Unobangela kunye nonyango lwe-hoffa faphu

I-Hoffa thaphu ukuqhekeka kukuqhekeka kwenqwelomoya ye-cominal ye-ofisi yebhokhwe. Yaqala ichazwe yi-ridrich budch ngo-1869 kwaye yaxelwa kwakhona ngu-Albert Huffer ngo-1904, waza walandelwa kwathiwa. Ngelixa amaqhekeza ahlala eyenzeka kwindiza ethe tyaba, i-Hoffa Friations yenzeka kwinqwelomoya kwaye inqabile, ke ihlala iphoswa ngexesha lokuqala kweklinikhi nakwimitha.

Yenzeka nini i-hoffa facki?

I-Hoffaphu Ukonzakala okuphezulu kuhlala kubangela i-incondylar kunye ne-supracondylar quatures ze-distar femur. Ezona ndlela zixhaphakileyo zibandakanya imoto kunye neengozi zemoto kwaye ziwe ukusuka phezulu. Lewis et al. Chaza ukuba uninzi lwezigulana ezinemondekisa ezinxulumene noko zabangelwa kukungafikeleli ngokuthe ngqo kwi-Ofisi yeFayile yeFayile ngelixa ukhwele isithuthuthu ngedolo eline-90 °

Zithini izinto zokuveliswa kwekliniki yeHFFA?

Iimpawu eziphambili ze-hoffari eyodwa ye-hoffaphu i-profrision kunye ne-hemarthrosis, ukudumba, kunye ne-genur genum ye-genum okanye i-chagus kunye nokungazinzi. Ngokungafaniyo ngokungafaniyo ne-Inderkondylar kunye ne-Supracondylar Fractures, i-Hoffa iqhekeza kunokwenzeka ukuba ifumaneke ngokutsha ngexesha lokucinga. Ngenxa yokuba uninzi lwe-hoffaphuls ikhokelela ekulimaleni kweendlela eziphakamileyo zamandla, ukudibanisa kwi-hip, i-pelvis, i-feella, i-Patella, iTibia, i-tibia, kunye neenqanawa zedolo kufuneka zingabandakanywa.

Xa i-hofaphu irhanelwa, kufuneka ithathe njani i-x-rays iphelele ilahlekile ilahleko?

I-anterosiver esemgangathweni kunye ne-radiographs ye-Oteral isebenza rhoqo, kwaye imibono ye-oblique yenziwa xa kufuneka. Xa iqhekeza alichithwanga kakhulu, kusoloko kunzima ukuyifumanisa kwi-radiographs. Kwimbono yangasemva, ukuthandwa kancinci komgca odibeneyo we-themoral ngamanye amaxesha kubonwa, okanye ngaphandle okanye ngaphandle kokuhlanjwa kwe-challalar kuxhomekeke kwi-coloctlet. Kuxhomekeka kwi-contour ye-femur, i-disckinuisity okanye inyathelo kumgca wokuqhekeka unokubonwa kwimbonakalo yophando. Nangona kunjalo, kwimbono yenyani yohlobo oluyinyani, ii-coritys zenyani zibonakala zingasebenzi, ngelixa i-coridys inqamlezwe kwaye isusiwe, zinokugqobhoza. Ke ngoko, umbono ongachanekanga we-RE odibeneyo odibeneyo unokusinika umbono wobuxoki, onokuthi uboniswe ziimbono ezi-oblique. Ke ngoko, uviwo lwe-CT luyimfuneko (umzobo 1). I-Magnetic Sysing Icinga (i-MRI) inokunceda ukuvavanya izicubu ezithambileyo ezijikeleze idolo (ezinje nge-ligaments okanye i-menisci) yomonakalo.

Umzobo 1 ct ubonise ukuba isigulana sine-lenteneur ⅱc i-hoffa

Zithini iindlela zeHoffa?

I-Hoffaphu iqhekeza yahlulwe yanguhlobo lwe-B3 kunye nohlobo lwe-33.b3.2 kwi-AO / OTAROROOR KUNGCIDS NGOKUQHELEKILEYO. Emva kwexesha, le-lenteneur et al. Yahlula-hlula iqhekeza kwiindidi ezintathu ngokusekwe kumgama we-femoral filtime ukusuka kwi-porttex ye-fetrol.

Umzobo2 Lenteneur Ukuhlelwa kwe-Hoffaphu

Chwetheza i:Umgca wokuqhekeka ubekwe kwaye upatlellel kwi-portex ye-portex ye-suft ye-femoral.

Chwetheza ii:Umgama ukusuka kumgca wokuqhekeka kumgca we-porture ortere of the femur quel ongezelelekileyo kwi-IIA ye-IIA, ib kunye ne-IIC ngokomgama ophuma kwithambo le-phlity kwithambo le-phrating kwithambo le-phrating kwithambo lasemva kwethambo. Chwetheza i-IIA ikufutshane ne-portsex ye-shaft ye-themoral, ngelixa i-IIC intle kwi-porttex cortex ye-surtex ye-themoral.

