E 50% o ngā whati hope ko ngā whati o te rohe intertrochanteric o te femur, ā, koinei te momo whati tino noa i roto i ngā tūroro kaumātua. Ko te whakapiringa whao intramedullary te paerewa koura mō te maimoatanga pokanga o ngā whati intertrochanteric. He whakaae tahi kei waenganui i ngā taote pokanga wheua kia karohia te "pānga poto" mā te whakamahi i ngā whao roa, poto rānei, engari kāore anō kia whakaaetia i tēnei wā te whiriwhiri i waenga i ngā whao roa me ngā whao poto.
I roto i te ariā, ka taea e ngā whao poto te whakapoto i te wā pokanga, te whakaiti i te toto e ngaro ana, me te karo i te reaming, engari ko ngā whao roa ka pai ake te pumau. I te wā e whakaurua ana te whao, ko te tikanga tuku iho mō te ine i te roa o ngā whao roa ko te ine i te hohonu o te pine ārahi kua whakaurua. Heoi, kāore i te tino tika tēnei tikanga, ā, ki te mea he rerekētanga te roa, mā te whakakapi i te whao intramedullary ka nui ake te toto e ngaro ana, ka nui ake te whara pokanga, ka roa ake hoki te wā pokanga. Nō reira, ki te taea te aromatawai i te roa e hiahiatia ana o te whao intramedullary i mua i te pokanga, ka taea te whakatutuki i te whāinga o te whakauru whao i te kotahi nganatanga, ka karo i ngā mōrearea i roto i te pokanga.
Hei whakatika i tēnei wero haumanu, kua whakamahia e ngā tohunga o tāwāhi tētahi pouaka tākai whao intramedullary (Pouaka) hei aromatawai i te roa o te whao intramedullary i mua i te pokanga i raro i te fluoroscopy, e kiia nei ko te "tikanga Pouaka". He pai te pānga o te tono haumanu, e tohaina ana i raro nei:
Tuatahi, whakatakotoria te tūroro ki runga i te moenga kukume, ā, me mahi te whakaiti kati i raro i te kukume. Kia tutuki te whakaiti pai, tangohia te whao intramedullary kāore anō kia whakatuwheratia (tae atu ki te pouaka takai) ka whakanoho i te pouaka takai ki runga ake i te femur o te peka e pāngia ana:
Mā te āwhina o te mīhini fluoroscopy C-arm, ko te tohutoro tūranga proximal ko te whakarite i te pito proximal o te whao intramedullary ki te cortex i runga ake i te kaki femur, ka whakanoho ki te putanga mai o te pūwāhi tomo o te whao intramedullary.
Kia pai te tūnga tata, puritia te tūnga tata, kātahi ka panaia te ringa-C ki te pito tawhiti, ka mahi i te fluoroscopy kia kitea ai te hononga turi i te taha. Ko te tohutoro tūnga tawhiti ko te kōhao waenga o te femur. Whakakapia te whao intramedullary ki ngā roa rerekē, me te whai kia tutuki he tawhiti i waenga i te pito tawhiti o te whao intramedullary femoral me te kōhao waenga o te femur i roto i te 1-3 diameters o te whao intramedullary. He tohu tēnei he roa tika te whao intramedullary.
Hei tāpiritanga, i whakaahuahia e ngā kaituhi ētahi āhuatanga whakaahua e rua e tohu ana he roa rawa te whao intramedullary:
1. Ka whakaurua te pito tawhiti o te whao intramedullary ki roto i te 1/3 o te mata o te hononga patellofemoral (kei roto i te rārangi mā i te ahua i raro nei).
2. Ka whakaurua te pito tawhiti o te whao intramedullary ki roto i te tapatoru i hangaia e te rārangi Blumensaat.
I whakamahia e ngā kaituhi tēnei tikanga hei ine i te roa o ngā whao intramedullary i roto i te 21 tūroro, ā, i kitea he tika o te 95.2%. Heoi, tera pea he raruraru pea ki tēnei tikanga: ina whakaurua te whao intramedullary ki roto i te kiko ngohengohe, tera pea ka puta he pānga whakanui i te wā o te fluoroscopy. Ko te tikanga o tēnei me poto ake te roa tuturu o te whao intramedullary i whakamahia i te inenga i mua i te pokanga. I kite ngā kaituhi i tēnei āhuatanga i roto i ngā tūroro momona rawa, ā, i kī atu mō ngā tūroro momona rawa, me whakapoto te roa o te whao intramedullary i te wā inenga ai, me whakarite rānei kia 2-3 diameter te tawhiti i waenga i te pito tawhiti o te whao intramedullary me te notch intercondylar o te femur o roto i te whao intramedullary.
I ētahi whenua, ka taea te tākai takitahi i ngā whao intramedullary me te whakahoromata i mua, engari i ētahi wā, ka whakaranua ngā roa rerekē o ngā whao intramedullary ki ngā momo roa, ā, ka whakahoromata ngātahitia e ngā kaihanga. Nō reira, kāore pea e taea te aromatawai i te roa o te whao intramedullary i mua i te whakahoromata. Heoi, ka taea te whakaoti i tēnei tukanga i muri i te whakamahinga o ngā ārai whakahoromata.
Wā tuku: Paenga-whāwhā-09-2024
