Okwangoku, eyona ndlela ixhaphakileyo yotyando yokuqhekeka kwe-calcaneal ibandakanya ukulungiswa kwangaphakathi ngepleyiti kunye nesikrufu kwindlela yokungena ye-sinus tarsi.I-lateral "L" indlela eyandisiweyo eyandisiweyo ayisakhethwa kwisenzo seklinikhi ngenxa yeengxaki eziphezulu ezinxulumene nenxeba.I-plate kunye ne-screw system fixation, ngenxa yeempawu zayo ze-biomechanical zokulungiswa kwe-eccentric, inomngcipheko ophezulu we-varus malalignment, kunye nophando oluthile olubonisa ukuba kunokwenzeka emva kokusebenza kwe-varus yesibini malunga ne-34%.
Ngenxa yoko, abaphandi baye baqala ukufunda iindlela zokulungisa i-intramedullary ye-calcaneal fractures ukujongana neengxaki ezinxulumene nesilonda kunye nomcimbi we-varus malalignment yesibini.
01 Ni-ail central nailing technique
Obu buchule bunokunceda ekunciphiseni indlela yokungena ye-sinus tarsi okanye phantsi kwesikhokelo se-arthroscopic, efuna iimfuno ezisezantsi ezithambileyo kunye nokunciphisa ixesha lokulaliswa esibhedlele.Le ndlela ikhethwa ngokukhethekileyo kuhlobo lwe-II-III fractures, kunye ne-comminuted comminuted calcaneal fractures, isenokunganikeli ugcino oluluqilima lokunciphisa kwaye inokufuna ukulungiswa kwe-screw okongeziweyo.
02 Sisikhonkwane se-intramedullary-plane
Isikhonkwane se-intramedullary senqwelomoya enye sinezikrufu ezibini kwincam yeproximal kunye ne-distal ends, enesikhonkwane esinomgongxo esivumela ukuxhunyelelwa kwethambo kwisikhonkwane esikhulu.
03 MUlti-plane isikhonkwane intramedullary
Eyilwe ngokusekelwe kwi-morphology ye-three-dimensional structural morphology ye-calcaneus, le nkqubo yokulungiswa kwangaphakathi ibandakanya izikhonkwane eziphambili ezifana ne-screws protrusion protrusion screws kunye ne-posterior process screws.Emva kokunciphisa indlela yokungena ye-sinus tarsi, ezi zikhonkwane zingafakwa phantsi kwe-cartilage yokuxhasa.
Kukho iingxabano ezininzi malunga nokusetyenziswa kwezikhonkwane ze-intramedullary kwi-calcaneal fractures:
1. Ukufaneleka okusekelwe kwi-fracture complexity: Kuxutyushwa ukuba ngaba iifractures ezilula azifuni izikhonkwane ze-intramedullary kunye ne-complex fractures azifanelekanga kubo.Kuhlobo lwe-Sanders II/III fractures, ubuchule bokunciphisa kunye nokulungiswa kwe-screw ngokusebenzisa indlela yokungena ye-sinus tarsi sele ikhulile, kwaye ukubaluleka kwesikhonkwane se-intramedullary kunokubuzwa.Kwiifractures eziyinkimbinkimbi, iingenelo zendlela eyandisiweyo ye "L" eyongeziweyo ihlala ingenakulinganiswa, njengoko inika ukubonakaliswa okwaneleyo.
2. Imfuneko yomjelo we-medullari eyenziweyo: Icalcaneus ngokwendalo ayinamsele we-medullary.Ukusebenzisa isikhonkwane esikhulu se-intramedullary kunokubangela ukwenzakala okugqithisileyo okanye ukulahleka kwamathambo.
3. Ubunzima bokususwa: Kwiimeko ezininzi e-China, izigulana zisephantsi kokususwa kwe-hardware emva kokuphiliswa kwe-fracture.Ukuhlanganiswa kwesikhonkwane kunye nokukhula kwethambo kunye nokufakela i-screws esecaleni phantsi kwethambo le-cortical kunokukhokelela kubunzima bokususwa, okuyingqwalasela ebonakalayo kwizicelo zeklinikhi.
Ixesha lokuposa: Aug-23-2023
