Karyewar tibial plateau tare da karyewar tibial shaft ana yawan ganinta a cikin raunuka masu ƙarfi, inda kashi 54% suka kasance karyewar budewa. Binciken da aka yi a baya ya gano cewa kashi 8.4% na karyewar tibial plateau suna da alaƙa da karyewar tibial shaft tare, yayin da kashi 3.2% na marasa lafiya da karyewar tibial shaft tare suna da karyewar tibial plateau tare. A bayyane yake cewa haɗakar tibial plateau da shaft ba abu ne mai sauƙi ba.
Saboda yawan ƙarfin irin waɗannan raunuka, sau da yawa akwai mummunan lalacewar nama mai laushi. A ka'ida, tsarin faranti da sukurori yana da fa'idodi a cikin gyara na ciki don karyewar plateau, amma ko kyallen mai laushi na gida zai iya jure wa gyara na ciki tare da tsarin faranti da sukurori shi ma abin la'akari ne na asibiti. Saboda haka, a halin yanzu akwai zaɓuɓɓuka guda biyu da aka saba amfani da su don gyara karyewar tibial plateau tare da karyewar shaft na tibial:
1. MIPPO (Ƙananan Faranti Osteosynthesis) dabarar da aka yi da faranti mai tsayi;
2. Kusa da ke cikin intramedullary + sukurori mai faɗi.
An ruwaito dukkan zaɓuɓɓukan biyu a cikin wallafe-wallafen, amma a halin yanzu babu wata yarjejeniya kan wanne ya fi kyau ko kuma ya fi ƙasa dangane da saurin warkar da karyewar, lokacin warkar da karyewar, daidaita ƙananan gaɓoɓi, da kuma matsaloli. Don magance wannan, masana daga wani asibitin jami'a na Koriya sun gudanar da wani bincike na kwatantawa.
Binciken ya haɗa da marasa lafiya 48 da suka samu karyewar tibial plateau tare da karyewar shaft na tibial. Daga cikinsu, an yi wa mutane 35 magani ta hanyar amfani da dabarar MIPPO, tare da saka farantin ƙarfe a gefe don gyarawa, sannan an yi wa mutane 13 magani da sukurori na plateau tare da hanyar infrapatellar don gyara ƙusa a cikin intramedullary.
▲ Shari'a ta 1: Daidaitawar ciki ta farantin ƙarfe na MIPPO na gefe. Wani namiji mai shekaru 42, wanda ya shiga hatsarin mota, ya sami karyewar buɗaɗɗen shaft na tibial (nau'in Gustilo II) da kuma karyewar tsakiyar tibial plateau mai matsewa (nau'in Schatzker IV).
▲ Lamarin 2: Sukurin Tibial plateau + gyaran farce na ciki na suprapatellar intramedullary. Wani namiji mai shekaru 31, wanda ya shiga hatsarin mota, ya samu karyewar shaft ɗin tibial (nau'in Gustilo IIIa) da kuma karyewar shaft ɗin tibial a gefe (nau'in Schatzker I). Bayan cire rauni da maganin raunin matsin lamba mara kyau (VSD), an dasa raunin a fata. An yi amfani da sukuran 6.5mm guda biyu don ragewa da gyara plateau, sannan aka yi amfani da sukuran intramedullary na shaft ɗin tibial ta hanyar amfani da hanyar suprapatellar.
Sakamakon ya nuna cewa babu wani bambanci mai mahimmanci tsakanin hanyoyin tiyata guda biyu dangane da lokacin warkar da karaya, saurin warkar da karaya, daidaita ƙananan gaɓoɓi, da kuma rikitarwa.
Kamar haɗuwar karyewar shaft ɗin tibial tare da karyewar haɗin gwiwa na idon sawu ko karyewar shaft ɗin femoral tare da karyewar wuyan femoral, karyewar shaft ɗin tibial mai ƙarfi wanda ke haifar da ƙarfi kuma yana iya haifar da raunuka a haɗin gwiwa na gwiwa da ke kusa. A aikin asibiti, hana kuskuren ganewar asali shine babban abin damuwa a cikin ganewar asali da magani. Bugu da ƙari, a cikin zaɓin hanyoyin gyarawa, kodayake binciken da ake yi a yanzu bai nuna bambance-bambance masu mahimmanci ba, har yanzu akwai abubuwa da yawa da za a yi la'akari da su:
1. A yanayin da aka samu karyewar tibial plateau inda gyaran sukurori mai sauƙi ke da ƙalubale, ana iya ba da fifiko ga amfani da dogon faranti tare da gyaran MIPPO don daidaita tibial plateau yadda ya kamata, dawo da daidaiton saman haɗin gwiwa da daidaita ƙananan gaɓoɓi.
2. A cikin yanayin da aka samu karaya mai sauƙi a kan tibial plateau, a ƙarƙashin yanke-yanke masu ɗan haɗari, ana iya cimma ingantaccen raguwa da gyara sukurori. A irin waɗannan yanayi, ana iya ba da fifiko ga gyaran sukurori sannan a gyara ƙusa na suprapatellar intramedullary na shaft ɗin tibial.
Lokacin Saƙo: Maris-09-2024
