"I-10% yokuqhekeka kweqakala kuhamba nokulimala kwe-tibiofibular syndesmosis ekude. Izifundo zibonise ukuba i-52% yee-screws ze-tibiofibular ezikude zibangela ukuncipha okungekuhle kwe-syndesmosis. Ukufaka i-screw ye-tibiofibular ekude ethe nkqo kumphezulu we-syndesmosis kubalulekile ukuze kuthintelwe i-iatrogenic malreduction. Ngokwe-AO manual, kucetyiswa ukuba ufake i-screw ye-tibiofibular ekude kwi-2 cm okanye i-3.5 cm ngaphezulu komphezulu we-tibial articular ekude, kwi-engile ye-20-30° ukuya kwindawo ethe tye, ukusuka kwi-fibula ukuya kwi-tibia, iqakala likwindawo engathathi cala."
Ukufakwa ngesandla kwezikrufu ze-tibiofibular ezikude kudla ngokubangela ukuphambuka kwindawo yokungena kunye necala, kwaye okwangoku, akukho ndlela ichanekileyo yokumisela icala lokufakwa kwezi krufu. Ukujongana nale ngxaki, abaphandi bamanye amazwe basebenzise indlela entsha—'indlela ye-angle bisector'.
Kusetyenziswa idatha yemifanekiso evela kwi-16 ankle joints eziqhelekileyo, kwenziwa iimodeli ezili-16 eziprintiweyo ze-3D. Kumgama we-2 cm kunye ne-3.5 cm ngaphezulu komphezulu we-tibial articular, iingcingo ezimbini zeKirschner eziyi-1.6 mm ezihambelana nomphezulu odibeneyo zabekwa kufutshane nemiphetho yangaphambili nengasemva ye-tibia kunye ne-fibula, ngokulandelelana. I-engile phakathi kweingcingo ezimbini zeKirschner yalinganiswa kusetyenziswa i-protractor, kwaye i-drill bit eyi-2.7 mm yasetyenziswa ukugrumba umngxuma kumgca we-engile bisector, kulandele ukufakwa kwe-screw eyi-3.5 mm. Emva kokufakwa kwe-screw, i-screw yanqunyulwa kubude bayo kusetyenziswa isarha ukuvavanya ubudlelwane phakathi kwecala le-screw kunye ne-axis ephakathi ye-tibia kunye ne-fibula.
Uvavanyo lweesampuli lubonisa ukuba kukho ukuhambelana okuhle phakathi kwe-axis esembindini ye-tibia kunye ne-fibula kunye nomgca we-angle bisector, kunye naphakathi kwe-axis esembindini kunye necala lesikrufu.
Ngokwe-heoretically, le ndlela inokubeka isikrufu ngokufanelekileyo kwi-axis ephakathi ye-tibia kunye ne-fibula. Nangona kunjalo, ngexesha lotyando, ukubeka iingcingo zeKirschner kufutshane nemiphetho yangaphambili nengasemva ye-tibia kunye ne-fibula kubeka umngcipheko wokonakalisa imithambo yegazi kunye nemithambo-luvo. Ukongeza, le ndlela ayisombululi ingxaki ye-iatrogenic malreduction, njengoko ulungelelwaniso lwe-tibiofibular distal lungenakuhlolwa ngokwaneleyo ngaphambi kotyando ngaphambi kokubekwa kwesikrufu.
Ixesha lokuthumela: Julayi-30-2024
