Ukulungiselela ngaphambi kokuhlinzwa kanye nendawo njengoba kuchaziwe ngaphambilini ukuze kulungiswe uhlaka lwangaphandle oluhamba phambili.
Ukulungiswa nokulungiswa kokuphuka kwangaphakathi kwe-articular：
Kusetshenziswa ukunciphisa nokuqinisa okulinganiselwe. Ukuphuka kobuso obungaphansi kwe-articular kungabonakala ngqo ngokusebenzisa ukusikwa okuncane kwe-anteromedial kanye ne-anterolateral kanye nokusikwa kwe-lateral kwe-capsule ye-joint ngaphansi kwe-meniscus.
Ukudonsa isitho esithintekile kanye nokusetshenziswa kwemisipha ukuqondisa izingcezu ezinkulu zamathambo, kanye nokucindezela okuphakathi kungabuyekezwa kabusha ngokususa nokususa.
Qaphela ukubuyisela ububanzi be-tibial plateau, futhi uma kukhona iphutha lethambo ngaphansi kobuso be-articular, yenza i-bone grafting ukuze usekele ubuso be-articular ngemva kokuzama ukusetha kabusha ubuso be-articular.
Naka ukuphakama kwamapulatifomu aphakathi nendawo kanye nawaseceleni, ukuze kungabikho sinyathelo sobuso esiqondile.
Ukulungiswa kwesikhashana nge-reset clamp noma iphini likaKirschner kusetshenziselwa ukugcina ukusetha kabusha.
Ukubekwa kwezikulufo ezingenalutho, izikulufo kufanele zihambisane nobuso obuhlangene futhi zibekwe ethanjeni le-subchondral, ukuze kwandiswe amandla okuqina. I-X-ray fluoroscopy kufanele yenziwe ngesikhathi sokuhlinzwa ukuze kuhlolwe izikulufo futhi kungalokothi kufakwe izikulufo esibayeni.
Ukubekwa kabusha kwe-Epiphyseal fracture：
Ukudonsa kubuyisela ubude kanye ne-axis yomshini yesitho esithintekile.
Kuqashelwa ukulungisa ukufuduka kokujikeleza kwesitho esithintekile ngokuthinta i-tibial tuberosity bese uyiqondisa phakathi kwezinzwane zokuqala nezesibili.
Ukubekwa Kwendandatho Eseduze
Uhla lwezindawo eziphephile zokubekwa kwentambo yokucindezela ye-tibial plateau：
Umthambo we-popliteal, umthambo we-popliteal kanye nomthambo we-tibial kudlula ngemuva kuya e-tibia, kanti umthambo ovamile we-peroneal udlula ngemuva kuya ekhanda le-fibular. Ngakho-ke, kokubili ukungena nokuphuma kwenaliti kufanele kwenziwe ngaphambili kuya ethafeni le-tibial, okungukuthi, inaliti kufanele ingene futhi iphume ngenaliti yensimbi ngaphambili iye emngceleni ophakathi we-tibia kanye nangaphambili kuya emngceleni ongaphambili we-fibula.
Ohlangothini oluseceleni, inaliti ingafakwa kusukela onqenqemeni olungaphambili lwe-fibula bese idluliselwa kusukela ohlangothini olungaphambili noma ohlangothini oluphakathi; indawo yokungena ephakathi ivame ukuba semkhawulweni ophakathi we-tibial plateau kanye nohlangothi lwayo olungaphambili, ukuze kugwenywe ukuthi ucingo olucindezelayo ludlule ezicutshini eziningi zemisipha.
Kuye kwabikwa ezincwadini ukuthi indawo yokungena yocingo lokucindezela kufanele okungenani ibe yi-14 mm ukusuka ebusweni be-articular ukuvimbela ucingo lokucindezela ukuthi lungangeni ku-capsule ehlangene futhi kubangele isifo samathambo esithathelwanayo.
Beka ucingo lokuqala lokucindezela:
Kungasetshenziswa iphini yomnqumo, edluliselwa ngephini yokuphepha ephethe indandatho, ishiye ikhanda lomnqumo ngaphandle kwephini yokuphepha.
Umsizi ugcina indawo yesibambi sendandatho ukuze ihambisane nobuso obuhlangene.
Donsa iphini lomnqumo phakathi kwezicubu ezithambile kanye nethafa le-tibial, unakekele ukulawula indlela eliqondiswe ngayo ukuqinisekisa ukuthi izindawo zokungena nezokuphuma zisendaweni efanayo.
Ngemva kokuphuma esikhumbeni ohlangothini oluphambene qhubeka uphuma enalitini kuze kube yilapho ikhanda lomnqumo lithinta iphini lokuphepha.
