Ko te whiriwhiri i te wāhi tomo mō te Intramedullary o ngā Whati Tibial tētahi o ngā mahi matua mō te angitu o te maimoatanga pokanga. Ki te kore e pai te wāhi tomo mō te Intramedullary, ahakoa i roto i te huarahi suprapatellar, infrapatellar rānei, ka kore pea e taea te neke i te tūnga, te koki o te pito whati, me te whara i ngā hanganga ora o te turi huri noa i te wāhi tomo.
Ka whakamāramahia ngā āhuatanga e toru o te pūwāhi whakaurunga whao intramedullary tibial.
He aha te pūwāhi whakaurunga whao tibial intramedullary paerewa?
He aha ngā pānga o te whao tibial intramedullary deviated?
Me pēhea te whakatau i te wāhi tika mō te whakaurunga i te wā o te pokanga?
I. He aha te wāhi whakauru paerewa mōTibialI roto i te medullary?
Kei te whakawhitiwhitinga o te tuaka ā-ringa o te tibia me te papa tibial te tūranga orthotopic, te taha waenga o te tuaiwi intercondylar lateral o te tibia, ā, kei te rohe whakawhiti i waenganui i te papa tibial me te rohe hekenga o te kakau tibial te tūranga lateral.
Te whānuitanga o te rohe haumaru i te pūwāhi tomokanga
22.9±8.9mm, ka taea te wero i te ngira ki tēnei wāhi, me te kore e kino te pito wheua o te ACL me te kiko meniscus.
II. He aha ngā pānga o te he o te hinengaroTibialIte pokapū o roto Nmate?
I runga i ngā whati o te tibial proximal, te waenganui, me te distal, ko te whati tibial proximal te mea tino kitea te pānga, ko te whati tibial waenga te mea iti rawa te pānga, ā, ko te pito distal te mea matua e pā ana ki te tūranga me te nekehanga anō o te whao distal intramedullary.
# Ngā Whati o te Tibial Proximal
# Ngā whati o te tibia waenga
He iti noa te pānga o te pūwāhi tomo ki te nekehanga, engari he pai ake te whakauru i te whao mai i te pūwāhi tomo paerewa.
# Ngā whati o te tibia tawhiti
Me rite te pūwāhi tomo ki te whati proximal, ā, me tū te tūnga o te whao intramedullary distal ki waenganui o te fornix distal ki te taha ortholateral.
Ⅲ. HMe pēhea te whakatau mēnā he tika te pūwāhi whakauru ngira i te wā e pokanga ana?
Me whai i te fluoroscopy hei whakatau mēnā he tika te wāhi whakauru o te ngira. He mea tino nui te tango i te orthopantomogram paerewa o te turi i mua i te pokanga, nō reira me pēhea te tango?
Orthopantomogram paerewa - rārangi whakarara o te pane fibular
Ka hangaia te tuaka ā-ringa o te hihi-X-o-te-tuaka hei rārangi tika, ā, ka hangaia he rārangi whakarara o te tuaka ā-ringa ki te taha taha o te papa tibial, e wehea ai te pane fibular i runga i te hihi-X-o-te-tuaka. Mēnā ka whiwhihia tētahi o aua hihi-X, ka kitea kua tika te tango.
Mena kāore te poro-orthodo i te paerewa, hei tauira, ki te whāngaihia te whao mai i te pūwāhi whāngai paerewa, ina tangohia te tūranga hurihuri o waho, ka whakaatuhia kei waho te pūwāhi whāngai, ā, mā te tūranga hurihuri o roto ka whakaatuhia kei roto te pūwāhi whāngai, ka pā tēnei ki te whakatau pokanga.
I runga i te hihi-X paerewa, he nui te taupatupatu o ngā condyles femur medial me lateral, ā, he nui te taupatupatu o te medial me lateral tibial plateau, ā, i te tirohanga lateral, ko te pūwāhi urunga kei te rohe wai i waenganui i te plateau me te kakau tibial.
IV. Whakarāpopototanga o ngā Ihirangi
Ko te pūwāhi whakauru whao tibial intramedullary paerewa kei te taha waenga o te tuaiwi intercondylar lateral o te tibia, me te taha hoki i te watershed i waenganui i te tibial plateau me te rohe hekenga o te kakau tibial.
He tino iti te rohe haumaru i te pūwāhi tomo, 22.9±8.9 mm noa iho, ā, ka taea te wero i te ngira ki tēnei wāhi me te kore e kino te ārai wheua o te ACL me te kiko meniscal.
Me tango ngā whakaahua orthopantomograph paerewa me ngā whakaahua x-ray taha o te turi i te wā e pokanga ana, koinei te mea nui hei whakatau mēnā he tika te wāhi whakauru ngira.
Wā tuku: Hanuere-02-2023
