Njengotyando lwamathambo ngo-2023, kukho ubunzima.Omnye umngeni kukuba iinkqubo ezininzi ze-orthopedic ziyingozi kwaye zifuna ixesha elide lokubuyisela.Oku kunokungakhululeki kwizigulane kunye nokulibazisa ukuchacha.Ukongezelela, iingxaki ezifana nokusuleleka okanye ukopha zingenzeka.
Nangona kunjalo, kwiminyaka engama-20 ezayo, utyando lwamathambo kulindeleke ukuba luxhamle kubuchwephesha obutsha.Enye indawo eza kuqhubeka iphuhliswa lutyando lwerobhothi.Iirobhothi zinokwenza iintshukumo ezichanekileyo kwaye zincede oogqirha botyando kwiinkqubo ezinzima.Oku kunokukhokelela kwiziphumo ezingcono kunye namaxesha amafutshane okubuyisela.
Inkqubela phambili eyongezelelweyo ilindeleke kwiyeza lokuvuselela.Itekhnoloji entsha efana nonyango lwe-stem cell kunye nobunjineli bezicubu zinokunika ithuba lokulungisa okanye ukubuyisela izicubu ezonakalisiweyo.Oku kunokunciphisa imfuno yokufakelwa kunye nokuphucula ukuchacha kwesigulana.
Ukongezelela, ukuqhubela phambili kweteknoloji ye-imaging kulindeleke.Imifanekiso ye-3D kunye nenyani yenyani inokunceda oogqirha botyando benze uxilongo oluchanekileyo kwaye bacwangcise ngcono inkqubo.
Enyanisweni, utyando lwamathambo ehlabathini lonke luye lwazoyisa iingxaki ezahlukahlukeneyo ukutyhubela iminyaka.Ubugcisa obuphambili obukhankanywe ngasentla buye benza igalelo elibalulekileyo ekuphuculeni utyando lwamathambo.Eminye imizekelo esebenzayo yile:
1. Utyando olungenabungozi obuncinci: Ngokusetyenziswa kwee-endoscopes kunye nezixhobo ezincinci, utyando lunokwenziwa ngeendawo ezincinci.Oku kubangela intlungu engaphantsi kokuhlinzwa, ukubuyisela ngokukhawuleza kunye neengxaki ezimbalwa.
2. Utyando olulawulwa yirobhothi: Iinkqubo ezincediswa yirobhothi zenza ukuba kube lula ukuchaneka kunye neenkqubo ezingaphantsi.Ngokomzekelo, zingasetyenziselwa ukufakelwa kwamadolo okanye i-hip endaweni yokuphucula ukuchaneka kunye nokufaneleka.
3. Iisistim zokukhangela: Iisistim zokukhangela ezincediswa ngekhompyutha zinceda oogqirha botyando benze iindlela ezichanekileyo zokusikeka kunye nokufakwa kwezixhobo zokufakelwa.Ngokomzekelo, zingasetyenziselwa utyando lomgogodla ukuphucula ukhuseleko kunye nokuchaneka.
Ezi teknoloji zinceda ukuphucula iziphumo zotyando lwamathambo, ukunciphisa ixesha lokubuyisela, kunye nokuphucula izigulane, umgangatho wobomi.Ngokubanzi, kwiminyaka engama-20 ezayo, utyando lwamathambo luya kuzuza kwiiteknoloji ezintsha ezivumela utyando oluchanekileyo, ukubuyisela ngokukhawuleza, kunye neziphumo eziphuculweyo.
Eli nqaku likhetha esinye sezifo eziqhelekileyo ukubonisa impembelelo yokuphindaphinda kwezobuchwepheshe kwiminyaka.
I-Intertrochanteric fractures ye-femur yingozi eqhelekileyo eyenzekayo kubantu abadala kwaye ihambelana nokugula okuphawulekayo kunye nokufa.Iindlela zonyango ziye zavela ekuhambeni kweminyaka, kunye nenkqubela phambili kubuchule botyando kunye noyilo lofakelo olukhokelela kwiziphumo eziphuculweyo.Kule nqaku, siza kuphonononga iindlela ezahlukeneyo zonyango zokuqhekeka kwe-intertrochanteric ye-femur, sihlalutye inkqubela phambili yezobuchwepheshe ngokuguquguquka kweminyaka, kwaye sixoxe ngeendlela zonyango zakutshanje.
