Gabatar da tsarin gyaran intramedullary guda uku don karyewar calcaneal.

A halin yanzu, hanyar fiɗa da aka fi amfani da ita don karyewar ƙwayar cuta ta haɗa da gyara ciki tare da faranti da dunƙule ta hanyar shiga sinus tarsi. Ba a fi son tsarin faɗaɗa tsarin “L” na gefe ba a cikin aikin asibiti saboda manyan matsalolin da ke da alaƙa da rauni. Gyaran tsarin faranti da dunƙule, saboda halayensa na biomechanical na gyaran eccentric, yana ɗaukar haɗari mafi girma na cutar ɓarna, tare da wasu nazarin da ke nuna yiwuwar ɓarna na sakandare na kusan 34%.

Sakamakon haka, masu bincike sun fara nazarin hanyoyin gyara intramedullary don karyewar calcaneal don magance rikice-rikicen da ke da alaƙa da rauni da kuma batun rashin daidaituwa na ɓarna na biyu.

01 Nail tsakiya nailing dabara

Wannan fasaha na iya taimakawa wajen ragewa ta hanyar shiga sinus tarsi ko ƙarƙashin jagorancin arthroscopic, buƙatar ƙananan buƙatun nama mai laushi da yiwuwar rage lokacin asibiti. Wannan hanyar zaɓen tana da amfani ga nau'in II-III karaya, kuma don haɗaɗɗen rarrabuwar kasusuwa, maiyuwa baya samar da ƙarfi mai ƙarfi na raguwa kuma yana iya buƙatar ƙarin gyare-gyaren dunƙule.

02 Sintramedullary intramedullary jirgin sama

Farcen intramedullary na jirgin sama guda ɗaya yana da kusoshi biyu a kusa da ƙarshen nesa, tare da babban ƙusa mai zurfi wanda ke ba da damar dasa ƙashi ta babban ƙusa.

03 Multi-plane intramedullary ƙusa

An ƙera shi bisa tsarin sifa mai girma uku na calcaneus, wannan tsarin gyare-gyaren cikin gida ya haɗa da maɓalli masu mahimmanci kamar sukukuwan da ke ɗaukar kaya da screws na baya. Bayan an rage ta hanyar shiga sinus tarsi, ana iya sanya waɗannan sukurori a ƙarƙashin guringuntsi don tallafi.

Akwai rikice-rikice da yawa game da amfani da kusoshi na intramedullary don karayar calcaneal:

1. Dacewar da aka danganta da rikitarwar karaya: Ana muhawara ko raguwa mai sauƙi ba sa buƙatar kusoshi na intramedullary da kuma karaya masu rikitarwa ba su dace da su ba. Ga nau'in Sanders na II/III, dabarar ragewa da gyara dunƙule ta hanyar shiga sinus tarsi ya girma sosai, kuma ana iya tambayar mahimmancin ƙusa na intramedullary. Don hadaddun karaya, fa'idodin faɗuwar hanyar "L" mai siffa ta kasance maras maye gurbinsa, saboda tana ba da isasshen haske.

2. Lalacewar magudanar ruwa ta wucin gadi: Ƙaƙwalwar ƙwayar cuta ta halitta ta rasa magudanar ruwa. Yin amfani da babban ƙusa na intramedullary na iya haifar da rauni mai yawa ko asarar yawan kashi.

3. Wahalar cirewa: A lokuta da yawa a kasar Sin, marasa lafiya har yanzu suna shan kayan aikin cirewa bayan waraka. Haɗin ƙusa tare da haɓakar kashi da haɗa sukurori na gefe a ƙarƙashin kashin cortical na iya haifar da wahalar cirewa, wanda shine la'akari mai amfani a aikace-aikacen asibiti.