"10% yemakumbo ekuputsika kwemakumbo anoperekedzwa nekukuvara kwe distal tibiofibular syndesmosis. Zvidzidzo zvakaratidza kuti 52% ye distal tibiofibular screws inokonzera kuderera kwakashata kwe syndesmosis. Kuisa distal tibiofibular screw perpendicular kune syndesmosis joint surface inokosha kuti urege kudzivirira iatrogenic malreduction. Maererano nebhuku reAO, zvinokurudzirwa kuisa distal tibiofibular screw 2 cm kana 3.5 cm pamusoro pe distal tibial articular surface, pakona ye 20-30 ° kusvika kune ndege yakatsetseka, kubva pafibula kusvika kune tibia, nemakumbo. munzvimbo isina kwaakarerekera.
Kuiswa nemaoko kwe distal tibiofibular screws kazhinji kunokonzeresa kutsauswa munzvimbo yekupinda uye kutungamira, uye parizvino, hapana nzira chaiyo yekuona yekuisa kutungamira kweaya screws. Kugadzirisa nyaya iyi, vaongorori vekune dzimwe nyika vakatora nzira itsva-iyo 'angle bisector method.
Kushandisa data yekufungidzira kubva ku16 yakajairika majoini emakumbo, 16 3D-yakadhindwa mhando dzakagadzirwa. Pakati pemasendimita maviri uye 3.5 masendimita pamusoro petibial articular surface, maviri 1.6 mm Kirschner waya dzakafanana nepamusoro pekubatana dzakaiswa pedyo nechemberi uye shure kwemashure etibia uye fibula, maererano. Kona pakati pewaya mbiri dzeKirschner yakayerwa pachishandiswa protractor, uye chibooreso che 2.7 mm chakashandiswa kuboora gomba parutivi pemutsetse wekona, kuchiteverwa nekupinzwa sikuruu 3.5 mm. Mushure mekuiswa sikuruwa, sikuruu yakachekwa nekureba kwayo pachishandiswa saha kuongorora hukama pakati pesiruu nzira nepakati pe axis yetibia nefibula.
Mienzaniso yekuongorora inoratidza kuti pane kuwirirana kwakanaka pakati pepakati pe axis ye tibia uye fibula uye angle bisector line, uyewo pakati pepakati pepakati uye screw direction.
heoretically, nzira iyi inogona kunyatsoisa sikururu parutivi rwepakati axis yetibia uye fibula. Zvisinei, panguva yekuvhiyiwa, kuisa tambo dzeKirschner pedyo nechemberi uye shure kwemashure etibia uye fibula kunoisa njodzi yekukuvadza tsinga dzeropa uye tsinga. Uyezve, iyi nzira haigadzirisi nyaya ye iatrogenic malreduction, sezvo distal tibiofibular alignment haigoni kuongororwa zvakakwana intraoperatively isati yaiswa screw.
Nguva yekutumira: Jul-30-2024
