Ukuphuka kwe-Tibial plateau fractures ukulimala komtholampilo okuvamile, ngokuhlukana kohlobo lwe-Schatzker II, olubonakala ngokuhlukaniswa kwe-cortical lateral kuhlanganiswe nokucindezeleka kwe-lateral articular surface, okuvame kakhulu. Ukuze ubuyisele i-articular surface ecindezelekile futhi uvuselele ukuqondanisa okujwayelekile kwamadolo, ukwelashwa kokuhlinzwa kuvame ukunconywa.
Indlela ye-anterolateral yokuhlangana kwamadolo ihilela ukuphakamisa ngokuqondile i-lateral articular surface eduze kwe-cortex ehlukanisiwe ukuze kubekwe kabusha indawo ye-articular ecindezelekile futhi enze i-bone grafting ngaphansi kombono oqondile, indlela evame ukusetshenziswa emisebenzini yomtholampilo eyaziwa ngokuthi "indlela yokuvula incwadi". Ukudala iwindi ku-lateral cortex nokusebenzisa ilifti ngefasitela ukuze ubeke kabusha i-articular surface ecindezelekile, eyaziwa ngele-"windowing" technique, ngokombono kuyindlela ehlasela kancane.
Asikho isiphetho esiqondile sokuthi iyiphi kulezi zindlela ezimbili engcono kakhulu. Ukuqhathanisa ukusebenza kahle komtholampilo kwalezi zindlela ezimbili, odokotela base-Ningbo Sixth Hospital benza ucwaningo lokuqhathanisa.
Ucwaningo lubandakanya iziguli eziyi-158, kanti amacala angama-78 asebenzisa indlela yokufaka amawindi kanye namacala angama-80 asebenzisa indlela yokuvula incwadi. Idatha eyisisekelo yamaqembu amabili ayizange ibonise umehluko obalulekile ngokwezibalo:
▲ Isibalo sibonisa izimo zezindlela ezimbili zokunciphisa indawo ene-articular: AD: indlela yokufaka amawindi, i-EF: indlela yokuvula incwadi.
Imiphumela yocwaningo ibonisa:
- Kwakungekho umehluko obalulekile ngokwezibalo ngesikhathi kusukela ekulimaleni kuya ekuhlinzweni noma ubude besikhathi sokuhlinzwa phakathi kwalezi zindlela ezimbili.
- I-postoperative CT scans ibonise ukuthi iqembu lamafasitela lalinamacala angu-5 okucindezelwa kwe-postoperative articular surface, kanti iqembu lokuvula incwadi linamacala angu-12, umehluko ophawulekayo wezibalo. Lokhu kuphakamisa ukuthi inqubo yokufaka amafasitela ihlinzeka ngokuncishiswa okungcono kwe-articular surface kunendlela yokuvula incwadi. Ukwengeza, izehlakalo ze-arthritis ebuhlungu kakhulu ngemva kokuhlinzwa zaziphakeme eqenjini lokuvula incwadi uma kuqhathaniswa neqembu le-fasitela.
- Awukho umehluko obalulekile wezibalo kuzikolo zokusebenza kwamadolo ngemva kokuhlinzwa noma amaphuzu we-VAS (Visual Analog Scale) phakathi kwamaqembu amabili.
Ngokwethiyori, indlela yokuvula incwadi ivumela ukubonwa okuqondile okuqondile kwendawo ye-articular, kodwa ingase iholele ekuvulekeni ngokweqile kwendawo ye-articular, okuholela ekungeneleleni kwamaphoyinti okubhekisela ekuncishisweni kanye nokukhubazeka ekuncishisweni kwe-articular kwalandelayo.
Emsebenzini womtholampilo, iyiphi indlela ongayikhetha?
Isikhathi sokuthumela: Jul-30-2024
