3 Sabbin Hanyoyi na Tiya don Magance Karuwar Patella

Ƙwararrun ƙwayar cuta na lissafin 1% na duk lokuta masu rauni, kuma jagorar halin yanzu ya ba da shawarar aikin tiyata don maganin ƙananan ƙwayoyin cuta mai sauƙi tare da ƙaurawar bangon bango shine waya mai tayar da hankali (TBW), wanda ke aiki a matsayin na'urar antitension lokacin da patellar (mike) surface ya kasance ƙarƙashin ƙarfin lanƙwasa.

Koyaya, rikice-rikice na wannan hanya sun haɗa da gazawar gyaran ciki na waya, kamuwa da cuta, da raunin rauni. Bugu da ƙari, aikace-aikacen wayoyi masu tsayi na iya zama ƙalubale sosai, musamman lokacin da ake yankewa da binne ƙarshen waya a cikin tendon patellar da tendon quadriceps.

Mun tsara sabbin fasahohin 3 don gyara ɓarnawar ɓarna na patella ta amfani da kayan iri ɗaya kamar daidaitaccen TBW.

1. aikace-aikace na siffa-na-takwas waya tashin hankali band bayan giciye-tuki da kerf fil.

2. Matsakaicin Kirschner na tsaye da maƙallan tashin hankali a bangarorin biyu na patella.

3. Ketare Kirschner fil da madaurin tashin hankali na gefe.

Don haka, makasudin wannan binciken na biomechanical shine kwatanta sabbin hanyoyin gyarawa guda 3 tare da ma'aunin gwal na AO na igiyar tashin hankali na waya. 

Hasashenmu na farko shi ne cewa amincin tsarin sifofi da ke amfani da kerf ɗin da aka ketare bai kamata ya lalace ba. Hasashenmu na biyu shine cewa TBW na gefe zai sami sakamako iri ɗaya zuwa daidaitaccen TBW.

Hanyoyin

An yanke sassauƙan karaya mai jujjuyawar patellar tare da tsintsiya madaurinki ɗaya, sannan aka yi amfani da sabbin dabaru guda 3 a jere don raba gwiwoyi don tabbatar da cewa za a iya gina su ta hanyar da ke wakiltar tsari mai aminci da sake sakewa bisa tsarin jikin ɗan adam (kamar yadda aka nuna a Figures 2 da 3). Duk an samu nasara. An yi amfani da na'urar biomechanical don gwada amincin biomechanical na sabbin dabaru guda 3.

Sakamako

Ana nuna sakamakon duk gwaje-gwaje a Figures 4 da 5.

Sakamakon ya nuna cewa Tsarin tare da mafi ƙanƙancin jimlar raguwar raguwa shine kerf fil ɗin da aka ƙetare tare da TBW na gefe (fasaha 3), tare da maƙasudin raguwa na 0.43 mm (kewayon 0.10-0.80 mm) bayan 100 hawan keke, da kyau a ƙasa da gagarumin ƙaura na 2 mm.

Madaidaicin TBW wanda aka haɗe tare da kerf fil ɗin kerf (fasaha 1) shine mafi kyau na gaba, tare da maƙasudin raguwa na 0.61 mm (0.06 zuwa 2.06 mm).

Matsakaicin nauyin da aka yi amfani da shi shine 69.2 N. Ma'auni na AO shine mafi muni, tare da maƙasudin raguwa na ƙarshe na 1.72 mm (0.47 zuwa 2.24 mm) da nauyin da aka yi amfani da shi na 79.6 N. Ma'auni na AO ya kasance mafi muni, tare da ma'anar raguwa na ƙarshe na 1.72 mm (20.44 zuwa mm).

Dangane da ƙayyadaddun ƙaura a kowane sake zagayowar, duka kerf ɗin da ke ƙetare (hanyoyi 1 da 3) suna nuna ƙananan ƙaura: 0.27 mm don tsarin kerf ɗin da aka ketare a cikin zagaye na ƙarshe, idan aka kwatanta da 0.41 mm da 0.60 mm don daidaitaccen AO da tsarin kerf na tsaye tare da TBW na gefe, bi da bi. wannan shaida ce cewa tsarin kerf ɗin da aka ketare yana ba da ƙarfi ga karaya a ƙarƙashin kaya Wannan ita ce shaidar mafi girma na raguwar raguwa a ƙarƙashin nauyin da aka ba da tsarin Clinch fil.

Tattaunawa

Sakamakon ya nuna cewa sake daidaita fil ɗin Kirschner zuwa wani tsari mai siffar giciye nesa da sassa masu laushi da ke kewaye, amma ajiye shi a cikin jirgin sama guda (watau 5 mm a baya na gaba na patella na gaba), baya haifar da mummunan tasiri ga amincin biomechanical, amma a maimakon haka yana tasiri ga kwanciyar hankali na ƙayyadaddun fashewar ciki. Idan aka kwatanta da fil ɗin kerf na tsaye, tsarin cruciform ɗin ya bayyana yana da kyau daidaita toshewar karaya a kan tashin hankali na baya kuma yana iya ƙara damuwa mai matsa lamba a farfajiyar articular.

Waɗannan bayanan suna goyan bayan hasashen mu na farko cewa ketare fil ɗin kyphotic ba hanya ce mafi muni ba idan aka kwatanta da fil ɗin kyphotic na tsaye, kuma a zahiri, duka sifofi biyu suna aiki mafi kyau fiye da fil ɗin kyphotic na tsaye ta amfani da fil ɗin kyphotic. Hasashen mu na biyu ya kasance daidaitacce, saboda har yanzu ba a fayyace ba daga wannan binciken ko sakamakon TBW na gefe yana kama da daidaitaccen TBW.

Wannan shine binciken farko na biomechanical don nuna fifiko akan dabarar AO ta hanyar sake kimanta tsarin tiyata kawai ga TBW. Babu ƙarin farashi kuma hanya na iya zama da sauri saboda ana buƙatar ƙarancin fallasa. Yin amfani da fil ɗin kyphotic da aka ketare yana rage lalacewa ga kyallen takarda masu laushi da ke kewaye da su (musamman quadriceps da tendons na patellar). Bugu da ƙari, idan likitocin tiyata sun damu game da ingancin kayan laushi masu laushi da aka rufe da kuma hadarin fushi ko haɓakawa na gyaran ƙarfe na baya na ciki, wannan binciken ya kamata ya sake tabbatar musu cewa sanya TBW a kowane gefen patella ya guje wa wannan kuma yana inganta gyaran gaba ɗaya.

Wannan binciken ya nuna cewa sabbin fasahohin kerf ɗin kerf guda biyu sun fi ma'aunin zinare a halin yanzu da AO ke siffanta shi a cikin maganin karaya mai sauƙi.