ʻO ka pā paʻa he mea hoʻoponopono nahā me kahi puka wili. Ke wili ʻia ka wili me ke poʻo wili i loko o ka lua, e lilo ka pā i mea hoʻopaʻa kihi (screw). Hiki ke loaʻa i nā pā kila paʻa (angle-stable) nā puka hoʻopaʻa a paʻa ʻole no nā wili like ʻole e wili ʻia (i kapa ʻia ʻo nā pā kila hui).
1.History a me ka ulu ana
Ua hoʻokomo mua ʻia nā papa laka ma kahi o 20 mau makahiki i hala no ka hoʻohana ʻana i nā ʻoki spinal a me maxillofacial. I ka hopena o nā makahiki 1980 a me 1990, ua hoʻokomo nā haʻawina hoʻokolohua ma nā ʻano like ʻole o nā mea hoʻoponopono kūloko i nā papa laka i ka mālama ʻana i nā haki. Ua kūkulu mua ʻia kēia ʻano hoʻopaʻa paʻa no ka pale ʻana i ka wehe ʻana o ka ʻiʻo palupalu.
ʻO kekahi mau kumu i hāpai i ka hoʻohana ʻana i ka lāʻau lapaʻau o kēia pā, e like me:
Ke hoʻomau nei ka piʻi ʻana o nā haʻihaʻi comminuted i ka piʻi ʻana o ka nui o ke ola i nā poʻe maʻi me nā hōʻeha ikaika kiʻekiʻe a me ka piʻi ʻana o ka nui o nā poʻe maʻi me ka osteoporosis ma Western Europe a me ʻAmelika ʻAmelika.
ʻAʻole hauʻoli nā kauka a me nā mea maʻi i nā hopena o ka mālama ʻana no kekahi mau haʻihaʻi periarticular.
ʻO nā kumu hoʻoikaika kino ʻole ʻē aʻe paha: ka hoʻolaha ʻana o ka ʻoihana i nā ʻenehana hou a me nā mākeke hou; ke kaulana lohi o ka ʻokiʻoki liʻiliʻi invasive, etc.
2. Nā ʻano a me nā loina paʻa
ʻO ka ʻokoʻa biomechanical nui ma waena o ka paʻa ʻana i nā pā a me nā papa kuʻuna ʻo ia ka mea e hilinaʻi nei i ka friction ma ka iwi-plate interface e hoʻopau ai i ka paʻi ʻana o ka iwi e ka pā.
ʻO nā hemahema biomechanical o nā papa kila kuʻuna: hoʻopaʻa i ka periosteum a hoʻopilikia i ka hāʻawi koko i ka hopena haʻihaʻi. No laila, ʻoi aku ka kiʻekiʻe o ka hoʻopiʻi ʻana o ka pā osteosynthesis (e like me ka interfragmentary compression a me lag screws), me ka maʻi, ka haki ʻana o ka pā, ka hui hoʻopanee, a me ka nonunion.
Ke piʻi aʻe ka pōʻaiapili axial, hoʻomaka nā ʻūlū e wehe a hoʻemi i ka friction, a laila e hemo ka pā. Inā hemo ka pā ma mua o ka ho'ōla ʻana o ka haʻihaʻi, ʻaʻole paʻa ka hope o ka haʻi a ma hope e haki ka pā. ʻOi aku ka paʻakikī o ka loaʻa ʻana a me ka mālama ʻana i ka hoʻopaʻa paʻa ʻana (e like me ka metaphysis a me ka iwi osteoporotic), ʻoi aku ka paʻakikī o ka mālama ʻana i ke kūpaʻa o ka hopena haʻihaʻi.
Kūkākūkā paʻa:
ʻAʻole hilinaʻi nā papa paʻa i ka hakakā ma waena o ka pā iwi-papa. Mālama ʻia ke kūpaʻa e ka angularly stable interface ma waena o ka wili a me ka pā kila. Ma muli o ka paʻa paʻa o kēia ʻano hoʻopaʻa paʻa kūloko, ʻoi aku ka kiʻekiʻe o ka huki ʻana i waho o ka wili poʻo laka ma mua o nā wili maʻamau. Inā ʻaʻole i huki ʻia a haki ʻia nā wili a puni, he paʻakikī ke huki ʻia a haki wale paha ka wili.
3. Nā hōʻailona
ʻO ka hapa nui o nā haʻihaʻi i mālama ʻia ma ke kaʻe ʻana ʻaʻole pono e hoʻopaʻa paʻa paʻa. I ka wā e hahai ʻia ai nā loina o ka ʻokiʻoki orthopedic, hiki ke hoʻōla ʻia ka hapa nui o nā haʻihaʻi me nā papa kuʻuna a i ʻole nā kui intramedullary.
Eia nō naʻe, aia nō kekahi mau ʻano haʻihaʻi kūikawā i hiki ke nalowale i ka emi ʻana, ka haki ʻana o ka pā a i ʻole ka haki ʻana, a me ka nonunion iwi ma hope. ʻO kēia mauʻano, i kapa pinepineʻia he "ʻaʻole i hoʻoholoʻia" a iʻole "pilikia" nā haʻihaʻi, e komo pū me nā'āpana comminuted intra-articular, nā iwi pōkole periarticular, a me nā haʻihaʻi osteoporotic. ʻO ia mau haʻihaʻi nā hōʻailona no ka laka ʻana i nā papa.
4.Ke noi
Ke hāʻawi nei ka nui o nā mea hana i nā papa anatomical me nā puka laka. No ka laʻana, nā papa anatomic preshaped no nā femurs proximal a me distal, tibias proximal a me distal, humerus proximal a me distal, a me ka calcaneus. ʻO ka hoʻolālā ʻana o ka pā kila e hoʻemi nui i ka pilina ma waena o ka pā kila a me ka iwi i nā manawa he nui, no laila e mālama ai i ke koko periosteal a me ka perfusion o ka hopena haʻihaʻi.
LCP (paʻa hoʻopaʻa paʻa)
Hoʻohui ka ʻenehana hoʻopaʻa paʻa paʻa hou i ʻelua mau ʻenehana hoʻoponopono kūloko i loko o hoʻokahi implant.
Hiki ke hoʻohana ʻia ʻo LCP ma ke ʻano he pā hoʻopaʻa, kahi paʻa paʻa i loko, a i ʻole ka hui pū ʻana o nā mea ʻelua
Hoʻopilikia liʻiliʻi:
ʻO ka hoʻonui nui ʻana o nā papa paʻa i loaʻa nā lima stent waho, nā mea paʻa, a me nā hoʻolālā ʻāʻī blunt e hiki ai i nā kauka ke kau i ka pā ma lalo o ke kino a i ʻole subcutaneously no nā kumu invasive liʻiliʻi.
Inā makemake ʻoe e ʻike e pili ana i kā mākou huahana, e ʻoluʻolu e kelepona:
ʻO Yoyo
Whatsapp/Tele: +86 15682071283
Ka manawa hoʻouna: Sep-25-2023
