I-46% ye-ankle fractures ejikelezayo ihamba kunye ne-posterior malleolar fractures. Indlela ye-posterolateral yokujonga ngokuthe ngqo kunye nokulungiswa kwe-malleolus yangasemva yindlela esetyenziswa ngokuqhelekileyo yotyando, enikezela ngeenzuzo ezingcono ze-biomechanical xa kuthelekiswa nokunciphisa okuvaliweyo kunye ne-anteroposterior screw fixation. Nangona kunjalo, kwi-posterior malleolar fracture fractures enkulu okanye i-posterior malleolar fractures ebandakanya i-posterior colliculus ye-medial malleolus, indlela ye-posteromedial inikeza umbono ongcono wokuhlinzwa.
Ukuthelekisa i-exposure range ye-posterior malleolus, uxinzelelo kwi-bundle ye-neurovascular, kunye nomgama phakathi kwe-incision kunye ne-neurovascular bundle kwiindlela ezintathu ezahlukeneyo ze-posteromedial, abaphandi baqhube uphando lwe-cadaveric. Iziphumo zisanda kupapashwa kwijenali yeFAS. Iziphumo zishwankathelwa ngolu hlobo lulandelayo:
Okwangoku, kukho iindlela ezintathu eziphambili ze-posteromedial zokubonisa i-posterior malleolus:
1. Indlela ye-Posteromedial ephakathi (i-mePM): Le ndlela ingena phakathi komda we-posterior we-malleolus ephakathi kunye ne-tendon ye-tibialis yangasemva (Umfanekiso we-1 ubonisa i-tendon posterior tibialis).
2. Indlela yePosteromedial elungisiweyo (i-moPM): Le ndlela ingena phakathi kwe-tendon ye-tibialis yangasemva kunye ne-flexor digitorum longus tendon (Umfanekiso we-1 ubonisa i-tendon ye-tibialis yangasemva, kunye ne-Figure 2 ibonisa i-flexor digitorum longus tendon).
3. Indlela yePosteromedial (PM): Le ndlela ingena phakathi komda we-Achilles tendon kunye ne-flexor hallucis longus tendon (Umfanekiso 3 ubonisa i-tendon ye-Achilles, kwaye i-4 ibonisa i-flexor hallucis longus tendon).
Ngokumalunga noxinzelelo kwi-neurovascular bundle, indlela ye-PM ine-tension ephantsi kwi-6.18N xa kuthelekiswa neendlela ze-mePM kunye ne-moPM, ebonisa amathuba aphantsi okulimala kwe-intraoperative traction kwi-neurovascular bundle.
Ngokubhekiselele kwi-exposure range ye-posterior malleolus, indlela ye-PM iphinda ibonelele ngakumbi, ivumela ukubonakala kwe-71% ye-posterior malleolus. Xa kuthelekiswa, iindlela ze-mePM kunye ne-moPM zivumela i-48.5% kunye ne-57% ye-exposure ye-posterior malleolus, ngokulandelanayo.
● Umzobo ubonisa uluhlu lokuvezwa kwe-malleolus yangasemva kwezi ndlela zintathu. I-AB imele uluhlu olupheleleyo lwe-posterior malleolus, i-CD imele uluhlu olucacileyo, kunye ne-CD / AB yi-exposure ratio. Ukusuka phezulu ukuya ezantsi, uluhlu lokuvezwa lwe-mePM, i-moPM, kunye ne-PM luyaboniswa. Kucacile ukuba indlela ye-PM inolona luhlu lukhulu lokutyhileka.
Ngokumalunga nomgama phakathi kwe-incision kunye ne-neurovascular bundle, indlela ye-PM nayo inomgama omkhulu, ukulinganisa i-25.5mm. Oku kukhulu kune-mePM's 17.25mm kunye ne-moPM's 7.5mm. Oku kubonisa ukuba indlela ye-PM inomngcipheko ophantsi wokulimala kwe-neurovascular bundle ngexesha lotyando.
● Umzobo ubonisa imigama phakathi kokusikwa kunye ne-neurovascular bundle kwiindlela ezintathu. Ukusuka ekhohlo ukuya ekunene, imigama ye-mePM, i-moPM, kunye neendlela ze-PM iyaboniswa. Kuyabonakala ukuba indlela ye-PM inomgama omkhulu ukusuka kwi-neurovascular bundle.
Ixesha lokuposa: May-31-2024
