Ama-46% eempundu ezijikelezayo zeqakala zihamba kunye neempundu ezingasemva kwe-malleolar. Indlela ye-posterolateral yokubona ngokuthe ngqo kunye nokulungisa i-posterior malleolus yindlela yotyando esetyenziswa rhoqo, enika iingenelo ezingcono ze-biomechanical xa kuthelekiswa nokunciphisa okuvaliweyo kunye nokulungisa izikrufu ze-anteroposterior. Nangona kunjalo, kwiingceba ezinkulu ze-posterior malleolar fracture okanye iimpundu ezingasemva kwe-posterior malleolar ezibandakanya i-posterior colliculus ye-medial malleolus, indlela ye-posteromedial inika umbono ongcono wotyando.
Ukuze kuthelekiswe uluhlu lokuchatshazelwa kwe-posterior malleolus, uxinzelelo kwi-neurovascular bundle, kunye nomgama phakathi kwe-incision kunye ne-neurovascular bundle kwiindlela ezintathu ezahlukeneyo ze-posteromedial, abaphandi benze uphando lwesidumbu. Iziphumo zipapashwe kutshanje kwi-FAS journal. Iziphumo zishwankathelwe ngolu hlobo lulandelayo:
Okwangoku, kukho iindlela ezintathu eziphambili ze-posteromedial zokubonisa i-posterior malleolus:
1. Indlela yeMedial Posteromedial (mePM): Le ndlela ingena phakathi komphetho ongasemva we-medial malleolus kunye ne-tibialis posterior tendon (Umfanekiso 1 ubonisa i-tibialis posterior tendon).
2. Indlela eGuquliweyo yePosteromedial (moPM): Le ndlela ingena phakathi kwe-tibialis posterior tendon kunye ne-flexor digitorum longus tendon (Umfanekiso 1 ubonisa i-tibialis posterior tendon, kwaye Umfanekiso 2 ubonisa i-flexor digitorum longus tendon).
3. Indlela Yokuchukumisa Imisipha Engasemva Kwethambo (PM): Le ndlela ingena phakathi komphetho wethambo le-Achilles kunye nethambo le-flexor hallucis longus (Umfanekiso 3 ubonisa ithambo le-Achilles, kwaye Umfanekiso 4 ubonisa ithambo le-flexor hallucis longus).
Ngokuphathelele uxinzelelo kwi-neurovascular bundle, indlela ye-PM inoxinzelelo oluphantsi kwi-6.18N xa kuthelekiswa neendlela ze-mePM kunye ne-moPM, nto leyo ebonisa ukuba amathuba okuba i-neurovascular bundle itsale kancinci ngexesha lotyando ayancipha.
Ngokuphathelele uluhlu lokubonakala kwe-posterior malleolus, indlela ye-PM ikwabonelela ngokubonakala okukhulu, okuvumela ukubonakala kwe-posterior malleolus nge-71%. Xa kuthelekiswa, iindlela ze-mePM kunye ne-moPM zivumela ukubonakala kwe-posterior malleolus nge-48.5% kunye ne-57% ngokwahlukeneyo.
● Umzobo ubonisa uluhlu lokuchatshazelwa yi-posterior malleolus kwiindlela ezintathu. I-AB imele uluhlu olupheleleyo lwe-posterior malleolus, i-CD imele uluhlu oluchatshazelweyo, kwaye i-CD/AB yi-exposure ratio. Ukusuka phezulu ukuya ezantsi, uluhlu lokuchatshazelwa yi-mePM, i-moPM, kunye ne-PM luyaboniswa. Kuyacaca ukuba indlela ye-PM inoluhlu olukhulu lokuchatshazelwa.
Ngokuphathelele umgama ophakathi kwe-incision kunye ne-neurovascular bundle, indlela ye-PM nayo inomgama omkhulu, olinganisa i-25.5mm. Oku kukhulu kune-17.25mm ye-mePM kunye ne-7.5mm ye-moPM. Oku kubonisa ukuba indlela ye-PM inamathuba amancinci okwenzakala kwe-neurovascular bundle ngexesha lotyando.
● Umzobo ubonisa umgama ophakathi kwe-incision kunye ne-neurovascular bundle kwezi ndlela zintathu. Ukusuka ekhohlo ukuya ekunene, umgama weendlela ze-mePM, i-moPM, kunye ne-PM ubonisiwe. Kuyacaca ukuba indlela ye-PM inomgama omkhulu ukusuka kwi-neurovascular bundle.
Ixesha leposi: Meyi-31-2024
