Ukuphuka kwe-Tibial shaft kuwukulimala okuvamile komtholampilo. Ukulungiswa kwangaphakathi kwezinzipho ze-Intramedullary kunezinzuzo ze-biomechanical zokulungiswa okuncane kwe-axial, okwenza kube yisixazululo esijwayelekile sokwelashwa kokuhlinzwa. Kunezindlela ezimbili eziyinhloko zokubethela izipikili ze-tibial intramedullary nail: i-suprapatellar ne-infrapatellar nailing, kanye nendlela ye-parapatellar esetshenziswa ezinye izazi.
Ngokuphulwa kwe-proximal 1/3 ye-tibia, njengoba indlela ye-infrapatellar idinga ukuguqa kwamadolo, kulula ukubangela ukuphuka kwe-angle phambili ngesikhathi sokusebenza. Ngakho-ke, indlela ye-suprapatellar ngokuvamile inconywa ukwelashwa.
▲Umfanekiso obonisa ukubekwa kwesitho esithintekile ngokusebenzisa indlela ye-suprapatellar
Kodwa-ke, uma kukhona ukuphikisana kwendlela ye-suprapatellar, njengezilonda zezicubu ezithambile zendawo, indlela ye-infrapatellar kufanele isetshenziswe. Indlela yokugwema i-angulation yokuphela kwe-fracture ngesikhathi sokuhlinzwa kuyinkinga okufanele ibhekane nayo. Ezinye izazi zisebenzisa amapuleti ensimbi anezimbobo ezincane ukuze alungise i-cortex yangaphambili okwesikhashana, noma asebenzise izinzipho ezivimbile ukuze alungise i-angulation.
▲ Isithombe sibonisa ukusetshenziswa kwezipikili ezivimbayo ukulungisa i-engeli.
Ukuze kuxazululwe le nkinga, izazi zakwamanye amazwe zasebenzisa indlela yokuhlasela kancane. Lesi sihloko sisanda kushicilelwa kumagazini othi "Ann R Coll Surg Engl":
Khetha izikulufu ezimbili zesikhumba ezingu-3.5mm, eduze nechopho lesiphetho esiphukile, faka isikulufu esisodwa phambili nangemuva ezingxenyeni zamathambo kuzo zombili iziphetho zokuphuka, bese ushiya ngaphezu kuka-2cm ngaphandle kwesikhumba:
Bopha ama-forceps okunciphisa ukuze ulondoloze ukunciphisa, bese ufaka isipikili se-intramedullary ngokwezinqubo ezivamile. Ngemuva kokufakwa kwe-intramedullary nail, susa isikulufu.
Le ndlela yobuchwepheshe ifaneleka ezimweni ezikhethekile lapho izindlela ze-suprapatellar noma ze-parapatellar zingasetshenziswa, futhi azinconywa njalo. Ukubekwa kwalesi sikulufu kungase kuthinte ukubekwa kwesipikili esikhulu, noma kungase kube nengozi yokuphuka kwesikulufu. Ingasetshenziswa njengereferensi ezimweni ezikhethekile.
Isikhathi sokuthumela: May-21-2024
