I-Tibial Plateau Fractures ehlanganiswe ne-IPsilateral Tibial Sheff Fractures ivame ukubonwa ekulimaleni kwamandla aphezulu, lapho kungu-54% wokuvulwa kwama-fractures. Ucwaningo lwangaphambilini luthole ukuthi ama-8.4% ama-tibial plateau fractures ahlotshaniswa nama-concomitant tibial shaft fractures, kanti ama-3.2% weTibial Shaft Fracture iziguli anezitabane zethafa leTibialTant tibial ane-Tibial Tlateau. Kuyabonakala ukuthi inhlanganisela ye-IPsimelial Tibial Tibial Plateau kanye neShaft fractures akuyona into evamile.
Ngenxa yohlobo olunamandla lwamandla okulimala okunjalo, kuvame ukulimala kanzima kwezicubu ezithambile. Ethiyori Ngakho-ke, okwamanje kukhona izinketho ezimbili ezisetshenziswayo ezisetshenziswayo zokulungiswa kwangaphakathi kwamathafa e-tibial plateau kuhlanganiswe ne-tibial shaft shaft fractures:
1. I-MIPPO (ngokuhlanza kancane ipuleti osteosynthesis) inqubo ende;
2. I-intramenduvaltary Nail + Plateau isikulufa.
Zombili lezi zinketho zibikwa ezincwadini, kepha okwamanje akukho ukuvumelana okuphezulu noma okuphansi ngokwesilinganiso sokuphulukisa, isikhathi sokuphulukisa, isikhathi esiphansi semilenze. Ukubhekana nalokhu, izifundiswa ezibhedlela zaseKorea University zaqhuba isifundo sokuqhathanisa.
Lolu cwaningo lufake iziguli ezingama-48 ngeTibial Plateau Fractures ezihlanganiswe neTibial Shaft Fractures. Phakathi kwazo, amacala angama-35 aphathwa ngenqubo ye-MIPPO, ngokufakwa kwe-lateral kwepuleti yensimbi yokulungiswa, futhi amacala ayi-13 aphathwa ngezikulufo zethalaau ezihlanganiswe nendlela yokulungiswa kwezipikili.
I-Case 1: Ukulungiswa kwensimbi ye-Mippo yensimbi yangaphakathi. Owesilisa oneminyaka engu-42 ubudala, obandakanyeka engozini yemoto, eyethulwa ngohlobo oluvulekile lweTibial Shaft Fracture (Gustilo II) kanye nohlobo lwethafa oluhlangene lwe-tibial tibial tibial trateau ukuxabana (uhlobo lweSchatzker IV).
I-Case 2: I-Tibial Plateau Screw + suprapatellar intramelvary nipity yangaphakathi. Owesilisa oneminyaka engu-31 ubudala, obandakanyeka engozini yemoto, owethulwe ngotshani ovulekile weTibial Shaft Fracture (Tustilo IIIA) kanye ne-contokomitant yamuva tibial Tlanteau fracture (Schatzker I Type). Ngemuva kokushintshana ngamanxeba kanye nokwelashwa okulimele kwengcindezi engemihle (vsd), isilonda sahlanganiswa isikhumba. Izikulufo ezimbili ezi-6.5mm zazisetshenziselwa ukuncishiswa kanye nokulungisa i-plateau, kulandelwa ukulungiswa kwezipikili kwe-intrametundary of the tibial shaft ngendlela ye-suprapatellar.
Imiphumela ikhombisa ukuthi akukho mehluko obalulekile ngokwezibalo phakathi kwalezindlela ezimbili zokuhlinzwa ngokuya ngesikhathi sokuphulukisa, izinga lokuphulukisa, izinga lokuhlangana eliphansi, kanye nezinkinga.
Ifana nenhlanganisela yeTibial Shaft Fractures nge-Ankle Joint Fractures noma i-Femor Shaft Fractures nge-Femol Fembunt Fractures, i-Tibial-Ender-Elensial Thibial Shaft Shaft Fractures nayo ingaholela ekulimaleni kwedolo elisondelene ne-Knee ehlanganisiwe. Ekusebenzeni kwemitholampilo, ukuvimba i-misdiagnosis kuyinto ekhathalela kakhulu ekuxilongeni nokwelashwa. Ngokwengeziwe, ekukhetheni kwezindlela zokulungiswa, yize ucwaningo lwamanje lubonisa umehluko obalulekile, kusekhona amaphuzu ambalwa okufanele acatshangelwe:
1
2 Ezimweni ezinjalo, kungabaluleka kunganqunyelwa ukulungiswa kwesikulufu kulandelwe yi-suprapatatellar intramellar ye-intrametullary yokulungiswa kwezipikili ze-tibial shaft.
Isikhathi sePosi: Mar-09-2024
