Tibial fracture, suprapatellar intramedullary nailing technique .

Tibial intramedullary tibial nailing: a sɔrɔli ani a ɲɔgɔnna, gɛnɛgɛnɛ ɲɛfɛla dimi .

Opereli fɛɛrɛ min bɛ kɛ ka tibial fractures nailing intramedullary intramedullary kɛ, o nafa ka bon walasa ka kɔnɔbara basigilen don a kɔnɔ ka tɛmɛ don yɔrɔ ɲuman fɛ, walasa ka tiɲɛni dɔgɔya gɛnɛgɛnɛ kɔnɔ, ani ka kariyɔrɔ segincogo ɲuman sɔrɔ ani ka nɛgɛ doncogo ɲuman sɔrɔ.

Tibial stem fractures kɔrɔlenw ye infrapatellar median walima infrapatellar parapatellar fɛɛrɛ ye. Hali ni nin fɛɛrɛ ninnu bɛ jira cɛmancɛ-yɔrɔ karilenw na, opereli kɔfɛ valgus, ɲɛfɛ, walima fɛnɲɛnamafagalanw faralen ɲɔgɔn kan tuma caman na kariw la minnu ka surun kosɛbɛ.

Banakisɛ minnu bɛ sɔrɔ tibial proximale fractures la, olu sababuba ye tiɲɛni ye min bɛ sɔrɔ senkɔniw sɔgɔli fɛ gɛnɛgɛnɛ jiginni waati ni u ka masinw ka ɲɔgɔndɛmɛ na wulu kunbere ni kɔfɛla ɲɛgɛnɛsira kɔfɛla dontuma na. Patella fana bɛ axial nail don bali sagittal plane kɔnɔ (Ja 1A, b). O la, fɛɛrɛ wɛrɛ min bɛ kɛ ka ɲɛsin yɔrɔ ma, o ye parapatellar incision medial ye, o bɛ na ni cɛmancɛ dɔɔni ye ka se lateral nail insertion ma (Ja 1C ani 2). Ni nɛgɛ bɛ don kɔnɔboli kɔnɔ ka a fara ka kari, a yɔrɔ min bɛ a kɛrɛfɛ, o bɛ kɔrɔta ka kɛ valgus ye (Jaa 2). A laban na, ɲɛfɛla yɔrɔw farikolow ka lafiɲɛbɔ bɛ dɛmɛ dɔɔnin ka ɲɛsin Valgus ma (Jaa 3).

Jaa 1 a,b ni infrapatellar fɛɛrɛ kɔrɔlen ye, patella bɛ nɛgɛ don axiale bali, o bɛ na ni apical sagittal alignment ani valgus coronal alignment commune ye. C Baara kɛ ni parapatellar fɛɛrɛ ye walasa ka fɛnɲɛnamafagalanw labɛn.

Jaa 2 Ka gɛrɛ don yɔrɔ la ni parapatellar incision medial ye, o bɛ na ni nail doncogo cɛmancɛ ye dɔɔnin. Ni nɛgɛ bɛ don medullary kanal distal la ka kari (a), a yɔrɔ surun bɛ kɔrɔta ka don valgus (b) kɔnɔ .

Jaa 3 Lafiɲɛbɔ gɛlɛya ɲɛfɛla farikolo yɔrɔ la ( a ) bɛ kɛ sababu ye ka ɲɛgɛnɛsiralabanaw labɛn ( b ) .

Ni aw ye tibia siri yɔrɔ la min janya ka bon, o bɛ a to aw kana gɛlɛyaw sɔrɔ minnu bɛ sɔrɔ gɛnɛgɛnɛ jiginni jugumanba la. O fɛɛrɛ in ɲɛfɔra Gelbke, Jakma et al. San 2010 ani a kɛra fɛn ye min bɛ fɔ ka caya nin san laban ninnu na bawo ka senkɔniw siri a farikolo yɔrɔ tilennen jɔyɔrɔ la, o bɛ kari manipule ni a jɔyɔrɔ kura nɔgɔya. Fluoroscopie kɛra fɛɛrɛ ye min kɛli ka nɔgɔn fɛɛrɛko siratigɛ la. Fluoroscopie waatiw ka ɲɛsin suprapatellar nailing ma, a fɔra ko u ka surun kosɛbɛ ka tɛmɛ infrapatellar nailing kan. Ka fara o kan, nɛgɛ doncogo (sanu-plan na) bɛ bɛn ni tibia janya janya ye nin fɛɛrɛ in na ka tɛmɛ infrapatellar nail kan; O bɛ kɛ sababu ye ka masinw ka bɛnbaliya bali nɛgɛ kun ni kɔfɛla cɛ, o bɛ kɛ sababu ye ka kari dɔgɔyali nɔgɔya.

