Indlela yokulungisa i-tibial

Ukulungiswa kwe-Intramedullary Nations Ukulungiswa kuhlala kunyango lokhetho lwe-tibial engazinzanga kunye ne-tibial ye-tibial kubantu abadala. Injongo yonyango lonyango kukubuyisela ubude, ulungelelwaniso kunye nokujikeleza kwe-tibia kunye nokufezekisa ukuphiliswa kwamaqhekeza. Izibonelelo zoncedo lwe-Intramellary i-toives incinci yoxinzelelo oluncinci kunye nokugcinwa okufanelekileyo kwegazi ekuqhekekeni. Ukongeza, i-Intramellary yabenga i-tibia ibonelela ngokuzinza ezifanelekileyo ze-bibiation kwaye isebenze njengesixhobo sokwabelana ngomthwalo esivumela ukufuduswa kwendawo yokuhlala. Inkqubela phambili yoyilo lwe-Intramedullary kunye neendlela zokuncitshiswa ziye zandise iimpawu zokulungiswa kwe-Inramelilary ukubandakanya i-proximal tibia kunye nenqanaba eliphantsi eliphantsi.

Ukuza kuthi ga ngoku, ukunciphisa ukuncitshiswa kwe-intanethi Ngaphandle kokuthandwa kokulungiswa kwe-Inramelilary Nail ukulungiswa kwe-tibial ye-tibial ye-tibial ye-tibial, kuhlala kunomngeni kwaye unengxaki ezininzi ezinokubakho. Iindlela zoqhawulo-mvume ziyaqhubeka zivela. Injongo yeli nqaku kukuchaza iikhonsepthi zangoku kwi-Intramelilary Nations ye-Tibial Squares kunye nokushwankathela inkqubela phambili kwicandelo.

一. Uvavanyo lokuqala kunye nokuhlolwa

Kwizigulana ezincinci, i-tibial stem zihlala zibangelwa kukulimala okuninzi kwamandla, kwaye izigulana kufuneka zivavanywe ngenxa yoxinzelelo olunxulumene neNkxaso-mali yoBomi boBomi (i-ATLS). Ukuvavanya ulusu olujikelezileyo kunye ne-tiss ye-tiss ethambileyo njengokuqhekeka kweebhulukhwe, i-boososion yolusu, ukuvutha, i-ecchymosis, okanye ukuphakama kwesikhumba; Cacisa ukuba ngaba i-phraction ivulekile, kwaye ukuba iphathe nge-tetanus kunye neentsholongwane; kwaye wenze uviwo lwe-neurovascular kunye noxwebhu olungentla. Vavanya ukuvela kwe-Syndrome ye-Osteofial Plastiment kwaye wenze uthotho lweemviwo zeklinikhi kwezi zigulana.

Izifundo zamva nje zibonise ukuba i-Sydrome ye-OsteromeT Syndrome ilandela i-tibial tuberasity ye-tuberosity isenokuphakama kwi-11.5%. Ngokukodwa, amaqela amancinci amancinci kunokwenzeka ukuba aphuhlise i-Osterome ye-Osteofasic. Isifo sokuchonga i-osterome ye-Osteofial Syndrome kufuneka isekwe kwiziphumo zeklinikhi, kubandakanya iintlungu eziqatha, i-neurovascular yotshintsho, ukungcungcutheka kwendlela yengqondo, kunye nentlungu eyandisiweyo evela kulwandiso lwenzuzo. Ke ngoko, i-osterome ye-Osterome i-syndrome ihlala inyanzeliso lwekliniki kunye namaxwebhu afanelekileyo oviwo lweklinikhi kubalulekile. Ingcinezelo ngaphakathi kwendawo yengqondo inokulinganiswa nge-nenale yoxinzelelo (umzobo 1) njengendlela yoviwo ehambelana novavanyo olukhethekileyo.

