3 Nā ʻano hana hou no ka hoʻoponopono ʻana i nā haʻihaʻi o Patella

ʻO nā haʻihaʻi Patellar he 1% o nā hihia trauma āpau, a ʻo ke alakaʻi i kēia manawa i ʻōlelo ʻia i ke kaʻina hana ʻokiʻoki no ka mālama ʻana i nā haʻihaʻi patellar transverse maʻalahi me ka neʻe ʻana o ka ʻaoʻao articular, ʻo ia ka tension band wire (TBW), e hana ana ma ke ʻano he mea antitension ke hoʻokau ʻia ka patellar (stretched) i nā ikaika kulou.

Eia nō naʻe, ʻo nā pilikia o kēia kaʻina hana e pili ana i ka hiki ʻole o ka hoʻoponopono ʻana i loko, ka maʻi, a me ka dehiscence ʻeha. Eia kekahi, hiki i ka hoʻohana ʻana i nā uea longitudinal ke paʻakikī loa, ʻoiai ke ʻoki a kanu ʻana i ka hope o ka uea i loko o ka tendon patellar a me quadriceps tendon.

Ua hoʻolālā mākou i nā ʻenehana hou 3 no ka hoʻoponopono ʻana i nā haʻihaʻi patella transverse me ka hoʻohana ʻana i nā mea like me ka TBW maʻamau.

1. ka hoʻohana ʻana i kahi hui hoʻopaʻapaʻa uea kiʻekiʻe ma hope o ke kalaiwa ʻana i nā pine kerf.

2. nā pine Kirschner lōʻihi a me nā kaula hoʻopaʻapaʻa ma nā ʻaoʻao ʻelua o ka patella.

3. nā pine Kirschner a me nā kaula hoʻopaʻapaʻa ʻaoʻao.

No laila, ʻo ke kumu o kēia noiʻi biomechanical ʻo ia ka hoʻohālikelike ʻana i nā ʻano hana hoʻoponopono hou 3 me ke kūlana gula AO o ka hoʻopaʻa ʻana i ka uea. 

ʻO kā mākou kuhiakau mua, ʻaʻole pono e hōʻino ka pono biomechanical o nā hale e hoʻohana ana i nā pin kerf crossed. ʻO kā mākou kuhiakau ʻelua e loaʻa nā hopena like me ka TBW maʻamau.

Nā ʻano hana

Ua ʻoki ʻia ka haʻihaʻi patellar transverse maʻalahi me kahi ʻike pendulum, a ua hoʻohana ʻia nā ʻenehana hou 3 i ka hoʻokaʻawale ʻana i nā kuli e hōʻoia i hiki ke kūkulu ʻia i ke ʻano e hōʻike ana i kahi kaʻina hana palekana a hana hou ʻia e pili ana i ke anatomy kanaka (e like me ka hōʻike ʻia ma nā Kiʻi 2 a me 3). Ua hoʻokō pono ʻia nā mea a pau. Ua hoʻohana ʻia kahi mea hana biomechanical e hoʻāʻo i ka pono biomechanical o nā ʻenehana hou 3.

Nā hualoaʻa

Hōʻike ʻia nā hopena o nā hoʻokolohua āpau ma nā Kiʻi 4 a me 5.

Ua hōʻike ʻia nā hualoaʻa ʻO ka hoʻonohonoho me ka liʻiliʻi loa o ka hoʻoneʻe ʻana i nā awāwa haʻihaʻi, ʻo ia nā pine kerf i hui ʻia me ka lateral TBW (technique 3), me ka mean fracture gap displacement o 0.43 mm (mahele 0.10-0.80 mm) ma hope o 100 cycles, ma lalo o ka neʻe nui ʻana o 2 mm.

ʻO ka TBW maʻamau i hui pū ʻia me nā pine kerf crossed (technique 1) ʻo ia ka mea maikaʻi loa aʻe, me ka mean fracture gap displacement o 0.61 mm (0.06 a 2.06 mm).

