Karya shaft na Tibial rauni ne na asibiti na kowa. Gyaran ƙusa na intramedullary na ciki yana da fa'idodin biomechanical na ƙarancin ɓarna da gyare-gyaren axial, yana mai da shi daidaitaccen bayani don maganin tiyata. Akwai manyan hanyoyin ƙusa ƙusa guda biyu don gyaran ƙusa na intramedullary na tibial: suprapatellar da infrapatellar nailing, da kuma tsarin parapatellar da wasu malamai ke amfani da su.
Don karyewar kusan 1/3 na tibia, tun da tsarin infrapatellar yana buƙatar jujjuyawar gwiwa, yana da sauƙi don haifar da raguwa zuwa kusurwa gaba yayin aiki. Sabili da haka, ana ba da shawarar tsarin suprapatellar yawanci don magani.
▲ Hoton da ke nuna wurin da abin ya shafa ta hanyar tsarin suprapatellar
Duk da haka, idan akwai contraindications ga tsarin suprapatellar, irin su ciwon daji mai laushi na gida, dole ne a yi amfani da tsarin infrapatellar. Yadda za a kauce wa angular karshen karaya a lokacin tiyata shine matsala da dole ne a fuskanta. Wasu malaman suna amfani da ƙananan faranti na ƙarfe don gyara cortex na gaba na ɗan lokaci, ko amfani da toshe kusoshi don gyara angulation.
▲ Hoton yana nuna yadda ake amfani da toshe farce don gyara kwana.
Don magance wannan matsalar, masanan kasashen waje sun rungumi dabarar cin zarafi kadan. An buga labarin kwanan nan a cikin mujallar "Ann R Coll Surg Engl":
Zaɓi sukulan fata na 3.5mm guda biyu, kusa da ƙarshen ƙarshen karyewar, saka dunƙule ɗaya gaba da baya cikin gutsuttsuran kashi a duka ƙarshen faɗuwar, kuma barin fiye da 2cm a waje da fata:
Matsa ƙarfin raguwa don kula da raguwa, sannan saka ƙusa na intramedullary bisa ga hanyoyin al'ada. Bayan an saka ƙusa na intramedullary, cire dunƙule.
Wannan hanyar fasaha ta dace da lokuta na musamman inda ba za a iya amfani da hanyoyin suprapatellar ko parapatellar ba, kuma ba a ba da shawarar akai-akai ba. Sanya wannan dunƙule na iya yin tasiri ga sanya babban ƙusa, ko kuma ana iya samun haɗarin fashewar dunƙulewa. Ana iya amfani da shi azaman tunani a cikin yanayi na musamman.
Lokacin aikawa: Mayu-21-2024
