A rilru a buai em em a, a rilru a hah em em bawk a. Locking Plate Series - Distal Tibial Compression Locking Bone Plate
Distal tibial Pilon fracture hi a tlem hle a, ke ruh vel a fracture zinga 10% aia tlem lo a ni. Distal tibia-a soft tissue te hian soft tissue coverage tling lo chu an tuar thei lo a, hei hian fracture enkawlna harsatna a tipung a ni. Pilon fracture hi comminution, articular surface displacement, leh soft tissue injury avanga hriat a ni. Joint congruity leh limb alignment a inthlak avangin fracture tam zawkah chuan surgical fixation a ngai thin. Definitive surgical treatment hi fracture chi hrang hrang, soft tissue hliam, leh damlote tan a inmil tur a ni. Surgery hmanga enkawlna hun remchang hi hlawhtlinna kawngkhar a ni.
Anatomical Features te chu a awm
Pilon fracture-ah hian metaphyseal fragment a awm a, a chang chuan diaphyseal fragment pawh a tel bawk. Tin, ruh (joint depression) leh comminuted fractures te pawh a awm bawk. Ruh chi hrang hrang pathum a awm fo thin a, chungte chu anterolateral fragment, medial malleolar fragment leh posterolateral fragment te an ni.
Joint comminution awmna hmun tlangpui pathum a awm a: Lateral comminution hi anterolateral leh posterolateral fragment inkarah a awm a, a tlangpuiin fibula bulah a awm thin. Central comminution hi free bone fragment emaw posterolateral fragment compression emaw angin a lang thei. Medial comminution hian medial fragment thenkhat emaw medial malleolus bula compression emaw a huam a ni.
Comminution hi fracture line inzawmkhawmna hmunah a thleng tlangpui. Fracture fragment lian pathum zinga pakhat zel chu comminuted a ni thei a, fracture line dang pawh a awm thei bawk. Ankle blood vessels venhim a pawimawh hle. Soft tissue te hi uluk taka enkawl tur a ni a, a tul hunah chauh retract tur a ni a, chu chuan hliam - damna lama harsatna a awm loh nan. Fracture fragment te hi stripping tam lutuk hi tih loh tur a ni a, chu chu avascular necrosis a awm loh nan a ni.
Hliam tuar dan tur
High - energy injuries: Hmun sang atanga tlak, skiing, car accident, etc. Low - energy injuries: Lei zau takah tlu.
Tharum thawhna lam hawi: Axial compression; Rotational shear force a ni a; Varus shear chakna a ni a; Valgus shear force a ni.
Varus force violence: Thalai zingah a tam zawk a, trauma na zawk leh high - energy injuries an nei tam zawk. Fracture line hi sagittal plane-ah a awm a, fibula pawh a intact fo thin.
Valgus force violence: Tarte zingah a tam zawk a, trauma na lo zawk leh low - energy injuries an nei. Fracture line hi coronal plane-ah a awm a, fibular fracture nen a inzawm fo thin.
Imaging Examination hrang hrang neih a ni
Routine standard anteroposterior, lateral, leh mortise view X - rays te chu ke ruh atanga lak a ni. Tibia full - length X - ray hmangin alignment leh a chunga khup joint chu a lang thei. Fracture complex zawk nei damlo thenkhat tan chuan fracture reconstruction atana reference siam nan leh pre - existing anatomical or congenital variations hmuhchhuah nan contralateral limb X - ray lak thin a ni.
X - rays-a fibular fracture chi hrang hrang aangin hliam awm dan hi hriat theih a ni a, hetiang hian thliar hran a ni: Compressive violence (valgus deformity), Tensile violence (varus), Axial loading (intact fibula). Fibula a awm loh chuan a tlangpuiin partial intra - articular (Type B) hliam na tak a ni. Axial loading injuries hian displacement tam tak a thlen lo nain distal tibia-ah axial loading tam tak a awm a, articular surface fragment te te tam tak a awm a, articular cartilage compression avanga secondary prognosis tha lo a awm bawk. Fracture fragment displacement kalna tur chu talar displacement chi hrang hrang (a tlangpuiin anterior displacement) tarlanna lateral X - ray atang hian hriat theih a ni.
Two - dimensional leh three - dimensional CT reconstruction hi a pawimawh hle. Anni hian fracture comminution degree, ruh chi hrang hrang awmna leh a awm zat, leh a inthlakna lam te pawh an pe thei a ni.
