Ukulungiswa kwangaphakathi ngepuleti yamathambo
I-Ankle Fusion enamapuleti kanye nezikulufo kuyinqubo evamile evame ukuhlinzwa njengamanje. Ukukhiya ipuleti yokulungiswa kwangaphakathi kusetshenziswe kabanzi ku-ankle fusion. Njengamanje, i-Plate Ankle Fusion ikakhulukazi ifaka ipuleti elingaphandle kanye ne-lateral Plate Ankle Fusion.
Lesi sithombe esingenhla sibonisa amafilimu we-X-ray ngaphambi nangemva kokuhlinzwa kwe-Ankle Ankle Osteoarthritis nge-anterior Locking Plate Fembutha I-Ankle ehlanganisiwe fusion
1. Indlela yangaphandle
Indlela ye-Anterterior ukwenza i-Anteritudinal incision egxile endaweni ehlanganyelwe ye-ankle, usike ungqimba ngongqimba, bese ungena endaweni ye-tendon; Sika i-capsule ehlanganisiwe, uveze i-tibiotalar Joint, susa i-cartilage nethambo le-subchondral, bese ubeka ipuleti elingaphandle elingaphandle le-ankle.
2. Indlela ye-Lateral
Indlela eyalandela ukusika i-osteotomy cishe nge-10 cm ngaphezulu kwesihloko se-fibula bese ususa isiqu ngokuphelele. Isiqu sethambo esikhansula esikhanyiselwe sithathwa ngokuxhunyelelwa ithambo. I-Fusion Surface Osteotomy isiqediwe futhi igezwe, futhi ipuleti libekwe ngaphandle kwe-ankle Joint.
Inzuzo ukuthi amandla okulungiswa aphezulu futhi ukulungiswa kuqinile. Ingasetshenziselwa ukulungiswa nokwakhiwa kabusha kokulimala okukhulu kwe-varias noma i-valgus ehlanganisiwe kwe-ankle ngokuhlangene kanye namathambo amaningi ngemuva kokuhlanza. Ipuleti le-fusion elakhiwe nge-anatomically lisiza ukubuyisela i-anatomy ejwayelekile yokuhlangana kwe-ankle. Indawo.
Okubi yilokho i-periosteum eyengeziwe nezicubu ezithambile endaweni yokuhlinzwa kudingeka zihluthwe, futhi ipuleti lensimbi likhulu, okulula ukucasulayo imithende ezungezile. Ipuleti lensimbi elibekwe ngaphambili kulula ukuthinta ngaphansi kwesikhumba, futhi kunengozi ethile.
Ukulungiswa kwezipikili kwe-intramentuvary
Eminyakeni yamuva, ukusetshenziswa kwe-retrograde intramengrary nail-thayipha ankle arthrodisi ekwelapheni i-End-Stage Ankle Arthlethred kancane kancane yasebenza emtholampilo.
Njengamanje, inqubo yokukhohlisa eyi-intrameraryuntary kakhulu isebenzisa ukufakwa kwe-anterior mediation kokuhlangana kwe-ankle noma i-anteroinrior ateral incision ye-fibular yokuhlanza indawo ye-articular surface noma ithambo. I-intramenduvaltary nail ifakwa kusuka ku-calcaneus kwi-tibial medullary cavity, okuzuzisa ekulungiseni kokulimala futhi kuthuthukisa i-bone fusion.
I-Ankle Osteoarthritis ihlanganiswe ne-subtalar arthritis. Amafilimu we-Anteroposterorterior angabasebenzi kanye nama-X-ray amafilimu akhombisa ukulimala okuhlangene ne-Tibiothalar ehlanganisiwe kanye ne-subtalar ehlanganisiwe, ukuwa okuyingxenye kweTalus, kanye nokwakheka kwe-osteophyte ezungeze okuhlanganyelwe (kusuka kwireferensi 2)
I-Divergent Fusion Screw Implantation angle yokukhiya i-Hindfoot Fusion I-Intermoot FUSALDULPARIPARY NAIL ingukulungiswa kwendiza ehlukahlukene, futhi ongakwazi ukumelana ngempumelelo nokusika, ukunciphisa ubungozi bokuhoxiswa kwesikulufa.
I-Tibiothalar ehlanganisiwe kanye ne-subtalar ehlanganisiwe yadalulwa futhi yacutshungulwa ngendlela ye-lateral eshintshashintshayo, kanye nobude be-incision emnyango we-plaplar intrametullary nail yayingu-3 cm
I-intramerary nail isetshenziswa njengokulungiswa okuphakathi nendawo, futhi ukucindezelwa kwayo kuhlakazeka, okungakugwema umphumela wokuvikelwa kwengcindezi futhi kuhambisana kakhulu nemigomo ye-biomechanics.
I-Anteroposteronter and Lateral X-ray Film 1 inyanga yenyanga ikhombisa ukuthi umugqa wezinyawo wangemuva wawulungile futhi i-intrametuundary nail yalungiswa ngokuthembekile
Kufaka isicelo sokubuyisa izipikili ezihlangene ne-Ankle Joint Fusion kunganciphisa ukulimala kwezicubu ezithambile, ukunciphisa i-necrosion yesikhumba yesikhumba, ukutheleleka nezinye izinkinga, futhi kunganikeza ezinye izinto ezizinzile ngaphandle kokulungiswa kwangaphandle.
