Ithumba le-pelvic lolunye lweentlobo ezintsonkothileyo nezinzima zotyando lwethumba, kwaye ukususwa kwethumba kunokukhokelela ekulahlekeni kwethambo elikhulu.Ubume be-anatomical kunye ne-morphology ye-pelvis inzima xa kuthelekiswa nezinye iindawo.Ngaphezu koko, i-pelvis ikufuphi namalungu abalulekileyo kumqolo wesisu kunye nezakhiwo ezininzi ezijikelezayo zezicubu ezithambileyo, ngoko ke kukho imingeni enzima kucwangciso lwangaphambili kunye nolawulo lwangaphakathi.
Kwi-preoperative design ye-prosthesis, indawo yokutshatyalaliswa kufuneka yenziwe ngokufanelekileyo ngokuhambelana nokugula kwesigulane, kwaye emva koko ukwakhiwa kwendawo echaphazelekayo kunye nokufakelwa kwe-prosthesis kufuneka kucwangciswe ngokwendawo yokutshatyalaliswa.
Ubunzima bokuyila “i-pelvic tumor prosthesis” abukho kuphela kwimilo entsonkothileyo ye-anatomical ye-pelvis kodwa nakwinyani yokuba indawo yokuqikelela isigulana iyahluka ukusuka kumntu ukuya kumntu, ngoko ke indlela yokuyila iprosthesis enokuthi ihambelane ngcono nemfuno yesigulana kwaye ifezekiswe. iziphumo zotyando ezigqwesileyo yeyona nto iphambili kwimpumelelo yotyando.
Iinjineli ze-LDK zivavanya umahluko we-morphological wesigulane ngasinye, indawo yokulahleka kwethambo kunye nemeko-bume yomatshini apho iprosthesis iya kuhlala khona, "Yenza buqu" indawo eyakhiwe ngokutsha kwaye uqhube ukulinganisa kwekhompyuter ukulinganisa kunye nokuhlekisa ukuqinisekisa ukuba iprothesis. ingatyalwa ngoqhaqho.Kweli nqaku, siye sakhetha 6 ummeli ithumba uyilo prosthesis ulwahlulo ezahlukeneyo ithumba esinqeni kule minyaka 5 yokugqibela ireferensi kunye nengxoxo.
1 ingingqi I Isifuba ithumba
Eli tyala lithumba lommandla we-pelvic I kunye nokubandakanyeka kwe-joint sacroiliac.Ukuphela kwe-proximal yayiyi-osteotomized nge-joint ye-sacroiliac kumda wangaphandle we-sacral foramen, kwaye isiphelo esikude sasi-osteotomized ngokuthe tye ukusuka kwi-acetabular apex ukuya phezulu.I-pelvic prosthesis eyenziwe ngokwezifiso yasetyenziselwa ukwakha kwakhona iphiko le-iliac elinesiphene.Ubume kunye nobukhulu beprosthesis yalungiselelwa kwisiphene sesigulane, kwayeiprosthesis-bone interface(ukunxibelelana namathambo e-sacral kunye ne-iliac) yenzelwe ukulinganisa i-porous mesh ye-trabeculae yamathambo ukuze kube lula ukungena kwamathambo kunye nokufezekisa ukulungiswa kwexesha elide le-prosthesis.Udonga lwangasemva lwe-acetabulum lunomgca wensimbi enye eprintiweyo kunye nenkqubo ye-nail bar inokudibaniswa kwicala elingasemva le-prosthesis ukuphucula ukuzinza kweprosthesis.
2 Ummandla II Ithumba lePelvis
Isigulane sinesilonda esincinci kwaye kwenziwa kuphela i-acetabular resection, kunye ne-osteotomy ethe nkqo kwi-acetabulum yesigulane kunye ne-osteotomy enqamlekileyo kwinqanaba eliphezulu le-acetabulum, kunye nokususwa kwethambo le-pubic kunye nokugcinwa kwesebe le-sciatic.Iprosthesis ye-pelvic eyenziwe ngokwezifiso yaprintwa kwisiqwenga esinye, kunye ne-prosthesis-bone interface eyenziwe ngomatshini ukulinganisa i-mesh ene-porous ye-trabeculae.I-diameter yangaphandle ye-acetabulum yesigulane ilinganiswe kwaye indebe ye-acetabular ye-cemented ehambelana nemilinganiselo ye-acetabular yesigulane inqunywe ukuba ibe sisiseko sokwakhiwa kwakhona, kunye neplate eprintwe kwisiqwenga esinye ngaphandle kweprosthesis.Esi sisombululo sandise ukugcinwa kwesebe le-sciatic kunye nenxalenye ye-acetabulum yesigulane kwaye iphumelele ukuchithwa ngokuchanekileyo kunye nokwakhiwa kwakhona.
