Amekokomɔnu Yeye 3 Siwo Woatsɔ Akpɔ Patella ƒe Gbagbãƒewo Gbɔ

Patellar fractures nye 1% le nuveviwɔame ƒe nyawo katã me, eye mɔfiame si wokafu fifia be woawɔ amekoko ƒe mɔnu si woatsɔ ada transverse patellar fractures bɔbɔe siwo me articular surface displacement le enye tension band wire (TBW), si wɔa dɔ abe antitension device ene ne wotsɔ patellar (stretched) surface de bending forces me.

Gake kuxi siwo dona tso dɔ sia me dometɔ aɖewoe nye ka ƒe ememe ƒoƒo ƒe kpododonu, dɔlékuiwo xɔxɔ, kple abi ƒe ʋuʋu. Tsɔ kpe ɖe eŋu la, ka didiwo zazã ate ŋu asesẽ ŋutɔ, vevietɔ ne wole ka la ƒe nuwuwu lãm heɖii ɖe patellar tendon kple quadriceps tendon me.

Míewɔ mɔnu yeye 3 siwo woatsɔ aɖɔ afɔkpodzi ƒe gbagbã siwo le tsia dzi la ɖo to nu siwo wozãna abe TBW si wozãna ɖaa ene la ke zazã me.

1. ka ƒe tete ƒe ka si ƒe xexlẽme nye enyi zazã le atitsoga ƒe ʋukuku le kerf pins ŋu vɔ megbe.

2. Kirschner pins didiwo kple tension bands siwo le patella ƒe akpa eveawo.

3. Kirschner pins kple axadzi tete ka siwo tso wo nɔewo ŋu.

Eyata taɖodzinu si le biomechanical numekuku sia ŋue nye be woatsɔ fixation mɔnu yeye 3 asɔ kple AO sika dzidzenu si nye wire tension banding. 

Míaƒe nukpɔsusu gbãtɔe nye be mele be xɔtunu siwo zãa kerf pin siwo wotso ɖe wo nɔewo ŋu ƒe biomechanical integrity nagblẽ o. Míaƒe nukpɔsusu eveliae nye be axadzi TBW akpɔ emetsonuwo abe TBW si wozãna ɖaa ene.

Mɔnuwo

Wotsɔ pendulum saw tso afɔkpodzi ƒe gbagbã bɔbɔe si le ŋgɔgbe la, eye emegbe wozã mɔnu yeye 3 la ɖe wo nɔewo yome tsɔ ɖe klowo ɖe vovo be woakpɔ egbɔ be woate ŋu awɔ wo le mɔ si tsi tre ɖi na ɖoɖo si le dedie eye woate ŋu agbugbɔ wo awɔ si wotu ɖe amegbetɔ ƒe ŋutilã ƒe wɔwɔme dzi (abe alesi woɖee fia le Nɔnɔmetata 2 kple 3 me ene). Wo katã wowɔ dzidzedzetɔe. Wozã biomechanical device tsɔ do aɖaŋu yeye 3 la ƒe biomechanical integrity kpɔ.

Metsonu

Woɖe dodokpɔawo katã me tsonu fia le Nɔnɔmetata 4 kple 5 me.

Emetsonuwo ɖee fia be Ðoɖo si me gbagbã ƒe dometsotso bliboa ƒe ʋuʋu suetɔ kekeake le lae nye crossed kerf pins siwo wotsɔ ƒo ƒu kple axadzi TBW (mɔnu 3), kple gbagbã ƒe dometsotso ƒe ʋuʋu le mama dedie nu si nye 0.43 mm (ƒe didime 0.10-0.80 mm) le tsatsam 100 megbe, si le ʋuʋu ɖedzesi si nye 2 mm la te ŋutɔ.

TBW si wozãna ɖaa si wotsɔ ƒo ƒu kple crossed kerf pins (mɔnu 1) ye nye nyuitɔ si kplɔe ɖo, eye eƒe gbagbã ƒe dometsotso ƒe ʋuʋu le mama dedie nu nye 0.61 mm (0.06 va ɖo 2.06 mm).

