ukuma kwe-meniscus
I-meniscus yangaphakathi nangaphandle.
Ibanga phakathi kwamaphethelo amabili e-meniscus ephakathi likhulu, libonisa umumo othi "C", futhi umphetho uxhumeke ku-meniscus.okuhlangene i-capsule kanye nongqimba olujulile lwe-medial collateral ligament.
I-meniscus yangemuva inomumo othi "O".Ithenda ye-popliteus ihlukanisa i-meniscus kusuka ku-capsule ehlangene phakathi nangemuva kwe-1/3, yenza igebe.I-meniscus yangemuva ihlukaniswe ne-lateral collateral ligament.
Inkomba yokuhlinzwa yakudala yei-meniscus sutureunyembezi longitudinal endaweni ebomvu.Ngokuthuthukiswa kwemishini nobuchwepheshe, ukulimala okuningi kwe-meniscus kungenziwa i-sutured, kodwa iminyaka yesiguli, inkambo yesifo, kanye nomugqa wamandla aphansi nawo kufanele kucatshangelwe., ukulimala okuhlangene nezinye izimo eziningi, inhloso yokugcina ye-suture iwukuba nethemba lokuthi ukulimala kwe-meniscus kuzophulukisa, hhayi i-suture ye-suture!
Izindlela ze-meniscus suture zihlukaniswa ngokuyinhloko zibe izigaba ezintathu: ngaphandle-ngaphakathi, ngaphakathi-ngaphandle nangaphakathi konke.Ngokuya ngendlela yokufaka i-suturing, kuzoba nezinsimbi zokuthunga ezihambisanayo.Okulula kakhulu Kunezinaliti zokubhoboza i-lumbar noma izinaliti ezijwayelekile, futhi kukhona nemishini ekhethekile yokuthungatha i-meniscal kanye namadivayisi e-meniscal suturing.
Indlela yangaphandle ingabhobozwa ngenaliti yokubhoboza i-lumbar eyi-gauge engu-18 noma inaliti evamile yomjovo egauge engu-12.Kulula futhi kuwusizo.Isibhedlela ngasinye sinaso.Yiqiniso, kunezinaliti zokubhoboza ezikhethekile.- Ⅱ kanye no-0/2 wesimo sothando.Indlela yangaphandle idla isikhathi futhi ayikwazi ukulawula imbobo yenaliti ye-meniscus ekuhlanganyeleni.Ifanele uphondo lwangaphambili nomzimba we-meniscus, kodwa hhayi uphondo lwangemuva.
Kungakhathaliseki ukuthi ucupha kanjani umkhondo, umphumela wokugcina wendlela yangaphandle ukuhambisa kabusha i-suture engene ngaphandle futhi ngokusebenzisa i-meniscus izinyembezi ukuya ngaphandle komzimba futhi ihlanganiswe endaweni ukuze iqedele ukulungiswa kwe-suture.
Indlela yangaphakathi-ngaphandle ingcono futhi iphambene nendlela yangaphandle.Inaliti nomthofu kudluliselwa kusuka ngaphakathi kwelunga kuya ngaphandle kwelunga, futhi kuphinde kuhlanganiswe nefindo ngaphandle kwelunga.Ingakwazi ukulawula indawo yokufaka inaliti ye-meniscus ekuhlanganyeleni, futhi umthungo ucoceke kakhulu futhi uthembekile..Kodwa-ke, indlela yangaphakathi engaphandle idinga amathuluzi okuhlinza akhethekile, futhi izimbobo ezengeziwe ziyadingeka ukuze kuvikelwe imithambo yegazi nezinzwa ngama-arc baffles lapho kuthunga uphondo lwangemuva.
Izindlela ezingaphakathi kuzo zonke zihlanganisa ubuchwepheshe be-stapler, ubuchwepheshe be-suture hook, ubuchwepheshe be-suture forceps, ubuchwepheshe be-anchor kanye nobuchwepheshe bomhubhe odlulayo.Ibuye ifanele ukulimala kophondo lwangaphambili, ngakho-ke ihlonishwa kakhulu odokotela, kodwa i-intra-articular suturing ephelele idinga amathuluzi okuhlinza akhethekile.
