He aha te DHS me te DCS?
DHS (Whiringa Hope Hihiri)He mea pokanga te whakatōnga e whakamahia ana mō te rongoā i ngā whati o te kaki o te femur me ngā whati i waenganui i ngā uaua o te hononga. He tīwiri me he pūnaha pereti e whakarato ana i te pumau mā te tuku i te pēhanga hihiri ki te wāhi whati, hei whakatairanga i te whakaora.
DCS (Whiripiri Ārai Hihiri)He taputapu whakapiri e whakamahia ana mō ngā whati o te femur distal me te tibia proximal. Ka whakakotahi i ngā painga o ngā tīwiri cannulated maha (MCS) me ngā whakaurunga DHS, e whakarato ana i te pēhanga hihiri whakahaeretia mā roto i ngā tīwiri e toru kua whakaritea i roto i te whirihoranga tapatoru hurihuri.
He aha te rerekētanga i waenganui i te DHS me te DCS?
Ko te DHS (Dynamic Hip Screw) te mea matua e whakamahia ana mō ngā whati o te kaki femur me ngā whati o waenga-trochanter, e whakarato ana i te pumau me te pūnaha tīwiri me te pereti. Ko te DCS (Dynamic Condylar Screw) he mea hanga mō ngā whati o te femur distal me te tibia proximal, e tuku ana i te pēhanga hihiri whakahaeretia mā te whirihoranga tīwiri tapatoru.
He aha te whakamahinga o te DCS?
E whakamahia ana te DCS hei rongoā i ngā whati o te femur distal me te tibia proximal. He tino whai hua ki te whakarato i te pumau me te whakatairanga i te whakaora i ēnei wāhi mā te whakamahi i te pēhanga hihiri whakahaeretia ki te wāhi whati.
He aha te rerekētanga i waenga i te DCS me te DPL?
DPL (Maukati Pēhanga Hihiri)Ko tētahi atu momo pūnaha whakapiri e whakamahia ana i roto i te pokanga wheua. Ahakoa ko te whāinga a te DCS me te DPL he whakarato i te whakapiri pumau mō ngā whati, ko te tikanga ka whakamahia e te DPL ngā tīwiri me ngā pereti raka hei whakatutuki i te whakapiri pakari, ko te DCS ia e arotahi ana ki te pēhanga hihiri hei whakarei ake i te whakaora whati.
He aha te rerekētanga i waenga i te DPS me te CPS?
DPS (Pūnaha Pereti Hihiri)meCPS (Pūnaha Pereti Kōpeketanga)e whakamahia ana mō te whakatika i ngā whati. Ka taea e te DPS te pēhi hihiri, ka taea te whakarei ake i te whakaora whati mā te whakatairanga i te nekehanga i waenga i ngā kongakonga i te wā e amo ana i te taumaha. Ko te CPS, i tetahi atu ringa, ka whakarato i te pēhi pumau, ā, ka whakamahia mō ngā whati pumau ake ina kore e hiahiatia te pēhi hihiri.
He aha te rerekētanga i waenga i te DCS 1 me te DCS 2?
Ko te DCS 1 me te DCS 2 e pā ana ki ngā whakatupuranga, ngā whirihoranga rerekē rānei o te pūnaha Dynamic Condylar Screw. Tērā pea ka tukuna e te DCS 2 ngā whakapainga i runga i te hoahoa, te rauemi, te tikanga pokanga rānei, ki te whakatauritea ki te DCS 1. Heoi, ko ngā rerekētanga motuhake ka whakawhirinaki ki ngā whakahoutanga me ngā whanaketanga a te kaihanga i roto i te pūnaha.
Me pēhea te whakahaere i tētahi DHS?
He tikanga pokanga te DHS hei rongoā i ngā whati o te femur proximal, tae atu ki ngā whati intertrochanteric me subtrochanteric. Ko ngā mahi o tēnei tikanga ko:
1. Te Whakarite i mua i te Tātaritanga: Ka arotakehia te tūroro, ā, ka whakarōpūtia te whati mā te whakamahi i ngā rangahau whakaahua pēnei i ngā hihi-X.
