Indlela ye-Suprapatellar ye-Tibial Nail

I-Suprapatellar Approach Tibial Nail: Umhlahlandlela Ophelele

Ukuphuka kwe-tibia ukulimala okuvamile okuvame ukudinga ukungenelela kokuhlinzwa. Enye yezindlela ezithandwa kakhulu zokuhlinza ukusetshenziswa kwezipikili ze-intramedullary. I-suprapatellar approach tibial nail iyindlela ethole ukuthandwa eminyakeni yamuva ngenxa yezinzuzo zayo eziningana. Kulesi sihloko, sizoxoxa nge-suprapatellar approach tibial nail ngokuningiliziwe, kufaka phakathi izinzuzo zayo, izinkomba, inqubo yokuhlinzwa, ukuphathwa kwe-post-operative, kanye nezinkinga ezingase zibe khona.

Okuqukethwe

1. Isingeniso

2. I-Anatomy ye-Tibia

3. Izinkomba ze-Suprapatellar Approach Tibial Nail

4. Izinzuzo Suprapatellar Indlela Tibial Nail

5. Ukulungiselela Ngaphambi Kokuhlinzwa

6. Indlela Yokuhlinza ye-Suprapatellar Approach Tibial Nail

7. Ukuphathwa kwangemva kokusebenza

8. Izinkinga Ezingenzeka

9. Ukuqhathanisa namanye amasu

10. Isiphetho

11. Imibuzo Evame Ukubuzwa

1. Isingeniso

I-tibia ingelinye lamathambo amade avame ukuphuka emzimbeni. Ukuphuka kwe-tibia ngokuvamile kudinga ukungenelela kokuhlinzwa ngenxa yengozi enkulu ye-malunion kanye ne-non-union. Izipikili ze-Intramedullary ziye zaba yizinga legolide lokwelapha ukuphuka kwe-tibial ngenxa yezinzuzo zabo eziningi, kuhlanganise nokuzinza okuthuthukisiwe kanye nezikhathi zokuphulukisa ngokushesha.

I-suprapatellar approach tibial nail iyindlela ethole ukuthandwa eminyakeni yamuva ngenxa yezinzuzo zayo eziningana ngaphezu kwamanye amasu. Lesi sihloko sihlose ukunikeza umhlahlandlela ophelele we-suprapatellar approach tibial nail.

2. I-Anatomy ye-Tibia

Ngaphambi kokuxoxa nge-suprapatellar approach tibial nail, kubalulekile ukuqonda i-anatomy ye-tibia. I-tibia inkulu kumathambo amabili amade emlenzeni ongezansi futhi ithwala ingxenye enkulu yesisindo somzimba. Ukuphela okuseduze kwe-tibia kuhambisana ne-femur ukuze kwakhiwe idolo elihlangene, kuyilapho ukuphela kwe-distal kuhambisana ne-fibula ne-talus ukuze kwakhiwe i-ankle joint.

I-tibia inomsele we-intramedullary ohamba ngobude bayo. I-canal iba banzi ekugcineni kwe-proximal futhi incipha ibheke ekugcineni okukude. Lo msele yilapho kufakwa khona isipikili se-intramedullary.

3. Izinkomba ze-Suprapatellar Approach Tibial Nail

I-suprapatellar approach tibial nail iboniswa ekwelapheni ukuhlukana okuhlukahlukene kwe-tibial, kuhlanganise:

• Ukuhlukana kwe-distal kwe-tibial yesithathu

• I-Proximal tibial fractures

• I-Tibial shaft fractures

• Ukuphuka kwe-Oblique

• Ukuphuka kwe-spiral

• Ukuphuka okuphindaphindiwe

• Ukuphuka okunokukhubazeka okuphawulekayo kwe-cortical

4. Izinzuzo Suprapatellar Indlela Tibial Nail

I-suprapatellar approach tibial nail inikeza izinzuzo eziningana ngaphezu kwamanye amasu, okuhlanganisa:

• Ukunciphisa ukuphuka okuthuthukisiwe: Indlela ye-suprapatellar ivumela ukubonwa okungcono kwesayithi lokuphuka, okuholela ekunciphiseni okuthuthukisiwe kokuphuka.

• Ukulahlekelwa kwegazi okuncishisiwe: Indlela ye-suprapatellar ihilela ukuhlukaniswa kwezicubu ezithambile kancane, okuholela ekunciphiseni ukulahlekelwa kwegazi ngesikhathi sokuhlinzwa.

