Kusarudzwa kwenzvimbo yekupinda yeIntramedullary yeTibial Fractures

Kusarudzwa kwenzvimbo yekupinda yeIntramedullary yeTibial Fractures ndeimwe yematanho akakosha mukubudirira kwekuvhiya kurapwa.Nzvimbo isina kunaka yekupinda yeIntramedullary, ingave iri suprapatellar kana infrapatellar nzira, inogona kuguma nekurasikirwa kwekugadzirisa, kukanganisa kweangular yekuguma kwekuputsika, uye kukuvadzwa kune zvivako zvakakosha zvemabvi zvakapoteredza nzvimbo yekupinda.

Iyo 3 zvikamu zvetibial intramedullary chipikiri yekuisa poindi ichatsanangurwa.

Chii chinonzi tibial intramedullary chipikiri chekuisa poindi?

Ndeipi mhedzisiro yekutsauka tibial intramedullary nail?

Ko nzvimbo chaiyo yekupinda inogadziriswa sei intraoperative?

I. Ndeipi iyo standard point yekupindaTibialIntramedullary?

Nzvimbo ye orthotopic inowanikwa pamharadzano ye mechanical axis ye tibia uye tibial plateau, iyo yepakati yepakati ye lateral intercondylar spine ye tibia, uye nzvimbo ye lateral iri panzvimbo yemvura pakati petibial plateau uye tibial stem migration. zone.

Range yenzvimbo yekuchengetedza panzvimbo yekupinda

22.9±8.9mm, munzvimbo iyo tsono inogona kuiswa pasina kukuvadza bony kumira kweACL uye meniscus tissue.

II.Ndeipi mhedzisiro yekutsaukaTibialIntramedullary Nail?

Zvichienderana neproximal, yepakati, uye Distal Tibial Fractures, iyo proximal tibial fracture ine yakanyanya kutaurwa, iyo yepakati tibial fracture ine mhedzisiro, uye magumo ekupedzisira anonyanya kuenderana nechinzvimbo uye repositioning yeDistal intramedullary nail.

# Proximal Tibial Fractures

# Pakati Tibial Fractures

Iyo poindi yekupinda ine zvishoma mhedzisiro pakutamisa, asi zviri nani kuisa mbambo kubva payakajairwa nzvimbo yekupinda.

# Distal Tibial Fractures

Nzvimbo yekupinda inodiwa kuti ive yakafanana neyekutsemuka kwepamusoro, uye nzvimbo ye distal intramedullary nail inodiwa kuti iwanikwe ortholaterally pakati peiyo distal fornix.

Ⅲ.How yekuona kuti panopindwa netsono here intraoperatively?

Tinoda fluoroscopy kuti tione kana tsono yekupinda nayo ndiyo yakarurama.Zvinonyanya kukosha kutora orthopantomogram yemabvi intraoperatively, saka inofanira kutorwa sei?

Standard orthopantomogram-parallel line yefibular head

Iyo mechanical axis ye ortho-x-ray inogadzirwa mutsara wakatwasuka, uye mutsara wakafanana weiyo mechanical axis inogadzirwa pamucheto wepamusoro wetibial plateau, iyo inofanira kuparadzanisa musoro wefibula pane ortho-x-ray.Kana imwe x-ray yakadaro yawanikwa, inoratidza kuti yakatorwa nemazvo.

Kana iyo ortho-slice isiri chiyero, semuenzaniso, kana mbambo ichidyiswa kubva kune yakajairwa feed point, kana nzvimbo yekutenderera yekunze inotorwa, inoratidza kuti iyo feed point ndeyekunze, uye iyo yemukati inotenderera chinzvimbo inoratidza kuti feed point iri mukati, izvo zvinozokanganisa kutonga kwekuvhiya.

Pamusoro peiyo lateral x-ray, iyo medial uye lateral femoral condyles inonyanya kupindirana uye yepakati uye lateral tibial plateau inonyanya kupindirana, uye pakatarisana nekuona, nzvimbo yekupinda iri panzvimbo yemvura pakati pechikomo uye tibial stem.

IV.Content Summary

Muyero wetibial intramedullary nail entry point inowanikwa orthogonally pamucheto wepakati we lateral intercondylar spine yetibia uye nechemberi pamvura yemvura pakati petibial plateau uye tibial stem migration zone.

Nzvimbo yekuchengetedza painopindwa nayo idiki kwazvo, chete 22.9±8.9 mm, uye tsono inogona kupinzwa munzvimbo iyi pasina kukuvadza kumira kwebhonzo yeACL uye meniscal tissue.

Intraoperative standard orthopantomographs uye lateral radiographs yemabvi inofanira kutorwa, iyo ndiyo kiyi yekuona kana iyo tsono yekupinda poindi yakarurama kana kwete.