Tibial intter tekinike yo gukosora imisumari

Intramedillary ikosora imisumari ikomeje kuvura amahitamo yo guhitamo ibiti bidahungabana kandi byimuwe byimuwe mubantu bakuru. Intego yo kwivuza nukugarura uburebure, guhuza no kuzunguruka tibia no kugera ku gukiza. Ibyiza byimisumari ya inttttttttttttttttttttttttttttttttttttttramedilla ni bike kubaga nubutaha no kubungabunga amaraso kugirango bigavura amaraso. Byongeye kandi, intera ya Intramedullary yo muri Tibia itanga ibirego bifatika biremereye kandi bikora nkibikoresho byo gusangira imitwaro bituma ubukangurambaga bwamahoro hakiri kare. Iterambere mu misumari y'imisumari no kugabanya kugabanya ibimenyetso byerekana intera imisumari yo gukosora imisumari yo gushyiramo tibia ya proxima no hagati ya gatatu hagati.

Kugeza uyu munsi, kugabanuka gufunga imisumari yo gukosora imitako ya tibial yabaye uburyo rusange bwo kubaga amagufwa. Nubwo yakunzwe imisumari yimisumari yimurwa, ikomeje kuba ingorabahizi kandi ifite ibibazo byinshi bishobora kuba. Ubuhanga bwo kubaga bukomeje guhinduka. Intego yiyi ngingo ni ugusobanura ibitekerezo byubu muri intttttttttttttttttterlary gukosora imisumari ya tibial stem ivunika no kuvuga muri make iterambere rya vuba mumurima.

一. Isuzuma ryambere no kugenzura

Mu barwayi bato, kuvunika indwara zo muri Tibial akenshi akenshi bikomoka ku bikomere by'ingufu nyinshi, kandi abarwayi bagomba gusuzumwa mu mbaraga zijyanye n'ubuyobozi bwateye imbere mu buryo buharanira inyungu zateye imbere. Suzuma uruhu ruzengurutse uruhu ruzengurutse hamwe n'ibikomere byoroshye nko kuvunika ibisekuruza, ibihuha, gutwika, ecchymose, cyangwa uruhu; gusobanura niba kuvunika bifunguye, kandi niba aribyo kuvura hamwe na Tetanusi na antibiotique; Kandi kora ikizamini cyiza cya neurovascular hanyuma wandike ibyavuzwe haruguru. Suzuma ibibaho bya Syndrome ya OsteoFofcecialcation hanyuma ugakora urukurikirane rwibizamini byubuvuzi muri aba barwayi.

Ubushakashatsi buherutse gukorwa bwerekanye ko ari ikibazo cy'ikigereranyo cya OsteoFomemiocial gikurikira gikurikira kuvunika amarumbukibindi bishobora kuba byinshi nka 11.5%. By'umwihariko, amatsinda ato yo kwihangana birashoboka cyane guteza imbere syndrome ya OsteofAsment. Gusuzuma syndrome ya OsteoFosisment bikunze gushingira ku mvugo, harimo n'ububabare bukabije, hashyizweho impinduka nini, kubyimba icyumbano myfficial, no kongera ububabare bwo kwaguka kwa paye. Kubwibyo, syndrome ya Osteofasment Coverment Ari zikomeje kwisuzumisha no gutanga neza kwipimisha ubuvuzi ni ngombwa. Umuvuduko mubice myofAstement birashobora gupimwa hakoreshejwe urushinge rwigitutu (Ishusho 1) nkikintu cyibizamini byuzuzanya.

Igishushanyo 1. Gupima igitutu muri septum ya septum hakoreshejwe urushinge rwibiti

Kugirango ubone amakuru yizewe, imikazo idakoreshwa mubice bine byanofsication no ahantu hatandukanye muri buri gice myofsication. Ubushakashatsi mubitabo byerekana ko itandukaniro ry'umuvuduko wo munsi ya 30 mmhg (igitutu cya diastolike kirimo igitutu cyimiterere yibyishimo) byerekana ko habaho syndrome yihuta. Umuvuduko wa Diastolick mubisanzwe ugabanuka mugihe cyo kubagwa, kandi umuvuduko ukabije wa diastolive ugomba kwitabwaho mugihe ubara igitutu gitandukanye.