Faka isilayidi se-wire clamp ohlangothini oluphambene bese udlulisa iphini lomnqumo ngesilayidi se-wire clamp.
Qaphela ukuthi i-tibial plateau iphakathi nendawo yohlaka lwendandatho ngaso sonke isikhathi ngesikhathi sokusebenza.
Ngomhlahlandlela, intambo yesibili yokucindezela ibekwa ngokulingana, futhi nangakolunye uhlangothi lwesilayidi se-wire clamp.
Beka ucingo lwesithathu lokucindezela, kufanele lube sebangeni eliphephile ngangokunokwenzeka ngesethi yangaphambilini yocingo lokucindezela oluwela ekhoneni elikhulu kunawo wonke, ngokuvamile amasethi amabili ocingo lwensimbi angaba yi-engeli engu-50 ° ~ 70 °.
Ukulayisha kusengaphambili okufakwe kuntambo yokucindezela: Cindezela ngokuphelele isiqinisi, dlulisa isihloko sentambo yokucindezela ngesiqinisi, cindezela isibambo, faka okungenani ukulayisha kusengaphambili okungu-1200N kuntambo yokucindezela, bese ufaka isihluthulelo sesibambo se-L.
Ukusebenzisa indlela efanayo yokubopha kwangaphandle edolweni njengoba kuchaziwe ngaphambilini, beka okungenani izikulufo ezimbili ze-Schanz ku-tibia ekude, unamathisele i-fixator yangaphandle enengalo eyodwa, bese uyixhuma ku-fixator yangaphandle ejikelezayo, bese uqinisekisa ukuthi i-metaphysis kanye ne-tibial stem zisesimweni esijwayelekile se-mechanical axis kanye nokulungiswa kokujikeleza ngaphambi kokuqeda i-fixation.
Uma kudingeka ukuzinza okwengeziwe, uhlaka lwendandatho lunganamathiselwa engalweni yokuqinisa yangaphandle ngenduku yokuxhuma.
Ukuvala ukusikwa
Ukusika ngokuhlinzwa kuvaliwe ungqimba ngalunye.
Ipayipi lenaliti livikelwe nge-alcohol gauze wraps.
Ukuphathwa Kwangemva Kokuhlinzwa
I-Fascial syndrome kanye nokulimala kwemizwa
Kungakapheli amahora angu-48 ngemuva kokulimala, kufanele kuthathwe ukunakekelwa ukuze kubhekwe futhi kutholakale ukuthi kukhona yini i-fascial compartment syndrome.
Qaphela ngokucophelela imithambo yegazi yesitho esithintekile. Ukuphazamiseka kokunikezwa kwegazi noma ukulahlekelwa okuqhubekayo kwezinzwa kufanele kuphathwe ngendlela efanele njengesimo esiphuthumayo.
Ukuvuselelwa kokusebenza kahle
Ukuzivocavoca okusebenzayo kungaqalwa ngosuku lokuqala ngemva kokuhlinzwa uma kungekho okunye ukulimala endaweni noma izifo ezihambisana nakho. Isibonelo, ukufinyela kwe-isometric kwe-quadriceps kanye nokunyakaza okungasebenzi kwedolo kanye nokunyakaza okusebenzayo kweqakala.
Inhloso yemisebenzi yokuqala esebenzayo nengashukumiyo ukuthola ububanzi obukhulu bokunyakaza kwejoyinti ledolo isikhathi esifushane ngangokunokwenzeka ngemva kokuhlinzwa, okungukuthi, ukuthola ububanzi obuphelele bokunyakaza kwejoyinti ledolo ngangokunokwenzeka emavikini angu-4 kuya kwangu-6. Ngokuvamile, ukuhlinzwa kuyakwazi ukufeza injongo yokwakha kabusha ukuqina kwedolo, okuvumela kusenesikhathi
umsebenzi. Uma izivivinyo zokusebenza zibambezeleka ngenxa yokulinda ukuvuvukala ukuthi kudambe, lokhu ngeke kube usizo ekuvuseleleni ukusebenza.
Ukuthwala isisindo: Ukuthwala isisindo kusenesikhathi ngokuvamile akukhuthazwa, kodwa okungenani amasonto ayi-10 kuya kwangu-12 noma kamuva ngenxa yokuqhekeka kwangaphakathi kwe-articular okuklanyelwe.
Ukuphola kwenxeba: Qaphelisisa ukuphola kwenxeba zingakapheli amasonto amabili ngemva kokuhlinzwa. Uma kwenzeka ukutheleleka kwenxeba noma ukuphola okulibazisekile, ukungenelela kokuhlinzwa kufanele kwenziwe ngokushesha okukhulu.
Isikhathi sokuthunyelwe: Agasti-16-2024
