Mhinduro yemubvunzo uyu ndeyekuti hapana kutyoka kwechitsitsinho kunodiwa kuti mapfupa apinzwe mukati memuviri.
Sanders akadaro
Muna 1993, Sanders et al [1] vakaburitsa chiratidzo chakakosha munhoroondo yekurapwa kwekutyoka kwetsinga dzemudumbu muCORR nekupatsanurwa kwavo kwetsinga dzemudumbu zvichibva paCT. Munguva pfupi yapfuura, Sanders et al [2] vakagumisa kuti hapana kusungirirwa kwemapfupa kana maplate ekukiya kwaidiwa mukutyoka kwetsinga dzemudumbu zana nemakumi maviri nekutevera kwenguva refu kwemakore gumi kusvika makumi maviri.
Kunyorwa kweCT kwekutyoka kwechitsitsinho kwakabudiswa naSanders nevamwe muCORR muna 1993.
Kubatanidza mapfupa kune zvinangwa zviviri zvikuru: kusanganisa mapfupa nesimbi kuti zvitsigire mapfupa, zvakaita semu fibula, uye kusanganisa mapfupa nesimbi kuti zvizadze uye zvikonzere osteogenesis.
Sanders akataura kuti pfupa rechitsitsinho rine goko guru re cortical rakafukidza pfupa re cancellous, uye kuti kuputsika kwechitsitsinho kwakabviswa mukati me articular kunogona kugadziriswa nekukurumidza ne cancellous bone rine trabecular structure kana cortical shell ikagona kugadziriswa zvishoma nezvishoma. Palmer et al [3] ndivo vakatanga kutaura nezvekuiswa kwemapfupa muna 1948 nekuda kwekushaikwa kwemidziyo yakakodzera yekugadzirisa mukati me articular kuti fracture iri panzvimbo yayo panguva iyoyo. Nekuvandudzwa kuri kuitwa kwemidziyo yekugadzirisa mukati senge posterolateral plates uye screws, kuchengetedza rutsigiro rwekudzikisa kuburikidza ne bone graft kwakava kusingakoshi. Zvidzidzo zvayo zvekiriniki zvenguva refu zvakasimbisa maonero aya.
Ongororo yekiriniki inogumisa kuti kuisirwa mapfupa mumiviri hakudiwi
Longino nevamwe [4] vakaita ongororo yakadzorwa yezvakatyoka 40 zvechitsitsinho zvakabviswa nepakati nepakati kwemakore maviri ekutevera uye havana kuwana mutsauko wakakosha pakati pekuiswa kwemapfupa uye kusaiswa kwemapfupa maererano nemifananidzo kana mhedzisiro yekushanda. Gusic nevamwe [5] vakaita ongororo yakadzorwa yezvakatyoka 143 zvechitsitsinho zvakabviswa nepakati nepakati nemhedzisiro yakafanana.
Singh nevamwe vake [6] vekuMayo Clinic vakaita ongororo yekuongorora mapfupa evarwere mazana maviri nevaviri uye kunyangwe kubatanidzwa kwemapfupa kwaive kwakanaka maererano nekona yaBohler uye nguva yekutakura huremu hwakazara, pakanga pasina musiyano wakakosha mumhedzisiro yekushanda uye matambudziko.
Kubatanidzwa kwemapfupa sechinhu chinokonzera matambudziko ekukuvara
Purofesa Pan Zhijun nechikwata chake paZhejiang Medical Second Hospital vakaita ongororo yakarongeka uye meta-analysis muna 2015 [7], iyo yaisanganisira mabhuku ese aigona kuwanikwa kubva kumadhatabhesi emagetsi kusvika muna 2014, kusanganisira kutyoka kwemapfupa 1651 muvarwere 1559, uye vakagumisa kuti kuiswa kwemapfupa, chirwere cheshuga, kusaisa nzira yekubvisa tsvina, uye kutyoka kwakanyanya zvinowedzera njodzi yematambudziko ekurwadziwa mushure mekuvhiyiwa.
Mukupedzisa, kuisirwa mapfupa hakudikanwi panguva yekugadziriswa kwemukati mezvitsitsinho zvakatyoka uye hakubatsiri pakushanda kana mhedzisiro yekupedzisira, asi kunowedzera njodzi yematambudziko anokonzerwa nekukuvara.
1.Sanders R, Fortin P, DiPasquale T, nevamwe. Kurapa kwekuvhiya muzvikamu zana nemakumi maviri zve intraarticular calcaneal fractures. Mhedzisiro uchishandisa prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;(290):87-95.
2.Sanders R, Vaupel ZM, Erdogan M, nevamwe. Kurapa kwekutyoka kwe calcaneal fractures intraarticular: kwenguva refu (Makore 10-20) kunoguma nekutyoka 108 uchishandisa CT classification yekufanotaura. J Orthop Trauma. 2014;28(10):551-63.
3. Palmer I. Maitiro uye kurapwa kwekutyoka kwe calcaneus. J Bone Joint Surg Am. 1948;30A:2–8.
4.Longino D, Buckley RE. Kuiswa kwemapfupa mukurapa kwekuvhiyiwa kwekutyoka kwe intraarticular calcaneal: zvinobatsira here? J Orthop Trauma. 2001;15(4):280-6.
5.Gusic N, Fedel I, Darabos N, nevamwe. Kurapa kwekutyoka kwe calcaneal intraarticular: Mhedzisiro yemuviri uye yekushanda kwenzira nhatu dzakasiyana dzekuvhiya. Kukuvara. 2015;46 Suppl 6:S130-3.
6.Singh AK, Vinay K. Kurapwa kwekutyoka kwe calcaneal intra-articular: kuisirwa mapfupa kwakakosha here? J Orthop Traumatol. 2013;14(4):299-305.
7. Zhang W, Chen E, Xue D, nevamwe. Zvinhu zvinokonzera matambudziko emaronda ekutyoka kwetsinga mushure mekuvhiyiwa: ongororo yakarongeka uye meta-analysis. Scand J Trauma Resusc Emerg Med. 2015;23:18.
Nguva yekutumira: Zvita-07-2023