Umzobo 1. Umlinganiso woxinzelelo kwi-septum ye-waptum usebenzisa inaliti yoxinzelelo

Ukufumana idatha ethembekileyo, uxinzelelo lwe-intrafastal kufuneka lulinganiswe kwiindawo ezine zengqondo nakwiindawo ezahlukeneyo ngaphakathi kwendlela nganye. Izifundo kuncwadi zibonisa ukuba uxinzelelo olungaphantsi kwe-30 mmhg (i-Diastolic Unerastic thabatha thabatha uxinzelelo lwe-colocaltion) ibonisa i-syndrome eqhelekileyo. Uxinzelelo lweDiastolic luhlala luncipha ngexesha lotyando, kwaye i-Diastolic yoxinzelelo lwe-diastolic kufuneka ithathelwe ingqalelo xa kubalwa ingcinezelo eyahlukileyo.

Izifundo zamva nje zibonise ukuba iliso loxinzelelo ngaphakathi sisixhobo esinokuba sisixhobo esifanelekileyo sokuxilongwa kwe-Abchrome, eneemvakalelo ezingama-94% kunye nobuchule bama-98%. Nangona kunjalo, ngenxa yeziphumo ezibi ze-Syndrome, isifo se-Syndrome kufuneka sisekwe kwiziphumo zekliniki, kunye nemilinganiselo yoxinzelelo lwamanqanaba aphezulu kufuneka isetyenziswe kwiimeko ezizodwa, njengoko isigulana sonzakala okanye xa iKlinikhi yeKlinikhi yeKliniki ayicacanga.

Uvavanyo lokuvavanya kufuneka lubandakanye i-orthopantoms egudileyo kunye neembonakalo zamva ze-tibia eyonzakeleyo kunye ne-radiography yedolo kunye ne-ankle yokudibanisa i-ankle, ephinda iphonononge isebenzisa i-tomady ye-computer (CT). Ngokufanayo, iskena se-ct se-ankle sinokuba yimfuneko ukuba sibene filtity imigca eyadlulayo kwi-tibial plates kunye ne-ankle enxulumene ne-ankle

二. Iiklinikhi zeKlinikhi

Ipesenti ephezulu ye-quations ephantsi yesithathu kwi-tibia eneziqwengana ze-ankle zixeliwe. Sebenzisa izikali ze-CT eziqhelekileyo, iipesenti ezingama-43 zokuqhekeka kwenqanaba eliphakathi kunye nesezantsi kwe-Tibia behamba kunye ne-ankle quations, uninzi lwazo bafuna unyango. Olona hlobo luqhelekileyo lokuqhekeka yayikukuqhekezwa kweSpiral Spreen ephakathi kwisithathu se-dibia edibene ne-Ankle i-Postered (umfanekiso 2). Ngenxa yokufuduka okuncinci kwengqokelela ye-ankle enxulumene noko, kuphela i-45% yengozi inokufunyanwa kwi-radimadys ecacileyo. Ke ngoko, i-scans ye-CT ye-Ankle kufuneka igxininiswe kakhulu xa i-tibia esezantsi yeTibia ikhoyo (umzobo 3).

Umzobo we-2.af Proral Fracral Spreen ephakathi kwisithathu se-tibia (A, B) ofanelekileyo ekuthini i-ankle show (c). I-Intraoperapeation C-Arm Fluoroscopy ibonisa ukuqhekezwa kwe-Popotior ye-Posteringior ye-Posteringi: D) i-Postopes Postopes emva kokulungiswa kwe-subnication (d) ibonisa ukuphiliswa ngokugudileyo kwe-tibial kunye ne-ankle quations

Umzobo 3. I-AFS SPRAL YOKUGQIBELA YOKUGQIBELA NESITHATHU SESITHATHU SESITHATHU SESIFUNDO SE-TIIB (AB) Premouses; . .

三. Iindlela zoNyango

I-01. I-Tibial Inaliti yokuNgena

Ukuseka indawo yokungena echanekileyo kudlala indima ebalulekileyo kwaye izifundo ezininzi ezincwadini zibonelele ngolwazi olubalulekileyo kwindawo ye-anatomical indawo yendawo yokungena kwi-Intramelity. Ezi zifundo zibonakalisile ukuba indawo efanelekileyo yokuphamba ikwindawo engaphandle ye-tibial plates kunye ne-tibial tibial spur. Indawo yokhuseleko enobubanzi obungama-22,9 mm ± 8.9 mm, engabangeli monakalo kwizakhiwo ezidibeneyo ezikude, nazo zachazwa. Ngokwesiqhelo, indawo yokuqala yokulungiswa kwe-Intramellary ye-tibial stem fectures isuswe ngendlela ye-infrapatellar, nokuba yeyokwahlula i-patellar tendon (i-Transpatellar) okanye ngokumisa i-paten tendon

