Kuvhiya Kwekuvhiya | Ipsirilateral femore cinely condyle graft yemukati yekugadziriswa kwekurapa kwe tibial Plateau fractures

TALLARAL Tibial Plateau inodonha kana kupatsanurana kudonha ndiyo mhando yakajairika yemhando yeTibial Plave. Chinangwa chikuru chekuvhiya ndechekudzoreredza kusimba kweiyo yakabatanidzwa pamusoro uye kuenzanisa iyo yepazasi gumbo. Iyo yakadonhedzwa yakabatana, kana ikasimudzwa, inosiya pfuma yakaremara pasi pe cartilage, kazhinji inoda kuiswa kweiyo autogen iliac bone, allograft pfupa, kana pfupa rekugadzira. Izvi zvinoshanda zvinangwa zviviri: kutanga, kudzoreredza bony rutsigiro rwemhando, uye chechipiri, kusimudzira kupora kwepfupa.

Tichifunga nezve yekuwedzera incision inodiwa kune autogen Boath Bone, iyo inotungamira kune yakakura kusviba kwesimba uye neutachiona Ivo vanoti vanowedzera chiitiko chimwe chete kusvika panguva yekuita uye kushandisa zvinowanzoita bwany graft kubva kune yakakwira femal femboral. Mishumo yemashumo yakati wandei yakanyora maitiro aya.

Chidzidzo ichi chakabatanidza zviitiko gumi nemaviri neyekutevera-kwakakwana kufungidzira data. Mune vese varwere, maitiro ezviitiko zveTibial anterior anotevera akashandiswa. Mushure mekufumura tibial Plateau, iyo incision yakawedzerwa kumusoro kuti iburitse iyo yakanyanya kukweretwa kondoti. A 12mm Eckman Bone Extractor akashanda, uye mushure mekudhirowa kuburikidza nekunze cortex yekati yechikadzi, haacherechedze pfupa kubva kune imwe nhamburiko yakakodzwa mune ina dzinodzokororwa. Iro vhoriyamu rakawanikwa kubva makumi maviri kusvika makumi mana kusvika makumi mana.

Mushure mekudzokorora kudiridza kwepopa canal, sipotiki chipanje inogona kuiswa kana zvichidikanwa. Iyo inokohwa mapfupa haina kuiswa mukati mekuremara kwepfupa pasi peiyo yakatevera tibili tibi, ichiteverwa nekugadziriswa kwemukati. Mhedzisiro yacho inoratidza:

① Kugadziriswa kwemukati kweiyo tibial Plateau, vese varwere vakawana kupora kupora.

Hapana marwadzo akakosha kana matambudziko akaonekwa panzvimbo iyo nzvimbo iyo pfupa yakakohwa kubva kune yakatevera central.

Kuporesa kwePfupa Pazvakaitika Chekukohwa: Pakati pevarwere gumi nevaviri, vatatu vakaratidza kupora zvakakwana kwevafudzi rezvonga,

Kuumbwa kwepaTitbeculae panzvimbo yekukohwa: Mune 9 kesi, pakanga pasina kuumbwa kunooneka kwepa trobeculae, uye mune matatu kesi, kusarudzika kwekuumbwa kwepa trobeculae akaonekwa.

⑤ Zvinetso zveOsteoarthritis: Pakati pevarwere gumi nevaviri, 5 yakagadziriswa post-inotambudza arthritis yebvi. Mumwe murwere ari pasi pejoini yekubatanidza makore mana gare gare.

Mukupedzisa, kukohwewa hakungabvepi pfupa kubva kuIpsilateral Longline fembol femori inoguma neTibial Plateau kupora pasina kuwedzera njodzi yekutora njodzi dzekupedza. Iyi nzira inogona kutariswa uye kuratidzwa mumakiriniki maitiro.