I.Farsamaynta buuxinta sibidhka
Qaabka buuxinta sibidhka ee laftiisa ayaa ku habboon bukaanka qaba Nooca yar ee Aori ee Cilladaha If If If If If iyo nashaadaadyo firfircoon.
Teknoolajiyadda sicir-bararka fudud ee farsamo ahaan waxaa loo baahan yahay nadiifin dhammaystiran ee cilada lafaha, iyo sibidhka lafta ayaa buuxisa cillada lafaha inta lagu gudajiro geedaha cilfalka inta ugu badan ee suuragalka ah, sidaasna lagu gaaro si adag oo ku habboon interface-ka lafaha.
Qaabka gaarka ah eeBhal / kowCement +STeknoolojiyadda shaqaalaha ayaa ah in si buuxda loo nadiifiyo cirifka lafaha, ka dibna ku hagaaji daboolka lafta martida loo yahay, oo ka taxaddar inaadan u oggolaan daboolka daboolka ka badan dusha sare ee ka dib osteotomi; Ka dib ku qas jilibka sibidhka, ka buuxi cillad lafaha marxaladda cajiinka, oo duub daboolka. Ritter ma et al. Qaabkan loo adeegsaday dib-u-dhiska cilladaha jilicsan ee lafaha, oo dhumucdii cilladda la gaaray 9mm, oo ma jirin wax furfuran 3 sano qalliinka ka dib. Sibidhka oo buuxinaya tikniyoolajiyadda ayaa meesha ka saaraysa lafaha yar, ka dibna adeegsiga dib-u-eegista sanaadaalka caadiga ah, taas oo lagu yareynayo kharashaadka daaweynta sababta oo ah adeegsiga sanaadajinta sanaadajinta, oo leh qiimo wax ku ool ah.
Qaabka gaarka ah ee lafaha + tikniyoolajiyadda xoqan waa in si fiican loo nadiifiyaa cillad lafta, ku hagaaji daboolka lafta martida, oo fiiro gaar ah u yeelato in daboolka daboolku uusan ka badneyn dusha sare ee ka dib osteotomi; Ka dib ku qas jilibka sibidhka, ka buuxi cillad lafaha marxaladda cajiinka, oo duub daboolka. Ritter ma et al. Qaabkan loo adeegsaday dib-u-dhiska cilladaha laf-dhabarka, oo dhumucdii cilladaadu gaadhay 9mm, oo ma jirin wax furfuran oo ah 3 sano qalliinka ka dib. Sibidhka oo buuxinaya tikniyoolajiyadda ayaa meesha ka saaraysa lafaha yar, ka dibna adeegsiga dib-u-eegista sanaadaalka caadiga ah, taasoo yareynaysa kharashka daaweynta sababta oo ah adeegsiga dib-u-eegista sanaadaalka, kaasoo leh qiimo wax ku ool ah (nambarka)I-1).
NambarI-1Sibidhka sibidhka iyo xoojinta daboolka
II.Farsamooyinka Grafting ee lafta
Kombiyuutarka lafaha lafaha ayaa loo isticmaali karaa in lagu hagaajiyo cilado lafaha loo dhan yahay ama loo dhan yahay ee qalliinka dib-u-eejinta jilibka. Waxay inta badan ku habboon tahay dib-u-dhiska Nooca Arooi Nooca III Cilladaha lafta. Qalliinka dib-u-eegista, maadaama baaxadda iyo heerka cilladaha lafta guud ahaan ay yihiin kuwo aad u daran, xaddiga lafaha istcimaaliga ee la helayo waa mid yar oo lafta loo yaqaan 'sclerotic' iyo sibidhka sclerotic-ka ayaa laga saaraa inta lagu jiro qalliinka si loo ilaaliyo cufnaanta lafaha si loo ilaaliyo cufnaanta lafaha si loo ilaaliyo tirada lafaha si loo ilaaliyo cufnaanta lafaha si loo ilaaliyo cufnaanta lafaha si loo ilaaliyo cufnaanta lafaha si loo ilaaliyo cufnaanta lafaha si loo ilaaliyo tirada lafaha si loo ilaaliyo cufnaanta lafaha si loo ilaaliyo cufnaanta lafaha. Sidaa darteed, lafaha geesaha leh ee loo yaqaan 'alfogeneic' oo la istcimaalo waxaa badanaa loo isticmaalaa kombiyuutarka lafaha lafaha inta lagu jiro qalliinka dib-u-eegista.
Faa'iidooyinka kombiru gelinta ee lafaha lafaha waa: xajista cufnaanta lafaha ee lafta martida; hagaajinta cilladaha lafaha ee fudud ama adag.
