Ndi mtundu wanji wa kuthyoka kwa chidendene chomwe chiyenera kuikidwa kuti chikhazikike mkati?

Yankho la funsoli ndiloti palibe kuthyoka kwa chidendene kumafuna kulumikiza mafupa pamene mukupanga kukonza mkati.

Sanders anatero

Mu 1993, Sanders et al [1] adafalitsa chodziwika bwino m'mbiri ya chithandizo cha opaleshoni ya fractures ya calcaneal ku CORR ndi gulu lawo la CT la calcaneal fractures.Posachedwapa, Sanders et al [2] adatsimikiza kuti kulumikiza mafupa kapena kutseka mbale sikunali kofunikira mu 120 chidendene fractures ndi kutsata kwa nthawi yaitali kwa 10-20 zaka.

Kujambula kwa CT kwa kuthyoka kwa chidendene kofalitsidwa ndi Sanders et al.mu CORR mu 1993.

Kumezanitsa mafupa kuli ndi zolinga zazikulu ziwiri: kumezanitsa kwapang'onopang'ono pothandizira makina, monga mufibula, ndi granular grafting kuti mudzaze ndi kuchititsa osteogenesis.

Sanders adanena kuti fupa la chidendene lili ndi chipolopolo chachikulu cha kortical encasing cancellous fupa, komanso kuti fupa la chidendene lomwe linasunthidwa likhoza kumangidwanso ndi fupa lachidendene lopangidwa ndi trabecular ngati chipolopolocho chikhoza kusinthidwa.Palmer et al [ 3] anali oyamba kufotokoza za kulumikiza mafupa mu 1948 chifukwa cha kusowa kwa zipangizo zoyenera zokonzera mkati kuti asungitse fracture ya articular pa nthawiyo.Ndikukula kosalekeza kwa zida zosinthira mkati monga ma plates a posterolateral ndi zomangira, kukonzanso kwapang'onopang'ono pogwiritsa ntchito kulumikiza mafupa kunakhala kosafunikira.Maphunziro ake azachipatala a nthawi yayitali atsimikizira izi.

Kafukufuku woyendetsedwa ndi chipatala amawona kuti kulumikiza mafupa sikofunikira

Longino et al [4] ndi ena adachita kafukufuku woyembekezeredwa wowongolera wa 40 omwe adasamutsidwa kuthyoka kwa chidendene ndi zaka zosachepera 2 zotsatiridwa ndipo sanapeze kusiyana kwakukulu pakati pa kulumikiza mafupa komanso kusalumikizana kwa mafupa potengera kujambula kapena kugwira ntchito. zotsatira.Gusic et al [5] adachita kafukufuku woyendetsedwa ndi 143 osasunthika kuphulika kwa intra-articular chidendene ndi zotsatira zofanana.

Singh et al [6] wochokera ku chipatala cha Mayo adachita kafukufuku wobwereza kwa odwala 202 ndipo ngakhale kuti kulumikiza mafupa kunali kopambana malinga ndi mbali ya Bohler ndi nthawi yolemera kwambiri, panalibe kusiyana kwakukulu muzotsatira zogwirira ntchito ndi zovuta.

Kulumikiza mafupa ngati chiwopsezo cha zovuta zowopsa

Pulofesa Pan Zhijun ndi gulu lake ku Zhejiang Medical Second Hospital anali atafufuza mwadongosolo komanso kusanthula meta mu 2015 [7], yomwe idaphatikizapo zolemba zonse zomwe zitha kutengedwa kuchokera kuzinthu zamagetsi kuyambira 2014, kuphatikiza 1651 zosweka mwa odwala 1559, ndi adatsimikiza kuti kulumikiza mafupa, shuga mellitus, kusayika kukhetsa, komanso kuthyoka kwakukulu kumawonjezera chiopsezo cha zovuta zapambuyo pa opaleshoni.

Pomaliza, kulumikiza mafupa sikofunikira panthawi yokonza mkati mwa chidendene chophwanyika ndipo sichikuthandizira kugwira ntchito kapena zotsatira zomaliza, koma kumawonjezera chiopsezo cha zovuta zowawa.

 
1.Sanders R, Fortin P, DiPasquale T, et al.Chithandizo cha opaleshoni mu 120 osamutsidwa intraarticular calcaneal fractures.Zotsatira pogwiritsa ntchito prognostic computed tomography scan classification.Clin Orthop Relat Relat.1993;(290):87-95.
2.Sanders R, Vaupel ZM, Erdogan M, et al.Kuchiza kwa opaleshoni ya intraarticular calcaneal fractures: kwa nthawi yaitali (10-20 Zaka) kumabweretsa 108 fractures pogwiritsa ntchito prognostic CT classification.J Orthop Trauma.2014;28(10):551-63.
3.Palmer I. Njira ndi chithandizo cha fractures ya calcaneus.J Bone Joint Surg Am.1948; 30A:2–8.
4.Longino D, Buckley RE.Kuphatikizika kwa mafupa pochiza matenda a intraarticular calcaneal fractures: kodi ndizothandiza?J Orthop Trauma.2001;15(4):280-6.
5.Gusic N, Fedel I, Darabos N, et al.Chithandizo cha opaleshoni ya intraarticular calcaneal fractures: zotsatira za anatomical ndi ntchito za njira zitatu zogwirira ntchito.Kuvulala.2015;46 Zowonjezera 6:S130-3.
6.Singh AK, Vinay K. Chithandizo cha opaleshoni ya intra-articular calcaneal fractures: kodi kulumikiza mafupa ndikofunikira?J Orthop Traumatol.2013;14(4):299-305.
7. Zhang W, Chen E, Xue D, et al.Zowopsa pazovuta zabala za kutsekedwa kwa calcaneal fractures pambuyo pa opaleshoni: kuwunika mwadongosolo ndi kusanthula meta.Scand J Trauma Resusc Emerg Med.2015; 23:18.