Ukuphuka komgodi we-tibial kuwukulimala okuvamile kwezokwelapha. Ukufakwa kwangaphakathi kwezipikili ngaphakathi kwe-intramedullary kunezinzuzo ze-biomechanical zokufakwa okuncane okungena emzimbeni kanye nokufakwa kwe-axial, okwenza kube yisisombululo esijwayelekile sokwelashwa ngokuhlinzwa. Kunezindlela ezimbili eziyinhloko zokubethela izipikili zokufakwa kwezipikili ngaphakathi kwe-tibial: ukubethela kwe-suprapatellar kanye ne-infrapatellar, kanye nendlela ye-parapatellar esetshenziswa ezinye izazi.
Uma kwenzeka ukwaphuka kwengxenye yesithathu ye-tibia, njengoba indlela ye-infrapatellar idinga ukugoba idolo, kulula ukubangela ukuthi ukwaphuka kugobe phambili ngesikhathi sokuhlinzwa. Ngakho-ke, indlela ye-suprapatellar ivame ukunconywa ekwelapheni.
▲Umfanekiso okhombisa indawo yesitho esithintekile ngendlela ye-suprapatellar
Kodwa-ke, uma kukhona okuphambene nendlela ye-suprapatellar, njengokusikwa kwezicubu ezithambile zasendaweni, indlela ye-infrapatellar kumele isetshenziswe. Indlela yokugwema ukugoba kwengxenye yokuphuka ngesikhathi sokuhlinzwa iyinkinga okumele ibhekane nayo. Abanye ochwepheshe basebenzisa amapuleti ensimbi amancane ukuze balungise okwesikhashana i-cortex yangaphambili, noma basebenzise izipikili ezivimbayo ukuze balungise ukugoba.
▲ Isithombe sibonisa ukusetshenziswa kwezipikili ezivimbayo ukulungisa i-engeli.
Ukuze kuxazululwe le nkinga, izazi zakwamanye amazwe zasebenzisa indlela engadingi ukungenelela okuningi. Lesi sihloko sisanda kushicilelwa kumagazini i-"Ann R Coll Surg Engl":
Khetha izikulufo ezimbili zesikhumba ezingu-3.5mm, eduze nesihloko sengxenye ephukile, faka isikulufo esisodwa phambili nangemuva ezingcezwini zamathambo kuzo zombili izinhlangothi zokuphuka, bese ushiya okungaphezu kuka-2cm ngaphandle kwesikhumba:
Bopha ama-reduction forceps ukuze ugcine ukuncipha, bese ufaka uzipho lwe-intramedullary ngokwezinqubo ezivamile. Ngemva kokufakwa kozipho lwe-intramedullary, susa isikulufu.
Le ndlela yobuchwepheshe ifaneleka ezimweni ezikhethekile lapho izindlela ze-suprapatellar noma ze-parapatellar zingasetshenziswa khona, futhi akukhuthazwa njalo. Ukubekwa kwalesi sikulufu kungathinta ukubekwa kwesipikili esiyinhloko, noma kungaba nengozi yokuphuka kwesikulufu. Ingasetshenziswa njengereferensi ezimweni ezikhethekile.
Isikhathi sokuthunyelwe: Meyi-21-2024
