Ukulungiswa kwangaphambi kotyando kunye nendawo njengoko kuchaziwe ngaphambili kwi-transarticular external frame fixation.
Ukutshintshwa kunye nokulungiswa kwe-intra-articular fracture：
Kusetyenziswa ukunciphisa nokuqinisa i-incisional. Ukuqhekeka komphezulu ongaphantsi kwe-articular kunokubonwa ngokuthe ngqo ngokusebenzisa imingxunya emincinci ye-anteromedial kunye ne-anterolateral kunye nokusikwa kwe-lateral capsule yejoint engaphantsi kwe-meniscus.
Ukutsala kwelungu elichaphazelekayo kunye nokusetyenziswa kwemisipha ukulungisa iziqwenga zamathambo amakhulu, kunye nokucinezelwa okuphakathi kunokuphinda kusetyenziswe ngokususa ithambo nokulihlutha.
Nika ingqalelo ekubuyiseleni ububanzi be-tibial plateau, kwaye xa kukho isiphene sethambo ngaphantsi komphezulu we-articular, yenza i-bone grafting ukuxhasa umphezulu we-articular emva kokuvavanya ukuseta kwakhona umphezulu we-articular.
Nika ingqalelo ekuphakameni kwamaqonga aphakathi nawasecaleni, ukuze kungabikho nyathelo lomphezulu elidibeneyo.
Ukulungiswa okwethutyana nge-reset clamp okanye i-Kirschner pin kusetyenziswa ukugcina ukuseta kwakhona.
Ukubekwa kwezikrufu ezingenanto, izikrufu kufuneka zihambelane nomphezulu we-articular kwaye zibekwe kwithambo le-subchondral, ukuze kwandiswe amandla okubambelela. Kufuneka kwenziwe i-X-ray fluoroscopy ngaphakathi kotyando ukujonga izikrufu kwaye ungaze uzifake izikrufu kwijoyinti.
Ukutshintshwa kwendawo yokuqhekeka kwe-Epiphyseal：
Ukutsala kubuyisela ubude kunye nomgca womatshini welungu elichaphazelekayo.
Kuthathwa inyameko ukulungisa ukujikeleza kwelungu elichaphazelekayo ngokulichukumisa i-tibial tuberosity kwaye liyijolise phakathi kwenzwane yokuqala neyesibini.
Ukubekwa kweRingi ekufutshane
Uluhlu lweendawo ezikhuselekileyo zokubeka ucingo lwe-tibial plateau tension wire：
Umthambo we-popliteal, umthambo we-popliteal kunye nomthambo we-tibial zihamba ngasemva ukuya kwi-tibia, kwaye umthambo oqhelekileyo we-peroneal uhamba ngasemva ukuya kwintloko ye-fibular. Ke ngoko, zombini ukungena kunye nokuphuma kwenaliti kufuneka kwenziwe ngaphambili ukuya kwi-tibial plateau, oko kukuthi, inaliti kufuneka ingene kwaye iphume kwinaliti yentsimbi ngaphambili ukuya kumda ophakathi we-tibia kunye nangaphambili ukuya kumda ongaphambili we-fibula.
Kwicala elisecaleni, inaliti ingafakwa ukusuka kumphetho wangaphambili we-fibula ize idluliselwe ukusuka kwicala elingaphambili okanye kwicala eliphakathi; indawo yokungena ephakathi idla ngokuba kumphetho ophakathi we-tibial plateau kunye necala layo elingaphambili, ukuze kuthintelwe ukuba ucingo oluxinzelelweyo ludlule kwizicubu zemisipha ezingaphezulu.
Kuye kwaxelwa kwiincwadi ukuba indawo yokungena kwintambo yoxinzelelo kufuneka ibe yi-14 mm ubuncinane ukusuka kumphezulu we-articular ukuthintela intambo yoxinzelelo ukuba ingangeni kwi-joint capsule ize ibangele isifo samathambo esosulelayo.
Beka ucingo lokuqala loxinzelelo:
Kungasetyenziswa iphini yomnquma, edluliselwa kwiphini yokhuseleko ekwisibambi seringi, ishiye intloko yomnquma ngaphandle kwephini yokhuseleko.
Umncedisi ugcina indawo yesibambi seringi ukuze ihambelane nomphezulu odibeneyo.
Gqobhoza iphini yomnquma kwizicubu ezithambileyo nakwithafa le-tibial, uqaphele ukulawula icala layo ukuqinisekisa ukuba iindawo zokungena nezokuphuma zikwindawo enye.