Ubushakashatsi buherutse gukorwa bwerekanye ko gukurikirana igitutu cya interineti ari igikoresho gishobora kuba gishobora kwisuzumisha ihohoterwa rishingiye ku gitsina rikomeye, hamwe na 94% na 98%. Ariko, ukurikije ingaruka zishobora guteza akaga, gusuzuma syndrome yicyumba bigomba gushingira kubikorwa byubuvuzi, nibipimo byimitutu byimitutu bigomba gukoreshwa mubihe byihariye, nkibibazo byakomeretse cyangwa mugihe umurwayi abupfurwa.

Isuzuma ryamashusho rigomba kubamo OrthopantomogramGograms Nkuru n'ibitekerezo bya Tibia na Radiyo yakomeretse bipfukaho n'ijwi ryegeranye n'ingingo, bikomeza gusuzuma ukoresheje tomografiya (ct). Mu buryo nk'ubwo, ct scan yo kugurumana irashobora gukenerwa no kwiyumvisha imirongo yo kuvunika kwagura ibibaya bya tibial kandi bifitanye isano n'imvune idahwitse

二. Imitego ya calinique

Ijanisha ryinshi ryibijyanye no hagati ya gatatu ya Tibia hamwe no kuvunika amaguru. Gukoresha STAS isanzwe, 43% by'ibice byo hagati no hepfo ya gatatu bya Tibia biherekejwe no kuvunika amaguru, ubwinshi muri byo busaba kwivuza. Ubwoko busanzwe bwo kuvunika bwari buvunika hagati ya gatatu hagati ya tibia ya kure bifitanye isano no kuvunika amaguru make cyangwa bidasubirwaho (Ishusho 2). Bitewe no kwimura bike byavuza amaguru, 45% gusa byimvune bishobora kugaragara kuri radio isanzwe. Kubwibyo, scan ct scan scan yiguru igomba gushimangirwa cyane mugihe kuvunika amati ya tibia yo hagati birahari (Ishusho 3).

Igishushanyo cya 2.ambika ivurungano yo hepfo ya gatatu ya tibia yiburyo (c) radiografiya yibanze ya ankle yerekana ibisanzwe (c). Kurwanya C-ART Fluoscopy yerekana kuvunika amaradiyo yinyuma (d) nyuma yinyuma ya posita nyuma yo gukosora (ef) kwerekana gukira neza kuvuza no gutwika

Igishushanyo cya 3. AF Flicral Kuvunika hagati no hepfo ya gatatu yibumoso (ab) ya radiyo yibanze; . (EF) Kwerekana gukira bidashoboka Kugabanuka kwa Tibia

三. Uburyo bwo kubaga

01. INGINGO ZIKURIKIRA

Gushiraho ingingo yinjira mu buryo bwinjiriro bufite uruhare runini kandi inyigisho nyinshi mu bitabo zatanze amakuru y'ingenzi kumwanya wa anatomical aho yinjira muburyo bwiza bwo kuvura. Ubu bushakashatsi bwerekanye ko ingingo nziza ya pinning iherereye kuruhande rwimbere yikibaya cya tibial kandi ihuza gusa mumitambiko ya parike. Agace k'umutekano dufite ubugari bwa 22.9 mm ± 8.9 mm, idatera kwangirika ku nzego zegeranye, nazo zatangajwe. Ubusanzwe, intangiriro yo kuvuza imisumari yo gukosora imitako ya tibial yashyizweho binyuze muburyo bwa infranslarLer, haba mugabanye patellar tendon (uburyo bwo kwamamaza) cyangwa mugushiramo igice cya patellar tendon ihagarara (inzira ya patellar).

Semi-yagutse intera imisumari yakunze kwitondera cyane mubuvanganzo bwa orttopedic iherutse, hanyuma Tornetta na Collins bavuga ko imisumari yo kwagura imbere kugirango yirinde umusumari wo kwagura imbere muri tibial for Intramedillary imisumari mumwanya wo kwagura kandi irasabwa. Gukoresha uburyo bwo gukwirakwiza kuri intera ya tibial intera no kwinjiza intera imisumari binyuze mu mpimbano ya patelloferal mumwanya wa kabiri urasabwa.

