Leqaqailaneng arthrodesis: ho buuoa, liphello, tsosoloso, mamello ulasan pelanggan

Ha pathologies tsohle tsa tsamaiso ya musculoskeletal ka e felisoe ka ho ntlafatsa boleng ba thepa ea motheo mehaho. Maemong a mang, e le emisang mosebetsi wa likarolo le 'ngoe kapa ho feta. Arthrodesis tsa leqaqailaneng kopanetsoeng - ho buuoa joalo. finyelle pakane ea lona e fetoha ho tlosa likarolo nonviable lokisa ka tlaase leoto selekane le fixation ho eketsehileng mehaho anatomic boemong bo fisioloji. Tlas'a hore na maemo e etsoa arthrodesis tsa leqaqailaneng joang? Liphello tsa ho kenella le tsosoloso melao-motheo efe? About ena - hamorao ka sehlooho se reng.

Bontšang bakeng sa ho buuoa

Arthrodesis - tshitsiso, ao ho 'ona e kopanetsweng ho khina le artificially e tsitsitseng le boemong ba. Tlhokeho ya tshebetso ya ho buoa e ke keng ea qojoa maemong a latelang:

1. Ho ba teng ha dangling kopanetsoeng. boemo ba hlahellang ka morao khatello interosseous kopanetsoeng. E ka ba leeme kapa ka ho feletseng. Phello ke ho tlōla deformation ea mosebetsi fisioloji hara kopanetsoeng (nako e telele shoele litho tsa mesifa, ligaments tsekolotsoeng, likotsi gunshot, ka tsela e feteletseng le manonyello katoloso).
2. Ntshetsopeleng ya deforming ramatiki. Arthrodesis tsa leqaqailaneng kopanetsoeng, ulasan pelanggan eo u ka e bala ka tlase, e hlokahalang ka purulent, tuberculous le foromo e sithabetsang ea bolwetse.
3. Holofatsang ramatiki le mathata. maemo Pathological akarelletsa liphetoho ka lesapo epiphysis.
4. Mathata a ea pholio.
5. A fracture hore folisa sa nepahalang kapa di ne tsa kopanngwa nakong e fetileng.
6. Haeba ho hlokahala, ea implantation ba bang kapa kaofela ha kopanetsoeng, haeba mefuta e meng ea tsereletsi lia khoneha.

Contraindications

Arthrodesis tsa leqaqailaneng (liphello tsa botho ba mpe, 'me mathata a ke ka seoelo haholo ka mor'a ho buuoa) e hanetsoeng ho phetha maemong a latelang:

• ho fihlela lilemong tsa bocha ho fihlela tsamaiso e khopo musculoskeletal ke ka ho ba sethaleng sa kholo ea tsona;
• ho ba teng ha fistula tlhaku tubercular bakoang ke ketso ya e sa tloaelehang atypical mycobacteria;
• ho ba teng ha tshwaetso ka sebaka sa tshebetso sa kenella;
• boemo bo tebileng boo ba le mamello, ho hloka botsitso ha nako e ntse.

Ka mor'a lilemo tse 60 tsa tshebetso ya arthrodesis tsa leqaqailaneng le ka boela bakela mathata a tebileng.

Mefuta ea kenella

Khetholla mefuta e ka sehloohong e mehlano ea ho buoa ho itšetlehile ka tsoelo-pele ea mellwane le thepa e sebediswa:

• Intra-articular arthrodesis tsa leqaqailaneng kopanetsoeng e etsoang ke tlosoe articular lefufuru.
• Tsamaiso e eketsehileng-articular se etsoa ke oxyphobe masatsoana likarolo litšoantšo nkiloe le mamello e tšoanang. Mohlomong tshebediso ya palaeform mofani.
• Kopantswe arthrodesis tsa leqaqailaneng kopanetsoeng kopanya mefuta bobeli ba tshebetso. Tlosa ho tswa ho e kopanetsoeng lefufuru le masapo palaeform oxyphobe e etsoa ke ho kenya tšepe lipoleiti khethehileng.
• mofuta wa katoloso ya tshebetso e thehiloe boitšoaro ba fracture maiketsetso. Ho ekelletsa moo likarolo lesapo ba tsitsitseng le boemong le ho khina fisioloji otlolotse sethusathuto. Ka mantsoe a mang, mofuta ona wa kenella o bitsoa "arthrodesis leqaqailaneng Ilizarov".
• The compression tshebetso e etsoa ke lokisa e elements'moho le spokes, pivots, melamu le lisebelisoa tse ling tse tobileng sebelisoa ka traumatology.

