Tibial shaft fracture inowanzoitika kukuvara kwekiriniki. Intramedullary chipikiri yemukati kugadzirisa ine biomechanical zvakanakira zvishoma invasive uye axial kugadzirisa, zvichiita kuti ive yakajairwa mhinduro yekuvhiya kurapwa. Pane nzira mbiri huru dzezvipikiri dzetibial intramedullary nail fixation: suprapatellar uye infrapatellar nailing, pamwe neparapatellar nzira inoshandiswa nedzimwe nyanzvi.
Nekutyoka kweproximal 1/3 yetibia, sezvo nzira ye infrapatellar inoda kuputika kwemabvi, zviri nyore kuita kuti kuputsika kuende mberi panguva yekushanda. Nokudaro, nzira ye suprapatellar inowanzokurudzirwa kurapwa.
▲ Mufananidzo unoratidza kuiswa kwegumbo rakakanganiswa kuburikidza ne suprapatellar approach
Zvisinei, kana pane zvinopesana kune nzira ye suprapatellar, yakadai semunharaunda yakapfava maronda emaronda, iyo infrapatellar nzira inofanira kushandiswa. Nzira yekudzivirira sei kushungurudza kwekuguma kwekuputsika panguva yekuvhiyiwa idambudziko rinofanira kutarisana. Dzimwe nyanzvi dzinoshandisa mahwendefa madiki-akacheka simbi kugadzirisa kwechinguva anterior cortex, kana kushandisa zvipikiri zvinovharira kugadzirisa kukanganisa.
▲ Mufananidzo unoratidza kushandiswa kwekuvhara zvipikiri kugadzirisa kona.
Kuti vagadzirise dambudziko iri, nyanzvi dzekune dzimwe nyika dzakatora hunyanzvi hwekuita zvishoma. Chinyorwa chakabudiswa munguva pfupi yapfuura mumagazini "Ann R Coll Surg Engl":
Sarudza maviri 3.5mm ematehwe screws, padhuze nemuromo wemagumo akatyoka, isa screw imwe kumberi uye kumashure mukati mezvimedu zvebhonzo kumagumo ese ekutyoka, uye siya anopfuura 2cm kunze kweganda:
Bata iyo yekudzikisa forceps kuchengetedza kudzikisira, wobva waisa iyo intramedullary mbambo zvinoenderana neyakajairwa maitiro. Mushure mekunge mbambo ye intramedullary yaiswa, bvisa screw.
Iyi nzira yehunyanzvi inokodzera zviitiko zvakakosha apo suprapatellar kana parapatellar nzira haigone kushandiswa, uye haiwanzo kukurudzirwa. Kuiswa kwe screw iyi kunogona kukanganisa kuiswa kwembambo huru, kana panogona kuve nenjodzi yekuputsika sikuru. Inogona kushandiswa sechiratidzo mumamiriro ezvinhu akakosha.
Nguva yekutumira: May-21-2024
