Kutyoka kwemubato wetibial kukuvara kunowanzoitika muchipatara. Kugadziriswa kwemukati wezano mukati memudumbu (Intramedullary nail fixation) kune zvakanakira zve biomechanical zvekusapinda zvakanyanya uye kugadzika kweaxial, zvichiita kuti ive mhinduro yakajairika yekurapa kwekuvhiya. Kune nzira mbiri huru dzekugadzira nail fixation yetibial intramedullary nails: suprapatellar uye infrapatellar nailing, pamwe nenzira yeparapatellar inoshandiswa nedzimwe nyanzvi.
Kana paine kutyoka kwechikamu chimwe chete kubva muzvitatu zvetibia, sezvo nzira ye infrapatellar ichida kuti ibvi ripindike, zviri nyore kuti kutyoka kuende mberi panguva yekuvhiyiwa. Saka, nzira ye suprapatellar inowanzo kurudzirwa pakurapa.
▲Mufananidzo unoratidza nzvimbo yegumbo rakabatwa kuburikidza nenzira ye suprapatellar
Zvisinei, kana paine zvinorambidzwa kushandisa suprapatellar approach, zvakaita se local soft tissue ulcer, infrapatellar approach inofanira kushandiswa. Maitiro ekudzivirira kukwenya kwemucheto wekutyoka panguva yekuvhiyiwa idambudziko rinofanira kutarisanwa naro. Vamwe vaongorori vanoshandisa ma small-incision steel plates kugadzirisa kwenguva pfupi anterior cortex, kana kushandisa blocking nails kugadzirisa angle.
▲ Mufananidzo unoratidza kushandiswa kwezvipikiri zvinovhara kugadzirisa kona.
Kuti vagadzirise dambudziko iri, nyanzvi dzekune dzimwe nyika dzakashandisa nzira isinganyanyi kupindira zvakanyanya. Nyaya iyi yakaburitswa munguva pfupi yapfuura mumagazini inonzi "Ann R Coll Surg Engl":
Sarudza masikuruu maviri eganda e3.5mm, ari pedyo nemucheto wemugumo wakatyoka, isa sikuruu imwe mberi nekumashure muzvidimbu zvemapfupa kumativi ese ekutyoka, wosiya anopfuura 2cm kunze kweganda:
Batanidza maforceps ekuderedza kuti uchengetedze kuderedzwa, wobva waisa nzara yemukati memedullary zvichienderana nemaitiro echinyakare. Mushure mekunge nzara yemukati memedullary yaiswa, bvisa sikuruu.
Nzira iyi yehunyanzvi yakakodzera zviitiko zvakakosha apo nzira dze suprapatellar kana parapatellar dzisingagone kushandiswa, uye hazvikurudzirwi nguva dzose. Kuiswa kwesikuruu iyi kunogona kukanganisa kuiswa kwechipikiri chikuru, kana kuti pangave nenjodzi yekutyoka kwesikuruu. Inogona kushandiswa senzira yekureva mumamiriro ezvinhu akakosha.
Nguva yekutumira: Chivabvu-21-2024