• Ukunciphisa ingozi yokutheleleka: Indlela ye-suprapatellar inciphisa ingozi yokutheleleka ngokugwema ukuhlangana kwamadolo, okungaba umthombo wokutheleleka.

• Ukunciphisa ingozi yokulimala kwe-patellar tendon: Indlela ye-suprapatellar igwema i-patellar tendon, inciphisa ingozi yokulimala kulesi sakhiwo esibalulekile.

• Ukululama ngokushesha: Iziguli ezibhekana nokuhlinzwa kwe-suprapatellar tibial nail zivame ukululama ngokushesha futhi zibe nokuhlala esibhedlela esifushane uma kuqhathaniswa nalabo ababhekana nezinye izindlela.

5. Ukulungiselela Ngaphambi Kokuhlinzwa

Ngaphambi kokuhlinzwa kwe-suprapatellar nail ye-tibial, iziguli ngokuvamile zizobhekana namalungiselelo amaningana ngaphambi kokuhlinzwa. Lokhu kuzobandakanya umlando wezokwelapha ophelele, ukuhlolwa ngokomzimba, nezifundo zezithombe ezifana nama-X-ray, ama-CT scan, noma izikena ze-MRI ukuze kuhlolwe izinga nendawo yokuphuka.

Iziguli zingase futhi zihlolwe igazi ngaphambi kokuhlinzwa kanye nezinye izifundo zaselabhorethri ukuze zihlole impilo yazo yonke futhi zihlonze noma yiziphi izimo zezokwelapha ezivele zikhona ezingase zithinte ukuhlinzwa nokululama kwazo.

Kubalulekile ukuthi iziguli zazise udokotela wazo ohlinzayo nganoma yimiphi imithi eziyithathayo, okuhlanganisa nemithi etholakala ngaphandle kwekhawunta kanye nezithasiselo, njengoba eminye imithi ingase idinge ukuba iyekwe ngaphambi kokuhlinzwa ngenxa yengozi yokopha noma ezinye izinkinga.

Iziguli zingase futhi zelulekwe ukuba ziyeke ukubhema futhi zigweme utshwala emasontweni andulela ukuhlinzwa, njengoba lezi zinto zingaphazamisa inqubo yokwelapha futhi zandise ingozi yezinkinga.

6. I-Surgery Technique ye-Suprapatellar Approach Tibial Nail

I-suprapatellar approach tibial nail surgery ngokuvamile eyenziwa ngaphansi kwe-anesthesia ejwayelekile futhi ingase ithathe amahora ambalwa ukuqeda. Indlela yokuhlinzwa ihlanganisa lezi zinyathelo ezilandelayo:

1. Isiguli sibekwe etafuleni lokusebenza endaweni ephansi, umlenze othintekile uphakanyisiwe futhi usekelwe umnikazi womlenze.

2. Ukusika okuncane esikhumbeni ngenhla nje kwe-patella, futhi ucingo oluqondisayo lufakwa esikhumbeni nasemseleni we-intramedullary we-tibia.

3. I-reamer isetshenziselwa ukulungisa umsele wokufakwa kwesipikili.

4. Khona-ke isipikili sishuthekwa ngokusikwa bese siqondiswa emseleni kusetshenziswa i-fluoroscope.

5. Uma isipikili sesisendaweni, izikulufo zokukhiya zishuthekwa ngozipho nasethanjeni ukuze ziqine.

6. Ukusika kuyavalwa, bese umlenze unganyakazi kusetshenziswa ukhonkolo noma i-brace.

7. Ukuphathwa Kwangemva Kokuhlinzwa

Ukulandela i-suprapatellar approach tibial nail surgery, iziguli zizochitha izinsuku ezimbalwa esibhedlela ukuze ziqashwe futhi ziphathwe ubuhlungu. Bazokwaziswa ukuthi bagcine umlenze othintekile uphakeme futhi bagweme ukubeka isisindo kuwo amasonto ambalwa.

Iziguli zizophinde zinikezwe izivivinyo zokwenza ukusiza ukuqinisa imisipha ezungeze idolo futhi kuvimbele ukuqina. Ukwelapha ngokomzimba kungase futhi kunconywe ukusiza iziguli ziphinde zithole uhla olugcwele lokunyakaza namandla emlenzeni othintekile.

