Cirugia Preprotesica Basica.

 

[ogvkrsglcl Oc`ghocd Cutðohjc lk Jçxg`h Nc`udtcl lk Hlhothdhmêc @dêog`c Qkrgnçrg`c lk Hrgkotk @dêog`c gotkmrcd lk cludths5 @grumêc Hrcd. \kjc9 —@grumêc Qrkprhtksg`c bãsg`c‚

 

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@HO@KQ\H

Dc `grumêc prkprhtçsg`c ks kd ãrkc lk dc `grumêc bu`cd y jcxgdhnc`gcd quk komdhbc thlcs cqukddcs tç`og`cs h prh`klgjgkoths qugrùrmg`hs `uyh ngo ks prkpcrcr c dhs tkiglhs bdcolhs, pcrc dc `hdh`c`gðo clk`uclc y lurclkrc lk dcs prðtksgs lkotcdks.

 

@GR[MÊC QRKQRH\ÇPG@C. •

\ç`og`cs qugrùrmg`cs lkstgoclcs c `rkcr h jkihrcr dcs kstru`turcs lk shphrtk pcrc kd ush lk lgsphsgtgvhs prhtçsg`hs.

 

NGPGHQC\HDHMÊC LK DC RKPHR@GÐO ÐPKC •

Dc nhrjc`gðo y dc prksko`gc lk dc cpðngsgs cdvkhdcr lkpkolko lk dc prksko`gc lk dhs lgkotks csê `hjh sus `crc`tkrêstg`cs jhrnhdðmg`cs, tcjcóh y nhrjc.

 

Dcs kxtrc``ghoks lkotcdks prkjcturcs prhvh`c uoc rãpglc rkshr`gðo ko dhs prgjkrhs skgs jksks  phstqugrùrmg`hs  phstqugrùr mg`hs

 

RKPHR@GÐO ÐPKC Dc kxtrc``gðo lkotcd, golu`k uoc skrgk lk `cjbghs clcptctgvhs lk dhs tkiglhs lurhs y  bdcolhs. •

Dc jcxgdc y dc jcolêbudc9 lgsjgou`gðo ngsghdðmg`c `hotgouc lk dc lkosglcl ðskc y `hotkoglh jgokrcd.

 

Qrh`kshs pcthdðmg`hs dh`cdks h Sugstks h \ujhrks hlhothmçog`hs h Dksghoks trcujãtg`cs h

H\RHP NC@\HRKP

h

Nrc`turc rclg`udcr  h Konkrjklcl pkrghlhotcd cvcozclc h Nrc`csh ko trctcjgkoths kolhlðotg`hs h

Lknk`ths lkd lkscrrhddh h Nrc`csh ko gjpdcotks lkotcdks h Qcthdhmêcs sgstçjg`cs

 

@DCPGNG@C@GÐO LK DC RKPHR@GÐO LKD QRH@KP QRH @KPH H CD^KHD CDÐPKC ^KHDCR CR QRHQ[KP\C QHR @C]HHL W FH]KDD

 

@dcsk G. Lkotclh.

@dcsk GG. @rkstc cdvkhdcr Qhst

kxtrc``gðo.

@dcsk GGG. Rkbhrlk rklholkclh,

clk`uclcs cdturc y co`furc.

 

@dcsk G^. Rkbhrlk cngdclh,

clk`uclc cdturc, goclk`uclc co`furc. @dcsk ^. Rkbhrlk pdcoh, cdturc y

co`furc goclk`uclcs. 

@dcsk ^G. Rkbhrlk lkprgjglh `ho mrcolks

vcrgcbdks lk pçrlglc lk fuksh bcscd quk  puklk skr cjpdgc pkrh prklk`gbdk.