I-semi ye-semi ye-Intramellary itsalele ingqalelo ebonakalayo kuncwadi lwamathambo, kwaye iTornetta kunye ne-collins iphakamisa i-opex ye-opex ye-opex ye-opex ye-tibial ye-tibial ye-tibial ye-tibial tibial timial ye-tibial tibial timial tibial tibial tibial tibial tibial tibial tibial tibial tibial tibial tibial tibial tibial tibial timial tibial tibial tibial tibial tibial. I-Intramellary saising kwindawo yonyuko ikwacetyiswa. Ukusetyenziswa kwendlela ye-curipatellar ye-tibial ye-tibial gailing kunye nokufakelwa kwetayile ye-intramellary ngokusebenzisa i-patellomeraral edibeneyo kwi-semi-phambili icetyiswa.

Inkqubo yenziwa kunye nedolo eguqulweyo malunga ne-15-20 degrees, kunye nokuncipha kwexesha malunga neesentimitha ezi-3 kwenziwa malunga nobubanzi bomnwe omnye ngaphezulu kwe-patella. I-vodriceps tendon iqhekezwe kwifashoni ye-creashinal kunye nokuhlambela okuqhekeneyo kwenziwe kwi-patelloferal Joint. Isokethi ebukhali ifakwe kwi-patelloferal edibeneyo yokudala indawo yokungena kwi-curximal cortex kunye nomgangatho wobugcisa (umzobo 4).

Umzobo 4 (b) Imbono ye-intraoperaperapeation yendawo yokungena

I-3.2 mm isetyenziselwa ukufumanisa indawo yokuqala yenaliti phantsi kwesikhokelo se-C-AM. Isokethi eqhotsiweyo inikezelwa ukuba ihlawulwe i-gonerness kunye namanqaku aphumayo. Iinkqubo zotyando ezisele zibandakanya ukuhlengahlengiswa kunye nokufakwa kwe-tibial zenziwe kwisokethi.

Izibonelelo ezinokubakho: Isikhundla somkhosi esikhuselweyo sinokunceda ekuqhekekeni, ngakumbi kwi-proximal eqhelekileyo yesithathu se-tibia kunye ne-angled ngaphambili. , Isikhundla esisiseko sinokuphelisa uxinzelelo kwimisipha ye-quadriceps kunye noncedo lokuqhekeka endaweni yesimo. , I-Scierial Supree Pripatellar inokuba nenye indlela yendlela ye-infrapatellar yemveli (umzobo 5).

Umzobo we-5

Izifundo zibonakalise ukuba indlela ye-suerapatellar ye-tibial ye-tibilimerlary yabelela kwindawo ekhuselekileyo yendlela ekhuselekileyo nesebenzayo. Kuvunyelwe ukuqhubela phambili ukuphanda izibonelelo kunye nokungalunganga kwendlela ye-SupraPlatellar yeya kwi-Inramellary yaya kunye nokuvavanya iziphumo zexesha elide ezinxulumene nale ndlela.

02. Hlela kwakhona itekhnoloji

Ukubekwa kwe-tibial ye-tibial ye-tibilidlary yedwa ayikhokelela ekunciphiseni okwaneleyo; Ukuncitshiswa okufanelekileyo kwesaphulelo kufuneka kugcinwe kuyo yonke inkqubo ehlaziyiweyo kunye nokubekwa kwe-intramellary. Isicelo sokuThunyelwa kweTumathi sodwa sinokungasoloko siphumelela ukuncitshiswa kwe-anatomic yokuqhekeka yedwa. Eli nqaku liza kuchaza iintlobo ezahlukeneyo zokuvalwa, ezihlaselayo ezincinci, kunye nokuncitshiswa okuvulekileyo.

Iingcebiso zendlela yokubuyisela

Ukuncitshiswa kokuncitshiswa okuvaliweyo kunokufezekiswa ngesixhobo sokunciphisa njengokuqhekeka kwe-F-Fractures, i-F-Fitmed Fiedragraphic Essistraction Isixhobo sokunciphisa isixhobo esifanelekileyo esichanekileyo se-Itvision / i-angles ye-ackes kunye ne-6).