Inzira ikorwa hamwe na direfe ihindagurika hafi ya dogere 15-20, hamwe no guhagarika uburebure bwa santimetero 3 zigizwe nubugari bumwe kugeza kuri patel. Amayeri ya Quadrices yacitsemo ibice muburyo burebire kandi butarimo kutagaragara bikozwe mu mpimbano. Sock ya Blunt yinjijwe mu mpimbano ya patelloferal kugirango ireme ingingo yinjire kumurimo wa Proximal Intertex Imbere hamwe nubuso bwa Articular (Ishusho 4).

Igishushanyo cya 4. AB amafoto ahinnye ya (a) kugabana quadrices ya quadrices hanyuma ushyiremo trocar unyuze mu mpimbano unyuze kumurongo winjira mubyinjira. (b) Kubona ibintu bifatika byerekana aho byinjira

Umuyoboro wa MM 3.2 ukoreshwa kugirango umenye igingoro cyo gutangizwa munsi ya C-RMY. Sokeya yatunganijwe ihabwa neza-humura neza. Uburyo busigaye bwo kubaga harimo no gusubiramo imisumari bisubirwamo bikozwe binyuze muri sock.

Ibyiza bishobora kuba: Umwanya wa kabiri wamaguru urashobora gufasha muguhagarika, cyane cyane mumiterere hamwe na kimwe cya gatatu cya gatatu cya Tibia no imbere. , Umwanya wa kabiri wo muri kimwe cya kabiri urashobora gukuraho impagarara kuri quadriceps imitsi nimfashanyo muburyo bwo kuvunika. , Igice cya kabiri cya secapatellar gishobora kandi kuba ubundi buryo bwinzira ya GrandAtellar (Ishusho 5).

Igishushanyo cya 5. Ifoto ifatika yerekana imvune yoroheje mukarere ka infrapatellar nkigipimo cyo kwerekana uburyo bwo gukwirakwiza mu gice cya kabiri.

Ubushakashatsi bwerekanye ko uburyo bwo kwerekana gahunda ya Tibial Intramedial Ibigeragezo by'amavuriro bizaza kugirango byongere gukora iperereza ku nyungu n'ibibi bya suprapatellar wegere intera imisumari no gusuzuma ibizamuro birebire bifitanye isano n'ubuhanga.

02. Ongera usubize ikoranabuhanga

Gushyira Intemere ya Tibial Intersullary Yonyine ntabwo bivamo kugabanuka bihagije; Kugabanya amakuru neza bigomba kubungabungwa muburyo bwo gusubira inyuma ndetse no gushira imisumari. Gushyira mu bikorwa gukurura intoki byonyine ntibishobora kugera ku kugabanya anatomic kumeneka ubwayo. Iyi ngingo izasobanura ibintu bitandukanye bifunze, bidafite imbaraga, no kugabanuka kumugaragaro.

-Ibikoresho byo gusubiramo tekinike

Kugabanya amafaranga yafunzwe birashobora kugerwaho nigikoresho cyo kugabanya nka F-Citraction Igikoresho cyo kugabanya amajinya gikosora ihindagurika / kugambura ibirungo byanduye / gutandukana (Ishusho 6).

Igishushanyo cya 6. F-SHACED igabanya kugabanya kubagwa

Ariko, igikoresho gishobora gushira imihangayiko ikomeye kumyenda yoroshye, kandi ikoreshwa rimwe ryibikoresho byo gusubiramo bigomba kwirindwa. Kugabanuka kwingufu birashobora kandi gushyirwa mubisanzwe, nkuko biri mubice bivunika kandi bya oblique. Ibi bikoresho birashobora gukoreshwa muburyo bworoshye-tissue muburyo bwa gicuti binyuze mumateka mato (Ishusho 7).

Igishushanyo cya 7. Kugaragaza neza kugirango usubize kuvunika tibial

Ubwoko bwa clamp hamwe niherererwa ko kubaga bigomba gutoranywa bishingiye ku ngamba zo kugabanya ibyangiritse igihe kirekire kubice byoroheje byo gushira (Ishusho 8).

Igishushanyo cya 8. Yerekanye imbaraga zo gusubiramo kugirango usubiremo imiti

Abasubiramo nabo nimwe mubikoresho bisanzwe byo gusubiramo byakoreshwaga mugarura uburebure kuri Tibia. Mubisanzwe bishyirwa mu buryo bworoshye kandi kure y'aho umusumari w'inganda ugomba gushyirwa. Amapikikoni yo gukurura ibintu arashobora gushyirwaho umwanya wa proximal ukuramo umwanya wa screw, wemerera kugabanya kuvuka iyo umusumari wa Intramedullar arahari.