 

 •Fgsthrgc `dêog`c

 K^CD[C@GÐO W LGCMOÐP\G@H QRH\ÇPG@H

-@cusc lk dc pçrlglc lkotcd   -\gkjph trcos`urrglh   -Qhsgbdks rgksmhs pcrc kd pc`gkotk -Pus kxpk`tctgvcs -@holg`ghocotks psg`hdðmg`hs •^cdhrc`gðo lkd kstclh dh`cd y mkokrcd •^cdhrc`gðo m kokrcd •Kstulgh `dêog`h y rclghmrãng`h pcrc lgcmoðstg`h •Qdco lk trctcjgkoth

S[GRÙRMG@H

-Gonhrjcr cd pc`gkotk shbrk dcs vkotcics y dc

 phsgbgdglcl lk `hjpdg`c`ghoks

 

K^CD[C@G K^ CD[C@GÐO ÐO @ @DÊOG@ DÊOG@C C J[@HPC

Ngrjk y clfkrglc cd fuksh quk sgrvc lk shphrtk c dc prðtksgs

P[R@HP ^KP\GB[DCRKP

Pung`gkotkjkotk prhnuolhs y dgbrks lk Pung`gkotkjkotk goskr`ghoks jus`udcrks

NRKOGDDHP

Jðvgdks quk gjpglco dc prhdhomc`gðo lk dcs cdktcs lk dc prðtksgs

 

JCVGDCRKP W JCOLÊB[DC

Cdturc, nhrjc y rkmudcrglcl lk dcs `rkstcs ðskcs

\HR[P

Hbskrvc`gðo

QGPH LK DC BH@C

@ho sus goskr`ghoks jus`udcrks y dc kxgstko`gc lk nrkogddh dgomucd.

 

K^CD[C@GÐO RCLGHMRÃNG@C

 Dc kxpdhrc`gðo kxpdhrc`gðo rclghdðmg`c ks uo `hjpdkjkoth gjphrtcotk lk dc `dêog`c

-Qhsgbdk kxgstko`gc lk rcê`ks -Sugstks rksglucdks -Lgkotks rktkoglhs -Rkdc`gðo lk dcs kstru`turcs ðskcs kotrk sê `ho ðrmcohs vk`gohs

K^CD[C@GÐO CD[C@GÐO LK DHP JHLKDHP LK KP\[LGH K^

 

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Kstcbdk`k kd lgcmoðstg`h Lktkrjgoc sg fcy uoc rkdc`gðo kotrk dhs jcxgdcrks y dc jcolêbudc lksncvhrcbdk lksncvhrcbdk quk puklc lkskstcbgdgzcr lkskstcbgdgz cr dc prðtksgs.

 

Kstk kxcjko prkvgh skrvgrã pcrc9 •

Cdtkrc`ghoks ju`hscs, jus`udcrks u Cdtkrc`ghoks ðskcs.

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Kdkmgr dc tkrcpçutg`c cprhpgclc Kdgjgocr dhs `cshs koqugrùrmg`c quk kd nrc`csh sk lkbc c uoc kik`u`gðo goclk`uclc lk dc tç`og`c prhtçsg`c prhtçsg`c y oh c dcs `holg`gho `holg`ghoks ks cohrjcdks lk dhs tkiglhs lk shphrtk

 

CD\KRC@GHOKP LK DHP \KIGLHP BDCOLHP. NRKOGDDHP ^KP\GB[DCRKP •

Dc kxtgrpc`gðo lk dhs nrkogddhs nr kogddhs vkstgbudcrks oh hnrk`k lgng`udtcl cdmuoc, og fcy quk tkjkr ogomùo tgph lk `hjpdg`c`ghoks, scdvh dc rk`glgvc.

 

Ko dhs nrkogddhs vkstgbudcrks dctkrcdks gonkrghrks sk puklk  prhlu`gr dc dksgðo lkd pcquktk jkothogcoh. Dc tç`og`c sk bcsc ko ks`gsghoks ko rhjbh, zktcpdcstêcs h ko —v‚

 

‚KV@KRKPGP LK BRGLCP @G@C @G@C\RÊYCDKP‚ \RÊYCDKP‚

Ngdcjkoths jkjbrcohshs quk sk nhrjco cdrklklhr lk dcs fkrglcs

 

Golg`c`ghoks9 sgkjprk quk skco uo hbstã`udh pcrc dc goskr`gðo y rktko`gðo lk prðtksgs. prðtksgs.

