Iindlela zotyando
Emva kokwamkelwa, izigulane zaphathwa ngonyango lotyando oluxhomekeke kwimeko.Okokuqala, i-fixator yangaphandle yayilungisiwe, kwaye ukuba iimeko ze-tissue ezithambileyo zivunyelwe, zatshintshwa ukulungiswa kwangaphakathi.
Ababhali bashwankathela amava abo kwaye bafumanisa ukuba isitshixo sokunciphisa ukuphuka kunye nokugcinwa kokunciphisa ukunciphisa i-cortical fracture yangemva kwe-tibia kuqala, kwaye emva koko ujongane nokunyanzeliswa kwe-compression fracture ye-anterior tibial plateau, ukwenzela ukubuyisela indiza ye-sagittal eqhelekileyo. umgca.
Ababhali batusa ukusetyenziswa kwe-proximal tibial anterolateral kunye neendlela ze-posteromedial zokunciphisa i-fracture kunye nokulungiswa.
Indlela ye-posterior tibial ingasetyenziselwa ukuveza i-posterior structure ye-tibia kwaye yenza ukunciphisa kunye nokulungiswa kweplate yenkxaso ye-anteromedial ngexesha lokusebenza.
Ukongezelela, ukulungiswa kwesikhashana kwe-posterior tibial plateau fractures kunokusebenza njenge-fulcrum yokunyusa i-fracture yangaphambili kunye nokunciphisa ukuchithwa kwe-fracture ngexesha lokulungiswa okulandelayo kokulungelelaniswa kwe-sagittal.
Emva kokuba i-fracture yokunciphisa i-posterior igqityiwe, isixhobo sokulungiswa kwesikhashana kufuneka sisetyenziselwe ukulungiswa, njengeplate ye-tubula ye-1/3 okanye i-screw ye-3.5mm ukusuka kwi-distal end yangaphambili ukuya kwi-posterior proximal end.
Emva koko, buyisela ukulungelelaniswa kwe-tibial plateau articular surface kunye ne-sagittal plane.Ngexesha lokusebenza, sebenzisa isixhobo sokunciphisa kunye nencam ebanzi yokunciphisa uxinzelelo kwaye ugweme ukunyanzeliswa kokwaphuka.
Ukubuyiselwa kwe-posterior tibial inclination kwaqaliswa kunye ne-anterior flap spacer okanye i-osteotome ngaxeshanye (umzobo 2).Ngaphantsi komgca odibeneyo osondeleyo, iingcingo ezininzi ze-Kirschner zifakwe ngokufana ukusuka phambili ukuya ngasemva, kwaye i-tibial retroversion yabuyiselwa ngokuphakamisa iingcingo ze-Kirschner, kwaye emva koko zilungiswe kwi-cortex yangasemva.
I-A-Fibular head autograft;B- I-Spinal Cage yokuzalisa isiphene samathambo
I-X-ray yecala ibonisa ukukhubazeka kwe-sagittal, kunye nefilimu ecacileyo ecacileyo ibonisa i-forceps yokunciphisa ukunciphisa ukuphuka kwe-tibial yangasemva ngoncedo lwe-distractor space sheet.
Ekugqibeleni, ipleyiti yayisetyenziselwa ukunciphisa iqhekeza leqhekeza ukulungisa i-sagittal retroversion.Isiphelo esiphezulu se-proximal lateral tibial plate (ukutshixa okanye ukungavalwa) kufuneka sihambelane nomgangatho we-articular, kwaye isiphelo esikude kufuneka sibe ngasemva kancinci.I-plate igxininiswe kwi-proximal fragment kunye ne-screws, kwaye ke i-plate kunye ne-proximal fragment yancitshiswa kwaye igxininiswe kwi-shaft ye-tibial ngokulungisa i-distal plate, ukwenzela ukubuyisela ukuthambekela okuqhelekileyo kwe-tibial posterior.
Emva kokuba ukuncitshiswa kwe-fracture kugqityiwe, ukulungiswa kwexeshana ngeengcingo ze-Kirschner kunokusetyenziswa.Kwezinye iimeko, ukulungiswa kwexeshana okuzinzileyo kunzima ukwenza ngaphandle kokuqala ukubuyisela umgca wamandla kunye ne-graft (i-tricortical iliac graft, i-fibular head graft, njl.
Ixesha lokuposa: May-09-2022