Na puupuu wawae arthrodesis:ʻoki kino, ka hopena, hoʻopulapula, ahonui hōʻike manaʻo

Aʻole ka pathologies a pau o ka musculoskeletal'ōnaehana hiki ke eliminated ma ka hoʻomaikaʻi i ka mea e like ai o mall hehee wale. I kekahi manawa, he wahi hana o kekahi a oi Hoʻohana. Arthrodesis o ke kuʻekuʻe wāwae ami - iaʻoki kino. Kona pahuhopu i wehe nonviable hehee wale koho i ka lalo lala (axis), a me ka hou fixation o anatomic hale i loko o ka physiological kulana. Ma lalo o na hana hea ua hana arthrodesis o ke kuʻekuʻe wāwae? He aha nō i ka hopena o ka 'uao a me ka hoʻopulapulaʻana me nā loina? About keia - hope o ka pauku.

Nāʻikepili no kaʻoki kino

Arthrodesis - 'ākeʻakeʻa, ai ka hui immobilized a artificially paa i hoʻomoana. Ka nele no kaʻoki lāʻau lapaʻau ana mea inevitable i loko o ka kēia hihia.

1. Ke alo aku o ka dangling ami. He ano ia lŘlŘ i loko o ke kāʻei kua ke kanana nei interosseous ami. Ua hiki e ka helehelena a piha. Ka hopena o ka 'aʻe' ana o deformation o physiological haʻawina i loko o ka ami (hooloihiia lōlō o nāʻiʻo, haehae ligaments, gunshot nā palapū, excessive mailaila aku ami).
2. ? Ac? O ino arthritis. Arthrodesis o ke kuʻekuʻe wāwae hui, hōʻike manaʻo e pili ana i 'oe ke heluhelu lalo, ua koi' ia ma ka purulent, tuberculous a me traumatic ano o ka pathology.
3. Degenerative arthritis me complications. Pathological kumu entail loli ma ka iwi epiphysis.
4. Complications o ke polio.
5. A fracture e hoola paha improperly paha merged i loko o ka hala.
6. Inā pono,, nō ka implantation o kekahi a me nā mea a pau o ka hui, inā nāʻano o nā uao ai 'hiki.

Contraindications

Arthrodesis o ke kuʻekuʻe wāwae (ka hopena o ka io ano, a me complications i loa pohihihi keia ma hope oʻoki kino) ua papaia e lawe mai i loko o ka kēia hihia.

• a adolescence a musculoskeletal'ōnaehana mea i loko o ke kahua o ka ulu ana;
• alo fistula tubercular ano, kena ae la ma ka hana o'āno'ē atypical mycobacteria;
• i ke alo o ka maʻiʻaʻai i loko o ka wahi o ka 'uao;
• mea ano o ka hoomanawanui, me ka nele o ke kumupaʻa no manawa.

Ma hope o 60 makahiki o ka hana o ka arthrodesis o ke kuʻekuʻe wāwae hiki no hoi i complications nui.

'ano o ka' uao

Hoomaopopoʻelima ka papa kuhikuhi ano o keʻoki kino ke kaumaha ma muli o ka holomua o ka manipulation a me ka hoʻohana 'ia lako a pan.

• Ke kūʻai '-articular arthrodesis o ke kuʻekuʻe wāwae ami ua lawe mai ma ka ana o ka articular cartilage.
• Keu-articular ke kaʻina hana no ua hanaʻia e ka ponaʻana pokou hehee wale kiʻi lawe mai i ka ia hoʻomanawanui. Paha ka hoʻohana a ka pou pakuiia auanei lakou.
• Hui arthrodesis o ke kuʻekuʻe wāwae ami hiehie nāʻano o nā hana. Wehe mai ke ami cartilage a me ka iwi pakuiia auanei lakou ka ponaʻana ua hana ia e kanu pūʻia ana kūikawā metala papa.
• I ka palena manawaʻano o ka hana ua ma muli o ka hana o kaʻimi hoʻopunipuni fracture. E möakäka hou iwi oihana mua i paa i ka wahi, a immobilized physiological'ōʻia i hoʻomākaukauʻia. Ma na olelo e ae, i kēia 'ano o ka' uao ua kapaia "arthrodesis na puupuu wawae Ilizarov".
• Ka mīkini'opihia ana ua hana ia e hoʻopunipuni kekahi ami hehee ai me ka mau huila, pivots, ua mau laau la, a me ka ho'ākāka 'ia i manaʻo i hoʻohana ma traumatology.

pili anesthesia

Local anesthesia ma keiaʻoki lāʻau lapaʻau ina hana ua i hoʻohana 'ia no ka mea, o ka mea i ka manipulation i wahi i ka hohonu cartilage a me ka iwi kanu'ōiwi. Pili i ka kēia mauʻano o ka anesthesia:

