A na-ahụkarị mgbaji ụkwụ femoral dị nso site na mmerụ ahụ nke ụlọ ọgwụ na-esite na mkpamkpa ike dị elu.N'ihi njirimara anatomical nke femur proximal, eriri mgbaji na-adịkarị nso na elu articular ma nwee ike ịgbatị na nkwonkwo, na-eme ka ọ ghara ịdị mma maka nhazi ntu intramedullary.N'ihi ya, akụkụ dị ịrịba ama ka na-adabere na nhazi site na iji efere na ịghasa usoro.Agbanyeghị, njirimara biomechanical nke efere ndị etinyere n'ụzọ kwụ ọtọ na-ebute nnukwu nsogbu nke nsogbu dị ka ọdịda nrụzi nke mpụta, mgbawa nke ime ime, na ịpụpụ.Ojiji nke enyemaka nke etiti etiti maka ndozi, ọ bụ ezie na ọ dị irè, na-abịa na ndọghachi azụ nke ịba ụba nke trauma, ogologo oge ịwa ahụ, ihe ize ndụ nke ibute ọrịa mgbe ịwachara ahụ, na gbakwunyere ibu ego maka ndị ọrịa.
N'iburu n'uche echiche ndị a, iji nweta nguzozi ezi uche dị n'etiti ihe ndọghachi azụ biomechanical nke otu efere mpụta na ọnya ịwa ahụ metụtara ojiji nke okpukpu abụọ nke etiti na mpụta, ndị ọkà mmụta mba ọzọ ewerela usoro metụtara idozi efere mpụta na mgbakwunye percutaneous screw fixation. n'akụkụ etiti.Usoro a egosipụtala nsonaazụ ụlọ ọgwụ dị mma.
Mgbe ngụsị ahụ gasịrị, a na-etinye onye ọrịa ahụ n'ọnọdụ dị ala.
Nzọụkwụ 1: Mbelata mgbaji.Fanye agịga Kocher 2.0mm n'ime tuberosity tibial, traction iji tọgharịa ogologo aka, ma jiri ikpere ụkwụ dozie mgbagharị ụgbọ elu sagittal.
Nzọụkwụ 2: Ịtinye efere nchara n'akụkụ.Mgbe mbelata nke isi site na traction, bịaruo nso femur dị anya, họrọ efere mkpọchi ogologo kwesịrị ekwesị iji kwado mbelata ahụ, ma tinye skru abụọ na nso na njedebe nke mgbaji ahụ iji nọgide na-ebelata mgbaji ahụ.N'ebe a, ọ dị mkpa iburu n'obi na a ga-etinye skru abụọ dị anya ka ọ dị nso n'ihu dị ka o kwere mee iji zere imetụta ntinye nke screws medial.
Nzọụkwụ 3: Ndokwa nke skru medial kọlụm.Mgbe emechara mgbaji ahụ na efere nchara dị n'akụkụ, jiri 2.8mm na-eduzi screwed iji banye site na condyle medial, na ebe agịga dị n'etiti ma ọ bụ n'azụ ọnọdụ nke mgbochi femoral distal, diagonally apụta na elu, na-abanye na nke ọzọ. ọkpụkpụ cortical.Mgbe mbelata fluoroscopy na-eju afọ, jiri mgbịrịgba 5.0mm mepụta oghere wee tinye 7.3mm ịkagbu ịghasa ọkpụkpụ.
Eserese na-egosi usoro nke mbelata mgbaji na ndozi.Nwanyị dị afọ 74 nwere mgbawa intra-articular femoral distal (AO 33C1).(A, B) Igwe redio dị n'akụkụ na-arụ ọrụ nke ọma na-egosi nhụpụ dị ịrịba ama nke mgbaji femoral dị anya;(C) Mgbe mbelata gbajiri agbaji, a na-etinye efere mpụta nke dị n'èzí nwere skru na-echekwa ma akụkụ dị nso na nke dị anya;(D) Ihe oyiyi fluoroscopy na-egosi ọnọdụ na-eju afọ nke waya nduzi mgbasa ozi;(E, F) Mpụta redio na anteroposterior redio mgbe ịtinyechara skru medial.
N'oge usoro mbelata, ọ dị mkpa ịtụle isi ihe ndị a:
(1) Jiri waya nduzi na ịghasa.Ntinye nke screws medial medial dị oke oke, na iji waya nduzi na-enweghị ihe nkedo nwere ike iduga n'ogo dị elu n'oge a na-egwupụta ihe site na condyle medial, na-eme ka ọ dị mfe na-amị amị.
(2) Ọ bụrụ na skru na efere mpụta nke ọma jidesie cortex mpụta nke ọma mana ha agaghị enweta nrụzi cortex abụọ dị mma, gbanwee ntụzịaka ahụ na-aga n'ihu, na-ekwe ka skru ahụ banye n'akụkụ ihu nke efere mpụta iji nweta nhazi cortex abụọ na-eju afọ.
(3) Maka ndị ọrịa nwere osteoporosis, ịtinye onye na-ehicha ihe na kọlụm nke etiti nwere ike igbochi ihe nkedo site na ịkpụ n'ime ọkpụkpụ.
(4) Ihe nkedo dị na njedebe nke efere ahụ nwere ike igbochi ntinye nke skru medial.Ọ bụrụ na a na-ahụ ihe mgbochi ịghasa n'oge ntinye nke kọlụm medial, tụlee ịwepu ma ọ bụ dogharịa skru dị n'akụkụ efere dị n'akụkụ, na-ebute ụzọ na ntinye nke skru medial kọlụm.
Ikpe 2. Nwanyị na-arịa ọrịa, 76 afọ, na a distal femoral extra-articular mgbaji.(A, B) Ụzarị X-ray na-aga n'ihu na-egosi nhụpụ dị ịrịba ama, nrụrụ akụkụ, na ngbanwe ụgbọ elu coronal nke mgbaji;(C, D) X-ray na-aga n'ihu na-arụ ọrụ na mpụta na echiche anteroposterior na-egosi nhazi na efere mpụta dị n'èzí jikọtara ya na skru medial;(E, F) X-ray na-esochi na ọnwa 7 ka emechara ya na-ekpughe ọgwụgwọ mgbaji dị mma na-enweghị akara nke ọdịda nrụzi nke ime.
Ikpe 3. Onye ọrịa nwanyị, dị afọ 70, nwere mgbawa periprosthetic gburugburu ebe etinyere femoral.(A, B) ụzarị X-ray tupu arụ ọrụ nke ọma na-egosi mgbaji periprosthetic gburugburu ebe a na-etinye nwa femoral mgbe ọkpụkpụ nkwonkwo ikpere zuru oke, na mgbaji mgbaji na-arụ ọrụ na nhazi prosthetic kwụsiri ike;(C, D) X-ray arụ ọrụ nke na-egosi ndozi ya na efere mpụta dị n'èzí jikọtara ya na skru medial site na usoro ihe ọzọ;(E, F) X-ray na-esochi na ọnwa 6 ka emechara ya na-ekpughe ọgwụgwọ mgbaji dị mma, yana nhazi nke ime n'ime ya.
Oge nzipu: Jan-10-2024
