Sekuvhiyiwa kwemapfupa muna 2023, pane zvimwe zvinonetsa.Rimwe dambudziko nderekuti maitiro mazhinji emapfupa anopindira uye anoda nguva refu yekupora.Izvi zvinogona kunge zvisingafadzi kuvarwere uye kunonoka kupora.Mukuwedzera, zvinetso zvakadai sehutachiona kana kubuda ropa zvinogona kuitika.
Nekudaro, mumakore makumi maviri anotevera, kuvhiyiwa kwemapfupa kunotarisirwa kubatsirwa kubva kune matekinoroji matsva.Imwe nharaunda icharamba ichikura kuvhiyiwa kwerobhoti.Marobhoti anogona kuita mafambiro chaiwo uye kubatsira vanachiremba mukuvhiya maitiro akaomarara.Izvi zvinogona kutungamirira kumigumisiro iri nani uye nguva shoma yekupora.
Kumwe kufambira mberi kunotarisirwa mune regenerative mushonga.Tekinoroji nyowani senge stem cell therapy uye tishu engineering inogona kupa mukana wekugadzirisa kana kutsiva matishu akakuvadzwa.Izvi zvinogona kuderedza kudiwa kwemaimplants uye kunatsiridza kupora kwemurwere.
Pamusoro pezvo, kufambira mberi kwehunyanzvi hwekufungidzira kunotarisirwa.3D imaging uye chaiyo chaiyo inogona kubatsira vanachiremba vanovhiya kuti vanyatso ongorora uye kuronga zvirinani maitiro.
Kutaura zvazviri, kuvhiyiwa kwemapfupa pasi rose kwakakunda matambudziko akasiyana-siyana mumakore apfuura.Unyanzvi hwataurwa pamusoro apa hwakabatsira zvikuru mukuvandudza kuvhiyiwa kwemapfupa.Mimwe mienzaniso mukuita ndeiyi:
1. Kuvhiyiwa kuduku: Kuburikidza nekushandisa endoscopes uye midziyo miduku, kuvhiyiwa kunogona kuitwa nediki diki.Izvi zvinoguma nekurwadziwa kwepashure pekushanda, kukurumidza kupora uye matambudziko mashoma.
2. Robhoti-inodzorwa kuvhiyiwa: Robhoti-inobatsira masisitimu inogonesa kunyatsojeka uye kushoma maitiro ekuita.Semuyenzaniso, anogona kushandiswa mumabvi kana hudyu kutsiva implantation kunatsiridza kurongeka uye kukwana.
3. Mafambisirwo ezvifambiso: Mafambisirwo anoitwa nekombiyuta anobatsira vanachiremba vanovhiya kuti vacheke chaizvo uye kuisa ma implants.Semuenzaniso, vanogona kushandiswa mukuvhiyiwa kwepelinha kuti vavandudze kuchengeteka nekururama.
Aya matekinoroji anobatsira kuvandudza mhedzisiro yekuvhiya kwemapfupa, kupfupisa nguva yekupora, uye kuwedzera varwere, kunaka kwehupenyu.Pakazara, pamusoro pemakore anotevera e20, kuvhiyiwa kwemapfupa kuchabatsirwa kubva kune hutsva hutsva hunobvumira kuvhiyiwa kwakanyatsojeka, kukurumidza kupora, uye migumisiro yakavandudzwa.
Ichi chinyorwa chinosarudza chimwe chezvirwere zvakajairika kuratidza kukanganisa kwetekinoroji iterations mumakore.
Intertrochanteric fractures of the femur zvinowanzoitika kukuvadzwa kunoitika muhuwandu hwevanhu vakwegura uye kunobatanidza nekunyanya kurwara uye kufa.Nzira dzekurapa dzakashanduka nekufamba kwemakore, nekufambira mberi kwehunyanzvi hwekuvhiya uye magadzirirwo ekudyara zvinotungamira kune zvakavandudzwa.Muchikamu chino, tichaongorora nzira dzakasiyana dzekurapa dze intertrochanteric fractures yefemur, kuongorora kufambira mberi kwetekinoroji maererano nekushanduka kwemakore, uye kukurukura nzira dzekupedzisira dzekurapa.
Makore zana apfuura, kurapwa kwe intertrochanteric fractures kwakange kwakasiyana chaizvo nemaitiro emazuva ano.Panguva iyoyo, maitiro ekuvhiya akanga asina kufambira mberi, uye pakanga pane zvishoma zvingasarudzwa zvekugadzirisa midziyo yemukati.
Nzira dzisiri dzekuvhiya: Nzira dzekurapa dzisina-kuvhiya dzaiwanzoshandiswa kune intertrochanteric fractures.Izvi zvaisanganisira kuzorora pamubhedha, kudhonza, uye kusamira nepurasita kana kuti simbi.Chinangwa chaive chekubvumira kuputsika kupora kwechisikigo, nekufamba kudiki uye kutakura uremu panhengo yakabatwa.Zvisinei, nzira idzi dzaiwanzokonzera kusafamba kwenguva refu uye njodzi dzakawedzerwa dzezvinetso zvakadai sekuparara kwemhasuru, kuoma kwemajoini, uye maronda ekumanikidzika.
