Ukukhethwa kwendawo yokungena ye-Intramedullary of Tibial Fractures

Ukukhethwa kwendawo yokungena ye-Intramedullary of Tibial Fractures kungenye yezinyathelo ezibalulekile empumelelweni yokwelashwa ngokuhlinzwa. Indawo yokungena embi ye-Intramedullary, kungakhathaliseki ukuthi isetshenziswa ngendlela ye-suprapatellar noma ye-infrapatellar, ingabangela ukulahlekelwa indawo yokubeka kabusha, ukukhubazeka kwengxenye yokuphela kokuqhekeka, kanye nokulimala kwezakhiwo ezibalulekile zedolo ezizungeze indawo yokungena.

Izici ezintathu zephuzu lokufaka izinzipho ngaphakathi kwe-tibial zizochazwa.

Iyini indawo ejwayelekile yokufaka izinzipho ngaphakathi kwe-tibial intramedullary?

Iyini imiphumela yozipho lwe-intramedullary oluphambukile lwe-tibial?

Iphuzu elifanele lokungena linqunywa kanjani ngesikhathi sokuhlinzwa?

I. Iyini iphuzu elijwayelekile lokungenaTi-ibialI-Intramedullary?

Indawo ye-orthotopic itholakala ekuxhumaneni kwe-axis ye-mechanical ye-tibia kanye ne-tibial plateau, umkhawulo ophakathi womgogodla we-lateral intercondylar we-tibia, kanti indawo eseceleni itholakala endaweni egeleza amanzi phakathi kwe-tibial plateau kanye nendawo yokufuduka kwe-tibial stem.

Ububanzi bendawo yokuphepha endaweni yokungena

22.9±8.9mm, lapho inaliti ingafakwa khona ngaphandle kokulimaza ukuma kwethambo le-ACL kanye nezicubu ze-meniscus.

II. Iyini imiphumela yomuntu ophambukile?Ti-ibialIi-ntramedullary Nail?

Kuye ngokuthi i-proximal, i-middle, kanye ne-Distal Tibial Fractures ziphuka kanjani, i-proximal tibial fracture inomphumela ocacile kakhulu, i-middle tibial fracture inomphumela omncane kakhulu, kanti i-distal end ihlobene kakhulu nendawo kanye nokubekwa kabusha kwe-Distal intramedullary nail.

# Ukuphuka Kwe-Proximal Tibial

# Ukuphuka Kwe-Middle Tibial

Indawo yokungena ayinawo umthelela omkhulu ekushintsheni, kodwa kungcono ukufaka uzipho kusukela endaweni evamile yokungena.

# Ukuphuka Kwe-Tibial Ekude

Indawo yokungena iyadingeka ukuthi ifane nokuqhekeka kwe-proximal, futhi indawo ye-distal intramedullary nail iyadingeka ukuthi ibekwe eceleni kwe-ortholateral endaweni ephakathi ne-distal fornix.

Ⅲ. HIngabe kufanele nginqume ukuthi indawo yokungena ngenaliti ilungile yini ngesikhathi sokuhlinzwa?

Sidinga i-fluoroscopy ukuze sithole ukuthi indawo yokungena kwenaliti ilungile yini. Kubaluleke kakhulu ukuthatha i-orthopantomogram ejwayelekile yedolo ngaphambi kokuhlinzwa, ngakho-ke kufanele ithathwe kanjani?

Umugqa ojwayelekile we-orthopantomogram-parallel wekhanda le-fibular

I-axis yomshini we-ortho-x-ray yenziwa umugqa oqondile, kanti umugqa ohambisanayo we-axis yomshini wenziwa emaphethelweni aseceleni kwe-tibial plateau, okufanele ihlukanise ikhanda le-fibular ku-ortho-x-ray. Uma kutholakala i-x-ray eyodwa enjalo, kusobala ukuthi ithathwe kahle.

Uma i-ortho-slice ingeyona ejwayelekile, isibonelo, uma uzipho luphakelwa endaweni yokudla ejwayelekile, lapho kuthathwa indawo yokujikeleza yangaphandle, kuzobonisa ukuthi indawo yokudla ingaphandle, kanti indawo yokujikeleza yangaphakathi izobonisa ukuthi indawo yokudla ingaphakathi, okuzothinta isahlulelo sokuhlinzwa.

Ku-x-ray ejwayelekile eseceleni, ama-condyle e-medial kanye ne-lateral femoral ahlangana kakhulu kanti i-medial kanye ne-lateral tibial plateau zihlangana kakhulu, kanti ekubukeni okuseceleni, indawo yokungena itholakala endaweni ephakathi kwe-plateau kanye nesiqu se-tibial.

IV. Isifinyezo Sokuqukethwe

Indawo ejwayelekile yokungena kwezipikili ze-tibial intramedullary itholakala ngendlela eqondile emaphethelweni aphakathi komgogodla we-lateral intercondylar we-tibia kanye naseceleni endaweni egeleza amanzi phakathi kwe-tibial plateau kanye nendawo yokufuduka kwesiqu se-tibial.

Indawo yokuphepha endaweni yokungena incane kakhulu, ingu-22.9±8.9 mm kuphela, futhi inaliti ingafakwa kule ndawo ngaphandle kokulimaza ukuma kwamathambo kwe-ACL kanye nezicubu ze-meniscal.

Kufanele kuthathwe ama-orthopantomograph ajwayelekile ngesikhathi sokuhlinzwa kanye nama-radiograph aseceleni edolo, okuyiwona obalulekile ekunqumeni ukuthi indawo yokungena ngenaliti ilungile noma cha.