Ubuchwepheshe obuhle

I-Abstract: Inhloso: Ukuphenya ngezinto ezihlangene zokusebenza kokusebenza kokusebenza kwensimbi yangaphakathi ukubuyiselaI-Tibial Plateau Fracture. Indlela: Iziguli ezingama-34 ezine-Tibial Plateau Fracture zazisetshenziswa ngokusebenzisa ipuleti yensimbi yangaphakathi uhlangothi olulodwa noma ezimbili, zibuyiselwe i-Thei tibal plateau anatomical isakhiwo, ukulungiswa ngokuqinile, futhi kuthatha umsebenzi wokuqala wokuzivocavoca umzimba ngemuva. Umphumela: Zonke iziguli zalandelwa izinyanga ezingama-4-36, ezinyangeni eziyi-15, ngokusho kwesikolo seRasmussen, iziguli ezingama-21 zazinhle kakhulu, ezi-8 ziye zavuma, 2. Isilinganiso esihle kakhulu sasingama-85.3%. Isiphetho: Bamba amathuba okusebenza afanele, sebenzisa izindlela ezilungile futhi uthathe izivivinyo zomsebenzi wangaphambilini, uzinike imiphumela emihle yokusebenza ekwelaphenithintwayoUkuphuka kwethafa.

1.1 Imininingwane Ejwayelekile: Leli qembu lalineziguli ezingama-34 ezinabantu abangama-26 kanye nabesifazane abangu-8. Iziguli zazineminyaka engama-27 kuya ku-72 ezineminyaka engu-39.6. Kwakunamacala angama-20 ezingozi zengozi, amacala ayi-11 okulimala okuwa kanye namacala ama-3 okuchotshozwa kakhulu. Onke amacala avalwa ukuqhekeka ngaphandle kokulimala kwemithambo. Kunamacala ama-3 we-ligament amnyama alimala, amacala ama-4 wokulimala kwama-collateral ligament kanye namacala ama-4 okulimala kwe-meniscus. Ama-fractures ahlukaniswe ngokuya nge-Schatzker: amacala ayi-8 e-II, amacala ayi-12 ohlobo lwe-II, amacala ama-2 wohlobo lwe-III, amacala ama-4 wohlobo lwe-V, amacala ama-3 we-VIT. Zonke iziguli zihlolwe yi-X-ray, i-CT Scan yeTibial Plateau kanye nokwakhiwa kabusha kwezintathu, kanti ezinye iziguli zahlolwa uMnu. Ngaphandle kwalokho, isikhathi sokusebenza sasingu-7 ~ 21d ngemuva kokulimala, isilinganiso se-10D. Kulokhu, kwakukhona iziguli ezingama-30 ezamukela ukwelashwa kwamathambo, iziguli ezi-3 zamukela ukulungiswa kwepuleti kabili, kanye neziguli zokuphumula ezamukela ukulungiswa kwangaphakathi kwe-Unilaterateratel.

1.2 Indlela yokuhlinza: KwenziweumfaziI-anesthesia noma i-incubation anesthesia, isiguli sasisesimweni sokuphakama, futhi sasebenza ngaphansi kwe-pneumatic tourniquet. Ukuhlinzwa kwasebenzisa i-anteterolateral knee, i-anterior tibial noma i-latealukuhlanganiswa kwedoloukuvela kwangemuva. I-coronary ligament yavunyelwa eduze kwale ncimo ephethe umngcele ongezansi we-meniscus, futhi yaveza indawo ye-tibial plateau. Yehlisa ama-Platheura Fractures ngaphansi kombono oqondile. Amanye amathambo aqala ukulungiswa ngezikhonkwane ze-kirschner, bese elungiswa ngamapuleti afanele (ipulazi le-golf, amapuleti, i-t Amaphutha amathambo agcwala ithambo le-allogenic (ekuqaleni) kanye ne-allograft bone grafting. Ekusebenzeni, udokotela ohlinzayo wabona ukuncishiswa kwe-anatomical kanye nokuncishiswa kwe-anatomical anatomical, kugcinwe i-axis ejwayelekile yeTibial, ukulungiswa okuqinile kwangaphakathi, ukuhlanganiswa kwethambo elihlanganisiwe nokusekelwa kwethambo elihlanganisiwe kanye nokusekelwa okuhlanganisiwe. Uhlolisise i-knee ligament ne-meniscus yokuxilongwa okubangela ukuxilonga noma amacala asolwa nge-intra, futhi enza inqubo efanele yokulungiswa.

1.3 Ukwelashwa nge-postoperative: Ibhandeji ye-postoperative elastic e-elastic kufanele ifakwe ngesandla, futhi i-seft incision ifakwe nge-drainage tube, okufanele ikhishwe ngo-48h. Inqubo evamile ye-analgesia. Iziguli zithathe izicubu zomzimba ezivivinya umzimba ngemuva kwe-24h, futhi zathatha ukuzivocavoca kwe-CPM ngemuva kokususa ishubhu le-dractage lokuqhekeka okulula. Kuhlanganiswe iLigament Collateral Ligament, amacala angemva kokulimala kwe-ligament, ngentshiseko futhi ahanjiswe ngamadolo ngemuva kokulungisa udaka noma umfakeli ngenyanga eyodwa. Ngokusho kwemiphumela yokuhlolwa kwe-X-ray, iSurgeon iqondiswa iziguli ukuthi kancane kancane zithathe izivivinyo zokulayisha isisindo, futhi ukulayisha okugcwele kwesisindo kufanele kwenziwe okungenani ezinyangeni ezine kamuva.