Faa'iido darrooyinka tikniyoolajiyadani waa: Qalliinku waa waqti-qaadasho; Tikniyoolajiyadda dib-u-dhiska ayaa dalbanaya (gaar ahaan marka la isticmaalayo qodobka mesh ee mesh ah); Waxaa jira suurtogal ah in faa iido gudbinta cudurada.
Cashuur fudud oo lafaha ah:Cadaadis fudud oo lafaha ah ayaa badanaa loo isticmaalaa cilladaha lafaha loo dhan yahay. Farqiga u dhexeeya cadaadiska lafaha lafaha iyo grafting lafaha lafdhabarta ayaa ah in sheyga granular granular ee lagu sameeyo cadaadiska grafting lafaha lafta si dhakhso leh oo gabi ahaanba dib loo qiimeeyo.
XAQIIQOOYINKA MACLUUMAADKA MACLUUMAADKACilladaha lafaha ee loo dhan yahay ee lafaha ah badanaa waxay u baahan yihiin dib-u-dhiska iyadoo la adeegsanayo baqashada birta mesh si loo gartado lafaha ka hortagga ah. Dib-u-dhiska femrka badanaa way ka adag tahay dib-u-dhiska tibiyada. Raajooyinku waxay muujinayaan in is dhexgalka lafta iyo qaabeynta lafaha ee maaddada budada si tartiib tartiib ah loo buuxiyo (Jaantus)II-1-1, TiradaasiII-1-2).
NambarII-1-1Cashuur-ka-dhasha ee Mesh-ka ayaa ku xadgudubka lafaha si loo dayactiro cillad lafaha. Intraippice; B pspopoottopit raajada
Miroe Ii-1-2Dayactirka 'diskoomka' iyo tabia lafta lafaha ee lafaha leh ee lafaha miskulka gudaha ee titanium-ka ee lafaha ah ee lafaha. Intraippice; B pspopoottopit raajada
Inta lagu gudajiro dib-u-eegista arthroplasty, laf dhismeedka qaab dhismeedka alfogenec ayaa inta badan loo isticmaalaa dib-u-dhiska Nooca II ama ciladaha lafaha lafta. Ka sokow in lagu daro xirfadaha qalliinka ee superb-ga iyo khibrad hodan ah oo ku saabsan beddelka jilibka adag, takhtarka qalliinka waa inuu sidoo kale ka dhigaa qorsheyaal taxaddar leh oo faahfaahsan. Grawort-ka lafaha ah ee lafaha ayaa loo isticmaali karaa in lagu hagaajiyo cilladaha lafaha lafaha oo kordhin cufnaanta lafaha.
Faa'iidooyinka tikniyoolajiyaddan waxaa ka mid ah: Waxaa lagu sameyn karaa cabir iyo qaab kasta oo laqabsashada cilladaha lafaha ee qaababka joomatariyada kala duwan; Waxay saameyn wanaagsan ku leedahay taageerida dib-u-eegista sanaadajinta; Is dhexgalka bulshada ee noolaha muddada-dheer waxaa lagu gaari karaa inta u dhexeysa lafta allogenenic iyo lafta.
Faa'iido darrooyinka waxaa ka mid ah: Waqtiga hawlgalka dheer ee muddada dheer markii goynta lafaha allogeneic ah; ilaha xadidan ee lafaha allogeneic; Khatarta ah in musaafurinta iyo dib-u-dhigista dib-u-dhigga sababa ay sabab u tahay dib-u-soo-celinta lafaha iyo jilbaha lafaha ka hor inta aan la dhameystirin nidaamka is-dhexgalka lafaha; Dhibaatooyinka nuugista iyo infekshanka ee agabyada ku-tallaalida; suurtagalnimada gudbinta cudurada; oo aan ku filnayn xasilloonida bilowga ah ee lafta allogenenic lafta. Lafaha qaab-dhismeedka alfogenec-ka ayaa laga gooyaa dulucda dulucda, tibimal tibia, ama madaxa fekerka. Haddii maaddada ku-tallaalidda ay weyn tahay, dib u soo noqoshada dhameystiran badanaa ma dhacdo. Madaxa-andeveric and waxaa loo isticmaali karaa in lagu dayactiro futada futada ah ee cilladaha lafaha, inta badan dayactirka nooca caloosha ee nooca, waxaana lagu hagaajiyaa isku-darka-riixitaanka ka dib goosashada iyo qaabeynta. Natiijooyinka caafimaad ee hore ee lafaha qaab dhismeedka alfogenec si ay u dayactiraan ciladaha lafaha waxay muujiyeen sicirka bogsashada sare ee lafaha la beddelay (JaantusII-1-3, TiradaasiII-1-4).
