U-Li Guishan, umqondisi womnyango we-Arthroplasty we-Guizhou Huaxia Orthopedic Hospital, wabona isiguli esikhethekile esasiphethwe izinhlungu zedolo iminyaka engu-11+, weza esibhedlela ephethe ibhentshi ukuze angene emnyangweni, enokukhubazeka okukhulu kokubili. amadolo nobunzima obukhulu ekuhambeni.Ama-radiographs asikisela ukuthi isiguli sinokwephuka okudala (okungaphuluki) kwe-femur yesobunxele + ukugudluzwa kwakudala kwedolo lesobunxele + i-osteoarthrosis yamadolo angakwesokudla.Ukuze uthole ukwelashwa okwengeziwe, isiguli safuna usizo emnyangweni wokuhlinza ngokuhlanganyela esibhedlela iGuizhou Huaxia Orthopedic Hospital, sinethemba lokuhlinzwa edolweni.
Ukusabela esimweni sedolo lesiguli elihlangene, ithimba likaMqondisi uGuishan Li lenze ukubonisana okuphelele futhi lacwaninga imininingwane yokuhlinzwa, futhi ekugcineni lenze uhlelo oluphelele noluphelele lokuhlinza isiguli, lase lenza i-arthroplasty "yamazwe amabili" amadolo kusetshenziswa i-LDK "Hinged". I-Knee Prosthesis” kanye “Ne-Modular Tumor Knee Prosthesis”, futhi ukuhlinzwa kwahamba kahle.
Incazelo:
Isiguli, owesifazane, oneminyaka engama-62
Isikhalazo:
Ubuhlungu bamadolo amabili kanye nomkhawulo wokunyakaza iminyaka engu-11+.
Umlando wamanje wezokwelapha:
Isiguli sasinobuhlungu emadolweni womabili kusukela eminyakeni engaba ngu-11+ edlule ngaphandle kwesizathu esicacile, futhi kancane kancane sanciphisa ukunyakaza (uhlangothi lwesobunxele lunzima kakhulu), kodwa akazange akhathazeke ngaleso sikhathi futhi akazange athole ukwelashwa okuhlelekile.Wayengakwazi ukuhamba, exhuga lapho ehamba ngezinduku, equkula futhi ehla enyuka emithambekeni, neminye imisebenzi yokuthwala isisindo.Ukukhubazeka kwedolo kwesokunxele kwaba kubi kancane kancane;idolo elingakwesokudla kancane kancane laqala ukukhula nokukhubazeka kwe-flexion inversion, okwathinta kakhulu ukuphila kwansuku zonke.
Ngonyaka odlule, izimpawu ezingenhla zaba zimbi nakakhulu, futhi wangeniswa esibhedlela sendawo ukuze athole ukwelashwa okwengeziwe, futhi wacela ukuhlinzwa edolweni lesiguli.
Umlando odlule:
Eminyakeni engu-13+ edlule, ukulimala okudabukisayo edolweni lesokunxele kwabangela ukukhubazeka nobuhlungu kanye nomsebenzi olinganiselwe, futhi ngemva kokuzithiba, ukukhubazeka, ubuhlungu kanye nomsebenzi wedolo lesokunxele kwathuthukiswa;eminyakeni engu-13+, wakhishwa emzimbeni mahhala edolweni lesokunxele esibhedlela sendawo futhi wadedelwa elashwa;iminyaka engu-8+, wayenomlando wendle emnyama engenazikhawu ngaphandle kokwelashwa okusemthethweni.
Izivivinyo ezikhethekile:
I-curvature ye-physiological yomgogodla yaba engajulile, kwakungekho ubuhlungu bengcindezi kanye nobuhlungu bokushaywa endaweni ye-lumbosacral, futhi umgogodla we-lumbar wawushukunyiswa kuzo zonke izinkomba.
