Ukuqhekeka kwe-ankle yangaphakathi kaninzi kufuna ukuncitshiswa kwe-incision kunye nokulungiswa kwangaphakathi, mhlawumbi nge-screw fixation yodwa okanye kunye nokudibanisa kwamacwecwe kunye nezikrufu.
Ngokwesiko, i-fracture ilungiswe okwethutyana kunye ne-Kirschner pin kwaye ilungiswe kunye ne-half-threaded cancellous tension screw, enokuthi idibaniswe nebhendi yoxinzelelo. Abanye abaphengululi baye basebenzisa izikrufu ezinemisonto egcweleyo ukunyanga ukuqhekeka kweqatha eliphakathi, kwaye ukusebenza kwazo kubhetele kunoko kwezikrufu zoxinzelelo ezinemisonto ezinesiqingatha. Nangona kunjalo, ubude bee-screws ezigcweleyo buyi-45 mm, kwaye zigxininiswe kwi-metaphysis, kwaye ininzi yezigulane ziya kuba nentlungu kwi-ankle ephakathi ngenxa yeprotrusion yokulungiswa kwangaphakathi.
UDkt Barnes, ovela kwiSebe le-Orthopedic Trauma kwiSibhedlele seYunivesithi yaseSt Louis e-USA, ukholelwa ukuba i-screws yoxinzelelo olungenantloko inokulungisa zombini iifractures zangaphakathi ze-ankle ngokubhekiselele kwithambo, ukunciphisa ukungahambi kakuhle ekuphumeni kwangaphakathi, kunye nokukhuthaza ukuphulukiswa kwe-fracture. Ngenxa yoko, uGqr Barnes wenza uphando malunga nokusebenza kwe-screws yoxinzelelo olungenantloko kunyango lwe-ankle fractures yangaphakathi, esanda kupapashwa kwi-Injury.
Uphononongo lubandakanya izigulane ze-44 (iminyaka yobudala eyi-45, i-18-80 iminyaka) eyaye yanyangwa ngenxa yokuphuka kwe-ankle yangaphakathi kunye ne-screws yoxinzelelo olungenantloko kwiSibhedlele saseYunivesithi yaseSaint Louis phakathi kwe-2005 kunye ne-2011. Emva kokuhlinzwa, izigulane zazingenakunyakaziswa kwii-splints, i-casts okanye i-braces de kubekho ubungqina bokucinga ukuphulukiswa kwe-ambubering ngaphambi kobunzima obupheleleyo.
Uninzi lwezaphukile ngenxa yokuwa kwindawo yokuma kwaye ezinye zazingenxa yeengozi zesithuthuthu okanye imidlalo njl njl (Itheyibhile 1). Abangamashumi amabini anesithathu kubo babene-fractures ye-ankle ephindwe kabini, i-14 yayine-triple fractures ye-ankle kwaye i-7 eseleyo yayine-ankle fractures enye (Umfanekiso 1a). I-intraoperatively, izigulane ze-10 zaphathwa nge-screw yoxinzelelo olungenantloko olungenantloko kwi-fractures ye-ankle ye-medial, ngelixa izigulane ze-34 eziseleyo zinezikrini ezimbini zokucinezela ezingenantloko (Umfanekiso 1b).
Uluhlu 1: Indlela yokwenzakala
Umzobo 1a: Ukuphuka kwe-ankle enye; Umzobo we-1b: Ukuphuka kwe-ankle enye iphathwa nge-screws e-2 engenantloko.
Ngexesha lokulandelelana kweeveki ze-35 (iiveki ze-12-208), ubungqina bomfanekiso wokuphulukisa ukuphuka kwafunyanwa kuzo zonke izigulane. Akukho sigulana sasifuna ukususwa kwesikruphu ngenxa ye-screw protrusion, kwaye isigulane esinye kuphela esasifuna ukususwa kwesikrufu ngenxa yokusuleleka kwangaphambili kwe-MRSA kwisigxina esisezantsi kunye ne-postoperative cellulitis. Ukongeza, izigulane ze-10 zazinokukhathazeka kancinci kwi-palpation ye-ankle yangaphakathi.
Ngako oko, ababhali baphetha ngokuthi unyango lwe-ankle fractures kunye ne-screws yoxinzelelo olungenantloko lubangele izinga eliphezulu lokuphulukisa i-fracture, ukubuyiswa okungcono komsebenzi we-ankle, kunye neentlungu ezingaphantsi kokuhlinzwa.
Ixesha lokuposa: Apr-15-2024
