PFNA Internal fixation txheej txheem
PFNA (Proximal Femoral Nail Antirotation), proximal femoral anti-rotation intramedullary ntsia thawv.Nws yog haum rau ntau hom femoral intertrochanteric fractures;subtrochanteric puas;femoral caj dab puag pob txha;femoral caj dab tawg ua ke nrog femoral ncej tawg;femoral intertrochanteric fractures ua ke nrog femoral ncej tawg.
Main ntsia thawv tsim nta thiab qhov zoo
(1) Tus qauv ntsia hlau tseem ceeb tau pom los ntawm ntau dua 200,000 tus neeg mob ntawm PFNA, thiab nws tau ua tiav qhov kev sib tw zoo tshaj plaws nrog lub cev nqaij daim tawv ntawm medullary kwj dej;
(2) 6-degree abduction lub kaum sab xis ntawm lub ntsiab ntsia hlau kom yooj yim ntxig los ntawm apex ntawm ntau dua trochanter;
(3) Hollow ntsia thawv, yooj yim rau ntxig;
(4) Lub distal kawg ntawm tus ntsia thawv tseem ceeb muaj qee qhov elasticity, uas yooj yim rau ntxig rau lub ntsiab ntsia hlau thiab tsis txhob muaj kev ntxhov siab.
Spiral hniav:
(1) Ib qho kev txhim kho sab hauv ib txhij ua tiav los tiv thaiv kev sib hloov thiab angular stabilization;
(2) Cov hniav muaj thaj tsam loj thiab maj mam nce core txoj kab uas hla.Los ntawm kev tsav tsheb hauv thiab compressing cov pob txha tshem tawm, lub zog anchoring ntawm helical hniav tuaj yeem txhim kho, uas yog tshwj xeeb tshaj yog rau cov neeg mob uas muaj pob txha tawg;
(3) Lub helical hniav yog nruj nruj nrog cov pob txha, uas txhim khu kev ruaj ntseg thiab tiv thaiv kev sib hloov.Qhov kawg ntawm pob txha muaj zog muaj peev xwm ua rau tawg thiab varus deformity tom qab nqus.
Cov ntsiab lus hauv qab no yuav tsum tau them sai sai rau hauv kev kho mob ntawm femoral fractures nrogPFNA sab hauv fixation:
(1) Cov neeg laus feem ntau raug kev txom nyem los ntawm cov kab mob kho mob yooj yim thiab tsis zoo rau kev phais.Ua ntej kev phais, tus mob ntawm tus neeg mob yuav tsum tau soj ntsuam tag nrho.Yog tias tus neeg mob muaj peev xwm zam tau qhov kev phais, qhov kev phais yuav tsum tau ua kom ntxov li sai tau, thiab cov ceg uas cuam tshuam yuav tsum tau ua haujlwm ntxov tom qab kev phais.Txhawm rau tiv thaiv lossis txo qhov tshwm sim ntawm ntau yam teeb meem;
(2) Qhov dav ntawm medullary kab noj hniav yuav tsum tau ntsuas ua ntej ua ntej ua haujlwm.Qhov txoj kab uas hla ntawm tus ntsia thawv tseem ceeb yog 1-2 hli me dua li qhov tseeb medullary kab noj hniav, thiab nws tsis haum rau kev siv nruj heev kom tsis txhob muaj qhov tshwm sim ntawm cov teeb meem xws li distal femur tawg;
(3) Tus neeg mob yog supine, qhov cuam tshuam ntawm ceg ceg yog ncaj, thiab kev sib hloov sab hauv yog 15 °, uas yog yooj yim rau kev ntxig rau ntawm daim ntawv qhia koob thiab lub ntsiab ntsia hlau.Txaus traction thiab kaw txo cov pob txha tawg nyob rau hauv fluoroscopy yog cov yuam sij rau kev phais kom tiav;
(4) Kev ua haujlwm tsis raug ntawm lub ntsiab lus nkag ntawm lub ntsiab ntsia hlau tseem ceeb yuav ua rau PFNA lub ntsiab ntsia hlau raug thaiv hauv cov kab noj hniav los yog txoj hauj lwm ntawm cov hniav ntawm cov hniav yog eccentric, uas yuav ua rau qhov sib txawv ntawm qhov txo qis lossis kev ntxhov siab shearing. ntawm lub caj dab femoral thiab femoral lub taub hau los ntawm cov kauv hniav tom qab kev phais, txo cov nyhuv ntawm kev phais;
(5) Lub C-arm X-ray tshuab yuav tsum nco ntsoov xyuam xim rau qhov tob thiab eccentricity ntawm cov ntsia hlau hniav qhia koob thaum ntsia hlau rau hauv, thiab qhov tob ntawm cov ntsia hlau hniav taub hau yuav tsum yog 5-10 hli hauv qab ntawm pob txha mos saum npoo. femoral taub hau;
(6) Rau kev sib xyaw subtrochanteric fractures los yog ntev oblique fracture fragments, nws raug nquahu kom siv PFNA txuas ntxiv, thiab qhov xav tau qhib qhov txo qis yog nyob ntawm qhov txo qis ntawm cov pob txha thiab kev ruaj ntseg tom qab txo.Yog tias tsim nyog, siv cov hlua steel siv los khi cov pob txha tawg, tab sis nws yuav cuam tshuam rau kev kho pob txha thiab yuav tsum zam;
(7) Rau kev sib cais cov pob txha nyob rau sab saum toj ntawm cov trochanter ntau dua, kev ua haujlwm yuav tsum maj mam li ua tau kom tsis txhob muaj kev sib cais ntxiv ntawm cov pob txha tawg.
Qhov zoo thiab qhov txwv ntawm PFNA
Raws li hom tshiab ntawmintramedullary fixation ntaus ntawv, PFNA tuaj yeem hloov cov khoom thauj los ntawm extrusion, kom sab hauv thiab sab nraud ntawm lub femur tuaj yeem dais cov kev ntxhov siab, yog li ua tiav lub hom phiaj ntawm kev txhim kho kev ruaj ntseg thiab kev ua tau zoo ntawm kev txhim kho sab hauv ntawm cov pob txha.Cov nyhuv ruaj khov yog qhov zoo thiab lwm yam.
Daim ntawv thov ntawm PFNA kuj muaj qee qhov kev txwv, xws li nyuaj rau kev tso cov ntsia hlau ntsia hlau distal, muaj kev pheej hmoo ntawm kev puas tsuaj nyob ib puag ncig cov ntsia hlau xauv, coxa varus deformity, thiab mob hauv thaj tsam sab hauv ncej puab los ntawm kev khaus ntawm iliotibial band.Osteoporosis, yog li ntawdintramedullary fixationfeem ntau muaj peev xwm ntawm fixation tsis ua hauj lwm thiab tawg nonunion.
Yog li ntawd, rau cov neeg laus cov neeg mob uas tsis ruaj tsis khov intertrochanteric fractures nrog hnyav osteoporosis, thaum ntxov luj bearing yog kiag li tsis tso cai tom qab noj PFNA.
Post lub sij hawm: Sep-30-2022