Rimwe na rimwe, harasigaranye uburyo bwo kugabanya uburyo buracyafite budahagije kubona kugabanuka kwa anatomic. Mu bihe nk'ibi, tekinike yo kugabanya igomba gufatwa no gucunga neza imyenda yoroshye. Izi Ingaruka zo kugabanya uburyo bwo kugabanya ikubiyemo ihungabana ryo kubaga, zishobora kongera ibyago byo kwandura urubuga. Byongeye kandi, inyongera yinyongera yo gutanga amaraso kurubuga rushobora kongera ibyago byo kuvunika nyuma yo kuvuka.

-Inyabumenyi mu buryo bwo gutegurwa no kwisubiraho

Kugabanuka kwa INTERVaLD TENES ntabwo ari ingufu zo kubaga gusa zishyizwe mumwanya ukwiye, ariko nanone gushyira mubice bito cyangwa minioture ku rubuga rwo kuvunika kugirango bagabanuke mu nzira yo gutera imisumari.

Ibisahani bifite agaciro hamwe nibice byacitse kandi bya kure ukoresheje imigozi ya monocortike. Imvugo iragumishijwe mu nzira yo kongera gushimangira no gushyira umusumari mu musumari mu Tibia. Nyuma yo gushyira imvururu za Intramedullary, isahani yakuweho cyangwa igasigaranweho kugirango yongere umutekano wimiterere ihamye (Ishusho 9). Mugusiga isahani mu mwanya, imigozi imwe co correy igomba guhuzwa hamwe na screki ebyiri corts. Bikwiye gufatwa nkibikoreshwa mu manza zahisemo aho uruti rwa tibial rusaba kubaga rufunguye kugirango tugere ku kugabanya kugabanuka kwemerwa.

Igishushanyo cya 9. Fungura Tibia Kuvunika hamwe ninguzanyo zikabije hamwe nububiko bukabije bwamagufwa

Intego yo guhagarika imisumari ni ukugabanya umwobo wabagaburiye mukarere ka Metaphyseal. Guhagarika imisumari bishyirwa mubice bigufi bya arcoular no kuruhande rwubumuga mbere yisi yo mu mujyi wa Intramedullary. Kurugero, ubumuga busanzwe bwo kuvunika bwa gatatu bwa gatatu ya Tibia irangwa na Valgus no Kubaza imbere. Kugirango ukosore udusimba twijimye, gufunga gufunga birashobora gushyirwa mugice cyijimye cyo gucika intege (ni ukuvuga, kuruhande rwibitabo) mubyerekezo bya anteroposition. Umusumari wa Intramedillary uyobowe kuruhande, bityo urinde valgus. Mu buryo nk'ubwo, ubumuga bwo kurangiriza burashobora kuneshwa no gushyira umuhanga mu gufunga kugeza ku gice cy'inyuma cyo guhagarika umutima (ni ukuvuga uruhande rw'ubumuga) (Ishusho ya 10).

Igishushanyo cya 10. Guhuza Gusubiramo Kuvunika no gushyiramo imisumari

-Guhanagurira kwaguka

Nyuma yo kurangiza kuvunika, kwishura kwabisabwe byatoranijwe kugirango utegure igufwa rya intramedillary instail insdion. Umupira-wangije umupira winjijwe mu cyuho cya marike ya tibial no kurubuga, kandi imyitozo yo gusubira inyuma yanyuze hejuru yumupira. Umwanya wa Ball-wasomejwe na C-ART Fluoscopy kuba kurwego rwa Akle, kandi umuyobozi wayobora ashingiye cyane kuri Anteropoposter hamwe nibitekerezo bya Anteroposterior no kuruhande byombi (Ishusho ya 11).

Igishushanyo cya 11. Erekana umwanya wa Discalwill mu cyuho kidahuzaga kuri C-ART Fluoscopy mu myanya y'imbere n'inyuma

Ikibazo cyo kwagurwa na Medullas idasubikwa yaguye. Twizera ko abaganga benshi muri Amerika ya ruguru bahitamo kwagutse kwagutse intera imisumari ya Tibiemedis ya Tibiamed ya Tibia kubatungurwa. Ariko, imisumari yagutse kandi idashobora kwagurwa imbaraga zirashobora gukoreshwa nkubuhanga busanzwe, kandi ibisubizo byiza birashobora kubisanga hamwe nuburyo bwombi.

