Uburyo bwo guhitamo icyitegererezo gikwiyeUrusenda rw'imbere mu nda y'abagore?
Guhitamo uburyo bukwiyefamarangamutimanubuzimabisaba isuzuma ryimbitse ry’ubwoko bw’umurwayi bwo kuvunika, imiterere y’umubiri we, imiterere y’amagufwa ye, uburyo bwo kubaga, n’ibyo umuganga w’inzobere mu kubaga akunda, bigatuma afata ibyemezo ku giti cye. Ibipimo by’ingenzi by’isuzuma ni ibi bikurikira:
I. Guhitamo hashingiwe ku gace kavunitsemo n'ubwoko bwako (Ibimenyetso)
Kuvunika kw'inkondo y'umugongo (intertrochanteric na transcervical):
Igisanzweimbere mu ruhu rw'inyuma umusumari(nk'uko bimeze muri PFNA isanzwe): Igaragazwa ku mvune zo mu bwoko bwa intertrochanteric (nk'ubwoko bwa 31-A1, 31-A2), imvune zo mu bwoko bwa reverse intertrochanteric (ubwoko bwa 31-A3), n'imvune zo mu rwego rwo hejuru (32-A1). Uburyo busanzwe ntibukosowe kandi bukwiriye abarwayi bafite amagufwa meza kandi bafite imvune zidahindagurika.
Udusimba two mu nda y'umugongo (nk'udusimba two mu nda y'umugongo): Bigaragazwa ku mvune nke zo mu nda y'umugongo, imvune zirimo umurongo w'imvune urenga impera ya acetabulum ntoya urenga cm 3, imvune zo mu nda y'umugongo zirenga impande zose, imvune nyinshi, imvune ziterwa n'indwara, cyangwa abarwayi ba osteoporotic. Ubwoko bwa mvune bukenera gukaraba kandi bushobora gutanga uburyo bworoshye bwo gufata neza no kudahindagurika kw'izunguruka.
Andi moko (nk'iya InterTan,Umunyu wa Gamma): InterTan (inzara ebyiri zivanze n'insinga) ikwiriye kuvunika cyane bisaba gukanda; inzara ya Gamma ikoreshwa mu kuvunika byoroshye kandi bihamye cyangwa kuvunika kwa subtrochanteric.
Uduce two hagati mu gice cy'inyuma: Amahitamo meza ni utwo hagati mu gice cy'inyuma. Uduce dukwiye n'uburebure bw'urusyo rwo hagati mu gice cy'inyuma bigomba gutoranywa hashingiwe ku bugari bw'umwobo w'inyuma n'urugero rw'aho imvune yavunitse.
Kuvunika kw'inkari zo mu kibuno (condylar upper/intercondylar): Uburyo bwiza bwo kuvura ni ukuvura inzara zo mu kibuno zifungana mu buryo bwa reverse locked intramedullary, zikwiriye ku mvune zo mu kibuno zo hejuru, imvune zo mu kibuno zifata ingingo, cyangwa imvune ziri munsi y'agahu k'inkari ko mu kibuno.
II. Hashingiwe ku hantu winjirira n'uburyo bwo kubaga
Aho umuntu yinjira mu gasongero ka trochanter nini (uburyo bwa antegrade): Bikwiriye abarwayi bafite umubyibuho ukabije (uburyo bworoshye, igihe gito cyo kubaga, fluoroscopy nke) ndetse n'imvune zisanzwe hagati y'imitsi. Ariko, hagomba kwitonderwa kugira ngo hirindwe gukomeretsa imitsi ya abductor.
Aho icyuma gipfukirana mu nsinus ya Pyriform (icyerekezo cy'imbere): Bikwiriye kuvunika hagati y'imitsi, ariko aho iherereye ni hato. Biragoye cyane kubaga abarwayi bafite umubyibuho ukabije kandi hakwiye kwitabwaho kugira ngo hirindwe kwangiza amaraso yo mu ijosi ry'ijosi cyangwa umutwe w'ijosi.
