I-Tibial Fracture, I-Suprapatellar intramenduval inquboiling inqubo

I-Intramenduvary Tibial Kiling: Ukufinyelela nokuqondanisa, ubuhlungu bamadolo angemuva

Indlela yokuhlinza yokungena emgqeni weTibial Fractures ibalulekile ukuze ufake i-intrametullary netract top ngenqubo yokungena efanele, ukuze unciphise ukulimala kwe-intra-articular knee

Izindlela zakudala zeTibial Stem Fractures iyindlela ye-infrapatellar Median noma infrapatellar parapatellar indlela. Yize lezi zindlela zikhonjiswa ukuqhekeka kwengxenye yaphakathi nengxenye, i-valgus ye-postoperative, i-anterior, noma yokukhubazeka okuhlangene kuvame ukwenzeka kuma-fractures amaningi.

Imbangela eyinhloko yeMalalignment in profimal tibial fractures ikhubazeka okubangelwa ukudonsa ama-quadriceps tendon ngesikhathi sokuguquguquka kwe-knee kanye ne-mehendi engqubuzana phakathi kwesipikili se-kibial ngesikhathi sokufakwa kwe-lifent. I-Patella futhi ivimbela ukungena kwezipikili ezi-axial endizeni ye-sagittal (Fig. 1a, b). Ngakho-ke, enye indlela evamile yokuthola iphuzu kungenziwa incikeli ye-parapatellar ye-medial, okuholela ekumeni okuncane kokufakwa kwezipikili okulandelayo (amakhiwane. 1c no-2). Njengoba izipikili zifaka i-intramerary Canal Distal ekuqhekekeni, ingxenye yengxenye ye-Proximal ibe yi-Valgus (Umdwebo 2). Ekugcineni, ukungezwani okuphumule kwemisipha yegumbi elingaphandle kunomthelela ku-Valgus (Umdwebo 3).

Umdwebo 1 a, B usebenzisa indlela ejwayelekile ye-infrapatellar, i-Patella ivimbela ukungena kwe-axial kwesipikili, okuholela ekulimaleni okujwayelekile kokuqondanisa kokuqondakala kwe-anterior apical sagittal kanye ne-Valgus colonal ukuqondanisa. c usebenzisa indlela ye-parapatellar yokuqondanisa kwe-intrametundary nail.

Umdwebo 2 usondela endaweni yokungena nge-medial parapatellar incision eholela ekumeni okuncane kokufakwa kwezipikili okulandelayo. Njengoba izipikili zifaka i-medullary callal distal ekuqhekekeni (a), ingxenye yengxenye ye-proximal ibe yi-Valgus (B)

Umdwebo 3 Ukuvuselela ukungezwani egumbini elingaphandle lemisipha (a) kukhiqiza ilungiselelo elicashile e-ectopic (b)

Ukungena eTibia esimweni esandisiwe kusiza ukugwema izinkinga ezihambisana nokuguquguquka okukhulu kwamadolo angenhla. Le ndlela yachazwa nguGelbke, uJakma et al. Ngo-2010 futhi uye wathandwa kakhulu eminyakeni yamuva ngoba unvening i-tibia ngesimo esisezingeni eliphakeme esiqondile senza lula ukukhohlisa nokuphindaphinda. I-FluoRoscopy isibe lula ngokweqiniso. Izikhathi ze-FluoRoscopy ze-suprapatellar zibe zimfushane kakhulu kunokuba zikhonkotha nge-infrapatellar. Ngaphezu kwalokho, i-angle yokufakwa kwezipikili (endizeni ye-sagittal) ifana kakhulu ne-eksisi ende ye-tibia kule nqwaba yezipikili; Lokhu kuvimbela ukungqubuzana kwemishini phakathi kwethiphu yesipikili ne-cortex yangemuva, ngaleyo ndlela kusiza ukuncishiswa kwe-fracture.

