"10% yekutyoka kwegumbo kunoperekedzwa nekukuvara kwe distal tibiofibular syndesmosis. Zvidzidzo zvakaratidza kuti 52% ye distal tibiofibular screws inokonzera kuderera kwakashata kwe syndesmosis. Kuisa distal tibiofibular screw yakatarisana ne syndesmosis joint surface kwakakosha kudzivirira iatrogenic malreduction. Sekureva kwebhuku reAO, zvinokurudzirwa kuisa distal tibiofibular screw 2 cm kana 3.5 cm pamusoro pe distal tibial articular surface, pakona ye20-30° kuenda kune yakatwasuka, kubva pa fibula kuenda ku tibia, gumbo riri panzvimbo isina kutwasuka."
Kuisa sikuruu dzetibiofibular nemaoko kunowanzo kukonzera kutsauka panzvimbo yekupinda nekwakananga, uye parizvino, hapana nzira chaiyo yekuona kwakananga sikuruu idzi. Kuti vagadzirise dambudziko iri, vaongorori vekune dzimwe nyika vakatora nzira itsva—nzira ye'angle bisector method'.
Kushandisa data remifananidzo kubva kumajoini gumi nematanhatu ezvigunwe zvetsoka, mamodheru gumi nematanhatu akadhindwa ne3D akagadzirwa. Padaro re2 cm ne3.5 cm pamusoro petibial articular surface, waya mbiri dzeKirschner dze1.6 mm dzakafanana nepamusoro pejointi dzakaiswa pedyo nemipendero yekumberi neyekumashure yetibia nefibula, zvichiteerana. Kona iri pakati pewaya mbiri dzeKirschner yakayerwa uchishandisa protractor, uye 2.7 mm drill bit yakashandiswa kuboora gomba pamutsetse wekona, zvichiteverwa nekuiswa kwesikuruu ye3.5 mm. Mushure mekuiswa kwesikuruu, sikuruu yakachekwa pahurefu hwayo uchishandisa saha kuti uongorore hukama huripo pakati pegwara resikuruu nepakati petibia nefibula.
Kuedzwa kwemuenzaniso kunoratidza kuti pane kuenderana kwakanaka pakati pepakati petibia nefibula nemutsetse we angle bisector, pamwe nepakati pepakati pepakati negwara re screw.
Nenzira yeheori, nzira iyi inogona kunyatsoisa sikuruu pakati petibia nefibula. Zvisinei, panguva yekuvhiyiwa, kuisa waya dzeKirschner pedyo nemipendero yekumberi neyekumashure yetibia nefibula kune njodzi yekukuvadza mitsipa yeropa netsinga. Pamusoro pezvo, nzira iyi haigadzirise dambudziko rekudzikiswa kweropa, sezvo distal tibiofibular alignment isingakwanise kuongororwa zvakakwana mukati mekuvhiyiwa usati waisa sikuruu.
Nguva yekutumira: Chikunguru-30-2024
