Hoffee hoffka ndeyekupwanya kwendege yemari yekadzi. Yakatangwa yakatsanangurwa neFriedrich Busch muna 1869 uye yakanzi Albert Hoffta muna 1904, ndokutumidza zita rake shure kwake. Nepo fractures inowanzoitika mumapepa akagwinya, Hoffe Fracts anoitika mundege yeCoronal.
Hofffa inokona riini?
Hoffe Fractures anokonzerwa nekumanikidza kune iyo yekushomeka kwechikadzi pabvi. Yakakwira-simba kukuvara kazhinji inokonzeresa kusangana uye supracondlar fractures yeiyo distal femur. Iyo inonyanya kuzivikanwa mashini inosanganisira mota mota uye mota dzetsaona dzemotokari uye dzinodonha kubva pakukwirira. Lewis et al. akataura kuti varwere vazhinji vane kukuvara kwakanangana nekukonzerwa nesimba rekumanikidza kumauto ezvekutungamira echikadzi vachitasva mudhudhudhu nebvi rakachinjika kusvika 90 °
Ndeipi kuratidzwa kwekiriniki kweHoffa Bracture?
Zviratidzo zvekutanga zveimwe hofa hoffeta leger are ecee effusi uye anozvimba, uye nyoro den er varum kana valguus uye kusagadzikana. Kusiyana neIntercondlar uye Supracondlar Fractures, Hoffeta Fracts anonyanya kuwanikwa achiona zvinonyanya kufungidzira panguva yekufungidzira. Nekuti vazhinji veHoffe Frutses vanokonzeresa kubva pakakwirira-simba kukuvara, kwakabatanidzwa kukuvara kwechiuno, pelvis, Femur, Tibia, Tibia, Tibia, mabvi mabvi, uye ngarava dzemapango dzinofanira kusiiwa.
Kana hoffeta hoffita inofungidzirwa kuti, munhu anofanira kutora sei X-rays kuti adzivise kushayikwa kuongororwa?
Standard anteroposter uye yakazotevera radiographs inoitwa nenzira yakaitwa, uye oblique maonero ebvi anoitwa pazvinenge zvichidikanwa. Kana kupwanya uku kusingadzivisike zvakanyanya, zvinowanzooma kuzviona pane radiographs. Pane imwe chete maonero, kusarudzika kushoma kweiyo fook yeiyo foint mutsara dzimwe nguva inoonekwa, ne kana pasina conylar kuremara kwealgus zvichienderana nemharadziro inobatanidzwa. Zvichienderana neContour yeiyo femur, kusiiwa kana nhanho mumutsara wetsika kunogona kuoneka pane inoona yakazotevera. Nekudaro, pane yechokwadi maonero ekutevera, canlyles echikadzi anoonekwa asina-kuyambuka, nepo kana izvo zvisikwa zvikapfupikiswa uye zvichimanikidzwa, zvinogona kuwanda. Naizvozvo, maonero asiri iwo emabbvu akajairwa anokwanisa kutipa fungidziro yenhema, iyo inogona kuratidzwa nemaonero emukati. Naizvozvo, kuongororwa kweCT kuri madikanwa (Mufananidzo 1). Magnetic Resonance fungidziro (MRI) inogona kubatsira kuongorora iyo yakapfava matinji akatenderedza ibvi (senge ligaments kana menisci) kukuvara.
Mufananidzo 1 CT wakaratidza kuti murwere aive nemurwere weLetenneur
Ndedzipi mhando dzeHoffeta Fractures?
Hoffeta Fractures yakakamurwa kuita mhando B3 uye Type 33.2.2 Gare gare, letenneur et al. Yakakamurwa kupwanyika mumhando nhatu zvichienderana neyekureba kweiyo fral fracture mutsara kubva kune yepashure cortex yeiyo femur.
Mufananidzo2 Letenneur Kuenzaniswa kweHoffa Fractures
Nyora i:Iyo fracture mutsara inowanikwa uye yakafanana neyekupedzisira cortex yeiyo fooral shaft.
Type II:Iyo chinhambwe kubva kune yakatsemuka mutsara kune iyo yepashure mutsara weiyo femur inoparadzaniswa kuti yakakamurwa muIIA, iib uye iic maererano nenzvimbo kubva kune yakatsemuka mutsara kune iyo poster yekoramu. Type IIa iri padyo neyepashure peposeri yeiyo fooral shaft, nepo iic iri kure kubva kune yepashure pekisimusi yeiyo fooral shaft.
