I-Elastic Intramedullary Nail— Yenzelwe Abantwana: Uxinzelelo Oluncinci Lokubuyisela Impilo Ngokukhawuleza
Yintoni iIsipikili se-Elastic? — I-Scaffold Yangaphakathi Ethambileyo
I-Elastic Intramedullary Nail(ESIN) sisithambisi sesinyithi esithambileyo esilungiselelwe ngokukodwa ukwaphuka kwamathambo amade ebantwaneni. Senziwe nge-titanium alloy, sisikhonkwane esincinci esinobubanzi obuqala kwi-1.5 mm ukuya kwi-4.0 mm. Ubungakanani bukhethwa ngokobukhulu bamathambo omntwana. Ngokugoba kwangaphambili kunye nokuthamba, sifakwa kwindawo ephakathi.
Inkqubo yotyando ibeka izikhonkwane ezibini ezithambileyo ngaphakathi kwendawo engenanto yethambo ukuze kuxhaswe iindawo eziqhekekileyo ngaphakathi. Akukho mfuneko yokuvula indawo eqhekekileyo okanye ukufaka iipleyiti zamathambo.
Kutheni ibizwa ngokuba “sisipho sabantwana”? – Yenzelwe ngokukodwa abantwana
Abantwana abangobantu abadala abancinci. Unyango lwamathambo abantwana alunakulandela nje iindlela ezisetyenziswa kubantu abadala. I-intramedullary nail elastic yenzelwe ngokuchanekileyo ngokusekelwe kwiimpawu ezikhethekileyo zamathambo abantwana.
Okokuqala, Musa ukonakalisa i-epiphysis (ipleyiti yokukhula).
Zombini iziphelo zethambo elide lomntwana zine-epiphysis, "eyinjini" yokukhula kwamathambo. Ukuba i-epiphysis yonakele, inokubangela ubude okanye ukukhubazeka kwamalungu angalinganiyo. Indawo yokufaka yethambooi-rhetopedicei-lasticniintlunguikude kakhulu ne-epiphysis (umzekelo, indawo yokufaka kwisiphelo esikude se-femur ikhethwe ngaphezulu kwe-metaphysis ye-epiphysis), kwaye uzipho aluyi kudlula kwi-epiphysis, nto leyo ethintela ngokupheleleyo ipleyiti yokukhula. Le yinto ebangela ukubaamathamboiipleyitikunye nabantu abadalaiinzipho ze-intramedullaryayinakukwazi ukufezekisa.
Okwesibini, Akukho kususwa kwe-periosteum, akukho kuphazamiseka kokunikezelwa kwegazi.
Unyango lokwaphuka kwamathambo luxhomekeke kwi-periosteum kunye nokuhanjiswa kwegazi okujikelezileyo. Utyando oluvulekileyo lwendabuko lufuna ukunqumla ulusu kunye nemisipha kwindawo yokuqhekeka kwamathambo, ukususa i-periosteum, uze ufake ipleyiti. Oku kuya kuphazamisa ukuhanjiswa kwegazi ekupheleni kokuqhekeka kwamathambo.ei-lasticnulwandleoi-rhetopedicAyivuli indawo apho kwaqhekeka khona. Ifakwa ngenxeba elincinci lesikhumba ukusuka kwindawo ekude. I-periosteum ayichaphazelekanga kwaye igazi eliphumayo ekupheleni kwaqhekeka alichaphazeleki - isantya sokuphiliswa sikhawuleza ngokwendalo.
Okwesithathu, ukulungiswa kwe-elastic kukhuthaza ukuphiliswa.
Xa kunyangwa ukwaphuka kwamathambo kwabantu abadala, kulandelwa "ukulungiswa okuqinileyo", okujoliswe ekugcineni iziphelo zamathambo zingashukumi. Nangona kunjalo, amathambo abantwana anamandla okuphilisa, kwaye "intshukumo encinci ye-elastic" efanelekileyo inokukhuthaza ukukhula kwe-bone callus.ititaniumuzipho olulastikiukubonelela ngolu hlobo "lokuqiniswa kwe-elastic" - kukho intshukumo encinci kwiziphelo zokuqhekeka, kodwa akukho kushukuma okwenzekayo, kwaye i-bone callus ikhula ngokukhawuleza nangokufanelekileyo.
Okwesine, Ukusikwa okuncinci, isilonda esincinci.
Utyando lwendabuko lwepleyiti yentsimbi lufuna ukunqunyulwa kweesentimitha ezisi-8 ukuya kwezili-15, nto leyo eshiya isilonda eside emva kokuphola. Uzipho oluthambileyo olungaphakathi kwe-medullary lufuna ukunqunyulwa okuncinci okubini kuphela okuziisentimitha ezi-1.5 ukuya kwezi-2 (enye okanye ezimbini kuxhomekeke kwindawo eqhekeziweyo kuyo), kwaye emva kokuphola, akukho mkhondo ushiyekileyo.