NambarII-1-3Dayactirka ciladaha lafaha lafta leh oo leh madax-ka-dhiska dhaawaca gawaarida
NambarII-1-4Hagaajinta cilladaha lafaha lafaha leh oo leh madaxa-lafaha badhtanka
III.Tikniyoolajiyadda birta
Tiknoolajiyadda tikniyoolajiyada tikniyoolajiyada modular micnaheedu waa in waxyaabaha la buuxiyo bir lagu soo ururin karo sanaaciyo iyo afkoda intrats. Kuwa wax ku dhejiya waxaa ka mid ah qaabab kala duwan si loo fududeeyo dib-u-dhiska cilladaha lafaha ee cabbirrada kaladuwan.
Macdan ka duwan yihiin Barara Kharash:Meelaha birta ee modular ah ayaa inta badan ku habboon nooca atori nooca iI ee ciladaha aan lafaha ahayn ee cilladaha lafaha oo leh dhumuc ilaa 2 cm.Adeegsiga qaybaha birta si loo dameeyo cilladaha lafaha waa mid ku habboon, sahlan, waxayna leedahay saameyn caafimaad.
Xirmooyinka biraha waxay noqon karaan mid adag ama adag, iyo qaababkooda waxaa ka mid ah aroosyada ama baloogyada. Meelaha birta waxaa lagu xiri karaa saldhiga gogosha leh ee ku yaal boolal ama lagu hagaajiyo sibidhka laftiisa. Aqoonyahanada qaar ayaa rumeysan in hagaajinta sibidhka sibidhka lafta uu ka fogayn karo xirashada macdanta inta udhaxeysa biraha oo kula taliya hagaajinta sibidhka sibidhka. Culimada qaar ayaa sidoo kale u doodaya habka loo isticmaalo sibidhka laftiisa marka hore ka dibna ku xoojinta boolal u dhexeeya meelaha bannaan iyo sanaaciyada. Cilladaha Fems-ka ayaa inta badan ka dhaca qaybaha dambe iyo meelaha fog ee ka mid ah iskaashatada gawaarida, sidaa darteed meelaha durdurrada ah ayaa badanaa lagu meeleeyaa qaybaha dambe iyo meelaha fog ee futada. Cilladaha lafdhabarta lafta, aroosyada ama baloogyada ayaa loo xulan karaa dib-u-dhiska si ay ula qabsadaan qaababka cilladaha kaladuwan. Suugaanta ayaa soo sheegeysa in heerarka aad u fiican iyo heerarka wanaagsan ay u badan yihiin 84% ilaa 98%.
Baloogyada qaab-qaabeysan ayaa la istcimaalaa marka cillad lafta lafaha yahay qaab-qaabeysan, kaas oo ilaalin kara lafta martida badan. Qaabkani wuxuu u baahan yahay osteotomihed osteotomi oo sax ah si dusha sare ee osteotomy ay u dhigantaa barta. Ka sokow walaaca cadaadiska, sidoo kale waxaa jira xoog xiir ah oo u dhexeeya xidhiidhka xiriirka. Sidaa darteed, xagasha xididdada waa inaysan dhaafin 15 °. Marka la barbar dhigo baloogyada qaab-qaabeysan, block-ka birta ee dhululubo ayaa leh faa iido kordhinta xaddiga osteotomi, laakiin qalliinka qalliinku waa mid sahlan oo sahlan, iyo saamaynta farsamada ayaa u dhow sidii caadiga ahayd (III-1-1A, b).
NambarIII-1-1Xirmooyinka Birta: Meel-dhimis qaab-dhismeedka ah si loo dayactiro ciladaha tabial; B Difaac-qaabeeya safka si loo dayactiro ciladaha tabial
Sababtoo ah qulqulatada birta waxaa loogu talagalay qaabab iyo cabbirro kala duwan, waxaa si weyn loogu isticmaalaa cilladaha lafaha aan lahayn oo lafaha iyo cilladaha lafaha ee qaabab kala duwan, waxayna bixiyaan xasillooni farsamo oo bilow ah. Si kastaba ha noqotee, daraasadaha muddada-dheer waxay ogaadeen in masaafada biraha ay ku guuldareystaan gaashaandhigga walaaca. Marka la barbardhigo gubashada lafaha, haddii meelaha biraha ay ku guuldareystaan oo ay u baahan yihiin in dib loo eego, waxay sababi doonaan cilladaha lafaha weyn.
Waqtiga Post: Oktoobar-28-2024
