"I-10% yama-ankle fractures ahambisana nokulimala kwe-distal tibiofibular jwayelekile I-Tibiofibular screw 2 cm noma i-3.5 cm ngaphezulu kwe-distal tibial articular ebunjiwe, engela ka-20-30 ° kuya endizeni evundlile, kusuka ku-fibulallal kuya eTibia, nge-ankle endaweni yokungathathi hlangothi. "
Ukufakwa kwe-Manual of distal tibiofibular izikulufo zivame ukuphumela ekuphambukeni endaweni yokungena nokuqondisa, futhi njengamanje, ayikho indlela eqondile yokunquma indlela yokufaka kulezi zikulungisa. Ukubhekana nalolu daba, abacwaningi bakwamanye amazwe bathathe indlela entsha - 'indlela ye-Angle Bisector.
Kusetshenziswa idatha yokucabanga kusuka kumajoyinti ayi-16 ajwayelekile ama-ankle, kwadalwa amamodeli aphrintiwe ayi-16. Emabanga angu-2 cm kanye ne-3.5 cm ngaphezulu kwe-tibial articular ebunjiwe, ama-2,6 mm kirschner izintambo ngokuhambisana nendawo ehlanganyelwe abekwe eduze kwemiphetho ye-tibia ne-fibula, ngokulandelana. I-engela phakathi kwezintambo ezimbili zeKistschner yalinganiswa kusetshenziswa i-protractor, kanye ne-2.7 mm bird bit yayisetshenziselwa ukumba umgodi eceleni komugqa we-angle bisector, kulandelwa ukufakwa kwesikulufa se-3.5 mm. Ngemuva kokufakwa kwesikulufu, isikulufa sasikwa ngobude baso sisebenzisa i-SAW ahlole ubudlelwano phakathi kokuqondisa kwesikulufa kanye ne-axis ephakathi ne-tibala.
Ukuhlolwa okucacisiwe kukhombisa ukuthi kunokuvumelana okuhle phakathi kwe-axis ephakathi yeTibia ne-Fibula kanye nomugqa we-Angle Bies, kanye naphakathi kwe-axis central kanye ne-screw indlela.
Ngokuqinisekile, le ndlela ingabeka ngempumelelo isikulufa eceleni kwe-axis central yeTibia ne-Fibula. Kodwa-ke, ngesikhathi sokuhlinzwa, ukubeka izintambo zeKistchner zisondele emaphethelweni angaphandle nasemuva kweTibia noFibula kubeka engcupheni yokulimaza imithambo yegazi nezinzwa. Ngokwengeziwe, le ndlela ayixazululi udaba lokuzala kwe-Iatrogenic, njengoba ukuqondana kwe-distal tibiofibular akunakuhlolwa ngokwanele nge-Intraoperatively ngaphambi kokubekwa kwesikulufa.
Isikhathi sePosi: Jul-30-2024
