"No nā haki ʻāʻī femoral ʻaʻole no ka poʻe ʻelemakule, ʻo ke ʻano hoʻopaʻa kūloko i hoʻohana pinepine ʻia ʻo ia ka hoʻonohonoho 'inverted triangle' me ʻekolu mau wili. Hoʻokomo ʻia ʻelua mau wili kokoke i nā cortices mua a me hope o ka ʻāʻī femoral, a hoʻonoho ʻia kekahi wili ma lalo. Ma ka nānā ʻana o ka anteroposterior, pili nā wili ʻelua proximal, e hana ana i kahi ʻano '2-wili', ʻoiai ma ka nānā ʻana o ka ʻaoʻao, ʻike ʻia kahi ʻano '3-wili'. Ua manaʻo ʻia kēia hoʻonohonoho ʻana ʻo ia ke kūlana kūpono loa no nā wili."
"ʻO ke aʻa femoral medial circumflex ke kumu koko nui i ke poʻo femoral. Ke kau ʻia nā wili 'i loko-i waho-i loko' ma luna o ka ʻaoʻao hope o ka ʻāʻī femoral, hiki ke hōʻeha ʻia nā kīʻaha koko iatrogenic, e hoʻopilikia ana paha i ke kahe koko i ka ʻāʻī femoral a, no laila, e hoʻopilikia ana i ka ho'ōla ʻana o ka iwi."
"I mea e pale aku ai i ka hanana 'in-out-in' (IOI), kahi e hele ai nā wili ma o ka cortex waho o ka ʻāʻī femoral, puka i waho o ka iwi cortical, a komo hou i ka ʻāʻī femoral a me ke poʻo, ua hoʻohana nā kānaka akamai ma ka home a me ka honua i nā ʻano loiloi kōkua like ʻole. ʻO ka acetabulum, aia ma luna o ka ʻaoʻao waho o ka ʻāʻī femoral, he lua concave ia i loko o ka iwi. Ma ke aʻo ʻana i ka pilina ma waena o nā wili i kau ʻia ma luna o ka ʻaoʻao hope o ka ʻāʻī femoral a me ka acetabulum ma ka nānā anteroposterior, hiki i kekahi ke wānana a loiloi paha i ka pilikia o ka wili IOI."
▲ Hōʻike ke kiʻikuhi i ke kiʻi iwi cortical o ka acetabulum ma ka ʻike anteroposterior o ka hui ʻūhā.
Ua pili ke aʻo ʻana i 104 mau maʻi, a ua nānā ʻia ka pilina ma waena o ka iwi cortical o ka acetabulum a me nā wili hope. Ua hana ʻia kēia ma o ka hoʻohālikelike ʻana ma nā kukuna X a ua hoʻokō ʻia e ke kūkulu hou ʻana o ka CT postoperative e loiloi i ka pilina ma waena o nā mea ʻelua. Ma waena o nā maʻi 104, ua hōʻike ʻo 15 i kahi hanana IOI maopopo ma nā kukuna X, 6 i loaʻa ka ʻikepili kiʻi piha ʻole, a he 10 i kau ʻia nā wili kokoke loa i waenakonu o ka ʻāʻī femoral, e hoʻolilo ana i ka loiloi i mea ʻole. No laila, ua hoʻokomo ʻia he 73 mau hihia kūpono i ka loiloi.
Ma nā hihia 73 i kālailai ʻia, ma nā kukuna X, he 42 mau hihia i kau ʻia nā wili ma luna o ka iwi cortical o ka acetabulum, ʻoiai he 31 mau hihia i kau ʻia nā wili ma lalo. Ua hōʻike ka hōʻoia CT ua loaʻa ka hanana IOI ma 59% o nā hihia. Hōʻike ka loiloi ʻikepili ma nā kukuna X, ʻo nā wili i kau ʻia ma luna o ka iwi cortical o ka acetabulum he 90% ka ʻike a me ka kikoʻī o 88% i ka wānana ʻana i ka hanana IOI.
▲ Hihia ʻEkahi: Hōʻike ka X-ray o ka hui ʻūhā ma ka nānā anteroposterior i nā wili i kau ʻia ma luna o ka iwi cortical o ka acetabulum. Hōʻoia nā hiʻohiʻona CT coronal a me transverse i ke alo o ka hanana IOI.
▲Hihia ʻElua: Hōʻike ka X-ray o ka hui ʻūhā ma ka nānā anteroposterior i nā wili i kau ʻia ma lalo o ka iwi cortical o ka acetabulum. Hōʻoia nā hiʻohiʻona CT coronal a me transverse aia nā wili hope i loko o ka cortex iwi.
Ka manawa hoʻouna: Nov-23-2023
