"10% o ngā whati pona waewae e haere tahi ana me te whara o te distal tibiofibular syndesmosis. Kua whakaatuhia e ngā rangahau e 52% o ngā tīwiri distal tibiofibular ka hua ake he whakaiti iti o te syndesmosis. He mea nui te whakauru i te tīwiri distal tibiofibular poutū ki te mata o te hononga syndesmosis hei karo i te whakaiti kino iatrogenic. E ai ki te pukapuka AO, e taunakihia ana kia whakaurua te tīwiri distal tibiofibular 2 cm, 3.5 cm rānei i runga ake i te mata hononga distal tibial, i te koki 20-30° ki te papa whakapae, mai i te fibula ki te tibia, me te pona waewae i te tūranga kūpapa."
Ko te whakaurunga ā-ringa o ngā tīwiri tibiofibular distal ka hua ake he rerekētanga o te pūwāhi whakauru me te ahunga, ā, i tēnei wā, kāore he tikanga tika hei whakatau i te ahunga whakaurunga o ēnei tīwiri. Hei whakatika i tēnei take, kua tangohia e ngā kairangahau o tāwāhi tētahi tikanga hou—te 'tikanga wehewehe koki'.
Mā te whakamahi i ngā raraunga whakaahua mai i ngā hononga pona waewae noa e 16, i hangaia he tauira tā-3D e 16. I ngā tawhiti o te 2 cm me te 3.5 cm i runga ake i te mata hononga tibial, i whakanohoia ngā waea Kirschner e rua 1.6 mm te whānui e whakarara ana ki te mata hononga tata ki ngā taha o mua me muri o te tibia me te fibula. I inehia te koki i waenga i ngā waea Kirschner e rua mā te whakamahi i te protractor, ā, i whakamahia he mata wiri 2.7 mm hei keri i tētahi kōhao i te rārangi wehewehe koki, ā, i muri mai ka whakauruhia he tīwiri 3.5 mm. I muri i te whakaurunga o te tīwiri, i tapahia te tīwiri i tōna roa mā te whakamahi i te kani hei aromatawai i te whanaungatanga i waenga i te ahunga o te tīwiri me te tuaka pokapū o te tibia me te fibula.
E whakaatu ana ngā tauira whakamātautau he pai te ōritetanga i waenga i te tuaka pokapū o te tibia me te fibula me te rārangi wehe koki, tae atu ki waenga i te tuaka pokapū me te ahunga o te tīwiri.
I roto i ngā ariā, ka taea e tēnei tikanga te whakanoho i te tīwiri i te taha o te tuaka pokapū o te tibia me te fibula. Heoi, i te wā o te pokanga, ko te whakanoho i ngā waea Kirschner ki te taha o mua me muri o te tibia me te fibula ka tūpono ka kino ngā oko toto me ngā io. Hei tāpiri, kāore tēnei tikanga e whakatau i te take o te whakaiti iatrogenic, nā te mea kāore e taea te aromatawai tika i te tūnga o te tibiofibular distal i te wā o te pokanga i mua i te whakatakotoranga o te tīwiri.
Wā tuku: Hurae-30-2024
