Ama-ankle fractures angenye yezinhlobo ezivame kakhulu zokuqhekeka ekusebenzeni emtholampilo. Ngaphandle kokulimala okuthile kwebanga le-I / II, ukulimala kokuthumba, iningi lama-ankle fractures livame ukubandakanya i-malleolus yamuva. I-Weber A / B Uhlobo lwe-Malleolus Fractures ngokuvamile luba nomphumela ku-distal tibiofibur syndesmosis ezinzile futhi ungafinyelela ukuncishiswa okuhle ngokubona okuqondile kusuka ekude nasekude nasekude nasekude nasekude nasekude nasekude nasekude nasekude nasekude nasekude nasekude nasekude nasekude nasekude nasekude nase-Proximal. Ngokuphambene, nohlobo lwe-C-Feral Malleolus Fractures lubandakanya ukungazinzi ku-malleolus lateral kuwo wonke ama-abiafibular ukulimala okude: Ukunciphisa / ukuncipha kwendiza ye-distal tibiafibular, okuvela endizeni ye-sagittal, i-medial / lateral endizeni yendiza, ukushintshana ukuthutha, kanye nezinhlanganisela zalezi zinhlobo ezinhlanu zokulimala.
Ucwaningo oluningi lwangaphambilini lukhombisile ukuthi ukunciphisa / ukwandisa kungahlolwa ngokuhlola uphawu lweDime, umugqa we-stenton, kanye ne-angle ye-tibial-gibing, phakathi kwabanye. Ukuthutha ezindizeni zama-coronal kanye nama-sagittal kungahlolwa kahle kusetshenziswa ukubukwa kwangaphakathi nokuhamba kwesikhathi; Kodwa-ke, ukuthutha okujikelezayo kuyinselelo enkulu kakhulu ukuhlola i-Interaoperaively.
Ubunzima ekuhlolweni ukuthunyelwa kokujikeleza bubonakala ngokuncishiswa kwe-FIBULA lapho ufaka isikulufa esidakayo se-tibiofibur. Iningi lezincwadi libonisa ukuthi ngemuva kokufakwa kwesikulufa se-distal tibiofibular screw, kukhona okungu-25% -50% kokuncishiswa okumpofu, okuholela ekunciphiseni nasekulungiseni izinqumo ze-mibular. Ezinye izazi zihlongoze ukusebenzisa ukuhlolwa kwe-CT ezisebenzayo, kepha lokhu kungaba yinselele ukusebenzisana. Ukubhekana nalolu daba, ngonyaka we-2019, uSolwazi Zhang Shimin's Team avela esibhedlela saseTongPu ashicilelwe i-Tongji University ekhishwe i-athikili kwi-International Orthopedic Journal * ukulimala *, ahlongoza inqubo yokushintshanisa i-latelial. Izincwadi zibika ngokusebenza kahle kwemitholampilo yale ndlela.
Isisekelo se-theory ngale ndlela ukuthi ukubukwa kwe-fluoroscopic kwe-ankle, i-cortex yodonga lwasemuva lwe-malleolar fossa ikhombisa i-metal Malleolus, futhi iphakathi nendawo yaphezulu yomugqa oxhumanisa ama-cortices aphakathi nendawo.
Umzekeliso we-Ankle Fluoroscopic View ekhombisa ubudlelwano obuyisisekelo phakathi kwe-ateral wall cortex ye-malleolar fossa (B-line) kanye nama-cortices aphakathi nendawo we-malleolus (a kanye ne-C). Imvamisa, i-B-line itholakala emgqeni wangaphandle wesithathu phakathi kwemigqa A no c.
Isikhundla esijwayelekile se-malleolus lateral, ukujikeleza kwangaphandle, nokujikeleza kwangaphakathi kungakhiqiza ukubonakala okuhlukile kokucabanga ekubukeni kwe-fluoroscopic:
- I-Latelal Malleolus ijikelezwe esimweni esijwayelekile **: I-evamile ye-malleolus controud ene-cortical shard odongeni lwasemuva lwe-malleolar fossa, ibekwe ohlwini lwangaphandle lwesithathu lwama-cortices aphakathi nendawo e-malleolus asolwandle.
Ukuguquguquka kokujikeleza kwangaphandle kwe-malleolus kwangaphandle **
-Laterary Malle Norve Rock Delour Dealformation **
Iqembu lifake iziguli ezingama-56 nge-C-Type Lateral Malleolar Fractures ehlanganiswe ne-distal tibiofibular syndesmosis ukulimala okukuhle futhi wasebenzisa indlela yokuhlola ngenhla. Ukuhlolwa kabusha kwe-CT RT kukhombisa ukuthi iziguli ezingama-44 zithola ukuncishiswa kwe-anatomic ngaphandle kwezifo ezishintshashintshayo, kanti iziguli eziyi-12 zibhekana nokukhubazeka okuncane okushintshashintshayo (ngaphansi kwamacala ayi-7 wokujikeleza kwangaphakathi namacala angu-5 okujikeleza kwangaphandle. Awekho amacala alinganiselwe (5-10 °) noma aqine (ngaphezulu kuka-10 °) ukwehla kwangaphandle kwenzeke.
Ucwaningo lwangaphambilini luveze ukuthi ukuncishiswa kwe-lateral malleolar fracture kungasuselwa kumapharamitha amathathu amakhulu we-Weber: ukulingana okuhambisanayo phakathi kwezindawo ezihlanganayo zeTalar, ukuqhubeka komugqa we-shempon, kanye nesibonakaliso sedimeli.
Ukwehliswa okungekuhle kwe-lateral Malleolus kuyinkinga evame kakhulu emtholampilo. Ngenkathi ukunakwa okufanele kunikezwa ngokubuyiselwa kobude, ukubaluleka okulinganayo kufanele kubekwe ekulungisweni kokujikeleza. Njengokuhlanganiswa kwesisindo, noma yikuphi ukucwaswa kwe-ankle kungaba nemiphumela eyinhlekelele emsebenzini wayo. Kukholakala ukuthi inqubo ye-Fluoroscopic ye-Intrapeaperate ehlongozwe nguSolwazi Zhang Shimin ingasiza ekufezeni ukuncishiswa okuqondile kwe-C-Type Merleal Fracties. Le ndlela isebenza njengereferensi ebalulekile yodokotela be-frontline.
Isikhathi sePosi: Meyi-06-2024
