Kukuvara kweAnkle ndiko kumwe kukuvara kwemitambo kunoitika munenge makumi maviri neshanu muzana emasalasskeletal kukuvara, ne lallateral ligament (lcl) kukuvara kuve kwakanyanya. Kana mamiriro akasimba asina kurapwa munguva, zviri nyore kutungamira kudzokorora mashure, uye zvimwe zvakakomba zviitiko zvinokanganisa basa remubatanidzwa. Naizvozvo, zvakakosha kwazvo kuongorora uye kurumbidza kukuvara kwevarwere pakutanga nhanho. This article will focus on the diagnostic skills of lateral collateral ligament injuries of the ankle joint to help clinicians improve the accuracy of diagnosis.
I. Anatomy
Anterior Talofius Ligamente (ATFL): Yakabiridzirwa, yakasarudzika kune iyo inotevera capsule, kutanga anterior kune fibula uye kupera anterior kumuviri weiyo Luus.
Calcanefibular Ligment (CFL-yakaumbwa-yakaumbwa, inotangira pamuganho wekunze weiyo distal lalterallus uye inogumisa kuCalcaneus.
Posterior Talofius Ligament (PTFL): Inobva pane medial pamusoro peiyo yakazotevera mallleolus uye inopera posterior kune medial talus.
ATFL ega akaverengera kweanenge 80% yekukuvara, nepo atfl yakabatanidzwa neCFL kukuvara kwakaverengerwa kweanenge 20%.
Schematic Diagram uye Anatomical Diagram yeiyo Lateral Colateral Ligament of the Ankle Joint
Ii. Michina yekukuvara
Kukudzwa Kwekukurudzirwa: Anterior Talofius Ligament
Calcaneofill Ligament Varus Kukuvara: Calcanefibular Ligament
III. Kukuvara grading
Giredhi I: Ligament Strin
Giredhi II: Partial macherroscopic kupurika kweLigament, kurwadziwa zvine mwero, kuzvimba, uye nyoro, uye kusakwana kwebasa rakabatanidzwa;
Giredhi III: Iyo ligament yakabvaruka zvachose uye inorasikirwa nekuvimbika kwayo, inoperekedzwa nekuzvimba kwakakura, kubuda ropa uye nyoro, kuperekedzwa nekuratidzwa kwakarongedzwa kwebasa uye kuratidzwa kwekusawirirana.
Iv. Clinical bvunzo kumberi kwekutanga bvunzo
Murwere akagara nebvi rakachinjika uye kuguma kwemhuru yakatorwa, uye muongorori akabata tibia panzvimbo neruoko rumwe uye anosundira tsoka kumashure kwetsitsinho neimwe.
Nenzira imwe cheteyo, murwere ari supine kana akagara nebvi rakakotama pamakumi matanhatu kusvika makumi mapfumbamwe emadhigirii, chitsitsinho chinosimbisa kudzvinyirira kuTibia.
Kufungidzira kwakanaka kuputika kweiyo anterior talopius ligrament.
Inversion kushushikana bvunzo
Iyo proximal ankle yakasvibiswa, uye kushushikana kwevarus kwakaiswa kune iyo distal ankle kuti uongorore talus tilt angle.
Kuenzaniswa neyekudzokorora side,> 5 ° ndeyekufungidzira zvakanaka, uye> 10 ° yakanaka; kana unilateral> 15 ° iri zvakanaka.
Kufanotaura kwakanaka kweCalcaneofibular ligament kuzadza.
Kufungidzira bvunzo
X-RAIYS YEMAHARA ANOGONESESWA SHOKO RUPTION
X-RAIYS haina kunaka, asi MRI inoratidza misodzi yeanorterior talofibular uye calcaneofular ligaments
Zvakanakira: X-Ray ndiyo yekutanga sarudzo yekuongororwa, iyo iri hupfumi uye yakapusa; Kukura kwekukuvara kunotongwa nekutonga degree realus. Zvinokuvadza: Kuratidzwa Kwakanaka kweTishu nyoro, kunyanya zvigadzirwa zvekunyora izvo zvakakosha kuti urambe wakabatanidzwa.
