Ukukhethwa kwendawo yokungena ye-Intramedullary of Tibial Fractures

Ukukhethwa kwendawo yokungena ye-Intramedullary of Tibial Fractures kungenye yezinyathelo ezibalulekile empumelelweni yokwelashwa kokuhlinzwa.Indawo yokungena empofu ye-Intramedullary, kungakhathaliseki ukuthi iyindlela ye-suprapatellar noma ye-infrapatellar, ingase ibangele ukulahlekelwa ukuhlelwa kabusha, ukukhubazeka kwe-angular kokuphela kwe-fracture, nokulimala kwezakhiwo ezibalulekile zamadolo eduze kwendawo yokungena.

Izici ezi-3 zephoyinti lokufaka izinzipho ze-tibial intramedullary zizochazwa.

Liyini iphuzu elijwayelekile lokufaka izinzipho ze-tibial intramedullary?

Iyini imiphumela ye-tibial intramedullary nail ephambukile?

Ngabe iphoyinti elilungile lokungena linqunywa kanjani ngokusebenza?

I. Lithini iphuzu elijwayelekile lokungenaTibialI-Intramedullary?

Isikhundla se-orthotopic sise-intersection ye-axis yemishini ye-tibia kanye ne-tibial plateau, umkhawulo ophakathi we-lateral intercondylar spine ye-tibia, futhi isikhundla se-lateral sitholakala emanzini phakathi kwe-tibial plateau kanye ne-tibial stem migration. indawo.

Ibanga lendawo yokuphepha endaweni yokungena

22.9±8.9mm, lapho inaliti ingafakwa khona ngaphandle kokulimaza isitobhi samathambo se-ACL kanye nezicubu ze-meniscus.

II.Iyini imiphumela yomuntu ophambukileTibialIi-tramedullary Nimpilo?

Kuye ngokuthi i-proximal, i-middle, kanye ne-Distal Tibial Fractures, i-proximal tibial fracture inomphumela ovezwe kakhulu, ukuhlukana kwe-tibial okuphakathi kunomphumela omncane kakhulu, futhi ukuphela kwe-distal ngokuyinhloko kuhlobene nesimo nokubekwa kabusha kwe-Distal intramedullary nail.

# I-Proximal Tibial Fractures

# Ukuqhekeka kweTibial Ephakathi

Iphuzu lokungena linomthelela omncane ekuthuthweni, kodwa kungcono ukufaka isipikili kusuka endaweni evamile yokungena.

# Ama-Distal Tibial Fractures

Iphoyinti lokungena liyadingeka ukuze lifane nokuphuka okuseduze, futhi indawo ye-distal intramedullary nail iyadingeka ukuze ibekwe i-ortholaterally maphakathi ne-distal fornix.

Ⅲ.Hkanjani ukunquma ukuthi indawo yokungena yenaliti ilungile ngokuhlinza?

Sidinga i-fluoroscopy ukuze sinqume ukuthi indawo yokungena yenaliti ilungile.Kubaluleke kakhulu ukuthatha i-orthopantomogram evamile yamadolo ngokuhlanganyela, ngakho-ke kufanele kuthathwe kanjani?

Umugqa ojwayelekile we-orthopantomogram-parallel wekhanda le-fibular

I-axis yemishini ye-ortho-x-ray yenziwa umugqa oqondile, futhi umugqa ohambisanayo we-axis mechanical wenziwa emaphethelweni asemaphethelweni ethafa le-tibial, okufanele lihlukanise kabili ikhanda le-fibula ku-ortho-x-ray.Uma i-x-ray eyodwa enjalo itholakala, ifakazela ukuthi ithathwe ngendlela efanele.

Uma i-ortho-slice ingeyona indinganiso, isibonelo, uma isipikili siphakelwa kusuka endaweni yokuphakela ejwayelekile, lapho kuthathwa indawo yokuzungezisa yangaphandle, izobonisa ukuthi indawo yokuphakelayo ingaphandle, futhi indawo yokuzungezisa yangaphakathi izobonisa ukuthi Iphoyinti lokuphakelayo lingaphakathi, elizothinta ukwahlulela kokuhlinzwa.

Ku-x-ray ye-lateral ejwayelekile, i-condyles ye-femoral ephakathi nendawo kanye ne-lateral ngokuvamile idlulana futhi i-medial ne-lateral plateau ye-tibial ngokuvamile idlulana, futhi ekubukeni kwe-lateral, indawo yokungena itholakala endaweni yamanzi phakathi kwe-plateau ne-tibial stem.

IV.Isifinyezo sokuqukethwe

Iphuzu lokungena elijwayelekile le-tibial intramedullary entry itholakala nge-orthogonally emaphethelweni aphakathi kwe-lateral intercondylar spine ye-tibia futhi eceleni endaweni yamanzi phakathi kwe-tibial plateau kanye ne-tibial stem migration zone.

Indawo yokuphepha endaweni yokungena incane kakhulu, i-22.9±8.9 mm kuphela, futhi inaliti ingafakwa kule ndawo ngaphandle kokulimaza i-bone stop ye-ACL kanye nezicubu ze-meniscal.

I-intraoperative standard orthopantomographs kanye nama-radiographs asemaceleni emadolweni kufanele athathwe, okuyisihluthulelo sokunquma ukuthi indawo yokungena yenaliti ilungile noma cha.