I-pelvic tumor ingenye yezinhlobo eziyinkimbinkimbi futhi ezinzima zokuhlinzwa kwe-tumor yamathambo, futhi ukukhishwa kwesimila kungaholela ekulahlekelweni kwamathambo amakhulu.Isakhiwo se-anatomical kanye ne-morphology ye-pelvis iyinkimbinkimbi uma iqhathaniswa nezinye izindawo.Ngaphezu kwalokho, i-pelvis iseduze nezitho ezibalulekile emgodini wesisu ezinezakhiwo eziningi ezizungezile zezicubu ezithambile, ngakho-ke kunezinselele ezinkulu kukho kokubili ukuhlela kwangaphambi kokuhlinzwa kanye nokuphathwa kwe-intraoperative.
Ekwakheni kwangaphambi kokuhlinzwa kwe-prosthesis, indawo yokuhlinza idinga ukuklanywa ngokunengqondo ngokuya ngokugula kwesiguli, bese ukwakhiwa kabusha kwendawo ethintekile kanye nokufakwa kwe-prosthesis kudingeka kuhlelwe ngokuya ngendawo yokuhlinzwa.
Ubunzima bokuklama “i-pelvic tumor prosthesis” abukho nje kuphela esimweni se-anatomical esiyinkimbinkimbi ye-pelvis kodwa futhi yiqiniso lokuthi izindawo zokubikezela kwesiguli ziyahlukahluka kuye ngomuntu nomuntu, ngakho-ke indlela yokuklama i-prosthesis engakwazi ukuhambisana kangcono nesidingo sesiguli futhi ifinyelele. imiphumela yokuhlinzwa engcono kakhulu iyisici esibalulekile empumelelweni yokuhlinzwa.
Onjiniyela be-LDK bahlola umehluko we-morphological wesiguli ngasinye, indawo yokulahleka kwamathambo kanye nemvelo yemishini lapho kuzohlala khona i-prosthesis, "Yenza ngokwezifiso" indawo eyakhiwe kabusha futhi wenze ukulingisa kwekhompyutha kokufaka kanye nokuhlekisa ukuze kuqinisekiswe ukuthi i-prosthesis. ingafakwa ngaphakathi kokuhlinzwa.Kulesi sihloko, sikhethe imiklamo eyi-6 emele i-tumor prosthesis yezigaba ezihlukene zesimila se-pelvic eminyakeni engu-5 edlule ukuze kubhekiselwe kuyo futhi kuxoxwe.
1 isifunda I Isifuba isimila
Leli cala liyisimila sesifunda se-pelvic I ngokubandakanyeka kwejoyinti le-sacroiliac.Isiphetho esiseduze sakhiwe nge-osteotomized ngejoyinti ye-sacroiliac emaphethelweni angaphandle e-sacral foramen, futhi isiphetho esikude sakhiwe nge-osteotomized ngokuvundlile ukusuka phezulu kwe-acetabular kuya phezulu.I-pelvic prosthesis eyenziwe ngokwezifiso yasetshenziswa ukuze kwakhiwe kabusha iphiko le-iliac elikhubazekile.Ukuma nosayizi we-prosthesis kwenziwa ngokwezifiso ukukhubazeka kwesiguli, futhii-prosthesis-bone interface(ithintana namathambo e-sacral kanye ne-iliac) yenziwe ngomshini ukuze ilingise i-porous mesh ye-bone trabeculae ukuze kube lula ukungena kwamathambo futhi kufinyelele ukulungiswa kwesikhathi eside kwe-prosthesis.Udonga olungemuva lwe-acetabulum lunepuleti yensimbi ephrintiwe eyodwa futhi uhlelo lwe-nail bar lungaxhunywa ohlangothini olungemuva lwe-prosthesis ukuze kuthuthukiswe ukuzinza kwe-prosthesis.