-Guhanagura screw

Gukoresha imiyoboro yo guhagarika imiyoboro yimyanda ya tibial igamije gukumira no gucika intege, kwagura ibimenyetso byerekana intera imisumari ya tibiamedi. Mu mivuni ikubiyemo akarere ka metaphyseal, guhagarika imigozi byabaye ingenzi mu gukomeza guhuza.

Ibice bitatu byangiza imiyoboro iteye imbere cyane, kandi imigozi ihuriweho na inguni irashobora gutanga umutekano unyuranye, bishobora kwemerera umutekano umwe wimigozi, ishobora kwemerera umutekano umwe wimigozi, ishobora kwemerera umutekano mubi, ishobora kwemerera umutekano umwe wimigozi, ishobora kwemerera umutekano umwe wimigozi, ishobora kwemerera umutekano umwe wimigozi, ishobora kwemerera umutekano umwe wimigozi, ishobora kwemerera umutekano umwe wimigozi, ishobora kwemerera umutekano umwe wimigozi, ishobora kwemerera umutekano umwe wimigozi, ishobora kwemerera ihuriro rimwe ryubaka rishobora kuboneka hamwe numubare muto wo guhagarika imigozi. Amakuru yubuvuzi kumubare no guhuza imiyoboro ikenewe kugirango ikosorwe imbere ya Tibia ikomeza kugarukira.

Gushyira imiyoboro myiza ihuriweho nubusanzwe bikorwa ukoresheje urwego rwometse kuri intttttttttttttttttttttttttttttttttttttttramedilary umusumari. Imiyoboro igabanya ubudakemwa yinjijwe kubuntu munsi yubuyobozi bwa fluroscopic. Gukoresha sisitemu ya electromagnetic ya mudasobwa-yafashaga kwinjiza imiyoboro ya kure (ishusho 12). Ubu buhanga bwemerera imirasire-kubuntu bwimigozi ihuza na kure kandi yerekanwe ko ari uburyo bushoboka kandi bwuzuye.

Igishushanyo 12. Gufunga Gufunga unyuze kuri C-Ukuboko; Cd gufunga imigozi binyuze muri electromagnetic ifunze mudasobwa

Gushyira imiyoboro myiza na kure cyane ni inzira nziza yo kubaga hamwe nimigozi ihuza igomba kwinjizwa muburyo busobanutse kandi bworoshye.

Ubushakashatsi bwa Anatomic bwerekanye ko hakiriho ibyago byo kwiringira pelsit ya peroneal mugihe ushyira hagati ya Proximil kugeza kuruhande rwa oblique yo guhagarika imigozi. Kugabanya iyi mbaraga, abaganga bagomba gutekereza ku miyoboro iyobowe na C-RORTSCOPOPIC ya C-Blooscopique ya C-Kumanuka ku ndege ya Drill bit. Gucukura kwinjira muri cortex ya tibia ya matal birashobora kugorana kubona ibitekerezo byamayeri, kandi hafi yumutwe wa fibular butangaje kandi bukaba umuganga wa fibular winjiye. Uburebure bwaremuwe bugomba kugenwa nudukoko twarangije gusa ahubwo tunabisanzwe nibipimo byimbitse. Igipimo icyo ari cyo cyose cyo gucukura cyangwa kwinubira neza mm 60 zigomba guhinga inyaburaguzi yerekana ibisobanuro, bishobora gushira imitsi rusange ya Peroneal ifite ibyago byo gukomeretsa.

Ikirangantego cyimbere kandi inyuma yibanze ku rwego rwo kurengera bundle ya Netevascular Bundle, Tibialis Ansirtoior, kandi yagura Digitum ndende. Nubwo imitekerereze ya perctaneous isanzwe ifite umutekano, abaganga bakeneye kubaga bakeneye kumenya ingaruka zikikinisha. Kubintu byinshi byo kuvunika. Kuvunika kwa tibial kandi bya kure birashobora kungukirwa no gushyiramo imigozi yinyongera mumirongo itandukanye kugirango yongere umutekano wiyi miterere (Ishusho 13).

