Ukulimala kwe-ankle kungukulimala kwezemidlalo okuvamile okwenzeka cishe ngama-25% okulimala kwama-musculoskeletal, okulimale kakhulu (i-LCL) ukulimala okuvame kakhulu. Uma isimo esinzima singalashwa ngesikhathi, kulula ukuholela kuma-sprains aphindaphindwayo, futhi amacala abucayi azothinta umsebenzi wokuhlanganiswa kwe-ankle. Ngakho-ke, kubaluleke kakhulu ukuthola nokuphatha ukulimala kweziguli ekuqaleni. Le ndatshana izogxila kumakhono okuxilonga okulimala kwe-lateral liathement yokulimala kwe-ankle Joint ukusiza abadokotela bezothola ukunemba kokuxilongwa.
I. Anatomy
I-Anterior talofibular ligament (ANLL): Ukuthambisa, kuthambekele kwi-capsule elemuva, kuqala ukungaphandle kwe-FIBULA NOKUQALA KWESITOLO KWENKOLO YAMAHHALA.
I-Calcaneofibular Ligament (CFL): I-Cord-Shaped, isuka emngceleni wangaphandle we-malleolus ye-distal latelal futhi inqanyulwa e-calcaneus.
I-Poterior Talofibular Ligament (PTFL): Iqhamuka ebusweni bemithombo ye-malleolus yamuva futhi iphela ngemuva kwe-medial talus.
I-atfl iyodwa ibalwa cishe ama-80% okulimala, ngenkathi kuhlaselwa ukulimala kwe-CFL kube ngu-20%.
Umdwebo we-Schematic kanye nomdwebo we-anatomical we-lateral collateral ligament ye-ankle Joint
II. Indlela yokulimala
Ukulimala okuvinjelwe: I-Anterior Talofibular Ligament
I-Calcaneofibular ligament VarUS ukulimala: I-calcaneofibur ligament
III. Ukulimala kokulimala
Ibanga I: strain ligament, alikho i-ligament ye-ligament ebonakalayo, kuyaqabukela ukuvuvukala noma ubumnene, futhi akukho zimpawu zokulahleka komsebenzi;
Ibanga II: Ukuqhekeka kwe-macroscopic okuyingxenye ye-ligament, ubuhlungu obulinganiselayo, ukuvuvukala kanye nobumnene, kanye nokulimazeka okuncane komsebenzi ohlanganyelwe;
I-Grade III: I-Ligament idwengulwe ngokuphelele futhi ilahlekelwa ubuqotho bayo, ihambisana nokudumba okubalulekile, ukopha kanye nobumnene, kuhambisana nokulahleka okumakiwe kokusebenza okuhlangene.
IV. Ukuhlolwa kwekhabethe yangaphambili emtholampilo
Isiguli sihleli ngedolo siguqulwe futhi ukuphela kwethole elibandayo, futhi umhloli ubamba i-tibia esikhundleni ngesandla esisodwa futhi adonsela phansi unyawo phambili ngemuva kwesithende nomunye.
Ngenye indlela, isiguli siphezulu noma sihleli nedolo eligobekile ngama-60 kuye kwangama-90 degrees, isithende sigxile emhlabathini, futhi umhloli osebenzisa ingcindezi engemuva kweTibia.
Kubikezelwa okuhle ukuqhekeka kwe-anterior talofibular ligament.
Ukuhlolwa kokucindezelwa kwe-Inversion
I-ankle ye-proximal yayingasebenzi kahle, futhi ukucindezela kwe-varus kwasetshenziswa i-ankle distal ukuyohlola i-angle ye-talus emot.
Uma kuqhathaniswa nohlangothi lwamakhompiyutha,> 5 ° luyahle kakhulu, futhi> 10 ° kulungile; noma i-unilateral> 15 ° ihle.
Isibikezeli esihle sokuqhuma kwe-calcaneofibulalar ligament.
Ukuhlolwa kokucabanga
I-X-ray yokulimala kwe-ankle yezemidlalo
Ama-X-ray awalungile, kepha uMnu ukhombisa izinyembezi ze-anterior talofibular kanye ne-calcaneofibular ligaments
Izinzuzo: I-X-ray ingukuqala kokuhlolwa kokuhlolwa, okungokomnotho futhi okulula; Ubungako bokulimala buhlulelwa ngokwahlulela izinga lokuthambekela kweTalus. Okubi: Ukuboniswa okungalungile kwezicubu ezithambile, ikakhulukazi izakhiwo ezilukhuni ezibalulekile ukuze zilondoloze ukuzinza okuhlanganyelwe.
Igunya
Fig.1 Isikhundla esingu-20 ° esingu-20 ° sikhombise i-anterior talofibur ligament (atfl); I-Fig.2 Azimuth Line of Atfl Scan
Izithombe ze-MRI zokulimala kwe-anterior talofibular ligament ehlukene zibonisa ukuthi: (B) izinyembezi ze-anterior talofibular ligament; (C) ukuqhekeka kwe-anterior talofibular ligament; (D) Ukulimala kwe-anterior talofibular ligament nge-AVulsion Fracture.
