Locking Plate series - distal tibial compression locking ruh plate a ni.

Locking Plate series - distal tibial compression locking ruh plate a ni.

            Distal tibial pilon fractures hi a tlem hle a, ankle vel a fracture 10% aia tlem lo a awm. Distal tibia-a soft tissue te hian soft tissue coverage tha tawk lo turin tolerance tha lo tak an nei a, hei hian fracture treatment harsatna a tipung a ni. Pilon fractures hi comminution, articular surface displacement, leh soft tissue injury neia hriat a ni. Joint congruity leh limb alignment inthlak danglam avangin fracture tam zawkah chuan surgical fixation a ngai a ni. Definitive surgical treatment chu fracture chi hrang hrang, soft tissue hliam leh damlote nena inmil tur a ni. Surgical treatment hun remchang chu hlawhtlinna kawngkhar a ni.

     

            Hliam dan tur .

High - Energy Hliam: A san zawng atanga a tlak, skiing, car accident, etc. Low - energy hliam: lei zau takah a tlu.

Tharum thawhna kawng: Axial compression; rotational shear force a ni a; Varus Shear Force tih a ni a; valgus shear force a ni.

Varus force violence:   thalaiah a tam zawk a, trauma na zawk leh high - energy injury a awm bawk. Fracture line chu sagittal plane-ah a awm a, fibula chu a awm reng fo bawk.

Valgus hian tharum thawhna a thlen a:   tarte zingah a tam zawk a, trauma na lo zawk leh energy hliam hniam zawk a awm bawk. Fracture line hi coronal plane-ah a awm a, fibular fracture nen a inzawm fo bawk.

Imaging enfiahna .

            Routine standard anteroposterior, lateral, leh mortise view x - rays of the ankle te chu an la a. Tibia full - length X - ray hian a chunga alignment leh a chunga knee joint te hi a entir thei a ni. Fracture complex zawk nei damlo thenkhat tan chuan fracture reconstruction atana reference pe turin leh pre - anatomical emaw congenital variation awm tawh te hriat theih nan contralateral limb x - rays te chu lak a ni.

            Injury mechanism hi x - rays-a fibular fracture chi hrang hrang atang hian sawi lawk theih a ni a, chu chu: compressive violence (valgus deformity), tensile violence (varus), axial loading (intact fibula) tiin an thliar hrang thei a ni. Fibula chu a intact a nih chuan a tlangpuiin severe partial intra - articular (type B) injury a ni. Axial loading injuries hian displacement tam tak a thlen lo va, distal tibia-ah axial loading tam tak a thlen a, articular surface fragment te te tam tak a awm a, articular cartilage compression secondary prognosis tha lo tak a awm bawk. Fracture fragment displacement direction chu lateral x - ray atang hian talar displacement chi (a tlangpuiin anterior displacement) tarlanna atang hian predict theih a ni.

            Pahnih - dimensional leh pathum - dimensional CT siam thar leh a pawimawh hle. Anni hian fracture comminution degree, ruh fragment awmna leh awm zat, leh displacement lam hawi zawng te an pe thei a ni.

Classification hrang hrang .

Non - surgery hmanga enkawlna .

            Distal tibial pilon fractures te chu non - surgical treatment a awm tlem hle. Indications te hi a tlem berah chuan fracture chi hrang hrang leh comorbidities nei damlote chuan surgery hmanga enkawlna an neih theihna a tipung a ni. Extra - articular fractures leh overall tibial alignment-a inthlak danglamna tlemte pawh hi operation ngai lovin plaster immobilization hmangin enkawl theih a ni bawk. A tir lamah chuan splint chu a hmin hma loh chuan 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 neih theihna turin X - ray examination kalpui zel a ngai a ni.

            Selective intra - articular fractures pawh non - surgery hmanga enkawl theih a ni bawk. Intra - articular fractures 2 mm aia tlem fracture displacement leh step - off 3 mm aia tlem lo tan chuan non - surgical treatment chu functional requirement hniam tak nei tan ngaihtuah theih a ni.

Surgical lama hriattirna te .

Surgical hun hman dan tur .

            (1) emergency treatment: dislocations tihtlem leh fixation; open fractures te; associated vascular injury te; Compartment syndrome a ni.

            (2) A hmasa ber - stage (tlem sei leh alignment siamthat): calcaneal traction; pawn lam fixation; fibular fractures tihtlem leh internal fixation, open reduction tihtlem leh posterior tibial malleolar fractures chhunga fixation te 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 conditions chu: surgical site-a hematoma absorption, fracture blisters-a epidermal regeneration, infection nei lo open fractures hliam dam, soft tissue edema subsidence, leh vun hring.

Surgical hmanga hmalakna .

            (1) Fracture line a exposure a tam thei ang bera siam.

            (2) Surgical approach tlem ber hmangin fracture zawng zawng chinfel vek tur a ni.

            (3) Soft tissue dinhmun tha lo awmna hmunte chu pumpelh rawh.

            (4) Hliam mechanism ngaihtuah rawh.

            (5) Plate dahna hmun ngaihtuah rawh.

•                     Varus deformity nei fractures tan chuan medial buttress plate thlan a ni a, anteromedial approach hman a ni bawk.

•                     Valgus deformity nei fracture atan chuan lateral buttress plate thlan a ni a, anterolateral approach hman a ni bawk.

•                     Incision pahnih inkar hi a tlem berah 5 - 7 cm a ni tur a ni.

CZMedItech atanga thil siam chhuah te .