Umkhawulo ophansi wesobunxele wawumfushane kunomkhawulo ophansi wesokudla cishe ngo-6.0 cm;idolo elingakwesokudla lalikhulisiwe futhi i-flexion ikhubazekile (ukuguqulwa okungaba ngu-30 °);ithanga lesokunxele laliqhekezekile eduze kwedolo;umbala wesikhumba kanye nezinga lokushisa kwawo womabili amadolo kwakujwayelekile;cishe u-8.0 cm wezibazi zakudala zokuhlinza zabonakala ohlangothini olungaphambili lwedolo lesokunxele, elalulama kahle.
Womabili amadolo ane-peripatellar ephawulekayo kanye nobuhlungu obuphelele be-medial ne-lateral yegebe lokucindezela kwamadolo, ukuhlolwa kwe-patella entantayo (-), ukuhlolwa kwedrowa elingakwesokudla (-), ukuhlolwa kwedrowa lesobunxele (akukwazanga ukuhlolwa ngokujwayelekile), ukuhlolwa kokucindezeleka kwe-lateral (+), uphawu lukaMcSweeney ( +), ukuhlolwa kokugaya kwe-patellar (+), ukuhlolwa kokuphakamisa umlenze oqondile wesokudla okunegethivu, ukuhlolwa kokuphakamisa umlenze wesokunxele oqondile akukwazanga ukwenziwa;ukunyakaza kwamadolo angakwesokudla kwakunomkhawulo: ukunwetshwa kwedolo elingakwesokudla cishe -5 °;ukugoba kwedolo elingakwesokudla mayelana no-70 °;ukujikeleza kwangaphakathi kwedolo elingakwesokudla cishe ngo-5 °, ukujikeleza kwangaphandle mayelana no-5 °.
Ukulahlekelwa kwesandiso, ukugoba, ukujikeleza kwangaphakathi nokujikeleza kwangaphandle kwedolo lesokunxele;ukuzwa okuhle nokugeleza kwegazi engxenyeni ekude yazo zombili izitho ezingezansi;ithoni yemisipha evamile engxenyeni engezansi yesokudla;ithoni yemisipha engxenyeni engezansi kwesokunxele ayikwazanga ukulinganiswa ngokujwayelekile;ukushayeka okuhle komthambo we-dorsalis pedis ngokubili.
Izivivinyo ezisizayo:
1, I-Bilateral knee osteoarthrosis
2, Ukuphuka okudala kwe-distal left femur (okungapholi)
3, Ukugudluka okudala kokuhlangana kwedolo kwesokunxele
4, ukopha emathunjini?
Ngaphambi kokuhlinzwa
Ngemuva kokuhlinzwa
Udokotela Ohlinzayo Isingeniso
Guishan LI
Umqondisi Wokuhlinza Ngokuhlanganyela, Isibhedlela Samathambo e-Guizhou Huaxia
Owake waba ngumqondisi woMnyango Wezamathambo, Isibhedlela sama-91 se-PLA
Iziqu ze-Masters, Udokotela Oyisikhulu Esihlangene
Ilungu elimile leKomidi Lesithathu Lochwepheshe Lokulimala Nokulungiswa Kwe-Guizhou Rehabilitation Medicine Association;
Ilungu Le-Guiyang City Medical Accident Technical Accident Pool
Okukhethekile:ukuhlinzwa kokwenziwa esikhundleni sokubuyisela amalunga nokuhlinzwa okubukeziwe, imithi yezemidlalo (ukuhlinzwa kwe-arthroscopic), ukwelashwa ngokuhlinzwa ukulimala komgogodla, ukuphuka okuyinkimbinkimbi kwamaphethelo, ukukhubazeka kwezicubu ezithambile, nokulungiswa kokukhubazeka, njll. Unokuqonda okukhethekile mayelana nokuxilongwa nokwelashwa kwekhanda lesifazane. i-necrosis.
Isikhathi sokuthumela: May-09-2023