U-Li Guishan, umlawuli weSebe le-Arthroplasty yeSibhedlele saseGuizhou Huaxia Orthopedic, wabona isigulana esikhethekileyo esinentlungu edolophini iminyaka eyi-11+, weza esibhedlele enebhentshi yokungena kwisebe, enokukhubazeka okukhulu kuzo zombini. amadolo kunye nobunzima obukhulu ekuhambeni.I-radiographs iphakamise ukuba isigulane sine-fracture endala (engaphiliyo) ye-femur ye-distal yasekhohlo + i-dislocation endala yedolo lasekhohlo + i-osteoarthrosis yedolo lasekunene.Ukufumana unyango olongezelelweyo, isigulane safuna uncedo kwisebe lotyando oludibeneyo lweSibhedlele saseGuizhou Huaxia Orthopedic Hospital, sinethemba lokufumana utyando lwamadolo.
Ekuphenduleni imeko yedolo yesigulane, iqela likaMlawuli uGuishan Li liqhube ukubonisana ngokucokisekileyo kwaye lafunda iinkcukacha zotyando, kwaye ekugqibeleni liphuhlise isicwangciso esipheleleyo kunye nesicokisekileyo sotyando lwesigulane, emva koko lenze "bilateral" idolo arthroplasty usebenzisa i-LDK "Hinged". I-Knee Prosthesis "kunye ne "Modular Tumor Knee Prosthesis", kwaye utyando lwahamba kakuhle.
Inkcazo:
Isigulane, umfazi, iminyaka engama-62 ubudala
Isikhalazo:
Iintlungu zamadolo amabini kunye nokunciphisa ukuhamba kweminyaka eyi-11 +.
Imbali yonyango yangoku:
Isigulane sasinentlungu emadolweni omabini ukususela malunga ne-11 + iminyaka edlulileyo ngaphandle kwesizathu esicacileyo, kwaye ngokuthe ngcembe sancipha ekuhambeni (icala lasekhohlo linzima kakhulu), kodwa akazange akhathalele ngelo xesha kwaye akazange afumane unyango olucwangcisiweyo.Wayengakwazi ukuhamba, eqhwalela xa ehamba ngeentonga, e-squat and ehla enyuka amathambeka, kunye neminye imisebenzi yokuthwala ubunzima.Ukukhubazeka kwedolo lasekhohlo kuye kwanda ngokuthe ngcembe;idolo lasekunene liye lakhula ngokuthe ngcembe ukukhula kunye nokukhubazeka kwe-flexion inversion, echaphazela kakhulu ubomi bemihla ngemihla.
Kulo nyaka uphelileyo, ezi mpawu zingasentla ziye zaba mandundu, waza walaliswa kwisibhedlele sasekuhlaleni ukuze afumane unyango olungakumbi, waza wacela utyando lwedolo labagulayo.
Imbali yangaphambili:
Iminyaka eyi-13 + edlulileyo, ukulimala okubuhlungu kwidolo lasekhohlo kubangele ukukhubazeka kunye nentlungu kunye nomsebenzi olinganiselweyo, kwaye emva kokuzinyanga, ukukhubazeka, intlungu kunye nomsebenzi wedolo lasekhohlo liphuculwe;kwiminyaka eyi-13 +, wakhupha umzimba wamahhala wedolo lasekhohlo kwisibhedlele sendawo kwaye wakhutshwa ekliniki waphiliswa;iminyaka eyi-8 +, wayenembali yesitulo esimnyama esingenasiphelo ngaphandle konyango olusesikweni.
Iimviwo ezizodwa:
I-spinal physiological curvature yaba nzulu, kwakungekho ntlungu yoxinzelelo kunye neentlungu ze-percussion kummandla we-lumbosacral, kwaye i-lumbar spine yayishukunyiswa kuwo onke amacala.
Icala elisezantsi lasekhohlo lalimfutshane kunomlinganiselo osezantsi wasekunene malunga ne-6.0 cm;idolo lasekunene landiswa kwaye i-flexion ikhubazekile (i-inversion malunga ne-30 °);ithanga lasekhohlo laliyipseudo-articularly dislocated kufuphi nedolo;umbala wolusu nobushushu bamadolo omabini buqhelekile;malunga ne-8.0 cm yamanxeba amadala otyando abonwa kwicala langaphambili ledolo lasekhohlo, elaphilisa kakuhle.
Omabini amadolo ane-peripatellar ebalulekileyo kunye neentlungu ezipheleleyo ze-medial kunye ne-lateral ye-gap ye-knee gap, uvavanyo olujikelezayo lwe-patella (-), uvavanyo lwe-drawer yasekunene (-), uvavanyo lwe-drawer ekhohlo (alunakuvavanywa ngokuqhelekileyo), uvavanyo loxinzelelo lwecala (+), uphawu lukaMcSweeney ( +), uvavanyo lokusila lwe-patellar (+), uvavanyo lokuphakamisa umlenze othe ngqo ongalunganga, uvavanyo lokuphakamisa umlenze othe ngqo wasekhohlo alukwazanga ukwenziwa;ukunyakaza kwedolo lasekunene kwakulinganiselwe: ukwandiswa kwedolo lasekunene malunga -5 °;ukuguqa kwedolo lasekunene malunga ne-70 °;idolo lasekunene ukujikeleza kwangaphakathi malunga ne-5 °, ukujikeleza kwangaphandle malunga ne-5 °.
Ukulahleka kokwandiswa, ukuguquka, ukujikeleza kwangaphakathi kunye nokujikeleza kwangaphandle kwedolo lasekhohlo;ukuva okulungileyo kunye nokuhamba kwegazi kwindawo ekude yemilenze yomibini ephantsi;ithoni yemisipha eqhelekileyo kwilungu elisezantsi lasekunene;ithoni yezihlunu kwilungu elisezantsi lasekhohlo alikwazanga ukulinganiswa ngokuqhelekileyo;ukubetheka kakuhle komthambo we-dorsalis pedis macala omabini.
Iimviwo ezincedisayo:
1, I-osteoarthrosis yamadolo amabini
2, Ukwaphuka kwakudala kwe-distal left femur (engaphiliyo)
I-3, ukuchithwa kwakudala kwedolo elisekhohlo
4, ukopha emathunjini?
Utyando lwangaphambili
Emva koqhaqho
Intshayelelo yoGqirha
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Iingcali:utyando olufakelweyo lokubuyisela amalungu kunye notyando oluhlaziyiweyo, iyeza lezemidlalo (utyando lwe-arthroscopic), unyango lotyando lokwenzakala komnqonqo, ukophuka okuntsokothileyo, iziphene ezithambileyo, kunye nokulungiswa kokukhubazeka, njl. i-necrosis.
Ixesha lokuposa: May-09-2023