Ukuwa kwethafa le-tibial lateral okanye ukuwa okuqhekekileyo lolona hlobo luqhelekileyo lokuqhekeka kwethafa le-tibial. Injongo ephambili yotyando kukubuyisela ukuguda komphezulu we-joint kunye nokulungelelanisa umlenze ongezantsi. Umphezulu we-joint owileyo, xa uphakanyisiwe, ushiya isiphene sethambo phantsi kwe-cartilage, okudla ngokufuna ukubekwa kwethambo le-iliac eliyi-autogenous, ithambo le-allograft, okanye ithambo lokwenziwa. Oku kufeza iinjongo ezimbini: okokuqala, ukubuyisela inkxaso yesakhiwo sethambo, kwaye okwesibini, ukukhuthaza ukuphiliswa kwamathambo.
Xa kujongwa ukusikwa okongezelelweyo okufunekayo kwithambo le-iliac eliyi-autogenous, okukhokelela kwingozi enkulu yotyando, kunye neengozi ezinokubakho zokwaliwa kunye nosulelo oluhambelana nethambo le-allograft kunye nethambo lokwenziwa, ezinye iingcali zicebisa indlela eyahlukileyo ngexesha lokunciphisa i-lateral tibial plateau open reduction kunye ne-internal fixation (ORIF). Zicebisa ukwandisa ukusikwa okufanayo phezulu ngexesha lenkqubo kunye nokusebenzisa i-cancellous bone graft evela kwi-lateral femoral condyle. Iingxelo ezininzi zamatyala zibhale le ndlela.
Olu phononongo luquke iimeko ezili-12 kunye nedatha epheleleyo yokulandela imifanekiso. Kuzo zonke izigulane, kusetyenziswe indlela eqhelekileyo ye-tibial anterior lateral. Emva kokuveza i-tibial plateau, ukusika kwandiswe phezulu ukuze kubonakale i-lateral femoral condyle. Kwasetyenziswa i-12mm Eckman bone extractor, kwaye emva kokugqobhoza kwi-cortex yangaphandle ye-femoral condyle, ithambo le-cancellous elivela kwi-lateral condyle lavunwa ngokuphindaphindiweyo kane. Umthamo ofunyenweyo wawuphakathi kwe-20 ukuya kwi-40cc.
Emva kokunkcenkceshela umjelo wamathambo ngokuphindaphindiweyo, isiponji esihambisa igazi singafakwa ukuba kuyimfuneko. Ithambo elivuniweyo elirhoxisiweyo lifakwa kwisiphene sethambo phantsi kwethafa elisecaleni le-tibial, kulandele ukulungiswa kwangaphakathi rhoqo. Iziphumo zibonisa:
① Ukuze kulungiswe ngaphakathi kwethafa le-tibial, bonke abaguli baphumelele ukuphiliswa kwamathambo abo.
② Akukho ntlungu okanye iingxaki ezibonakalayo ezibonwe kwindawo apho ithambo lithathwe khona kwi-lateral condyle.
③ Ukuphiliswa kwethambo kwindawo yokuvuna: Phakathi kwabaguli abali-12, aba-3 babonakalise ukuphiliswa ngokupheleleyo kwethambo le-cortical, aba-8 babonakalise ukuphiliswa okungaphelelanga, kwaye omnye akabonisanga ukuphiliswa okucacileyo kwethambo le-cortical.
④ Ukwakheka kwe-trabeculae yamathambo kwindawo yokuvuna: Kwiimeko ezili-9, akukho kwakheka kubonakalayo kwe-trabeculae yamathambo, kwaye kwiimeko ezi-3, ukwakheka okuncinci kwe-trabeculae yamathambo kwabonwa.
⑤ Iingxaki ze-osteoarthritis: Phakathi kwabaguli abali-12, aba-5 baba nesifo samathambo esibuhlungu esimalunga nedolo. Omnye wabaguli watshintshwa amalungu emva kweminyaka emine.
Ukuqukumbela, ukuqokelela ithambo elirhoxisiweyo kwi-ipsilateral lateral femoral condyle kuphumela ekupholisweni kakuhle kwethambo le-tibial plateau ngaphandle kokwandisa umngcipheko weengxaki emva kotyando. Le ndlela inokuqwalaselwa kwaye ibhekiselwe kuyo kwizonyango.
Ixesha leposi: Oktobha-27-2023