 

\rctcjgkoth9 Pk rkcdgzc dc sk``gðo h `hrtk lkd tkiglh `ho tgikrcs pcrc ko`êc h  bgsturê. W sk suturc

 

QDCP\GCP W KV@GPGÐO S[GRÙRMG@C LK DCP FGQKRQDCPGCP Ks dc rkjhlkdc`gðo phr jklgh lk lgnkrkotks tç`og`cs qugrùrmg`cs, `ho kd hbiktgvh lk jhlgng`cr dc nhrjc lk dhscsê tkiglhs bdcolhs quk nukrho cdtkrclhs tcjbgço `hjh dc kdgjgoc`gðo lk lgvkrscs  pcthdhmêcs quk gjpglco h gotkrngkrco ko dc dcbhr prhtçsg`c. •

 

FGQKRQDCPGC N GBRHPC GONDCJC\HRGC (ÇQ[DGP NGP[RC\[J •

 

Ktghdhmêc9 \rcujãtg`c \rcujãtg `c grrgtctgvc phr prðtksgs5 - Lknk`tuhscs - Lksciustclcs -- Rkc``ghoks Rkc``ghoks cdçrmg`cs quêjg`cs

 

FGQK FGQKRQDCP RQDCP GC NGBRHPC GONDCJC\HRGC GONDCJC\HRGC (ÇQ[DGP NGP[RC\[J) @uclrh `dêog`h9 - Jãs nrk`ukotks ko zhoc cotkrh supkrghr  - Bcolkdktc lk tkiglh clfkrglh c dc ju`hsc cdvkhdcr  - @hdhrc`gðo ohrjcd - Bcsk co`fc - Quklk skr ùog`h h jùdtgpdks - Pg sho jùdtgpdks tgkoko bcsk co`fc y vcrghs  pklê`udhs

\rctcjgkoth9 - Qhlkjhs uscr bgsturê h kdk`trhbgsturê. - Pk rkcdgzc dc kx`gsgho thtcd lkd tkiglh. - Pk puklk `hdh`cr goikrth lk pgkd h ju`hsc `ucolh kd çpudgs ks juy mrcolk - Puturcjhs.

 

‚RKJH@GÐO LK \KIGLH FGQK RQDÃPG@H LK DC \[BKRHPGLCL LKD JCVGDCR‚ Ks uo cujkoth lkd tcjcóh lkd tkiglh bdcolh lk dc tubkrhsglcl lkd jcxgdcr.

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Pk prhlu`k ko pc`gkotks pcr`gcdjkotk lkslkotclhs `ho cusko`gcs lk 2lhs y 0rhs jhdcrks supkrghrks. •

Kd trcujc lk dc h`dusgðo ks kd quk prhlu`k kstk cujkoth lk vhdujko •

Lgcmohstg`h9 Dh fc`kjhs `ho bcsk uoc Rx pcrc scbkr sg kd cujkoth lk vhdujko govhdu`rc tkiglh ðskh.

 

‚RKJH@GHO LK \KIGLH FGQKRQDÃPG@H LK DC \[BKRHPGLCL LKD JCVGDCR‚

@uclrh `dêog`h9 - Cujkoth lkd kspkshr lk ju`hpkrghstg`h - @hosgstko`gc lurc, lkosc - @hdhr ohrjcd - Gotkrngkrk `ho dc jcstg`c`gðo h `ho dc prðtksgs \rctcjgkoth9 - Cdvkhdhpdcstgc Cdvkhdhpdcstgc lk dc zhoc phr dc `rkstc lkd rkbhrlk cdvkhdcr  - Kdgjgoc`gðo ko `uóc lkd tkiglh ngbrhjcthsh - Rksk``gðo lk dc subju`hsc vkstgbudc vkstgbudcrr y pcdctgoc - Pg ks kd `csh kdgjgocr grrkmudcrglclks ðskcs `ho nrkscs h dgjcs - Grrgmcr cbuolcotkjko cbuolcotkjkotk tk - Puturcr 

 

‚FGQKRQDCPGC RK\RHJHDCR JCOLGB[DCR‚ - Dc nhrjc`gðo lk tkiglh fgpkrtrðng`h ko kd ãrkc rktrhjhdcr lk dc jcolêbudc •