A rilru a buai em em a, a rilru a hah em em bawk a. Distal Lateral Fibular Locking Plate
VA Distal Medial Tibia Locking Plate hmanga siam a ni
Classification hrang hrang
AO/OTA Fracture - Dislocation chi hrang hrang
Extra - articular Type A fractures hi a tlangpuiin a awlsam hmel hle a, mahse soft tissue hliam nasa tak nen a inzawm thei. Typical partial intra - articular Type B fracture-ah hian articular comminution a awm a, intra - articular fragment tihtlem nan buttress plate a ngai a ni. Complete intra - articular Type C fractures hian tibio - talar joint tihchhiatna, distal tibio - fibular syndesmosis, fibular fractures, leh tibial metaphyseal fractures te nena inzawm high - energy injuries a kawk a, soft tissue hliam na tak tak nen a inzawm tlangpui.
Ruedi - Allgower chi hrang hrang
Type I: 'T' - ang chi split fracture, displacement lian tham awm lo.
Type II: Articular surface a inthen a, fracture line chu a inthlak danglam tih a chiang a, a comminution pawh a tlem hle.
Type III: Distal tibial articular surface leh metaphysis-a comminuted leh compressive fracture na tak tak a awm.
Non - surgical Enkawlna a ni
Distal tibial Pilon fracture te hi non - surgical treatment hi a awm lo. Indication te hi minimally displaced fracture type leh comorbidities nei damlo te an ni a, chu chuan surgical treatment risk a tipung a ni. Extra - articular fracture, tibial alignment pum puia inthlak danglamna tlemte chauh awm pawh hi operation tel lovin plaster immobilization hmangin enkawl theih a ni bawk. A tirah chuan a hring a reh hma loh chuan splint an hmang a, chutah chuan plaster cast an hnawih leh thin. Tibial emaw articular surface alignment-a inthlak danglamna nasa tak chuan limb alignment leh stability-ah harsatna a thlen thei a ni. Joint congruity leh limb alignment a awm theih nan X - ray enfiah chhunzawm zel a ngai a ni.
Selective intra - articular fractures pawh hi non - surgically hmanga enkawl theih a ni bawk. Intra - articular fracture fracture displacement mm 2 aia tlem leh step - off mm 3 aia tlem nei tan chuan functional requirement hniam tak takte tan non - surgical treatment ngaihtuah theih a ni.
Surgery hman dan tur
Articular surface step - off 2 mm aia tam.
Valgus angulation 5° aia tam a ni.
Varus angulation eng pawh.
Open fractures a awm.
Compartment natna (Compartment) natna (Compartment syndrome) a ni.
Vascular hliam a awm.
Hliam tam tak a awm.
Surgery hun hman dan tur
(1) Emergency treatment: Dislocations tihtlem leh fixation; Open fractures a awm a; A kaihhnawih vascular injury te; Compartment natna (Compartment) natna (Compartment syndrome) a ni.
(2) Pakhatna - stage (Kha leh sa sei zawng leh alignment siamthat): Calcaneal traction; Pawn lam atanga fixation; Fibular fracture tihtlem leh chhungril lama fixation, open reduction limited leh posterior tibial malleolar fracture chhunga fixation; Thrombus laka invenna.
(3) Second - stage: Ni 10 - 14 vel hnuah tibial fracture chu open reduction leh internal fixation a ni.
(4) Second - stage surgery atana soft tissue condition te chu: Surgery neihna hmuna hematoma absorption, fracture blisters-a epidermal regeneration, infection awm lovin open fracture hliam dam, soft tissue edema subsidence, leh vun hrual.
Surgery hmanga tih dan tur
(1) Fracture line exposure chu a tam thei ang ber siam rawh.
(2) Surgery approach tlem ber hmangin fracture zawng zawng chinfel vek tur.
(3) Soft tissue dinhmun tha lo awmna hmun chu pumpelh tur a ni.
(4) Hliam tuar dan tur ngaihtuah rawh.
(5) Plate dahna hmun ngaihtuah rawh.
Varus deformity nei fracture tan chuan medial buttress plate thlan a ni a, anteromedial approach hman a ni.
Valgus deformity nei fracture tan chuan lateral buttress plate thlan a ni a, anterolateral approach hman a ni.
Incision pahnih inkar hlat zawng chu cm 5 - 7 tal a ni tur a ni.
CZMEDITECH thil siam chhuah te