thethebatso ho hlokehang

thethebatso Local ka mokhoa ona ho buoa e sa sebelisoa ka lebaka la 'nete ea hore mellwane sa etsahala tebileng lefufuru le masapo dibopeho. Sebelisa mefuta e latelang ea thethebatso:

• endotracheal thethebatso - mokuli e qoelisoa ka ho robala thethefatsa medicaments khethehileng ke inhalation, e ajoa foromo gaseous;
• lesapo la mokokotlo thethebatso - mokuli e elang hloko, o bona le ho utloa tsohle, empa maoto le matsoho ka tlaase ka ho feletseng ho khina le ho haella ha ba nahanela;
• kopantswe thethebatso - lesapo la mokokotlo analgesia kopantswe le ho qoelisoa ka halofo-robetse puso, e sebediswa bakeng sa bakuli ba hlokolosi haholo le hlokolosi haholo.

Arthrodesis tsa leqaqailaneng la, Testimonials mamello eo e bontša hore ke buuoe ke ho ena nako e telele 'me ho ka nka lihora tse 2 ho ea ho 6. Ho itšetlehile ka hore na ka thata ka boemo lekhetlo la pele, le khethiloeng mokhoa kenella le hore ho hlokahala hore ho ba le mamello e tšoanang le palaeform.

ba lokisetsa ho ba le mamello

Arthrodesis tsa leqaqailaneng la, Testimonials mamello eo li bontša hore ho hlokahala hore ho lokisetsa preoperative, hloka hore a hlahlobe tse feletseng tsa mokuli. Ka pele ho kenella efe kapa efe, operable lokela fetisa liteko litleleniki tsa mali, moroto, Biochemistry. Beha boemo ba coagulation, sehlopha mali le RH lebaka. Nkoa liteko tlamang bakeng sa HIV, mokaola, lefu la sebete, a tšoere: x-ray.

matsatsi a 7 pele ho buuoa ho hlokahala hore ho lahla lithethefatsi tse amang mali a tsamaiso e khopo hoama, 'me batho bao e seng steroidal-ba khahlanong le a hlabang lithethefatsi. Ka letsatsi la ho qetela o ile a lumella feela lentsoe le akaretsang tsa lijo. Hoseng ha letsatsi le ho ja le ho noa metsi a pele ho kenella e thibetsoe, ho qoba mathata 'nang nakong thethebatso.

Ba bonnete ba hore, ka mokuli e tla ba sepetlele, o lokela ho lokisa tikolohong e phutholohile ka tlung. Ho hlokomela lintho tse joalo ba lokela ho tsoela pele ho:

• tlosa limmete, o ka ba thellisoe ke makaka;
• e diseke ee ha ho khoneha ho beha lithapo, eo leshano fatše, e le hore ho ba le mamello e sa lemaletse ho bona;
• ya ho hlapela ho reka moseme le linoelo fire, e le hore a se ke a jarisa ka mokatong metsi;
• lokisetsa mehaho tsohle tse hlokahalang bakeng sa ho phetha mekgwa ya tshebetso bohloeki e le haufi kamoo ho ka khonehang, e le hore a se ke a lokela ho li finyella.

mokhoa oa

Arthrodesis tsa mo ntša kotsi leqaqailaneng mora dithulaganyo se felloe ke nako kapa a tšoaetsanoang hore ba entse hore ho ditlolo tsa maikarabelong tshebetso, e etsoa ka mekhahlelo e 'maloa:

1. Sebaka sa ho kenella e tšoaroa ka antiseptics, 'me a koahela le line ea boleng bo nyopa ho buoa.
2. The boqapi kopanetsoeng e khaola ho cm, 15 ka bolelele. Dikarolo dissected fascia le mesifa fihlela bokaholimo articular ha ba a bonahatsa ka ho leqeba leo a.
3. Lefufuru dinama tse nyenyane tse e tlosoa, e ntšitsoeng bao e seng ee solofetsang le lemetse likarolo kopanetsoeng.
4. Bokaholimo talus le tibia, e leng tla lumellane ka thata-thata ho e mong le e tse ling tse, di thehoa ka nepo. Sena se etsoa e le hore ho theha selekane e nepahetseng ea leoto tlaase.
5. Sebopeho sephetho le e tsitsitseng ka ho fittings khethehileng tšepe e tsitsitseng tsela.
6. Ka mor'a nako, lesapo tla hōla hammoho likarolo le mong ho e mong le e kopanetsoeng ke ke ba hlola ba le foromo ea pele. mesebetsi lona tla mokhoa o sa fellang fetisetsoa ho lintho tse ling.