Ubuhlungu be-Antererior Knee abasebenza ngenkinga yinkinga ehlobene. Ubuhlungu be-Beterior Knee bubikwe ku-50-70% yeziguli ze-Fracture, ngamaphesenti angama-30 kuphela eziguli ezibhekene nokukhululeka kobuhlungu ngemuva kokususwa kwesitshalo sangaphakathi. Kulinganiselwa ukuthi ukwakheka kwesikhafu okuhambisana nokufinyelela ku-Patellar Tendon kanye ne-Hot Pad Pad kungaba ngumthombo wobuhlungu bezinhlansi abasebenza kabi. Ngaphezu kwalokho, indlela ye-suprapatellar igwema ukuvela kwendabuko kwegatsha le-patellar ye-patellar yezinzwa ezingezona, ngaleyo ndlela kugwemeke ukuthuthuka kwamadolo wangaphandle kanye nobubi bezinzwa (Umdwebo 4). Ukudlula ezipikili nge-quadriceps tendon, ngaleyo ndlela kushiye i-patellar tendon, kubonakala kuncipha kakhulu isilinganiso sobuhlungu bezinkune.

Ngenxa yemiphumela emihle yokuqhekeka kwe-proximal, izinkomba zokuzijwayeza zokwelashwa ziye zanwetshwa kulo lonke uqhekeze.

Kufanele isetshenziswe nini i-suprapatellar intramendultary nail?

Izinzuzo

• Isikhundla se-Semi-Extended Knee sigqugquzela ukukhohlisa nokubuyisela emuva ngokuphumula amandla emisipha nokugcinwa ngesikhathi sokufakwa kwezipikili

• Ingozi ephansi yokungasebenzi kahle kwe-proximal, izingxenye kanye ne-distal fractures ngokuqhathaniswa namasu ajwayelekile

• Ukusebenza Kokukhala Kulula Ezobuchwepheshe

• Ukufakwa kwezipikili kungenzeka njengenqubo 'eyodwa surgeon '

• Isikhathi se-fluoroscopy

• Akukho monakalo kwi-Patellar Tendon kanye nezehlakalo eziphansi zobuhlungu be-anterior-stapling ye-anteple

• Kulula ukwenza inqubo yeqembu eliningi, njengasebukhazikhazi abaningi

  
  

Izinkomba

• Ukuqhekeka okwengeziwe kwe-acticular kwe-Proximal Tibia (AO 41A Type)

• Ukuqhekeka okulula okwenziwe nge-diaphysion ye-tibial (AO 42A-C TYPE)

• I-Segtal Tibial Diaphyseal Fracture (AO 42C TYPE)

• I-distal tibial extra-articular fractures kanye ne-intra-articular destal destal ukunwetshwa kokunwetshwa (AO 43a nezinhlobo ze-C1)

• Idolo elintantayo

• I-Patellar Ossation nge-Patellar Tendon Ossifiation

• Inxeba elingcolisiwe ezingeni le-patellar tendon

Ungayithenga kanjani izimila zamathambo namathuluzi ama-orthopedic?

Ingomane I-CZMeditech , sinomugqa womkhiqizo ophelele we-Orthopedic Surgery izimila nezinsimbi ezihambisanayo, imikhiqizo kubandakanya izimila ze-spine, Izipikili ze-intramentundary, Ipuleti le-Trauma, Ukukhiya ipuleti, I-Cranial-maxillofacial, UProsuthesis, Amathuluzi Amandla, Finators yangaphandle, I-Arthroscopy, ukunakekelwa kwezilwane kanye nezinsimbi zabo ezisekelayo.

Ngaphezu kwalokho, sizibophezele ekuthuthukiseni ngokuqhubekayo imikhiqizo emisha kanye nokwandisa imigqa yomkhiqizo, ukuze sihlangabezane nezidingo zokuhlinzwa zodokotela neziguli eziningi, futhi zenze inkampani yethu icindezele ngokwengeziwe ezindaweni zonke zemboni yama-orthopedic kanye nemboni yezinsimbi.

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