Kwiqela le-HEVBTP, i-32% yezigulane zidibene nezinye izicubu okanye umonakalo wesakhiwo, kunye nezigulane ze-3 (i-12%) zine-popliteal vascular nzakala efuna ukulungiswa kokuhlinzwa.
Ngokwahlukileyo, kuphela i-16% yezigulane kwiqela le-non-HEVBTP lalinokulimala okunye, kwaye kuphela i-1% yayifuna ukulungiswa kwe-popliteal vascular.Ukongezelela, i-16% yezigulane ze-EVBTP zinokulimala okuyingxenye okanye okupheleleyo kwe-nerve peroneal kunye ne-12% yayine-calf compartment syndrome, xa kuthelekiswa ne-8% kunye ne-10% yeqela lokulawula, ngokulandelanayo.
Iinkqubo zokuhlukaniswa kwe-tibial plateau fracture, ezifana ne-Schatzker, i-Moore, kunye nokuhlelwa kwe-AO / OTA, yenzelwe ukunceda oogqirha botyando bachonge ukulimala okuhambelanayo kunye nokuphuhlisa izicwangciso zonyango.
Ezi ziqhekeza zidla ngokuhlelwa njenge-AO C kunye ne-Schatzker V okanye i-VI
Nangona kunjalo, iinkcukacha zolu hlobo lokuphuka lunokungahoywa ngolu luhlu, olunokuthi lushiye ezinye izigulana zinesifo esingeyomfuneko xa kukho iingxaki ezinzima ze-neurovascular.
Indlela yokulimala ye-HEVBTP ifana neye-anteromedial tibial plateau fracture edityaniswe nokulimala kwangasemva kwangaphandle kunye nokuqhekeka kwe-ligament cruciate.
Ngoko ke, ngenxa yokuphulwa kweplateau ye-anteromedial tibial, ingqalelo kufuneka ihlawulwe kwingozi yecala le-posterolateral lamadolo.
Kuphononongo lwangoku, ukulimala okuchazwe kwimeko yethu kwakudla ngokufana nokunyanzeliswa kwe-compression fracture ye-tibial plateau.Nangona kunjalo, ngokungafaniyo nokulimala kwezicubu ezithambileyo ze-posterolateral okanye i-posterior cruciate ligament, ukwenzakala kwezi meko kumathambo kwaye kujongwa njengokuqhekeka koxinzelelo kwi-metaphysis okanye kwiplati elisecaleni.
Ngokucacileyo, ukuchongwa kweepateni zokulimala yinto evumela oogqirha ukuba baphathe ngokufanelekileyo izigulane ezaphukileyo.Ukuchonga kwenziwa ngokufunyanwa kwangaxeshanye kwi-imaging ye-multiplanar kunye ne-computed tomography ukugqiba ubuqili bokulimala.
Kubalulekile ukuqaphela ukubaluleka kokulimala, okuyiyona nto ibalulekileyo enxulumene nokwenzakala.
UMoore waqaphela ukuba iintlobo ezithile zokulimala kwe-tibial plateau azikho zodwa kodwa zimele i-spectrum yokulimala okubandakanya ukulimala kwe-ligamentous kunye ne-neurovascular.
Ngokufanayo, kolu cwaningo, i-hyperextension kunye ne-varus tibial plateau i-bicondylar fractures ifunyenwe idibene ne-32% ingozi ephezulu yokulimala, kubandakanywa ukulimala kwenqanawa ye-popliteal, ukulimala kwe-nerve peroneal, kunye ne-compartment syndrome.
Ukuququmbela, i-hyperextension kunye ne-varus bicondylar tibial plateau fractures yindlela ekhethekileyo yokuphuka kwe-tibial plateau fractures.Iimpawu zomfanekiso wale modi zezi
(1) Ukulahleka kwethambeka elingasemva eliqhelekileyo phakathi kwendiza ye-sagittal kunye ne-tibial articular surface
(2) Ukuqhekeka koxinzelelo kwi-cortex yangasemva
(3) Ukunyanzeliswa kwe-cortex yangaphambili, i-varus deformity kwi-coronal view.
Oogqirha kufuneka baqonde ukuba le nzakala inokuthi yenzeke emva kwendlela yokulimala ephantsi kwamandla kubantu abadala abadala abanezinga eliphezulu lokulimala kwe-neurovascular.Izicwangciso zokunciphisa kunye ne-immobilization ezichazwe zingasetyenziselwa ukunyanga le ndlela yokulimala.
Ixesha lokuposa: May-16-2022