2 Isifunda II Isimila se-Pelvis
Isiguli sasinesilonda esincane futhi kwenziwa kuphela ukukhishwa kwe-acetabular okuyingxenye, nge-osteotomy eqondile ku-acetabulum yesiguli kanye ne-osteotomy enezingqimba emaphethelweni aphezulu e-acetabulum, ngokususwa kwethambo le-pubic nokugcinwa kwegatsha le-sciatic.I-pelvic prosthesis eyenziwe ngokwezifiso yaphrintwa ibe yisiqephu esisodwa, nesixhumi esibonakalayo sethambo lokufakelwa okwenziwe ngomshini ukulingisa i-mesh enezimbotshana ze-trabeculae.Ububanzi obungaphandle be-acetabulum yesiguli bulinganiselwe futhi indebe ye-acetabular ehlanganisiwe ehambisana nobukhulu be-acetabular yesiguli yanqunywa ukuthi ibe yisisekelo sokwakhiwa kabusha, nepuleti eliphrintiwe engxenyeni eyodwa ngaphandle kwe-prosthesis.Lesi sixazululo sandise ukulondolozwa kwegatsha le-sciatic kanye nengxenye ye-acetabulum yesiguli futhi yazuza ukukhishwa okuqondile nokwakhiwa kabusha.
3 Isifunda I + II isimila okhalo
Kulokhu, isimila senzeka ku-Regional I + II, i-lateral sacral osteotomy yasika ilunga le-sacroiliac.amagatsha e-pubic kanye ne-sciatic agcinwe ngokuvumelana nesimo se-intraoperative.Indawo yokuxhumana ye-pelvic prosthesis eyenziwe ngokwezifiso ne-sacrum yenziwe nge-mesh enezimbotshana elingisa i-bone trabeculae, ene-stopper eklanyelwe ukuphumula ohlangothini lwangaphakathi lwe-sacrum.Ukusekelwa kwe-iliac okwenziwe ngokwezifiso kanye nenkomishi ye-acetabular kuhlanganiswe ngokuhlukana futhi kuyalungiseka ngokuhlanganyela ukuze kunamathiselwe okulula nokuthembekile.Imigqa emibili yezimbobo zezinzipho ibekelwe ukunamathiselwa kwamagatsha agciniwe we-pubic kanye ne-sciatic.
4 Isifunda I + II isimila okhalo
Kulokhu, isimila senzeka ku-Regional I + II, i-lateral sacral osteotomy yasika ilunga le-sacroiliac.amagatsha e-pubic kanye ne-sciatic agcinwe ngokuvumelana nesimo se-intraoperative.Indawo yokuxhumana ye-pelvic prosthesis eyenziwe ngokwezifiso ne-sacrum yenziwe nge-mesh enezimbobo ilingisa i-bone trabeculae, Uhlangothi olungemuva lwe-prosthesis lungaxhunywa ohlelweni lwe-nail bar, ubude kanye nokuma kwe-screws ku-sacrum kwenziwa ngokwezifiso kusuka kusiguli. Idatha ye-CT kanye nonqenqema lwangaphandle lwe-prosthesis yakhelwe ngomugqa wezimbobo ze-suture ukuze kube lula ukulungiswa kwezicubu ezithambile.
5 Isifunda II + III isimila okhalo
Leli cala liyisimila ku-pelvis II + III ene-osteotomy evundlile esuka kurimu lwe-acetabular ephakeme.I-prosthesis yenziwe ngokwezifiso ze-pelvis kanye nepuleti lokunamathisela lethambo le-pubic.Ubukhulu bendawo yokuxhumana ye-pelvis prosthesis eyenziwe ngokwezifiso iklanywe ngokuhambisana nokuma kwendawo ye-osteotomy futhi iqiniswa ipuleti eliphrintiwe langaphandle elinesiqephu esisodwa.Ipuleti lokunamathisela lethambo le-pubic lenziwa ngendlela oyifisayo esimweni sangempela sethambo le-pubic lesiguli futhi linamathiselwe ohlangothini olunempilo lwe-pubic bone.
6 Isimila se-pelvis yesifunda IV
Kulokhu, isimila senzeke esifundeni IV, izinhlangothi zesokudla nesobunxele zafakwa i-osteotomized kusukela ekuhlanganyeleni kwe-sacroiliac, igcina ingxenye ye-olecranon, futhi i-prosthesis yayixhunywe ethanjeni le-iliac ezinhlangothini zombili nasekupheleni kwe-vertebra yesihlanu.I-pelvic prosthesis eyenziwe ngokwezifiso iphrintiwe ibe yisiqephu esisodwa futhi inezikulufu ze-lumbar vertebrae kanye nezinhlangothi zesokudla nesobunxele ngokulandelana, kanye nethuba lokunamathisela uhlelo oluyisisekelo ohlangothini olungemuva.
Isikhathi sokuthumela: Feb-21-2023