Ukuphuka kweqakala elingaphakathi ngokuvamile kudinga ukuncishiswa kwe-incision kanye nokulungiswa kwangaphakathi, noma ngokulungiswa kwesikulufa sodwa noma ngenhlanganisela yamapuleti nezikulufu.
Ngokwesiko, ukuphuka kulungiswa okwesikhashana ngephinikhodi ye-Kirschner bese kulungiswa ngesikulufu se-cancelous tension screw esinemicu enguhhafu, esingahlanganiswa nebhendi ye-tension.Ezinye izazi zisebenzise izikulufu ezinentambo egcwele ukuze zelaphe ukuphuka kweqakala eliphakathi nendawo, futhi ukusebenza kwazo kungcono kunokwezikulufu zendabuko zokukhanselwa zemicu ewuhhafu.Kodwa-ke, ubude bezikrini ezinezintambo ezigcwele buyi-45 mm, futhi zigxilwe ku-metaphysis, futhi iningi leziguli lizoba nobuhlungu e-ankle ephakathi ngenxa yokukhishwa kwe-fixation yangaphakathi.
UDkt Barnes, ovela eMnyangweni Wezokulimala Kwamathambo esibhedlela i-St Louis University Hospital e-USA, ukholelwa ukuthi izikulufi zokucindezelwa ezingenakhanda zingalungisa kokubili ukuphuka kweqakala ngaphakathi ethanjeni, kunciphise ukungaphatheki kahle ngenxa yokuphuma kwangaphakathi, futhi kukhuthaze ukuphulukiswa kokuphuka.Ngenxa yalokho, uDkt Barnes wenze ucwaningo ngokusebenza kwezikulufu zokucindezelwa ezingenakhanda ekwelapheni ukuphuka kwangaphakathi kweqakala, okusanda kushicilelwa ku-Injury.
Ucwaningo lwaluhlanganisa iziguli ze-44 (iminyaka yobudala engama-45, i-18-80 iminyaka) ezalashelwa ukuphuka kwe-ankle yangaphakathi ngezikulufa zokucindezela ezingenakhanda esibhedlela sase-Saint Louis University phakathi kuka-2005 no-2011. ubufakazi bokucabanga bokuphulukiswa kwe-fracture ngaphambi kokuthola isisindo esigcwele.
Ukuphuka okuningi kwakungenxa yokuwa endaweni yokuma kanti okunye kwakungenxa yezingozi zezithuthuthu noma ezemidlalo njll (Ithebula 1).Abangamashumi amabili nantathu kubo babenokwephuka kweqakala okuphindwe kabili, abangu-14 babenemifantu emithathu eqakaleni kanti abangu-7 abasele babenemifantulo yeqakala elilodwa (Umfanekiso 1a).Ngokungena ngaphakathi, iziguli ze-10 zelashwa ngesikulufa sokucindezela esingenakhanda esisodwa sokuphuka kwe-ankle ephakathi, kuyilapho iziguli ze-34 ezisele zinezikulufu ezimbili zokucindezela ezingenakhanda (Figure 1b).
Ithebula 1: Indlela yokulimala
Umfanekiso 1a: Ukuphuka kweqakala elilodwa;Umfanekiso 1b: Ukuphuka kweqakala elilodwa kuphathwe ngezikulufu zokuminyanisa ezi-2 ezingenakhanda.
Ekulandeleni okulinganiselwe kwamaviki e-35 (amaviki angu-12-208), ubufakazi bezithombe zokuphulukisa ukuphuka kwatholakala kuzo zonke iziguli.Asikho isiguli esasidinga ukukhishwa isikulufu ngenxa yokuvela kwesikulufu, futhi isiguli esisodwa kuphela esasidinga ukukhishwa kwesikulufu ngenxa yokutheleleka kwe-MRSA yangaphambi kokuhlinzwa endaweni ephansi kanye ne-postoperative cellulitis.Ngaphezu kwalokho, iziguli eziyi-10 zazinokungakhululeki okuncane ekushayeni iqakala elingaphakathi.
Ngakho-ke, abalobi baphetha ngokuthi ukwelashwa kwe-ankle fractures yangaphakathi nge-screws yokucindezela engenamakhanda kubangele izinga eliphezulu lokuphulukiswa kwe-fracture, ukubuyiswa okungcono komsebenzi we-ankle, kanye nobuhlungu obuncane be-postoperative.
Isikhathi sokuthumela: Apr-15-2024
