Intramedullary nailingbụ usoro nhazi ime orthopedic a na-ejikarị eme ihe nke malitere na 1940s.A na-eji ya eme ihe n'ọtụtụ ebe n'ịgwọ ọkpụkpụ ogologo ọkpụkpụ, ndị na-abụghị ndị otu, na mmerụ ndị ọzọ metụtara ya.Usoro a gụnyere itinye ntu intramedullary n'ime ọwa etiti nke ọkpụkpụ iji mee ka ebe mgbaji sie ike.N'okwu dị mfe, ntu intramedullary bụ ogologo usoro nwere otutukpochidoro ịghasaoghere na nsọtụ abụọ ahụ, nke a na-eji edozi nso nso na njedebe nke mgbawa.Dabere na nhazi ha, mbọ intramedullary nwere ike ịkewa dị ka akụkụ siri ike, tubular, ma ọ bụ oghere mepere emepe, a na-ejikwa ya na-agwọ ụdị ọrịa dị iche iche.Dịka ọmụmaatụ, mbọ intramedullary siri ike nwere nguzogide ọrịa ka mma n'ihi enweghị oghere nwụrụ anwụ n'ime ha.
Kedu ụdị mgbaji dị mma maka mbọ intramedullary?
Intramedullary mbọbụ ezigbo ịkụnye maka ọgwụgwọ mgbaji diaphyseal, karịsịa na femur na tibia.Site na usoro mmekpa ahụ dị ntakịrị, ntu intramedullary nwere ike inye ezigbo nkwụsi ike ka ọ na-ebelata mmebi anụ ahụ dị nro na mpaghara mgbaji.
Mbelata mechiri emechi na ịwa ahụ ntu intramedullary nwere uru ndị a:
Mbelata mechiri emechi na intramedullary nailing (CRIN) nwere uru dị n'ịzere mbepụ ebe mgbawa ahụ na ibelata ihe ize ndụ nke ibute ọrịa.Site na obere mbepụ, ọ na-ezere mgbasa nke anụ ahụ dị nro dị ukwuu na mmebi nke ọbara na-agbaji na saịtị ahụ, si otú a na-eme ka ọnụọgụ ọgwụgwọ nke ọkpụkpụ ahụ dịkwuo mma.Maka ụfọdụ ụdịmgbaji ọkpụkpụ dị nso, CRIN nwere ike inye nkwụsi ike mmalite zuru oke, na-enye ndị ọrịa ohere ịmalite mmegharị nkwonkwo n'oge;ọ dịkwa mma karịa n'ihe gbasara iburu nrụgide axial tụnyere ụzọ ndị ọzọ eccentric fixation na usoro nke biomechanics.Ọ nwere ike ka mma igbochi ịtọpụ nhazi nke ime ime mgbe ịwachara ahụ site n'ịbawanye mpaghara kọntaktị n'etiti ntinye na ọkpụkpụ, na-eme ka ọ dịkwuo mma maka ndị ọrịa nwere osteoporosis.
Tinyere na tibia:
Dị ka e gosiri na ọnụ ọgụgụ a, usoro ịwa ahụ na-agụnye ime obere mbepụ nke 3-5 cm naanị n'elu tubercle tibial, na ịtinye skru 2-3 na-ekpochi site na nkwụsị nke ihe na-erughị 1 cm na nso na njedebe nke ụkwụ ala.Tụnyere mbelata oghe oghe ọdịnala na ntinye n'ime ya na efere igwe, enwere ike ịkpọ nke a usoro mkpasu iwe n'ezie.
Etinyere femur:
1.Interlocking ọrụ nke femoral kpọchiri ntu intramedullary:
Na-ezo aka na ikike ya iguzogide ntụgharị site na usoro mkpọchi nke ntu intramedullary.
2.Nhazi nke ntu intramedullary akpọchiri akpọchi:
N'ihe gbasara ọrụ: ọkọlọtọ ekpochi intramedullary ntu na nwughari ekpochi intramedullary ntu;kpebisiri ike site na nnyefe nrụgide site na nkwonkwo hip na nkwonkwo ikpere, yana ma akụkụ elu na nke dị n'etiti ndị na-atụgharị (n'ime 5cm) kwụsiri ike.Ọ bụrụ na ejighị n'aka, nwughari nke nnyefe nrụgide hip dị mkpa.
N'ihe dị n'ogologo: ụdị mkpụmkpụ, dị nso, na ogologo oge, nke a na-ahọrọ na-adabere n'ịdị elu nke saịtị mgbawa mgbe ị na-ahọrọ ogologo ntu intramedullary.
2.1 Standard interlocking intramedullary ntu
Isi ọrụ: nkwụsi ike nke axial.
Ngosipụta: Ọkpụkpụ nke ogwe femoral (anaghị etinye ya na mgbaji subtrochanteric)
2.2 Ntu intramedullary na-ejikọta nwughari
Isi ọrụ: Mgbasa nrụgide sitere na hip na ogwe femoral adịghị eguzosi ike, na nkwụsi ike nke nnyefe nrụgide na akụkụ a kwesịrị ka e wughachi ya.
Ihe ngosi: 1. Subtrochanteric fractures;2. Ọkpụkpụ nke olu femoral jikọtara ya na ọkpụkpụ femoral na-agbaji n'otu akụkụ (akụkụ abụọ n'otu akụkụ).
PFNA bụkwa ụdị ntu intramedullary ụdị nwughari!
2.3 Usoro mkpọchi anya nke ntu intramedullary
Usoro mkpọchi anya nke mbọ intramedullary dịgasị iche dabere na onye nrụpụta.N'ozuzu, a na-eji otu mkpuchi mkpọchi static eme ihe maka mbọ intramedullary femoral dị nso, mana maka mgbaji ụkwụ femoral ma ọ bụ mbọ intramedullary ogologo, a na-ejikarị skru abụọ ma ọ bụ atọ static skru na mkpọchi siri ike na-eme ka nkwụsi ike na-agbanwe agbanwe.A na-edozi mbọ ntu intramedullary nke femoral na tibial nwere skru abụọ.
Oge nzipu: Mar-29-2023
