Okwangoku, indlela yotyando esetyenziswa kakhulu xa kuqhekeka i-calcaneal ibandakanya ukufakwa ngaphakathi ngepleyiti kunye nesikrufu ngendlela yokungena kwi-sinus tarsi. Indlela enwetshiweyo efana ne-"L" esecaleni ayisathandwa kakhulu kwizonyango ngenxa yeengxaki eziphezulu ezinxulumene namanxeba. Ukufakwa kwenkqubo yepleyiti kunye nesikrufu, ngenxa yeempawu zayo ze-biomechanical zokufakwa kwe-eccentric, kunomngcipheko ophezulu wokungalungelelani kwe-varus, kunye nezinye izifundo ezibonisa ukuba amathuba okuba i-varus yesibini emva kotyando angama-34%.
Ngenxa yoko, abaphandi baqalise ukufunda iindlela zokulungisa i-intramedullary kwiingxaki zokuqhekeka kwe-calcaneal ukuze bajongane neengxaki ezinxulumene namanxeba kunye nomba we-varus secondary malalignment.
01 Nindlela yokubethela ephakathi
Le ndlela inokunceda ekunciphiseni ngokusebenzisa indlela yokungena kwi-sinus tarsi okanye phantsi kwesikhokelo se-arthroscopic, ifuna iimfuno eziphantsi zezicubu ezithambileyo kwaye inokunciphisa ixesha lokulaliswa esibhedlele. Le ndlela isetyenziswa ngokukhethekileyo kwiintlobo zezaphuko ze-II-III, kwaye kwiintlobo zezaphuko ze-calcaneal ezintsonkothileyo, isenokungabi nakho ukugcinwa kokunciphisa okunamandla kwaye inokufuna ukulungiswa okongeziweyo kwezikrufu.
02 Sisikhonkwane se-intramedullary esineplane enye
I-single-plane intramedullary nail inezikrufu ezimbini kwiziphelo ezikufutshane nezikude, kunye ne-main nail engenanto evumela ukuba amathambo afakwe kwi-main nail.
03 Misikhonkwane se-intramedullary esisezantsi
Yenzelwe ngokusekelwe kwimo yesakhiwo esinemilinganiselo emithathu ye-calcaneus, le nkqubo yokuqinisa yangaphakathi ibandakanya izikrufu ezibalulekileyo ezifana nezikrufu zokuvela ezithwala umthwalo kunye nezikrufu zenkqubo yangasemva. Emva kokunciphisa ngendlela yokungena kwi-sinus tarsi, ezi zikrufu zinokubekwa phantsi kwe-cartilage ukuze zixhaswe.
Kukho iimpikiswano ezininzi malunga nokusetyenziswa kwezipikili ze-intramedullary kwiindlela zokuqhekeka kwe-calcaneal:
1. Ukufaneleka okusekelwe kubunzima bokwaphuka: Kuxoxwa ngokuba ingaba ukwaphuka okulula akudingi zinzipho zangaphakathi kwe-medullary kwaye ukwaphuka okuntsonkothileyo akuzifanele na. Kwizaphuko zohlobo lweSanders II/III, indlela yokunciphisa kunye nokulungisa izikrufu ngendlela yokungena kwi-sinus tarsi ivuthiwe, kwaye ukubaluleka kwenzipho eziphambili zangaphakathi kwe-medullary kunokungathandabuzeki. Kwizaphuko ezintsonkothileyo, iingenelo zendlela ende enesimo se-"L" azinakutshintshwa, njengoko inika ukukhanya okwaneleyo.
2. Ukufuneka komjelo we-medullary owenziweyo: I-calcaneus ngokwemvelo ayinawo umjelo we-medullary. Ukusebenzisa uzipho olukhulu olungaphakathi kwe-medullary kunokubangela ukwenzakala okukhulu okanye ukulahleka kwamathambo.
3. Ubunzima bokususwa: Kwiimeko ezininzi eTshayina, izigulana zisasuswa izixhobo emva kokuba ziphulukene nokwaphuka. Ukuhlanganiswa kwezikhonkwane nokukhula kwamathambo kunye nokufakwa kwezikrufu ezisecaleni phantsi kwethambo le-cortical kunokukhokelela ekubeni kube nzima ukususwa, nto leyo enokuqwalaselwa kwizicelo zonyango.
Ixesha lokuthumela: Agasti-23-2023
