Ukuqhekeka kwe-ankle edibeneyo ebangelwa yimikhosi ejikelezayo okanye ethe nkqo, efana ne-Pilon fractures, ihlala ibandakanya i-malleolus yangasemva. Ukuvezwa kwe "posterior malleolus" okwangoku kuphunyezwa ngeendlela ezintathu eziphambili zotyando: indlela ye-posterior lateral, i-posterior medial approach, kunye ne-modified posterior medial approach. Ngokuxhomekeke kuhlobo lokuphuka kunye ne-morphology yamathambo amathambo, indlela efanelekileyo inokukhethwa. Abaphengululi bamazwe angaphandle baye baqhuba izifundo ezithelekisayo kwi-exposure range ye-posterior malleolus kunye noxinzelelo kwi-vascular and neural bundles ye-ankle joint ehambelana nezi ndlela zintathu.
Ukuqhekeka kwe-ankle edibeneyo ebangelwa yimikhosi ejikelezayo okanye ethe nkqo, efana ne-Pilon fractures, ihlala ibandakanya i-malleolus yangasemva. Ukuvezwa kwe "posterior malleolus" okwangoku kuphunyezwa ngeendlela ezintathu eziphambili zotyando: indlela ye-posterior lateral, i-posterior medial approach, kunye ne-modified posterior medial approach. Ngokuxhomekeke kuhlobo lokuphuka kunye ne-morphology yamathambo amathambo, indlela efanelekileyo inokukhethwa. Abaphengululi bamazwe angaphandle baye baqhuba izifundo ezithelekisayo kuluhlu lokuvezwa kwe-posterior malleolus kunye noxinzelelo.
kwi-vascular and neural bundles ye-ankle joint ehambelana nezi ndlela zintathu.
1. Indlela yangasemva ePhakathi
Indlela ye-posterior medial ibandakanya ukungena phakathi kwe-flexor ende yeenzwane kunye neenqanawa ze-posterior tibial. Le ndlela inokutyhila i-64% ye-malleolus yangasemva. Uxinzelelo kwi-vascular and neural bundles kwicala lale ndlela ilinganiswa kwi-21.5N (19.7-24.1).
▲ Indlela eNgasemva ePhakathi (Utolo olumthubi). 1. I-tendon ye-posterior tibial; 2. Ithenda ende ye-flexor yeenzwane; 3. Iinqanawa ze-posterior tibial; 4. I-nerve yeTibial; 5. Umthambo we-Achilles; 6. I-Flexor hallucis longus tendon. I-AB = 5.5CM, i-posterior malleolus exposure range (AB / AC) yi-64%.
2. Indlela yangasemva kweLateral
Indlela ye-posterior lateral ibandakanya ukungena phakathi kwe-peroneus longus kunye ne-brevis tendon kunye ne-flexor hallucis longus tendon. Le ndlela inokutyhila i-40% ye-malleolus yangasemva. Uxinzelelo kwi-vascular and neural bundles kwicala lale ndlela ilinganiswa kwi-16.8N (15.0-19.0).
▲ Indlela yangasemva kwecala (utolo olumthubi). 1. I-tendon ye-posterior tibial; 2. Ithenda ende ye-flexor yeenzwane; 4. Iinqanawa ze-posterior tibial; 4. I-nerve yeTibial; 5. Umthambo we-Achilles; 6. I-Flexor hallucis longus tendon; 7. Umthambo we-Peroneus brevis; 8. Umthambo we-Peroneus longus; 9. Umthambo omncinci we-saphenous; 10. I-nerve ye-fibular eqhelekileyo. AB = 5.0CM, i-posterior malleolus exposure range (BC/AB) yi-40%.
3. Indlela eNgemva ePhakathi eLungisiweyo
Indlela ehlaziyiweyo ye-posterior medial ibandakanya ukungena phakathi kwe-nerve ye-tibial kunye ne-flexor hallucis longus tendon. Le ndlela inokutyhila i-91% ye-malleolus yangasemva. Uxinzelelo kwi-vascular and neural bundles kwicala lale ndlela ilinganiswa kwi-7.0N (6.2-7.9).
▲ Indlela eNgasemva eMediyo eLungisiweyo (utolo olumthubi). 1. I-tendon ye-posterior tibial; 2. Ithenda ende ye-flexor yeenzwane; 3. Iinqanawa ze-posterior tibial; 4. I-nerve yeTibial; 5. I-Flexor hallucis longus tendon; 6. Umthambo we-Achilles. AB = 4.7CM, i-posterior malleolus exposure range (BC/AB) yi-91%.
Ixesha lokuposa: Dec-27-2023
