Ukukhetha iphuzu lokungena le-intrametundary of tibial fractures

Ukukhethwa kwephuzu lokungena le-intrametundary of tibial fractures kungenye yezinyathelo ezibalulekile empumelelweni yokwelashwa kokuhlinzwa. Iphuzu lokungena elimpofu le-intramenduvary, kungaba sesikhathini se-suprapatellar noma inforapatellar, kungahle kuholele ekulahlekelweni kokuphindwaphindwayo, ukulimala kwe-angular kokuphela kokuphela, nokulimala kwezakhiwo ezibalulekile zedolo eliseduzane.

Izici ezi-3 zeTibials Intramengrary Feat Point zizochazwa.

Yiliphi iphuzu elijwayelekile lokufaka iTibial Nail?

Yimiphi imiphumela yesipikili esiphambukayo se-tibial intramentary nail?

Iphuzu elifanele lokungena linqume kanjani i-Intraoperaipeivelity?

I. Yiliphi iphuzu elijwayelekile lokungenaTibhidiI-intramenduldary?

Isikhundla se-Orthotopic sitholakala lapho kuhlangana khona i-axis yemishini yeTibia neTaterial Plateau, umphetho we-metal we-intercondlar we-tibia, futhi isikhundla samuva sisemanzini phakathi kwethafa leTibial kanye neTibial Stem Migration Zone.

Uhla lwendawo yokuphepha endaweni yokungena

22.9 ± 8.9mm, lapho inaliti ingafakwa khona ngaphandle kokulimaza ukumiswa kwe-bony ye-acl kanye nezicubu zamanzi.

II. Yini imiphumela yokuphambukaTibhidiII-NTREDUREDURDARY NAIL?

Ngokuya nge-proximal, maphakathi ne-distal tibial fractures, i-proximal tibial fracture inomphumela oshiwo kakhulu, i-Middle Tibial Fracture inomphumela omncane, futhi isiphetho se-dist

# Proximal tibial fractures

# Ama-Middle Tibial Fractures

Iphuzu lokungena linomphumela omncane ekuthungeni, kepha kungcono ukufaka isipikili endaweni evamile yokungena.

# Distal tibial fractures

Iphoyinti lokungena liyadingeka ukuthi lifane nokuqhekeka kweProximal, kanye nesikhundla se-distal intramentary nail kudingeka ukuba sibe khona ngomsele ngemithambo ye-distal fornix.

Ⅲ. HOw ukuthola ukuthi iphuzu lokungena ngenaliti lilungile nge-Intraoperaitively?

Sidinga i-fluoroscopy ukuthola ukuthi iphuzu lokungena ngenaliti lilungile. Kubaluleke kakhulu ukuthatha i-orthopantocogram ejwayelekile ye-Knee Inaperaiperatively, ngakho-ke kufanele ithathwe kanjani?

Umugqa ojwayelekile we-orthopantocogram-parallel wekhanda le-fibular

I-axis yemishini ye-Ortho-X-ray yenziwa umugqa oqondile, futhi umugqa ofanayo we-axis mehendi wenziwa emaphethelweni we-lateral we-tibial plateau, okufanele akwazi ukubheka ikhanda le-fibular ku-ortho-x-ray. Uma eyodwa i-X-ray itholakala, kufakazela ukuthi ithathwe kahle.

Uma i-ortho-slice ingeyona ejwayelekile, ngokwesibonelo, uma ngabe i-nail isondliwa iphuzu lokuphakelayo langaphandle, lapho kukhombisa indawo yokuthengisa yangaphandle, futhi isikhundla sokuphakelayo singaphandle, futhi kuzokubonisa indawo yokudla ingaphakathi, yona ethinta ukwahlulelwa.

Esikhathini esijwayelekile se-X-ray, ama-commes asemoyeni aphakathi nendawo futhi alandelanayo agqekeza futhi ithafa le-tibial nelimuva lakamuva kakhulu futhi lamuva kakhulu, futhi ngombono olandelayo, iphuzu lokungena litholakala emanzini aphakathi kwethafa nesiqu seTibial.

IV. Ukufingqwa kokuqukethwe

Iphuzu elijwayelekile lokungena kwe-tibial intramentary nail litholakala ngo-orthovolly emaphethelweni emphethweni we-wateral i-intercondlar umgogodla we-tibia futhi kamuva ezindaweni ezinamanzi aphakathi kweTibial Plateau kanye neTibial Stem Migration Zone.

Indawo yokuphepha endaweni yokungena incane kakhulu, yi-22,9 ± 8.9 mm, futhi inaliti ingafakwa kule ndawo ngaphandle kokulimaza ukumiswa kwe-acl nezicubu ze-acl kanye ne-meniscal.

I-Intraoperative standard standard kanye radiliared radiographs yedolo kufanele ithathwe, yiluphi ukhiye ukuthola ukuthi iphuzu lokungena ngenaliti lilungile noma cha.