Njengamanje, indlela yokuhlinzwa esetshenziswa kakhulu yokuqhekeka kwe-calcaneal ihilela ukufakwa kwangaphakathi nge-plate bese ugoqa umzila wokungena we-sinus tarsi. Indlela enwetshiwe enomumo we-"L" ohlangothini ayisathandwa emtholampilo ngenxa yezinkinga eziphezulu ezihlobene nenxeba. Ukufakwa kwe-plate kanye ne-screw system, ngenxa yezici zayo ze-biomechanical zokufakwa kwe-eccentric, kuthwala ingozi ephezulu yokungahambisani kahle kwe-varus, kanti ezinye izifundo zibonisa amathuba okulimala kwe-varus yesibili angaba ngu-34%.
Ngenxa yalokho, abacwaningi sebeqalile ukufunda izindlela zokubopha i-intramedullary zokuphuka kwe-calcaneal ukuze babhekane nezinkinga ezihlobene nenxeba kanye nenkinga yokungahambi kahle kwe-varus yesibili.
01 Nindlela yokuzinamela ephakathi
Le ndlela ingasiza ekunciphiseni ngokusebenzisa indlela yokungena kwe-sinus tarsi noma ngaphansi kwesiqondiso se-arthroscopic, okudinga izidingo eziphansi zezicubu ezithambile futhi okungenzeka kunciphise isikhathi sokulaliswa esibhedlela. Le ndlela isetshenziswa ngokukhethekile ekuqhekekeni kohlobo lwe-II-III, futhi ekuqhekekeni kwe-calcaneal okuyinkimbinkimbi, kungenzeka kungahlinzeki ngokugcinwa okuqinile kokuncipha futhi kungadinga ukulungiswa okwengeziwe kwesikulufo.
02 Suzipho lwe-intramedullary oluyindilinga
Uzipho olungaphakathi kwe-medullary olune-plane eyodwa lunezikulufo ezimbili emaphethelweni aseduze nawakude, olunezinzipho eziyinhloko ezingenalutho ezivumela ukuxhunyelelwa kwamathambo kuzipho eziyinhloko.
03 Misipikili sangaphakathi se-ulti-plane
Yakhelwe ngokusekelwe ku-morphology yesakhiwo esinezinhlangothi ezintathu ze-calcaneus, lolu hlelo lokuqinisa lwangaphakathi luhlanganisa izikulufo eziyinhloko njengezikulufo ezithwala umthwalo kanye nezikulufo zenqubo yangemuva. Ngemva kokunciphisa ngendlela yokungena ye-sinus tarsi, lezi zikulufo zingafakwa ngaphansi kwe-cartilage ukuze zisekelwe.
Kunezimpikiswano eziningana mayelana nokusetshenziswa kwezipikili ze-intramedullary ukuze kuphuke i-calcaneal:
1. Ukufaneleka okusekelwe ebunzimeni bokuqhekeka: Kuxoxwa ngokuthi ukuqhekeka okulula akudingi yini izinzipho zangaphakathi kwe-medullary futhi ukuqhekeka okuyinkimbinkimbi akuzifanele yini. Kuma-fracture ohlobo lwe-Sanders II/III, inqubo yokunciphisa nokulungisa izikulufo ngendlela yokungena kwe-sinus tarsi ivuthiwe, futhi ukubaluleka kwezipikili zangaphakathi kwe-medullary eziyinhloko kungangatshazwa. Kuma-fracture ayinkimbinkimbi, izinzuzo zendlela enwetshiwe enomumo we-"L" azinakuphikwa, njengoba inikeza ukuchayeka okwanele.
2. Isidingo somsele we-medullary wokwenziwa: I-calcaneus ngokwemvelo ayinawo umsele we-medullary. Ukusebenzisa uzipho olukhulu lwangaphakathi kungabangela ukulimala okukhulu noma ukulahlekelwa amathambo.
3. Ubunzima bokususwa: Ezimweni eziningi eShayina, iziguli zisasuswa ihadiwe ngemva kokuphulukiswa kokuphuka. Ukuhlanganiswa kwezipikili nokukhula kwamathambo kanye nokushumeka kwezikulufo eziseceleni ngaphansi kwethambo le-cortical kungaholela enkingeni yokususwa, okuyinto ewusizo ekusetshenzisweni kwezokwelapha.
Isikhathi sokuthunyelwe: Agasti-23-2023
