Ko te hangarau whao intramedullary he tikanga whakau ā-roto orthopedic e whakamahia whānuitia ana. Ka taea te whai i tōna hītori mai i te tekau tau atu i 1940. He whānuitia te whakamahinga mō te rongoā i ngā whati wheua roa, ngā kore-hononga, me ētahi atu, mā te whakatakoto i tētahi whao intramedullary ki waenganui o te kōhao medullary. Whakatikahia te wāhi whati. I roto i ēnei putanga, ka whakamōhio atu mātou ki a koe i ngā kōrero e pā ana ki ngā whao intramedullary.
He whakarāpopototanga noa iho, he hanganga roa te whao intramedullary me ngā kōhao tīwiri raka maha i ngā pito e rua hei whakau i ngā pito tata me ngā pito tawhiti o te whati. E ai ki ngā hanganga rerekē, ka taea te wehewehe ki te totoka, ki te ngongo, ki te wāhanga tuwhera, me ētahi atu, e tika ana mō ngā tūroro rerekē. Hei tauira, he ātete te whao intramedullary totoka ki te mate nā te mea kāore he wāhi mate o roto. He pai ake te kaha.
Hei tauira, he rerekē te whānui o te kōhao medullary i ia tūroro. E ai ki te hiahia kia whakatikatikahia, ka taea te wehewehe i ngā whao intramedullary ki te whao kua whakatikatikahia me te whao kāore i whakatikatikahia. Ko te rerekētanga kei te hiahia kia whakamahia ngā reamers mō te whakatikatika medullary, tae atu ki ngā taputapu ā-ringa, hiko rānei, me ētahi atu, ā, ka whakamahia ngā mata wiri nui ake hei whakanui ake i te kōhao medullary kia uru ai ngā whao intramedullary nui ake te whānui.
Heoi, ka pakaru te endosteum i te tukanga o te whānui o te hinu wheua, e whakaaturia ana i te pikitia, ā, ka pā ki tētahi wāhanga o te pūtake toto o te wheua, ka arahi pea ki te mate kore toto rangitahi o ngā wheua ā-rohe, ka piki ake te mōrearea o te mate. Heoi, e pā ana ki tēnei. Ka whakakahoretia e ngā rangahau haumanu he rerekētanga nui. Kei reira anō ngā whakaaro e whakaū ana i te uara o te medullary reaming. I tētahi taha, ka taea te whakamahi i ngā whao intramedullary he nui ake te diameter mō te medullary reaming. Ka piki ake te kaha me te pakari i te pikinga o te diameter, ā, ka piki ake te wāhi e pā ana ki te kōhao medullary. Kei reira anō te tirohanga ko ngā maramara wheua iti i puta i te tukanga o te whānui o te hinu wheua he mahi anō hoki i roto i te whakawhitinga wheua autologous.
Ko te tautohe matua e tautoko ana i te tikanga kore-reaming ko te mea ka taea e ia te whakaiti i te tūponotanga o te mate me te embolism pulmonary, engari ko te mea kāore e taea te wareware ko te angiangi o te diameter ka puta he ngoikore o ngā āhuatanga miihini, ka hua ake he tere teitei ake o te pokanga anō. I tēnei wā, ko te nuinga o ngā whao tibial intramedullary e whakamahi ana i ngā whao intramedullary whānui, engari me paunatia tonu ngā painga me ngā huakore i runga i te rahi o te kōhao medullary o te tūroro me ngā āhuatanga whati. Ko te hiahia mō te reamer ko te whakaiti i te waku i te wā tapahi me te whai putorino hohonu me te kakau diameter iti, kia whakaitihia ai te pēhanga i roto i te kōhao medullary me te karo i te wera nui o ngā wheua me ngā kiko ngohengohe i puta mai i te waku. Necrosis.
I muri i te whakaurunga o te whao intramedullary, me whakapiripiri te tīwiri. Ko te whakapiripiri tūranga tīwiri tuku iho e kiia ana ko te raka tūmau, ā, e whakapono ana ētahi tāngata ka roa pea te whakaora. Hei whakapai ake, ka hangaia ētahi kōhao tīwiri raka kia āhua porotītaha, e kiia nei ko te raka hihiri.
He kupu whakataki tēnei ki ngā wāhanga o te whao intramedullary. I te putanga e whai ake nei, ka tohaina atu e mātou ki a koutou te tukanga poto o te pokanga whao intramedullary.
Wā tuku: Hepetema-16-2023
