Parizvino, nzira inonyanya kushandiswa yekuvhiya yekupwanyika kwecalcaneal inosanganisira kugadzika mukati neplate uye sikuruu kuburikidza nenzira yekupinda mu sinus tarsi. Nzira yakawedzerwa yakaita se "L" haichadiwi mukiriniki nekuda kwematambudziko akanyanya ane chekuita nemaronda. Kugadzika kweplate nescrew system, nekuda kwehunhu hwayo hwe biomechanical hwe eccentric fixation, kune njodzi yakakura yekusagadzikana kwevarus, nedzimwe ongororo dzichiratidza mukana wekuti varus yechipiri ivepo mushure mekuvhiyiwa weinenge 34%.
Nekuda kweizvozvo, vaongorori vakatanga kudzidza nzira dzekugadzirisa mapfupa emukati memedullary kuti vagadzirise matambudziko ane chekuita nemaronda pamwe nedambudziko rekusagadzikana kwemuviri wevarus.
01 Nnzira yekurovera misoro yepakati
Nzira iyi inogona kubatsira mukuderedza kukuvara kuburikidza nekupinda kwe sinus tarsi kana pasi pe arthroscopic guide, zvichida kuderedzwa kwekuda kwenyama dzakapfava uye zvingangoderedza nguva yekurara muchipatara. Nzira iyi inoshanda zvakanyanya kune mapfupa erudzi rwe II-III, uye kune mapfupa e calcaneal akaomarara, inogona kusachengetedza kuderedzwa kwakasimba uye inogona kuda kuwedzerwa screw fixation.
02 Snzara yemukati memedullary
Nzara yemukati memudullary ine purani imwe chete ine masikuru maviri kumagumo epedyo neakati, ine nzara huru isina chinhu inobvumira mapfupa kubatanidzwa nepanzara huru.
03 Mnzara yemukati memedullary yepamusoro-soro
Yakagadzirwa zvichibva pachimiro chechimiro che calcaneus chine mativi matatu, iyi sisitimu yekuisa mukati inosanganisira masikuruu akakosha akadai semasikuruu anoburitsa mutoro uye masikuruu ekumashure. Mushure mekuderedzwa kuburikidza nenzira yekupinda mu sinus tarsi, masikuruu aya anogona kuiswa pasi pekatsi kuti atsigirwe.
Pane gakava rakati wandei maererano nekushandiswa kwembambo dzemukati medullary pakukuvara kwe calcaneal:
1. Kukodzera kwakavakirwa pakuoma kwekutyoka: Zviri kukurukurwa kana kutyoka kuri nyore kusingadi nzara dzemukati memedullary uye kutyoka kwakaoma hakukodzeri kwavari. Kune kutyoka kwerudzi rweSanders II/III, nzira yekuderedza nekusunga sikuruu kuburikidza nenzira yekupinda mu sinus tarsi yakakura, uye kukosha kwechipikiri chikuru chemukati memedullary kunogona kupokana. Kune kutyoka kwakaoma, mabhenefiti enzira yakawedzerwa yakaita se "L" anoramba asina kutsiviwa, sezvo ichipa mukana wakakwana.
2. Kukosha kwemugero wekugadzira we medullary: Calcaneus inoshaya mugero we medullary. Kushandisa nzara hombe yemukati memedullary kunogona kukonzera kukuvara kwakanyanya kana kurasikirwa nehuremu hwemapfupa.
3. Kuoma kwekubvisa: Muzviitiko zvakawanda muChina, varwere vachiri kubviswa michina yesimbi mushure mekupora kwekutyoka. Kubatanidzwa kwenzara nekukura kwemapfupa uye kuiswa kwe lateral screws pasi pe cortical bone kunogona kukonzera kuoma kwekubvisa, inova pfungwa inoshanda mukushandiswa kwekiriniki.
Nguva yekutumira: Nyamavhuvhu-23-2023
