Kayan aikin na TiBia na duniya na duniya suna sunan 2025 manyan 6 m

Distal tibial IntraLary Nail (DTN)

Suprapatellar ta kusanci ƙusa na intra

Kwararre Tibia Intramedulyullory Nail

1.Proximal oblique yanke

Wurin yankan yankan da aka yanke a cikin wakili na gaba daya yana hana haushi ga Perellar Lagubati.

2. Tsarin Kulle Kulle

Tsarin kulle na kulle kusa yana ƙara yanayin da ake so don tsarin kusancin.

3. Distal kulle

Zaɓin Kulla na Kulle na Oblique don hana lalacewa mai laushi da kuma karuwa mai cike da kwanciyar hankali.

4. Biyu Dandalin zaren

Kulle dunƙule da aka tsara tare da zaren jagora sau biyu don shigowa da sauki.

Kulle kayan aiki

Tsarin Kulle don gyararru mai ƙarfi, rage radiyo mai amfani.

Tallafin da yawa

Pointsungiyoyin gyaran gyaran da yawa suna ba da kwanciyar hankali da tallafi mai barga ga Palteau na Tibal.

Matakai matakai

Na'urar tana da fasali mai daidaitawa aikin gyara, tare da canje-canje na ilimin cututtukan cututtukan cututtukan cututtukan cututtukan da aka nuna a cikin misalai a ƙarƙashin abubuwan da aka riga aka gabatar dasu duka biyu (jihar kwance) da kuma mawuyacin hali) da yanayin aiki.

Mafi kusa-distal gyarawa

Hanya mai gyara da yawa daga wakili da na nesa, yana nuna ƙarin ƙarfin gwiwa da karkatarwa na Tibal.

Tsarin lebur don sauƙaƙawa

Matsakaicin ƙarshen ƙusa yana da zane mai laushi, yana sauƙaƙe shigar da sauƙi a cikin rami na Medullary.

Kwace kulle-kulle

Kwataye na kulle biyu na undrular a ƙarshen akidar hana juyawa da kuma gudun hijira na sashin karaya.

Curvatical curvature

Wani muhimmin tsarin cura na Anatmical yana tabbatar da babban ƙusa an ɗora shi a cikin rami na Medullary.

Ruraye kusurwa kusurwa

Kwataye uku na kewayawa kusurwa na kusurwa uku a ƙarshen ƙarshen yana ba da tallafi mai tasiri da gyarawa.

Askar:

Ya dace da yawancin fashewar tafin (mishaft da kuma wasu tsoratarwa / enshimal cractal), yayin da sauran nau'ikan (misali, DTN ko ƙiren ƙwararru) don takamaiman yankuna masu rikitarwa ko tsararren rauni.

Hankali na tarko:

Standardara daidaitaccen tsarin (fasali ko transpatelar) ya bi hanya mai kyau tare da ƙananan ilmantarwa, yayin da keɓaɓɓen hanyoyi (misali, supratellar) na buƙatar ƙarin horo na fasaha.

Ingantacce:

Idan aka kwatanta da ƙusoshin ƙusa kamar ƙwararren ƙusa ko DTN, daidaitattun ƙusoshin ƙusoshin da ke motsa jiki suna iya ƙara araha, sa su dace da yanayin yau da kullun.

Karfinsa mai yawa:

Mai jituwa tare da kayan aiki na duniya (misali, kulle-kullewa, na'urorin da aka shirya), yayin da ƙusoshin ƙwararru (misali, ƙwararrun kusoshi) na iya buƙatar kayan aikin mallaka.

1. Shirya shirye-shirye

Hoto Evaluation: Preolesative X-ray / CT don tabbatar da karaya, Canal Canal Diamia da tsawon, tare da ma'aunin Tibiya Tibia a matsayin maimaitawa.

Matsayi: Supine matsayi tare da lebe na gwiwa 90 ° -120 ° kuma kadan kari (don rage tashin hankali na Tashar Tefenson). Tsarin Radiolular na Triangular na iya tallafawa Fossa Popliteal Fossa don gogewa.

