Njengokuhlinzwa kwamathambo ngo-2023, kunobunzima obuthile.Enye inselele ukuthi izinqubo eziningi zamathambo ziyahlasela futhi zidinga izikhathi ezinde zokululama.Lokhu kungase kungakhululeki ezigulini futhi kubambezele ukululama.Ngaphezu kwalokho, izinkinga ezinjengokutheleleka noma ukopha zingenzeka.
Nokho, phakathi neminyaka engu-20 ezayo, ukuhlinzwa kwamathambo kulindeleke ukuba kuzuze ezobuchwepheshe obusha.Enye indawo ezoqhubeka nokuthuthuka ukuhlinzwa ngamarobhothi.Amarobhothi angakwazi ukunyakaza okunembe kakhudlwana futhi asize odokotela abahlinzayo ezinqubweni eziyinkimbinkimbi.Lokhu kungaholela emiphumeleni engcono kanye nezikhathi ezifushane zokululama.
Kulindeleke inqubekelaphambili eyengeziwe emithini yokuvuselela kabusha.Ubuchwepheshe obusha obufana nokwelashwa kwe-stem cell kanye nobunjiniyela bezicubu bunganikeza ithuba lokulungisa noma ukufaka esikhundleni sezicubu ezilimele.Lokhu kunganciphisa isidingo sokufakelwa futhi kuthuthukise ukululama kwesiguli.
Ngaphezu kwalokho, intuthuko kubuchwepheshe bezithombe kulindeleke.I-3D imaging kanye ne-virtual reality kungasiza odokotela abahlinzayo ukuthi benze ukuxilonga okunembe kakhudlwana futhi bahlele kangcono inqubo.
Eqinisweni, ukuhlinza amathambo emhlabeni wonke kuye kwanqoba ubunzima obuhlukahlukene phakathi neminyaka edlule.Ubuchwepheshe obuphambili obalulwe ngenhla buye benza umnikelo omkhulu ekuthuthukiseni ukuhlinzwa kwamathambo.Ezinye izibonelo ezisebenzayo yilezi:
1. Ukuhlinzwa okuhlaselayo okuncane: Ngokusetshenziswa kwama-endoscope namathuluzi amancane, ukuhlinzwa kungenziwa ngezisindo ezincane.Lokhu kubangela ubuhlungu obuncane ngemva kokuhlinzwa, ukululama ngokushesha kanye nezinkinga ezimbalwa.
2. Ukuhlinzwa okulawulwa yirobhothi: Izinhlelo ezisizwa ngamarobhothi zinika amandla izinqubo ezinembe kakhulu nezingangeneleli kancane.Isibonelo, zingasetshenziswa ekufakweni esikhundleni samadolo noma i-hip ukuze kuthuthukiswe ukunemba nokufaneleka.
3. Amasistimu okuzulazula: Amasistimu okuzulazula asekelwa ikhompuyutha asiza odokotela abahlinzayo ukwenza ukusikeka okunembile nokubeka izimila.Isibonelo, zingasetshenziswa ekuhlinzeni komgogodla ukuthuthukisa ukuphepha nokunemba.
Lobu buchwepheshe busiza ukuthuthukisa imiphumela yokuhlinzwa yamathambo, ukunciphisa isikhathi sokululama, nokuthuthukisa iziguli, izinga lempilo.Sekukonke, phakathi neminyaka engu-20 ezayo, ukuhlinza amathambo kuzozuza kubuchwepheshe obusha obuvumela ukuhlinzwa okunembe kakhudlwana, ukululama ngokushesha, kanye nemiphumela ethuthukisiwe.
Lesi sihloko sikhetha esinye sezifo ezivamile ukukhombisa umthelela wokuphindaphinda kwezobuchwepheshe phakathi neminyaka.