Chwetheza iii:Ukwaphuka kwe-oblique.

UKWENZA NJANI ISICWANGCISO SOKUGQIBELA?

I-1. Ukhetho lwangaphakathi lokulungisa lukholelwa ngokubanzi ukuba ukuncitshiswa okuvulekileyo kunye nokulungiswa kwangaphakathi ngumgangatho weGold. I-Hoffa iqhekeza, ukhetho lweempawu ezifanelekileyo zokulungisa zilinganiselwe. I-screen esinentambo yokuxilongwa ngentloko ilungele ukulungiswa. Ukhetho oluphambili lubandakanya i-3.5mm, i-4mm, i-4.5mm kunye ne-6.5mm ye-6.5mm ye-screen tick screen kunye ne-herbert screws. Xa kufanelekile, iipleyiti ezifanelekileyo ze-slip zinokusetyenziswa apha. I-jarit ifunyenwe ngokusebenzisa izifundo ze-canaver biomechanical ukuba i-Posteroanaanaanaanaanaatharierior Leg Screws iZizinze ngakumbi kune-screen esingabalulekanga. Nangona kunjalo, indima yokukhokelo yale nto kusetyenzwa kwekliniki ayisacaci.

2. Itekhnoloji yokuqhawula umtshato xa i-Hoffa Frature ifunyenwe ihamba kunye ne-incondyylar kunye ne-Studracondylar Fracture, kufuneka inikwe ingqalelo eyaneleyo, kuba ukhetho lokulungisa lwangaphakathi luchazwe ngokusekwe kule meko ingentla. Ukuba i-colocy scorley iqhekezwe, ibonakaliso yookhokho lifana ne-Hoffa uqhelisweni. Nangona kunjalo, ayibobulumko ukusebenzisa isikrini se-right fynamler, kunye neplate ye-anatomive, iplate yenkxaso ye-conterlar okanye iplate ye-liss kufuneka isetyenziselwe ukulungiswa endaweni yoko. I-concedy ye-medial kunzima ukuyilungisa ngokudibeneyo. Kule meko, i-anteroment eyongezelelweyo ye-anteromedial iyacelwa ukuba inciphise kwaye ilungise i-Hoffa uqhelisweni. Ngayiphi na imeko, zonke iziqwengana ze-cerlings eziphambili zimiselwe ngesikhafu se-lag emva kokuncitshiswa kwe-anatomical.

1. Indlela yokuhlinqwa isigulana ikwindawo ye-Supine kwibhedi ye-fluoroscopic enelungelo lokutya. I-bolster isetyenziselwa ukugcina i-engile yedolo yedolo elimalunga ne-90 °. Ngeendlela ezilula zeMedial Hoffaf, umbhali ukhetha ukusebenzisa i-medionation yendlela ye-parapatellarllar. Ye-herffa quires, i-themotion yaqala. Abanye oogqirha babonisa ukuba indlela yeParapatellar yakudala ikwanokhetho olufanelekileyo. Nje ukuba ukuqhekezwa kwe-quacture kutsho, ukuhlolwa kwesiqhelo kwenziwa, kwaye emva koko ukuqhekezwa kwe-phract icocwe nge-creatte. Ngaphantsi kombono ongqalileyo, ukuncitshiswa kwenziwa usebenzisa inqaku lokunciphisa inqaku. Ukuba kukho imfuneko, "Indlela ye" yonystick "isetyenziselwa ukuncitshiswa, kwaye emva koko iingcingo zeKirschner zisetyenziselwa ukuncitshiswa nokulungiswa kokuthintela ukufuduswa, kodwa iingcingo zeKirschner azinakuthintela ukufakwa kwezinye iikati (umzobo 3). Sebenzisa ubuncinci izikrelem ezimbini ukufezekisa ukulungiswa kwezinto ezininzi kunye nokunyanzelwa kobuninzi. I-Drill Prepecular yokuqhekezwa kwaye kude ne-patelloferal genent. Kulumkele ukuqhuba kwi-Posterity Cavity cavity, ngokukhethekileyo nge-c-arm fluoroscopy. Izikrikhi zibekwe ngaphakathi okanye ngaphandle kwehehersher njengoko kufuneka. Izikrikhi kufuneka zibe ngumqhinga kunye nobude obaneleyo bokulungisa i-cartilage ye-carticar. I-intraoperailly, idolo lihlolwe ukwenzakala okuhambelanayo, uzinzo, kunye noluhlu lwentshukumo, kwaye ukunkcenkceshela kwenziwa phambi kokuvalwa kwenkungu.

Umzobo 3 Ukuncitshiswa okwethutyana kunye nokulungiswa kwe-bicondylar Hoffa quires nge-kirschner i-kirschner ngexesha lotyando, usebenzisa iingcingo zeKirschner kwi-piys