Umzobo 6

Nangona kunjalo, isixhobo sinokubeka uxinzelelo olubalulekileyo kwizicubu ezithambileyo, kwaye ukusetyenziswa ixesha elide kwale fowuni kufuneka kuphephe. Ukuncitshiswa kwamandla kunokufakwa ngokungekho mthethweni, njengakwimeko ye-spiral kunye ne-oblique. Ezi zixhobo zinokusetyenziswa kwindawo ethambileyo yokuthantamisa ngokusebenzisa izithuba ezincinci (umzobo 7).

Umzobo 7

Uhlobo lwe-clamp kunye nendawo ekungacacanga kuyo kufuneka ikhethwe ngokusekwe kwisicwangciso sokunciphisa umonakalo wexesha elide kwizicubu ezithambileyo zokubekwa kwindawo yokubekwa kwenkuni (umzobo 8).

Umzobo 8. Ukuphononongwa ngokutsha ukulungisa ukuseta i-tibial facking

Imali-mbophelelo yenye yezixhobo eziqhelekileyo zokuseta kwakhona zisetyenziselwa ukubuyisela ubude kwi-tibia. Zihlala zibekwa ngecala kwaye zide kwindawo apho kufuneka kubekwe khona isikhonkwane se-intramellary. Izikhonkwane ze-proximal zinokubekwa ukulinganisa isikhundla sokuqhekeka kwi-proximal screw, evumela ukuncitshiswa okulula kwesaphulelo kube kanye kwikhonkwane kwi-Intramellary.

Kwezinye iimeko, iindlela ezivaliweyo nezingahlatyweyo ezihlaselweyo azikanelanga ukufumana ukuncitshiswa kwe-anatomic. Kwiimeko ezinjalo, iindlela zokuncitshiswa kwempumelelo kufuneka ziqwalaselwe ngolawulo ngononophelo lwezicubu ezithambileyo. Ukungancedi okunokubakho kweendlela ezivulekileyo zokuncitshiswa kubandakanya umothuko olongezelelweyo, onokuthi anyuse umngcipheko wosulelo lwendawo. Ukongeza, ukuqunjelwa okungaphezulu kokunikezelwa kwegazi kwindawo yokuqhekeka kunokunyusa umngcipheko wokongeza i-SPROPION.

Izakhono ze-thechnical zokubekwa kunye nokubeka kwakhona

Ukuncitshiswa kokuncitshiswa kwempumelelo kungekuphela nje amandla onciphiso olwenziweyo ebekwe kwindawo efanelekileyo, kodwa kunye nokusetyenziswa kwezinto ezincinci okanye ezincinci kwindawo yokuqhekeka ukugcina inkqubo yokuncitshiswa kwe-Intramerelary.

Iipleyiti zikhuselwe kwindawo ye-proximal kunye ne-distal uqhetseba usebenzisa i-monocorical. I-splint igcinwa kuyo yonke inkqubo yokuhlengahlengiswa kunye nokubekwa kwetayile ye-intramellary kwi-tibia. Emva kokubekwa kwesikhonkwane se-intramellary, iplate yasuswa okanye ishiywe yindawo yokuphucula uzinzo lwesakhiwo esiqingqiweyo (umzobo 9). Ngokushiya iplate endaweni, isikrikhi esinye se-cortical kufuneka singenelwe kwisikhafu esiphindwe kabini. Ifanele ithathelwe ingqalelo ukuba isetyenziswe kwiimeko zokukhetha apho i-Tibial Stem ifuna utyando oluvulekileyo ukufezekisa ukuncitshiswa okwamkelekileyo okwamkelekileyo.