1. Indlela ye-stapler iyindlela evame ukusetshenziswa kakhulu ene-articular.Izinkampani eziningi ezifana nomshana kaSmith, uMitek, uLinvatec, u-Arthrex, uZimmer, njll. zikhiqiza ama-staplers azo, ngayinye inezinzuzo zayo kanye nokubi.Odokotela bavamise ukuwasebenzisa ngokwezinto abazithandayo kanye Nokujwayelana ukuze bakhethe, esikhathini esizayo, ama-meniscus staplers amasha futhi angabantu azovela ngobuningi.
I-2.Ubuchwepheshe be-suture forceps butholakala kubuchwepheshe be-arthroscopy yamahlombe.Odokotela abaningi banomuzwa wokuthi i-suture forceps ye-rotator cuff ilula futhi iyashesha ukuyisebenzisa, futhi idluliselwa kumthungo wokulimala kwe-meniscus.Manje kukhona okucwengisiswe okwengeziwe futhi okukhethekilei-meniscus suturesemakethe.Amapulangwe ayathengiswa.Ngenxa yokuthi ubuchwepheshe be-suture forceps benza umsebenzi ube lula futhi bufinyeze kakhulu isikhathi sokusebenza, bufaneleka ngokukhethekile ukulimala kwempande engemuva ye-meniscus, okunzima ukuyixhuma.
3. Ubuchwepheshe be-anchor bangempela kufanele bubhekisele esizukulwaneni sokuqalaukulungiswa kwe-meniscal sature, okuyisisekelo esiklanyelwe ngokukhethekile i-meniscus suture.Lo mkhiqizo awusatholakali.
Namuhla, ubuchwepheshe be-anchor ngokuvamile bubhekisela ekusetshenzisweni kwamahange wangempela.Engelsohn et al.okokuqala kubikwa ku-2007 ukuthi indlela yokulungisa ihange le-suture yasetshenziselwa ukwelashwa kwe-meniscus yangaphakathi yokulimala kwezimpande zangemuva.Amahange afakwa endaweni ephrintiwe futhi afakwe i-sutured.Ukulungisa ihange le-Suture kufanele kube indlela enhle, kodwa kungakhathaliseki ukuthi ukulimala kwezimpande ezimaphakathi noma ezingemuva kwe-semilunar, ihange le-suture kufanele libe nezinkinga eziningi njengokuntuleka kwendlela efanelekile, ubunzima bokubeka, kanye nokungakwazi ukukrufusha ihange ngendlela eqondile. indawo yethambo., ngaphandle uma kukhona uguquko oluguquguqukayo ekwenziweni kwehange noma izinketho ezingcono zokufinyelela ngokuhlinzwa, kunzima ukuba indlela elula, elula, ethembekile futhi evame ukusetshenziswa.
4. Indlela ye-transosseous tract ingenye yezindlela eziphelele ze-intra-articular suture.Ku-2006, u-Raustol waqala ukusebenzisa le ndlela ukuthunga ukulimala kwezimpande ze-meniscus ezingemuva, futhi kamuva yasetshenziselwa ngokukhethekile ukulimala kwezimpande ze-meniscus ezingemuva kanye ne-meniscus ye-radial yokudabula nokuklebhula esifundeni se-meniscus-popliteus tendon, njll. Indlela yokudlulisa -i-osseous suture iwukuba kuqala ukunwaya uqwanga endaweni yokufaka ngemva kokuqinisekisa ukulimala ngaphansi kwe-arthroscopy, futhi usebenzise i-ACL tibial sight noma ukubona okukhethekile ukuze uhlose nokubhoboza umhubhe.Kungasetshenziswa umsele onethambo elilodwa noma onamathambo amabili, kanti umsele onethambo elilodwa ungasetshenziswa.Indlela Umhubhe wamathambo mkhulu futhi ukusebenza kulula, kodwa ngaphambili kufanele kulungiswe ngezinkinobho.Indlela yomhubhe enamathambo amabili idinga ukubhola omunye umhubhe wamathambo, okungelula kwabaqalayo.Ingaphambili lingahlanganiswa ngokuqondile phezu kwethambo, futhi izindleko ziphansi.
Isikhathi sokuthumela: Sep-23-2022
