chimiro che meniscus
Meniscus yemukati nekunze.
Nharaunda pakati pemigumo miviri yeMeniscus yepakati yakakura, inoratidza chimiro che "C", uye mupendero wakabatana nejoint capsule uye yakadzika layer ye medial collateral ligament.
Iyo lateral meniscus ndeye "O" yakaumbwa.Iyo popliteus tendon inoparadzanisa meniscus kubva pajojo capsule iri pakati uye kumashure 1/3, ichigadzira gap.Iyo lateral meniscus inoparadzaniswa kubva kune lateral collateral ligament.
The classic kuvhiya chiratidzo chemeniscus suturendiko kubvarura kwenguva refu munzvimbo dzvuku.Nekuvandudzwa kwemidziyo uye tekinoroji, kukuvadzwa kwakawanda kwemeniscus kunogona kuve kwakashongedzwa, asi zera remurwere, chirwere chechirwere, uye mutsara wesimba rezasi rinodawo kutariswa., kukuvara kwakabatanidzwa uye mamwe mamiriro ezvinhu akawanda, chinangwa chekupedzisira che suture ndechekutarisira kuti meniscus kukuvara kuchapora, kwete suture ye suture!
Iyo meniscus suture nzira dzinonyanya kukamurwa muzvikamu zvitatu: kunze-mukati, mukati-kunze uye zvese-mukati.Zvichienderana neiyo suturing nzira, pachave neinowirirana suturing zviridzwa.Izvo zvakapfava Kune lumbar puncture tsono kana dzakajairika tsono, uye kune zvakare yakakosha meniscal suturing zvishandiso uye meniscal suturing zvishandiso.
Nzira yekunze-mukati inogona kubaiwa ne 18-gauge lumbar puncture tsono kana 12-gauge beveled yakajairika jekiseni tsono.Zviri nyore uye zviri nyore.Chipatara chese vanacho.Zvechokwadi, kune tsono dzakakosha dzokubaya.- Ⅱ uye 0/2 yenzvimbo yerudo.Iyo yekunze-in nzira inotora nguva uye haigone kudzora tsono yekubuda kwe meniscus mujoini.Iyo yakakodzera kune nyanga yepamberi uye muviri we meniscus, asi kwete kune posterior nyanga.
Hazvina mhosva kuti iwe unopinza sei madhiri, mhedzisiro yekunze-mukusvika ndeyekudzosera suture yakapinda ichibva kunze uye kuburikidza nemeniscus kubvarura kusvika kunze kwemuviri uye yakasungwa panzvimbo yekupedzisa kugadzirisa suture.
Iyo yemukati-kunze nzira iri nani uye inopesana neyekunze-mukati nzira.Tsono nemutobvu zvinopfuudzwa kubva mukati mejoinhi kuenda kunze kwejoini, uye zvinogadziriswa nepfundo kunze kwejoini.Inogona kudzora nzvimbo yekuisa tsono ye meniscus mujoini, uye suture yakanyanya kunaka uye yakavimbika..Zvisinei, nzira yemukati-kunze inoda midziyo yekuvhiya yakakosha, uye mamwe majekiseni anodiwa kuchengetedza tsinga dzeropa uye tsinga dzine arc baffles pakusutudzira nyanga yepashure.
Nzira dzese dzemukati dzinosanganisira stapler tekinoroji, suture hook tekinoroji, suture forceps tekinoroji, anchor tekinoroji uye transosseous tunnel tekinoroji.Inokodzerawo kukuvara kwenyanga yepamberi, saka inoremekedzwa zvakanyanya nanachiremba, asi yakazara intra-articular suturing inoda hunyanzvi hwekuvhiya zviridzwa.
1. Iyo stapler nzira ndiyo inonyanya kushandiswa yakazara-articular nzira.Makambani mazhinji akadai saSmith muzukuru, Mitek, Linvatec, Arthrex, Zimmer, etc. vanogadzira mastaplers avo, imwe neimwe iine zvayakanakira nezvayakaipira.Vanachiremba vanowanzozvishandisa zvinoenderana nezvavanofarira uye Kuzivana kwekusarudza, mune ramangwana, nyowani uye yakawanda yemunhu meniscus staplers ichabuda muhuwandu.
2.Iyo suture forceps teknolojia inotorwa kubva pafudzi arthroscopy teknolojia.Vanachiremba vazhinji vanofunga kuti suture forceps ye rotator cuff iri nyore uye inokurumidza kushandisa, uye inotamirwa kune suture yekukuvara kwemeniscus.Iye zvino kune zvimwe zvakanatswa uye nyanzvimeniscus suturespamusika.Pliers dziri kutengeswa.Nekuti iyo suture forceps tekinoroji inorerutsa kuvhiyiwa uye inopfupisa zvakanyanya nguva yekuvhiya, inonyanya kukodzera kukuvara kweiyo posterior mudzi we meniscus, iyo yakaoma suture.
3. Iyo chaiyo anchor tekinoroji inofanira kureva chizvarwa chekutangameniscal sature kugadzirisa, inova chikafu chakanyatsogadzirirwa meniscus suture.Ichi chigadzirwa hachichawanikwi.
Mazuva ano, tekinoroji yeanchor kazhinji inoreva kushandiswa kweiyo anchor.Engelsohn et al.yakatanga kutaurwa mu2007 kuti suture anchor kugadzirisa nzira yakashandiswa pakurapa kwepakati meniscus posterior midzi kukuvara.Anchors anopinzwa munzvimbo yakadhindwa uye sutured.Suture anchor kugadzirisa kunofanira kunge iri nzira yakanaka, asi ingave iri yepakati kana lateral semilunar midzi posterior midzi kukuvara, suture anchor inofanira kunge ine matambudziko akawanda sekushaikwa kwemaitiro akakodzera, kuomerwa kwekuiswa, uye kusakwanisa kukwenya anchor mune perpendicular to. pfupa pamusoro., kunze kwekunge paine shanduko yekuchinja mukugadzirwa kweanchor kana zvirinani zvekuvhiya nzira dzekuwana, zvakaoma kuva nzira iri nyore, yakanakira, yakavimbika uye inowanzoshandiswa.
4. Iyo transosseous turakiti nzira ndeimwe yeakazara intra-articular suture nzira.Muna 2006, Raustol akatanga kushandisa nzira iyi kuti suture meniscus posterior midzi yekukuvara, uye gare gare yakashandiswa zvakanyanya kune lateral meniscus posterior midzi kukuvara uye radial meniscus muviri kubvarura uye kubvarura munharaunda ye meniscus-popliteus tendon, nezvimwewo. -osseous suture ndeyokutanga kukwenya cartilage panzvimbo yekuisa mushure mekusimbisa kukuvara pasi pe arthroscopy, uye kushandisa ACL tibial kuona kana kuona kwakakosha kuti chinangwa uye kuboora mugero.Bhonzo rimwe chete kana kaviri-bhonzo canal rinogona kushandiswa, uye rimwe-bhonzo canal rinogona kushandiswa.Nzira Iyo pfupa tunnel yakakura uye kushanda kuri nyore, asi kumberi kunofanira kugadziriswa nemabhatani.Iyo kaviri-bone tunnel nzira inoda kuchera imwezve bhonzo mugero, izvo zvisiri nyore kune vanotanga.Iyo yekumberi inogona kuve yakananga pfupa kumusoro, uye mutengo wakaderera.
Nguva yekutumira: Sep-23-2022