Seo manonyello a mang sebetsa

Arthrodesis hase kenella itseng, ho e balwa ka leqaqailaneng la. Ka tsela e tšoanang, ho sithabela lingaka tse buoang ka immobilize latelang libakeng anatomical:

• noka e kopanetsoeng - hlahisa excision tsa meniscus le lokisa hlooho ea femur ho noka ya, e kopanetsweng ntse li eme ka ho feletseng;
• masatsoana lengole kopanetsoeng - o lumelloa feela ho ba sieo ha pathologies ea tsamaiso ea pelo le methapo;
• mahetla kopanetsoeng - Tsamaiso tseo hangata li sebelisa lesapo palaeform ba mokuli (a se ke a etsahala ho khesoa) kapa mofani;
• metatarsophalangeal articulation - sepheo ke ho felisa ho sitisa kapa valgus deformation iatrogenic motona kopanetsoeng tsamaiso boloke ka mor'a nako ea ho hlaphoheloa.

Mabaka a hore hlokang arthrodesis la manonyeletso, tsamaisana le tsohle tse ka holimo.

nako hlaphoheloa

Arthrodesis tsa leqaqailaneng kopanetsoeng, e photo photo photo photo ea eo lumella kutloisiso e qaqileng ea buuoa, ho hloka ho hlaphoheloa e telele. Ka letsatsi la pele u sitoa ho theoha betheng e le ho qoba mathata a khonehang ho tloha thethebatso (molikoalikoane, hlooho e opang, ho hlatsa).

ngaka alakisi tshebediso ya analgesics le batho bao e seng steroidal-ba khahlanong le a hlabang lithethefatsi bakeng sa ho utloa ho re kokololo bohloko. mahlahana antibacterial sebelisoa, haeba ho hlokahala. Ena e amanang le kotsing e khōlō ea suppuration ka lefelo la 'mele tsoang linaheng tse ling (linale, lipoleiti, melamu). Ea lithibela-mafu ratang o fuoa ho bonyane nang le chefo e ho le mamello:

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

Nakoana ka mor'a hore ke buuoe ho hlokahala hore ho apara liaparo tse sa samente tlamisa, ho mamella boemo ba pheletsong e ka tlaase o hlola ka ho e 'ngoe eo ho eona ho tlalehiloeng setsebi. Bolelele ba gypsum ka nka ho fihlela ho likhoeli tse 3-4.

ngaka e tla eletsa mokuli ha ho khoneha ho nosetsa sebaka online, ho fihlella. Nang le tsona hona ke ke etsoang ho thibela sebaka tshwaetso. Ka mor'a ho tlosa liheloe samente ho hlokahala hore ho botjha X-ray tlhlahlobo ho netefatsa logan nepahetseng ya metsoako masatsoana.

Pele 2 dikgwedi tse hata ka leoto sebetsa e hanetsoeng, kahoo u lokela ho reka lithupa le tsamaea feela le bona. Ka likhoeli tse 3 ka mor'a X-ray ho rarolla ho sithabela lingaka tse buoang ka qala ho itšetleha ka maoto le ho sebedisa ea physiotherapy mekhoa ea phekolo e.

ea physiotherapy

Rehabilitation mora arthrodesis tsa leqaqailaneng kopanetsoeng e reretsoe ho kenyeletsa phekolo 'meleng, sililoa,' me likarolo tse ling tse ka postoperative mohato hlaphoheloa. ho ikoetlisa phekolo ke mokhoa bohlokoa ka ho fetisisa hobane ke leboha bakuli hae ho thibela ntshetsopele ya contractures kopanetsoeng.

La e mong oa phekolo 'meleng ngaka alakisi:

1. Electrophoresis - sebakeng leqaqailaneng ke tšusumetso ea linaoa kamehla motlakase. Ba ka tsamaisoa ka tsela litokisetso medicated thunyana ho ruruha, ho tshwarwa soreness, felisa ho ruruha, normalizing metabolism, phepelo ea mali ho ebe o kenya tshebetsong sebakeng buuoa.
2. UHF - tsamaiso eo ho eona ho ke tšusumetso ea motlakase tšimo UHF ka lisele le dinama tse nyenyane tse. UHF khothalletsa Tshebediso ya ya dithulaganyo regenerative, pholiso ea fractures le maqeba, lopollang ruruha, lopollang bohloko, di hlohleletsago ea moo ajoa mali.
3. Matla a khoheli - battlefield keying, e sebelisa matla a khoheli. Le hlaha ka ho felisoa ha bohloko le edema, thibeloa ho sebakeng tshitsiso ea tšoaetso, e ile ea eketseha elasticity ea methapo ea mali le ho ntlafatsa ajoa ka likopi mali ka sebakeng se amehileng.
4. Laser phekolo - khoneha tshebediso ya holim'a metsi le mokhoa intraosseous tsa pepesehela, eo e leng karolo ea ho phekola le ho hlaphoheloa tsa mafu a manonyeletso.

