Tibial shaft fracture ndi kuvulala kofala kwachipatala. Intramedullary msomali mkati kukonza kuli ndi ubwino wa biomechanical waing'ono invasive ndi axial fixation, kupangitsa kukhala njira yothetsera chithandizo cha opaleshoni. Pali njira ziwiri zazikulu zokhomerera misomali ya tibial intramedullary: suprapatellar ndi infrapatellar nailing, komanso njira ya parapatellar yomwe akatswiri ena amagwiritsa ntchito.
Kwa fractures ya proximal 1/3 ya tibia, popeza njira ya infrapatellar imafuna kupindika kwa mawondo, n'zosavuta kuchititsa kuti fracture ipite patsogolo panthawi ya opaleshoni. Chifukwa chake, njira ya suprapatellar nthawi zambiri imalimbikitsa chithandizo.
▲Fanizo losonyeza kuyika kwa mwendo wokhudzidwa kudzera mu njira ya suprapatellar
Komabe, ngati pali zotsutsana ndi njira ya suprapatellar, monga zilonda zam'deralo zofewa, njira ya infrapatellar iyenera kugwiritsidwa ntchito. Momwe mungapewere kupwetekedwa kwa mapeto a fracture panthawi ya opaleshoni ndi vuto lomwe liyenera kukumana nalo. Akatswiri ena amagwiritsa ntchito zitsulo zong'ambika ting'onoting'ono kuti akonze kamphindi kakang'ono, kapena kugwiritsa ntchito misomali yotchinga kuti akonze vutolo.
▲ Chithunzichi chikuwonetsa kugwiritsa ntchito misomali yotsekereza kukonza ngodya.
Kuti athetse vutoli, akatswiri a maphunziro ochokera kumayiko ena anagwiritsa ntchito njira yochepetsetsa kwambiri. Nkhaniyi idasindikizidwa posachedwa m'magazini "Ann R Coll Surg Engl":
Sankhani zomangira ziwiri zachikopa za 3.5mm, pafupi ndi nsonga ya nsonga yosweka, ikani zomangira limodzi kutsogolo ndi kumbuyo mu zidutswa za fupa pamapeto onse a fracture, ndikusiya oposa 2cm kunja kwa khungu:
Limbikitsani mphamvu zochepetsera kuti muchepetse, ndiyeno ikani msomali wa intramedullary molingana ndi njira wamba. Mukalowetsa msomali wa intramedullary, chotsani screw.
Njira yamakonoyi ndi yoyenera pazochitika zapadera zomwe njira za suprapatellar kapena parapatellar sizingagwiritsidwe ntchito, ndipo sizikulimbikitsidwa nthawi zonse. Kuyika kwa screw iyi kungakhudze kuyika kwa msomali waukulu, kapena pangakhale chiopsezo chosweka. Itha kugwiritsidwa ntchito ngati chofotokozera muzochitika zapadera.
Nthawi yotumiza: May-21-2024
