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) eyanyangwa ngenxa yokuphulwa kwe-ankle yangaphakathi kunye ne-screws yoxinzelelo olungenantloko kwiSibhedlele saseYunivesithi yaseSaint Louis phakathi kwe-2005 kunye ne-2011. Emva kokuhlinzwa, izigulane zazingenakunyakaziswa kwi-splints, i-casts okanye i-braces de kubekho. ubungqina bomfanekiso wokuphiliswa kokwaphuka ngaphambi kokuba i-ambulation ethwele ubunzima.
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