Aho gutobora inyuma (unyuze muri fossa ya intercondylar): Bikwiriye kuvunika kwa distal femoral. Hakwiye kwitonderwa kugira ngo wirinde kwangiza inkomoko y'umugongo w'inyuma.
III. Hashingiwe ku burebure bw'inzara za Titanium Femor
Uducurama tugufi (170–200 mm): Bigenewe abarwayi bafite umuyoboro muto w’amaraso yo mu kibuno, imvune zidahindagurika, kandi bafite imiterere y’inyuma y’ikibuno. Bigabanya igihe cyo kubagwa, ariko hakenewe kwitonda kugira ngo hirindwe ko imiyoboro migari yo mu kibuno idahindagurika neza.
Umunyu w'uburebure buri hagati (235–240 mm): Ukwiriye nk'ubundi buryo bwo gusimbura inzara ngufi, cyangwa ku mvune nke zifata amaguru, aho imyobo ifunga ikwiye kugumana ariko inzara ndende ntizishobora gukoreshwa.
Udusimba ture ndende (260–480 mm): Bikwiriye abarwayi bafite imiyoboro miremire y’amaraso, indwara yo gucika intege kw’imitsi, kuvunika kw’indwara, ubusembwa bw’ingingo zo mu gice cy’imbere cy’umutima, imiyoboro y’amaraso igera kure, cyangwa abakeneye gufatirwa igihe kirekire. Ariko, igihe cyo kubagwa n’amaraso biziyongera cyane.
IV. Hashingiwe ku gusana umurambararo w'inzara cyangwa ubunini bwayo
Ihame ryo guhitamo umurambararo: Rigomba guhuzwa hakurikijwe igice gito cyane cy'umwobo w'umurwayi (cyangwa umwobo w'umurambararo ugereranyijwe) kugira ngo ritange imbaraga zihagije zo gufata (gukanda-gufata neza) kandi hirindwe kuvunika kw'ivunji.
Umusumari utaraguka: Hitamo umusumari ufite umurambararo muto wa mm 1 ugereranyije n'umurambararo w'umwobo utose (urugero, niba umurambararo w'umwobo utose ari mm 10, hitamo umusumari wa mm 9).
Umusumari wagutse (urugero, niba umurambararo w'umuyoboro wagutse ari mm 11, hitamo inzara zifite umurambararo wa mm 9-10).
Ingano isanzwe: Ingano isanzwe ikoreshwa ku bantu bakuru ni 9-11mm, mu gihe ku bana ari 4-6mm.
V. Guhitamo hashingiwe ku miterere y'amagufwa n'imiterere y'umurwayi
Abarwayi barwaye indwara yo gucika kw'amagufwa: Ni byiza guhitamo ibininiIndwara y'amagufwa Umusumari (gushyiraho icyuma gikandagira) cyangwa ndende kugira ngo hirindwe gucibwa inzara zo mu mutwe cyangwa ngo imbogamizi zo mu mutwe zikoreshwe bitewe n'imbaraga zidahagije zo kuzifata.
Abarwayi bakiri bato/ bafite amagufwa meza: Inzara zo mu nda ziciriritse zishobora gutoranywa kugira ngo zigumane amaraso mu gice cyo hagati cy’amagufwa no kugabanya ibyago byo kwangirika kw’ubushyuhe buterwa no kwaguka kw’amagufwa.
Icyitonderwa: Amahitamo ya nyuma yaInzu z'abagore zo mu rugo zo kuvugurura inzarabisaba gusuzuma neza hashingiwe ku bipimo nyabyo byakozwe mbere yo kubagwa (X-ray/CT), imiterere ya fluoroscopy mu gihe cyo kubagwa, ndetse n'ubuhanga bw'umuganga.
Igihe cyo kohereza ubutumwa: 16 Nzeri 2026