Ukukhethwa kwendawo yokungena ye-Intramedullary ye-Tibial Fractures

Ukukhethwa kwendawo yokungena kwi-Intramedullary ye-Tibial Fractures yenye yamanyathelo aphambili kwimpumelelo yonyango lotyando.Indawo yokungena ehluphekileyo ye-Intramedullary, ingaba yindlela ye-suprapatellar okanye ye-infrapatellar, inokubangela ukulahlekelwa kwe-repositioning, i-angular deformity of the end fracture, kunye nokulimala kwezakhiwo ezibalulekileyo zamadolo malunga nendawo yokungena.

Iinkalo ze-3 ze-tibial intramedullary nail point point ziya kuchazwa.

Ithini indawo yokufakwa kwezikhonkwane ze-tibial intramedullary?

Ziziphi iimpembelelo ze-tibial intramedullary nail ephambukayo?

Ingaba indawo echanekileyo yokungena igqitywe njani ngokusebenza?

I. Yintoni indawo esemgangathweni yokungenaTibialIntramedullary?

Isikhundla se-orthotopic sifumaneka kwi-intersection ye-axis ye-mechanical ye-tibia kunye ne-tibial plateau, i-medial edge ye-lateral intercondylar spine ye-tibia, kunye ne-lateral position itholakala kwi-watershed phakathi kwe-tibial plateau kunye ne-tibial stem migration. indawo.

Uluhlu lwezowuni yokhuseleko kwindawo yokungena

I-22.9± 8.9mm, apho inaliti ingafakwa khona ngaphandle kokulimaza i-bony stop ye-ACL kunye ne-meniscus tissue.

II.Zithini iziphumo zokutenxaTibialIi-ntramedullary Nimpilo?

Ngokuxhomekeke kwi-proximal, i-middle, kunye ne-Distal Tibial Fractures, i-proximal tibial fracture inempembelelo ecacileyo, i-tibial fracture ye-tibial inefuthe elincinci, kwaye i-distal end ihambelana ngokuyinhloko kwindawo kunye nokubeka kwakhona i-Distal intramedullary nail.

# Ukwaphuka kweTibial okuPhambili

# Ukuqhekeka kweTibial kuMbindi

Inqaku lokungena linempembelelo encinci ekufudukeni, kodwa kungcono ukufaka isikhonkwane ukusuka kwinqanaba eliqhelekileyo lokungena.

# Ukuqhekeka kwe-Distal Tibial

Indawo yokungena iyadingeka ukuba ifane ne-proximal fracture, kwaye indawo ye-distal intramedullary nail iyadingeka ukuba ibekwe kwi-ortholaterally kwi-midpoint ye-distal fornix.

Ⅲ.Ho ukumisela ukuba indawo yokungena yenaliti ichanekile ngonyango?

Sidinga i-fluoroscopy ukujonga ukuba indawo yokungena inaliti ichanekile.Kubaluleke kakhulu ukuthatha i-orthopantomogram eqhelekileyo yamadolo ngokusebenza, ngoko kufuneka kuthathwe njani?

Umgca oqhelekileyo we-orthopantomogram-parallel wentloko ye-fibular

I-axis ye-mechanical ye-ortho-x-ray yenziwe umgca ochanekileyo, kwaye umgca ohambelanayo we-mechanical axis wenziwa kwi-lateral ye-plateau ye-tibial, ekufuneka idibanise intloko ye-fibular kwi-ortho-x-ray.Ukuba i-x-reyi enye enjalo ifunyenwe, ingqina ukuba ithathwe ngokuchanekileyo.

Ukuba i-ortho-slice ayikho esemgangathweni, umzekelo, ukuba isikhonkwane sondliwe ukusuka kwindawo yokutya eqhelekileyo, xa indawo yokujikeleza yangaphandle ithathwa, iya kubonisa ukuba indawo yokutya ingaphandle, kwaye indawo yokujikeleza yangaphakathi iya kubonisa ukuba feed point ingaphakathi, nto leyo eya kuchaphazela isigwebo sotyando.

Kwi-x-ray ye-lateral ye-x-ray, i-condyles ye-female ephakathi kunye ne-lateral idibanisa kakhulu kunye ne-medial and lateral tibial plateau ubukhulu becala, kunye nombono wecala, indawo yokungena ifumaneka kwindawo yamanzi phakathi kwe-plateau kunye ne-tibial stem.

IV.Isishwankathelo somxholo

I-standard standard ye-intramedullary nail entry point ifumaneka nge-orthogonally kwi-medial edge ye-lateral intercondylar spine ye-tibia kunye ne-lateral in the watershed phakathi kwe-tibial plateau kunye ne-tibial stem migration zone.

Indawo yokukhusela kwindawo yokungena incinci kakhulu, kuphela i-22.9 ± 8.9 mm, kwaye inaliti ingafakwa kule ndawo ngaphandle kokulimaza i-bony stop ye-ACL kunye ne-meniscal tissue.

I-orthopantomographs ye-intraoperative standard kunye ne-radiographs ye-lateral yamadolo kufuneka ithathwe, eyona nto ibalulekileyo ekunqumeni ukuba indawo yokungena inaliti ichanekile okanye cha.