He lāʻau lapaʻau i hoʻohana nui ʻia i ka ʻoki ʻana o ka iwi Orthopedic. Hoʻohana nui ia no ka hoʻoponopono ʻana i nā prostheses hui pū, hoʻopiha i nā lua kīnā iwi, a hāʻawi i ke kākoʻo a me ka hoʻoponopono ʻana i ka mālama ʻana. Hoʻopiha ia i ke āpau ma waena o nā hui artificial a me nā iwi iwi, hoʻemi i ka ʻaʻahu a hoʻopuehu i ke kaumaha, a hoʻonui i ka hopena o ke ʻoki ʻana i ka hui.
ʻO ka hoʻohana nui ʻana o nā kui sima iwi:
1. Hoʻoponopono i nā haʻihaʻi: Hiki ke hoʻohana ʻia ka sima iwi e hoʻopiha a hoʻoponopono i nā wahi haʻihaʻi.
2. ʻO ka ʻokiʻoki ʻana: Ma ke ʻoki ʻoki ʻana, hoʻohana ʻia ka sima iwi e hoʻoponopono a hana hou i nā ʻili hui.
3. Hoʻoponopono ʻino iwi: Hiki i ka sima iwi ke hoʻopiha i nā hemahema o ka iwi a hoʻoikaika i ka hana hou ʻana o ka iwi.
ʻO ke kūpono, pono e loaʻa i nā ʻano ʻano like ʻole o ka iwi sima: (1) kūpono i ka injectability, programmable properties, cohesion, a me radiopacity no ka maikaʻi o ka lawelawe ʻana i nā waiwai; (2) ka ikaika mīkini kūpono no ka hoʻoikaika koke ʻana; (3) ka porosity kūpono e ʻae ai i ke kahe ʻana o ka wai, ka neʻe ʻana o ke kelepona, a me ka ulu ʻana o ka iwi hou; (4) maikaʻi ka osteoconductivity a me ka osteoinductivity e hoʻoikaika i ka hana iwi hou; (5) ka biodegradability haʻahaʻa e hoʻohālikelike i ka resorption o ka mea sima iwi me ka hana iwi hou; a me (6) hiki ke hāʻawi lāʻau maikaʻi.
I ka makahiki 1970, ua hoʻohana ʻia ka iwi sima nohuiprosthesis fixation, a hiki ke hoʻohana ʻia e like me ka hoʻopiha piha ʻana a me ka hoʻoponopono ʻana i nā mea i loko o ka orthopedics a me ka dentistry. I kēia manawa, ʻo nā sima iwi i hoʻohana nui ʻia a noiʻi ʻia, ʻo ia ka polymethyl methacrylate (PMMA) iwi sima, calcium phosphate iwi sima a me ka calcium sulfate iwi sima. I kēia manawa, ʻo nā ʻano ʻano sima iwi i hoʻohana mau ʻia, ʻo ia ka polymethyl methacrylate (PMMA) iwi sima, calcium phosphate iwi cement a me ka calcium sulfate iwi sima, a ma waena o ia mea ka mea maʻamau i hoʻohana ʻia. Eia nō naʻe, he haʻahaʻa haʻahaʻa ka hana ola kino a ʻaʻole hiki ke hana i nā paʻa kemika ma waena o nā grafts calcium sulfate a me nā ʻiʻo iwi, a e hoʻohaʻahaʻa koke. Hiki ke hoʻopaʻa piha ʻia ka iwi calcium sulfate i loko o ʻeono pule ma hope o ke kanu ʻana i ke kino. ʻAʻole kūpono kēia hoʻohaʻahaʻa wikiwiki i ke kaʻina hana iwi. No laila, ke hoʻohālikelike ʻia me ka iwi calcium phosphate cement, ʻo ka hoʻomohala ʻana a me ka hoʻohana ʻana i ka lāʻau lapaʻau o ka calcium sulfate iwi sima he mea liʻiliʻi. ʻO ka sima iwi ʻo PMMA he polymer acrylic i hana ʻia ma ka hui ʻana i ʻelua mau mea: ka wai methyl methacrylate monomer a me ka dynamic methyl methacrylate-styrene copolymer. Loaʻa iā ia ke koena monomer haʻahaʻa, haʻahaʻa haʻahaʻa haʻahaʻa haʻahaʻa haʻahaʻa a me ka haʻihaʻi kaumaha, a hiki ke hoʻoulu i ka hoʻokumu ʻana o ka iwi hou a hoʻemi i ka hopena o nā hopena ʻino i hana ʻia e nā haʻihaʻi me ka ikaika tensile kiʻekiʻe a me ka plasticity. ʻO ka mea nui o kāna pauka he polymethyl methacrylate a i ʻole methyl methacrylate-styrene copolymer, a ʻo ka mea nui o ka wai he methyl methacrylate monomer.
He kiʻekiʻe ka ikaika tensile a me ka plasticity o ka iwi PMMA, a paʻa koke, no laila hiki i nā poʻe maʻi ke haʻalele i kahi moe a hana i nā hana hoʻoponopono ma hope o ke kaʻina. Loaʻa iā ia ka plasticity maikaʻi loa, a hiki i ka mea hana ke hana i kekahi plasticity ma mua o ka paʻa ʻana o ka iwi sima. He hana palekana maikaʻi ka mea, ʻaʻole ia e hoʻohaʻahaʻa ʻia a ʻae ʻia e ke kino kanaka ma hope o ka hana ʻana i ke kino. Paʻa ke ʻano kemika, a ʻike ʻia nā ʻano mechanical.
