Whakauruhia mai ētahi pūnaha whakapiri intramedullary e toru mō ngā whati calcaneal.

I tēnei wā, ko te huarahi pokanga e whakamahia whānuitia ana mō ngā whati calcaneal ko te whakapiri ā-roto ki te pereti me te tīwiri mā te ara whakaurunga sinus tarsi. Kāore e pai ake ana te huarahi whānui taha "L" i roto i te mahi haumanu nā te nui ake o ngā raruraru e pā ana ki te patunga. Ko te whakapiri pereti me te pūnaha tīwiri, nā ōna āhuatanga koiora o te whakapiri eccentric, he nui ake te mōrearea o te varus mislignment, me ētahi rangahau e tohu ana i te tūponotanga o te varus tuarua i muri i te pokanga tata ki te 34%.

Nā reira, kua tīmata ngā kairangahau ki te ako i ngā tikanga whakapiri intramedullary mō ngā whati calcaneal hei aro atu ki ngā raruraru e pā ana ki te patunga me te take o te kore honotanga tuarua o te varus.

01 Ntikanga whao pokapū katoa

Ka taea e tēnei tikanga te āwhina i te whakaiti mā te ara whakaurunga o te sinus tarsi, i raro rānei i te arataki arthroscopic, me te whakaiti i te tono kiko ngohengohe, ā, ka taea hoki te whakaiti i te wā e noho ana i te hōhipera. He mea whiriwhiri tēnei huarahi mō ngā whati momo II-III, ā, mō ngā whati calcaneal kua pakaru, kāore pea e taea te pupuri i te whakaiti me te hiahia pea ki te whakapiripiri tīwiri.

02 Swhao intramedullary papa-ingle

E rua ngā tīwiri o te whao intramedullary papa kotahi i ngā pito proximal me ngā pito distal, me te whao matua tuwhera e taea ai te hono wheua mā roto i te whao matua.

03 Mwhao intramedullary ulti-plane

I hangaia i runga i te āhua hanganga toru-ahu o te calcaneus, kei roto i tēnei pūnaha whakapiri ā-roto ngā tīwiri matua pērā i ngā tīwiri piko e mau ana i te kawenga me ngā tīwiri tukanga o muri. I muri i te whakahekenga mā te ara whakaurunga sinus tarsi, ka taea te whakanoho i ēnei tīwiri ki raro i te kiriuhi hei tautoko.

He maha ngā tautohetohe e pā ana ki te whakamahinga o ngā whao intramedullary mō ngā whati calcaneal:

1. Te whaihua i runga i te uaua o te whati: Kei te tautohetia mēnā kāore e hiahiatia he whao intramedullary mō ngā whati ngāwari, ā, kāore hoki he pai mō ngā whati uaua. Mō ngā whati momo Sanders II/III, kua tino pakari te tikanga whakaiti me te whakapiri tīwiri mā te ara whakaurunga sinus tarsi, ā, tera pea ka pātaihia te hiranga o te whao intramedullary matua. Mō ngā whati uaua, kāore e taea te whakakapi i ngā painga o te huarahi whānui āhua "L", nā te mea ka nui te whakaaturanga.

2. Te hiranga o tētahi awaawa medullary horihori: Kāore i te tino kitea he awaawa medullary i roto i te calcaneus. Mā te whakamahi i tētahi whao nui i roto i te medullary ka nui rawa te whara, ka ngaro rānei te papatipu wheua.

3. Te Uauatanga ki te Tango: I roto i te nuinga o ngā wā i Haina, ka tangohia tonutia ngā tūroro i muri i te whakaora whati. Ko te whakaurunga o te whao ki te tipu o te wheua me te whakaurunga o ngā tīwiri taha ki raro i te wheua cortical ka arahi pea ki te uauatanga o te tango, he mea whai hua tēnei i roto i ngā tono haumanu.