chimiro chemeniscus
Meniscus yemukati neyekunze.
Daro riri pakati pemigumo miviri ye meniscus yakakura, richiratidza chimiro che "C", uye mupendero wakabatana nejoini kapisiyumu nechikamu chakadzika che ligament yepakati.
Meniscus yedivi ine chimiro che "O". Katsinga kepopliteus kanoparadzanisa meniscus nekapisi kejoini pakati nepashure pechikamu che1/3, zvichiita mukaha. Meniscus yedivi yakaparadzaniswa nekatsi kedivi.
Chiratidzo chekare chekuvhiya chesuture yemeniscusndiyo kukuvara kwenguva refu munzvimbo tsvuku. Nekuvandudzwa kwemidziyo netekinoroji, kukuvara kwemeniscus kwakawanda kunogona kusukwa, asi zera remurwere, nzira yechirwere, uye simba remakumbo epasi zvinofanirawo kufungwa. , kukuvara kwakabatana nedzimwe mamiriro akawanda, chinangwa chikuru chesuture ndechekutarisira kuti kukuvara kwemeniscus kuchapora, kwete suture yesuture!
Nzira dzekubatanidza meniscus dzakakamurwa kuita mapoka matatu: kunze-mukati, mukati-kunze uye mukati mese. Zvichienderana nenzira yekusunga, pachava nezvishandiso zvekusunga zvinoenderana. Zviri nyore. Pane tsono dzekubooresa lumbar kana tsono dzakajairika, uye kunewo zvishandiso zvekusunga meniscal uye zvishandiso zvekusunga meniscal.
Nzira yekunze-mukati inogona kuboorwa netsono yekuboorwa kwechiuno ine gauge 18 kana tsono yejekiseni yakajairika ine gauge 12. Zviri nyore uye zviri nyore. Chipatara chega chega chinayo. Ehe, kune tsono dzakakosha dzekuboorwa. - Ⅱ uye 0/2 yemamiriro erudo. Nzira yekunze-mukati inotora nguva uye haigone kudzora kubuda kwetsono yemeniscus mujoini. Yakakodzera nyanga yepamberi nemuviri wemeniscus, asi kwete nyanga yekumashure.
Hazvina mhosva kuti unoisa sei tambo pamitsetse, mhedzisiro yenzira yekunze-mukati ndeyekushandura suture yaipinda kubva kunze uye nepaburi remeniscus kuenda kunze kwemuviri uye yakasungirirwa panzvimbo yayo kuti suture igadziriswe.
Nzira yekupinda nekunze iri nani uye inopesana nenzira yekupinda nekunze. Tsono ne lead zvinopfuudzwa kubva mukati mejoini kuenda kunze kwejoini, uye zvinosungirirwawo nepfundo riri kunze kwejoini. Inogona kudzora nzvimbo inopinzwa netsono yemeniscus mujoini, uye suture yacho yakanyatsonaka uye yakavimbika. . Zvisinei, nzira yekupinda nekunze inoda zvishandiso zvekuvhiya zvakakosha, uye mamwe macheko anodiwa kuchengetedza mitsipa yeropa netsinga ne arc baffles paunenge uchisunga horn yekumashure.
Nzira dzekushandisa zvese dzinosanganisira tekinoroji ye stapler, tekinoroji ye suture hook, tekinoroji ye suture forceps, tekinoroji ye anchor uye tekinoroji ye transosseous tunnel. Yakakodzerawo kukuvara kwenyanga dzemberi, saka inonyanya kuremekedzwa navanachiremba, asi suturing yese ye intra-articular inoda michina yekuvhiya ine hunyanzvi.
1. Nzira ye stapler ndiyo inonyanya kushandiswa zvizere. Makambani mazhinji akadai saSmith muzukuru, Mitek, Linvatec, Arthrex, Zimmer, nezvimwewo anogadzira stapler dzavo, imwe neimwe ine zvayakanakira nezvayakaipira. Vanachiremba vanowanzoshandisa izvi zvichienderana nezvavanofarira uye kujairana kusarudza, mune ramangwana, stapler itsva uye dzakagadzirwa nevanhu dzichabuda dzakawanda.
2. Tekinoroji ye suture forceps inobva patekinoroji ye arthroscopy yepafudzi. Vanachiremba vazhinji vanofunga kuti suture forceps ye rotator cuff iri nyore kushandisa uye inokurumidza kushandiswa, uye inoendeswa kune suture yekukuvara kwemeniscus. Iye zvino kune mamwe magadzirirwo akanyatsogadzirwa uye ane hunyanzvi.suture dzemeniscuspamusika. Pliers dziri kutengeswa. Nekuti tekinoroji ye suture forceps inoita kuti kuvhiyiwa kuve nyore uye inopfupisa nguva yekuvhiyiwa, inonyanya kukodzera kukuvara kwemudzi wekumashure we meniscus, iyo yakaoma kusukwa.
3. Tekinoroji chaiyo yekusimbisa inofanira kureva chizvarwa chekutangakugadziriswa kweganda remurume, inova chinhu chikuru chakagadzirirwa suture yemeniscus. Chigadzirwa ichi hachichawanikwe.
Mazuva ano, tekinoroji yeanchor inowanzo reva kushandisa maanchor chaiwo. Engelsohn nevamwe vake vakatanga kutaura muna 2007 kuti nzira yekugadzirisa suture anchor yakashandiswa pakurapa kukuvara kwemidzi yepakati pemeniscus. Maanchor anoiswa munzvimbo yakadhindwa uye anosukwa. Kugadzirisa suture anchor kunofanirwa kunge kuri nzira yakanaka, asi ingave iri kukuvara kwemidzi yepakati kana yerutivi rweserimunar posterior root, suture anchor inofanira kunge iine matambudziko akawanda akadai sekushaya nzira yakakodzera, kuoma kwekuisa, uye kutadza kuskurura anchor yakatwasuka pamusoro pemapfupa. , kunze kwekunge paine shanduko huru mukugadzirwa kweanchor kana nzira dziri nani dzekuvhiya, zvakaoma kuva nzira iri nyore, iri nyore, yakavimbika uye inowanzoshandiswa.
4. Nzira ye transosseous tract ndeimwe yenzira dzese dze intra-articular suture. Muna 2006, Raustol yakatanga kushandisa nzira iyi kusveta medial meniscus posterior root injury, uye gare gare yakashandiswa zvakanyanya pakukuvara kwe lateral meniscus posterior root uye radial meniscus body kubvaruka uye kubvaruka munzvimbo ye meniscus-popliteus tendon, nezvimwewo. Nzira ye trans-osseous suture ndeyekutanga kukwenya cartilage panzvimbo yekuisa mushure mekusimbisa kukuvara uchishandisa arthroscopy, uye kushandisa ACL tibial sight kana special sight kunanga nekuboora tunnel. Single-bone kana double-bone canal inogona kushandiswa, uye single-bone canal inogona kushandiswa. Nzira Tunnel yemapfupa yakakura uye mashandiro acho ari nyore, asi kumberi kunofanirwa kugadziriswa nemabhatani. Nzira ye double-bone tunnel inoda kuboora imwe tunnel yemapfupa, izvo zvisiri nyore kune vanotanga. Kumberi kunogona kusungirirwa zvakananga pamusoro pemapfupa, uye mutengo wakaderera.
Nguva yekutumira: Gunyana-23-2022
