3 opereli kɛcogo kura minnu bɛ kɛ ka patella karilenw ɲɛnabɔ .

Patellar fractures account for 1% of all trauma cases, and the current guideline recommended surgical procedure for the treatment of simple transverse patellar fractures with articular surface displacement is the tension band wire (TBW), which acts as an antitension device when the patellar (stretched) surface is subjected to bending forces.

Nka, nin wale in gɛlɛyaw ye wire kɔnɔna-filɛli dɛsɛ ye, banakisɛ sɔrɔli, ani joginda-bɔli. Ka fara o kan, nɛgɛ janyalenw tali bɛ se ka gɛlɛya kosɛbɛ, kɛrɛnkɛrɛnnenya la ni aw bɛ nɛgɛ laban tigɛ ani ka a su don ɲɛgɛnɛsiralabanaw ni senkɔniw na.

An ye fɛɛrɛ kura 3 dilan ka ɲɛsin patelli transversale fractures ma ni fɛn kelenw ye ni Standard TBW ye.

1. Figure-of-eight wire tension band (ja-la-filɛ ten tension band) kɛli KERF pinɛw ni ɲɔgɔn cɛ.

2. Kirschner pinɛw janyalen ani tension bands bɛ patella fan fila bɛɛ la.

3. Kirschner pinɛw tigɛlenw ani lateral tension sirilanw.

O la, nin biomekaniki kalan in kun tun ye ka fixation fɛɛrɛ kura 3 ni AO Gold standard of wire tension banding suma ɲɔgɔn na. 

An ka hakilina fɔlɔ tun ye ko biomekaniko dafalen min bɛ kɛ ni KERF pinɛw tigɛlen ye, o man kan ka tiɲɛ. An ka hakilina filanan tun ye ko TBW lateral tun bɛna kɛ ni o ɲɔgɔnna sɔrɔli ye ni TBW standard ye.

Fɛɛrɛw .

O kɔfɛ, patelli karili karili nɔgɔman tigɛra ni pendule saw ye, wa o kɔfɛ, fɛɛrɛ kura 3 kɛra ɲɔgɔn kɔ walasa ka gɛnɛgɛnɛw fara ɲɔgɔn kan walasa u ka se ka dilan cogo la min bɛ kɛ cogo la min tɛ mɔgɔ tɔɔrɔ ani min bɛ se ka segin ka bɔ a nɔ na (i n’a fɔ a jiralen bɛ cogo min na ja 2 ni 3 la). U bɛɛ ye ɲɛtaa sɔrɔ ka ɲɛ. Biomekaniki minɛn dɔ kɛra ka fɛɛrɛ kuraw 3 ka biomekaniki dafalen kɔrɔbɔ.

Jaabiw

Sɛgɛsɛgɛliw bɛɛ jaabiw jiralen bɛ ja 4nan ni 5nan na.

Jateminɛw y’a jira ko cogoya min na, kariyɔrɔ bɛɛ lajɛlen jiginni bɛɛ lajɛlen ye Kerf pinɛw ye minnu bɛ ɲɔgɔn cɛ, olu faralen ɲɔgɔn kan ni TBW lateral ye (fɛɛrɛ 3), n’a kariyɔrɔ hakɛ jiginni hakɛ cɛmancɛ ye milimɛtɛrɛ 0,43 ye (a hakɛ bɛ se 0,10-0,80 ma) 100 cycles kɔfɛ, o bɛ 2 mm jiginni nafama jukɔrɔ kosɛbɛ.

TBW sariyalen min faralen don ɲɔgɔn kan ni KERF pinɛw ye minnu tigɛra (fɛɛrɛ 1) o kɛra a nɔfɛta ye min ka fisa ni tɔw bɛɛ ye, ni a kariyɔrɔ cɛmancɛ jiginni hakɛ cɛmancɛ ye milimɛtɛrɛ 0,61 ye (0,06 fo 2,06 mm).

doni hakɛ dantɛmɛnen tun ye 69,2 N. AO sariya tun ka jugu kosɛbɛ, ni a ka kari laban cɛmancɛ jiginni hakɛ cɛmancɛ ye milimɛtɛrɛ 1,72 ye (0,47 fo 2,24 mm) ani doni hakɛ dantɛmɛnen ye 79,6 n. AO hakɛ ye min ka jugu kosɛbɛ, ni a kariyɔrɔ laban hakɛ jiginni ye milimɛtɛrɛ 1,72 ye (0,47 ka se 2,24 ma).

