Izikulufu zokuminyanisa ezifakwe amathini seziphenduke enye yemishini eguquguqukayo nebalulekile yokulungisa ekuhlinzweni kwamathambo kwanamuhla. Idizayinelwe ngomsele omaphakathi ongenalutho ovumela ukufakwa phezu kwentambo yokuqondisa, lezi zikulufu zinika amandla ukubekwa okunembayo, ukulungisa okuzinzile, nezindlela zokuhlinza ezihlasela kancane.
Ikhono labo lokuletha ukucindezelwa okulawulwayo kuyo yonke imigqa yokuphuka kubenza balungele ukuphatha ukuphuka ezindaweni ezicindezelekile noma ezithambile, ikakhulukazi inqulu, iqakala, namathambo amancane esandla nonyawo. Lesi sihloko sibuyekeza izinhlelo zokusebenza ezibalulekile zomtholampilo zezikulufu zokucindezelwa ekheniwe futhi igqamisa ukuthi zithuthukisa kanjani imiphumela yokuhlinzwa kuzo zonke izifunda ze-anatomical.
Ukuhlinzwa Kwe-Hip: Ukulungiswa Okuzinzile Kwe-Femoral Neck Fractures
I-Femoral neck fractures-evamile phakathi kwabantu abadala asebekhulile kanye neziguli ezihlukumezekile ezinamandla-zidinga ukulungiswa kwangaphakathi okuthembekile ukubuyisela ukuhamba nokuvimbela izinkinga ezifana ne-nonunion noma i-avascular necrosis.Izikulufu zokucindezelwa ezikheniweziyisixazululo esijwayelekile ngenxa yokunemba kwazo okuphezulu kanye nendlela yokufaka engangeneleli kancane.
Isibonelo Somtholampilo:
Isiguli esineminyaka engu-65 ubudala esaphuka intamo ye-femoral engasuswanga endaweni siye sancishiswa futhi salungiswa ngaphakathi ngezikulufu ezintathu ezihambisanayo zokuminyanisa ze-cannulated. Kuqondiswa izintambo ze-K, izikulufu zafakwa ekucushweni kukanxantathu ohlanekezelwe ukuze kukhuliswe ukuzinza kwe-biomechanical. Ama-X-ray angemuva kokuhlinzwa abonise ukuqondana okuhle kakhulu nokucindezelwa okuqhubekayo. Emavikini angu-12, isiguli sabonisa ikhono eligcwele lokuthwala isisindo nge-radiographic union eqinile.
Kungani Basebenza Kahle Nge-Hip Fractures:
Ukubekwa okusizwa nge-Guidewire kuqinisekisa i-screw trajectory enembile.
Ukucindezelwa okulawulwayo kuthuthukisa ukuzinza okuyinhloko nokuphulukiswa kwamathambo.
Indlela yokuhlasela kancane inciphisa ukuhlukumezeka kwezicubu ezithambile futhi isheshise ukululama.
Ukulungiselelwa kwezikulufu eziningi kukhulisa ukujikeleza nokusimama kwe-axial.
Ukuhlinzwa Kwe-Ankle: Ukulungiswa Kwe-Malleolar ne-Talar Fractures
I-anatomy eyinkimbinkimbi yelunga le-ankle kanye nezidingo ezithwala isisindo zidinga izimila zokulungisa ezihlinzeka ngokucindezelwa okuqinile nokugcina ukuqondana ngaphansi kwengcindezi yemishini. Izikulufu zokucindezelwa ngamakhenithi zisetshenziswa kakhulu ekwephukeni kwe-malleolus emaphakathi, ukuphuka kwe-malleolus avulsion lateral, kanye nokulimala komzimba we-talar noma intamo.
Isibonelo Somtholampilo:
Umsubathi oneminyaka engu-30 ubudala uphuke i-malleolus phakathi nokulimala kwezemidlalo. Odokotela abahlinzayo banciphise ukuphuka futhi bafaka izikulufu ze-cannulated ezimbili ezinentambo kancane ukuze bathole ukucindezela kusayithi lokuphuka. Indlela eqondisiwe yanciphisa ukuphazamiseka kwezicubu ezithambile—okubaluleke kakhulu eqakaleni, lapho izakhiwo ze-neurovascular ziminyene. Isiguli sibuyele ekuqeqesheni phakathi nezinyanga ezine, sisekelwa ukulungiswa okuzinzile kanye nokugqugquzela kusenesikhathi.