He 69.2 N ka haawe i hoʻohana ʻia. ʻO ka maʻamau AO ka mea ʻino loa, me ka neʻe ʻana o ka haʻihaʻi hope loa o 1.72 mm (0.47 a i ka 2.24 mm) a me ka haʻahaʻa haʻahaʻa o 79.6 N. ʻO ka maʻamau AO ka ʻoi loa, me ka mean o ka haʻihaʻi hope loa o 1.0.472 mm o ka haʻihaʻi hope loa (0.472 mm).

Ma ke ʻano o ka hoʻoneʻe ʻana i kēlā me kēia pōʻai, ua hōʻike nā hale kerf ʻelua (ʻenehana 1 a me 3) i nā neʻe liʻiliʻi: 0.27 mm no nā hale kerf i hala i ka pōʻai hope, i hoʻohālikelike ʻia me 0.41 mm a me 0.60 mm no ka AO maʻamau a me ka hale kerf longitudinal me TBW lateral. He mea hōʻike kēia i ka ʻoi aku o ka ʻoi aku o ka ʻoi aku o ka ʻoi aku o ka ʻoi aku o ka ʻoi aku o ka ʻoi aku o ka haʻi ma lalo o ka ukana.

Kūkākūkā

Hōʻike nā hopena i ka hoʻonohonoho hou ʻana i ka pine Kirschner i kahi ʻano keʻa mai nā ʻiʻo palupalu a puni, akā mālama ʻia i ka mokulele hoʻokahi (ʻo ia hoʻi, 5 mm ma hope o ka ʻili convex mua o ka patella), ʻaʻole ia e hoʻopilikia i ka pono biomechanical, akā e hoʻopilikia maikaʻi i ka paʻa o ka hoʻoponopono ʻana i ka haki. Ke hoʻohālikelike ʻia me nā pine kerf longitudinal, ʻoi aku ka maikaʻi o ka hoʻokumu ʻana o ke cruciform e hoʻopaʻa maikaʻi i ka poloka haʻihaʻi e kūʻē i ka haʻalulu mua a hiki ke hoʻonui i ke koʻikoʻi compressive ma ka ʻili articular.

Kākoʻo kēia mau ʻikepili i kā mākou kuhiakau mua ʻaʻole i ʻoi aku ka maikaʻi o ke kaʻina hana ʻoi aku ka maikaʻi o nā pine kyphotic ma mua o nā pine kyphotic longitudinal, a ʻoiaʻiʻo, ʻoi aku ka maikaʻi o nā hale ʻelua ma mua o nā pine kyphotic longitudinal me ka hoʻohana ʻana i nā pine kyphotic crossed. Ke kaulike nei kā mākou kuhiakau ʻelua, no ka mea, ʻaʻole maopopo ia mai kēia haʻawina inā e hoʻohālikelike ʻia nā hopena o ka TBW lateral me TBW maʻamau.

ʻO kēia ka noiʻi biomechanical mua e hōʻike i ke kūlana kiʻekiʻe ma mua o ka ʻenehana AO ma o ka loiloi hou ʻana i ke ala ʻokiʻoki i TBW. ʻAʻohe kumu kūʻai hou a ʻoi aku ka wikiwiki o ke kaʻina hana no ka mea ʻoi aku ka liʻiliʻi o ka ʻike. ʻO ka hoʻohana ʻana i nā pine kyphotic crossed e hōʻemi i ka pōʻino i nā ʻiʻo palupalu a puni (ʻo ka nui o nā quadriceps a me nā tendon patellar). Eia kekahi, inā hopohopo nā kauā i ka maikaʻi o nā ʻiʻo palupalu i uhi ʻia a me ka pilikia o ka huhū a i ʻole ka puka ʻana o ka hoʻoponopono kūloko metala mua, pono e hōʻoia kēia haʻawina iā lākou ʻo ka waiho ʻana i ka TBW ma kēlā ʻaoʻao kēia ʻaoʻao o ka patella e pale i kēia a hoʻomaikaʻi i ka hoʻoponopono holoʻokoʻa.

Hōʻike kēia haʻawina i ʻelua mau ʻenehana pin kerf hou i ʻoi aku ka maikaʻi ma mua o ke kūlana gula i wehewehe ʻia e ka AO i ka mālama ʻana i nā haʻihaʻi patella transverse maʻalahi.