Umzobo 9. Vula i-tibia uqhekene ne-comncations enzima kunye nethambo elinesidima esine-splint encinci kwisiphelo sokwaphuka emva kokuncitshiswa kwe-splime

Injongo yekhonkco yokubhloka kukuphefumla i-cavity cavity kwingingqi yeMetaphyseal. I-Blocks ifakwe ngaphakathi kwesiqwengana esifutshane sobugcisa nakwicala le-cocave liphesheya ngaphambi kokubekwa kwe-Intramelilary. Umzekelo, isiphene esiqhelekileyo sokuqhekeka kwesithathu se-proximal yesithathu se-tibia sibonakaliswa yi-gethi kunye ne-anghum phambili. Ukulungisa isiphene se-qualms, isikhafu sokutshixa sinokubekwa kwinxalenye ye-Specimal Fracimal Fractiment (okt, icala le-cocave kwicala elingaphandle) kwicala elingaphandle. Isikhonkwane se-intramellary sikhokelwa kwicala leMedial, ngaloo ndlela sithintela i-getgus. Ngokufanayo, ukuphathwa gadalala kungayiswa ngokubeka isikhafu sokutshixa i-screw kwi-paters kwinxalenye ye-Posterimal ye-Proximal block (okt, icala le-10).

Umzobo we-10. I-Cwangcisa kwakhona i-tibial racking ngokubekwa kwezipikili

Ulwandiso lwe-demellary

Emva kokuba ugqitywe ukuqhekeka kwakhona, ukubuyela umva kukhethwe ukulungiselela ithambo lokufakwa kwesikhonkwane. Isikhokelo esiphelelwe yibhola sifakwe kumda we-tibial marrow kunye nendawo yokuqhekeka, kwaye idrile yokutsalwa komhlaba idluliselwe kwisikhokelo sebhola esiphelweni. Isikhundla sokusikhokela esiphelweni sebhola siqinisekisiwe phantsi kwe-C-Arm Fluoroscopy ukuba ibe kwinqanaba le-ankle, kwaye umsikisi wawugxininiswa kakuhle kwi-anterosterior nangasemva (Umzobo we-11).

Umzobo 11. Ibonisa indawo yeSikhokelo kwi-Cavellary cavity kwi-C-Arm Arm Flooroscopy kwizikhundla ze-FARTAL kunye nezikhundla zamva

Umcimbi we-medulla eyandisiweyo ye-medulla ibe yimpikiswano. Sikholelwa ukuba uninzi logqirha eNyakatho Melika lufuna ukwandiswa kwe-mellamer elandisiweyo kwi-tibia ukungakhubekiswa. Nangona kunjalo, zombini ukubethwa kwe-intramenting kunye nokungaphundiswanga okungapheliyo kunokusetyenziswa njengeendlela ezifanelekileyo ezisemgangathweni, kwaye iziphumo ezilungileyo zinokufumaneka ngazo zombini iindlela.

-Ukubekwa kwindawo yokubekwa kwesikroba

Ukusetyenziswa kwezikrelemnqa kwi-tibial stem quares zenzelwe ukuthintela ukunqunyulwa kunye nokubekwa, ukwandisa iimpawu ze-tibimal kunye ne-tibial stem ye-proximal kunye ne-dibial stem equka i-metaphysis. Kwi-quaphys ebandakanya ingingqi yeMetaphyseAl, i-skick yaqala ukuba ibaluleke ngakumbi ekugcineni ulungelelwaniso lwe-axial.

Ukuqhutywa kwezinto ezintathu eziguquguqukayo kukhula kakhulu, kunye nokuzinzisa ii-angle-kunye nokuzinzisa izikrelemnqa kunokubonelela ngeendlela ezininzi zokungaziphathi kakuhle kwizikrelem eziqhelekileyo, ezinokuvumela ukubanjwa okufanayo kwezikrelemnqa. Idatha yeklinikhi kwinani kunye noqwalaselo lokunxibelelana nokunxibelelana okufunekayo ukuze ulungiswe lwangaphakathi kwe-tibia luhlale lulinganiselwe.

Ukufakwa kwezikrelemnqa ze-proximal kuvame ukwenziwa usebenzisa i-Scoper eqhotyoshelwe kwisipikili se-Intramellary. I-distal edibeneyo i-screws ifakiwe i-freethand phantsi kwesikhokelo seFluoroscopic. Ukusetyenziswa kwenkqubo yokukhokelwa kwekhompyuter ye-elektromagnetic kuyacetyiswa ekufakeni kwe-difili ye-dibial ye-dibial tiilic (umzobo 12). Obu buchule buvumela ukufakelwa kwe-radiation-radiation ye-distal ye-distal i-distal screws kwaye kubonisiwe ukuba yindlela enokwenzeka neyochayo.