Opereli kɔfɛ gɛnɛgɛnɛ dimi ye gɛlɛya ye min bɛ tali kɛ o la. Gɛnɛgɛnɛ ɲɛfɛla dimi fɔra banabagatɔ 50-70% la, banabagatɔ 30% dɔrɔn de bɛ dimi madali la kɔnɔna jiri bɔlen kɔfɛ. A jateminɛna ko joli bɔli min bɛ sɔrɔ senkɔniw ni Hoffa Fat Pad sɔrɔli la, o ye gɛnɛgɛnɛ dimi sababu ye min bɛ se ka kɛ opereli kɔfɛ. Ka fara o kan, suprapatellar fɛɛrɛ bɛ a yɛrɛ tanga safensi nɛrɛmugu bolokɔni bolokɔni tigɛcogo laadalama ma, o la, a bɛ a yɛrɛ tanga gɛnɛgɛnɛ ɲɛfɛla numbness ni dusukunnataw labɔli ma (Jaa 4). Ni aw ye nɛgɛ tɛmɛ senkɔni naani fɛ, o la, a bɛ kɛ ko a bɛ to ka senkɔniw da ka ɲɛ, o bɛ dɔ bɔ kosɛbɛ gɛnɛgɛnɛ dimi hakɛ la opereli kɔfɛ.

K’a sababu kɛ gɛrɛgɛrɛ karilenw jaabi ɲumanw ye, taamasiɲɛ minnu bɛ kɛnɛyaso baarakɛcogo la, olu bɛ bonya ka se kari bɛɛ ma.

Suprapatellar intramedullary nail ka kan ka kɛ tuma jumɛn?

Nafaw .

• gɛnɛgɛnɛ jɔyɔrɔ tilancɛ bɛ kari manipule ni a sigiyɔrɔ kura sabati ni farikolo fanga lafiyali ye ani ka to a la wuluw dontuma na .

• Farati min bɛ sɔrɔ opereli kɔfɛ, o bɛ dɔgɔya ka bɔ kariw la minnu bɛ sɔrɔ u kɛrɛfɛ, segin ani yɔrɔjanw na ni u bɛ tali kɛ fɛɛrɛ kɔrɔw la .

• Nailing operation (Nailing Operation) bɛ nɔgɔya fɛɛrɛko siratigɛ la .

• Nail doncogo bɛ se ka kɛ i n'a fɔ 'Single Surgeon Procedure' .

• Fluoroscopie waati dɔgɔyali .

• Tiɲɛni si ma kɛ senkɔniw na ani gɛnɛgɛnɛ ɲɛfɛla dimi hakɛ dɔgɔyali .

• A kɛli ka nɔgɔn ekipu caman kɛcogo la, i n’a fɔ bɔnɛ caman bɛ sɔrɔ cogo min na .

  
  

Taamaʃyɛnw .

• Aw bɛ joli-sira-funu (AO 41A suguya) ka kari.

• Tibial diaphysis (AO 42A-C suguya) karili nɔgɔman.

• Tibial dibial diaphyseal fracture (AO 42C suguya) .

• Tibial distal extra-articulaire fractures ani distal distal extension fractures simples (AO 43A ani C1 suguyaw)

• Gɛnɛgɛnɛ min bɛ pan .

• Patellar ossification ni patellar tendon ossification .

• Jogin nɔgɔlen bɛ kɛ patellar tendon nivo la .

Orthopedic Implants ani Orthopedic Instruments (Fɛn minnu bɛ se ka kɛ ka ɲɛgɛnɛ kɛ) san cogo min na, o ye .

Kosɔn CzMedItech , an bɛ ni kolotuguda opereli fɛnw ye minnu dafalen don kosɛbɛ ani minɛnw minnu bɛ bɛn o ma, o ye fɛn ye . Spine Implants ., Nails intramedullaires ., Plate de traume ., locking plate ., kunkolo-maxillo-facial ., Prothèse ., Seko ni dɔnko baarakɛminɛnw ., kɛnɛma fixateurs ., Arthroscopie ., Baganw ladonni n’u dɛmɛnanw.

Ka fara o kan, an b’an jija ka fɛn kuraw dilan tuma bɛɛ ani ka fɛn dilannenw caya, walasa ka dɔgɔtɔrɔw ni banabagatɔ caman ka opereli magow ɲɛ, ani fana k’an ka tɔn kɛ ɲɔgɔndan ye diɲɛ kɔnɔ kolotugudaw ni minɛnw dilanni bɛɛ la.

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