Tibial fracture, suprapatellar intramedullary nailing fɛɛrɛ

Kɔnɔbara basigilen sɔgɔsɔgɔninjɛ : doncogo ni a labɛncogo, gɛnɛgɛnɛ ɲɛfɛla dimi

Opereli fɛɛrɛ min bɛ kɛ ka senkɔni karilenw sɔgɔsɔgɔ senkɔniw kɔnɔ, o nafa ka bon walasa ka senkɔniw donna yɔrɔ ɲuman fɛ, ka tiɲɛni dɔgɔya gɛnɛgɛnɛw kɔnɔ, ani ka kariyɔrɔw sigicogo ɲuman sɔrɔ ani ka doncogo ɲuman sɔrɔ.

Fɛɛrɛ kɔrɔ minnu bɛ kɛ ka tibial stem fractures sɔrɔ, olu ye infrapatellar median walima infrapatellar parapatellar fɛɛrɛ ye. Hali ni nin fɛɛrɛ ninnu jiralen don cɛmancɛ yɔrɔ karilenw na, opereli kɔfɛ ɲɛdawolo, ɲɛfɛla walima u faralen ɲɔgɔn kan, olu ka teli ka kɛ kariw la minnu ka surun.

Senkɔni kɛrɛfɛla karilenw ka ɲɔgɔndɛmɛbaliya sababuba ye sɔgɔsɔgɔninjɛ ye min bɛ sɔrɔ senkɔni naani samali fɛ gɛnɛgɛnɛ kuruli waati ani masinko gɛlɛya min bɛ wulu kun ni kɔfɛla kɔkolo cɛ fɛn donta waati. Patella fana bɛ axial nail don bali sagittal plane kɔnɔ (Ja 1a, b). O la, fɛɛrɛ wɛrɛ min ka teli ka kɛ ka se yɔrɔ la, o ye cɛmancɛla parapatellar tigɛcogo ye, o bɛ na ni nɛgɛ donni dɔɔni ye cɛmancɛ la ka taa kɛrɛfɛ (ja 1c ani 2). Ni wulu donna ɲɛgɛnɛsira kɔnɔ min ka jan ni kari ye, a kɛrɛfɛyɔrɔ bɛ kɔrɔta ka kɛ valgus ye (Jaa 2). A laban na, ɲɛfɛla yɔrɔ fasaw ka lafiɲɛbɔ tension bɛ dɔɔni kɛ valgus la (Jaa 3).

Jaa 1 a,b Ni aw bɛ baara kɛ ni infrapatellar fɛɛrɛ kɔrɔlen ye, patella bɛ wulu doncogo bali aksidan na, o bɛ na ni ɲɛda ɲɛfɛla sagittal alignment ni valgus coronal alignment deformité commune ye. c Ka baara kɛ ni parapatellar fɛɛrɛ ye walasa ka wuluw labɛncogo kɛ ɲɛgɛnɛsira kɔnɔ.

Jaa 2 Ni i gɛrɛla dondaw la ni cɛmancɛ parapatellar tigɛcogo ye, o bɛ na ni nɛgɛ donni ye dɔɔni cɛmancɛ la ka taa kɛrɛfɛ. Ni wulu donna ɲɛgɛnɛsira la min bɛ kari yɔrɔ jan (a), a kɛrɛfɛyɔrɔ bɛ kɔrɔta ka kɛ valgus (b) ye .

ja 3 lafiɲɛbɔ tension min bɛ ɲɛfɛla farikolo yɔrɔ la ( a ) o bɛ kɔnɔbara kɔkanna labɛncogo nɔgɔlen dɔ lase ( b ) .

