ʻO ka pilikia o ke koho ʻana i ka mānoanoa o nā kui intramedullary no nā iwi tubular lōʻihi o nā lālā haʻahaʻa.

ʻO ke kui intramedullary ke kūlana gula no ka mālama ʻana i nā haki diaphyseal o nā iwi tubular lōʻihi ma nā lālā haʻahaʻa. Hāʻawi ia i nā pono e like me ka trauma ʻoki liʻiliʻi a me ka ikaika biomechanical kiʻekiʻe, e hoʻohana nui ʻia ai i nā haki tibial, femoral, a me humeral shaft. Ma ke ʻano lapaʻau, ʻo ke koho ʻana o ke anawaena kui intramedullary e makemake pinepine i ke kui mānoanoa loa hiki ke hoʻokomo ʻia me ka reaming kaulike, e hōʻoia i ka paʻa nui. Eia nō naʻe, inā paha e pili pololei ana ka mānoanoa o ke kui intramedullary i ka prognosis haki, ʻaʻole i maopopo.

Ma kahi ʻatikala ma mua, ua kūkākūkā mākou i kahi noiʻi e nānā ana i ka hopena o ke anawaena kui intramedullary i ka ho'ōla ʻana o ka iwi i nā poʻe ma luna o 50 me nā haki intertrochanteric. ʻAʻole i hōʻike nā hopena i kahi ʻokoʻa helu i nā helu ho'ōla haki a me nā helu hana hou ma waena o ka hui 10mm a me ka hui me nā kui i ʻoi aku ka mānoanoa ma mua o 10mm.

Ua hōʻea pū kekahi pepa i paʻi ʻia i ka makahiki 2022 e nā haumāna mai ka Panalāʻau ʻo Taiwan i kahi hopena like:

Ua hoʻokaʻawale ʻia nā mea maʻi i ʻehā mau pūʻulu ma muli o ke anawaena o ke kui i loko o kahi noiʻi e pili ana i 257 mau maʻi, i hoʻopaʻa ʻia me nā kui intramedullary o ke anawaena he 10mm, 11mm, 12mm, a me 13mm. Ua ʻike ʻia ʻaʻohe ʻokoʻa helu i nā helu ho'ōla haki ma waena o nā hui ʻehā.

No laila, ʻo kēia nō hoʻi ke ʻano no nā haki tibial shaft maʻalahi?

Ma kahi noiʻi hihia-kaohi e pili ana i 60 mau maʻi, ua hoʻokaʻawale like nā mea noiʻi i nā maʻi 60 i ʻelua mau pūʻulu o 30 pākahi. Ua hoʻopaʻa ʻia ka Hui A me nā kui intramedullary lahilahi (9mm no nā wahine a me 10mm no nā kāne), ʻoiai ua hoʻopaʻa ʻia ka Hui B me nā kui intramedullary mānoanoa (11mm no nā wahine a me 12mm no nā kāne):

Ua hōʻike nā hopena ʻaʻohe ʻokoʻa koʻikoʻi i nā hopena lapaʻau a i ʻole ke kiʻi ʻana ma waena o nā kui intramedullary lahilahi a me ka mānoanoa. Eia kekahi, ua pili nā kui intramedullary lahilahi me nā manawa ʻokiʻoki pōkole a me ka fluoroscopy. Me ka nānā ʻole inā ua hoʻohana ʻia kahi kui mānoanoa a lahilahi paha, ua hana ʻia ka reaming kaulike ma mua o ke kau ʻana o ke kui. Manaʻo nā mea kākau no nā haki tibial shaft maʻalahi, hiki ke hoʻohana ʻia nā kui intramedullary lahilahi no ka hoʻopaʻa ʻana.