Arthrodesis tsa leqaqailaneng kopanetsoeng, ka mor'a moo tsosoloso ka nka ho fihlela ho likhoeli tse 8, mokuli hloka mosebetsi kamehla ka itlohellang. Feela tabeng ena hoa khoneha ho qoba ntshetsopele ya mathata 'me a tsosolosa mosebetsi oa sebaka sebetsa.

mathata khoneha

Joalokaha eka ke ka ho buuoa leha e le efe, arthrodesis tsa leqaqailaneng kopanetsoeng ka ba le palo ya la mathata:

• tshwaetso-'moho le tsoelo-pele ho eketsehileng osteomyelitis;
• tsoa mali, hematoma sebopeho;
• paresthesia - ho tlōla ho nahanela ka lebaka la dissection ya tse nyenyane methapo ea kutlo akira theo gun;
• ho hloka monyetla oa ho lokisa e kopanetsoeng;
• lameness le tse ling tse pathological gait;
• tlhokeho ya mekgwa ya tshebetso eketsehileng ho buoa;
• thrombosing methapong tebileng tsa leoto tlaase;
• thromboembolism ka sehloohong methapo.

Ba bonnete ba hore a bolelle setsebi sa matšoao a latelang:

• feberu;
• utloe bohloko bo boholo ka sebaka sa ho fihlella ho buoa;
• matlafatsang tsa ruruha;
• boteng ba shoohlo kapa tingling;
• leoto kapa blueness ponahalo ea sootho matheba a;
• ponahalo ea bokhutšoanyane phefumoloho, ho nyekoa ke pelo, ho hlatsa.

bokooa

Arthrodesis tsa leqaqailaneng kopanetsoeng, e leng ho nkoa ho nang le bokooa ka mor'a boemo seoelo hloka hore ntlafatsoa fuoa koetliso leoto mpe ho tloha mokuli. Bakeng sa nako tse nyenyane ka mor'a ho kenella ea bokooa ke khoneha, empa feela ha se le ho tsosolosoa ha boemo bo tshebetso ya e kopanetsoeng.

Ho ea ka melao, tse amoheloang ke Order tsa Lekala la Mesebetsi, e neng e tšoaretsoe tshebetso ke qobelloa immobilization tsa leqaqailaneng likarolo kopanetsoeng maemong a mangata lebisa ditlolo nyenyane tsa ee sa fetoleng boemo-matla litšobotsi tse tshebetso, e bolelang hore ho na le bokooa ha e thehilweng.

Ka taelo ea bokooa tiisa diphesente la boemo bo lefu le karo-karolelano ea bolwetse itseng ho lethathamo le ka holimo la mafu. Ha boemo ba bolwetse ho 30% (hakanngoa ke litsebi MSEC Komisi) bokooa e sa beha, 40-60% - sehlopha sa boraro sa 70-80% - ka sehlopha sa bobeli, 90-100% - sehlopha sa pele. Ngoana a fumana bokooa ka lebelo le ho tswa 40 ho ea ho 100%.

liphetoho tse nyenyane tseo ka tsona motho a khona ho sebeletsa bona, e seng tsa dihlopha tsena. Tabeng ea contractures le mafu musculoskeletal mesebetsi ee sa fetoleng boemo hore ba bitsoa arthrodesis tsa leqaqailaneng kopanetsoeng, liphello - bokooa, ho hloleha ho nosi itlhokomela le ho hlokomela litlhoko tsa ntshetsopeleng ka morao ena ea mathata a kelello.

Testimonials

Ho ea ka tseo ba ileng ba pholoha ho sebetsa ha immobilization kopanetsoeng, ke thata nako e telele ka mokhoa o buoa e hlokang tsebo e phahameng ba ngaka e buoang le. Nako tsosoloso ke ntlha ea bohlokoa ke hore bakuli ba qala ho ikutloela bohloko 'me u underperforming ya ka dipehelo tsa ho phetha ea ho ikoetlisa letsatsi le letsatsi. Ke mefokolo tsena ba elements ea bohlokoa ho ntshetsopele ya contractures kopanetsoeng le litsebeng mesebetsi tsa likoloi.

Ha ho bohloko, esita le boemong ba meroalo e boima, e hlaphoheloa tletse gait, ho hloka boemong bo sa thabiseng ka sebakeng seo ho kenella, e ntle le setlolo ponahalo ea - litsupa ya tshebetso e atlehileng.