I-Intertrochanteric fractures ye-femur ukulimala okuvamile okwenzeka kubantu asebekhulile futhi kuhlotshaniswa nokugula okuphawulekayo nokufa.Izindlela zokwelapha ziye zavela phakathi neminyaka edlule, ngokuthuthuka kwamasu okuhlinza kanye nemiklamo yokufakela okuholela emiphumeleni ethuthukisiwe.Kulesi sihloko, sizobuyekeza izindlela ezahlukene zokwelapha zokuhlukana kwe-intertrochanteric ye-femur, sihlaziye inqubekelaphambili yezobuchwepheshe ngokusho kokuvela kweminyaka, futhi sixoxe ngezindlela zakamuva zokwelapha.
Eminyakeni eyikhulu edlule, ukwelashwa kwe-intertrochanteric fractures kwakuhluke kakhulu ezindleleni zanamuhla.Ngaleso sikhathi, amasu okuhlinza ayengakathuthuki, futhi kwakukhona izinketho ezilinganiselwe zamadivayisi okulungisa angaphakathi.
Izindlela ezingezona zokuhlinzwa: Izinketho zokwelapha ezingahlinzeki zazivame ukuqashwa ngenxa ye-intertrochanteric fractures.Lokhu kwakuhlanganisa ukuphumula kombhede, ukudonsa, nokuvala izinsimbi ngokhonkolo noma ama-splints.Umgomo wawuwukuvumela ukuphuka ukuba kuphole ngokwemvelo, ngokunyakaza okuncane nokuthwala isisindo esithweni esithintekile.Kodwa-ke, lezi zindlela zazivame ukuphumela ekunganyakazini isikhathi eside kanye nokwanda kwezingozi zezinkinga ezifana nokuwohloka kwemisipha, ukuqina kwamalunga, nezilonda zokucindezela.
Izindlela zokuhlinza: Ukungenelela kokuhlinzwa kwe-intertrochanteric fractures wlapha okungajwayelekile futhi ngokuvamile kubekelwe amacala okufuduka kakhulu noma ukuphuka okuvulekile.Izindlela zokuhlinza ezazisetshenziswa emuva ngaleso sikhathi zazilinganiselwe futhi ngokuvamile zazihilela ukunciphisa okuvulekile nokulungiswa kwangaphakathi kusetshenziswa izintambo, izikulufu, noma amapuleti.Kodwa-ke, izinto ezitholakalayo nezinsimbi bezingasebenzi njengokwethenjelwa noma okusebenzayo njengezigxivizo zesimanje, okuholela emazingeni aphezulu okuhluleka, ukutheleleka, nokungahlanganisi.
Sekukonke, ukwelashwa kwe-intertrochanteric fractures eminyakeni eyikhulu edlule bekungasebenzanga kahle futhi kuhlotshaniswa nezingozi eziphakeme kanye nezinkinga uma kuqhathaniswa nezinqubo zamanje.Intuthuko kumasu okuhlinza, amathuluzi okulungisa angaphakathi, kanye nezinqubo zokuvuselela izimilo kuye kwaba ngcono kakhulu imiphumela yeziguli ezine-intertrochanteric fractures eminyakeni yamuva.
Ukubethelwa kwe-intramedullary kuhilela ukufakwa kwenduku yensimbi kumsele we-medullary we-femur ukuze kuzinze ukuphuka.Le ndlela ithole ukuduma eminyakeni yamuva nje ngenxa yesimo sayo esincane sokuhlasela kanye namazinga aphansi ezinkinga uma kuqhathaniswa ne-ORIF.Ukubethelwa kwe-Intramedullary kuhlotshaniswa nokuhlala esibhedlela isikhathi esifushane, izikhathi zokululama ngokushesha, kanye namazinga aphansi okungewona inyunyana nokwehluleka kokufakelwa.
Izinzuzo zokufakelwa kwezinzipho ze-intramedullary zokuqhekeka kwe-intertrochanteric ye-femur:
Ukuzinza: Izinzipho ze-Intramedullary zinikeza ukuzinza okuhle kakhulu ethanjeni eliphukile, okuvumela ukuhlanganisa kusenesikhathi kanye nokuthwala isisindo.Lokhu kungaholela ekululameni okusheshayo nokuncipha kokuhlala esibhedlela.