Type III:Oblique kupwanya.
Maitiro ekugadzira kuronga kurapa mushure mekuongororwa?
1. Yemukati yekugadzirisa sarudzo inowanzo kutendwa kuti yakazaruka kuderedzwa uye kugadziriswa kwemukati ndiyo goridhe chiyero. Kune Hoffata Fractures, kusarudzwa kwekugadzirisa kwakakodzera kushoma. Chidimbu chakarukwa chakamanikidzwa kusunganidzwa screws yakanakira kugadzirisa. Zvisarudzo zvinosemesa zvinosanganisira 3.5mm, 4mm, 4.5mm uye 6.5mm chidimbu chakarukwa chakarukwa kusungwa uye herbert screws. Kana zvichidikanwa, akakodzera anti-slip mahwendefa anogona kushandiswawo pano. Jarit inowanikwa kuburikidza neCadaver Biomeekanical fundo iyo prodenereri screws yakagadzikana pane anterior-posterior lag screws. Nekudaro, basa rekutungamira rekutsvaga uku mumakiriniki kushanda kwakashata.
2. Kana iyo yakazotevera central iri kupatsanurana kakawanda, kuratidzwa kwekuvhiya kwakafanana neiyo yeHoffakazi Hoffe. Nekudaro, haina kuchenjera kushandisa dynamic cyyylar canylar canylar screw, uye anatomical plate, clate ripi plate kana liss plate inofanira kushandiswa kuti ishandiswe for fixation pachinzvimbo. Iyo medhial medha inomiririsa kugadzirisa kuburikidza neyakagarisana. Mune ino kesi, imwe yekuwedzera anteromaridial incision inodiwa kuti ideredze uye kugadzirisa hoffeta hoffka. Chero zvazvingaitika, zvese zvakakura clonglar pfupa dzakarongedzwa ne lag screws mushure meanatomical kuderedzwa kweiyo kondhi.
- Nzira yekuvhiya iyo murwere ari mune iyo supine chinzvimbo pane mubhedha weFluoroscopic ine tarishi. Iyo bolster inoshandiswa kuchengetedza iyo ibvi yekubhururuka kona yeanenge 90 °. Kuti uwane miti yeMedial yeHoffeta, munyori anofarira kushandisa pakati peMedhia yekuwoneka neyekuita medial parapatellar nzira. Nekuti Lagral Hoffata Fractures, chiitiko chakapfuura chinoshandiswa. Vamwe vanachiremba vanoratidza kuti nzira yakatevera parapatellar iri zvakare sarudzo inonzwisisika. Kamwe kuunganidzwa kwakatyamiswa kunoonekwa, kuongororwa kunoitwa, uyezve kupunzika kwemafuta kucheneswa nehurongwa. Pasi pazivikanwa zvakananga, kuderedzwa kunoitwa uchishandisa nzvimbo yekudzikisa nzvimbo. Kana zvichidikanwa, iyo "Jaytick" maitiro eKireni Wires anoshandiswa pakudzikiswa, uyezve maWores wairwadziswa kuti adzivise kupfuudza, Shandisa kanenge kaviri zviyero kuti uwane yakagadzikana gadziriso uye kurangana kwekumanikidza. Drill perpendicular kune iyo bracture uye kure ne patellofural yekubatanidzwa. Dzivisa kuchera mukati mePosterior kubatana, kunyanya neC-ruoko fluoroscopy. Screws yakaiswa kana isina mauto sezvinodiwa. Iyo screws inofanira kunge iri collerk uye yehurefu hwakakwana kugadzirisa iyo subarticular cartilage. Intraaoperaratily, ibvi rinoongororwa nekukuvara kwemvumo, kugadzikana, uye huwandu hwekufamba, uye kudiridza kwakakwana kunoitwa kusati kwatanga kuvharwa.
Mufananidzo 3 kuderedzwa kwechinguvana uye kugadziriswa kweBiconylar Hoffeta neKirschner Wires panguva yekuvhiya, uchishandisa Kirschner Wires kuti pry the Bone Fartgment
Kutumira Nguva: Mar-12-2025
