Intertrochanteric fractures nke femur na-akpata 50% nke mgbawa hip na ndị agadi.Ọgwụgwọ na-agbanwe agbanwe na-enwekarị nsogbu dị ka thrombosis miri emi, pulmonary embolism, ọnya nrụgide, na ọrịa akpa ume.Ọnụọgụ ọnwụ n'ime otu afọ gafere 20%.Ya mere, n'ọnọdụ ebe ọnọdụ anụ ahụ onye ọrịa na-enye ohere, nhazi ime ime n'oge ịwa ahụ bụ ọgwụgwọ kachasị mma maka mgbaji intertrochanteric.
Ntuzi ime ntu intramedullary bụ ugbu a ọkọlọtọ ọla edo maka ọgwụgwọ nke mgbaji intertrochanteric.N'ọmụmụ ihe gbasara ihe ndị na-emetụta nhazi ime PFNA, ihe ndị dị ka ogologo ntu PFNA, akụkụ varus na imewe ka akọpụtala n'ọtụtụ ọmụmụ gara aga.Agbanyeghị, ọ ka amabeghị ma ọkpụrụkpụ nke ntu isi na-emetụta nsonaazụ ọrụ.Iji dozie nke a, ndị ọkà mmụta mba ọzọ ejirila mbọ intramedullary nwere ogologo nha ma dị iche iche iji dozie mgbaji intertrochanteric na ndị agadi (afọ> 50), na-achọ iji tụnyere ma enwere ọdịiche dị na nsonaazụ ọrụ.
Ọmụmụ ihe ahụ gụnyere ikpe 191 nke mgbawa intertrochanteric otu, ha niile ejiri nhazi ime PFNA-II.Mgbe a gbajiri obere trochanter ma kewapụ ya, a na-eji ntu dị mkpirikpi 200mm mee ihe;mgbe obere trochanter adịghị emebi ma ọ bụ na-ekewapụghị ya, ejiri ntu dị mkpụmkpụ 170mm mee ihe.Dayameta nke ntu isi sitere na 9-12mm.Isi ntụnyere n'ime ọmụmụ ihe ahụ lekwasịrị anya n'ihe ngosi ndị a:
1. Obosara trochanter pere mpe, iji chọpụta ma ọnọdụ ahụ ọ bụ ọkọlọtọ;
2. Mmekọrịta dị n'etiti cortex medial nke isi-n'olu nke isi na nke dị anya, iji nyochaa àgwà nke mbelata;
3. Tip-Apex Distance (TAD);
4.Nail-to-canal ratio (NCR).NCR bụ nha nke dayameta ntu isi na dayameta ọwa medullary n'ụgbọ elu mkpọchi dị anya.
N'ime ndị ọrịa 191 gụnyere, nkesa nke ikpe dabere na ogologo na dayameta nke ntu isi ka egosiri na foto a:
Nkezi NCR bụ 68.7%.N'iji nkezi nke a dị ka ọnụ ụzọ, a na-ahụta ikpe ndị nwere NCR karịrị nkezi ka ha nwere dayameta isi ntu buru ibu, ebe ikpe ndị NCR na-erughị nkezi ka a na-ewere na ha nwere dayameta ntu isi dị gịrịgịrị.Nke a mere ka e kewa ndị ọrịa n'ime Thick Main Nail group (ikpe 90) na Thin Main Nail group (101 case).
Nsonaazụ na-egosi na enweghị ọdịiche pụtara ìhè dị n'etiti Thick Main Nail group na Thin Main Nail group n'ihe gbasara Tip-Apex Distance, akara Koval, ọnụ ọgụgụ ọgwụgwọ egbu oge, ọnụego nrụpụta, na mgbagwoju anya ọkpụkpụ.
N'otu aka ahụ n'ọmụmụ ihe a, e bipụtara otu isiokwu na "Journal of Orthopedic Trauma" na 2021: [Title of the Article].
Ọmụmụ ihe ahụ gụnyere ndị ọrịa agadi 168 (afọ> 60) nwere mgbawa intertrochanteric, niile ejiri mbọ cephalomedullary mesoo ya.Dabere na dayameta nke ntu isi, a na-ekewa ndị ọrịa n'ime otu 10mm na otu nke nwere dayameta karịa 10mm.Nsonaazụ ahụ gosikwara na enweghị ọdịiche dị ịrịba ama na ọnụ ọgụgụ nrụpụta ọrụ (ma n'ozuzu ma ọ bụ nke na-adịghị efe efe) n'etiti otu abụọ ahụ.Ndị na-ede akwụkwọ na-atụ aro na, na ndị agadi na-arịa ọrịa intertrochanteric, na-eji ntu isi 10mm dayameta zuru oke, ọ dịghịkwa mkpa maka ịmegharị oke, n'ihi na ọ ka nwere ike nweta nsonaazụ ọrụ dị mma.
Oge nzipu: Feb-23-2024
