Uburyo bushya bwo kubaga uburyo bwo gukemura ibibazo bya Patella

Ivunika rya Patellar rifite 1% mubibazo byose by’ihungabana, kandi umurongo ngenderwaho uriho wasabye uburyo bwo kubaga uburyo bwo kuvura imvune zoroheje zo mu bwoko bwa transellar hamwe no kwimura hejuru y’imitsi ni insinga ya tension (TBW), ikora nk'igikoresho cyo kwirinda igihe ubuso bwa patellar (burambuye) bwakorewe imbaraga zunamye.

Nyamara, ingorane zubu buryo zirimo gutsindira insinga imbere kunanirwa, kwandura, no gukomeretsa ibikomere. Byongeye kandi, gukoresha insinga ndende birashobora kuba ingorabahizi, cyane cyane iyo gukata no gushyingura impera yinsinga muri patellar tendon na quadriceps tendon.

Twashizeho uburyo 3 bushya bwo gukosora ibice byavunitse bya patella dukoresheje ibikoresho bimwe na TBW isanzwe.

1. Gushyira mu gishushanyo-cyumunani wumurongo wumurongo nyuma yo kwambukiranya ibipapuro bya kerf.

2. uburebure bwa Kirschner pin hamwe na bande ya tension kumpande zombi za patella.

3. yambutse imipira ya Kirschner hamwe nudushumi twa tension.

Kubwibyo, intego yubu bushakashatsi bwibinyabuzima kwari ukugereranya uburyo 3 bushya bwo gutunganya hamwe na AO zahabu ya zahabu yo guhuza insinga. 

Igitekerezo cyacu cya mbere ni uko uburinganire bwibinyabuzima bwububiko ukoresheje pin ya kerf yambutse bitagomba kwangirika. Igitekerezo cyacu cya kabiri ni uko TBW kuruhande yaba ifite ibisubizo bisa na TBW isanzwe.

Uburyo

Ivunika ryoroheje ryimyanya ndangagitsina ryaciwe na pendulum, hanyuma tekinike 3 nshya zikoreshwa muburyo bukurikiranye kumavi atandukanye kugirango barebe ko zishobora kubakwa muburyo bwerekana uburyo bwizewe kandi bwororoka bushingiye kuri anatomiya yabantu (nkuko bigaragara ku gishushanyo cya 2 nicya 3). Byose byagezweho neza. Igikoresho cyibinyabuzima cyakoreshejwe mugupima uburinganire bwibinyabuzima bwa tekinike 3 nshya.

Ibisubizo

Ibisubizo by'ibizamini byose byerekanwe ku gishushanyo cya 4 n'icya 5.

Ibisubizo byerekanye ko Iboneza hamwe nuduce duto duto two kwimura icyuho ari pine ya kerf yambutse ihujwe na TBW ikurikira (tekinike 3), hamwe no gutandukanya icyuho cyavunitse cya mm 0.43 (intera 0.10-0.80 mm) nyuma yizunguruka 100, munsi yikwirakwizwa rya mm 2.

TBW isanzwe ihujwe na pin ya kerf yambutse (tekinike 1) niyo yakurikiyeho nziza, hamwe no gutandukanya icyuho cyo kuvunika cya mm 0,61 mm (0.06 kugeza 2.06 mm).

Umutwaro washyizwe mu bikorwa wari 69.2 N. Igipimo cya AO nicyo cyari kibi cyane, hamwe no gutandukanya icyuho cya nyuma cyo kuvunika kwa mm 1,72 mm (0.47 kugeza kuri 2,24 mm) hamwe n’umutwaro washyizwe kuri 79.6 N. Igipimo cya AO cyari kibi cyane, hamwe no gutandukanya icyuho cya nyuma cyavunitse cya mm 1,72 (0,47 kugeza kuri 2,24 mm).

Kubyerekeranye no kwiyongera kwimuka kuri buri cyiciro, byombi byambukiranya kerf (tekinike 1 na 3) byerekana kwimuka bito: mm 0.27 kubintu byombi byambukiranya kerf mucyiciro cyanyuma, ugereranije na 0.41 mm na 0,60 mm kuri AO isanzwe hamwe nuburyo bwa kerf ndende hamwe na TBW kuruhande. ibi nibimenyetso byerekana ko imiterere ya kerf yambutse itanga gukomera gukomeye kumeneka munsi yumutwaro Ibi nibimenyetso byerekana ubukana bwikinyuranyo cyacitse munsi yumutwaro watanzwe na Clinch pin yubatswe.

Ikiganiro

Ibisubizo byerekana ko kwerekeza pin ya Kirschner mumiterere yuburyo bwambukiranya kure yumubiri woroshye ukikije, ariko kuyigumisha mu ndege imwe (ni ukuvuga mm 5 inyuma yubuso bwimbere bwa patella), ntabwo bigira ingaruka mbi mubutungane bwibinyabuzima, ahubwo bigira ingaruka nziza kumitekerereze yimiterere yimbere. Ugereranije na pine ndende ya kerf, imiterere yimisaraba isa nkaho ihindura neza imvune yamenetse irwanya impagarara zimbere kandi irashobora kongera imbaraga zo kwikuramo hejuru yumutwe.

Aya makuru ashyigikira hypothesis yacu ya mbere yambutse pin ya kyphotic ntabwo aribwo buryo bubi bwo kubaga ugereranije na pine ndende ya kyphotic, kandi mubyukuri, izo nzego zombi zikora neza kurusha pine ndende ya kyphotic ukoresheje pin ya kyphotic. Igitekerezo cyacu cya kabiri gikomeje kuringaniza, kuko bitarasobanuka neza muri ubu bushakashatsi niba ibisubizo bya TBW kuruhande byagereranywa na TBW isanzwe.

Ubu ni bwo bushakashatsi bwa mbere bwibinyabuzima bwerekana ko busumba tekinike ya AO mu kongera gusuzuma uburyo bwo kubaga TBW. Nta kiguzi cyinyongera kandi inzira irashobora kwihuta kuko bisabwa bike. Gukoresha pin ya kyphotic yambutse bigabanya kwangirika kwinyama zoroshye zikikije (cyane cyane quadriceps na patellar tendons). Byongeye kandi, niba abaganga bahangayikishijwe nubwiza bwimyenda yoroheje itwikiriwe hamwe ningaruka zo kurakara cyangwa kuzamuka kwimbere yimbere yimbere, ubu bushakashatsi bugomba kubizeza ko gushyira TBW kumpande zombi za patella birinda ibi kandi bigateza imbere gukosorwa muri rusange.

Ubu bushakashatsi bwerekana ko tekiniki ebyiri nshya zambukiranya kerf pin ziruta igipimo cya zahabu muri iki gihe cyasobanuwe na AO mu kuvura imvune zoroshye za patella.