Kutyoka kwenhengo dzechikadzi dzinotevera kukuvara kunowanzoonekwa nekuda kwekukuvara kwakasimba. Nekuda kwehunhu hwemuviri wenhengo dzechikadzi dzinotevera kukuvara, mutsetse wekutyoka unowanzova pedyo nepamusoro penhengo uye unogona kusvika pajoini, zvichiita kuti isakodzere kugadziriswa kwezvipikiri mukati memudumbu. Nekuda kweizvozvo, chikamu chikuru chezviitiko chichiri kushandisa nzira yekubatanidza plate nescrew system. Zvisinei, maitiro e biomechanical emaplates akasimbiswa eccentrically anopa njodzi yakakura yezvinetso zvakaita sekukundikana kwekugadzirisa plate lateral, kuputika kwemukati, uye kudhonzwa kwescrew. Kushandiswa kweMedical plate assistance yekugadzirisa, kunyangwe zvichishanda, kunouya nezvikanganiso zvekukuvara kwakawedzera, nguva yakareba yekuvhiyiwa, njodzi yakawedzera yehutachiona mushure mekuvhiyiwa, uye mutoro wezvemari wevarwere.
Zvichitevera izvi, kuti pave nekuenzana kwakanaka pakati pezvikanganiso zve biomechanical zve lateral single plates uye kukuvara kwekuvhiyiwa kunokonzerwa nekushandiswa kwe medial ne lateral double plates, nyanzvi dzekune dzimwe nyika dzakashandisa nzira inosanganisira lateral plate fixation ne supplementary percutaneous screw fixation kudivi re medial. Nzira iyi yakaratidza mhedzisiro yakanaka yekiriniki.
Mushure mekunzwa kuneta, murwere anoiswa panzvimbo yakarara.
Danho 1: Kuderedza kutyoka. Isa tsono yeKocher ye2.0mm mu tibial tuberosity, dhonza kuti udzorere kureba kwegumbo, uye shandisa pad yebvi kugadzirisa kufamba kwe sagittal plane.
Danho rechipiri: Kuisa ndiro yesimbi yedivi. Mushure mekudzikisa nekukweva, swedera zvakananga kudistal lateral femur, sarudza ndiro yakakodzera yekukiya kuti uchengetedze kudzikisa, uye isa masikuru maviri pamagumo ekusvika nekumashure ekutyoka kuti uchengetedze kudzikisa kwekutyoka. Panguva ino, zvakakosha kucherechedza kuti masikuru maviri ekudivi anofanira kuiswa pedyo nepamberi sezvinobvira kudzivirira kukanganisa kuiswa kwesikuru dzepakati.
Danho rechitatu: Kuisa masikuruu epakati. Mushure mekudzikamisa kuputsika neplate yesimbi yedivi, shandisa chibooreso che2.8mm chinotungamirirwa nescrew kuti upinde nepakati pe condyle, nepo nzvimbo yetsono iri pakati kana kumashure kwe distal femoral block, yakatarisana nekunze uye kumusoro, ichipinda mu cortical bone yakatarisana. Mushure mekuderedzwa kwakanaka kwe fluoroscopy, shandisa chibooreso che5.0mm kugadzira gomba uye isa 7.3mm cancellous bone screw.
Dhiagiramu inoratidza maitiro ekuderedza nekugadzika kwekutyoka. Mukadzi ane makore 74 ekuberekwa ane kutyoka kwemukati memutsipa wepachipfuva (AO 33C1). (A, B) MaX-ray epamberi pekuvhiyiwa anoratidza kuchinjika kwakakosha kwekutyoka kwemutsipa wepachipfuva wepachipfuva; (C) Mushure mekuderedzwa kwekutyoka, plate yekunze yepamberi inoiswa nescrews dzinochengetedza magumo ese ari maviri eproximal needistal; (D) Mufananidzo weFluoroscopy unoratidza nzvimbo inogutsa yewaya yekufambisa yepakati; (E, F) MaX-ray epashure pekuvhiyiwa uye epamberi peshure mushure mekuiswa kwesikuruu yepakati.
Munguva yekudzikisa, zvakakosha kufunga nezvezvinhu zvinotevera:
(1) Shandisa waya yekutungamira ine sikuruu. Kuiswa kwemasikuruu epakati pemakoramu kwakakura, uye kushandisa waya yekutungamira isina sikuruu kunogona kukonzera kona yakakwira panguva yekuboora nepakati pemakonzo, zvichiita kuti ive nyore kutsvedza.
(2) Kana masikuru ari mu lateral plate akabata zvakanaka lateral cortex asi akatadza kugadzirisa cortex mbiri zvakanaka, gadzirisa screw direction kuenda mberi, zvichiita kuti masikuru apinde neparutivi rwemberi rwe lateral plate kuti agadzirise cortex mbiri zvakanaka.
(3) Kune varwere vane osteoporosis, kuisa muchina wekuwachisa une sikuruu yepakati kunogona kudzivirira sikuruu kuti isacheke mumapfupa.
(4) Zvikuruu zviri kumucheto weplate zvinogona kuvharira kuiswa kwezvikuruu zvepakati. Kana zvikuruu zvikavharira panguva yekuisa zvikuruu zvepakati, funga nezvekubvisa kana kuisazve zvikuruu zvepakati zveplate yedivi, uchipa nzvimbo yekutanga yekuisa zvikuruu zvepakati.
Nyaya 2. Murwere wechikadzi, ane makore 76 ekuberekwa, ane kutsemuka kwekunze kwemuviri wemukadzi. (A, B) MaX-ray asati avhiyiwa anoratidza kutsemuka kukuru, kuremara kwekona, uye kutsemuka kwechikamu chemuviri wemunhu; (C, D) MaX-ray mushure mekuvhiyiwa mumaonero eparutivi neashure anoratidza kutsemuka neplate yekunze yakasanganiswa nemasikiru epakati; (E, F) MaX-ray ekutevera pamwedzi 7 mushure mekuvhiyiwa anoratidza kupora kwakanaka kwetsemuka pasina zviratidzo zvekukundikana kwekugadzirisa mukati.
Nyaya 3. Murwere wechikadzi, ane makore makumi manomwe ekuberekwa, ane kukuvara kwepamuviri kwakatenderedza femoral implant. (A, B) MaX-rays asati avhiyiwa anoratidza kutyoka kwepamuviri kwakatenderedza femoral implant mushure mekuvhiyiwa kwebvi rese, nekutyoka kwepamuviri kwakatenderedza uye kugadzikana kweprosthetic fixation; (C, D) MaX-rays epashure pekuvhiyiwa anoratidza kugadzikana neplate yekunze yakasanganiswa ne medial column screws kuburikidza nenzira ye extra-articular; (E, F) MaX-rays ekutevera pamwedzi mitanhatu mushure mekuvhiyiwa anoratidza kupora kwakanaka kwekukuvara, nekugadziriswa kwemukati kuri panzvimbo.
Nguva yekutumira: Ndira-10-2024
