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

ʻO ka nailing intramedullary ke kūlana gula no ka mālama ʻana i nā haʻihaʻi diaphyseal o nā iwi tubular lōʻihi ma nā lālā haʻahaʻa. Hāʻawi ia i nā pōmaikaʻi e like me ka liʻiliʻi o ka hōʻeha hōʻeha a me ka ikaika biomechanical kiʻekiʻe, e hoʻohana pinepine ʻia i nā tibial, femoral, a me nā humeral shaft fractures. ʻO ka maʻi maʻi, ʻo ke koho ʻana i ke anawaena nail intramedullary makemake pinepine i ka nail mānoanoa hiki ke hoʻokomo ʻia me ka reaming haʻahaʻa, e hōʻoia i ka paʻa. Eia nō naʻe, inā pili pololei ka mānoanoa o ke kui intramedullary i ka prognosis haʻihaʻi 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 ma ka ho'ōla iwi i nā maʻi ma luna o 50 me nā intertrochanteric fractures. ʻAʻole i hōʻike ʻia nā hopena i ka ʻokoʻa helu helu i nā helu ho'ōla haʻihaʻi 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.

ʻO kahi pepa i paʻi ʻia ma 2022 e nā loea mai ka ʻāina ʻo Taiwan i loaʻa i kahi hopena like:

ʻO kahi haʻawina e pili ana i nā maʻi 257, i hoʻopaʻa ʻia me nā kui intramedullary o nā diameters 10mm, 11mm, 12mm, a me 13mm, ua hoʻokaʻawale i nā maʻi i ʻehā mau pūʻulu e pili ana i ke anawaena kui. Uaʻikeʻiaʻaʻole heʻokoʻa helu helu i ka nui o ka ho'ōla haʻihaʻi ma waena o nā huiʻehā.

No laila, ʻo ia hoʻi ka hihia no nā ʻoki ʻoki ʻāʻī tibial maʻalahi?

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

Ua hōʻike ʻia nā hopena ʻaʻohe ʻokoʻa koʻikoʻi i nā hopena lapaʻau a i ʻole ke kiʻi ʻana ma waena o nā kui intramedullary lahilahi a mānoanoa. Hoʻohui ʻia, ua pili nā kui intramedullary lahilahi me nā manawa pōkole a me nā manawa fluoroscopy. ʻAʻole paha i hoʻohana ʻia ke anawaena mānoanoa a lahilahi paha, ua hana ʻia ka reaming haʻahaʻa ma mua o ka hoʻokomo ʻana i ke kui. Manaʻo nā mea kākau no nā haʻihaʻi maʻalahi o ka tibial shaft, hiki ke hoʻohana ʻia nā kui intramedullary anawaena lahilahi no ka hoʻoponopono ʻana.