He taputapu whakapiri whati te pereti raka, he kōhao miro tōna. Ina whakawirihia he tīwiri he pane miro tōna ki roto i te kōhao, ka huri te pereti hei taputapu whakapiri koki (tīwiri). Ka taea e ngā pereti maitai raka (pūmau-koki) te whai kōhao tīwiri raka me te kore-raka mō ngā tīwiri rerekē hei whakapiri (e kiia ana hoki ko ngā pereti maitai whakakotahi).
1. Hītori me te whanaketanga
I te 20 tau ki muri i whakaurua tuatahitia ai ngā pereti raka hei whakamahi mā ngā pokanga tuaiwi me ngā pokanga kanohi. I te mutunga o te tekau tau atu i 1980 me te tekau tau atu i 1990, i whakauruhia ngā pereti raka ki roto i ngā momo taputapu whakapiri ā-roto i roto i ngā rangahau whakamātautau mō ngā momo taputapu whakapiri ā-roto. I whakawhanakehia tuatahitia tēnei tikanga whakapiri haumaru hei karo i te tapahi nui o ngā kiko ngohengohe.
He maha ngā āhuatanga kua whakatairanga i te whakamahinga haumanu o tēnei pereti, tae atu ki:
Kei te piki haere tonu te maha o ngā whati wheua pakaru i te mea ka piki ake te maha o ngā tūroro e ora ana i ngā whara pūngao nui, me te maha o ngā tūroro kaumātua e pāngia ana e te osteoporosis i Ūropi ki te Hauāuru me Amerika Te Raki.
Kāore ngā tākuta me ngā tūroro i te makona ki ngā hua o ngā maimoatanga mō ētahi whati periarticular.
Ko ētahi atu āhuatanga whakatairanga kore-haumanu ko: te whakatairanga a te umanga i ngā hangarau hou me ngā mākete hou; te rongonui haere o te pokanga iti rawa te whakaekenga, me ētahi atu.
2. Ngā āhuatanga me ngā mātāpono pumau
Ko te rerekētanga koiora matua i waenga i ngā pereti raka me ngā pereti tuku iho ko te whakawhirinaki o muri ki te waku i te atanga wheua-pereti hei whakaoti i te pēhanga o te wheua e te pereti.
Ko ngā hapa koiora-ā-tinana o ngā pereti maitai tuku iho: te pēhi i te periosteum me te pā ki te rere o te toto ki te pito whati. Nō reira, he nui te tere o ngā raruraru o te osteosynthesis pereti pumau tuku iho (pērā i te pēhitanga i waenga i ngā wahi me ngā tīwiri whakaroa), tae atu ki te mate, te whati pereti, te hononga whakaroa, me te kore hononga.
I te pikinga ake o te huringa kawenga tuaka, ka tīmata te wetekina o ngā tīwiri, ka whakaiti i te waku, ā, ka mutu, ka wetekina te pereti. Mēnā ka wetekina te pereti i mua i te ora o te whati, ka kore e pumau te pito whati, ā, ka pakaru te pereti i te mutunga. Ka nui ake te uaua ki te whiwhi me te pupuri i te pumau o te tīwiri (pērā i te metaphysis me ngā pito wheua osteoporosis), ka nui ake te uaua ki te pupuri i te pumau o te pito whati.
Te mātāpono pumau:
Kāore ngā pereti raka e whakawhirinaki ki te waku i waenga i te hononga wheua-pereti. Ka mau tonu te pumau mā te hononga koki pumau i waenga i te tīwiri me te pereti maitai. Nā te mea he pumau te hanganga o tēnei momo whakau raka ā-roto, he nui ake te kaha kukume o te tīwiri pane raka i tērā o ngā tīwiri noa. Ki te kore e unuhia, e whati rānei ngā tīwiri katoa e karapoti ana, he uaua ki te unuhia, ki te whati rānei i te tīwiri anake.
3. Ngā Tohu
Ko te nuinga o ngā whati e rongoatia ana e te pokanga, kāore e hiahiatia he whakapiringa pereti maukati. Mēnā ka whaihia ngā mātāpono o te pokanga wheua, ka taea te whakaora i te nuinga o ngā whati mā te whakamahi i ngā pereti tuku iho, i ngā whao intramedullary rānei.
Heoi anō, tera anō ētahi momo whati motuhake e ngāwari ana ki te ngaro o te whakaiti, te whati o te pereti, o te tīwiri rānei, ā, muri iho ka kore e hono te wheua. Ko ēnei momo, e kiia ana ko ngā whati "kāore i whakatauhia" he "raruraru" rānei, kei roto ko ngā whati pakaru o roto i te hononga, ngā whati wheua poto periarticular, me ngā whati osteoporosis. Ko ēnei whati he tohu mō ngā pereti maukati.
4. Tono
Kei te piki haere te maha o ngā kaihanga e tuku ana i ngā pereti tinana me ngā kōhao raka. Hei tauira, ko ngā pereti tinana kua oti te hanga mō ngā femur proximal me te distal, ngā tibia proximal me te distal, te humerus proximal me te distal, me te calcaneus. Ko te hoahoa o te pereti maitai ka tino whakaiti i te pā o te pereti maitai me te wheua i roto i te nuinga o ngā wā, ā, ka tiakina te rere toto periosteal me te rere o te toto ki te pito whati.
LCP (pereti kōpeketanga maukati)
Ka whakakotahihia e te pereti kōpeketanga raka auaha ngā hangarau whakapiri ā-roto e rua tino rerekē ki roto i te kōpuku kotahi.
Ka taea te whakamahi i te LCP hei pereti kōpeketanga, hei whāriki maukati o roto, hei whakakotahitanga rānei o ngā mea e rua
He iti noa te whakaekenga:
Kei te piki haere te maha o ngā pereti raka he kakau stent o waho, he pupuri, he hoahoa pito puhuruhuru e āhei ai ngā tākuta ki te whakatakoto i te pereti ki raro i te uaua, ki raro rānei i te kiri mō ngā take iti rawa te whakaekenga.
Mena kei te hiahia koe ki te mōhio mō ā mātou hua, whakapā mai ki:
Yoyo
Waea/Waea: +86 15682071283
Wā tuku: Hepetema-25-2023
