Mhinduro kumubvunzo uyu ndeyokuti hapana kuputsika kwechitsitsinho kunoda kusungirirwa kwepfupa paunenge uchiita kugadzirisa kwemukati.
Sanders akadaro
Muna 1993, Sanders et al [1] vakaburitsa chiitiko munhoroondo yekuvhiya kurapwa kwecalcaneal fractures muCORR neCT-based classification yecalcaneal fractures. Munguva ichangopfuura, Sanders et al [2] vakagumisa kuti hapana kusungirirwa kwepfupa kana kuvhara mahwendefa kwaidiwa mu120 chitsitsinho chakaputsika nekutevera kwenguva refu kwe10-20 makore.
CT kutaipa kwechitsitsinho kuputsika kwakabudiswa naSanders et al. muCORR muna 1993.
Bone grafting ine zvikonzero zviviri zvikuru: kugadzirwa kwechimiro chekutsigira kwemuchina, senge mufibula, uye granular grafting yekuzadza uye inducing osteogenesis.
Sanders akataura kuti pfupa rechitsitsinho rinoumbwa nehombe huru yekortical encasing cancellous bone, uye iyo yakadzingwa intra-articular fractures yechitsitsinho pfupa inogona kukurumidza kugadziriswa nekanzura pfupa ine trabecular structure kana cortical shell inogona kugadziriswa. kuputsika panzvimbo panguva iyoyo. Nekuenderera mberi kwekugadzirwa kwezvigadzirwa zvemukati zvekugadzirisa zvakadai semaplateti e-posterolateral uye screws, kutsigirwa kwekuchengetedza kwekuderedza kuburikidza nekuputika kwepfupa kwakava kusina kufanira. Zvidzidzo zvaro zvenguva refu zvekliniki zvakasimbisa maonero aya.
Chidzidzo chekiriniki chinodzorwa chinogumisa kuti kubatanidza pfupa hakuna basa
Longino et al [4] nevamwe vakaita chirongwa chinotarisirwa chekuongorora che 40 yakadzingwa intra-articular fractures yechitsitsinho nemakore angangoita 2 ekutevera uye haana kuwana misiyano yakakura pakati pekugadzirisa pfupa uye pasina kuputika kwepfupa maererano nekufungidzira kana kushanda.
Singh et al [6] kubva kuMayo Clinic vakaita chidzidzo chekare chevarwere ve202 uye kunyange zvazvo kubatanidza pfupa kwaive kwakakwirira maererano nekona yeBohler uye nguva yekutakura uremu hwakazara, pakanga pasina musiyano mukuru mumigumisiro yekushanda uye matambudziko.
Bone grafting sechinhu chinokonzera njodzi yekutambudzika kwematambudziko
Muzvinafundo Pan Zhijun nechikwata chake kuZhejiang Medical Second Hospital vakaita ongororo yakarongeka uye meta-analysis muna 2015 [7], iyo yaisanganisira mabhuku ese anogona kutorwa kubva kumagetsi dhatabhesi kubva muna 2014, kusanganisira 1651 kuputsika muvarwere ve1559, uye vakagumisa kuti kuputika kwepfupa, kusawedzera njodzi yechirwere cheshuga. postoperative traumatic complications.
Mukupedzisa, kusungirirwa kwepfupa hakudiwi mukati mekugadzirisa kwemukati kwechitsitsinho kuputsika uye hakubatsiri kuita basa kana kuguma kwekupedzisira, asi kunowedzera dambudziko rematambudziko anorwadza.
1.Sanders R, Fortin P, DiPasquale T, et al. Operative kurapwa muna 120 displaced intraarticular calcaneal fractures. Mhinduro uchishandisa prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;(290):87-95.
2.Sanders R, Vaupel ZM, Erdogan M, et al. Operative treatment of displaced intraarticular calcaneal fractures: nguva refu (10-20 Makore) inoguma ne108 fractures uchishandisa prognostic CT classification. J Orthop Trauma. 2014;28(10):551-63.
3.Palmer I. Iyo nzira uye kurapwa kwekuputsika kwecalcaneus. J Bone Joint Surg Am. 1948;30A:2–8.
4.Longino D, Buckley RE. Bone graft mukurapwa kwekushanda kwe displaced intraarticular calcaneal fractures: inobatsira here? J Orthop Trauma. 2001;15(4):280-6.
5.Gusic N, Fedel I, Darabos N, nevamwe. Operative kurapwa kwe intraarticular calcaneal fractures: Anatomical uye inoshanda mhedzisiro yemaitiro matatu akasiyana ekushandisa. Kukuvara. 2015;46 Suppl 6:S130-3.
6.Singh AK, Vinay K. Kuvhiyiwa kwekurapa kwe-displaced intra-articular calcaneal fractures: kusungirirwa kwepfupa kunodiwa here? J Orthop Traumatol. 2013;14(4):299-305.
7. Zhang W, Chen E, Xue D, nevamwe. Zvikonzero zvekukanganisa maronda ekuvharwa kwecalcaneal fractures mushure mekuvhiyiwa: kuongororwa kwakarongeka uye meta-analysis. Scan J Trauma Resusc Emerg Med. 2015;23:18.
Nguva yekutumira: Zvita-07-2023
