Ukukhethwa kwendawo yokungena kwi-Intramedullary of Tibial Fractures

Ukukhethwa kwendawo yokungena kwi-Intramedullary of Tibial Fractures yenye yamanyathelo abalulekileyo empumelelweni yonyango lotyando. Indawo yokungena embi kwi-Intramedullary, nokuba ikwindlela ye-suprapatellar okanye ye-infrapatellar, inokubangela ukulahlekelwa yindawo ebekwe kuyo, ukukhubazeka kwe-angular yesiphelo sokwaphuka, kunye nokulimala kwezakhiwo ezibalulekileyo zedolo ezijikeleze indawo yokungena.

Kuza kuchazwa iinkalo ezi-3 ze-tibial intramedullary nail insertion point.

Yintoni indawo eqhelekileyo yokufaka iinzipho ngaphakathi kwe-tibial intramedullary?

Zithini iziphumo ze-tibial intramedullary nail ephambukile?

Ifunyanwa njani indawo echanekileyo yokungena ngexesha lotyando?

I. Ithini indawo esemgangathweni yokungenaTi-ibialIntramedullary?

Indawo ye-orthotopic ikwindawo edibana kuyo i-mechanical axis ye-tibia kunye ne-tibial plateau, umda ophakathi womqolo we-lateral intercondylar we-tibia, kwaye indawo esecaleni ikwindawo yamanzi phakathi kwe-tibial plateau kunye nendawo yokufuduka kwe-tibial stem.

Uluhlu lwendawo yokhuseleko kwindawo yokungena

22.9±8.9mm, apho inaliti inokufakwa khona ngaphandle kokonakalisa ukuma kwamathambo e-ACL kunye nezicubu ze-meniscus.

II. Zithini iziphumo zomntu ophambukile kwindlela asebenza ngayoTi-ibialIi-ntramedullary Nuphilile?

Ngokuxhomekeke kwi-proximal, i-middle, kunye ne-Distal Tibial Fractures, i-proximal tibial fracture inefuthe elibonakalayo, i-middle tibial fracture inefuthe elincinci, kwaye i-distal end inxulumene kakhulu nendawo kunye nokubekwa kwakhona kwe-Distal intramedullary nail.

# Ukwaphuka kweTibial ekufutshane

# Ukwaphuka kweTibial eseMbindini

Indawo yokungena ayinampembelelo ingako ekutshintsheni, kodwa kungcono ukufaka isikhonkwane kwindawo yokungena eqhelekileyo.

# Ukuqhekeka kweTibial ekude

Indawo yokungena kufuneka ifane nendawo yokuqhekeka kweproximal, kwaye indawo yenzipho ze-intramedullary ezikude kufuneka ibekwe ngaphakathi kwe-ortholateral kwindawo ephakathi ye-fornix ekude.

Ⅲ. HNgaba ubuza kufumanisa ukuba indawo yokungena kwenaliti ichanekile na ngexesha lotyando?

Sidinga i-fluoroscopy ukuze sibone ukuba indawo yokungena kwenaliti ichanekile na. Kubaluleke kakhulu ukuthatha i-orthopantomogram eqhelekileyo yedolo ngaphambi kotyando, ngoko ke kufuneka ithathwe njani?

Umgca oqhelekileyo we-orthopantomogram-ohambelanayo wentloko ye-fibular

I-axis yomatshini ye-ortho-x-ray yenziwa umgca othe tye, kwaye umgca ohambelanayo we-axis yomatshini wenziwa kumda osecaleni we-tibial plateau, ekufuneka ihlukanise intloko ye-fibular kwi-ortho-x-ray. Ukuba i-x-ray enye enjalo ifunyenwe, iyabonakala ukuba ithathwe ngokuchanekileyo.

Ukuba i-ortho-slice ayiqhelekanga, umzekelo, ukuba uzipho lunikwa kwindawo yokutya eqhelekileyo, xa kuthathwa indawo yokujikeleza yangaphandle, kuya kubonisa ukuba indawo yokutya ingaphandle, kwaye indawo yokujikeleza yangaphakathi iya kubonisa ukuba indawo yokutya ingaphakathi, nto leyo eya kuchaphazela isigqibo sotyando.

Kwi-x-reyi eqhelekileyo esecaleni, ii-medial kunye ne-lateral femoral condyles ziyahlangana kakhulu kwaye i-medial kunye ne-lateral tibial plateau ziyahlangana kakhulu, kwaye kwimbono esecaleni, indawo yokungena ifumaneka kwindawo ephakathi kwe-plateau kunye ne-tibial stem.

IV. Isishwankathelo soMxholo

Indawo yokungena kwezipikili ye-intramedullary ye-tibial eqhelekileyo ibekwe ngendlela ehambelana nomphetho ophakathi komqolo we-lateral intercondylar we-tibia kwaye ibekwe ecaleni kwi-watershed phakathi kwe-tibial plateau kunye nendawo yokufuduka kwe-tibial stem.

Indawo yokhuseleko kwindawo yokungena incinci kakhulu, yi-22.9±8.9 mm kuphela, kwaye inaliti ingafakwa kule ndawo ngaphandle kokonakalisa ukuma kwamathambo e-ACL kunye nezicubu ze-meniscal.

Kufuneka kuthathwe ii-orthopantomographs eziqhelekileyo ngexesha lotyando kunye nee-radiographs ezisecaleni zedolo, nto leyo engundoqo ekuqinisekiseni ukuba indawo yokungena kwenaliti ichanekile okanye akunjalo.