Lub xauv phaj yog ib qho cuab yeej kho pob txha uas muaj lub qhov taub.Thaum cov ntsia hlau nrog lub taub hau threaded yog screwed rau hauv lub qhov, lub phaj ua ib tug (screw) lub kaum sab xis fixation ntaus ntawv.Xauv (lub kaum sab xis) steel daim hlau tuaj yeem muaj ob qho tib si xauv thiab tsis-ntsuas ntsia hlau qhov sib txawv rau cov ntsia hlau sib txawv (tseem hu ua cov hlau sib xyaw ua ke).
1. Keeb kwm thiab kev loj hlob
Xauv daim hlau thawj zaug tau tshaj tawm kwv yees li 20 xyoo dhau los rau kev siv hauv kev phais txha caj qaum thiab maxillofacial.Nyob rau xyoo 1980s thiab 1990s lig, kev sim kev tshawb fawb ntawm ntau hom kev kho cov khoom siv sab hauv tau qhia cov ntawv xauv rau hauv kev kho cov pob txha.Txoj kev ruaj ntseg fixation no yog thawj zaug tsim los kom tsis txhob muaj cov ntaub so ntswg ntau.
Ntau yam tau txhawb nqa kev kho mob siv cov phaj no, suav nrog:
Qhov xwm txheej ntawm comminuted fractures tseem nce ntxiv raws li kev ciaj sia nyob hauv cov neeg mob uas muaj hluav taws xob raug mob thiab cov neeg laus cov neeg mob pob txha nce ntxiv hauv Western Europe thiab North America.
Cov kws kho mob thiab cov neeg mob tsis txaus siab rau cov txiaj ntsig ntawm kev kho mob rau qee qhov periarticular fractures.
Lwm yam kev txhawb nqa uas tsis yog kev kho mob yuav suav nrog: kev lag luam kev txhawb nqa cov thev naus laus zis tshiab thiab kev lag luam tshiab;maj mam nrov ntawm minimally invasive phais, thiab lwm yam.
2. Cov yam ntxwv thiab cov qauv ruaj khov
Qhov sib txawv biomechanical tseem ceeb ntawm kev xauv cov phaj thiab cov phaj ib txwm yog tias tom kawg tso siab rau kev sib txhuam ntawm cov pob txha-phaj cuam tshuam los ua kom tiav cov pob txha ntawm cov phaj.
Cov teeb meem biomechanical ntawm cov ntawv hlau ib txwm muaj: compress lub periosteum thiab cuam tshuam cov ntshav mus rau qhov kawg ntawm pob txha.Yog li ntawd, cov txheej txheem ruaj khov kho cov phaj osteosynthesis (xws li interfragmentary compression thiab lag screws) muaj qhov cuam tshuam loj heev, suav nrog kev kis kab mob, phaj tawg, ncua kev sib koom ua ke, thiab nonunion.
Raws li lub voj voog axial load nce, cov ntsia hlau pib xoob thiab ua rau kev sib txhuam kom txo qis, nws thiaj li ua rau lub phaj loosen.Yog hais tias lub phaj loosens ua ntej lub pob txha kho, qhov tawg ntawm qhov kawg yuav tsis ruaj khov thiab thaum kawg lub phaj yuav tawg.Qhov nyuaj dua nws yog kom tau txais thiab tuav cov ntsia hlau ruaj khov (xws li cov pob txha metaphysis thiab osteoporotic kawg), qhov nyuaj dua nws yog los tswj kev ruaj ntseg ntawm cov pob txha tawg.
Txoj cai ruaj khov:
Xauv daim hlau tsis cia siab rau kev sib txhuam ntawm cov pob txha-phaj interface.Kev ruaj ntseg yog tswj los ntawm angularly ruaj khov interface ntawm cov ntsia hlau thiab steel phaj.Vim hais tias qhov no hom ntawm cov xauv sab hauv fixator muaj qhov ruaj khov, lub zog rub tawm ntawm lub taub hau ntsia hlau yog siab dua li cov ntsia hlau zoo tib yam.Tshwj tsis yog tias tag nrho cov ntsia hlau nyob ib puag ncig raug rub tawm lossis tawg, nws yog qhov nyuaj rau cov ntsia hlau rub tawm lossis tawg ib leeg.
3. Cov lus qhia
Feem ntau cov phais kho pob txha tsis tas yuav tsum tau xauv phaj fixation.Tsuav tau ua raws li cov hauv paus ntsiab lus ntawm kev phais orthopedic, feem ntau cov pob txha tuaj yeem kho tau nrog cov phiaj los yog cov rau tes intramedullary.
Txawm li cas los xij, muaj tseeb qee qhov tshwj xeeb ntawm cov pob txha tawg uas ua rau poob ntawm kev txo qis, phaj lossis ntsia hlau tawg, thiab cov pob txha txuas ntxiv.Cov hom no, feem ntau hu ua "tsis daws teeb meem" lossis "teeb meem" pob txha, suav nrog cov pob txha pob txha pob txha, pob txha luv luv periarticular, thiab pob txha pob txha.Cov pob txha zoo li no yog qhov qhia txog kev xauv daim hlau.
4. Daim ntawv thov
Ntau tus neeg tsim khoom tseem tab tom muab cov phiaj xwm anatomical nrog lub qhov xauv qhov.Piv txwv li, preshaped anatomic daim hlau rau proximal thiab distal femurs, proximal thiab distal tibias, proximal thiab distal humerus, thiab calcaneus.Kev tsim ntawm cov phaj steel zoo heev txo qhov kev sib cuag ntawm cov phaj steel thiab cov pob txha nyob rau hauv ntau zaus, yog li khaws cia cov ntshav periosteal thiab perfusion ntawm qhov kawg ntawm pob txha.
LCP (locking compression phaj)
Lub tshiab xauv compression phaj ua ke ob qho tib si sib txawv hauv kev txhim kho thev naus laus zis rau hauv ib qho kev cog qoob loo.
LCP tuaj yeem siv los ua cov phaj compression, lub xauv sab hauv, lossis ob qho sib xyaw ua ke
Minimally invasive:
Ntau tus lej ntawm cov ntawv xauv xauv muaj cov tes tuav sab nraud, cov tuav, thiab cov qauv blunt uas tso cai rau cov kws kho mob tso cov phaj submuscularly lossis subcutaneously rau lub hom phiaj me me.
Yog tias koj xav paub txog peb cov khoom, thov hu rau:
Yog
Whatsapp / Tel: +86 15682071283
Post lub sij hawm: Sep-25-2023