I-Fig.3 Isikhundla esiphakeme -15 °
Fig.4. I-CFL Scanning Azimuth
Izinyembezi ezibucayi, eziphelele ze-calcaneofibur ligament
Umdwebo 5: Ukubukwa kwe-coronal kukhombisa i-poterionior talofibular ligament (PTFL);
I-Fig.6 PTFL Scan Azimuth
Izinyembezi eziyingxenye ze-poterior talofibular ligament
Ukufakwa kokuxilongwa:
Ikilasi I: akukho monakalo;
Ibanga II: Ukukhishwa kweLigament, ukuqhubeka kokugcwala okuqhubekayo, ukuqina kwama-ligaments, i-hypoechogenicicity, i-edema yezicubu ezizungezile;
I-Grade III: Ukungaphelele kwe-morphology, ukuncipha noma ukuphazamiseka okuyingxenye kokuqhubeka kokugcwala, ukuqina kwama-ligaments, kanye nesiginali eyandayo;
Ibanga IV: Ukuphazamiseka okuphelele kokuqhubeka kwe-ligament, okungahambisana nokuphazamiseka kwe-AVulsion, ukuqina kwama-ligaments, kanye nokwenyuka kwesiginali yendawo noma ukwengeza.
Izinzuzo: Ukulungiswa okuphezulu kwezicubu ezithambile, ukubonwa okucacile kwezinhlobo zokulimala kwe-ligament; Ingakhombisa ukulimala kwe-cartilage, ukungqubuzana kwamathambo, kanye nesimo sonke sokulimala okuhlanganisiwe.
Okubi: Akunakwenzeka ukuthi unqume ngokunembile ukuthi ngabe ukulimala kwe-cartilage kuphazamiseka; Ngenxa yobunzima be-ankle ligament, ukusebenza kahle kokuhlolwa akuphezulu; Kubiza futhi kudla isikhathi.
I-ultrasound ephezulu
Umdwebo we-1A: Ukulimala kwe-Anterior Talofibular Ligament, izinyembezi ezithile; Umdwebo we-1b: I-Anterior Talofibular Ligament idwengulwe ngokuphelele, isiqu siqine, futhi ukugcwala okukhulu kuyabonakala esikhaleni esisemuva.
Umdwebo 2A: Ukulimala kwe-calconeofibulalar ligament, izinyembezi ezithile; Umdwebo 2b: Ukulimala kwe-calconeofibular ligament, ukuqhuma okuphelele
Umdwebo 3A: I-anterior talofibur ligament: isithombe se-ultrasound sibonisa isakhiwo se-hypoechoic esingenakuqhathaniswa; Umdwebo 3b: I-Calcaneofibur Ligament: I-Ecogenic ethambile nesakhiwo esiminyene esimnandi esithombeni se-ultrasound
Umdwebo we-4A: ukuvela okuyingxenye kwe-anterior talofibular ligament esithombeni se-ultrasound; Umdwebo 4b: Izinyembezi eziphelele ze-calcaneofibur ligament esithombeni se-ultrasound
Ukufakwa kokuxilongwa:
Ukuphefumula: Izithombe ze-Acoustic zibonisa ukwakheka okungaqondile, okuqinile futhi okuvuvukele ama-ligaments; Izinyembezi ezithile: Kukhona ukuvuvukala eLigament, kunokuphazamiseka okuqhubekayo kweminye imicu, noma imicu icindezelwe endaweni yakini. AmaSkan ashukumisayo akhombisa ukuthi ukungezwani kweLigament kwaba buthaka kakhulu, futhi i-ligament yanda futhi yanda futhi ukuqina kwaba buthaka endabeni kaValgus noma ngeVorrus.
Qedela izinyembezi: I-ligament ephazamise ngokuphelele futhi ephazamisa ngokuhlukile, ukuskena okunamandla kuphakamisa ukungezwani kwe-ligament noma ukwenyuka kwezinyembezi, naseValgus noma eValgus, i-ligament iqhubekela komunye umkhawulo, ngaphandle kokuhlalisana ngokugcwele.
Izinzuzo: Izindleko eziphansi, okulula ukusebenza kuzo, ezingahlaseli; Isakhiwo esicashile sesendlalelo ngasinye sezicubu esingezansi sikhonjiswa kahle, okulungele ukubonwa kwezilonda zezicubu ze-musculoskeletal. Ukuhlolwa kweSigaba Sokulamula, ngokusho kwebhande leLigament ukulandelela yonke inqubo ye-ligament, indawo yokulimala kweLagament iyacaciswa, futhi izinguquko ze-ligament kanye ne-morphological zibhekwe ngamandla.
Okubi: Ukulungiswa kwezicubu ezithambile ezithambile ngokuqhathaniswa ne-MRI; Bathembele ekusebenzeni kwezobuchwepheshe ochwepheshe.
Isheke se-Arthroscopy
Izinzuzo: Ngokuqondile qaphela izinhlaka ze-malleolus lateral kanye ne-hindfoot (njenge-talar ehlanganisiwe, i-anterior talofibular ligament, i-calconeofibular ligament, njll.) Ukuhlola ubuqotho be-ligaments futhi kusiza udokotela ohlinzayo ukunquma uhlelo lokuhlinzwa.
Okubi: Ukuhlanzeka, kungadala izinkinga ezithile, njengokulimala kwezinzwa, ukutheleleka, njll. Kuvame ukubhekwa njengendlela ephansi yokulimala kwe-ligament futhi okwamanje esetshenziswa kakhulu ekwelapheni ukulimala kwe-ligament.
Isikhathi sePosi: Sep-29-2024
