Suprapatellar Kusvika Tibial Nail

Suprapatellar Svika Tibial Nail: A Comprehensive Guide

Kuputsika kwetibia kunowanzokuvadzwa kunowanzoda kupindira kwekuvhiya. Imwe yenzira dzakakurumbira dzekuvhiya ndeye kushandiswa kwe intramedullary misumari. Iyo suprapatellar approach tibial nail inyanzvi yakawana mukurumbira mumakore achangopfuura nekuda kwezvakanaka zvayo zvakawanda. Muchikamu chino, tichakurukura nezve suprapatellar nzira yetibial nail zvakadzama, kusanganisira zvakanakira, zviratidzo, maitiro ekuvhiya, post-operative management, uye zvinogona kuitika.

Zviri Mukati

1. Nhanganyaya

2. Anatomy yeTibia

3. Zviratidzo zveSuprapatellar Nzira yeTibial Nail

4. Zvakanakira Suprapatellar Nzira Tibial Nail

5. Pre-operative Kugadzirira

6. Kuvhiya Technique yeSuprapatellar Nzira yeTibial Nail

7. Post-operative Management

8. Zvinogona Kunetsa

9. Kuenzanisa nemamwe Matekiniki

10. Mhedziso

11. FAQs

1. Nhanganyaya

Iyo tibia ndeimwe yeanowanzo kuputsika mapfupa marefu mumuviri. Kuputsika kwetibia kunowanzoda kupindira kwekuvhiya nekuda kwehuwandu hwemalunion uye husina kubatana. Intramedullary zvipikiri zvave chiyero chegoridhe chekurapa tibial fractures nekuda kwezvakanakira zvakawanda, kusanganisira kugadzikana kwakagadziridzwa uye nekukurumidza kupora nguva.

Iyo suprapatellar approach tibial nail inyanzvi yakawana mukurumbira mumakore achangopfuura nekuda kwezvakanaka zvayo zvakawanda pane mamwe maitiro. Ichi chinyorwa chine chinangwa chekupa gwara rakazara kune suprapatellar nzira tibial mbambo.

2. Anatomy yeTibia

Usati wakurukura nezve suprapatellar nzira yetibial nail, zvakakosha kuti unzwisise anatomy yetibia. Tibia ndiyo hombe pamapfupa maviri marefu ari mugumbo rezasi uye inotakura huremu hwakawanda hwemuviri. Mugumo wepedyo wetibia unotaura nefemur kuti ugadzire mabvi akabatanidzwa, apo kuguma kwekupedzisira kunopindirana nefibula uye talus kuti iite chitsiko chemakumbo.

Iyo tibia ine intramedullary canal inofamba nekureba kwayo. Iyo canal yakakura kumagumo uye inotetepa yakananga kure kure. Iyi canal ndipo panopinzwa mbambo ye intramedullary.

3. Zviratidzo zveSuprapatellar Nzira yeTibial Nail

Iyo suprapatellar nzira yetibial nail inoratidzirwa kurapwa kweakasiyana tibial fractures, kusanganisira:

• Distal yechitatu tibial fractures

• Proximal tibial fractures

• Tibial shaft fractures

• Oblique fractures

• Spiral fractures

• Mafractures akabatanidzwa

• Zvimedu zvine cortical defect yakakosha

4. Zvakanakira Suprapatellar Nzira yeTibial Nail

Iyo suprapatellar nzira yetibial nail inopa akati wandei mabhenefiti pane mamwe matekiniki, anosanganisira:

• Kuvandudzwa kwekuputsika: Iyo suprapatellar nzira inobvumira kutaridzika zviri nani kwenzvimbo yekuputsika, iyo inotungamirira kukudzikisira kuderedzwa kwekuputsika.

• Kuderedza kurasikirwa kweropa: Nzira ye suprapatellar inosanganisira zvishoma zvinyoro zvinyoro dissection, zvichiita kuti kuderedza kurasikirwa kweropa panguva yekuvhiyiwa.