Emva kokuphuma kwesikhumba kwicala elichaseneyo, qhubeka uphuma kwinaliti de intloko yomnquma iqhagamshelane nephini yokhuseleko.
Faka islayidi ye-wire clamp kwicala elichaseneyo uze udlulise iphini yomnquma kwislayidi ye-wire clamp.
Lumka ugcine i-tibial plateau embindini wesakhelo seringi ngamaxesha onke ngexesha lotyando.
Ngesikhokelo, ucingo lwesibini loxinzelelo lubekwa ngaxeshanye, lukwadlula kwelinye icala leslayidi ye-wire clamp.
Beka ucingo lwesithathu loxinzelelo, kufuneka lube kuluhlu olukhuselekileyo kangangoko kunokwenzeka kunye neseti yangaphambili yoxinzelelo lwentambo yoxinzelelo oluya kwi-engile enkulu, ngokuqhelekileyo iiseti ezimbini zentsimbi yentsimbi zingaba yi-engile ye-50 ° ~ 70 °.
Ukulayisha kwangaphambili okufakwe kwintambo yoxinzelelo: Cinezela ngokupheleleyo isiqinisi, udlulise incam yentambo yoxinzelelo kwi-stinner, ucinezele isiphatho, ufake ubuncinane i-1200N kwintambo yoxinzelelo, uze ufake isitshixo se-L-handle.
Ukusebenzisa indlela efanayo yokubopha kwangaphandle edolweni njengoko kuchaziwe ngaphambili, beka ubuncinane izikrufu ezimbini zeSchanz kwi-tibia ekude, uncamathisele i-fixator yangaphandle enengalo enye, kwaye uyiqhagamshele kwi-fixator yangaphandle ejikelezayo, kwaye uqinisekise kwakhona ukuba i-metaphysis kunye ne-tibial stem zikwi-axis eqhelekileyo ye-mechanical kunye ne-rotational alignment ngaphambi kokuba ugqibezele ukubopha.
Ukuba kufuneka uzinzo olongezelelekileyo, isakhelo seringi sinokuqhotyoshelwa kwingalo yokubopha yangaphandle ngentonga yokudibanisa.
Ukuvala isiko
Utyando luvaliwe macala omabini.
Inaliti ikhuselwe nge-alcohol gauze wraps.
Ulawulo emva kotyando
I-Fascial syndrome kunye nokulimala kwemithambo-luvo
Kwiiyure ezingama-48 emva kokwenzakala, kufuneka kuthathwe ingqalelo ukuze kujongwe kwaye kuchongwe ukuba kukho isifo se-fascial compartment syndrome.
Jonga ngononophelo imithambo-luvo yelungu elichaphazelekayo. Ukuphazamiseka kokunikezelwa kwegazi okanye ukulahleka kwemithambo-luvo okuqhubekayo kufuneka kulawulwe ngokufanelekileyo njengemeko engxamisekileyo.
Ukuvuselelwa kokusebenza kakuhle
Ukuzilolonga okusebenzayo kunokuqaliswa ngosuku lokuqala emva kotyando ukuba akukho monakalo uvela kwindawo okanye ezinye izifo ezihambisana nako. Umzekelo, ukucutheka kwe-isometric kwe-quadriceps kunye nentshukumo engasebenziyo yedolo kunye nentshukumo esebenzayo yeqakala.
Injongo yemisebenzi yokuqala esebenzayo nengashukumiyo kukufumana uluhlu oluphezulu lokushukuma kwedolo ixesha elifutshane kangangoko emva kotyando, oko kukuthi, ukufumana uluhlu olupheleleyo lokushukuma kwedolo kangangoko kunokwenzeka kwiiveki ezi-4 ukuya kwezi-6. Ngokubanzi, utyando luyakwazi ukufezekisa injongo yokwakha kwakhona uzinzo lwedolo, okuvumela kwangethuba
umsebenzi. Ukuba imithambo yokusebenza iyalibaziseka ngenxa yokulinda ukudumba kuphele, oku akuyi kunceda ekubuyiseleni ukusebenza kakuhle.
Ukuthwala ubunzima: Ukuthwala ubunzima kwangethuba akukhuthazwa, kodwa ubuncinane kwiiveki ezili-10 ukuya kwezili-12 okanye kamva kwiingxaki zokuqhekeka kwangaphakathi kwemisipha.
Ukuphola kwenxeba: Jonga ngokusondeleyo ukuphola kwenxeba kwiiveki ezimbini emva kotyando. Ukuba kukho usulelo lwenxeba okanye ukuphola okulibazisekileyo, kufuneka kwenziwe utyando ngokukhawuleza.
Ixesha leposi: Agasti-16-2024
