Njengamanje, indlela esetshenziswa kakhulu yokuhlinza yokuphuka kwe-calcaneal ihlanganisa ukulungisa kwangaphakathi ngepuleti nesikulufu kumzila we-sinus tarsi.Indlela enwetshiwe emise okwezinhlangothi "L" ayisakhethwa emisebenzini yomtholampilo ngenxa yezinkinga eziphezulu ezihlobene nesilonda.Ukulungiswa kwamapuleti nesikulufu, ngenxa yezici zayo ze-biomechanical zokulungiswa kwe-eccentric, kunengozi enkulu yokungalungi kahle kwe-varus, ngocwaningo oluthile olubonisa amathuba angemva kokuhlinzwa e-varus yesibili angaba ngu-34%.
Ngenxa yalokho, abacwaningi sebeqalile ukutadisha izindlela zokulungisa i-intramedullary zokuphuka kwe-calcaneal ukuze kubhekwane nazo zombili izinkinga ezihlobene nesilonda kanye nenkinga yokungalungi kahle kwe-varus yesibili.
01 Ni-ail central nailing technique
Le nqubo ingasiza ekwehliseni umzila wokungena we-sinus tarsi noma ngaphansi kokuqondiswa kwe-arthroscopic, edinga izidingo eziphansi zezicubu ezithambile futhi okungenzeka kunciphise isikhathi sokulaliswa esibhedlela.Le ndlela isetshenziswa ngokukhethekile ekuqhekekeni kohlobo lwe-II-III, futhi ezingxenyeni eziyinkimbinkimbi ze-calcaneal fractures, ingase inganikezeli ukugcinwa okuqinile kokunciphisa futhi ingase idinge ukulungiswa okwengeziwe kwezikulufu.
02 Si-ingle-plane intramedullary nail
Isipikili se-intramedullary sendiza eyodwa sinezikulufu ezimbili ekugcineni kwe-proximal ne-distal, nesipikili esikhulu esingenalutho esivumela ukuxhunyelelwa kwethambo ngozipho olukhulu.
03 MUlti-plane intramedullary nail
Idizayinelwe ngokusekelwe ku-morphology yesakhiwo enezinhlangothi ezintathu ze-calcaneus, le sistimu yokulungisa yangaphakathi ihlanganisa izikulufu ezingukhiye njengezikulufu ezithwala umthwalo nezikulufu zenqubo yangemuva.Ngemva kokuncishiswa ngomzila wokungena we-sinus tarsi, lezi zikulufi zingafakwa ngaphansi koqwanga ukuze zisekelwe.
Kunezingxabano eziningana mayelana nokusetshenziswa kwezipikili ze-intramedullary ze-calcaneal fractures:
1. Ukufaneleka okusekelwe kubunzima be-fracture: Kuphikiswana ngokuthi ama-fractures alula awadingi izipikili ze-intramedullary kanye nama-fractures ayinkimbinkimbi awafaneleki kubo.Ngokuphuka kohlobo lwe-Sanders II/III, indlela yokunciphisa nokulungisa izikulufu ngomzila we-sinus tarsi isikhulile ngokuqhathaniswa, futhi ukubaluleka kwesipikili esiyinhloko se-intramedullary kungase kungatshazwa.Ngokuphuka okuyinkimbinkimbi, izinzuzo zendlela enwetshiwe enomumo othi "L" zihlala zingenakushintshwa, njengoba zinikeza ukuchayeka okwanele.
2. Isidingo se-medullary canal yokwenziwa: I-calcaneus ngokwemvelo ayinawo umsele we-medullary.Ukusebenzisa isikhonkwane esikhulu se-intramedullary kungase kubangele ukuhlukumezeka ngokweqile noma ukulahlekelwa isisindo samathambo.
3. Ubunzima bokukhipha: Ezimweni eziningi e-China, iziguli zisakhishwa i-hardware ngemva kokuphulukiswa kokuphuka.Ukuhlanganiswa kwezipikili nokukhula kwethambo nokushumeka kwezikulufu ezingemuva ngaphansi kwethambo le-cortical kungaholela ebunzimeni ekukhishweni, okuwukucatshangelwa okungokoqobo ekusetshenzisweni komtholampilo.
Isikhathi sokuthumela: Aug-23-2023
