Amekokomɔnu yeye 3 siwo woatsɔ akpɔ patella ƒe gbagbã gbɔe .

Patellar fractures nye 1% le nuveviwɔame ƒe nyawo katã me, eye mɔfiame si li fifia kafu amekokomɔnu si woatsɔ ada patellar gbagbã bɔbɔe siwo le ŋgɔgbe kple articular surface displacement is the tension band wire (TBW), si wɔa dɔ abe antitension device ene ne wotsɔ patellar (stretched) surface de asi na bending forces.

Gake kuxi siwo dona tso dɔwɔwɔ sia me dometɔ aɖewoe nye ka ƒe ememe fixation ƒe kpododonu, dɔlékuiwo, kple abi ƒe ʋuʋu. Tsɔ kpe ɖe eŋu la, ka didiwo zazã ate ŋu asesẽ ŋutɔ, vevietɔ ne wole ka la ƒe nuwuwu kple eƒe nugbɔ ɖiɖim le patellar tendon kple quadriceps tendon me.

Míewɔ aɖaŋu yeye 3 hena patella ƒe gbagbã siwo le tsia dzi ƒe fixation to nu siwo sɔ kple Standard TBW zazã me.

1. Kaƒomɔ̃ si ƒe lolome nye enyi ƒe tete ɖe ame ŋu ƒe ka si wotsɔ ƒoe vɔ megbe la zazã vɔ megbe.

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

3. Kirschner pins kple lateral tension straps siwo wotso.

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

Míaƒe nukpɔsusu gbãtɔe nye be mele be xɔtuɖoɖoawo ƒe biomechanical integrity si zãa kerf pin siwo wotso la nagblẽ o. Míaƒe nukpɔsusu eveliae nye be lateral TBW akpɔ emetsonu siwo sɔ kple TBW si wozãna ɖaa.

Mɔnuwo .

Wotsɔ pendulum saw tso patellar fracture bɔbɔe si le tsia dzi la me, eye wotsɔ aɖaŋu yeye 3 la wɔ dɔe ɖe wo nɔewo yome tsɔ ɖe klowo ɖe vovo be woakpɔ egbɔ be woate ŋu atu wo le mɔ si tsi tre ɖi na ɖoɖo si le dedie eye woate ŋu agbugbɔe awɔ si wotu ɖe amegbetɔ ƒe ŋutilã ƒe wɔwɔme dzi (abe alesi woɖee fia le Nɔnɔmetata 2 kple 3 me ene). Wokpɔ dzidzedze le wo katã me 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 lia me.

Nusiwo do tso eme ɖee fia be ɖoɖo si wowɔ kple fracture dometsotso ƒe ʋuʋu suetɔ kekeake nye kerf pin siwo wotso kple lateral TBW (technique 3), kple fracture dometsotso ƒe ʋuʋu le mama dedie nu si nye 0.43 mm (ƒe 0.10-0.80 mm) le 100 ƒe tsatsam megbe, le teƒe nyui aɖe si le teƒe nyui aɖe.

TBW si wozãna ɖaa si wotsɔ ƒo ƒu kple kerf pin siwo wotso (technique 1) ye nye nyuitɔ kekeake si kplɔe ɖo, kple fracture dometsotso ƒe ʋuʋu le mama dedie nu si nye 0.61 mm (0.06 va ɖo 2.06 mm).

Agba si wozã le mama dedie nue nye 69.2 N. AO ƒe dzidzenuae nye esi vɔ̃ɖi wu, kple vovototo mamlɛtɔ ƒe vovototo ƒe ʋuʋu le mama dedie nu si nye 1.72 mm (0.47 va ɖo 2.24 mm) eye agba si wotsɔ de eme le mama dedie nu nye 79.6 N. AO ƒe dzidzenu si vɔ̃ɖi wu, si me 2.4 va ɖo 2.2 mm ƒe ʋuʋu le mama dedie nu nye.

