PFNA (Te Ārai i te Hurihanga o te Whao Femur Proximal), te whao intramedullary anti-rotation proximal femur. He pai mō ngā momo whati intertrochanteric femur; whati subtrochanteric; whati turanga kaki femur; whati kaki femur me ngā whati rakau femur; whati intertrochanteric femur me ngā whati rakau femur.
Ngā āhuatanga matua me ngā painga o te hoahoa whao
（1）Kua whakaaturia te hoahoa matua o ngā whao e te neke atu i te 200,000 ngā kēhi o te PFNA, ā, kua tutuki i a ia te ōritetanga pai rawa atu ki te hanganga o te awa medullary；
（2）Koki tango 6-tohu o te whao matua kia māmā ai te whakauru mai i te tihi o te trochanter nui；
（3）Whāo tuwhera, ngāwari ki te whakauru；
(4) He ngāwari te pito tawhiti o te whao matua, ā, he ngāwari ki te whakauru i te whao matua, ā, ka kore e nui te ahotea.
Mata porowhita:
(1) Kotahi te whakapiri ā-roto ka whakaoti i te ārai-hurihuri me te whakau koki i te wā kotahi;
(2) He nui te mata o te mata, ā, ka piki haere te whānui o te matua. Mā te pana me te pēhi i te wheua koretake, ka taea te whakapai ake i te kaha punga o te mata porowhita, he mea tino pai mō ngā tūroro he whati whati;
(3) He piri tonu te mata porowhita ki te wheua, e whakarei ake ana i te pumau me te ātete ki te hurihuri. He kaha te kaha o te pito whati ki te hinga me te whakarerekē i te āhua i muri i te mimiti.
Me aro atu ki ngā āhuatanga e whai ake nei i te maimoatanga o ngā whati o te femur:Te whakapiri ā-roto o te PFNA:
(1) Ko te nuinga o ngā tūroro kaumātua e pāngia ana e ngā mate hauora taketake, ā, he ngoikore te manawanui ki te pokanga. I mua i te pokanga, me arotake whānui te āhua whānui o te tūroro. Mena ka taea e te tūroro te manawanui ki te pokanga, me mahi wawe te pokanga, ā, me whakakorikori wawe te peka e pāngia ana i muri i te pokanga. Hei ārai, hei whakaiti rānei i te putanga mai o ngā raruraru maha;
(2) Me ine te whānui o te kōhao medullary i mua i te mahi. Ko te whānui o te whao matua o roto o te medullary he 1-2 mm te iti iho i te kōhao medullary tuturu, ā, kāore e pai mō te whakatakotoranga tutu hei karo i ngā raruraru pēnei i te whati o te femur distal;
(3) Kei te takoto te tūroro, he tika te peka e pāngia ana, ā, ko te hurihanga o roto he 15°, he mea watea mō te whakaurunga o te ngira ārahi me te whao matua. Ko te kaha o te kume me te whakaiti i ngā whati i raro i te fluoroscopy ngā kī ki te pokanga angitu;
(4) Mā te mahi hē o te pūwāhi whakauru o te ngira ārahi tīwiri matua ka āraia te tīwiri matua PFNA i roto i te kōhao medullary, ka rerekē rānei te tūranga o te mata porowhita, ka rerekē pea te whakaiti whati, ka kutikuti rānei te ahotea o te kaki femur me te pane femur e te mata porowhita i muri i te pokanga, ka whakaiti i te pānga o te pokanga;
(5) Me aro tonu te mīhini hihi-X ringa-C ki te hohonutanga me te rerekētanga o te ngira arataki mata tīwiri i te wā e tīwiri ana, ā, me 5-10 mm te hohonutanga o te pane mata tīwiri i raro i te mata kiriuhi o te pane femur;
(6) Mō ngā whati whati subtrochanteric kua whakakotahitia, ngā kongakonga whati roa whakarara rānei, e taunakihia ana kia whakamahia he PFNA kua whakaroahia, ā, ko te hiahia mō te whakaiti tuwhera e whakawhirinaki ana ki te whakaiti i te whati me te pumau i muri i te whakaiti. Mena e tika ana, ka taea te whakamahi i te taura maitai hei here i te poraka whati, engari ka pā ki te whakaora whati, ā, me karo;
(7) Mō ngā whati pakaru i te tihi o te trochanter nui, me ata mahi te mahi kia kore ai e wehea atu ngā kongakonga whati.
Ngā Painga me ngā Here o te PFNA
Hei momo hou otaputapu whakapiri intramedullary, Ka taea e te PFNA te whakawhiti i te kawenga mā te extrusion, kia taea ai e ngā taha o roto, o waho hoki o te femur te tu atu i te ahotea ōrite, kia tutuki ai te kaupapa o te whakapai ake i te pumau me te whai huatanga o te whakapiri ā-roto o ngā whati. He pai te pānga pumau me ērā atu.
He iti anō hoki ngā herenga o te whakamahinga o te PFNA, pērā i te uauatanga o te whakatakoto i te tīwiri raka tawhiti, te nui ake o te mōrearea o te whati i te taha o te tīwiri raka, te āhua o te coxa varus, me te mamae i te rohe o mua o te huha i puta mai i te mumura o te whitiki iliotibial. Ko te osteoporosis, nō reirate whakau i roto i te medullaryhe maha ngā wā ka kore e taea te whakapiri me te kore e taea te hono i te hononga.
Nō reira, mō ngā tūroro kaumātua he whati uaua te hononga o waenga-trochanteric me te osteoporosis kino, kāore rawa e whakaaetia te kawe taumaha wawe i muri i te tango i te PFNA.
Wā tuku: 30 o Hepetema 2022
