Ikibyimba cyo mu nda ni bumwe mu buryo bugoye kandi bugoye bwo kubaga ibibyimba byo mu magufa, kandi kuvanaho ikibyimba bishobora gutera amagufwa manini.Imiterere ya anatomique na morphologie yigitereko iragoye ugereranije nibindi bice.Byongeye kandi, pelvis yegeranye ningingo zingenzi mumyanya yinda hamwe ninzego nyinshi zoroshye zikikije ingirabuzimafatizo, bityo rero hari ingorane zitari nke haba mugutegura mbere yo gutangira no gucunga ibikorwa.
Mu gishushanyo mbonera cya prothèse, agace ka resection kagomba gutegurwa mu buryo bushyize mu gaciro hakurikijwe uburwayi bw’umurwayi, hanyuma hagomba gutegurwa iyubakwa ry’ahantu hafashwe no gutera prothèse hakurikijwe agace kegeranye.
Ingorabahizi mugushushanya "pelvic tumor prostothèse" ntabwo iri gusa muburyo bugoye bwa anatomique yigitereko gusa ahubwo no kuba aho umurwayi ateganya umurwayi atandukana kubantu, kuburyo bwo gukora prothèse ishobora guhuza neza ibyo umurwayi akeneye kandi akabigeraho ibisubizo byiza byo kubaga nibintu byingenzi mugutsindira ibikorwa.
Ba injeniyeri ba LDK basuzuma buri murwayi itandukaniro ryimiterere ya morfologiya, agace ko gutakaza amagufwa hamwe nubukanishi bwa prothèse izabamo, "Kwiha agaciro" agace kiyubatswe kandi bagakora mudasobwa yigana ibibereye no gushinyagurira kugirango prothèse Birashobora guterwa muburyo budasanzwe.Muri iki kiganiro, twahisemo ibishushanyo 6 byerekana ibibyimba byerekana ibibyimba bitandukanye byo mu bwoko bwa pelvic tumeri mu myaka 5 ishize kugirango tuyibone kandi tuyiganireho.
Intara I. Pelvis ikibyimba
Uru rubanza ni ikibyimba cyakarere ka pelvic I hamwe nuruhare rwa sacroiliac.Impera yegeranye yegeranijwe hifashishijwe osteoomique ikoresheje agace ka sacroiliac kuruhande rwinyuma rwabakozi ba sacral, kandi impera ya kure yari osteotomize itambitse kuva kuri acetabular hejuru.Prothèse yihariye ya pelvic yakoreshejwe mukubaka amababa ya iliac afite inenge.Imiterere nubunini bwa prothèse byashizwe ku nenge yumurwayi, naProthèse-Amagufwa.Urukuta rwinyuma rwa acetabulum rufite icyuma kimwe cyacapishijwe icyuma kandi sisitemu yimisumari irashobora kwomekwa kuruhande rwinyuma rwa prothèse kugirango iteze imbere prothèse.
2 Intara II Ikibyimba cya Pelvis
Umurwayi yari afite igikomere gito hanyuma hakorwa igice kimwe gusa cyo kuvura acetabula, hamwe na osteotomy ihagaritse muri acetabulum yumurwayi hamwe na osteotomie itambitse ku nkombe yo hejuru ya acetabulum, hakurwaho amagufwa ya pubic no kubungabunga ishami rya sciatic.Prothèse yihariye ya pelvic yacapishijwe mugice kimwe, hamwe na prothèse-amagufwa yimbere yakozwe kugirango bigane inshundura ya trabeculae.Dimetero yo hanze ya acetabulum yumurwayi yarapimwe hanyuma igikombe cya sima ya acetabula ihuye nubunini bwa acetabula yumurwayi cyemejwe ko ari ishingiro ryo kwiyubaka, isahani yacapishijwe igice kimwe hanze ya prothèse.Iki gisubizo cyarushijeho kubungabunga ishami rya sciatic hamwe nigice cya acetabulum kumurwayi kandi bigerwaho neza no kwiyubaka.
3 Akarere I + II ikibyimba
Muri iki gihe, ikibyimba cyabereye mu Karere I + II, osteotomy ya sacral ya latal yatemye ingingo ya sacroiliac.amashami ya pubic na sciatic yarazigamwe ukurikije imiterere idakorana.Ubuso bwo guhuza prothèse yihariye ya pelvic hamwe na sakramu yakorwaga meshi yuzuye yigana amagufwa trabeculae, hamwe na stoper yagenewe kuruhukira kuruhande rwimbere rwigitambo.Inkunga ya iliac yihariye hamwe nigikombe cya acetabular ikusanyirizwa hamwe kandi irashobora guhinduka muburyo budasanzwe kugirango byoroshye kandi byizewe.Imirongo ibiri yimyobo yabitswe kugirango ihuze amashami yagumanye hamwe na sciatic.
4 Akarere I + II ikibyimba
Muri iki gihe, ikibyimba cyabereye mu Karere I + II, osteotomy ya sacral ya latal yatemye ingingo ya sacroiliac.amashami ya pubic na sciatic yarazigamwe ukurikije imiterere idakorana.Ubuso bwo guhuza prothèse yihariye ya pelvic hamwe na sakrum yakorewe mumashini yinini yigana amagufwa trabeculae, Uruhande rwinyuma rwa prothèse rushobora guhuzwa na sisitemu yimisumari, uburebure hamwe nicyerekezo cyimigozi kuri sakramu byateganijwe kuva murwayi. CT amakuru hamwe nuruhande rwinyuma rwa prothèse yateguwe hamwe numurongo wimyobo ya suture kugirango byorohereze ikosorwa ryoroshye
5 Intara II + III ikibyimba
Uru rubanza ni ikibyimba kuri pelvis II + III hamwe na osteotomy ya horizontal iturutse kumurongo wo hejuru wa acetabular.Prothèse igizwe nigitereko cyabugenewe hamwe nisahani yamagufa.Ingano yubuso bwubuso bwihariye bwa pelvis prothèse yabugenewe ikozwe ukurikije imiterere yubuso bwa osteotomy kandi igashimangirwa nicyapa cyo hanze cyanditseho icyapa.Icyapa gifata amagufwa ya pubic cyashizwe kumiterere yumutima wambere wumurwayi kandi gifatanye kuruhande rwiza rwamagufwa.
6 Akarere ka IV ikibyimba
Muri iki gihe, ikibyimba cyabereye mu karere ka IV, impande z’iburyo n’ibumoso zashizwemo osteotomize kuva mu gihimba cya sacroiliac, zirinda igice cya olecranon, kandi prothèse yari ifatanye n'amagufwa ya iliac ku mpande zombi no ku mpera yo hepfo ya vertebra.Prothèse yihariye ya pelvic yacapishijwe mugice kimwe kandi ifite imigozi ya vertebrae yo mu ruti no kuruhande rwiburyo n'ibumoso, hamwe nibishoboka byo guhuza sisitemu yibanze kuruhande rwinyuma.
Igihe cyo kohereza: Gashyantare-21-2023