• endotracheal anesthesia - ka hoʻomanawanui ua bapetizo i loko o ka anesthetic moe kūikawā medicaments ma inhalation, ua māhele ma gaseous palapala;
• spinal anesthesia - i ke ahonui o ka manao, ike a lohe a pau, akā, haʻahaʻa lala loa immobilized a me ka nele o ka pā lonoaʻili;
• alu anesthesia - spinal analgesia hui me kaiapuni i loko o ka hapa-hiamoe moku'āina, ua hoʻohana 'ia no ka nui ikepili koʻikoʻi, a nui nā mea maʻi ikepili koʻikoʻi.

Arthrodesis o ke kuʻekuʻe wāwae, hoʻomanawanui e hoike i ka hōʻike i ka hana iʻano lōʻihi a hiki hope mai 2 a hiki i 6 hola. Ua hilinaʻi nui ma luna o ka paakiki o ka puka mua ana, i ka wae 'ana i kūpono' uao a me ka nele i ka mea ia hoʻomanawanui i ka pakuiia auanei lakou.

hoʻomanawanui hoomalolo

Arthrodesis o ke kuʻekuʻe wāwae, hoʻomanawanui e hoike i ka hōʻike i ka pono no ka preoperative la hoomalolo, pono i ka piha ninaninau o ka hoʻomanawanui. Like ma mua kekahi 'uao, operable pono kekahi i ka lapaʻau ho'āʻo ma o ke koko, mimi, biochemistry. Ho oholo i ka moku'āina o coagulation, koko pae a me RH ololi. Noonoo OAXA ho'āʻo ma no HIV, syphilis, hepatitis, e paa ana m-Ray.

7 lā ma mua o kaʻoki kino pono e haʻalele i ka ai 'e aloha ia ke koko clotting'ōnaehana, a me ka' ole-steroidal Anati-hoʻoʻino ai '. I kona lā hope Ke aeia'ku nei ia wale bland ai. Ke kakahiaka eʻai, a inu i ka wai ma mua 'uao ua hookapuia, e pale aku Loaʻaʻia complications i anesthesia.

E maopopo lea ai, e like me ke ahonui, e ia i loko o ka haukapila, e pono e hoomakaukau i kaʻoluʻolu lewa i loko o ka hale. E lawe mālama ana i na mea e mua:

• wehe i rugs, a hiki e hoʻopöholo ihola;
• me kana olelo hoopomaikai i hiki ke kau i na kaula, a moe ma ka papahele, no laila, i ka hoʻomanawanui ua i ka makau ma luna o ia mau mea;
• ka make up, e kūʻai i ka moena me ka omo na kiaha, no laila, i mea, aole ia e hoʻololi i ka wai palaoa;
• hooponopono i ka mea e pono iauaeoia no ka lawe ana mai i kou niho hana like kokoke loa i hiki, no laila, i ole e i, e hiki ia lakou.

'ana i kūpono a

Arthrodesis o ka ino ma hope o obsolete paha infectious keʻano o ka hanaʻana na puupuu wawae mea i alakai i ka 'aʻe' ana o ka loiloi nā pihana'ū, ua lawe mai i loko o kekahi mau kahua o ka hoʻonaʻauao.

1. Ka wahi o ka 'uao ua malamaia lakou nei, me antiseptics, a ua uhiʻia me ka sterileʻoki lāʻau lapaʻau i hiloʻia.
2. Ke ami wānana ua oki ia 15 knm ka lōʻihi. Papa dissected fascia a me Muscle a hiki i ka articular surfaces ka mea,ʻaʻole e hōʻike 'ia i loko o kaʻeha.
3. Cartilage'aʻaʻa ua wehe ', extracted ole-viable, a hana ino iki mai ami hehee wale.
4. Surfaces talus a me ka tibia, a e pono paa i kekahi i kekahi, e hana kūponoʻia. He ua hana i ka mea e hookupaa aku i ka pololei iho (axis) o ka lalo lala.
5. Ke kūpono 'ole ua paa ma kūikawā metala pono paa kela ano keia ano.
6. Ma manawa, i ka iwi, e ulu pu laua a nā kumumea a me kekahi i kekahi, a me ka ami e hou i ka palapala ano. Kona oihana, e e hapa 'ia' hele ma i nā 'ikamu.

