I. He aha te take he kōhao te tīwiri kua whakapūmautia?
Me pēhea te mahi a ngā pūnaha tīwiri kua whakapūtāhia? Mā te whakamahi i ngā waea Kirschner angiangi (waea-K) kua pokaia ki roto i te wheua hei whakatika tika i ngā ara tīwiri ki roto i ngā kongakonga wheua iti.
Mā te whakamahi i ngā waea-K ka kore e nui rawa te poka o ngā kōhao pairati, ā, ka taea te whakau i ngā kongakonga wheua e tata ana i te wā e whakaurua ana he tīwiri. Ka whakauruhia ngā taputapu tuwhera me ngā tīwiri tuwhera ki roto i te wheua i runga i ngā waea-K. He pai te whakau tīwiri cannulated i roto i te tuaiwi kaki hei whakau i ngā whati odontoid me te rongoā i te kore pumau o te atlantoaxial.
He maha ngā painga o ngā tīwiri kua whakapūpūhia ki te awa, ki te whakatauritea ki ngā tīwiri kāore i te whakapūpūhia: 1) mā ngā waea-K e ārahi te tūranga tīwiri ki roto i te wheua;
2) mā te ara K-wire ka ngāwari te neke mena kāore i te tino pai te ara taketake;
3) mā ngā waea-K ka taea te piri tonu o ngā kongakonga wheua kore pumau e tata ana;
4) Ka ārai ngā waea-K i te nekehanga o ngā kongakonga wheua kore pumau i te wā e whakaurua ana te tīwiri.
Ka taea te whakaiti i ngā raruraru e pā ana ki te waea-K (te whati, te nekeneke, me te nekehanga) mā te whakamahi i ngā tikanga pokanga tika. I whakawhanakehia he pūnaha taputapu tīwiri motuhake mō te whakapiri i te kaki o runga kia taea ai te keri kiri mā te whakamahi i ngā taputapu keri roa, ngā uhi kiko, ngā aratohu keri, me ngā waea-K roa. Mā ēnei taputapu ka taea te tuku i ngā tīwiri whakapiri i te koki iti ki te tuaiwi mā roto i ngā ara kiko ngohengohe roa. He nui ngā painga o ngā tīwiri whakapiri ki ngā tīwiri kāore i te whakapiri hei whakapiri i te tuaiwi kaki kāore i te pumau ki te pūnaha.
II.Ko tēhea te mea pai ake he tīwiri cannulated, he whao intrameduallary rānei?
He taputapu hauora ngā whao intramedullary me ngā whao cannulated e whakamahia ana mō te whakapiri ā-roto o ngā whati. He painga motuhake tō ia whao, ā, he pai mō ngā momo whati rerekē me ngā hiahia maimoatanga.
| Momo | Painga |
| Whao I roto i te Medullary | He pai te pānga o te whakapiringa whao intramedullary ki ngā whati pumau o ngā wheua roa, he iti ake te whara me te iti ake o te toto. Ko te whakapiringa whao intramedullary he whakapiringa pokapū. Ki te whakatauritea ki ngā pereti maitai, ka taea hoki e ngā whao intramedullary te tiaki i te hanganga o te kiriuhi extraosseous, te ārai i te whakaroa o te whakaora whati, me te whai wāhi ki te karo i te mate. |
| Tīwiri Whakapūmau | Ko te nuinga o te wā ka whakamahia ki ngā wāhi pēnei i te whati o te kaki o te huha, me ngā pānga whakapiri me te pēhi motuhake. Heoi anō, he iti noa te kino, ā, kāore e hiahiatia he pereti maitai. |
III. Āhea te whakamahi i ngā tīwiri kanselo me ngā tīwiri cortical?
Ko ngā tīwiri cancellous me ngā tīwiri cortical he momo tāpiringa wheua e whakamahia ana mō te whakapiri wheua, engari he rerekē te hoahoa mō ngā momo wheua, ā, he rerekē hoki ā rāua whakamahinga:
He mea hanga motuhake ngā tīwiri Cancellous mō te whakamahi i roto i te kiko wheua hautai, iti te matotoru, me te kiko trabecular, e kitea whānuitia ana i ngā pito o ngā wheua roa, pērā i te femur me te tibia. He mea whakamahi i ngā wāhi he nui ake te pūwero o te wheua, ā, he iti ake te matotoru, pērā i ngā rohe metaphyseal o ngā wheua roa. He maha ngā wā ka whakamahia i roto i ngā tikanga e pā ana ki te tuaiwi, te pelvis, me ētahi wāhanga o te pakihiwi me te hope.
Kua hangaia ngā Tīwiri Urutā hei whakamahi i roto i ngā wheua kōtui kiato ake, e hanga ana i te paparanga o waho o te nuinga o ngā wheua, ā, he tino mārō ake, he kaha ake hoki i te wheua korekore. E whakamahia whānuitia ana i roto i ngā āhuatanga e hiahiatia ana he kaha ake, he pumau ake hoki, pērā i te whakapūmau i ngā whati i roto i te diaphysis (pou) o ngā wheua roa. E whakamahia ana hoki i roto i ētahi taputapu whakapūmau ā-roto me ngā pereti.
Hei whakarāpopototanga, ko te kōwhiringa i waenga i ngā tīwiri cancellous me ngā tīwiri cortical e whakawhirinaki ana ki te momo wheua e mau ana me ngā whakaritenga motuhake o te tikanga orthopedic. He pai ngā tīwiri cancellous mō te wheua ngohengohe, he nui ake te pūwero, ko ngā tīwiri cortical ia he pai mō te wheua kikī, he nui ake te kawenga.
Wā tuku: Mei-09-2025