Ngonyaka owodwa ngemuva kokuhlinzwa, amafilimu ama-X-ray ane-handeal anesisindo abonisa ukuhlanganiswa kwe-Tibiothalar ehlanganisiwe kanye ne-subtalar ehlanganisiwe, futhi ukuqondanisa kwezinyawo zangemuva kwakukuhle.
Isiguli singaphuma embhedeni futhi sinesisindo kusenesikhathi, esithuthukisa ukubekezelelana nesiguli kanye nekhwalithi yempilo. Kodwa-ke, ngoba ukuhlangana okuhlanganisiwe okuhlosiwe kudinga ukulungiswa ngasikhathi sinye, akunconyelwe iziguli ezine-subtalar ehlanganisiwe. Ukulondolozwa kokuhlangana kwe-subtalar kuyindlela ebalulekile yokunxephezela umsebenzi wokuhlanganiswa kwe-ankle ezigulini ezine-ankle ehlanganisiwe fusion.
Screw Focing yangaphakathi
Ukulungiswa kwe-percutaneous yangaphakathi kuyindlela ejwayelekile yokulungiswa e-Ankthle Arthrodisis. Inezinzuzo zokuhlinzwa okuncane okuhlaselayo okufana nokuvela okuncane nokulahleka kwegazi okuncane, futhi kunganciphisa ngempumelelo ukulimala kwezicubu ezithambile.
Amafilimu we-Anteroposteronter kanye nama-X-ray amafilimu ahlangene ahlanganisiwe ngaphambi kokusebenza akhombisa ama-osteoarthritis aphezulu we-ankle efanelekile nge-varus deform, futhi i-engela phakathi kwe-tibiothalar articur komhlaba yalinganiswa ukuba ngu-19 ° Varus
Ucwaningo lukhombisile ukuthi ukulungiswa okulula okunama-2 kuya kwayi-4 lag screws kungafinyelela ukulungiswa okuzinzile nokucindezelwa, futhi ukuhlinzwa kulula futhi izindleko zishibhile kakhulu. Kungukukhetha kokuqala kwezazi eziningi njengamanje. Ngaphezu kwalokho, ukuhlanza okuncane okuhlaselayo kwe-ankle kungenziwa ngaphansi kwe-arthroscopy, futhi izikulufo zingafakwa ngenhlalo. Ukuhlukumezeka okuhlinzayo kuncane futhi umphumela owelashwa uyanelisa.
Ngaphansi kwe-arthroscopy, indawo enkulu yesici se-cartilage ye-carticular iyabonakala; ngaphansi kwe-arthroscopy, idivaysi ekhonjisiwe ye-microfracture ye-cone isetshenziselwa ukwelapha indawo ye-articular
Abanye ababhali bakholelwa ukuthi ukulungiswa kwesikulufu 3 kunganciphisa izehlakalo zengozi yokungasebenzi kahle, kanye nokwanda kwezinga le-fusion kungahle kuhlobane nokuqina okuqinile kokulungiswa kwesilinganiso esingu-3.
Ifilimu elilandelayo le-X-ray 15 ngemuva kokuhlinzwa kuboniswe i-bony fusion. I-AOFAS Score yayingamaphuzu angama-47 ngaphambi kokusebenza namaphuzu angama-74 ngonyaka owodwa ngemuva kokuhlinzwa.
Uma izikulufo ezintathu zisetshenziselwa ukulungiswa, isikhundla esiseduze sokulungiswa ukuthi izikulufo ezimbili zokuqala zifakwe ngokulandelana ezinhlangothini ze-tibia kanye ne-anterelaral of the tibia, bese kufakwa isikulufa sesithathu siye ohlangothini lwangemva kweTibia ohlangothini lwe-talus.
Indlela yokulungiswa kwangaphandle
Ama-Finators angaphandle ayengamadivayisi okuqala asetshenziswa ku-ankle arthrodisis futhi aqhamuke kusukela ngo-1950s kuya ku-Ilizarov, hoffman, hybrid kanye ne-taylor space Frame (TSF).
Ukulimala okuvulekile kwe-ankle ngokutheleleka iminyaka emi-3, ankle arthrodisis izinyanga eziyi-6 ngemuva kokulawulwa kokutheleleka
Kwamanye ama-ankthle ankle arthritis amacala anezifo eziphindaphindwayo, imisebenzi ephindaphindwayo, isikhumba sendawo esingesihle kanye nezimo zezicubu ezithambile, ukwakheka kwamathambo, indalo yamathambo kanye nezinto zokutheleleka zangaphandle zisetshenziswa ngokwezithoni ze-ankle.
I-fixilator enomumo yangaphandle enobumba ihlelwe endizeni ye-coronal kanye nendiza ye-sagittal, futhi inganikeza umphumela wokulungiswa okuzinzile. Enqubweni yokuthwala umthwalo wokuqala, kuzocindezela ukuphela kwe-fracture, ukukhuthaza ukwakheka kwe-callus, futhi kuthuthukise izinga lokufuya. Ezigulini ezinobuthi obukhulu, i-fixilator yangaphandle ingalungisa kancane kancane ukonakala. Kuyiqiniso, i-Finator Fexicator Ankle Fusion izoba nezinkinga ezinjengokuphazamiseka kweziguli ezizogqoka kanye nengozi yokutheleleka nge-Tract Tract.
Xhumana:
I-WhatsApp: +86 15682071283
Email:liuyaoyao@medtechcah.com
Isikhathi sePosi: Jul-08-2023