Iziguli zizonikezwa imishanguzo yezinhlungu kanye nama-antibiotics njengoba kudingeka ukuze kulawuleke ubuhlungu nokuvimbela ukutheleleka. Ukuqokwa kokulandelela kuzohlelelwa ukuqapha inqubo yokuphulukisa futhi kuhlolwe noma yiziphi izinkinga.

8. Izinkinga Ezingenzeka

Njenganoma yikuphi ukuhlinzwa, kunezingozi ezingenzeka kanye nezinkinga ezihlobene ne-suprapatellar approach tibial nail surgery. Lokhu kungase kuhlanganise:

• Ukutheleleka

• Ukopha

• Ukulimala kwezinzwa

• Amahlule egazi

• Ukuphulukiswa okubambezelekile

• Okungeyona inyunyana noma i-malunion yokuphuka

• Ukuhluleka kwezingxenyekazi zekhompuyutha

Kubalulekile ukuthi iziguli zixoxe ngalezi zingozi nodokotela wazo ohlinzayo futhi zilandele yonke imiyalelo yangaphambi nangemuva kokuhlinzwa ukuze kuncishiswe ubungozi bezinkinga.

9. Ukuqhathanisa namanye amasu

I-suprapatellar approach tibial nail ingenye yezindlela eziningana ezisetshenziselwa ukwelapha ukuphuka kwe-tibial. Amanye amasu ahlanganisa infrapatellar approach tibial nail, retrograde tibial nail, kanye plate and screw fixation.

Nakuba inqubo ngayinye inezinzuzo nezinkinga zayo, i-suprapatellar approach tibial nail inikeza izinzuzo eziningana eziyingqayizivele, kuhlanganise nokunciphisa ukuphuka okuthuthukisiwe, ukunciphisa ukulahlekelwa kwegazi, kanye nokunciphisa ingozi yokutheleleka kanye nokulimala kwe-tendon patellar.

10. Isiphetho

I-suprapatellar approach tibial nail iyindlela ethandwayo yokuhlinzwa yokwelapha ukuphuka kwe-tibial. Inikeza izinzuzo ezimbalwa ngaphezu kwamanye amasu, okuhlanganisa ukunciphisa ukuphuka okuthuthukisiwe, ukunciphisa ukulahlekelwa kwegazi, kanye nengozi encishisiwe yokutheleleka kanye nokulimala kwe-patellar tendon.

Kodwa-ke, njenganoma yikuphi ukuhlinzwa, kunezingozi nezinkinga ezingase zibe khona, futhi kubalulekile ukuthi iziguli zicabangele ngokucophelela izinketho zazo futhi zixoxe ngazo nodokotela wazo ohlinzayo ukuze zenze isinqumo esinolwazi.

11. Imibuzo Evame Ukubuzwa

1. I-suprapatellar ithatha isikhathi esingakanani ukuhlinzwa kwezinzipho ze-tibial?

   
   

   Ukuhlinzwa ngokuvamile kuthatha amahora ambalwa ukuqeda.

   
   

2. Kuthatha isikhathi esingakanani ukululama ekuhlinzweni kwezinzipho ze-suprapatellar?

   
   

   Isikhathi sokululama singahluka kuye ngezinga lokuphuka kanye nekhono lokuphulukisa lesiguli ngasinye, kodwa ngokuvamile kuthatha izinyanga ezimbalwa ukuze ithambo liphole ngokugcwele.

   
   

3. Liyini izinga lempumelelo ye-suprapatellar approach tibial nail surgery?

   
   

   Izinga lempumelelo yokuhlinzwa ngokuvamile liphezulu, kodwa lingahluka kuye ngezimo zesiguli ngasinye kanye nezinga lokuphuka.

   
   

4. Ngabe ngizodinga ukwelashwa ngokomzimba ngemuva kokuhlinzwa kwe-suprapatellar tibial nail?

   
   

   Ukwelashwa ngokomzimba kungase kunconywe ukukusiza ukuthi uphinde uthole uhla olugcwele lokunyakaza namandla emlenzeni othintekile.

   
   

5. Ingabe zikhona izindlela ezingezona zokuhlinzwa zokwelapha ama-tibial fractures?

   
   

   Kwezinye izimo, izinketho ezingezona zokuhlinzwa ezifana nokuphonsa noma ukubopha zingase zisetshenziselwe ukwelapha ukuphuka kwe-tibial, kodwa lokhu kuzoxhomeka ezimweni zesiguli ngasinye.