Inkcazo: Injongo: Ukuphanda izinto ezinxulumene nesiphumo sokusebenzisa ipleyiti yentsimbi ukulungiswa kwangaphakathi ukubuyiselai-tibial plateau fracture. Indlela: Izigulane ezingama-34 ezine-tibial plateau fracture zaqhutywa ngokusebenzisa ipleyiti yentsimbi yokulungiswa kwangaphakathi kwelinye okanye icala ezimbini, ibuyiselwe i-tibal Plateau isakhiwo se-anatomical, ukulungiswa ngokuqinileyo, kwaye yathatha umsebenzi wokuqala wokusebenza emva kokusebenza. Isiphumo: Zonke izigulana zilandelwe iinyanga ezi-4 ukuya kwezingama-36, umndilili weenyanga ezili-15, ngokwenqaku likaRasmussen, izigulane ezingama-21 zazikwizinga eliphezulu, ezisi-8 ngokulungileyo, ezi-3 zivunyiwe, ezi-2 kumahlwempu. Umlinganiselo ogqwesileyo ube ngama-85.3%. Isiphelo: Bamba amathuba okusebenza afanelekileyo, sebenzisa iindlela ezichanekileyo kwaye uthathe imithambo yokusebenza kwangaphambili, usinike iziphumo ezigqwesileyo zokusebenza ekunyangeni.i-tibialUkuqhekeka kwethafa.
1.1 Ulwazi oluphangaleleyo: eli qela linezigulane ezingama-34 ezinamadoda angama-26 kunye nabasetyhini abayi-8. Izigulana zazineminyaka engama-27 ukuya kwengama-72 kunye nobudala obuphakathi kwama-39.6. Kwakukho iimeko ze-20 zokulimala kweengozi zendlela, iimeko ze-11 zokulimala okuwa kunye neemeko ezi-3 zokutyunyuzwa okukhulu. Zonke iimeko zavalwa iifractures ngaphandle kokulimala kwe-vascular. Kwakukho iimeko ze-3 zokulimala kwe-cruciate ligament, iimeko ze-4 zokulimala kwe-collateral ligament kunye neemeko ze-4 zokulimala kwe-meniscus. Iifractures zahlulwa ngokuhambelana ne-Schatzker: iimeko ze-8 zohlobo lwe-I, iimeko ze-12 zohlobo lwe-II, iimeko ze-5 zohlobo lwe-III, iimeko ze-2 zohlobo lwe-IV, iimeko ze-4 zohlobo lwe-V kunye nee-3 ze-VI uhlobo. Zonke izigulane zavavanywa nge-X-ray, i-CT scan ye-tibial plateau kunye nokwakhiwa kwakhona kwe-dimensional-dimensional, kwaye ezinye izigulane zihlolwe ngu-MR. Ngaphandle koko, ixesha lokusebenza laliyi-7 ~ 21d emva kokulimala, umyinge we-10d. Koku, bekukho izigulane ezingama-30 ezamkela unyango lokufakelwa kwamathambo, izigulane ezi-3 zamkela ukulungiswa kwepleyiti ephindwe kabini, kwaye ezinye izigulane zamkela ukulungiswa kwangaphakathi kwe-unilateral.
1.2 Indlela yoTyando: yenziweumqoloi-anesthesia okanye i-intubation anesthesia, isigulane sasikwisikhundla esiphezulu, kwaye siqhutywe phantsi kwe-tourniquet ye-pneumatic. Utyando lusebenzise idolo le-anterolateral, i-tibial yangaphambili okanye i-lateralidolo ngokubambisanaukusika ngasemva. I-coronary ligament yahlanjululwa ecaleni kwe-Incision ecaleni komphetho ongezantsi we-meniscus, kwaye yaveza umphezulu we-articular we-tibial plateau. Nciphisa iifractures zeplateau phantsi kombono othe ngqo. Amanye amathambo aqala ukulungiswa kunye nezikhonkwane ze-Kirschner, aze agqitywe ngamacwecwe afanelekileyo (i-golf-plate, i-L-plates, i-T-plate, okanye idibaniswe ne-medial buttress plate). Iziphene zamathambo zazaliswa ngethambo le-allogen (kwangoko) kunye ne-allograft bone grafting. Kulo msebenzi, ugqirha waqaphela ukunciphisa i-anatomical kunye nokunciphisa i-anatomical proximal, igcinwe i-axis ye-tibial eqhelekileyo, ukulungiswa kwangaphakathi okuqinileyo, ukuxutywa kwethambo kunye nenkxaso echanekileyo. I-probed i-knee ligament kunye ne-meniscus yokuxilongwa kwangaphambili okanye iimeko ezikrokrelwayo ze-intra-operative, kwaye yenza inkqubo efanelekileyo yokulungisa.
1.3 Unyango lwasemva kokuhlinzwa: i-bandage elastiki ye-postoperative kufuneka iboshwe ngokufanelekileyo, kwaye i-incision kade ifakwe nge-tube yokuhambisa amanzi, ekufuneka ikhutshwe kwi-48h. I-analgesia yesiqhelo emva kokuhlinzwa. Izigulana zathatha i-exercise ye-muscle yomlenze emva kwe-24h, kwaye zathatha i-CPM yokuzivocavoca emva kokususa ityhubhu yokukhupha iifractures ezilula. Ukudibanisa i-collateral ligament, iimeko zokulimala kwe-posterior cruciate ligament, ngenkuthalo kunye nokunyanzeliswa kwedolo emva kokulungisa i-plaster okanye i-brace inyanga enye. Ngokweziphumo zovavanyo lwe-X-ray, ugqirha wotyando ukhokele izigulane ukuba zithathe ngokuthe ngcembe imithambo yomthwalo womzimba, kwaye ukulayisha ubunzima obupheleleyo kufuneka kwenziwe ubuncinane kwiinyanga ezine kamva.
Ixesha lokuposa: Jun-02-2022
