Tibial kupwanya, Suprapatellar Intramedullary Nailing Technique

Intramedullary Tibial Nailing: Kuwana uye kuwirirana, Anterior Kukara Kurwadziwa

Maitiro ekuvhiya kune intrameduutery nailing of tibial fractures yakakosha kuitira kuti isa chipikidzo chepfungwa, kuti udzikise kupfuudza kwechidimbu, uye kuzadzisa kupfupika nekupokana nekupinda namaira.

Nzira dzekare dzeTem Stem Fractures ndirwo renji rehunyanzvi kana Infrapetallar Parapetallar. Kunyangwe aya mafambiro akaratidzirwa pakati pemativi emukati, post elguus, anterior, kana kusanganiswa deformitions kazhinji kunoitika mune zvimwe zvikamu zveProximal.

Chikonzero chikuru cheMalagmment muProximal tibiel fractures inokonzerwa nekukwevera kweiyo quadriceps nebvi rekupindirana pakati pechidimbu chechipfuva Cortic Iyo Patella zvakare inodzivirira axial nail nail kupinda mune iyo Sagittal ndege (Fig. 1a, b). Naizvozvo, imwe nzira yakajairika yekuwana iyo poindi iri kuburikidza neyekufunga kwepadonyepedzera, iyo inotungamira kune zvishoma medial kuenda kuLateral nail Kuisa (maonde. 1c na 2). Sezvo chipikiri chinopinda mumatare emukati mernal Pakupedzisira, kushushikana kwekuzorora kweiyo anterior compartment mhasuru inopa zvishoma kualgus (Mufananidzo 3).

Mufananidzo 1 A, B Uchishandisa nzira yekunyanyisa yekurapa, patella inodzivirira kupinda kwechipikiri, zvichikonzera kuremara kwakajairika kweanorema eAnagittal alignment nealgus coronal alignment. c uchishandisa iyo parapatellar maitiro ekutenderera chipikiri chipikiri.

Mufananidzo 2 uchisvika iyo yekupinda nzvimbo kuburikidza neyekupinda mindapatellar incision inotungamira kune imwe miti yepakati kusvika kune imwe chete nail nail nail. Sezvo chipikiri chinopinda muMidllary canal disal distal kune kupwanya (a), iyo proximal chikamu tilts mualgus (b)

Mufananidzo 3 uchizorora kushushikana muAntherior Muscle Compartment (a) inoburitsa yakavanzika ECTOPIC kurongeka (B)

Inonline iyo tibia mune imwe nzvimbo yakawedzerwa inobatsira kudzivisa matambudziko anoenderana neyakanyanya intraoperative mabvi yekubhururuka. Maitiro acho akatsanangurwa naGelbke, Jakma et al. Muna 2010 uye rave kuwedzeredzwa mumakore achangopfuura nekuti vanopaza Tibia muchinhu chakananga chidimbu chakarerutsa manyoka uye kudzoreredza. Fluoroscopy yaita hunyanzvi nyore kuita. Nguva dzeFluoroscopy yenguva dze Suprapatellar Mbiri dzakataurwa kuti dzive dzakapfupika zvakanyanya pane kurasira kweinfepellar. Uye zvakare, iyo kona yekuisa mbichana Izvi zvinodzivirira zvekunetsana pakati pechipikiri chechipatara chechipatara uye posterior cortex, nekudaro chinobata kuderedza kuderedzwa.

Postoperative anterior knee kurwadziwa idambudziko rakabatana. Anterior knee kurwadziwa kwakataurwa mu50-70% yevarwere vanokona, pamwe chete 30% yevarwere vari kurwadziwa pakubviswa kwemari yemukati. Zvinofungidzirwa kuti vanga vabatanidzwa pamwe nekukwana kune patellar Tendon uye Hoffa Fat Pad pane inogona kuwanikwa kweiyo postoperative ibvi postoperative mabvi kurwadziwa. Uyezve, iyo suprapetallar mashanduko echinyakare ebazi rebazi rebazi reSaphenous nerve, nekudaro achidzivisa kupenya knofness uye sensory kuseka (Mufananidzo 4). Kupfuura namaira kuburikidza ne quadriceps Tendon, nokudaro uchisiya patellar tendon isina simba, inoratidzika kunge inoderedza zvakanyanya mwero wekurwadziwa kwebvi rekupaza.

Nekuda kwemigumisiro yakanaka yeProximal Fractures, zviratidzo mumakiriniki maitiro akawedzerwa kune ese mapundu.

NDI RINOFANIRA KUDZVARA MUCHITSAUKORALLARY NAI SEI Shandiswa?

Zvakanakira

• Semi-yakawedzera mabvi chinzvimbo inosimudzira kupwanya kunyengera uye kudzoreredza nekuzorodza tsandanyama Simba uye kuchengetwa panguva yekupfeka neti

• Yakadzika njodzi yekudzoreredza dislocation yeProximal, Segmental uye Disal Fractures achienzaniswa nehunyanzvi hwekunyika

• Kuvhiringidza kuvhiringidza hunyanzvi nyore kuita

• Nail kusaisa kunoonekwa se 'Single Surgeon maitiro '

• Yakaderedzwa fluoroscopy nguva

• Hapana kukuvara kune patellar tendon uye yakaderera zviitiko zvekutumira-stapling anterior ibvi kurwadziwa

• Zviri nyore kuita mune yakawanda-timu maitiro, sezvakaita mune dzakawanda trauma

  
  

Zviratidzo

• Kuwedzera-kunyengera kupwanya kweiyo proximal tibia (ao 41a type)

• Akareruka akagwinha kupwanyika kweiyo tibial diaphysis (AO 42a-c mhando)

• Segmental tibial diabyseal fracture (AO 42c mhando)

• Disal tibial Extra-Artular Fractures uye yakapusa Intra-Articular Dist Right Fractures (AO 43A 43A uye C1 mhando)

• Kufamba kwebvi

• Patellar Onssized nePatellar Tendon Onssification

• Akasvibiswa ronda padanho rePatellar Tendon

Matenga sei kuti utenge orthopedic mispende uye zviridzwa zveOrthopedic?

Nekuti Czmeditech​ Spine Implants, intramedullary zvipikiri, Traumal Plate, Locking Plate, cranial-maxillofacial, prostisesa, Zvishandiso zvine simba, vekunze taxators, arthroscopy, kutarisirwa kwevaterinary uye yavo inotsigira chiridzwa.

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