Umzobo we-17.bleck uthenge izikrelemnqa ngembono ye-C-ingalo; I-CD yokutshixa kwi-screws nge-elektromagnetic ikhompyuter incedisiwe

Ukubekwa kwezikrelemnqa kunye ne-distangs edibeneyo yinkqubo ekhuselekileyo yotyando kunye ne-screadting screws kufuneka ifakwe kwindawo echanekileyo nethambileyo.

Izifundo ze-Aatomic zibonise ukuba kusekho umngcipheko we-pilneal nerve palsy xa usenza iMemoximal Medical Consect Screen. Ukunciphisa lo mngcipheko, oogqirha kufuneka bathathele ingqalelo ukubamba izikrelemnqa phantsi kwesikhokelo se-C-Arm, kunye ne-GluorosCopic Angle ye-C-RMPURUR kwindiza yenqwelomoya. I-Drill Pleill kwiCortex ye-Dibia inokuba nzima ukuyibona ngempendulo ye-Tactile, kwaye ukusondelelana kwentloko ye-fibtal kunokuyicingela i-Tactile Tract kwaye inike ithambo le- 'xa intloko ifakwe intloko. Ubude be-screw kufuneka bugqitywe kungekuphela nje nge-drill eshiyiweyo kodwa nangemilinganiselo efanelekileyo yobunzulu. Nawuphi na umlinganiso wedrill okanye ubude obude ubude bungaphezulu kwe-60 mm kufuneka iphakamise i-Porteroalporal proTrusion, enokuthi ifake i-nerve yesiqhelo ye-peroneal emngciphekweni wokulimala.

I-distar engaphandle kwaye ingene endaweni yokudibana engasemva ifakwe ekukhuseleni ekukhuseleni i-aurovascular ye-neurovascular i-tendon, i-tibialis amten, kunye nebijimuum ye-Undes. Nangona indawo yokubekwa kwesikhafu idla ngokukhuseleka, ugqirha wogqirha kufuneka azi ukuba umngcipheko kwizakhiwo ezithambileyo ezijikelezileyo. Ngobuninzi be-tibial stem quatres, i-proximal ezimbini kunye nezibini ezihamba ngeenyawo zibonelela ngokuzinza ezifanelekileyo. I-proxial kunye ne-tibial tibial ye-tibial inokuxhamla ekubekweni kokungenelela ezongeziweyo kwiinqwelomoya ezahlukeneyo ukonyusa uzinzo lolu sakhiwo (umzobo 13).

Umzobo we-13. Amaqhekeza amaninzi e-tibia, anyangwa nge-Intramellary ibethe tyaba kunye ne-screximal ezimbini ze-proximal eziguquguqukayo, ii-X-rays ezilandelayo ziphakamisa ukuphiliswa kokuphiliswa.

-Ukulungiswa kwe

Ukuyilwa kwe-Inramellary ye-Intramellary enezipikili ze-distal i-disckings ziye zandise iimpawu ze-itramellary ye-tibia ukubandakanya i-cibimal kunye ne-diaphyse equka indawo yeMetaphyseAl.

Ukuqwalaselwa okwahlukileyo kokubhaliweyo kokubhaliweyo kwe-SCORW SPRICWs kwasetyenziswa kuphando (izikrelem ezi-2 ukusuka kwi-Medial kwi-Strells kwi-Treuper Trespecular enye kwenye kwaye iyonke i-screws kufuphi ne-screen i-screen) kuphela. Kwizigulana ezifakwe ulungiso lwe-fibul kunye ne-tibilial ye-gailimetion, ireyithi yokuseta ilahlekileyo iphantsi kakhulu. Iyonke i-13% yezigulana ezinesipikili se-Inramelilary ngaphandle kokulungiswa kwe-fibul ibonise ukulahleka kwe-POPTOPE ye-PROPTODE ye-PROPTODE ye-PROPTODE ye-PROPTODE ye-PROPTODE ye-PROPTODE ye-PROPTODE ye-PROPTODE ye-PROPTODE ye-PROPTODE ye-COSTOPE ye-CEBEAL ngaphandle kokulungiswa kwe-tibial.

