Ukuqhekeka kwe-tibial shaft kukwenzakala okuqhelekileyo kwezonyango. Ukufakelwa kwangaphakathi kwezipikili ngaphakathi kwe-intramedullary kuneengenelo ze-biomechanical zokufakelwa okuncinci kakhulu kunye nokufakelwa kwe-axial, okwenza kube sisisombululo esiqhelekileyo sonyango lotyando. Kukho iindlela ezimbini eziphambili zokubethela izipikili zokufakelwa kwezipikili ngaphakathi kwe-tibial: ukubethela kwe-suprapatellar kunye ne-infrapatellar, kunye nendlela ye-parapatellar esetyenziswa ngabanye abaphengululi.
Xa kuqhekeka i-1/3 ye-tibia ekufutshane, ekubeni indlela ye-infrapatellar ifuna ukugoba idolo, kulula ukuba loo ndlela ye-frapatellar ijike iye phambili ngexesha lotyando. Ke ngoko, indlela ye-suprapatellar idla ngokucetyiswa kunyango.
▲Umfanekiso obonisa indawo yelungu elichaphazelekayo ngendlela ye-suprapatellar
Nangona kunjalo, ukuba kukho izinto ezingahambelaniyo nendlela ye-suprapatellar, njengokudumba kwezicubu ezithambileyo zasekuhlaleni, indlela ye-infrapatellar kufuneka isetyenziswe. Indlela yokuphepha ukugungqa kwesiphelo sokuqhekeka ngexesha lotyando yingxaki ekufuneka ijongwane nayo. Abanye abaphengululi basebenzisa iipleyiti zentsimbi ezincinci ukulungisa okwethutyana i-cortex yangaphambili, okanye basebenzise izipikili ezivalayo ukulungisa ukugungqa.
▲ Umfanekiso ubonisa ukusetyenziswa kwezikhonkwane ezivalayo ukulungisa i-engile.
Ukusombulula le ngxaki, iingcali zamanye amazwe zasebenzisa indlela engeyiyo eyokuhlutha ulwazi. Eli nqaku lipapashwe kutshanje kwiphephancwadi elithi "Ann R Coll Surg Engl":
Khetha izikrufu ezibini zesikhumba ezingama-3.5mm, kufutshane nencam yesiphelo esiphukileyo, faka isikrufu esinye phambili nangasemva kwiziqwenga zamathambo kuzo zombini iziphelo zokwaphuka, uze ushiye ngaphezulu kwe-2cm ngaphandle kolusu:
Bamba i-reduction forceps ukuze ugcine i-reduction, uze ufake i-intramedullary nail ngokweenkqubo zesiqhelo. Emva kokuba i-intramedullary nail ifakwe, susa isikrufu.
Le ndlela yobugcisa ifanelekile kwiimeko ezikhethekileyo apho iindlela ze-suprapatellar okanye ze-parapatellar zingenakusetyenziswa, kwaye azikhuthazwa rhoqo. Ukubekwa kwesi sikrufu kunokuchaphazela ukubekwa kwesipikili esiphambili, okanye kunokubakho umngcipheko wokwaphuka kwesikrufu. Ingasetyenziswa njengesalathiso kwiimeko ezikhethekileyo.
Ixesha leposi: Meyi-21-2024
