Daidaita ciki da farantin ƙashi
Haɗa ƙafafu da faranti da sukurori hanya ce ta tiyata da aka saba amfani da ita a yanzu. An yi amfani da haɗa farantin kullewa sosai a haɗa ƙafafu. A halin yanzu, haɗa ƙafafu da faranti ya ƙunshi haɗa farantin gaba da kuma haɗa ƙafafu da ke gefe.
Hoton da ke sama yana nuna hotunan X-ray kafin da kuma bayan tiyata don ciwon osteoarthritis na idon sawu tare da haɗin gwiwa na idon sawu na ciki
1. Hanyar gaba
Hanyar da ake bi a gaba ita ce a yi wani yankewa na gaba mai tsayi a tsakiya a kan wurin haɗin idon sawu, a yanke layi ɗaya bayan ɗaya, sannan a shiga tare da sararin jijiya; a yanke kapsul ɗin haɗin, a fallasa haɗin tibiotalar, a cire guringuntsi da ƙashin subchondral, sannan a sanya farantin gaba a gaban idon sawu.
2. Hanyar gefe
Hanya ta gefe ita ce a yanke osteotomy kimanin santimita 10 a saman ƙarshen fibula sannan a cire kututturen gaba ɗaya. Ana cire kututturen ƙashi mai kauri don dasa ƙashi. Ana kammala osteotomy ɗin saman haɗin gwiwa kuma a wanke shi, sannan a sanya farantin a wajen haɗin idon.
Amfanin shine ƙarfin gyara yana da yawa kuma gyaran yana da ƙarfi. Ana iya amfani da shi don gyara da sake ginawa nakasar varus ko valgus mai tsanani na haɗin idon ƙafa da kuma lahani da yawa na ƙashi bayan tsaftacewa. Farantin haɗakar da aka tsara ta hanyar anatomical yana taimakawa wajen dawo da yanayin haɗin idon ƙafa na yau da kullun. Wuri.
Rashin kyawunsa shine cewa ana buƙatar cire ƙarin periosteum da nama mai laushi a yankin tiyata, kuma farantin ƙarfe ya yi kauri, wanda hakan yana da sauƙin fusata jijiyoyin da ke kewaye. Farantin ƙarfe da aka sanya a gaba yana da sauƙin taɓawa a ƙarƙashin fata, kuma akwai wani haɗari.
gyaran ƙusa a cikin medullary
A cikin 'yan shekarun nan, an fara amfani da maganin ciwon ƙafar ƙafa mai kama da na ƙafar ƙafa a matsayin maganin ciwon ƙafar ...
A halin yanzu, dabarar ƙusa ta intramedullary galibi tana amfani da yanke tsakiyar haɗin idon ƙafa ko yanke gefen fibula na anteroinferior don tsaftace saman articular ko dashen ƙashi. Ana saka ƙusa ta intramedullary daga calcaneus zuwa ramin tibial medullary, wanda ke da amfani ga gyaran nakasa kuma yana haɓaka haɗakar ƙashi.
Ciwon idon ƙafa tare da ciwon gwiwa na ƙasa. Fim ɗin X-ray na gaban ido da na gefe kafin tiyata sun nuna mummunan lalacewa ga haɗin tibiotalar da haɗin gwiwa na ƙasa, rugujewar talus na wani ɓangare, da kuma samuwar osteophyte a kusa da haɗin gwiwa (daga nassoshi na 2)
Kusurwar dasa sukurori masu bambanci na ƙusa ta baya ta intramedullary da ke kulle ƙafafuwa ita ce gyarawa mai matakai da yawa, wanda zai iya gyara takamaiman haɗin da za a haɗa, kuma ƙarshen nesa rami ne na kulle mai zare, wanda zai iya tsayayya da yankewa, juyawa, da kuma cirewa yadda ya kamata, wanda ke rage haɗarin janye sukurori.
An fallasa haɗin tibiotalar da haɗin subtalar kuma an sarrafa su ta hanyar hanyar transfibular ta gefe, kuma tsawon yankewar a ƙofar ƙusa ta intramedullary ta plantar shine 3 cm.
Ana amfani da ƙusa ta intramedullary a matsayin abin da ke daidaita tsakiya, kuma damuwarsa ta bazu sosai, wanda zai iya guje wa tasirin kariyar damuwa kuma ya fi dacewa da ƙa'idodin biomechanics.
Fim ɗin X-ray na gaban da na gefe bayan wata 1 bayan tiyata ya nuna cewa layin ƙafar baya yana da kyau kuma an gyara ƙusa ta intramedullary cikin aminci
Shafa farce a cikin haɗin gwiwa na idon sawu na iya rage lalacewar nama mai laushi, rage raunin fata, kamuwa da cuta da sauran matsaloli, kuma yana iya samar da isasshen gyara ba tare da ƙarin gyaran waje na filastik ba bayan tiyata.