Bakararre drapping: Standard reshe haifuwa sterig da kuma sauyawa, tabbatar da C-ADVOVOVOVOVorm izuwa.

2. Rage ragewa

Fasahar rage

Travection Traction: Mataimakin kayan aiki mai kyau yayin tiyata palpates tibial crest da anteromedial surfation don daidaita jingina (tsawon, juyawa, rotation).

Kayan aiki da kayan aiki:

• Joystick Dogulan: Skhanz Scran da aka saka cikin dabarun / karkatarwa na raguwa don raguwa.

• Percutaneatus clmping: Fadakarwa na Rage karfi don OBLILE / Kurace Karaya.

• Mai rarrafe: babban dractor da aka sanya a jiki (wakilai Schanz dunƙule, filin wasan Filato, na kusa da talus) don kula da tsayi.

3. Takaddun shigowa

Alamomin ƙasa:

• Fitowa na 1cm Distal zuwa gefen tibial na ƙasa mai yawa, wanda aka haɗa tare da medullary axis.

• Tabbatar da Tabbatarwa: Duba AP Aligns tare da Tibal Creast, a kaikaice Duba daidaici Thial Ageis.

Kayan buɗe kayan aiki:

• Wurin da aka yi akan jagora (tare da suturar kariya) ko mai laushi mai rauni.

• RAYUWA (6-8mm) don tsohuwar karaya tare da daskarewa.

4. Jagora Servion & Sake

Jagora Jaka: Ball-Tipped Bet Dot 10-15mm a tip don tashe rabuwa. Tabbatar da tabbaci a Distal Physeal Scar (IFKLE).

Reaming Protocol:

• M reals farawa a 8mm, insion 0.5mm har cortical 'Chatter ' (yawanci 1-1.5mm> ƙusa diamita).

• SAURARA: Kogin da ke haifar da tarkace; Guji binciken da yake ciki.

5. Batun ƙusa

Tsawon Tsawon Tsaro:

• Matsayi na ciki: Jagora Jagora ya mamaye hanyar ko kuma Mulkin Kulawa (Motoci zuwa Ankle hadin gwiwa).

• Tabbatar da ƙaili na ƙaili ya isa FimySeal Scar ba tare da tilastawa wakili ba.

Fayilolin Saka:

• Hannu-ci gaba akan Jagora; Daidaita raguwa idan juriya na faruwa.

• Rage raguwa yayin nassi don rabuwa.

6. Kafaffen dunƙule

Tsarin dabarun

• Rage-tsawan tsawan tsinkaye: makullin makullin farko (dunƙulen guda yana ba da izinin wayewa).

• Tsawon-tsawan tsawan-rashin ƙarfi / compinting na kwatsam: na farko da farko ya biyo bayan 'Backslap ' don damfara.

Kulle makullin

• ≥2 sukurori via na Na'urar (Multidirectional don kusurwar karaya).

Kwance kulle

• Furrooscopic dabara: katako mai tsayi na tsakiya na dunƙule don dunƙule ( 'cikakken da'irar '), hakowar cirewa.

• ≥2 sukurori don rarraƙƙarfan karaya (na iya haɗuwa da abubuwan da aka tsara na AP / Oblique).

7. Hanyoyi na ƙarshe

Endarshen CAP: Saukewa na ƙarshe (yana hana bony Farrowth), tabbatar da babu daidaituwar haɗin gwiwa.

Rikick da rauni: Patellarin jijiya patellarin gyara tare da kwance subcutanes.

8. Gudanarwa na baya

Da wuri da safiyar yau:

• Mafiya haye; Saka idanu don maganin karawaitar tsakanin 24hrs.

• Fara aiki hadin gwiwar haduwa mai aiki (famfo na gwiwa, daskararru) akan pod 1-2.

Protocol mai nauyi-kai:

• M-ɗaukar nauyi na makonni shida (gyara kowace kwanciyar hankali), ci gaba da cika lokacin da kira ya bayyana.

Biyo: Clinical / Radiolan kimantawa a 2, 6, da makonni 12.