He aha nā ami hana

Arthrodesis mea,ʻaʻole he mau 'uao, ka mea, he pōpilikia ma luna o ke kuʻekuʻe wāwae. Pela no, trauma surgeons ke immobilize ke kēia anatomical wahi:

• Hip ke ami hoi - paka excision o ka meniscus, a koho i ke poo o ka femur a hiki i ka pelvis, ka ami koe loa motionless;
• pokou kukuli ke ami hoi - ua ia wale nō i loko o ka wa e kaawale aku o pathologies o ka mea'ōnaehana mānowai koko oihana;
• poʻohiwi ke ami hoi - hana a pinepine hana iwi pakuiia auanei lakou o ka hoʻomanawanui (ʻaʻole i hiki mai rejection) a me kona mau pou;
• metatarsophalangeal articulation - ka pahuhopu mea e hoʻopau, keakea ole valgus deformation iatrogenic manamana nui ami ka hoʻoneʻe aua ma hope o ke ola au.

Nā kumu i noi aku arthrodesis o na ami, hoʻopili like me nā mea a pau o ka luna.

ke ola au

Arthrodesis o ke kuʻekuʻe wāwae hui, he Hawaii photo no i ae i ka piha naauao o ka hana, koi he lōʻihi ke ola. Ka mua ka lā e hiki ole kiʻi mai o ka moe i mea e pale aku hiki complications mai anesthesia (pōniuniu, headache, ka luaʻi).

Ke Kauka prescribes ka hoʻohana o analgesics, a non-steroidal Anati-hoʻoʻino ai 'no ka eha ke ola. antibacterial konohiki i hoʻohana, ina he pono. Keia ua pili i ka pilikia kiʻekiʻe o suppuration ma ka wahi o na kino (paipu, papa, mau laau la). Of antibiotics ua haawiia mai ana kāu mau koho a hiki i ka liʻiliʻi loa o kaʻawahia i ka hoʻomanawanui.

1. Cephalosporins - "cefotaxime" "Ceftriaxone".
2. Macrolides - "Erythromycin", "Clarithromycin".
3. Penicillins - "Ampicillin", "Ampioks".

Kekahi manawa ma hope o ka hana, ua pono e komo i ka puna lole wili, e kau i ke kulana o ka lalo palena koe kekahi ma i ka mea kākau o ka hoʻomalu. Duration o gypsum hiki mau mai i 3-4 mahina.

Ke Kauka e kuhikuhi i ka hoʻomanawanui ka wā hiki hooinu ai wahi online no ke kula. Iho keia hiki ole ke hana i ka pale aku i ka maʻiʻaʻai wahi. Ma hope o ka wehe 'ana i ka puna nou ana la o ka pono e hou-X-Ray keia hookolokolo ana, e hoʻokūpaʻa pololei kuʻi nukeliu o pokou hehee wale.

Ka mua 2 mahina o hehi ma luna o ka hoʻohana wāwae ua papaia, no laila, e pono e kuai oaʻiʻo, a hele wale me ia. At 3 mahina ma hope o ka X-Ray e hoʻonā i trauma surgeons hiki hoʻomaka e hilinai aku maluna o ka wawae a me ka hana physiotherapy kūlana kanaka.

physiotherapy

Hoʻopulapula ma hope o arthrodesis o ke kuʻekuʻe wāwae mau ua manaoia e komo physical Inc, lomilomi, a me nā kumumea i loko o ka postoperative ke ola pae. Pākōlea hoounauna o ka mea nui hana, no ka mea, o ke aloha i kona hoʻomanawanuiʻana, e pale aku i ke kūpono 'ana o ke ami contractures.

O ka mea 'ē aʻe physical Inc kauka prescribes:

1. Electrophoresis - ma ke kuʻekuʻe wāwae kahi o ka ole o ka ikaika ka pila lāʻau ikiʻai wale. Ka mea hiki ke lawelawe Via lapaʻau hoomakaukau pana li nui, soreness hopu, hoʻopau nani, normalizing pūnao, ke koko kokuaia e haʻalele i keʻoki kino ciia.
2. UHF - he hana i loko o a he mea ka ole o ka electromagnetic a kahua UHF ma aeee a me'aʻaʻa. UHF paipai 'ia ka ho'ā hope o regenerative keʻano o ka hanaʻana, hoola o fractures a me nāʻeha, relieves nani, relieves eha, stimulates kūloko koko holo.
3. ʻume mākenēki - naeaeaa keying, a hoʻohana i kaʻume mākenēki kahua. Ia lŘlŘ hoʻopau o kaʻeha a me ka edema, hooki mai 'ākeʻakeʻa māhele o ka maʻiʻaʻai, mahuahua elasticity o na moku koko a me ka hoʻomaikaʻi i ke koko holo i loko o ka hoʻohuli ai i nā wahi.
4. Kukuna Inc - hiki pono o ka ili a me ka intraosseous hana o ka waiū, a he hapa o ka lapaau a me ka hoʻopakeleʻana i nā maʻi o na ami.