Eia nō naʻe, loaʻa iā ia kekahi mau hemahema, e like me ka hoʻoulu ʻana i ke kaomi kiʻekiʻe i loko o ka ʻōpū o ka iwi i ka wā e hoʻopiha ai, e hoʻokomo ai i nā kulu momona i loko o nā kīʻaha koko a hoʻoulu i ka embolism. ʻAʻole like me nā iwi kanaka, hiki ke wehe ʻia nā ami hana i ka wā lōʻihi. Hoʻokuʻu ka PMMA monomers i ka wela i ka wā polymerization, hiki ke hōʻino i nā ʻiʻo a i ʻole nā pūnaewele a puni. ʻO nā mea i hana ʻia i ka iwi sima he cytotoxicity, etc.
Hiki i nā mea ʻokoʻa i loko o ka sima iwi ke hoʻoulu i nā hopena maʻi, e like me ka ʻūhū, urticaria, dyspnea a me nā hōʻailona ʻē aʻe, a i nā hihia koʻikoʻi, hiki mai ka haʻalulu anaphylactic. Pono e hana ʻia ka hoʻāʻo allergy ma mua o ka hoʻohana ʻana i mea e pale ai i nā hopena allergy. ʻO nā hopena maikaʻi ʻole i ka iwi sima, ʻo ia ka hopena o ka ʻeha iwi, ka leaka ʻana o ka iwi, ka wehe ʻana a me ka wehe ʻana. Hiki i ka leaka ʻana o ka iwi ke hoʻomake i ka ʻiʻo a me nā hopena ʻawaʻawa, a hiki ke hōʻino i nā aʻalolo a me nā kīʻaha koko, e alakaʻi ana i nā pilikia. ʻO ka hoʻopaʻa ʻana i nā iwi he mea hilinaʻi loa a hiki ke hoʻomau no nā makahiki ʻoi aku ma mua o ʻumi, a ʻoi aku paha ma mua o iwakālua makahiki.
ʻO ka ʻoki ʻana i ka iwi he hana maʻamau maʻamau, a ʻo kona inoa ʻepekema he vertebroplasty. He mea polymer ka iwi sima me ka wai maikaʻi ma mua o ka paʻa ʻana. Hiki iā ia ke komo maʻalahi i ka vertebrae ma o ka nila puncture, a laila hoʻopuehu ma nā māwae haʻi o loko o ka vertebrae; paʻa ka iwi sima ma kahi o 10 mau minuke, pipili i nā māwae i loko o nā iwi, a hiki i ka iwi paʻakikī ke pāʻani i ke kākoʻo i loko o nā iwi, e hoʻoikaika ai i ka iwi iwi. ʻO ke kaʻina hana holoʻokoʻa e lawe wale i 20-30 mau minuke.
I mea e pale ʻole ai i ka hoʻopuehu ʻana ma hope o ka hoʻoheheʻe ʻia ʻana o ka iwi, ua hana ʻia kahi ʻano hana ʻoki hou, ʻo ia ka vertebroplasty. Hana ʻo ia i kahi ʻoki liʻiliʻi ma ke kua o ka mea maʻi a hoʻohana i kahi nila puncture kūikawā e hou ai i ke kino vertebral ma o ka ʻili ma lalo o ka nānā ʻana o X-ray e hoʻokumu i kahi ala hana. A laila hoʻokomo ʻia kahi baluna e hana i ke kino vertebral haʻihaʻi i hoʻopaʻa ʻia, a laila hoʻokomo ʻia ka sima iwi i loko o ke kino vertebral e hoʻihoʻi i ke ʻano o ke kino vertebral fractured. Hoʻopili ʻia ka iwi cancellous i loko o ke kino vertebral e ka hoʻonui ʻana i ka baluna i mea e pale ai i ka leaka ʻana o ka iwi, ʻoiai e hoʻemi ana i ke kaomi i ka wā o ka hoʻoheheʻe ʻia ʻana o ka iwi, a laila e hōʻemi nui i ka leakage iwi. Hiki iā ia ke hoʻemi i ka hopena o nā pilikia e pili ana i ka hoʻomaha ʻana o ka moena, e like me ka maʻi pneumonia, nā ʻeha puʻuwai, nā maʻi urinary tract, a me nā mea ʻē aʻe, a pale aku i ka pōʻino ʻino o ka osteoporosis ma muli o ka nalowale o ka iwi ma muli o ka hoʻomaha moe lōʻihi.
Inā hana ʻia ke ʻoki PKP, pono e hoʻomaha ka mea maʻi ma kahi moe i loko o 2 mau hola ma hope o ke ʻoki ʻana, a hiki ke huli i ke koʻi. I loko o kēia manawa, inā loaʻa kekahi manaʻo ʻino a i ʻole e hoʻomau ka ʻeha, pono e hoʻomaopopo i ke kauka i ka manawa.
Nānā:
① Hōʻalo i ka hoʻololi ʻana i ka pūhaka nui a me nā hana kulou;
② Mai noho a kū paha no ka manawa lōʻihi;
③ Hōʻalo i ka lawe ʻana i ke kaumaha a i ʻole ke kūlou ʻana no ka ʻohi ʻana i nā mea ma ka honua;
④ Mai noho ma ka noho haʻahaʻa;
⑤ Kāohi i ka hāʻule a me ka hoʻi hou ʻana o nā haʻihaʻi.
Ka manawa hoʻouna: Nov-25-2024