Izinzuzo ku-Ankle Region:
Ilungele izingcezu ezincane, ezitshekile, noma okunzima ukuzifinyelela.
Ukucindezela kukhuthaza ukuhlanganiswa okusheshayo kwethambo elikhansela.
Usayizi oncishisiwe wokusika wehlisa ubungozi bezinkinga zangemva kokuhlinzwa.
Ihambisana nezinye izindlela zokulungisa (isb, amapuleti-screw constructs) zokuphuka okuyinkimbinkimbi.
Ukulungiswa Kwethambo Elincane: Ukuphuka Kwesandla, Isandla, Nezinyawo
Amathambo amancane adinga i-hardware ethambile enikeza ukuzinza ngaphandle kwenqwaba eyeqile. Izikulufu zokucindezelwa ze-cannulated—ezivamise ukutholakala ngobubanzi obuncane—zilungele ukuphuka kwe-scaphoid, ukuphuka kwe-metacarpal, nokulimala kwe-phalanx eseduze, kanye nokuphuka onyaweni, njenge-navicular ne-five metatarsal.
Isibonelo Somtholampilo:
Isiguli esineminyaka engu-22 esiqhekeze ukhalo lwe-scaphoid salungiswa nge-percutaneous sisebenzisa isikulufu sokuminyanisa se-cannulated esingenakhanda. Isikulufu silethe ukucindezelwa okuqhubekayo kuyo yonke indawo, okuvumela ukunyakaza kwesandla kusenesikhathi. Emasontweni ayisishiyagalombili, ukuhlolwa kwe-CT kwaqinisekisa ukuhlangana kwamathambo, futhi isiguli saphinde saqala ukwenza izinto ezivamile ngaphandle kokuqina.
Kungani Basebenza Kahle Emathanjeni Amancane:
Imiklamo yesikulufu engenakhanda isusa ukuvelela kwehadiwe nokucasuka.
Ukubekwa okunembayo kuvikela imisipha ezungezile nezindawo ezihlangene.
Ukucindezelwa okuqhubekayo kuthuthukisa izinga lokuhlangana emathanjeni anegazi eliphansi (isb, i-scaphoid).
Izindlela zokuhlasela kancane zinciphisa isibazi nesikhathi sokululama.
Izinzuzo Zobuchwepheshe Ukushayela Imiphumela Engcono Yokuhlinza
Kuzo zonke izifunda ezihlukene ze-anatomical, izikulufu zokucindezelwa ekheniwe zabelana ngezinzuzo ezimbalwa zobuchwepheshe ezizenza zikhethwe odokotela abahlinzayo bamathambo:
Ukunemba Okuphezulu Kokubekwa:
Ukufakwa kwe-Guidewire-based kunciphisa ubungozi bokungaqondani kahle.
Ukucindezelwa Okuqhubekayo:
Amadizayini anentambo engaphelele noma angenakhanda aletha ukucindezelwa kwe-interfragmentary okulawulwayo okubalulekile ekwelapheni okuzinzile.
I-Versatility in Approach:
Ifanele kokubili ukuhlinzwa okuvulekile kanye ne-percutaneous okuhlasela kancane.
Ukuhlukumezeka Kokuhlinzwa Okuncishisiwe:
Ukusikwa okuncane kuholela ezikhathini ezifushane zokusebenza kanye nokuvuselela ngokushesha.
Amandla e-Biomechanical:
Idizayinelwe ukumelana nemithwalo ejikelezayo ne-axial, ngisho nasezindaweni ezinesisindo esinjenge-hip neqakala.
Isiphetho:
Izikulufu zokuminyanisa ezenziwe ngamakhenethi zidlala indima ebalulekile ekulawuleni ukuphuka kwamathambo, zinikeza ukunemba, ukuzinza, kanye nezinzuzo ezihlasela kancane kuzo zonke izimo zomtholampilo. Kungakhathaliseki ukuthi isetshenziselwa ukuphuka kwentamo yesifazane, ukulimala kwe-malleolar, noma ukulungiswa kwamathambo amancane esandleni nasenyaweni, lezi zikulufi zithuthukisa ngokungaguquki imiphumela yesiguli namazinga okuphulukiswa. Ukuzivumelanisa nezimo ezidingweni ezihlukahlukene ze-anatomical namaphethini okuphuka kuwenza abe ingxenye ebalulekile yomkhuba wesimanje wamathambo.
Isikhathi sokuthumela: Nov-27-2025