Mri
Fig.1 Iyo 20 ° Oblique chinzvimbo chakaratidza yakanakisa anterior talofius ligament (atfl); Fig.2 azimuth mutsara weATFL SCAN
MRI mifananidzo yeakasiyana anterior talofius ligment yekukuvara yakaratidza izvozvo: (a) anterior talofius ligament inonyengera uye edema; . . (D) anterior talofibar ligament kukuvara neAvulsion kupwanya
Fig.3 Iyo -15 ° Oblique chinzvimbo chakaratidza yakanakisa calcaneofill ligament (CFI);
Fig.4. CFL Scanning Azimuth
Acute, zadza kubvarura kweiyo calcaneofular ligament
Mufananidzo 5: Coronal View inoratidza yakanakisa posterior talofius ligament (Ptfl);
Fig.6 PTFL SCAN Azimuth
Chidimbu kubvarura kweiyo posterior talofius ligament
Grading yekuongororwa:
Kirasi I: Hapana kukuvara;
Giredhi II: Ligament yekuunganidza, kuenderera mberi kwekuenderera mberi kwekuenderera, kujeka kwe ligaments, hypoechogenticity, edema yematisiki akatenderedza;
Giredhi III: isina kukwana ligmente morphology, kuonda kana kusarudzika kwekukanganisa kwekutonga kwekuenderera, kureruka kwemitsipa, uye kuwedzera chiratidzo;
Giredhi IV: Kukanganisa kwakazara kweLigament Kuenderera mberi, uko kunogona kuperekedzwa neAvulsion Fractures, kureruka kwemitsipa, uye kuwedzera chiratidzo kana kusarudzika chiratidzo.
Zvakanakira: Kugadziriswa kwepamusoro kweiyo nyoro tishu, kuongororwa kwakajeka kwemhando dzekukuvara kweLigament. Inogona kuratidza cartilage kukuvara, kupererwa kwepfupa, uye mamiriro ese ekukuvara kwakanyarara.
Zvinokuvadza: Hazvigoneki kuti uone kuti zvidimbu uye zvakarongeka cartilage kukuvara kwakakanganiswa; Nekuda kwekuoma kwechiitiko cheAnkle Ligament, kunyatsoongorora hakusi kwakakwirira; Inodhura uye inodhura-nguva.
Yakakwira-kuwanda-frequency ultrasound
Mufananidzo 1A: Anterior Talofius Ligament Kukuvara, kusarura kubvarura; Chifananidzo
Mufananidzo 2A: Calcaneofibular Svina kukuvara, rusarura misodzi; Mufananidzo 2B: Calcaneofibular vha kukuvara, kuputika kwakazara
Mufananidzo 3a: Zvakajairika Anterior Talofiular Ligament: Ultrasound mufananidzo unoratidza yakanangana neyakafukidzwa katsi hypoechoic chimiro; Mufananidzo 3B: Zvakajairika Calcanefibular Ligmental: Moderately Echogenic uye Dense Filineus Chimiro pane Ultrasound Image
Mufananidzo 4a: Chikamu kubvarura kweanopasikwa talofibular ligamende pane ultrasound mufananidzo; Mufananidzo 4B: Zadzisa misodzi yeiyo calcaneofular ligamende pane ultrasound mufananidzo
Grading yekuongororwa:
Kuunganidzwa: Acoustic Mifananidzo inoratidzira yakasimba chimiro, akakora uye akazvimba ligaments; Chikamu chemukati: Kune kuzvimba muLigament, pane kushomeka kwemamwe machira, kana mafambiro ari munharaunda yakatetepa. Scanmic Scans yakaratidza kuti kushushikana kweLigammence kwakanetsekana kwakanyanya kushungurudzwa, uye ligamende yakawedzera uye yakawedzera uye iyo elasticity yakadzora mune yealgus kana varus.
Kupedzisa kwakazara: Zvakanyanyisa kukanganisika ligament kupatsanurwa, simba rekusimbisa kwete kushushikana kweLighto, uye mualgus kana kuti Varus
Zvakanakira: mutengo wakaderera, nyore kushanda, kusasangana; Chimiro chakavanzika cheimwe danda rezvisikwa zvechisimba zvinonyatsoratidzwa, izvo zvinokodzera pakutarisa kwemasalosskeletal tishu lesions. Kuongorora kweanopokana, maererano nebhandi reLigament kuti rinotarisana neLigament, nzvimbo yekukuvara kweLigament inojekeswa, uye iyo Ligament neyakaona morphological inoonekwa zvine simba.
Zvinokuvadza: Lower Soft-tishu resution zvichienzaniswa naMri; Vimbiso pane nyanzvi yehunyanzvi hwekushanda.
Arthroscopy Check
Zvakanakirwa: zvakananga chengetedza zvimiro zveiyo Laterallus malleolus uye seyakaderera talar lignament, etc.) kuongorora kutendeka kweiyo ligaments uye kubatsira chiremba anovhenekera zano rekuvhiya.
Zvinokuvadza: Invanwa, inogona kukonzera zvimwe zvinonetsa, sekukuvara kwetsinga, hutachiona, etc
Kutumira Nguva: Sep-29-2024
