46% na jujjuya raunin idon sawun suna tare da karaya na malleolar na baya. Hanya na baya-bayan nan don hangen nesa kai tsaye da gyara malleolus na baya fasaha ce da aka saba amfani da ita, tana ba da fa'idodi mafi kyau na biomechanical idan aka kwatanta da rufaffiyar ragewa da gyaran dunƙule na gaba. Duk da haka, don mafi girma na ɓarna malleolar na baya ko kuma na baya-bayan nan na malleolar fractures wanda ya haɗa da colliculus na baya na medial malleolus, tsarin da aka yi a baya yana ba da kyakkyawan ra'ayi na tiyata.
Don kwatanta kewayon bayyanar da malleolus na baya, tashin hankali a kan kullin neurovascular, da kuma nisa tsakanin incision da ƙwayar jijiyoyin jini a cikin hanyoyi guda uku na baya-bayan nan, masu bincike sun gudanar da binciken cadaveric. An buga sakamakon kwanan nan a cikin mujallar FAS. An taƙaita sakamakon binciken kamar haka:
A halin yanzu, akwai manyan hanyoyi guda uku na baya-bayan nan don fallasa malleolus na baya:
1. Medial Posteromedial Approach (mePM): Wannan hanya ta shiga tsakanin gefen baya na malleolus na tsakiya da kuma tibialis na baya (Hoto na 1 yana nuna alamar tibialis na baya).
2. Modified Posteromedial Approach (moPM): Wannan hanya ta shiga tsakanin tibialis na baya tendon da flexor digitorum longus tendon (Hoto na 1 yana nuna jigon tibialis na baya, kuma Hoto 2 yana nuna flexor digitorum longus tendon).
3. Gabatarwa na Posteromedial (PM): Wannan hanya ta shiga tsakanin tsakiya na tsakiya na tendon Achilles da flexor hallucis longus tendon (Hoto na 3 yana nuna alamar Achilles, kuma Hoto 4 yana nuna flexor hallucis longus tendon).
Game da tashin hankali a kan tarin ƙwayoyin cuta, tsarin PM yana da ƙananan tashin hankali a 6.18N idan aka kwatanta da hanyoyin mePM da moPM, yana nuna ƙananan yiwuwar raunin raunin da ya faru a cikin ƙwayar ƙwayar cuta.
Dangane da kewayon kewayon malleolus na baya, tsarin PM shima yana ba da haske mafi girma, yana ba da damar ganin 71% na malleolus na baya. A kwatancen, hanyoyin mePM da moPM suna ba da izinin 48.5% da 57% fallasa malleolus na baya, bi da bi.
● Hoton yana kwatanta kewayon bayyanar malleolus na baya don hanyoyin uku. AB yana wakiltar kewayon gaba ɗaya na malleolus na baya, CD yana wakiltar kewayon fallasa, kuma CD/AB shine rabon fallasa. Daga sama zuwa kasa, ana nuna kewayon fiddawa na mePM, moPM, da PM. A bayyane yake cewa tsarin PM yana da mafi girman kewayon bayyanawa.
Game da nisa tsakanin incision da gungun neurovascular, tsarin PM shima yana da mafi girman nisa, yana auna 25.5mm. Wannan ya fi na mePM's 17.25mm da moPM's 7.5mm. Wannan yana nuna cewa tsarin PM yana da mafi ƙasƙanci yiwuwar raunin damshin neurovascular yayin tiyata.
● Hoton yana nuna nisa tsakanin ɓarna da ɗigon jijiyoyin jijiyoyin jini don hanyoyin uku. Daga hagu zuwa dama, ana nuna nisa don hanyoyin mePM, moPM, da PM. A bayyane yake cewa tsarin PM yana da nisa mafi girma daga gunkin neurovascular.
Lokacin aikawa: Mayu-31-2024