Kerf crossed (fɛɛrɛ 1 ani 3) fila bɛɛ lajɛlen na, u fila bɛɛ bɛ jiginni misɛnninw jira: 0,27 mm KERF tigɛlenw fila bɛɛ la sɛgɛsɛgɛli laban na, ni i ye olu suma ni 0,41 mm ani 0,60 mm ye AO standard ani longititudinal TBW la, o cogo kelen na. O ye dalilu ye min b’a jira ko Kerf structure crossed bɛ gɛlɛyaba di kari ma doni kɔrɔ nin ye dalilu ye min b’a jira ko kari danfara ka bon kosɛbɛ doni kɔrɔ min bɛ di crossed clinch pin structure fɛ.

Jɛkafɔ

O jaabiw b’a jira ko ka Kirschner pinɛ ɲɛsin yɔrɔ ma min bɛ i n’a fɔ a lamini na, ka bɔ a lamini na, nka k’a to a ka pankurun kelen kɔnɔ (o kɔrɔ ye ko milimɛtɛrɛ 5 bɛ patella ɲɛfɛla lamini na, o tɛ nɔ jugu bila biomekanikini dafalen na, nka a bɛ nɔ ɲuman bila kɔnɔna karili sabatili sabatili la. Ni an ye a suma ni KERF pinɛ janyalenw ye, a bɛ i n’a fɔ kurukuruli jɔcogo bɛ kari bloki sabati ka ɲɛ ka ɲɛsin ɲɛfɛla tansiyɔn ma ani a bɛ se ka dɔ fara degun degun kan joli sira fɛ.

Nin kunnafoniw b’an ka hakilina fɔlɔ sinsin ko kifoti pinɛw tigɛlen tɛ opereli jugu ye ni i ye a suma ni kifotiki pinɛ janyalenw ye, wa tiɲɛ na, o fɛn fila bɛɛ bɛ baara kɛ ka ɲɛ ka tɛmɛ kifotiki pinɛw kan minnu janya bɛ se ka kɛ ni kifotiki pinɛw ye minnu bɛ tigɛ. An ka hakilina filanan bɛ to balansi la, bawo a ma jɛya nin ɲinini in na ko TBW lateral jaabiw bɛ se ka suma ni TBW standard ye.

Nin ye biomekaniki kalan fɔlɔ ye min bɛ sanfɛla jira AO fɛɛrɛ kan ni opereli kɛcogo jateminɛ kokura dɔrɔn TBW kan. Muɲu wɛrɛ tɛ yen wa a kɛcogo bɛ se ka teliya barisa a tali ka dɔgɔn. Kyphotic pins tigɛlenw tali bɛ dɔ bɔ tiɲɛni na lamini farikolo yɔrɔ nugulenw na (kɛrɛnkɛrɛnnenya la, u bɛ kɛ ni senkɔniw ye minnu bɛ wele ko quadrices ani patellar tendons). Ka fara o kan, ni operelikɛlaw jɔrɔlen don farikolo yɔrɔ nɔgɔlenw na minnu datugulen don ani farati min bɛ u la ka ɲɛgɛnɛsira kɔnɔna lamaga walima ka u bɔ kɛnɛ kan, nin kalan in ka kan k’u hakili sigi ko TBW bilali patella fan fila bɛɛ la, o bɛ a tanga o ma, wa o bɛ fiɲɛ bɛɛ lajɛlen ɲɛ.

Nin ɲinini in b’a jira ko KERF PIN fɛɛrɛ kura fila minnu tigɛra, olu ka fisa ni sanu hakɛ ye min ɲɛfɔlen don sisan AO fɛ patelli transversale fractures simples furakɛli la.