- [o trcujc lk h`dusgðo h nrg``gðo ks dc  prgo`gpcd `cusc •

\rctcjgkoth kxkrksgs lkd tkiglh. \rctcjgkoth Fcy quk tkokr `hosglkrc`ghoks cotks lk dc `grumêc yc quk dcs vcrgcotks coctðjg`cs. Quklk fcbkr `hjpdg`c`gho `hjpdg`c`ghoks ks

 

—CD\KRC@GÐO LK \KIGLHP L[RHP‚ Pho thlcs cqukddcs gotkrnkrko`gcs cohrjcdks lk tkiglh ðskh, skco h oh lk hrgmko pcthdðmg`h. Kstcs sk prkskotco ko cjbcs cr`clcs y gotkrvgkoko kd dc `hrrk`tc rkfcbgdgtc`gðo prhtçsg`c. •

 

‚HP\KHQDCP\GC CD^KHDCR GOJKLGC\C‚ Ks kd prh`klgjgkot prh`klgjgkothh h `hoiuoth lk prh`klgjgkoths lkstgoclhs c jhlgng`cr dcs `crc`tkrêstg`cs lkd  prh`ksh cdvkhdcr. cdvkhdcr. @ho kd ngo lk fc`kr phsgbdk dc •

rkfcbgdgtc`gðo lkd pc`gkotk.

¸@uãolh sk rkcdgzc8 Gojklgctcjkotk lkspuçs lk dc kxtrc``gðo lk uo lgkotk yc quk c ogvkd lk bhrlks cdvkhdcrks sk puklko prkskotcr `rkstcs quk gotkrngkrco kd `gkrrk ju`hsh h gotkrngkrco ko dc kdcbhrc`gðo h ciustk lk uoc prðtksgs.

 

‚ÙOG@C‚ Pk rkcdgzc ko uo cdvkhdh ùog`h y `hosgstk ko dc rkjh`gðo lk kspê`udcs cmulcs.

3.-Go`gsgðo jcrmgocd

2.Kxtrc``gðo

 

‚ÙOG@C‚

0.-Kxçrksgs

.3.2.2 KDCBHRC@GÐO S[GRÙRMG@CP Cd tkrjgocr dc prkpcrc`gðo lkd jhlkdh ks ok`kscrgh pcrc `honk``ghocr uoc  pdcotgddc lk c`rêdg`h c`rê dg`h trcospcrkotk trcospcrkotk. . Dc muêc qugrùrmg qugrùrmg`c `clupdg`crdh lkbk9 3. Pkr uoc rçpdg`c kxc`tc lk dc supkrng`gk lk ciustk lk dc prðtksgs.

 

>.3.0 GO\KRPKQ\ GO\KRPKQ\CD CD

@hosgstk

cdvçhdh ðskhkocdrklu`gr mgrcr dckd `hrtg`cd vkstgbudcr nrc`turclc `ho su ju`hpkrghstgh goskrtclh fc`gc dc pcrkl pcdctgoc h dgomucd lk dhs cdvkðdhs lkspuçs lk lgvglgr dhs tcbgquks ðskhs gotkrlkotcrghs.

 

^KO\CICP

 @hoskrvcr

kd fuksh `hjpc`th `ho uo rgkmh scomùgokh gocdtkrclh  Pk hbtgkok uo prh`ksh cdvkhdcr jkihr y jãs co`fh  @ucolh sk usc prðtksgs ks jkohs prhbcbdk quk kd fuksh `hjpc`th sunrc rcbshr`gðo

 

Go`gsgðo jcrmgocd

Kxhlho`gc

Lgskóh lk dc hstkhthjêc lk dc `hrtg`cd kxtkroc

@holg`ghoclc ok`ksglcl h `hoskrvcr dcs gotkrlkotcrgcs. dkvcotc uo

phr dc oh lk pcpgdcs Pk `hdmcih

Pk rkcdgzco dcs kxtrc``ghoks `ho nðr`kps. Pk kxtrck ko zhoc cotkrghr lk

Gotkotcr `hoskrvcr êotkmrc dc `hrtg`cd vkstgbudcr 

ju`hpkrgðstg`h vkstgbudcr 

`cogoh c dctkrcdks

 

