Indlela yokuhlinzwa

Isifinyezo: Inhloso: Ukuphenya izici ezihlobene zomphumela wokusebenza kokusebenzisa ipuleti lensimbi ukulungisa ingaphakathiukuphuka kwethafa le-tibialIndlela: Iziguli ezingu-34 ezazine-tibial plate fracture fracture zahlinzwa ngokusebenzisa i-steel plate internal fixation ohlangothini olulodwa noma ezimbili, zalungisa isakhiwo se-anatomical se-tibal plate, zaqiniswa, futhi zaqala ukuzivocavoca ngemva kokuhlinzwa. Umphumela: Zonke iziguli zalandelwa izinyanga ezingu-4-36, isilinganiso sezinyanga ezingu-15, ngokusho kwesilinganiso sikaRasmussen, iziguli ezingu-21 zazisesimweni esihle kakhulu, ezingu-8 zisesimweni esihle, ezingu-3 zisesimweni esihle kakhulu, ezingu-2 zisesimweni esibi kakhulu. Isilinganiso esihle kakhulu sasingu-85.3%. Isiphetho: Bamba amathuba okuhlinzwa afanele, sebenzisa izindlela ezifanele futhi uthathe izivivinyo zokusebenza zakuqala, usinike imiphumela emihle kakhulu yokusebenza ekwelapheni.i-tibialukuphuka kwethafa.

1.1 Ulwazi Olujwayelekile: leli qembu lalineziguli ezingu-34, abesilisa abangu-26 kanye nabesifazane abangu-8. Iziguli zazineminyaka ephakathi kuka-27 kuya ku-72, ubudala obuphakathi kuka-39.6. Kwakukhona amacala angu-20 okulimala ezingozini zomgwaqo, amacala angu-11 okulimala kokuwa kanye namacala amathathu okuchotshozwa okunzima. Zonke izimo zaziyizifo ezivalekile ngaphandle kokulimala kwemithambo yegazi. Kwakukhona amacala amathathu okulimala kwemisipha ye-cruciate, amacala angu-4 okulimala kwemisipha ye-collateral kanye namacala angu-4 okulimala kwe-meniscus. Ukwaphuka kwahlukaniswa ngokuhambisana ne-Schatzker: amacala angu-8 ohlobo lwe-I, amacala angu-12 ohlobo lwe-II, amacala angu-5 ohlobo lwe-III, amacala amabili ohlobo lwe-IV, amacala angu-4 ohlobo lwe-V kanye namacala amathathu ohlobo lwe-VI. Zonke iziguli zahlolwa nge-X-ray, i-CT scan ye-tibial plateau kanye nokwakhiwa kabusha okunezinhlangothi ezintathu, kanti ezinye iziguli zahlolwa yi-MR. Ngaphandle kwalokho, isikhathi sokuhlinzwa sasiyizinsuku ezingu-7~21 ngemva kokulimala, isilinganiso sezinsuku ezingu-10. Kulokhu, kwakuneziguli ezingu-30 ezamukela ukwelashwa kokufakelwa kwamathambo, iziguli ezintathu ezamukela ukulungiswa kwe-double plate, kanti ezinye iziguli zamukela ukulungiswa kwangaphakathi kwe-underside.

1.2 Indlela Yokuhlinzwa: yenziweumgogodlaUma isiguli sihlinzwa nge-anesthesia noma i-intubation anesthesia, isiguli sasilele phansi, futhi sihlinzwa nge-pneumatic tourniquet. Ukuhlinzwa kwasebenzisa idolo elingaphambili, i-anterior tibial noma i-lateral.idolo elihlangeneukusikwa kwangemuva. I-coronary ligament yasikwa eceleni kwe-Incision eceleni komphetho ongezansi we-meniscus, futhi yaveza ubuso obuhlangene be-tibial plateau. Yehlisa ukuphuka kwe-plateau ngaphansi kokubona okuqondile. Amanye amathambo aqale aqiniswa ngezikhonkwane ze-Kirschner, bese eqiniswa ngamapuleti afanele (ipuleti yegalofu, amapuleti e-L, ipuleti le-T, noma ahlanganiswe nepuleti le-medial buttress). Amaphutha ethambo agcwaliswe ngethambo eli-allogenic (kwasekuqaleni) kanye ne-allograft bone grafting. Ekuhlinzeni, udokotela ohlinzayo waqaphela ukunciphisa kwe-anatomical kanye nokunciphisa kwe-proximal anatomical, wagcina i-tibial axis evamile, ukuqina kwangaphakathi okuqinile, i-compact bone graft kanye nokusekelwa okunembile. Wahlola i-knee ligament kanye ne-meniscus ukuze athole ukuxilongwa kwangaphambi kokuhlinzwa noma amacala okusolwa ngaphakathi kokuhlinzwa, futhi wenza inqubo efanele yokulungisa.

1.3 Ukwelashwa Ngemva Kokuhlinzwa: ibhandeji elinwebekayo lemilenze ngemva kokuhlinzwa kufanele liboshwe kahle, bese kufakwa ipayipi lokukhipha amanzi ngemuva kwesikhathi ngepayipi lokukhipha amanzi, okufanele likhishwe ngocingo emahoreni angu-48. Ukwelapha ubuhlungu obuvamile ngemva kokuhlinzwa. Iziguli zenze izivivinyo zemisipha yemilenze ngemva kwamahora angu-24, futhi zenze izivivinyo ze-CPM ngemva kokususa ipayipi lokukhipha amanzi ukuze kutholakale ama-fracture alula. Zihlanganise i-collateral ligament, amacala okulimala kwe-posterior cruciate ligament, zashukumisa idolo ngenkuthalo nangokungakhathali ngemva kokulungisa i-plaster noma i-brace inyanga eyodwa. Ngokwemiphumela yokuhlolwa kwe-X-ray, udokotela ohlinzayo waqondisa iziguli ukuthi zithathe kancane kancane izivivinyo zokulayisha isisindo semilenze, futhi ukulayisha isisindo esigcwele kufanele kwenziwe okungenani izinyanga ezine kamuva.