Karyawar tibial plateau da aka haɗe tare da ɓangarorin tibial na ipsilateral ana yawan gani a cikin raunin kuzari mai ƙarfi, tare da 54% kasancewa karaya a buɗe.Binciken da aka yi a baya ya gano cewa 8.4% na raguwa na tibial plateau yana da alaƙa da haɗin gwiwa na tibial shaft fractures, yayin da 3.2% na marasa lafiya na tibial.A bayyane yake cewa haɗuwa da ipsilateral tibial plateau da ɓarkewar shaft ba sabon abu bane.
Saboda yanayin ƙarfin ƙarfin irin waɗannan raunin da ya faru, sau da yawa ana samun mummunar lalacewar nama mai laushi.A cikin ka'idar, tsarin farantin karfe da tsarin dunƙule yana da fa'ida a cikin gyarawa na ciki don raunin plateau, amma ko nama mai laushi na gida zai iya jure wa gyare-gyaren ciki tare da farantin karfe da tsarin dunƙule shi ma la'akari ne na asibiti.Don haka, a halin yanzu akwai zaɓuɓɓuka guda biyu da aka saba amfani da su don gyaran ciki na ɓarna na tibial plateau fractures hade tare da karayar tibial shaft:
1. MIPPO (MINSTOSYNTONTHESS) dabara tare da farantin farantin;
2. Intramedullary ƙusa + plateau dunƙule.
Ana ba da rahoton zaɓuɓɓukan biyu a cikin wallafe-wallafen, amma a halin yanzu babu wata yarjejeniya akan wanda ya fi ko ƙasa da ƙimar waraka, lokacin warkar da karaya, ƙananan haɗin gwiwa, da rikitarwa.Don magance wannan, masana daga asibitin jami'ar Koriya sun gudanar da binciken kwatance.
Binciken ya haɗa da marasa lafiya 48 tare da raunin tibial plateau fractures tare da raguwar shaft tibial.Daga cikin su, an yi amfani da shari'o'i 35 tare da dabarar MIPPO, tare da saka farantin karfe na gefe don gyarawa, kuma an yi amfani da lokuta 13 tare da screws na plateau tare da tsarin infrapatellar don gyaran ƙusa na intramedullary.
▲ Case 1: Lateral MIPPO karfe farantin ciki gyarawa.Wani mutum mai shekaru 42, wanda ya shiga cikin hatsarin mota, an gabatar da shi tare da buɗaɗɗen buɗaɗɗen tibial (nau'in Gustilo II) da kuma raguwa na tsaka-tsakin tibial plateau compression (nau'in Schatzker IV).
▲ Case 2: Tibial Plateau Screw + Suprapatellar intramedullary ƙusa na ciki.Wani namiji mai shekaru 31, wanda ya shiga cikin hatsarin mota, an gabatar da shi tare da buɗaɗɗen raƙuman tibial (nau'in Gustilo IIIa) da kuma karayar tibial plateau (nau'in Schatzker I).Bayan ɓarkewar rauni da kuma maganin rauni mara kyau (VSD), raunin da aka dasa fata.An yi amfani da sukurori na 6.5mm guda biyu don ragewa da gyara tsaunuka, sannan kuma gyaran ƙusa na intramedullary na tibial shaft ta hanyar suprapatellar.
Sakamakon ya nuna cewa babu wani bambanci mai mahimmanci tsakanin hanyoyin tiyata guda biyu dangane da lokacin warkar da karaya, raguwar warkaswa, ƙananan haɗin gwiwa, da rikitarwa.
Hakazalika da haɗuwa da raguwa na tibial na tibial tare da haɗin gwiwa na ƙafar ƙafar ƙafar ƙafar ƙafar ƙafar ƙafar ƙafa ko ƙuƙwalwar ƙafar ƙafar femoral tare da ƙwanƙwasa wuyan femoral, babban ƙarfin makamashi wanda ya haifar da tibial shaft fractures zai iya haifar da raunuka a cikin haɗin gwiwa na kusa.A cikin aikin asibiti, hana rashin ganewar asali shine babban damuwa a cikin ganewar asali da magani.Bugu da ƙari, a cikin zaɓin hanyoyin gyarawa, kodayake bincike na yanzu bai nuna wani bambance-bambance ba, har yanzu akwai abubuwa da yawa da za a yi la'akari da su:
1. A cikin lokuta na comminuted tibial plateau fracrutures inda sauki dunƙule gyare-gyare yana da kalubale, za a iya ba da fifiko ga yin amfani da dogon farantin karfe tare da gyaran MIPPO don daidaita daidaitattun tibial plateau, maido da haɗin gwiwa tare da haɗin gwiwa.
2. A cikin lokuta masu sauƙi na tibial plateau fractures, a ƙarƙashin ƙananan ƙananan ɓarna, za a iya samun raguwa mai tasiri da gyaran gyare-gyare.A irin waɗannan lokuta, ana iya ba da fifiko ga gyare-gyaren dunƙule tare da gyaran ƙusa na intramedullary na suprapatellar na tibial shaft.
Lokacin aikawa: Maris-09-2024