Kwiminyaka elikhulu eyadlulayo, unyango lwe-intertrochanteric fractures lwaluhluke kakhulu kwiindlela zanamhlanje.Ngelo xesha, iindlela zotyando zazingekho phambili, kwaye kwakukho iinketho ezinqamlekileyo zezixhobo zokulungiswa kwangaphakathi.
Iindlela ezingezizo utyando: Iindlela zonyango ezingezizo utyando zazihlala zisetyenziselwa i-intertrochanteric fractures.Oku kwakuquka ukuphumla ibhedi, ukutsala, kunye nokungashukumi ngodaka lwesamente okanye izikhonkwane.Injongo yayikukuvumela ukuphuka ukuphilisa ngokwemvelo, kunye nokunyakaza okuncinci kunye nokuthwala ubunzima kwilungu elichaphazelekayo.Nangona kunjalo, ezi ndlela zihlala zibangela ukungasebenzi ixesha elide kunye nokwanda kweengozi zeengxaki ezifana nokuchithwa kwemisipha, ukuqina kwamalungu, kunye nezilonda zoxinzelelo.
Iindlela zokuhlinzwa: Ukungenelela kokuhlinzwa kwi-intertrochanteric fractures wapho ixhaphake kakhulu kwaye igcinelwe iimeko zokufuduswa okuqatha okanye ukwaphuka okuvulekileyo.Iindlela zotyando ezazisetyenziswa emva ngelo xesha zazilinganiselwe kwaye zazihlala zibandakanya ukunciphisa okuvulekileyo kunye nokulungiswa kwangaphakathi kusetyenziswa iingcingo, izikrufu, okanye iipleyiti.Nangona kunjalo, izinto ezikhoyo kunye nezixhobo azizange zithembeke okanye zisebenze njengokufakelwa kwanamhlanje, okukhokelela kumazinga aphezulu okusilela, usulelo, kunye nokungabikho komanyano.
Ngokubanzi, unyango lwe-intertrochanteric fractures kwikhulu leminyaka eyadlulayo lwalungasebenzi kwaye lunxulumene nemingcipheko ephezulu kunye neengxaki xa kuthelekiswa nezenzo zangoku.Ukuqhubela phambili kubuchule botyando, izixhobo zokulungiswa kwangaphakathi, kunye neeprothokholi zokubuyisela kwisimo sangaphambili ziye zaphucula kakhulu iziphumo kwizigulane ezine-intertrochanteric fractures kwiminyaka yamuva.
Ukubethelwa kwe-Intramedullary kubandakanya ukufakwa kwentonga yentsimbi kwi-medullary canal ye-femur ukuzinzisa ukuphuka.Le ndlela ifumene ukuthandwa kwiminyaka yakutshanje ngenxa yobume bayo obuncinci kunye namazinga aphantsi obunzima xa kuthelekiswa ne-ORIF.Ukubethelwa kwe-Intramedullary kunxulunyaniswa nokuhlala ixesha elifutshane esibhedlele, amaxesha okubuyisela ngokukhawuleza, kunye namazinga aphantsi okungabikho komanyano kunye nokusilela kokufakelwa.
Izinto eziluncedo zokufakelwa kwezikhonkwane ze-intramedullary zokwaphuka kwe-intertrochanteric ye-femur:
Ukuzinza: Izikhonkwane ze-Intramedullary zinika uzinzo olubalaseleyo kwithambo eliqhekekileyo, ukuvumela ukuhlanganiswa kwangaphambili kunye nokuthwala ubunzima.Oku kunokukhokelela ekubuyiseleni ngokukhawuleza kunye nokunciphisa ukuhlala esibhedlele.
Ukugcinwa kwegazi: Xa kuthelekiswa nezinye iindlela zokuhlinzwa, izikhonkwane ze-intramedullary zigcina ukunikezelwa kwegazi kwithambo eliqhekekileyo, ukunciphisa umngcipheko we-avascular necrosis kunye ne-non-union.