Hstkhthjêcs trgcomudcrks ko dcs zhocs lgstcdks

@hrtk lk dhs tcbgquks ðskhs gotkrlkotcrghs

@hjh sk vc c lkspdczcr dc `hrtg`cd kxtkroc ko lgrk``gðo c dc @ho pgozc mubgc sk gotkroc quk ks uo cr`h jkohr, sk  prhvh`c uoc nrc`turc lkbk rklu`gr su dhomgtul, phr dh fhrgzhotcd lkd fuksh `hrtg`cd vkstgbudcr, y sk quk sk lgvglklklhs nrcmjkoths trgcomudcrks fuksh ko kd kdgjgoco dhs tcbgquks

Pk``gðo phr  pcdctgoh

Pk `hrtco dhs tcbgquks ðskhs gotkrlkotcrghs phr su dclh vkstgbudcr y  pcdctgoh h dgomucd. dgomucd.

trgcomudcrks lk fuksh ko kd kxtrkjh phstkrghr lk `clc cdvçhdh.

ðskhs gotkrlkotcrgh gotkrlkotcrghs. s.

 

Duxc`gðo lk dc `hrtg`cd kxtkroc

Dc `hrtg`cd vkstgbudcr quklc fc`gc nukrc uoglc sðdh `ho su

@hjprksgðo jcoucd pcrc clcptcr dc `hrtg`cd kxtkroc fc`gc  pcdctgoh Pk dk lc nhrjc `ho dc `hjprksgðo cpdg`clc kotrk dhs lklhs êolg`k y

ju`hpkrghstgh.

 pudmcr lkd `gruicoh `gruicoh

 

Puturc

@hdh`c`gðo lk dc prðtksgs gojklgctc Cotks sk `hdh`c dc muêc qugrùrmg`c pcrc `hotrhdcr  phsgbdks puoths lk shbrkprksgðo ko dcs

zhocs lk shphrtk lk dc  prðtksgs.  

HP\KHQDCP HP\K HQDCP \ÊC CD^KHDC CD^KHDCR R\ \CRLÊC CRLÊC

Hstkhpdcstêc •

Hpkrc`gðo quk `hosgstk ko dc rk`hostru``gðo lkd fuksh `ho dc cyulc lk htrhs nrcmjkoths ðskhs.

Hstkhpdcstêc cdvkhdcr  •

Rkjhlkdc`gðo lkd prh`ksh cdvkhdcr quk sk puklk fc`kr `ho jctkrgcd cutðdhmh h bgh jctkrgcd sgo dc rkjh`gðo lkd fuksh lk shphrtk.

 

KVHP\HPGP

Kxhsthsgs •

\ujhr bkogmoh lkd fuksh quk cpcrk`k `hjh uoc oukvc nhrjc`gðo ko dc supkrng`gk lkd fuksh ohrjcd.

Quklk skr cgsdclh y cpcrk`k ko uoc ùog`c ubg`c`gðo lk uo shdh fuksh •

Kxhsthsgs jùdtgpdk9 Cnk`tc ju`fhs fukshs

 

JÙD\GQDKP JCVGDCRKP

Kxhsthsgs Qrhtubkrco`gcs ðskcs lk `rk`gjgkoth dkoth y dgjgtclh. Dc ju`hsc hrcd quk dh rk`ubrk dh jcotgkok gotc`th Ktghdhmêc lks`hoh`glc, `ho  prklgsphsg`gðo mkoçtg`c

\gphs

@crc`tkrêstg`cs `dêog`cs

Qcdctgoc9 Pupkrng`gk pcdctgoc lkd prh`ksh cdvkhdcr lk dc rkmgðo jhdcr

Qkqukócs @rk`gjgkoth dkoth Nhrjc ohludcr h dhbudclc

supkrghr  Bu`cd9 [sucdjkotk jùdtgpdk y dh`cdgzclc ko dc supkrng`gk vkstgbudcr lkd  prh`ksh cdvkhdcr 

Ùog`cs h jùdtgpdks @hosgstko`gc lurc Csgothjãtg`hs

 

Kxhsthsgs bu`cd

Kxhsthsgs jùdtgpdk

Kxhsthsgs bu`cd

@crc`tkrêstg`cs rclghmrãng`cs

Kxhsthsgs `uctrh `uclrcotks

 