Igicapo 13. Kuvunika byinshi bya Tibia, bivurwa hamwe na Intramedillary imisumari ibiri ireba

-Gushimangira

Imirire y'iki gihe yangiza imisumari yo guhagarika umutima yaguye ibimenyetso byerekana intera intera imisumari yo muri Tibia mu rwego rwo gushiramo imivurungano ya Tibia mu rwego rwo gushyira mu karere ka Preximal kandi ireba kuri metaphyseal akarere ka Metaphyseal.

Ibinyuranye bitandukanya ibintu byakoreshejwe mubyigisho (imiyoboro 2 kuva kuringaniza na screws 2 yashyizwe kuri buriwese hamwe nimigozi 3 ya kure ya kure). Mu barwayi bakosorwa ba fibular na tibial Intramedily gukosora imisumari, igipimo cyo gusubiramo cyatakaye cyari gito cyane. Umubare w'abarwayi 13% ufite imisumari yo mu misumari idafite fibular yerekana gutakaza posita, ugereranije na 4% by'abarwayi bafite imisumari y'imisumari idafite fibule.

Mu kindi kigeragezo kigereranya imikorere ya tibial Intramedily ikosorwa na fibular ikosora imisumari ya fibular na fibularlary, abarwayi bavurwa na fibular, abarwayi bavuza imisumari

Twanzuye ko gukosora fibuland ya fibula igera no kugabanya kugabanya imitambire kuri kure-ya tibia igabanijweho intera imisumari yo gukosora imisumari. Ariko, ikibazo cyibibazo byakomeretse mubice byinyongera mukarere ka tissue ihahamutse. Turasaba rero kwitonda mugukoresha fibular fix.

03. Ibisubizo

Intramedillary imisumari yo gukosora imiterere ya tibial irashobora gutanga ibisubizo byiza. Ibipimo byo gukira kwa intramedillary imisumari ya Tibia byavuzwe mu bushakashatsi butandukanye. Hamwe no gukoresha ingufu zigezweho hamwe nubuhanga bukwiye bwo kubaga, ibipimo bikiza biteganijwe kurenga 90%. Igipimo cyo gukiza cya Tibial Stem kinaniwe gukira nyuma yo gukosora imisumari byateye imbere cyane nyuma yo gukosorwa nyuma yo gukosorwa imbere yimbere hamwe nimisumari yaguye.

Isuzuma riva mu mwaka umwe nyuma yo kubagwa ryerekanye ko abarwayi bagera kuri 44% bakomeje kugira imbogamizi zifatika mu mpera z'amafaranga yakomeretse, kandi kugeza kuri 47% bakomeje kumenyesha ubumuga bujyanye nakazi mu mwaka umwe nyuma yo kubagwa ubumuga bujyanye nakazi nyuma yo kubagwa. Ubushakashatsi bwerekana ko abarwayi bafatwa na Intramedillary imisumari ya Tibia bakomeje kugira aho bigarukira mugihe kirekire. Abaganga babaga bagomba kumenya ibyo bibazo kandi bakagira inama abarwayi bakurikije!

四. Ingorabahizi

01. Ububabare bwa PATELAR

Ububabare bwa peteroli imbere nigipimo rusange nyuma yinyoni yo gukosora imisumari yo gukosora imitako ya tibial stem. Ubushakashatsi bwerekanye ko abarwayi bagera kuri 47% nyuma yo gutera imisumari bishobora guteza ububabare bwa mbere, teletiya yacyo idasobanutse neza. Irashobora guhindura ibintu bishobora kuba bikubiyemo ibibazo bitesha umutwe no kwavura mu nyubako za Arpranlis ya tibia, kandi isohoka yimpera ya proximal yumusumari.

Mugihe wiga teliology ububabare bwateguwe nyuma yimbere mu misumari, inzira ya tendon yo muri transpatellar yagereranijwe nuburyo bwa parapatellar. Uburyo bwa Transpatellar bwo muri Transpatellar bushobora kuba bufitanye isano no hejuru yibibazo byo hejuru ya pose. Ariko, abashaka kuvuza amakuru yubuvuzi ntibagaragaje itandukaniro rikomeye hagati ya transpatellar tendon hamwe nuburyo bwa parapatellar.

