Φ5.0 Uthotho lwangaphandle lweFixation Fixation – Isakhelo seradiyasi yeDistal

I-distal radius fractures (DRFs) iyenzeka ngaphakathi kwe-3 cm yecala elikude le-radius, eyona nto ixhaphakileyo kumalungu aphezulu phakathi kwabasetyhini abadala kunye namadoda aselula. Uphononongo luchaze ukuba i-DRFs yenza i-17% yazo zonke iifractures kunye ne-75% ye-forearm fractures.

Iziphumo ezanelisayo azinakufunyanwa ngokunciphisa okukhohlisayo kunye nokulungiswa kwe-plaster. Ezi fractures zinokutshintshela ngokulula kwisikhundla emva kokulawulwa kolondolozo, kwaye iingxaki, ezifana nokuxhatshazwa kwamathambo kunye nokungazinzi kwesandla, kungenzeka kwisigaba sokugqibela. Utyando lwenziwa ukunyanga i-distal radius fractures ukwenzela ukuba izigulane zikwazi ukwenza inani elaneleyo lokuzivocavoca okungenabuhlungu ukubuyisela umsebenzi oqhelekileyo ngelixa kuncitshiswa umngcipheko wokuguqulwa kwenguqu okanye ukukhubazeka.

Ulawulo lwe-DRFs kwizigulana ezineminyaka eyi-60 nangaphezulu lwenziwa kusetyenziswa ezi ndlela zintlanu zilandelayo: inkqubo yokutshixa i-volar, i-non-bridging fixation yangaphandle, i-bridging fixation yangaphandle, i-percutaneous Kirschner wire fixation, kunye ne-plaster fixation.

Izigulane ezenza utyando lwe-DRF ngokunciphisa okuvulekileyo kunye nokulungiswa kwangaphakathi kunomngcipheko ophezulu wokosuleleka kwenxeba kunye ne-tendonitis.

Izilungisi zangaphandle zohlulwe zibe zezi ntlobo zimbini zilandelayo: i-cross-joint kunye ne-non-bridging. I-fixator yangaphandle ye-cross-articular inqanda ukuhamba ngokukhululekile kwesandla ngenxa yokucwangciswa kwayo. I-nonbridging fixator yangaphandle isetyenziswa ngokubanzi kuba ivumela umsebenzi odibeneyo olinganiselweyo. Izixhobo ezinjalo zinokuququzelela ukunciphisa ukuphuka ngokulungisa iziqhekeza eziqhekezayo ngokuthe ngqo; zivumela ulawulo olulula lokulimala kwezicubu ezithambileyo kwaye azithinteli ukunyakaza kwesandla sendalo ngexesha lonyango. Ke ngoko, i-nonbridging fixators yangaphandle iye yacetyiswa ngokubanzi kunyango lwe-DRF. Kwiminyaka embalwa edlulileyo, ukusetyenziswa kwezixhobo zendabuko zangaphandle (i-titanium alloys) kuye kwafumana ukuthandwa, ngenxa ye-biocompatibility egqwesileyo, amandla aphezulu omatshini kunye nokumelana nokubola. Nangona kunjalo, izilungiso zangaphandle zendabuko ezenziwe ngetsimbi okanye i-titanium zingabangela ubugcisa obunzima kwi-computed tomography (CT) scans, ekhokelela ekubeni abaphandi bafune izinto ezintsha zokulungiswa kwangaphandle.

Ukulungiswa kwangaphakathi okusekelwe kwi-polyetheretherketone (PEEK) ifundwe kwaye isetyenziswe ngaphezu kweminyaka eyi-10. Isixhobo se-PEEK sineenzuzo ezilandelayo kwizinto ezisetyenziselwa ukulungiswa kwe-orthopedic yendabuko: akukho mayeza ensimbi, i-radiopacity, ukuphazamiseka okuphantsi kwe-imaging resonance magnetic (MRI), ukususwa kokufakelwa lula, ukuphepha "i-welding ebandayo" into, kunye neempawu ezingcono zomatshini. Umzekelo, inamandla okuqina alungileyo, amandla okugoba, kunye namandla empembelelo.

Olunye uphando lubonise ukuba izilungisi ze-PEEK zinamandla angcono, ukuqina, kunye nokuqina kunezixhobo zokulungisa isinyithi, kwaye banamandla angcono okukhathala13. Nangona i-modulus e-elastic yezinto ze-PEEK yi-3.0-4.0 GPa, inokuqiniswa nge-carbon fiber, kwaye i-modulus yayo e-elastic inokusondeza kwi-cortical bone (18 GPa) okanye ifikelele kwixabiso le-titanium alloy (110 GPa) ngokuguqula ubude kunye nolwalathiso lwe-carbon fiber. Ke ngoko, iipropathi zoomatshini zePEEK zisondele kwezo zethambo. Kule mihla, i-PEEK-based fixator yangaphandle yenzelwe kwaye isetyenziswe eklinikhi.