2. Whakamoemiti: Ka tukuna te whakamoemiti whānui, te whakamoemiti rohe rānei (hei tauira, te whakamoemiti tuaiwi).
3. Tapahi me te Whakaaturanga: Ka tapahia te hope ki te taha, ā, ka hoki whakamuri ngā uaua kia kitea te hope.
4. Te Whakaiti me te Whakatikatika: Ka whakaitihia (kia whakarārangihia) te whati i raro i te arataki fluoroscopic. Ka whakaurua he tīwiri nui cancellous (te tīwiri whakaroa) ki roto i te kaki me te pane o te femur. Kei roto i tēnei tīwiri he ringaringa whakarewa, e piri ana ki tētahi pereti e piri ana ki te cortex femur taha me ngā tīwiri. Mā te DHS ka taea te pēhi hihiri, ko te tikanga ka taea e te tīwiri te paheke ki roto i te ringaringa, ka whakatairanga i te pēhitanga me te whakaora i te whati.
5. Katinga: Ka katia te tapahi kia paparua, ā, ka taea te whakatakoto i ngā waikeri hei ārai i te hanganga o ngā hematoma.
He aha te Pokanga PFN?
Ko te pokanga PFN (Proximal Femoral Nail) tētahi atu tikanga e whakamahia ana hei rongoā i ngā whati o te femur proximal. Ko te whakaurunga o tētahi whao intramedullary ki roto i te awa femur, e whakarato ana i te pumau mai i roto i te wheua.
He aha te āhuatanga Z i roto i te PFN?
Ko te "āhuatanga Z" i roto i te PFN e pā ana ki tētahi raruraru pea ka taea e te whao, nā tōna hoahoa me ngā kaha i pā mai, te whakararu i te kaki o te femur. Ka taea e tēnei te arahi ki te kore e tika te tūnga me ngā hua mahi ngoikore. Ka puta tēnei ina heke, he rerekē rānei te āhua o te whao me ngā kaha i pā mai i te wā e amo ana i te taumaha, ka hua ake he āhua "Z" rerekē i roto i te whao.
Ko tēhea te mea pai ake: Te whao intramedullary, te tīwiri hope hihiri rānei?
Ko te kōwhiringa i waenga i te whao intramedullary (pērā i te PFN) me te Dynamic Hip Screw (DHS) e whakawhirinaki ana ki ētahi āhuatanga, tae atu ki te momo whati, te kounga o te wheua, me ngā āhuatanga o te tūroro. Kua whakaatuhia e ngā rangahau he maha ngā painga o te PFN:
1. Te Whakaiti i te Ngaronga Toto: Ko te tikanga he iti ake te ngaronga toto i te wā e pokangahia ana e te pokanga PFN ki te whakaritea ki te DHS.
2. Wā Pokanga Poto Ake: He tere ake ngā tikanga PFN, ka whakaiti i te wā i raro i te mate whakamoe.
3. Te Whakaoho Wawe: Ka taea e ngā tūroro e rongoatia ana me te PFN te nekeneke me te pikau i te taumaha i mua ake, ka tere ake te ora.
4. Te Whakaiti i ngā Āhuatanga Whakararuraru: Kua honoa te PFN ki te whakaiti i ngā āhuatanga whakararuraru, pērā i te mate urutā me te malunion.
Heoi anō, he kōwhiringa pai tonu te DHS, inā koa mō ētahi momo whati pumau ka taea e tōna hoahoa te whakarato i te whakatikatika whai hua. Me whakatau te whakatau i runga i ngā hiahia takitahi o te tūroro me te tohungatanga o te taote pokanga.
Ka taea te tango i te PFN?
I te nuinga o te wā, kāore e hiahiatia te tango i te PFN (Proximal Femoral Nail) ina ora te whati. Heoi, ka taea te whakaaro ki te tango mēnā ka pāngia te tūroro e te mamae, e ngā raruraru rānei e pā ana ki te whakaurunga. Me whakatau te taote pokanga wheua e rongoā ana ki te tango i te PFN, me te whakaaro ki ngā āhuatanga pēnei i te hauora whānui o te tūroro me ngā mōrearea me ngā painga pea o te tikanga tango.
Wā tuku: 19 Paenga-whāwhā 2025