Imikorere yo Guhitamo Gukuraho Imbere kugirango ukemure ububabare bwateguwe nyuma yimbere mu turere twa intramedial Turasaba ko gukuraho imisumari yo mu turere twa intttttttttttttttttttttttamedillas ifatwa nkaho etiologiya ya mashini ishobora kumenyekana, nko guhungabanya imisumari cyangwa imitekerereze isohoka. Ariko, inyungu za tibial ivaire yo gukuraho imisumari mubarwayi bagaragara bakomeje kubazwa.

Kubijyanye nububabare bwa Propanterllar, impamvu yububabare ntishobora kwerekana neza mubushakashatsi bwambere bwimirire ya Intramedial Kubwibyo, ubushakashatsi bunini bwubuvuzi bufite igihe kirekire bukenewe kugirango yemeze ingaruka za Intramedily gukosora imisumari muburyo bwo gutanga suprapatellar bwo kubanza kwangirika kwangirika.

02.Poor nyuma yo guhuza

Nyuma yo guhahamuka osteoarthritis ikomeje kuba ikibazo gikomeye nyuma yo kuvura ibiti bya tibial stem ivunika hamwe nintera imisumari. Ubushakashatsi bwibinyabuzima bwerekanye ko malablabment yo muri Tabial ishobora kuvamo impinduka zikomeye zo guhuza amaguru ku kigo cyegeranye na ivi.

Ubushakashatsi bwa Clinical asuzuma ibizaguzwa mu gihe kirekire kandi atekereza nyuma yo kuvunika indwara yo muri Tibial yatanze amakuru avuguruzanya ku gaciro ka katibili, nta myanzuro isobanutse kugeza ubu.

Raporo za malasi y'igihugu nyuma yo kuvumbuka mu misumari ya Tibia bigumaho kugarukira, hamwe n'umubare muto wavuzwe. Ubugizi bwa nabi bwasubiriwe inyuma bukomeje kuba ikibazo muri tibial intera imisumari, kandi isuzuma ryimibereho ryahinduwe mumitsi rikomeje kuba ingorabahizi. Kugeza ubu, nta kizamini c'amavuriro cyangwa uburyo bwo gushushanya bwashyizweho nk'ubusa bwa zahabu bwo kugena imivurungano. By'umwihariko, ubumuga bwo hanze bwo kuzunguruka bigaragara ko busanzwe kuruta ubumuga bwo kuzenguruka imbere. Isuzuma rya Clinical kugirango usuzume ivanga rya nyuma ryavuzwe ko ridahwitse kandi ryerekanaga isano nkeya hamwe na CT Isuzuma.

Twizera ko malayini akomeje kuba ikibazo kirekire mu kuvunika indwara zo muri Tibial bivurwa na InterttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttramedillaLary yo muri Tibia. Nubwo amakuru avuguruzanya yerekeye isano iri hagati ya malalignament hamwe nibisubizo byavukiyemo nibitekerezo, turasaba ko kubaga bagomba kwihatira kugera kuri anatomic guhuza no kugenzura ibi bihinduka kandi bakabona ibisubizo byiza.

五. Umwanzuro

Gufunga static byaguye intera intera Intramediry Inzu iracyariho imiti myinshi yimuratirwa. Ingingo yinjiye ikwiye ikomeje kuba igice cyo kubaga. Uburyo bwa SprapateLer mumwanya wa kabiri bufatwa neza kandi bunoze kandi bunoze bukenewe kugirango ukomeze gusuzuma ingaruka ninyungu zubu buryo. Kwitabira kubaga bigomba kuba bimenyereye tekinike yo kwisubiraho muri iki gihe. Niba guhuza ibinanatike bidashobora kugerwaho binyuze muburyo bufunze, tekinike yo kugabanya igabanuka igomba gusuzumwa. Igipimo cyiza cyo gukira kirenze 90% gishobora kugerwaho hamwe no kwagurwa kwagutse kandi bidasubiwe inyuma. Nubwo umubare mwiza ukiza, abarwayi baracyafite aho bagarukira. By'umwihariko, ububabare bwa Preptellar burakomeza kwitotomba muri Tibial Intramedillary imisumari. Byongeye kandi, ubugizi bwa nabi nyuma yo gukosorwa kwimbere bikomeje kuba ikibazo rusange.

INGINGO

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