Ukugcinwa kwegazi: Uma kuqhathaniswa nezinye izindlela zokuhlinza, izipikili ze-intramedullary zigcina ukunikezwa kwegazi ethanjeni eliphukile, ukunciphisa ingozi ye-avascular necrosis kanye ne-non-union.
Ukulimala kwezicubu ezithambile ezincane: Ukuhlinzwa kuhilela ukusika okuncane, okuholela ekulimaleni okuncane kwezicubu ezithambile.Lokhu kungaholela ekunciphiseni ubuhlungu be-postoperative kanye nokuphulukiswa ngokushesha.
Ingozi ephansi yokutheleleka: Indlela evaliwe esetshenziswa ekufakweni kwe-intramedullary nail inciphisa ubungozi bokutheleleka uma kuqhathaniswa nokuhlinzwa okuvulekile.
Ukuqondanisa okungcono nokunciphisa: Izipikili ze-Intramedullary zivumela ukulawula okungcono nokuqondisa kwethambo eliphukile, okuholela emiphumeleni yokusebenza ethuthukisiwe.
I-Hemiarthroplasty ihilela ukuguqulwa kwekhanda lesifazane ngokufakelwa kokufakelwa.Le ndlela ngokuvamile igcinelwe iziguli esezikhulile ezine-osteoporosis enzima noma lezo ezinesifo samathambo esivele sikhona.I-Hemiarthroplasty ihlotshaniswa nengozi ephezulu yezinkinga, okuhlanganisa ukugudluka, ukutheleleka, nokwehluleka kokufakelwa.
I-THA ihilela ukuguqulwa kwelunga le-hip lonke ngokufakelwa kokufakelwa.Le ndlela ngokuvamile igcinelwe iziguli ezincane ezinethambo elihle futhi azikho isifo samathambo esivele sikhona.I-THA ihlotshaniswa nesikhathi eside sokululama kanye nobungozi obukhulu bezinkinga uma kuqhathaniswa nezinye izindlela zokwelapha.
Ingqikithi yokuhlinzwa esikhundleni se-hip ngokuvamile inconywa ezigulini ezine-hip arthritis enzima, ukuphuka kwe-hip engakwazi ukwelashwa nge-hemiarthroplasty, noma ezinye izimo ezibangela ubuhlungu obukhulu nokukhubazeka.
I-Hemiarthroplasty inenzuzo yokuba inqubo engavamile kakhulu kunokuhlinzwa okuphelele kokushintshwa kwe-hip, okusho ukuthi ngokuvamile kuhilela ukuhlala esibhedlela okufushane kanye nesikhathi sokululama ngokushesha.Kodwa-ke, kungase kungabi ngempumelelo ekwelapheni izinhlobo ezithile zezimo ze-hip, futhi kunengozi yokuthi ingxenye esele ye-hip joint ingase yonakalise ngokuhamba kwesikhathi.
Ingqikithi yokuhlinzwa esikhundleni se-hip, ngakolunye uhlangothi, kuyindlela ebanzi kakhulu enganikeza ukukhululeka okuhlala isikhathi eside ebuhlungu be-hip futhi ithuthukise umsebenzi we-hip jikelele.Kodwa-ke, kuyinqubo ehlasela kakhulu engadinga ukuhlala isikhathi eside esibhedlela kanye nesikhathi eside sokululama.Kukhona futhi ingozi yezinkinga ezifana nokutheleleka, amahlule egazi, nokukhishwa kwe-hip joint.
Ekuphetheni, ukwelashwa kwe-intertrochanteric fractures ye-femur kuye kwavela ngokuphawulekayo phakathi neminyaka, ngokuthuthuka kwamasu okuhlinza kanye nemiklamo yokufakelwa okuholela emiphumeleni ethuthukisiwe.Izindlela zokwelapha zakamuva, ezifana nokubethelwa kwe-intramedullary, zinikeza izinketho ezihlasela kancane ezinamanani aphansi ezinkinga.Ukukhethwa kwendlela yokwelashwa kufanele kube umuntu ngamunye ngokusekelwe eminyakeni yobudala yesiguli, izifo ezihlangene, nezici zokuphuka.
Isikhathi sokuthumela: Oct-13-2023