Ni aw ye senkɔni siri yɔrɔ la min janya ka bon, o bɛ dɛmɛ ka gɛlɛyaw bali minnu bɛ sɔrɔ gɛnɛgɛnɛ kurulen jugumanba fɛ opereli kɔnɔ. fɛɛrɛ in ɲɛfɔra Gelbke, Jakma et al fɛ. san 2010 la, wa a kɛra fɛn ye min diyara kosɛbɛ nin san laban ninnu na bawo ni senkɔni sirilen don senkɔni yɔrɔ la min bɛ se ka kɛ a tilennen ye, o bɛ karilenw kɛcogo nɔgɔya ani ka a bila yɔrɔ wɛrɛ la. Fluoroscopie kɛcogo nɔgɔyara fɛɛrɛko siratigɛ la. A jirala ko fluoroscopie waati minnu bɛ kɛ suprapatellar nailing la, olu ka surun kosɛbɛ ka tɛmɛ infrapatellar nailing kan. Ka fara o kan, wulu doncogo yɔrɔ (sagittal plane kɔnɔ) bɛ bɛn senkɔni janya-yɔrɔ ma nin fɛɛrɛ in na ka tɛmɛ infrapatellar nail kan; o bɛ masinw ka kɛlɛ bali wulu kun ni kɔfɛla cɛ, o bɛ karilenw dɔgɔyali nɔgɔya.

Gɛnɛgɛnɛ ɲɛfɛla dimi opereli kɔfɛ, o ye gɛlɛya ye min bɛ tali kɛ o la. Gɛnɛgɛnɛ ɲɛfɛla dimi fɔra karilen banabagatɔ 50-70% la, banabagatɔ 30% dɔrɔn de ye dimi mada sɔrɔ kɔnɔna jiri bɔli kɔfɛ. A jateminɛna ko sɔgɔsɔgɔninjɛ sɔrɔli min bɛ tali kɛ senkɔni senkɔni ni Hoffa tulumafɛnw sɔrɔli la, o ye gɛnɛgɛnɛ dimi sababu ye opereli kɔfɛ. Ka fara o kan, suprapatellar fɛɛrɛ bɛ a yɛrɛ tanga saphenous nerve patellar bolo bolo tigɛcogo laadalama ma, o la, gɛnɛgɛnɛ ɲɛfɛla sɔgɔsɔgɔli ni dusukunnataw sɔgɔsɔgɔli tɛ (Jaa 4). Ni aw ye wulu tɛmɛ senkɔni naani fɛ, o la, a bɛ senkɔni to a cogo la, a bɛ i n’a fɔ o bɛ dɔ bɔ kosɛbɛ gɛnɛgɛnɛ dimi hakɛ la opereli kɔfɛ.

K’a sababu kɛ kɛrɛfɛla kariw nɔ ɲumanw ye, taamasiɲɛ minnu bɛ kɛ dɔgɔtɔrɔso la, olu cayara ka se kari bɛɛ ma.

Tuma jumɛn na, a ka kan ka kɛ ni suprapatellar intramedullary nail ye?

Nafa minnu b’a la

• Gɛnɛgɛnɛ jɔli tilayɔrɔba dɔ bɛ kariw labɛncogo ni a sigicogo kura sabati ni farikolo fanga ni a marali lafiyali ye wulu dontuma na

• Farati bɛ dɔgɔya opereli kɔfɛ kariw bɔli la kɛrɛfɛ, yɔrɔ dɔw ani yɔrɔjan kariw la ni i ye a suma ni fɛɛrɛ kɔrɔw ye

• Nailing operation (kɔlɔsili) kɛcogo ka nɔgɔn fɛɛrɛko siratigɛ la

• Nɛgɛ donni bɛ se ka kɛ i n'a fɔ 'opereli kelen kɛcogo'.

• Fluoroscopie waati dɔgɔyali

• Tiɲɛni tɛ kɛ senkɔni senkɔni na ani gɛnɛgɛnɛ ɲɛfɛla dimi bɛ dɔgɔya stapling kɔfɛ

• A kɛli ka nɔgɔn ekipu caman ka fɛɛrɛ la, i n’a fɔ bɔnɛ caman na

  
  

Taamaʃyɛnw

• Senkɔni kɛrɛfɛla karilen kɔfɛ (AO 41A suguya) .

• Tibial diaphyse karilen nɔgɔman (AO 42A-C suguya) .

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

• Tibial distal extra-articular fractures ani distal intra-articular distal extension fractures nɔgɔmanw (AO 43A ni C1 suguyaw) .

• Gɛnɛgɛnɛ min bɛ panpan

• Patellar ossification ni patellar tendon koloci

• Joginda nɔgɔlen bɛ senkɔni senkɔni hakɛ la

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