ibhanile

I-Schatzker uhlobo lwe-II ye-tibial plateau fracture: "ifestile" okanye "ukuvulwa kwencwadi"?

I-Tibial plateau fractures ixhaphake ukulimala kwekliniki, kunye ne-Schatzker type II fractures, ebonakaliswe ngokuhlukana kwe-cortical lateral kudityaniswe nokudandatheka kwe-lateral articular surface, eyona nto ixhaphake kakhulu. Ukubuyisela i-articular surface ecinezelekileyo kunye nokuvuselela ukulungelelaniswa okuqhelekileyo kwamadolo, unyango lotyando lunconywa ngokuqhelekileyo.

a

Indlela ye-anterolateral kwi-joint joint ibandakanya ukuphakamisa ngokuthe ngqo i-lateral articular surface ecaleni kwe-cortex yokwahlula ukubeka kwakhona indawo edangeleyo ye-articular kunye nokwenza i-bone grafting phantsi kombono othe ngqo, indlela esetyenziswa ngokuqhelekileyo kwikliniki eyaziwa ngokuba "ukuvulwa kwencwadi". Ukudala ifestile kwi-lateral cortex kunye nokusebenzisa i-elevator ngefestile ukubeka kwakhona umphezulu odangeleyo, owaziwa ngokuba bubuchule be-"windowing", ngokwethiyori yeyona ndlela yokuhlasela kancinane.

b

Akukho sigqibo siqinisekileyo sokuba yeyiphi kwezi ndlela zimbini igqwesileyo. Ukuthelekisa ukusebenza kweklinikhi kwezi ndlela zimbini, oogqirha baseNingbo Sixth Hospital baqhube uphando oluthelekisayo.

c

Uphononongo lubandakanya izigulane ze-158, kunye namatyala angama-78 asebenzisa ubuchule befestile kunye namatyala angama-80 asebenzisa indlela yokuvula incwadi. Idatha esisiseko yamaqela amabini ayibonisanga mahluko abalulekileyo:

d
e

▲ Umfanekiso ubonisa iimeko zeendlela ezimbini zokunciphisa umphezulu we-articular: AD: ubuchule befestile, i-EF: ubuchule bokuvula incwadi.
Iziphumo zophononongo zibonisa:

- Kwakungekho nantlukwano ephawulekayo ngexesha lokulimala ukuya kukuhlinzwa okanye ixesha lotyando phakathi kweendlela ezimbini.
- I-postoperative CT scans ibonise ukuba iqela lefestile lineemeko ze-5 ze-postoperative articular surface compression, kanti iqela lokuvula incwadi linamatyala angama-12, umehluko ophawulekayo. Oku kuphakamisa ukuba ubuchule befestile bubonelela ngokunciphisa umgangatho ongcono we-articular kunendlela yokuvula incwadi. Ukongezelela, iziganeko ze-arthritis ezibuhlungu emva kokuhlinzwa kwakuphezulu kwiqela lokuvula incwadi xa kuthelekiswa neqela lefestile.
- Kwakungekho nantlukwano ephawulekayo kumanqaku omsebenzi wamadolo emva kokusebenza okanye amanqaku e-VAS (i-Visual Analog Scale) phakathi kwamaqela amabini.

Ngokwethiyori, indlela yokuvula incwadi ivumela ukubonwa ngokuthe ngqo komphezulu we-articular, kodwa kunokukhokelela ekuvulekeni okugqithisileyo komphezulu we-articular, okukhokelela kumanqaku esalathiso angonelanga okunciphisa kunye neziphene ekunciphiseni umphezulu we-articular olandelayo.

Kwinkqubo yeklinikhi, yeyiphi indlela onokuyikhetha?


Ixesha lokuposa: Jul-30-2024