Arthrodesis o ke kuʻekuʻe wāwae hui, ma hope i hoʻopulapula hiki hope mai i ka 8 mahina, i ka hoʻomanawanui koi ikaika aku ka hana ma luna o oneself. Wale i keia hihia ia mea hiki ke pale i ke kūpono 'ana o nā complications, a hoihoi aku i ka hana o ka hoʻohana wahi.

hiki complications

E like me kekahiʻoki kino, arthrodesis o ke kuʻekuʻe wāwae ami hiki i ka helu o nā complications:

• ami maʻiʻaʻai me ka hou ana o ka osteomyelitis;
• kahe ana ke koko, hematoma ho okumu;
• paresthesia - he 'aʻe' ana i ka pā lonoaʻili i ka hopena o ka dissection o ka poe liilii, nā aʻalolo plexus;
• ka nele o ka manawa e koho i ka ami;
• lameness a me nā pathological gait;
• i ka pono no nāʻoki lāʻau lapaʻau ke kaʻina hana;
• thrombosing hohonu aa koko o ka lalo lala;
• thromboembolism ka papa kuhikuhiE arteries.

Mai poina e hai aku i ke akamai o ka mea kēia mau symptoms:

• kuni;
• hanahana loa kaʻeha ma ke kahua o kaʻoki lāʻau lapaʻau ka hookipaia;
• hoʻoikaika 'ana i ka nani;
• imua o ka numbness paha tingling;
• lala a ahinahina helehelena eleele kiko o;
• i ka helehelena o ka pokole o ka hanu, nausea, ka luaʻi.

kīnā o ke kino

Arthrodesis o ke kuʻekuʻe wāwae hui, a ua manaoia e e ka polokalamu JavaScript ma hope o ka nānā ke ano pono hoʻokāʻoi aʻo hewa wāwae mai ka hoʻomanawanui. No ka uuku manawa ma hope o ka piʻiʻana o ke kino, ua hiki, akā, wale mai i ka hoihoi hou ana o ka iaea ooieoeiiaeuiiai ano o ka ami.

E like me na rula, i aponoia ma ka Papa Hanohano o ke Kuhina o na Hana Lima, e paa ana ia hana ma ka hoʻoikaika immobilization o ke kuʻekuʻe wāwae mau hehee wale i loko o ka hapanui manawa hiki aku ai i ka nīnūnē 'aʻe' ana i kūpaʻa-hōʻeuʻeu ooieoeiiaeuiuo ano, a 'o ia hoʻi i ka mea i hookupaaia ke kīnā o ke kino.

By mea o ke kīnā o ke kino hoopaa pakeneka o ka maʻi ana, a me ka lākiō o ka hana i ho'ākāka 'pathology i ka luna o ka papa inoa o nā maʻi. A hiki i ka nui o ka pathology i 30% (oaeuiinoe ma ka poe akamai i MSEC Kuleana) kīnā o ke kino ua i kau, 40-60% - he kolu o ka pūʻulu o 70-80% - i ka lua o ka pūʻulu, 90-100% - ka mua pūʻulu. A keiki hookipa mai i ke kino kīnā ma holo 'awelika mai ka 40 a hiki i 100%.

Nā loli ma i ke kanaka mea hiki ke malama ia lakou iho, i hui ole ia i kēia mau waeʻano. Ma ka hihia o contractures a me musculoskeletal kāna hana o kūpaʻa oihana i ka poe i kaheaia arthrodesis o ke kuʻekuʻe wāwae hui, o ka hopena - kīnā o ke kino, hikiʻole ke kū kaʻawale e malama no lakou iho, a, e hālāwai me ka pono o ka? Acaeoey i loko o kēia kāʻei kua o ka manaʻoʻike pilikia.

e hoike

E like me ka poe i ola makou mahope o ka hana o ka hui immobilization, ia mea he lōʻihi huikauʻoki lāʻau lapaʻau hana i ka pono he kiʻekiʻe ke akamai o ka surgeon. Ke hoʻopulapula au mea nui he wahi mea i nā mea maʻi nanea minamina no oe ia oe iho, a underperforming i ka hua'ōlelo o ka hooko ana i kela la i keia hoounauna. He mau hewa lilo i kī hehee ai i loko o ka ulu ana o ka hui contractures , a hihia hoʻi Hawaii i hana '.

No eha, a hiki wale i loko o ka moku'āina o kaumaha wahie, he piha hou ana o ke ana, 'nele o ka discomfort i loko o ka' uao wahi, he maikai mea hoʻonani helehelena - nā hoailona o ka holomua hana.