Kwelinye iLizwe elithelekisa ukusebenza kwe-tibial gailimetion nangesipikili kwi-fibul ye-fibul kunye nokulungiswa kwe-tibul ngokuchaseneyo nokulungiswa kwe-fibul kunye nokudityaniswa kwe-fibul kunye notshintsho.

Sigqiba kwelokuba ukulungiswa kwe-fibultive izuzisa kwaye kugcinwe ukuncitshiswa kwe-tibial fility kwi-tibia ye-tibia yesithathu ye-tibia jeares iphinde icwangciswe i-Intrameldary Nation Syramentition. Nangona kunjalo, ingxaki yeengxaki ezinamanxeba ezivela kwiminyhadala eyongezelelweyo kwindawo ye-tishu ezigwenxa. Sincoma ke isilumkiso ekusebenziseni ukulungiswa kwe-fibunt.

03. Iziphumo

Ukulungiswa kwe-Intramellary Ukunyanga amaxabiso e-Inramedullarary Watising zeTibia axelwe kwizifundo ezahlukeneyo. Ngokusetyenziswa kokufakwa kwale mihla kunye neendlela ezifanelekileyo zoqhawulo-mveliso, amaxabiso okuphilisa kulindeleke ukuba adlule kwi-90%. Ireyitha yokuphilisa ye-tibial stem ephosakeleyo ephucukileyo yokuphilisa emva kokulungiswa kwe-Inramellary kwaphuculwe ngokumangalisayo emva kokulungiswa kwangaphakathi kunye nesipikili sesibini esandisiweyo.

UVAVANYO LOVAVANYO LONYAKA WOKUQALA WAYE KUFUNDILEYO KWI-44% yezigulana eziqhubekayo ukuba nemida esebenzayo kwisiphelo esezantsi, kwaye ukuya kuthi ga kwi-47% iqhubekile nokuxela ukhubazeko olunxulumene nomsebenzi kunyaka emva kotyando. Olu phononongo lucebisa ukuba izigulana ziphathwe nge-Intramellaring ye-tibia iyaqhubeka nokuba nemida esebenzayo kwixesha elide. Ugqirha kufuneka azi le micimbi aze acebise abaguli ngokufanelekileyo!

四. I-Postoperatives

I-01. Intlungu yangaphambi kwexesha

Intlungu engaphandle ye-patelloferal yintlukwano eqhelekileyo emva kokulungiswa kwe-Inramellary Izifundo zibonise ukuba malunga ne-47% yezigulana emva kokuba i-Intramellary Shaing inokuhlakulela intlungu yePrecitatellar, i-Emiolosilo apho ingaqondakaliyo. Izinto ezinokubangela ukuziphembelela ezinokubangela ukuba zikhathazekile kunye nezonyango kwimidlalo ye-Intra, ukulimala kwicandelo le-insuromateriel, i-fibrosis ye-theandoritis, i-patellar ye-patellar ekhokelela kwi-Intramellary i-Intramellary i-Intramellary ye Inxalenye ye-proximal ye-tibia, kunye nokupheliswa kwesiphelo se-proximal yesikhonkwane.

Xa ufunda i-Entimotology yentlungu yePheritellar emva kokupheliswa kwe-Inramellary, indlela yeTranspatellar ithelekiswa nendlela yeParapatellar. Indlela yeTranspatellar inokuthi inxulunyaniswa nesimo esiphakamileyo sentlungu yedolo. Nangona kunjalo, idatha yeklinikhi engekho mthethweni ayibonisi naluphi na umahluko obalulekileyo phakathi kwendlela yeTranspatellar kunye nendlela yeparapatellar.

Ukusebenza ngokukhutshelwa okukhethiweyo kokulungiswa kwangaphakathi ukuze kulungiswe iintlungu ze-Prespatellar emva kokuba i-tibial gailiment yaziisikidi ayiqinisekanga. Sicebisa ukuba ukususwa kwe-Itibial Tibial Tibial Taili iqwalaselwe ukuba i-Etiology yoomatshini inokuchongwa, njengokupheliswa kwesipikili okanye i-scrication screw. Nangona kunjalo, isibonelelo sokususwa kwe-tibial seisielimen esipikili kwizigulana eziphawuliweyo kuhlala kukuthandabuza.

