahaziri na nnọchi hemi-scapula.Mmezu nke teknụzụ a na-aga nke ọma ga-ewetara ọtụtụ ndị ọrịa nwere etuto ubu olileanya ịzọpụta ụkwụ, ma rite uru dị ukwuu nke ndị ọrịa.