Fasaha ta Tiyata | Gyaran Ciki na Ciki na Ciki na Ciki don Maganin Karyewar Tibial Plateau

Rushewar tibial plate ko rugujewar tsagewa ita ce nau'in karyewar tibial plate da aka fi sani. Babban burin tiyata shine a dawo da santsi na saman haɗin gwiwa da kuma daidaita ƙananan gaɓoɓi. Idan saman haɗin gwiwa ya faɗi, idan ya ɗaga, yana barin lahani a ƙarƙashin guringuntsi, wanda galibi yana buƙatar sanya ƙashin iliac na autogenous, ƙashin allograft, ko ƙashin wucin gadi. Wannan yana da amfani ga dalilai biyu: na farko, don dawo da tallafin tsarin ƙashi, da na biyu, don haɓaka warkar da ƙashi.

Idan aka yi la'akari da ƙarin yankewar da ake buƙata don ƙashin iliac na autogenous, wanda ke haifar da ƙarin rauni na tiyata, da kuma yuwuwar haɗarin ƙin yarda da kamuwa da cuta da ke tattare da ƙashin allograft da ƙashin wucin gadi, wasu masana sun ba da shawarar wata hanyar daban yayin rage buɗewar tibial plateau da gyara ciki (ORIF). Sun ba da shawarar faɗaɗa wannan yankewar sama yayin aikin da kuma amfani da dashen ƙashi na cancellous daga condyle na lateral femoral. Rahotanni da dama sun rubuta wannan dabarar.

Binciken ya haɗa da shari'o'i 12 tare da cikakkun bayanai na hoton da aka ɗauka. A cikin dukkan marasa lafiya, an yi amfani da hanyar da aka saba amfani da ita ta gefen tibial na gaba. Bayan fallasa plateau na tibial, an miƙa yankewar zuwa sama don fallasa central femoral condyle. An yi amfani da na'urar cire ƙashi ta Eckman mai tsawon mm 12, kuma bayan an haƙa ta cikin cortex na waje na femoral condyle, an ɗebo ƙashin cancellous daga lateral condyle a cikin matakai huɗu da aka maimaita. Girman da aka samu ya kama daga 20 zuwa 40cc.

Bayan an maimaita ban ruwa a magudanar ƙashi, ana iya saka soso mai hemostatic idan ya cancanta. Ana dasa ƙashin da aka girbe a cikin lahani na ƙashi a ƙarƙashin tudun tibial na gefe, sannan a bi shi da gyaran ciki na yau da kullun. Sakamakon ya nuna:

① Don gyara yanayin ƙashin baya na ciki, duk marasa lafiya sun sami waraka daga karyewar ƙashi.

② Ba a ga wani babban ciwo ko rikitarwa ba a wurin da aka cire ƙashi daga lateral condyle.

③ Warkar da ƙashi a wurin girbi: Daga cikin marasa lafiya 12, 3 sun nuna cikakkiyar warkarwa ta ƙashin cortical, 8 sun nuna wani ɓangare na warkarwa, kuma 1 bai nuna wata bayyananniyar warkar da ƙashin cortical ba.

④ Samuwar trabeculae na ƙashi a wurin girbi: A cikin shari'o'i 9, babu wani bayyanar samuwar trabeculae na ƙashi, kuma a cikin shari'o'i 3, an lura da samuwar trabeculae na ƙashi kaɗan.

⑤ Matsalolin osteoarthritis: Daga cikin marasa lafiya 12, 5 sun kamu da ciwon gwiwa bayan rauni. An maye gurbin wani majiyyaci bayan shekaru huɗu.

A ƙarshe, ɗaukar ƙashi mai kama da ƙashi daga cikin ƙashin da ke kan cinyar ƙafa yana haifar da waraka mai kyau ga ƙashin da ke kan cinyar ƙafa ba tare da ƙara haɗarin samun matsaloli bayan tiyata ba. Ana iya la'akari da wannan dabarar kuma a yi amfani da ita a aikin asibiti.