3 Ummandla we-I + II we-pelvis tumor
Kule meko, ithumba lenzekile kwiNgingqi I + II, i-lateral sacral osteotomy yasika ijoyini ye-sacroiliac.amasebe e-pubic kunye ne-sciatic agcinwe ngokwemeko ye-intraoperative.Umphezulu woqhagamshelwano weprosthesis ye-pelvic eyenziwe ngokwezifiso kunye ne-sacrum yenziwe nge-mesh ene-porous exelisa i-bone trabeculae, ene-stopper eyenzelwe ukuphumla kwicala langaphakathi le-sacrum.Inkxaso ye-iliac eyenziwe ngokwezifiso kunye nekomityi ye-acetabular ihlanganiswe ngokwahlukileyo kwaye i-adjustable intraoperatively ukuze i-attachment elula kwaye ethembekileyo.Imiqolo emibini yemingxuma yezikhonkwane igcinelwe ukuqhotyoshelwa kwamasebe agciniweyo e-pubic kunye ne-sciatic.
4 Ummandla we-I + II we-pelvis tumor
Kule meko, ithumba lenzekile kwiNgingqi I + II, i-lateral sacral osteotomy yasika ijoyini ye-sacroiliac.amasebe e-pubic kunye ne-sciatic agcinwe ngokwemeko ye-intraoperative.Indawo yoqhagamshelwano yeprosthesis ye-pelvic eyenziwe ngokwezifiso kunye ne-sacrum yenziwe nge-mesh ene-porous exelisa i-bone trabeculae, Icala elingasemva le-prosthesis linokudibaniswa nenkqubo ye-nail bar, ubude kunye nokuqhelaniswa kwe-screws kwi-sacrum yenziwe ngokwezifiso kwisigulane. Idatha ye-CT kunye nomda wangaphandle weprosthesis yenzelwe umqolo wemingxuma ye-suture ukuququzelela ukulungiswa kwezicubu ezithambileyo.
5 Ummandla we-II + III we-pelvis tumor
Le meko i-tumor kwi-pelvis II + III ene-osteotomy ethe tyaba ukusuka kwi-acetabular rim ephezulu.I-prosthesis yenziwe nge-pelvis eyenziwe ngokwezifiso kunye ne-pubic bone plate yokunamathisela.Ubungakanani bendawo yoqhagamshelwano yeprosthesis ye-pelvis eyenziwe ngokwezifiso yenzelwe ngokwemilo ye-osteotomy surface kwaye iqiniswa yiplate eprintiweyo yangaphandle.Ipleyiti yokuncamathela ye-pubic ilungiselelwe ngokwesimo sethambo lesigulana sokuqala kwaye sincanyathiselwe kwicala elisempilweni lethambo le-pubic.
6 Ummandla we-IV we-pelvis tumor
Kule meko, i-tumor yenzeke kummandla we-IV, amacala asekunene nasekhohlo ayenziwe nge-osteotomized ukusuka kwi-joint sacroiliac, egcina inxalenye ye-olecranon, kwaye i-prosthesis ifakwe kwithambo le-iliac kumacala omabini nakwisiphelo esisezantsi se-vertebra yesihlanu.I-prosthesis ye-pelvic eyenziwe ngokwezifiso iprintwa kwisiqwenga esinye kwaye inezikhonkwane ze-lumbar vertebrae kunye namacala asekunene nasekhohlo ngokulandelanayo, kunye nethuba lokudibanisa inkqubo yesigxina kwicala elingasemva.
Ixesha lokuposa: Feb-21-2023