I-Tibial shaft fracture yinto eqhelekileyo yokulimala kweklinikhi. I-Intramedullary nail fixation yangaphakathi ineenzuzo ze-biomechanical of minimal invasive kunye ne-axial fixation, eyenza isisombululo esiqhelekileyo sonyango lotyando. Kukho iindlela ezimbini eziphambili zokubethelela i-tibial intramedullary nail fixation: i-suprapatellar kunye ne-infrapatellar nailing, kunye nendlela ye-parapatellar esetyenziswa ngabaphengululi abathile.
Ukuqhekeka kwe-1/3 ye-tibia esondeleyo, ekubeni indlela ye-infrapatellar idinga ukuguqa ngamadolo, kulula ukubangela ukuba i-fracture ibheke phambili ngexesha lokusebenza. Ke ngoko, indlela ye-suprapatellar idla ngokucetyiswa kunyango.
▲Umfanekiso obonisa ukubekwa kwelungu elichaphazelekayo ngokusebenzisa indlela ye-suprapatellar
Nangona kunjalo, ukuba kukho ukuchasana kwindlela ye-suprapatellar, efana ne-soft tissue ulceration, indlela ye-infrapatellar kufuneka isetyenziswe. Indlela yokuphepha i-angulation yokuphela kwe-fracture ngexesha lotyando yingxaki ekufuneka ijongene nayo. Abanye abaphengululi basebenzisa iipleyiti zetsimbi ezinqamlekileyo ukuze balungise okwethutyana i-cortex yangaphambili, okanye basebenzise izikhonkwane zokuthintela ukulungisa i-angulation.
▲ Umfanekiso ubonisa ukusetyenziswa kwezipikili zokuthintela ukulungisa i-angle.
Ukucombulula le ngxaki, abaphengululi bamazwe angaphandle basebenzisa ubugcisa obungephi. Eli nqaku lisanda kupapashwa kwiphephancwadi elithi "Ann R Coll Surg Engl":
Khetha izikrufu ezibini zesikhumba eziyi-3.5mm, kufutshane nencam yesiphelo esaphukileyo, faka isikrufu esinye phambili nasemva kwiqhekeza lamathambo kuzo zombini iziphelo zokwaphuka, kwaye ushiye ngaphezulu kwe-2cm ngaphandle kwesikhumba:
Gquba i-forceps yokunciphisa ukugcina ukunciphisa, uze ufake i-intramedullary nail ngokweenkqubo eziqhelekileyo. Emva kokuba isikhonkwane se-intramedullary sifakwe, susa isikrufu.
Le ndlela yobugcisa ifanelekile kwiimeko ezikhethekileyo apho iindlela ze-suprapatellar okanye i-parapatellar azikwazi ukusetyenziswa, kwaye ayikhuthazwa ngokuqhelekileyo. Ukubekwa kwesi sikrufu kunokuchaphazela ukubekwa kwesikhonkwane esiphambili, okanye kunokubakho umngcipheko wokuqhekeka kwesikrufu. Ingasetyenziswa njengesalathiso kwiimeko ezikhethekileyo.
Ixesha lokuposa: May-21-2024