• Kuderedza ngozi yehutachiona: Nzira ye suprapatellar inoderedza dambudziko rehutachiona nekudzivisa mabvi akabatanidzwa, iyo inogona kukonzera utachiona.

• Kuderedza ngozi yekukuvara kwepatellar tendon: Iyo suprapatellar nzira inodzivirira patellar tendon, kuderedza dambudziko rekukuvara kune ichi chakakosha chimiro.

• Kukurumidza kupora: Varwere vanopinda suprapatellar vanosvika tibial nail kuvhiyiwa vanowanzopora nekukurumidza uye vane nguva pfupi yekugara muchipatara kana vachienzaniswa nevaya vanopinda mamwe maitiro.

5. Pre-operative Kugadzirira

Vasati vaitwa suprapatellar nzira yekuvhiya zvipikiri, varwere vanozowanzoita akati wandei pre-operative gadziriro. Izvi zvinosanganisira nhoroondo yezvokurapa yakakwana, kuongorora muviri, uye zvidzidzo zvekufungidzira zvakadai se-X-rays, CT scans, kana MRI scans kuti iongorore huwandu uye nzvimbo yekuputsika.

Varwere vanogona zvakare kuongororwa ropa vasati vavhiyiwa uye zvimwe zvidzidzo zvemurabhoritari kuti vaone hutano hwavo hwese uye kuona chero mamiriro ezvehutano agara aripo anogona kukanganisa kuvhiyiwa kwavo nekupora.

Zvakakosha kuti varwere vazivise chiremba wavo wemishonga chero ipi zvayo yemishonga yavanenge vachitora, kusanganisira pamusoro pe-the-counter mishonga uye kuwedzera, sezvo mamwe mishonga inogona kudiwa kuregedzwa vasati vavhiyiwa nekuda kwengozi yekubuda ropa kana zvimwe zvinetso.

Varwere vanogonawo kurairwa kurega kusvuta uye kudzivisa doro mumavhiki anotungamirira kuvhiyiwa, sezvo zvinhu izvi zvinogona kukanganisa nzira yekuporesa uye kuwedzera njodzi yezvinetso.

6. Nzira yekuvhiya yeSuprapatellar Nzira yeTibial Nail

The suprapatellar approach tibial nail kuvhiyiwa kunowanzoitwa pasi peanesthesia yakawanda uye inogona kutora maawa akawanda kuti ipedze. Nzira yekuvhiya inosanganisira matanho anotevera:

1. Murwere anoiswa patafura yekushanda munzvimbo ye supine, negumbo rakakanganiswa rakasimudzwa uye rinotsigirwa nemubati wegumbo.

2. Kuchekwa kudiki kunoitwa muganda pamusoro pe patella, uye waya yekutungamira inopinzwa mukati meganda uye mu intramedullary canal yetibia.

3. Reamer inoshandiswa kugadzira mugero wekupinzwa kwembambo.

4. Chipikiri chinobva chapinzwa kuburikidza nekuchekwa uye kutungamirirwa mugero uchishandisa fluoroscope.

5. Kana chipikiri chave panzvimbo, zvipikiri zvekukiya zvinopinzwa nepachipikiri uye mubhonzo kuti zvichengetedzeke panzvimbo.

6. Kuchekwa kunobva kwavharwa, uye gumbo racho harina kufamba uchishandisa cast kana brace.

7. Post-operative Management

Kutevera suprapatellar nzira yetibial nail kuvhiyiwa, varwere vanowanzopedza mazuva akati wandei muchipatara kuti vatarise uye kugadzirisa marwadzo. Vanozorairwa kuchengeta gumbo rakabatwa rakasimudzwa uye kudzivisa kuisa uremu pairi kwemavhiki akati wandei.

Varwere vachapihwawo maekisesaizi ekuita kubatsira kusimbisa mhasuru dzakatenderedza ibvi uye kudzivirira kuoma. Physical therapy inogonawo kukurudzirwa kubatsira varwere kuti vadzoke zvakakwana zvekufamba uye simba mugumbo rakakanganiswa.