Agba si wotsɔ de eme le mama dedie nu nye 69.2 N. AO ƒe dzidzenue nye esi gblẽ wu, eye eƒe dometsotso mamlɛtɔ si woɖe le gbagbãƒe ƒe ʋuʋu le mama dedie nu nye milimeta 1.72 (0.47 va ɖo 2.24 mm) eye agba si wozã le mama dedie nu nye 79.6 N. AO ƒe dzidzenuae nye esi vɔ̃ɖi wu, eye dometsotso mamlɛtɔ ƒe ʋuʋu le mama dedie nu nye milimeta 1.72 (0.47 va ɖo 2.24 mm).

Le dzidziɖedzi ƒe ʋuʋu le tsatsam ɖesiaɖe gome la, crossed kerf (aɖaŋu 1 kple 3) xɔtuɖoɖo eveawo siaa ɖea ʋuʋu suewo fiana: 0.27 mm na crossed kerf xɔtuɖoɖo eveawo le tsatsam mamlɛtɔ me, ne wotsɔe sɔ kple 0.41 mm kple 0.60 mm na standard AO kple longitudinal kerf structure kple lateral TBW, le wo nɔewo yome. esia nye kpeɖodzi be kerf ƒe wɔwɔme si wotso la naa ʋuʋudedi si le agba te la sesẽna wu Esia nye kpeɖodzi be dometsotso si le gbagbãƒea ƒe sesẽme lolo wu le agba te si Clinch pin xɔtuɖoɖo si wotso la na.

Numedzodzro

Nusiwo do tso eme ɖee fia be ne wogbugbɔ Kirschner ƒe pin la ɖo ɖe nɔnɔme si le abe atitsoga ene me si didi tso lãkusi falɛfalɛ siwo ƒo xlãe gbɔ, gake ne wotsɔe ɖo yameʋu ɖeka ma ke me (si fia be, milimeta 5 le megbe na patella ƒe ŋgɔgbe si le ʋuʋu ɖi), mekpɔa ŋusẽ gbegblẽ ɖe biomechanical integrity dzi o, ke boŋ ekpɔa ŋusẽ nyui ɖe ememe gbagbãƒea ƒe liƒo dzi. Ne wotsɔe sɔ kple kerf pin siwo didi la, edze abe atitsoga ƒe wɔwɔme la naa gbagbãƒea li ke nyuie wu ɖe ŋgɔgbe ƒe tete nu eye ate ŋu ana nutete si le ƒunukpeƒea ƒe nutetea nadzi ɖe edzi ene.

Nyatakaka siawo ɖo kpe míaƒe nukpɔsusu gbãtɔ dzi be crossed kyphotic pins menye amekoko ƒe ɖoɖo si vɔ̃ɖi wu ne wotsɔe sɔ kple longitudinal kyphotic pins o, eye le nyateƒe me la, xɔtuɖoɖo eveawo siaa wɔa dɔ nyuie wu longitudinal kyphotic pins siwo zãa crossed kyphotic pins. Míaƒe nukpɔsusu evelia gakpɔtɔ da sɔ, elabena mekɔ tso numekuku sia me nenye be axadzi TBW ƒe emetsonuwo sɔ kple TBW si wozãna ɖaa o.

Esiae nye biomechanical numekuku gbãtɔ si ɖee fia be enyo wu AO mɔnu to amekokomɔnu si wozãna tsɔ gbugbɔa ŋku léna ɖe TBW ŋu ko me. Womagazã ga bubu aɖeke kpee o eye dɔa ate ŋu awɔ kabakaba wu elabena mehiã be woaɖee ɖe go boo o. Kyphotic pin siwo wotso ɖe wo nɔewo ŋu zazã ɖea nusiwo gblẽna le lãmeka falɛfalɛ siwo ƒo xlãe ŋu (vevietɔ lãkusi ene kple afɔkpodzi ƒe lãkusiwo) dzi kpɔtɔna. Tsɔ kpe ɖe eŋu la, ne amekolawo tsi dzi ɖe lãkusi falɛfalɛ siwo wotsyɔ ƒe nyonyome kple afɔku si le ga si le ŋgɔgbe ƒe ememetɔ ƒe dzikudodo alo dodo me ŋu la, ele be numekuku sia nana kakaɖedzi wo be ne wotsɔ TBW la da ɖe akɔta ƒe akpa eveawo aƒo asa na esia eye wòana lãkusi bliboa nanyo ɖe edzi.

Numekuku sia ɖee fia be crossed kerf pin mɔnu yeye eve nyo wu sika ƒe dzidzenu si ŋu AO ƒo nu tsoe fifia le transverse patella fractures bɔbɔewo dada me.