Ukuphuka kweqakala kuwukulimala komtholampilo okuvamile. Ngenxa yezicubu ezithambile ezibuthaka ezizungeze iqakala, kukhona ukuphazamiseka okukhulu kokunikezwa kwegazi ngemva kokulimala, okwenza ukuphulukiswa kube inselele. Ngakho-ke, ezigulini ezinokulimala kwe-ankle evulekile noma ukuhlukunyezwa kwezicubu ezithambile ezingakwazi ukulungiswa ngokushesha kwangaphakathi, amafreyimu okulungiswa kwangaphandle ahlanganiswe nokunciphisa okuvaliwe nokulungiswa kusetshenziswa izintambo ze-Kirschner ngokuvamile zisetshenziselwa ukuqiniswa kwesikhashana. Ukwelashwa okuqondile kwenziwa esigabeni sesibili uma isimo sezicubu ezithambile sesithuthukile.
Ngemuva kokuphuka okuphindaphindiwe kwe-malleolus ehlangothini, kukhona ukuthambekela kokufinyeza nokujikeleza kwe-fibula. Uma kungalungiswanga esigabeni sokuqala, ukuphatha ukufinyezwa kwe-fibula okungapheli okulandelayo kanye nokukhubazeka kokujikeleza kuba inselele kakhulu esigabeni sesibili. Ukuze kubhekwane nalolu daba, izazi zakwamanye amazwe ziye zahlongoza indlela entsha yokunciphisa isigaba esisodwa kanye nokulungiswa kokuqhekeka kwe-malleolus yangemuva ehambisana nokulimala okukhulu kwezicubu ezithambile, okuhloswe ngayo ukubuyisela kokubili ubude nokujikeleza.
Iphuzu elingukhiye 1: Ukulungiswa kokufinyezwa kwe-fibula nokujikeleza.
Ukuphuka okuningi noma ukuhlukana okuncishisiwe kwe-fibula/lateral malleolus ngokuvamile kuholela ekufinyezweni kwe-fibula nokukhubazeka kokujikeleza kwangaphandle:
▲ Umfanekiso wokunciphisa i-fibular (A) nokujikeleza kwangaphandle (B).
Ngokucindezela ngesandla iziphetho eziphukile ngeminwe, ngokuvamile kungenzeka ukufeza ukuncishiswa kwe-lateral malleolus fracture. Uma ukucindezela okuqondile kunganele ukuncishiswa, ukusika okuncane eduze konqenqema lwangaphambili noma lwangemuva lwe-fibula lungenziwa, futhi i-forceps yokunciphisa ingasetshenziswa ukubopha nokubeka kabusha ukuphuka.
▲ Umfanekiso wokujikeleza kwangaphandle kwe-malleolus ehlangothini (A) nokunciphisa ngemva kokucindezela ngesandla ngeminwe (B).
▲ Umfanekiso wokusebenzisa imbobo encane kanye nezinsimbi zokunciphisa ukuze kuncishiswe usizo.
Iphuzu Elibalulekile 2: Ukugcinwa kokunciphisa.
Ngemva kokuncishiswa kokuphuka kwe-malleolus ehlangothini, izintambo ezimbili ze-Kirschner ezingenantambo ezingu-1.6mm zifakwa ngocezu olukude lwe-malleolus ehlangothini. Zibekwe ngokuqondile ukuze zilungise isiqeshana se-malleolus esiseceleni ku-tibia, sigcine ubude nokujikeleza kwe-malleolus ehlangene nokuvimbela ukufuduka okulandelayo ngesikhathi sokwelashwa okuqhubekayo.
Ngesikhathi sokulungiswa okuqondile esigabeni sesibili, izintambo ze-Kirschner zingakhishwa ngezimbobo zepuleti. Uma ipuleti seligxilile ngokuvikelekile, izintambo ze-Kirschner ziyasuswa, bese izikulufi zifakwa ngezimbobo zezintambo ze-Kirschner ukuze kuqiniswe okwengeziwe.
Isikhathi sokuthumela: Dec-11-2023
