Isku-dhafka Kiliinikada iyo Ganacsiga ee Saxanka Qufulka Dambe ee Tibial Proximal

jabka plateau dhexda ah (jabka/jilibka subluxation)

Nooca V:

Jab laba-jibbaaran oo ku lug leh kala qaybsanaanta taagga dhexe iyo kan dambe

Nooca VI:

Jab laba geesood ah oo kala sooca metaphysis tibial oo ka soo jeeda jirridda tibial

Tilmaamo dhammaystiran

• Duminta dusha wadajirka ah>2mm ama barokaca dambe>5mm

• Jab furan/isku-darka cilladda qaybta osteofascial

• Xasilooni la'aanta jilibka (wareejinta gudaha/dibada>5°) ama dhaawaca seedaha ee u baahan dayactir.

Tilmaamaha qaraabada ah

• Bukaannada da'da ah ee u baahan abaabul hore

• Dhaawaca meniscus ee la isku daray ee u baahan sahaminta arthroscopic

1. Qalitaanka gelitaanka

Jeexitaanka qalliinka waxaa loo doortaa inuu noqdo mid lateral ama dhexdhexaad ah jilibka, iyadoo ku xiran goobta jabka. Jeexitaanka dambe waxa caadi ahaan loo isticmaalaa jabka taagga dambe, oo ka soo bilaabmaya kondhile-ka bowdada ee ilaa tuberosity-ga dambe ee tibial. Maqaarku waa la gooyaa ka dibna lakabka kala soocaya, iyada oo fiiro gaar ah u leh ilaalinta dareemaha peroneal caadiga ah, dhaqdhaqaaquna waa inuu ahaado mid jilicsan marka uu soo bandhigayo dhamaadka jabka si looga fogaado inuu sii xumeeyo dhaawaca jilicsan ee jilicsan.

2. Dib-u-dejinta dusha sare ee articular

Dusha sare ee articular ee burburay waxaa lagu soo qaadaa xuubka xuubka xuubka xuubka, habkana waxaa lagu xaqiijiyay fluoroscopy soo noqnoqda oo leh mashiinka C-gadu. Jabka jaban, mararka qaarkood waxaa lagama maarmaan ah in lagu dhejiyo allograft ama taageerada lafaha macmal ah ee ka hooseeya dusha articular. Dusha wadajirka ah waa inay ahaataa mid siman, farqiga u dhexeeya dhererka dhinaca caafimaadka waa inuusan ka badnayn 2 mm, taas oo si toos ah u go'aamisa soo kabashada shaqada wadajirka ah ka dib qalliinka.

3. Dabagal

Jabka isku dhafan ee ku lug leh metaphysis-ku waxay u baahan yihiin hagaajin saxan taageero ah, oo leh taargooyin quful L-qaabeeya oo caadi ahaan loo isticmaalo saxanka dambe iyo taarikada T-qaabeeya ee midka dhexe. Jabka laba-geesoodka ah, dhakhaatiirta qalliinka qaarkood waxay doortaan hagaajinta saxanka laba geesoodka ah, laakiin waa in taxaddar la sameeyaa si looga fogaado in si xad-dhaaf ah loo siibo periosteum, taas oo saameyn karta bixinta dhiigga.

Habboonka Anatomical:

Naqshad horay loo qaabeeyey oo loogu talagalay dadka Aasiya, Afrikaan, iyo Laatiin Ameerika oo leh qaab-dhismeedka tibial-ka (shaxda isbarbardhigga biomechanical ayaa lagu lifaaqi karaa).

Nidaamka furka qufulka ee Multi-axial wuxuu la qabsanayaa cufnaanta lafaha kala duwan (tusaale, lafo-jileeca dadka waaweyn ee Afrikaanka ah, dhaawaca tamarta sare ee dhalinyarada Aasiya)

Saamiga kharashka-faa'iidada:

Kordhinta heerka guusha habraaca keliya iyo kharashyada dib u eegistoodu oo yaraatay (is barbar dhig xogta saxanka caadiga ah)

Adkeysiga sare iyo soo noqnoqda beddelka qalabka oo yaraada meelaha fogfog.

Saaxiibtinimada hawlwadeenka:

Habka qalliin ee la fududeeyay (tusaale, MIPO farsamada ugu yar), qalooca barasho ee dhakhaatiirta qalooca.

Qalabka taageerada la qaadi karo ee meelaha kheyraadku xaddidan yahay