Nzira dzekuvhiya: Kupindira kwekuvhiya kwe intertrochanteric fractures were zvishoma uye kazhinji zvakachengeterwa nyaya dzine kutama kwakanyanya kana kutsemuka kwakavhurika.Nzira dzekuvhiya dzaishandiswa kare ikako dzaive shoma uye dzaiwanzobatanidza kudzikisira kwakavhurika uye kugadzirisa kwemukati uchishandisa waya, screws, kana ndiro.Zvisinei, zvinhu zviripo uye zvishandiso zvakanga zvisingavimbiki kana kuti zvinobudirira sezvipfeko zvemazuva ano, zvichiita kuti mazinga akakwirira ekukundikana, kutapukirwa, uye kusabatanidzwa.
Kakawanda, kurapwa kwe intertrochanteric fractures zana remakore apfuura kwakanga kusina kushanda uye kwakabatana nenjodzi dzakakwirira uye zvinetso zvichienzaniswa nemaitiro emazuva ano.Iko kufambira mberi kwemaitiro ekuvhiya, zvigadziriso zvemukati, uye mapuroteni ekugadzirisa zvakavandudza zvakanyanya mhedzisiro yevarwere vane intertrochanteric fractures mumakore achangopfuura.
Intramedullary nailing inosanganisira kuiswa kwesimbi yesimbi mu medullary canal yefemur kudzikamisa kuputsika.Iyi nzira yave nemukurumbira mumakore achangopfuura nekuda kwehunhu hwayo hushoma uye huwandu hwakaderera hwekuoma kana uchienzaniswa neORIF.Intramedullary nailing inosanganiswa nekupfupika kwekugara muchipatara, kukurumidza kupora nguva, uye yakaderera mitengo yekusabatana uye kutadza kuisirwa.
Zvakanakira intramedullary chipikiri kuisirwa kune intertrochanteric fractures yefemur:
Kugadzikana: Intramedullary misumari inopa kugadzikana kwakanakisisa kune pfupa rakatyoka, zvichibvumira kutanga kuunganidza uye kutakura uremu.Izvi zvinogona kukonzera kupora nekukurumidza uye kuderedzwa kwekugara muchipatara.
Kuchengetedzwa kweropa: Kuenzaniswa nedzimwe nzira dzekuvhiya, intramedullary misumari inochengetedza ropa kune pfupa rakaputsika, kuderedza ngozi yeavascular necrosis uye isina kubatana.
Kukuvadzwa kwematishu akapfava: Kuvhiyiwa kunosanganisira kuchekwa kudiki, izvo zvinokonzeresa kukuvara kudiki kwetishu.Izvi zvinogona kutungamirira kukurwadziwa kwepashure uye kukurumidza kupora.
Kudzikira kwenjodzi yekutapukirwa: Iyo nzira yakavharwa inoshandiswa mu intramedullary mbambo yekudyara inoderedza njodzi yekutapukirwa kana ichienzaniswa nekuvhiya pachena.
Zviri nani kurongeka uye kuderedza: Intramedullary misumari inobvumira kudzora zviri nani uye kurongeka kwepfupa rakaputsika, zvichiita kuti zvive nani migumisiro yekushanda.
Hemiarthroplasty inosanganisira kuchinjwa kwemusoro wemukadzi neprosthetic implant.Iyi nzira inowanzochengeterwa varwere vakwegura vane osteoporosis yakaoma kana avo vane pre-existing hip arthritis.Hemiarthroplasty yakabatana nenjodzi yakakura yezvinetso, kusanganisira kubviswa, kutapukirwa, uye kutadza kwekudyara.
THA inosanganisira kuchinjwa kwejojo rehudyu rose neprosthetic implant.Iyi nzira inowanzochengeterwa varwere vadiki vane mapfupa akanaka uye vasina pre-existing hip arthritis.THA inosanganiswa nenguva yakareba yekudzikinura uye njodzi yepamusoro yezvinetso zvichienzaniswa nedzimwe nzira dzokurapa.
Kuvhiya kwese kwehudyu kutsiva kunowanzo kukurudzirwa kuvarwere vane hip arthritis yakanyanya, kuputika kwechiuno kusingakwanisi kurapwa nehemiarthroplasty, kana mamwe mamiriro anokonzera kurwadziwa kukuru nekuremara.
Hemiarthroplasty ine mukana wekuve isinganyanyi kupindira pane yakazara hudyu kutsiva kuvhiyiwa, izvo zvinoreva kuti kazhinji inosanganisira kupfupika muchipatara kugara uye nekukurumidza kupora nguva.Zvisinei, zvingave zvisina kubudirira mukurapa mamwe marudzi ehudyu, uye kune ngozi yokuti chikamu chakasara chejojo yehudyu chinogona kuparara nekufamba kwenguva.
Kuvhiyiwa kwehudyu kutsiva, kune rumwe rutivi, inzira yakazara iyo inogona kupa zororo rinogara kwenguva refu kubva kumarwadzo ehudyu nekuvandudza basa rose rehudyu.Zvisinei, inzira inoparadza iyo inogona kuda kugara muchipatara kwenguva refu uye nguva yakareba yekudzorera.Panewo njodzi yezvinetso zvakadai sehutachiona, kuvhara ropa, uye kuparara kwejojo rehudyu.
Mukupedzisa, kurapwa kwe intertrochanteric fractures ye femur yakashanduka zvakanyanya mumakore, nekufambira mberi kwemaitiro ekuvhiya uye magadzirirwo ekudyara anotungamirira kune zvakagadziriswa.Nzira dzemazuva ano dzekurapa, dzakadai se intramedullary nailing, dzinopa sarudzo shoma shoma ine yakaderera complication rates.Sarudzo yenzira yekurapa inofanirwa kuve yakasarudzika zvichienderana nezera remurwere, comorbidities, uye fracture maitiro.
Nguva yekutumira: Oct-13-2023