"U-10% wokuphuka kweqakala kuhambisana nokulimala kwe-tibiofibular syndesmosis ekude. Izifundo zibonise ukuthi ama-52% ezikulufo ze-tibiofibular ezikude zibangela ukwehla okungekuhle kwe-syndesmosis. Ukufaka isikulufo se-tibiofibular esikude siqonde ngqo ebusweni be-syndesmosis kubalulekile ukuze kugwenywe ukwehla okungaba khona kwe-iatrogenic. Ngokusho kwencwadi ye-AO, kunconywa ukufaka isikulufo se-tibiofibular esikude esingu-2 cm noma u-3.5 cm ngaphezu kobuso be-tibial articular ekude, nge-engeli engu-20-30° kuya endizeni evundlile, kusukela ku-fibula kuya ku-tibia, iqakala lisesimweni esingathathi hlangothi."
Ukufakwa ngesandla kwezikulufo ze-tibiofibular ezikude kuvame ukuholela ekuphambukeni endaweni yokungena kanye nesiqondiso, futhi okwamanje, ayikho indlela eqondile yokunquma indlela yokufaka yalezi zikulufo. Ukuze kuxazululwe le nkinga, abacwaningi bakwamanye amazwe basebenzise indlela entsha—indlela 'ye-angle bisector'.
Kusetshenziswa idatha yezithombe ezivela ezinhlanganisweni ezivamile zeqakala ezingu-16, kwadalwa amamodeli angu-16 aphrintiwe nge-3D. Ebangeni elingama-2 cm no-3.5 cm ngaphezu kobuso be-tibial articular, izintambo ezimbili ze-Kirschner ezingu-1.6 mm ezihambisana nobuso obuhlangene zabekwa eduze kwemiphetho yangaphambili nengemuva ye-tibia ne-fibula, ngokulandelana. I-engeli phakathi kwezintambo ezimbili ze-Kirschner yalinganiswa kusetshenziswa i-protractor, kwathi i-drill bit engu-2.7 mm yasetshenziswa ukubhoboza imbobo emgqeni we-engeli bisector, kwalandela ukufakwa kwesikulufu esingu-3.5 mm. Ngemva kokufakwa kwesikulufu, isikulufu sanqunywa ngobude baso kusetshenziswa isaha ukuze kuhlolwe ubudlelwano phakathi kwesiqondiso sesikulufu kanye ne-axis ephakathi ye-tibia ne-fibula.
Ukuhlolwa kwe-specimen kubonisa ukuthi kukhona ukuvumelana okuhle phakathi kwe-axis ephakathi ye-tibia ne-fibula kanye nomugqa we-angle bisector, kanye naphakathi kwe-axis ephakathi kanye nesiqondiso sesikulufu.
Ngokwe-heoretically, le ndlela ingabeka kahle isikulufu eceleni kwe-axis ephakathi ye-tibia ne-fibula. Kodwa-ke, ngesikhathi sokuhlinzwa, ukubeka izintambo ze-Kirschner eduze kwemiphetho yangaphambili nengemuva ye-tibia ne-fibula kubeka engcupheni yokulimaza imithambo yegazi kanye nemizwa. Ngaphezu kwalokho, le ndlela ayixazululi inkinga yokuncipha kwe-iatrogenic, njengoba ukulungelelaniswa kwe-tibiofibular distal kungeke kuhlolwe ngokwanele ngaphambi kokuhlinzwa ngaphambi kokufakwa kwesikulufu.
Isikhathi sokuthunyelwe: Julayi-30-2024