Okwesihlanu, ixesha lokulaliswa esibhedlele lifutshane kwaye ukuchacha kuyakhawuleza.
Uzipho oluthambileyo olungaphakathi kwe-medullary lubonelela ngozinzo oluhle emva kotyando, nto leyo evumela umntwana ukuba aqale ukuhambahamba kwangethuba. Abantwana abane-femoral shaft fractures banokunxiba i-brace baze bazimele kwiintsuku ezi-3 ukuya kwezi-5 emva kotyando, bahambe ngeentonga kwiiveki ezi-3 ukuya kwezi-4, baze babuyele kwimisebenzi eqhelekileyo kwiinyanga ezi-2 ukuya kwezi-3. Xa kuthelekiswa nonyango olugcina ixesha elide (ukulala phantsi iiveki ezi-6 ukuya kwezi-8) okanye i-plate fixation (efuna ukhuseleko olude emva kotyando), ixesha lokuchacha lifinyezwa kakhulu.
Ziziphi imibuzo ebalulekileyo abazali abaxhalabeleyo ngayo?
Ngaba uzipho oluthambileyo olungaphakathi kwe-medullary luya kuhlala emzimbeni ngonaphakade?
Hayi. Kufuneka isuswe emva kokuba ukwaphuka kupholile. Ngokwesiqhelo, utyando lokususa lwenziwa kwiinyanga ezi-6 ukuya kwezili-12 emva kotyando (okuqinisekiswa yi-X-ray ukuba ukwaphuka kupholile kakuhle).
Ingaba olu tyando luyingozi? Ngaba luya konakalisa imithambo-luvo kunye nemithambo yegazi?
Utyando lwezinzipho olusebenzisa i-intramedullary luyindlela evuthiweyo yonyango lwamathambo ebantwaneni, kwaye luneengozi ezincinci kakhulu. Ekubeni indawo yokungena kwezinzipho ikude kakhulu kwiibhakede zemithambo-luvo nemithambo yegazi, umngcipheko wokwenzakala ngengozi uphantsi kakhulu.
Ngaba kufuneka ndifake i-plaster cast emva kotyando?
Hayi, uzipho oluthambileyo olungaphakathi kwe-medullary lunika uzinzo olwaneleyo. Emva kokuphuka kwe-femoral shaft, i-brace (isiciko esiqinileyo esisuswayo) idla ngokunxitywa (umsebenzi wayo oyintloko kukukhusela endaweni yokulungisa).
Umntu angahamba ixesha elingakanani emva kotyando?
Emva kotyando lokwaphuka kwe-femoral shaft, i-brace inganxitywa xa ume kwaye uhamba ukusuka kusuku lwesithathu ukuya kolwesihlanu. Ukususela kwiveki yesi-2 ukuya kweyesithathu emva kotyando, umntu unokuthwala ubunzima kancinci ngeentonga (iinzwane zichukumisa umhlaba). Ukususela kwiveki yesi-4 ukuya kweyesi-6 emva kotyando, umntu unokuhamba kancinci kancinci ethwele ubunzima obupheleleyo. Ukususela kwinyanga yesi-2 ukuya kweyesi-3 emva kotyando, umntu unokubuyela ekubalekeni nasekutsibeni okuqhelekileyo. Kufuneka kugxininiswe ukuba nangona iinzipho zibonelela ngozinzo, azinakuyitshintsha ngokupheleleyo amandla okuthwala umthwalo wethambo - ixesha elithile lokuthwala ubunzima obupheleleyo kufuneka lilandelwe ngokwengcebiso kagqirha kwaye limiselwe ngokusekwe ekukhuleni kwe-bone callus kwi-X-ray.
Ingaba ixabiso lezipikili ze-intramedullary ezithambileyo liphezulu?
Izikhonkwane ze-intramedullary ezithambileyo zenziwe ngezinto ze-titanium alloy ezisuka kwamanye amazwe okanye zasekhaya ezikumgangatho ophezulu. Ixabiso lazo liphezulu kuneleentambo eziqhelekileyo zeKirschner, kodwa liphantsi kuneelebhile zentsimbi.
Ukuba ufuna ukufunda okungakumbi malunga ne-Izikhonkwane ze-Elasticulwazi, nceda uzive ukhululekileQhagamshelana nathiIqela lethu liza kukunika inkxaso yobungcali kunye neempendulo.
Ixesha leposi: Sep-08-2026