Kutyoka kwegumbo retsoka kunokonzerwa nemasimba ekutenderera kana ekumira, akadai sekutyoka kwePilon, kunowanzo sanganisira posterior malleolus. Kuratidzwa kwe "posterior malleolus" pari zvino kunowanikwa kuburikidza nenzira nhatu huru dzekuvhiya: posterior lateral approach, posterior medial approach, uye modified posterior medial approach. Zvichienderana nerudzi rwekutyoka uye chimiro chemapfupa, nzira yakakodzera inogona kusarudzwa. Nyanzvi dzekune dzimwe nyika dzakaita zvidzidzo zvekuenzanisa pamusoro pehuwandu hweposterior malleolus uye kushushikana pamapaketi eropa netsinga dzegumbo zvine chekuita nenzira idzi nhatu.
Kutyoka kwegumbo kunokonzerwa nemasimba ekutenderera kana ekumira, akadai sekutyoka kwePilon, kunowanzo sanganisira posterior malleolus. Kuratidzwa kwe "posterior malleolus" pari zvino kunowanikwa kuburikidza nenzira nhatu huru dzekuvhiya: posterior lateral approach, posterior medial approach, uye modified posterior medial approach. Zvichienderana nerudzi rwekutyoka uye chimiro chemapfupa, nzira yakakodzera inogona kusarudzwa. Nyanzvi dzekune dzimwe nyika dzakaita zvidzidzo zvekuenzanisa pahuwandu hweposterior malleolus nekumanikidzwa kwayo.
pamitsipa yeropa neyetsinga dzemugumbo zvine chekuita nenzira nhatu idzi.
1. Nzira yepakati yepakati yePosterior
Nzira yekumashure inosanganisira kupinda pakati penzira refu yekuchinjika kwezvigunwe nemidziyo yekumashure yetibial. Nzira iyi inogona kuburitsa 64% ye posterior malleolus. Kumanikidzwa kwemasumbu etsinga netsinga dzeropa kudivi renzira iyi kunoyerwa pa21.5N (19.7-24.1).
▲ Nzira yepakati pechiso (Museve Weyero). 1. Tendon yetibial yeposterior; 2. Tendon refu yezvigunwe; 3. Mitsipa yetibial yeposterior; 4. Nziyo yetibial; 5. Tendon yeAchilles; 6. Tendon yehallucis longus yeflexor. AB=5.5CM, posterior malleolus exposure range (AB/AC) i64%.
2. Nzira yePosterior Lateral
Nzira yekumashure yekubatanidza mativi inosanganisira kupinda pakati peperoneus longus nebrevis tendons neflexor hallucis longus tendon. Nzira iyi inogona kuratidza 40% ye posterior malleolus. Kumanikidzwa kwemasumbu etsinga netsinga dziri parutivi rwenzira iyi kunoyerwa pa16.8N (15.0-19.0).
▲ Nzira yePosterior Lateral (Museve Weyero). 1. Tendon yePosterior tibial; 2. Tendon refu rinochinjika rezvigunwe; 4. Mitsipa yePosterior tibial; 4. Tsinga yeTibial; 5. Tendon yeAchilles; 6. Tendon yeFlexor hallucis longus; 7. Tendon yePeroneus brevis; 8. Tendon yePeroneus longus; 9. Lesser saphenous vein; 10. Common fibular nerve. AB=5.0CM, posterior malleolus exposure range (BC/AB) i40%.
3. Nzira Yakagadziriswa yePosterior Medial
Nzira yakagadziriswa yekumashure inosanganisira kupinda pakati petsinga yetibial ne flexor hallucis longus tendon. Nzira iyi inogona kuratidza 91% ye posterior malleolus. Kumanikidzwa kwemabundle etsinga netsinga dziri parutivi rwenzira iyi kunoyerwa pa7.0N (6.2-7.9).
▲ Nzira Yakagadziriswa yePosterior Medial Approach (Museve Weyero). 1. Tendon yePosterior tibial; 2. Tendon refu yemakumbo etsoka; 3. Mitsipa yeposterior tibial; 4. Nerve yeTibial; 5. Tendon yeFlexor hallucis longus; 6. Tendon yeAchilles. AB=4.7CM, posterior malleolus exposure range (BC/AB) i91%.
Nguva yekutumira: Zvita-27-2023