Umonakalo omncinci wezicubu ezithambileyo: Utyando lubandakanya ukusika okuncinci, okukhokelela kumonakalo omncinci wezicubu ezithambileyo.Oku kunokukhokelela ekunciphiseni intlungu emva kokuhlinzwa kunye nokuphulukiswa ngokukhawuleza.
Umngcipheko osezantsi wosulelo: Indlela evaliweyo esetyenziswa kufakelo lwezikhonkwane kwi-intramedullary iyayinciphisa ingozi yokosuleleka xa ithelekiswa noqhaqho oluvulekileyo.
Ukulungelelaniswa okungcono kunye nokunciphisa: Izikhonkwane ze-Intramedullary zivumela ukulawula okungcono kunye nokulungelelaniswa kwethambo eliqhekekileyo, elikhokelela ekuphuculeni iziphumo zokusebenza.
I-Hemiarthroplasty ibandakanya ukutshintshwa kwentloko yowesifazane kunye nokufakelwa kweprothetic.Le ndlela ihlala igcinwe kwizigulane ezikhulileyo ezine-osteoporosis enzima okanye abo bane-hip arthritis esele ikhona.I-Hemiarthroplasty inxulunyaniswa nomngcipheko ophezulu weengxaki, kuquka ukuchithwa, ukusuleleka, kunye nokusilela kokufakelwa.
I-THA ibandakanya ukutshintshwa kwendawo yonke ye-hip joint kunye ne-prosthetic implant.Le ndlela ngokuqhelekileyo igcinelwe abaguli abancinci abanesitokhwe esihle samathambo kwaye akukho arthritis ye-hip ekhoyo ngaphambili.I-THA inxulumene nexesha elide lokubuyisela kunye nomngcipheko ophezulu weengxaki xa kuthelekiswa nezinye iindlela zonyango.
Utyando olupheleleyo lokutshintshwa kwe-hip lunconywa ngokubanzi kwizigulane ezine-arthritis enzima ye-hip, i-hip fractures engakwazi ukunyangwa nge-hemiarthroplasty, okanye ezinye iimeko ezibangela intlungu enkulu kunye nokukhubazeka.
I-Hemiarthroplasty inenzuzo yokuba yinkqubo engaphantsi kokuhlinzwa kokutshintshwa kwe-hip, oku kuthetha ukuba ngokuqhelekileyo kubandakanya ukuhlala esibhedlele okufutshane kunye nexesha lokubuyisela ngokukhawuleza.Nangona kunjalo, kungenako ukuphumelela ekuphatheni iintlobo ezithile zeemeko ze-hip, kwaye kukho umngcipheko wokuba inxalenye eseleyo ye-joint hip inokonakala ngokuhamba kwexesha.
Utyando olupheleleyo lokutshintshwa kwe-hip, ngakolunye uhlangothi, yinkqubo ebanzi ngakumbi enokubonelela ngokukhululeka okuhlala ixesha elide kwiintlungu ze-hip kunye nokuphucula umsebenzi we-hip jikelele.Nangona kunjalo, yinkqubo ehlaselayo ngakumbi enokufuna ukuhlala ixesha elide esibhedlele kunye nexesha elide lokubuyisela.Kukho umngcipheko weengxaki ezifana nokusuleleka, ukuchithwa kwegazi, kunye nokuchithwa kwe-hip joint.
Ukuqukumbela, unyango lwe-intertrochanteric fractures ye-femur luye lwavela ngokuphawulekayo kwiminyaka, kunye nenkqubela phambili kubuchule botyando kunye noyilo lokufakelwa olukhokelela kwiziphumo eziphuculweyo.Iindlela zonyango zamva nje, ezinje ngezikhonkwane ze-intramedullary, zibonelela ngeendlela ezihlaselayo ezincinci ezinamazinga asezantsi okuxakeka.Ukukhethwa kwendlela yonyango kufuneka ibe ngumntu ngamnye ngokusekelwe kwiminyaka yobudala besigulane, i-comorbidities, kunye neempawu zokuphuka.
Ixesha lokuposa: Oct-13-2023