Shekara guda bayan tiyata, an nuna hotunan X-ray masu ɗauke da nauyi masu kyau da kuma na gefe waɗanda suka haɗu da ƙashi na haɗin tibiotalar da haɗin subtalar, kuma daidaita ƙafar baya ya yi kyau.
Majinyaci zai iya tashi daga gado ya ɗauki nauyi da wuri, wanda hakan ke inganta haƙurin majiyyaci da ingancin rayuwa. Duk da haka, saboda haɗin subtalar yana buƙatar a gyara shi a lokaci guda, ba a ba da shawarar ga marasa lafiya da ke da kyakkyawan haɗin subtalar ba. Kiyaye haɗin subtalar muhimmin tsari ne don rama aikin haɗin idon ƙafa a cikin marasa lafiya da haɗin haɗin idon ƙafa.
gyara na ciki na dunƙule
Gyaran ciki na Percutaneous screw wata hanya ce ta gama gari ta gyara idon sawu. Yana da fa'idodin tiyata mai ƙarancin shiga jiki kamar ƙaramin yankewa da ƙarancin zubar jini, kuma yana iya rage lalacewar kyallen jiki masu laushi yadda ya kamata.
Fim ɗin X-ray na gefen idon da ke tsaye kafin a yi tiyata ya nuna mummunan osteoarthritis na idon ƙafar dama tare da nakasar varus, kuma an auna kusurwar da ke tsakanin saman tibiotalar articular zuwa 19° varus
Bincike ya nuna cewa gyarawa mai sauƙi tare da sukurori 2 zuwa 4 na iya samun daidaito da matsewa, kuma aikin yana da sauƙi kuma farashin yana da arha. Wannan shine zaɓi na farko da yawancin masana a halin yanzu suka zaɓa. Bugu da ƙari, ana iya yin tsaftace haɗin gwiwa na idon sawu mai ƙarancin guba ta hanyar arthroscopy, kuma ana iya saka sukurori ta hanyar da ta dace. Rauni na tiyata yana da ƙanƙanta kuma tasirin warkarwa yana da gamsarwa.
A ƙarƙashin arthroscopy, ana ganin babban yanki na lahani na guringuntsi na articular; a ƙarƙashin arthroscopy, ana amfani da na'urar microfracture mai nuna cone don magance saman articular
Wasu marubuta sun yi imanin cewa gyara sukurori guda 3 na iya rage yawan haɗarin rashin haɗa su bayan tiyata, kuma ƙaruwar yawan haɗa su na iya danganta da ƙarfin kwanciyar hankali na gyaran sukurori guda 3.
Wani hoton X-ray da aka ɗauka bayan tiyatar ya nuna haɗin ƙashi. Maki na AOFAS maki 47 ne kafin tiyatar da kuma maki 74 shekara 1 bayan tiyatar.
Idan aka yi amfani da sukurori uku don gyarawa, matsakaicin matsayin gyarawa shine a saka sukurori biyu na farko bi da bi daga gefen anteromedial da anterolateral na tibia, suna ratsawa ta saman articular zuwa jikin talar, sannan a saka sukurori na uku daga gefen baya na tibia zuwa gefen tsakiya na talus.
Hanyar gyarawa ta waje
Masu gyara na waje su ne na'urorin farko da ake amfani da su wajen magance ciwon idon ƙafa kuma sun samo asali daga shekarun 1950 zuwa tsarin sararin samaniya na Ilizarov, Hoffman, Hybrid da Taylor (TSF) na yanzu.
Raunin da ya buɗe idon sawu tare da kamuwa da cuta na tsawon shekaru 3, arthrodesis na idon sawu watanni 6 bayan shawo kan kamuwa da cuta
Ga wasu matsaloli masu rikitarwa na amosanin idon sawu masu kamuwa da cututtuka akai-akai, tiyata akai-akai, mummunan yanayin fata da nama mai laushi, samuwar tabo, lahani na ƙashi, osteoporosis da raunukan kamuwa da cuta na gida, ana amfani da na'urar gyara waje ta Ilizarov zobe don haɗa haɗin idon sawu.
An sanya na'urar gyara ta waje mai siffar zobe a kan jirgin sama na coronal da jirgin sama na sagittal, kuma tana iya samar da ingantaccen tasirin gyara. A farkon tsarin ɗaukar nauyi, zai matsa ƙarshen karyewar, ya haɓaka samuwar callus, da kuma inganta yawan haɗuwa. Ga marasa lafiya da ke da mummunan nakasu, na'urar gyara ta waje za ta iya gyara nakasar a hankali. Tabbas, haɗa idon ƙafar mai gyara ta waje zai sami matsaloli kamar rashin jin daɗi ga marasa lafiya su saka da kuma haɗarin kamuwa da cutar hanyar allura.
Tuntuɓi:
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Email:liuyaoyao@medtechcah.com
Lokacin Saƙo: Yuli-08-2023
