Raunin idon ƙafa shine raunin wasanni na yau da kullun wanda ke faruwa a cikin kusan 25% na raunin musculoskeletal, tare da raunin ligament na gefe (LCL) wanda ya fi kowa. Idan ba a kula da yanayin mai tsanani a cikin lokaci ba, yana da sauƙi don haifar da raguwa mai yawa, kuma mafi tsanani lokuta za su shafi aikin haɗin gwiwa na idon kafa. Sabili da haka, yana da mahimmanci don ganowa da kuma magance raunin marasa lafiya a farkon mataki. Wannan labarin zai mayar da hankali kan ƙwarewar bincike na raunin ligament na gefe na haɗin gwiwa don taimakawa likitocin su inganta daidaiton ganewar asali.
I. Anatomy
Jigon talofibular na gaba (ATFL): miƙewa, hade da capsule na gefe, farawa gaba zuwa fibula kuma yana ƙare gaba da jikin talus.
Calcaneofibular ligament (CFL): Siffar igiya, wanda ya samo asali a kan iyakar gaba na malleolus mai nisa kuma yana ƙarewa a calcaneus.
Ƙwararren talofibular ligament (PTFL): Ya samo asali a kan tsaka-tsakin tsaka-tsakin malleolus na gefe kuma ya ƙare a baya zuwa talus na tsakiya.
ATFL kadai ya ƙunshi kusan 80% na raunin da ya faru, yayin da ATFL tare da raunin CFL ya kai kusan 20%.
Zane-zane da zane-zane na jikin mutum na gefen haɗin gwiwa na haɗin gwiwa
II. Hanyar rauni
Raunin da aka yi da baya: jijiya talofibular na gaba
calcaneofibular ligament varus rauni: calcaneofibular ligament
III. Rauni daraja
Darasi na I: nau'in ligament, babu bayyanar ligament rupture, da wuya kumburi ko taushi, kuma babu alamun asarar aiki;
Mataki na II: ɓarna macroscopic na ligament, matsakaicin zafi, kumburi, da taushi, da ƙananan lahani na aikin haɗin gwiwa;
Darasi na III: ligament ya tsage gaba daya kuma ya rasa mutuncinsa, tare da kumburi mai mahimmanci, zubar da jini da taushi, tare da alamar asarar aiki da bayyanar cututtuka na haɗin gwiwa.
IV. Gwajin asibiti Gwajin aljihun gaba
Mai haƙuri yana zaune tare da ƙwanƙwasa gwiwa kuma ƙarshen maraƙi yana rawa, kuma mai binciken yana riƙe da tibia a wuri da hannu ɗaya kuma yana tura ƙafar gaba a bayan diddige tare da ɗayan.
A madadin, majiyyaci yana kwance ko ya zauna tare da durƙusa gwiwa a digiri 60 zuwa 90, diddige da aka kafa a ƙasa, kuma mai binciken yana amfani da matsa lamba na baya zuwa tibia mai nisa.
Tabbatacce yana annabta fashewar ligament na talofibular na gaba.
Inversion danniya gwajin
Ƙafafun da ke kusa bai motsa ba, kuma an yi amfani da matsananciyar damuwa a idon sawun nesa don tantance kusurwar karkatar da talus.
Idan aka kwatanta da gefen da aka saba,> 5° yana da tabbataccen shakku, kuma> 10° yana da kyau; ko a gefe>15° yana da inganci.
Kyakkyawan tsinkaya na fashewar ligament calcaneofibular.
Gwajin hoto
X-haskoki na gama-gari na raunin wasanni na idon sawu
X-haskoki ba su da kyau, amma MRI yana nuna hawaye na gaban talofibular da calcaneofibular ligaments.
Abũbuwan amfãni: X-ray shine zaɓi na farko don jarrabawa, wanda yake da tattalin arziki da sauƙi; Ana yin la'akari da girman raunin ta hanyar yin la'akari da matakin karkatar talus. Rashin hasara: Rashin ƙarancin nunin nama mai laushi, musamman ma sifofin ligamentous waɗanda ke da mahimmanci don kiyaye kwanciyar hankali na haɗin gwiwa.
MRI
Fig.1 Matsayin 20 ° oblique ya nuna mafi kyawun haɗin gwiwa na talofibular (ATFL); Hoto 2 Azimuth layin ATFL scan
Hotunan MRI na raunuka daban-daban na gaban talofibular ligament sun nuna cewa: (A) na gaban talofibular ligament thickening da edema; (B) tsagewar ligament talofibular na gaba; (C) fashewar ligament na talofibular na gaba; (D) Raunin ligament na talofibular na gaba tare da karaya.