 \HR[P JCVGDCR 

¸Suç ks8

Ktghdhmêc

Nhrjc`ghoks ðskcs lk bcsk sçsgd ko dc dêokc jklgc lkd  pcdclcr lurh • Qrkskotk ko kd 21% lk dc phbdc`gðo • Jãs `hjùo ko juikrks

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Lks`hoh`glc, tkolko`gc c uo  pctrðo fkrklgtcrgh

@crc`tkrêstg`cs `dêog`cs •

Dhs jãs pkqukóhs tgkolko c skr

c`fctclhs cjpdgc y lk bcsk • Dhs thrus jãs mrcolks puklko skr  pklg`udclhs • Csgothjãtg`h

 

\hrus cpdcoclh

\hrus ohludcr

\hrus dhbudcr  

 

@CRC@\KRÊP\G@CP RCLGHMRÃNG@CP

@crc`tkrêstg`cs rclghmrãng`cs Lkosglcl rclghpc`c • Dêjgtks lkngoglhs • Pgo `hrtg`cd • \cjcóh vcrgcbdk • Ko Rx pkrgcpg`cdks tgkolk c  prhyk`tcrsk shbrk shbrk dc rkmgðo lkd skoh jcxgdcr • Ko Rx pcohrãjg`cs sk hbskrvc •

`hjh uoc gjcmko lhbdk bgdctkrcd

 

RKJH@GÐO @hdmcih ko —W‚ y lhbdk —W‚

Pk lgvglk kd thrus `ho nrksc trho`h`ðog`c ko nhrjc lk pcocd lk cbkic

Lkpkolgkolh lk dc kxtkosgðo sk fc`ko

@ho `go`kd sk qugtc kd thrus

dêokcs fhrgzhotcdks

Pk kdgjgoco

grrkmudcrglclks `ho grrkmudcrglclks dgjc h nrksc

 

\HR[P JCOLGB[DCR 

¸Suç ks8 •

Qrhtubkrco`gc ðskc ko dc supkrng`gk dgomucd lk dc

jcolêbudc Qrkskotk ko kd 6% lk dc phbdc`gðo • Jãs `hjùo ko juikrks •

Ktghdhmêc •

Lks`hoh`glc, tkolko`gc c uo  pctrðo fkrklgtcrgh

@crc`tkrêstg`cs `dêog`cs •

Pgjçtrg`hs @hosgstko`gc pçtrkc

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Csgothjãtg`h

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Puturc

 

@CRC@\KRÊP\G@CP RCLGHMRÃNG@CP

@crc`tkrêstg`cs rclghmrãng`cs • • • • •

Lkosglcl rclghpc`c Dgjgtks lkngoglhs Pgo `hrtg`cd \cjcóh vcrgcbdk Lgnê`gd lk hbskrvcr ko rclghmrcnêcs pcohrãjg`cs

 

RKJH@GÐO

Go`gsgðo fhrgzhotcd

Kdkvc`gðo lkd `hdmcih lk kspkshr thtcd

Hstkhthjêc `ho nrksc lk `crburh pcrc bcic vkdh`glcl

Rkjh`gðo lk nrcmjkoths lk fuksh  

HP\KHQDCP\ÊC LK DC \[BKRHPGLCL LKD JCVGDCR 

Dc tubkrhsglcl lkd jcxgdcr nhrjc kd dêjgtk phstkrghr lkd cdvkhdh jcxgdcr. Ks uoc prhyk``gðo rklholkclc, ohrjcdjkotk lk fuksh trcbk`udcr, `ho uoc ngoc `cpc lk fuksh `hjpc`th quk `hotgouc `ho dc `rkstc `rkst c cdvkhdcr.

 

RKJH@GÐO

Pg ks tco cskotcjgkoth prhtubkrcotk lk qukdcgjpglk kd `hrrk`th prðtksgs rkcdgzcrkjhs su rkjhlkdc`gðo lk jcokrc pcr`gcd `hoskrvcolh dc jãxgjc `cotglcl lk fuksh jcxgdcry quk pkrjgtc uoc bukoc kstcbgdglcl rktko`gðo lk dc prðtksgs.