Le dzidziɖedzi ƒe ʋuʋu le tsatsam ɖesiaɖe me la, kerf si wotso (mɔ̃ɖaŋununya 1 kple 3) ƒe xɔtuɖoɖo eveawo siaa ɖea ʋuʋu suewo fiana: 0.27 mm na kerf xɔtuɖoɖo eveawo siaa le tsatsam mamlɛtɔ me, ne wotsɔe sɔ kple 0.41 mm kple 0.60 mm na AO si woɖo ɖi. Esia nye kpeɖodzi be kerf ƒe wɔwɔme si wotso la naa sesẽ geɖe wu le gbagbãƒe si le agba te la ŋu esia nye kpeɖodzi be gbagbãƒe ƒe dometsotso si le agba te si wotsɔ clinch pin ƒe wɔwɔme si wotso la na la ƒe sesẽme lolo wu.

Numedzodzro

Nusiwo do tso eme ɖee fia be kirschner pin la gbugbɔɖoɖo ɖe xɔtunu si le abe atitsoga ene me le adzɔge tso lãkusi falɛfalɛ siwo ƒo xlãe gbɔ, gake edzra ɖo ɖe yameʋu ɖeka me (si nye mm 5 megbe le akɔta ƒe ŋgɔgbe convex ƒe anyigba dzi), mekpɔa ŋusẽ gbegblẽ ɖe biomechanical integrity dzi o, ke boŋ ekpɔa ŋusẽ nyui ɖe ememe gbagbã ƒe fixation dzi. Ne wotsɔe sɔ kple kerf pin siwo didi la, edze abe atitsoga ƒe wɔwɔme na be wòali ke nyuie wu be wòali ke ɖe gbagbãƒea ƒe tete ŋu ene eye ate ŋu ana nutete ƒe nuteɖeamedzi nadzi ɖe edzi le articular ƒe anyime.

Nyatakaka siawo ɖo kpe míaƒe nukpɔsusu gbãtɔ si nye be kyphotic pin siwo wotso la menye amekoko ƒe mɔnu si vɔ̃ɖi wu ne wotsɔe sɔ kple kyphotic pin didiwo o, eye le nyateƒe me la, wɔwɔme eveawo siaa wɔa dɔ nyuie wu kyphotic pin didi siwo zãa kyphotic pin siwo wotso ɖe wo nɔewo ŋu. Míaƒe nukpɔsusu evelia gakpɔtɔ le dadasɔ me, elabena womenya le numekuku sia me o nenye be woate ŋu atsɔ TBW si le axadzi la me tsonu asɔ kple TBW si wozãna ɖaa hã.

Esia nye biomechanical numekuku gbãtɔ si ɖee fia be enyo wu AO mɔnu la to amekokomɔnu si wozãna le TBW me la gbugbɔgawɔ ko me. Ga bubu aɖeke megahiã o eye dɔa ate ŋu awɔ dɔ kabakaba wu elabena mehiã be woaɖee ɖe go boo o. Kyphotic pin siwo wotso ɖe wo nɔewo ŋu zazã ɖea nusiwo gblẽna le lãkusi falɛfalɛ siwo ƒo xlãe ŋu dzi kpɔtɔna (vevietɔ quadriceps kple patellar tendons). Tsɔ kpe ɖe eŋu la, ne amekolawo tsi dzi ɖe lãkusi falɛfalɛ siwo woxe ƒe nyonyome kple afɔku si nye be woado dziku alo ado ɖe ŋgɔ le ŋgɔgbe ga ememetɔ ƒe fixation ŋu la, ele be numekuku sia naka ɖe edzi na wo be TBW dada ɖe patella ƒe akpa eveawo ƒoa asa na esia eye wònana be fixation bliboa nyona ɖe edzi.

Numekuku sia ɖee fia be kerf pin ƒe mɔnu yeye eve siwo wotso ɖe wo nɔewo ŋu la de ŋgɔ wu sika ƒe dzidzenu si ŋu AO le nu ƒom tsoe fifia le patella ƒe gbagbã bɔbɔe siwo le tsia dzi la dada me.