Fig.3 Matsayin -15 ° oblique ya nuna mafi kyawun ƙwayar ligament na calcaneofibular (CFI);
Hoto.4. CFL scanning azimuth
M, cikakken tsagewar ligament na calcaneofibular
Hoto 5: Ra'ayin Coronal yana nuna mafi kyawun haɗin gwiwa na talofibular na baya (PTFL);
Hoto.6 PTFL scan azimuth
Tsagewar sashin ligament talofibular na baya
Ƙididdigar ƙididdiga:
Class I: Babu lalacewa;
Darasi na II: Ƙunƙarar ligament, ci gaba da rubutu mai kyau, thickening na ligaments, hypoechogenicity, edema na ƙwayoyin da ke kewaye;
Darasi na III: ilimin halittar ligament wanda bai cika ba, raguwa ko ɓarnawar juzu'i na ci gaba da rubutu, kauri na ligaments, da ƙarar sigina;
Darasi na IV: cikakken rushewar ci gaba na ligament, wanda zai iya kasancewa tare da karaya, kauri na ligaments, da ƙarar siginar gida ko watsawa.
Abũbuwan amfãni: Babban ƙuduri don kyallen takarda mai laushi, bayyananniyar lura da nau'in raunin ligament; Yana iya nuna lalacewar guringuntsi, raunin kashi, da yanayin gaba ɗaya na rauni na fili.
Rashin hasara: Ba zai yiwu a ƙayyade daidai ko an katse raguwa da lalacewar guringuntsi ba; Saboda rikitarwa na ligament na idon sawu, aikin jarrabawa ba shi da yawa; Mai tsada da cin lokaci.
Mai girma-mita duban dan tayi
Hoto 1a: Raunin ligament na talofibular na gaba, tsagewar yanki; Hoto na 1b: Jigon talofibular na gaba ya tsage gaba ɗaya, kututturen yana da kauri, kuma ana ganin babban zubar da jini a sararin gaba.
Hoto 2a: Calcaneofibular ligament rauni, tsagewar tsage; Hoto 2b: Calcaneofibular ligament rauni, cikakken rupture
Hoto 3a: Jigon talofibular na gaba na al'ada: hoton duban dan tayi yana nuna jujjuyawar alwatika mai jujjuya tsarin tsarin hypoechoic; Hoto 3b: Na al'ada calcaneofibular ligament: Matsakaicin echogenic da tsari mai yawa na filamentous akan hoton duban dan tayi
Hoto 4a: Tsage-tsage na ligament na talofibular na gaba akan hoton duban dan tayi; Hoto na 4b: Cikakken tsagewar ligament na calcaneofibular akan hoton duban dan tayi
Ƙididdigar ƙididdiga:
contusion: Hotunan murya suna nuna tsarin da ba daidai ba, jijiyoyi masu kauri da kumbura; Tsage-tsage: Akwai kumburi a cikin ligament, akwai rikicewar wasu zaruruwa, ko zaruruwan suna cikin siraran gida. Binciken mai ƙarfi ya nuna cewa tashin hankali na ligament ya ragu sosai, kuma ligament ɗin ya ragu kuma ya karu kuma elasticity ya raunana a yanayin valgus ko varus.
Cikakkun hawaye: gabaɗaya kuma dagewar katsewar ligament tare da rabuwa mai nisa, bincike mai ƙarfi yana ba da shawara cewa babu tashin hankali na ligament ko ƙãra hawaye, kuma a cikin valgus ko varus, ligament yana motsawa zuwa wancan ƙarshen, ba tare da wani elasticity ba kuma tare da haɗin gwiwa mara kyau.
Abũbuwan amfãni: ƙananan farashi, mai sauƙi don aiki, mara amfani; Tsarin dabara na kowane Layer na nama na subcutaneous yana nunawa a fili, wanda ke da tasiri don lura da raunuka na tsoka. Binciken sashe na wucin gadi, bisa ga bel ɗin ligament don gano dukkanin tsarin haɗin gwiwa, an bayyana wurin da aka samu rauni na ligament, kuma ana lura da tashin hankali na ligament da sauye-sauyen yanayi.
Rashin hasara: ƙananan ƙuduri mai laushi mai laushi idan aka kwatanta da MRI; Dogara ga aikin fasaha na ƙwararru.
Binciken arthroscopy
Fa'idodi: Kai tsaye lura da tsarin malleolus na gefe da ƙafar ƙafa (kamar haɗin gwiwa na ƙasa, ligament na gaba, calcaneofibular ligament, da dai sauransu) don kimanta amincin haɗin gwiwar kuma taimakawa likitan fiɗa don sanin tsarin tiyata.
Lalacewa: Ƙarfafawa, na iya haifar da wasu matsaloli, irin su lalacewar jijiya, kamuwa da cuta, da dai sauransu. An yi la'akari da shi azaman ma'auni na zinariya don gano raunin jijiya kuma a halin yanzu ana amfani dashi mafi yawa wajen maganin raunin jijiya.
Lokacin aikawa: Satumba-29-2024