Ngokuphathelele i-Preciatellar Intlungu, unobangela wentlungu awubonakaliswa ngokucacileyo kuphando lokuqala lweklinikhi lwe-Inramellary National National National Swives Ke ngoko, izifundo zeklinikhi ezinkulu ezinokulandelwa kwexesha elide ziyimfuneko ukuqinisekisa isiphumo sokulungiswa kwe-intramelilary kwindlela ye-suerapatellar kwi-PeCatellar yentlungu.

I-02.Poor Posttopeding

I-Osteoarthritis ye-Post-I-Osteoarthritis ihlala ibalulekile emva konyango lwe-tibial stem quations nge-Intramellary. Izifundo ze-biomechachacal zibonakalisile ukuba i-tibial malafing inokukhokelela kwiinguqu ezibalulekileyo kwiingcinezelo zoqhakamshelwano kwi-ankle esondele kunye namadolo.

Izifundo zeklinikhi ezivavanya iziphumo zeklinikhi yexesha elide kunye nengcinga emva kokuba i-tibial stem ibonelele ngedatha engquzulwano ye-seibial ye-seibial ye-tibial malallion, engenazigqibo ezicacileyo ukuza kuthi ga ngoku.

Iingxelo ze-POLTOPERITION EMVA KOKUVELA EMVA KOKUVUMELWA KWE-TIBIA HLALA, ngenani elincinci lamatyala achaziweyo. Ukubekwa kwe-Popositives kuhlala kuyingxaki eqhelekileyo kwi-tibial gaility yokwahlulahlula, kunye novavanyo olungenamsebenzi lokujikeleza kwe-Tibial kuhlala lucelomngeni. Ukuza kuthi ga ngoku, akukho luvavanyo lweklinikhi okanye indlela yokucinga sele isungulwe njengoMgangatho weGolide wokuzimisela okugqithisayo. Ngokukodwa, iziphoso zojikelezo lwangaphandle zibonakala ngathi zixhaphake ngakumbi kuneziphengu zojikelezo lwangaphakathi. Uvavanyo lweklinikhi ukuvavanya ukubekwa kwe-mostoperaperatives kuxelwe ukuba kungachanekanga kwaye kubonakalise unxibelelwano olusezantsi ngovavanyo lwe-CT.

Sikholelwa ukuba i-malaming iyongxaki yexesha elide kwi-tibial stem fectures ephathwe nge-intramellary yabethwa yiTibia. Ngaphandle kwedatha ephikisanayo malunga nobudlelwane phakathi kweMalaming kunye neziPhumo zeklinikhi, sicebisa ukuba ugqirha kufuneka azame ukufezekisa ulungelelwaniso lwe-anatomic ukuze ulawule loo mahluko kwaye ufumane iziphumo ezilungileyo.

五. Ukuqukumbela

I-Static evaliweyo eyandisiweyo eyandisiweyo ye-mellamer ye-Inramellary ihleli ingumba osemgangathweni we-tibial stem scot. Indawo yokungena echanekileyo ihlala ibaluleke kakhulu kwinkqubo yotyando. Inkqubo ye-Suprapatellar kwi-Suprapatellar ithathelwa ingqalelo inkqubo ekhuselekileyo nesebenzayo, kwaye izifundo ezizayo kufuneka zivavanye umngcipheko kunye nezibonelelo zale nkqubo. Ugqirha osiya kugqirha kufuneka aqhelane neendlela zokuphila zokuguqula kwakhona. Ukuba i-Anatomic Fracture Sportsure ingenakufezekiswa ngendlela evaliweyo, iindlela zokuncitshiswa ze-overaction kufuneka ziqwalaselwe. Ixabiso lokuphilisa eliphezulu elingaphezulu kwe-90% linokufezekiswa ngalowo ubini olwandisiweyo kunye nolwandisiweyo. Ngaphandle kwexabiso lokuphilisa elilungileyo, izigulana zisenazo iintsilelo zexesha elide. Ngokukodwa, iintlungu zePheritellar zihlala zisisikhalazo esiqhelekileyo emva kokupheliswa kwengqondo. Ukongeza, i-malstation emva kokulungiswa kwe-tibial zangaphakathi ihlala iyingxaki eqhelekileyo.

Izalathiso

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