Varwere vachapihwa mishonga yemarwadzo nemishonga inorwisa mabhakitiriya sezvinodiwa kugadzirisa marwadzo nekudzivirira utachiona. Mamiriro ekutevera acharongwa kuti atarise maitiro ekuporesa uye kuongorora chero matambudziko.

8. Zvinetso zvinogona kuitika

Sezvinoita chero kuvhiyiwa, kune njodzi dzinogona kuitika uye matambudziko anoenderana ne suprapatellar nzira yekuvhiya zvipikiri. Izvi zvinogona kusanganisira:

• Utachiona

• Kubuda ropa

• Kukuvadzwa kwetsinga

• Ropa rinogwamba

• Kunonoka kupora

• Kwete-mubatanidzwa kana malunion yekuputsika

• Hardware kutadza

Zvakakosha kuti varwere vakurukure njodzi idzi nachiremba wavo uye vatevedzere zvese pre-uye post-operative mirairo kuti kuderedze njodzi yematambudziko.

9. Kuenzanisa nemamwe Matekiniki

Iyo suprapatellar nzira yetibial nail ndeimwe yemaitiro akati wandei anoshandiswa kurapa tibial fractures. Mamwe maitiro anosanganisira infrapatellar approach tibial nail, retrograde tibial nail, uye ndiro uye screw fixation.

Nepo imwe neimwe nzira ine zvayakanakira nezvayakaipira, iyo suprapatellar nzira yetibial mbambo inopa zvakati wandei zvakanakira, kusanganisira yakagadziridzwa kuderera kwekupwanyika, kuderedzwa kurasikirwa kweropa, uye kuderedzwa kwengozi yehutachiona uye patellar tendon kukuvara.

10. Mhedziso

Iyo suprapatellar nzira yetibial nail inzira yakakurumbira yekuvhiya yekurapa tibial fractures. Inopa mabhenefiti akati wandei pane mamwe maitiro, anosanganisira kunatsiridza kutsemuka kwekutsemuka, kuderedza kurasikirwa kweropa, uye kuderedzwa kwengozi yehutachiona uye patellar tendon kukuvara.

Zvisinei, sekuvhiyiwa kupi zvako, kune njodzi dzinogona kuitika uye matambudziko, uye zvakakosha kuti varwere vanyatsofunga nezvezvavanosarudza uye vokurukura nezvavo nachiremba wavo kuti vaite sarudzo ine ruzivo.

11. FAQs

1. Inguva yakareba sei iyo suprapatellar inosvika tibial nail kuvhiyiwa inotora?

   
   

   Kuvhiya kunowanzotora maawa akawanda kuti kupere.

   
   

2. Zvinotora nguva yakareba sei kuti apore kubva kune suprapatellar nzira yetibial nail kuvhiyiwa?

   
   

   Nguva yekudzorera inogona kusiyana zvichienderana nekukura kwekutyoka uye kugona kwemurwere wega wega, asi zvinotora mwedzi yakati wandei kuti pfupa rinyatsopora.

   
   

3. Ndeipi chiyero chekubudirira kwe suprapatellar nzira yetibial nail kuvhiya?

   
   

   Kubudirira kwekuvhiyiwa kunowanzo kukwirira, asi kunogona kusiyana zvichienderana nemamiriro ezvinhu emurwere mumwe nomumwe uye kukura kwekuputsika.

   
   

4. Ndichada kurapwa kwemuviri mushure me suprapatellar nzira tibial mbambo kuvhiyiwa?

   
   

   Kurapa kwepanyama kunogona kukurudzirwa kukubatsira kuti uwanezve huwandu hwakazara hwekufamba uye simba mugumbo rakakanganiswa.

   
   

5. Pane here dzisiri dzekuvhiya sarudzo dzekurapa tibial fractures?

   
   

   Mune zvimwe zviitiko, zvisarudzo zvisiri zvekuvhiya zvakadai sekukanda kana kuputika zvinogona kushandiswa kurapa tibial fractures, asi izvi zvinoenderana nemamiriro ezvinhu omurwere.