I ke kaʻina hana hōʻemi o kahi haki i ʻoki ʻia, ʻo wai ka mea hilinaʻi nui ʻia, ka nānā anteroposterior a i ʻole ka nānā ʻaoʻao?

ʻO ka haki intertrochanteric femoral ka haki ʻūhā maʻamau i ka hana lapaʻau a ʻo ia kekahi o nā haki ʻekolu i pili pinepine ʻia me ka osteoporosis i ka poʻe ʻelemakule. Pono ka mālama conservative i ka hoʻomaha moe lōʻihi, e hōʻike ana i nā pilikia kiʻekiʻe o nā ʻeha kaomi, nā maʻi pulmonary, pulmonary embolism, deep vein thrombosis, a me nā pilikia ʻē aʻe. He koʻikoʻi ka paʻakikī o ka hānai ʻana, a he lōʻihi ka manawa hoʻōla, e kau ana i kahi kaumaha nui ma luna o ke kaiāulu a me nā ʻohana. No laila, ʻo ke komo ʻana i ka ʻoki mua, i ka wā e hiki ai ke ʻae ʻia, he mea nui ia no ka hoʻokō ʻana i nā hopena hana maikaʻi i nā haki ʻūhā.

I kēia manawa, ua manaʻo ʻia ka hoʻopaʻa ʻana o loko o ka PFNA (proximal femoral nail antirotation system) ʻo ia ke kūlana gula no ka mālama ʻana i nā haki ʻūhā. ʻO ka hoʻokō ʻana i ke kākoʻo maikaʻi i ka wā e hōʻemi ai i nā haki ʻūhā he mea nui ia no ka ʻae ʻana i ka hoʻoikaika kino mua. Hoʻokomo pū ka fluoroscopy intraoperative i nā hiʻohiʻona anteroposterior (AP) a me nā hiʻohiʻona ʻaoʻao e loiloi i ka hōʻemi ʻana o ka femoral anterior medial cortex. Eia nō naʻe, hiki ke kū mai nā hakakā ma waena o nā hiʻohiʻona ʻelua i ka wā o ke ʻoki ʻana (ʻo ia hoʻi, maikaʻi ma ka ʻaoʻao ʻaoʻao akā ʻaʻole ma ka ʻaoʻao anteroposterior, a i ʻole ka ʻaoʻao ʻē aʻe). I ia mau hihia, ʻo ka loiloi ʻana inā ʻae ʻia ka hōʻemi ʻana a inā pono ka hoʻoponopono ʻana he pilikia paʻakikī ia no nā kauka lapaʻau. Ua kamaʻilio nā loea mai nā haukapila kūloko e like me ka Oriental Hospital a me ka Zhongshan Hospital i kēia pilikia ma ka nānā ʻana i ka pololei o ka loiloi ʻana i ke kākoʻo maikaʻi a maikaʻi ʻole ma lalo o nā hiʻohiʻona anteroposterior a me ka ʻaoʻao me ka hoʻohana ʻana i nā scan CT ʻekolu-dimensional postoperative ma ke ʻano he kūlana.