Karyawar idon sawu ɗaya ne daga cikin nau'ikan karaya na yau da kullun a aikin asibiti. Sai dai wasu raunin jujjuyawar digiri na I/II da raunin sata, yawancin karayar idon sawun yakan ƙunshi malleolus na gefe. Nau'in Weber A/B na gefe malleolus fractures yawanci yana haifar da barga na tibiofibular syndesmosis kuma yana iya samun raguwa mai kyau tare da gani kai tsaye daga nesa zuwa kusa. Ya bambanta, nau'in nau'in nau'in malleolus na gefe ya ƙunshi rashin zaman lafiya a cikin malleolus na gefe a fadin gatari guda uku saboda rauni na tibiofibular mai nisa, wanda zai iya haifar da nau'i shida na ƙaura: ragewa / tsawo, fadadawa / kunkuntar sararin tibiofibular mai nisa, na baya / na baya. a cikin jirgin sama na sagittal, tsaka-tsaki / karkatar da hankali a cikin jirgin sama na coronal, juyawar juyawa, da haɗuwa da waɗannan nau'ikan raunuka guda biyar.
Yawancin karatu da suka gabata sun nuna cewa ana iya tantance raguwa / tsayi ta hanyar kimanta alamar Dime, layin Stenton, da kusurwar tibial-gapping, da sauransu. Ƙaura a cikin jiragen sama na coronal da sagittal za a iya kimantawa da kyau ta amfani da ra'ayi na gaba da na gefe; duk da haka, ƙaurawar juyawa shine mafi ƙalubale don tantancewa ta ciki.
Wahala wajen tantance matsuguni na juyawa yana bayyana musamman a cikin raguwar fibula lokacin shigar da dunƙule tibiofibular distal. Yawancin wallafe-wallafen sun nuna cewa bayan shigar da distal tibiofibular dunƙule, akwai 25% -50% abin da ya faru na raguwa mara kyau, wanda ya haifar da lalacewa da gyaran gyare-gyaren fibular. Wasu malamai sun ba da shawarar yin amfani da ƙididdigar CT na ciki na yau da kullun, amma wannan na iya zama ƙalubale don aiwatarwa a aikace. Don magance wannan batu, a shekarar 2019, tawagar Farfesa Zhang Shimin daga asibitin Yangpu dake da alaka da jami'ar Tongji, ta buga wata kasida a cikin mujallar kiwon lafiya ta kasa da kasa wato *Rauni*, inda ta gabatar da wata dabara ta tantance ko an gyara jujjuyawar malleolus a gefe ta hanyar amfani da X-ray na ciki. Littattafan sun ba da rahoton tasiri mai mahimmanci na asibiti na wannan hanya.
Tushen ka'idar wannan hanya shine cewa a cikin ra'ayi na fluoroscopic na idon sawu, bangon bango na gefe na gefen malleolar fossa yana nuna bayyananne, a tsaye, inuwa mai yawa, daidai da tsaka-tsakin tsaka-tsaki da na gefe na malleolus na gefe, kuma yana samuwa a tsakiya zuwa waje kashi ɗaya bisa uku na layin da ke haɗa tsaka-tsakin tsakiya da na gefe na malleolus na gefe.
Misali na idon idon ƙafar idon ƙafa yana nuna alaƙar matsayi tsakanin bangon bango na gefe na gefen malleolar fossa (b-line) da kuma tsaka-tsakin tsaka-tsakin tsaka-tsakin malleolus (a da c Lines). Yawanci, layin b yana kan layi na waje ɗaya bisa uku tsakanin layin a da c.
Matsayi na al'ada na malleolus na gefe, juyawa na waje, da juyawa na ciki na iya haifar da bayyanar hoto daban-daban a cikin kallon fluoroscopic:
- Malleolus na gefe yana jujjuyawa a matsayi na al'ada ***: Kwandon malleolus na al'ada na al'ada tare da inuwa na cortical a gefen bangon malleolar fossa na gefe, wanda aka sanya a kan layi na uku na uku na tsaka-tsakin tsaka-tsaki da na gefe na malleolus na gefe.
-Lateral malleolus nakasar juyawa ta waje**: Kwandon malleolus na gefe ya bayyana "mai kaifi-leafed," inuwar cortical a gefen malleolar fossa ta bace, sararin tibiofibular distal ya kunkuntar, layin Shenton ya zama yankewa kuma ya watse.
-Lateral malleolus ciki nakasar jujjuyawar ciki**: Kwandon malleolus na gefe yana bayyana "mai siffar cokali," inuwar cortical a gefen malleolar fossa ta bace, kuma sararin tibiofibular mai nisa yana fadada.
Ƙungiyar ta haɗa da marasa lafiya 56 tare da nau'in nau'in C-nau'in malleolar na gefe tare da raunin tibiofibular syndesmosis mai nisa kuma sun yi amfani da hanyar tantancewar da aka ambata. Binciken CT na baya-bayan nan ya nuna cewa marasa lafiya 44 sun sami raguwar jiki ba tare da nakasar juyi ba, yayin da marasa lafiya 12 suka sami nakasu mai sauƙi (kasa da 5 °), tare da lokuta 7 na juyawa na ciki da 5 lokuta na juyawa na waje. Babu wasu lokuta na matsakaici (5-10°) ko mai tsanani (mafi girma 10°) nakasar juyawa ta waje da ta faru.
Nazarin da suka gabata sun nuna cewa ƙima na raguwar raguwa na malleolar na gefe zai iya dogara ne akan manyan sigogin Weber guda uku: daidaitattun daidaito tsakanin tibial da talar haɗin gwiwa saman, ci gaba da layin Shenton, da alamar Dime.
Rage ƙarancin malleolus na gefe lamari ne da ya zama ruwan dare a aikin asibiti. Yayin da ake ba da kulawa mai kyau ga maido da tsayi, daidaitaccen mahimmanci ya kamata a sanya shi a kan gyaran juyawa. A matsayin haɗin gwiwa mai ɗaukar nauyi, duk wani rauni na idon sawu zai iya yin mummunan tasiri akan aikinsa. An yi imanin cewa, fasahar fluoroscopic na ciki da farfesa Zhang Shimin ya gabatar za ta iya taimakawa wajen cimma daidaiton raguwar karaya a gefe na nau'in C. Wannan dabarar tana aiki azaman mahimmin tunani ga likitocin gaba.
Lokacin aikawa: Mayu-06-2024
