"Mō ngā whati o te kaki o te huha kāore i te kaumātua, ko te tikanga whakau ā-roto e whakamahia whānuitia ana ko te whirihoranga 'tapatoru whakahurihuri' me ngā tīwiri e toru. E rua ngā tīwiri e whakanohoia tata ana ki ngā uho o mua me muri o te kaki o te huha, ā, kotahi te tīwiri e whakanohoia ana ki raro. I te tirohanga anteroposterior, ka taupatupatu ngā tīwiri e rua o mua, ka hanga he tauira '2-tīwiri', i te tirohanga taha, ka kitea he tauira '3-tīwiri'. E kiia ana ko tēnei whirihoranga te whakatakotoranga tino pai mō ngā tīwiri."
"Ko te uaua femoral circumflex medial te pūtake toto matua ki te pane o te femoral. Ina whakanohoia ngā tīwiri 'ki roto, ki waho' ki runga ake i te taha o muri o te kaki femoral, ka tūpono te whara o ngā oko toto iatrogenic, ka whakararu pea i te rere o te toto ki te kaki femoral, ā, nō reira, ka pā ki te whakaora o te wheua."
"Hei ārai i te putanga mai o te āhuatanga 'to-out-in' (IOI), arā, ka puta ngā tīwiri mā roto i te cortex o waho o te kaki femur, ka puta atu i te wheua cortical, ka hoki anō ki te kaki femur me te pane, kua whakamahia e ngā tohunga o te motu me te ao ngā tikanga aromatawai āwhina. Ko te acetabulum, kei runga ake i te taha o waho o te kaki femur, he kōhao piko i roto i te wheua. Mā te ako i te whanaungatanga i waenga i ngā tīwiri kua whakanohoia ki runga ake i te taha o muri o te kaki femur me te acetabulum i te tirohanga anteroposterior, ka taea te matapae, te aromatawai rānei i te mōrearea o te tīwiri IOI."
▲ E whakaatu ana te hoahoa i te whakaahua o te wheua cortical o te acetabulum i te tirohanga anteroposterior o te hononga hope.
I uru atu ki te rangahau te 104 o ngā tūroro, ā, i tirotirohia te whanaungatanga i waenga i te wheua cortical o te acetabulum me ngā tīwiri o muri. I mahia tēnei mā te whakataurite i ngā hihi-X, ā, i tāpirihia ki te hanga anō CT i muri i te pokanga hei aromatawai i te whanaungatanga i waenga i te tokorua. I roto i ngā tūroro 104, 15 i whakaatu i te āhuatanga IOI mārama i runga i ngā hihi-X, 6 kāore i oti ngā raraunga whakaahua, ā, 10 kāore i tino tata ngā tīwiri ki waenganui o te kaki femur, ā, kāore i whai hua te aromatawai. Nō reira, e 73 ngā take tika katoa i whakaurua ki te tātari.
I roto i ngā kēhi 73 i tātarihia, i runga i ngā hihi-X, 42 ngā kēhi he tīwiri kei runga ake i te wheua cortical o te acetabulum, ā, 31 ngā kēhi he tīwiri kei raro. I whakaatuhia e te whakaū CT i puta te āhuatanga IOI i roto i te 59% o ngā kēhi. E whakaatu ana te tātari raraunga i runga i ngā hihi-X, ko ngā tīwiri kei runga ake i te wheua cortical o te acetabulum he tairongo o te 90% me te motuhake o te 88% ki te matapae i te āhuatanga IOI.
▲ Take Tuatahi: E whakaatu ana te hihi-X o te hononga hope i te tirohanga anteroposterior i ngā tīwiri kei runga ake i te wheua cortical o te acetabulum. E whakaū ana ngā tirohanga CT coronal me te transverse i te aroaro o te āhuatanga IOI.
▲Tūnga Tuarua: Ko te hihi-X o te hononga hope i te tirohanga anteroposterior e whakaatu ana i ngā tīwiri kei raro i te wheua cortical o te acetabulum. Mā ngā tirohanga CT coronal me te transverse e whakaū kei roto katoa ngā tīwiri o muri i te cortex wheua.
Wā tuku: Whiringa-ā-rangi 23-2023
