Amsar wannan tambayar ita ce, babu karayar diddige da ke buƙatar gyaran kashi yayin yin gyaran ciki.
Sanders ya ce
A cikin 1993, Sanders et al [1] sun buga alamar tarihi a cikin tarihin aikin tiyata na ɓarkewar ƙwayar ƙwayar cuta a cikin CORR tare da rarrabuwar tushen CT na rarrabuwar kasusuwa.Kwanan nan, Sanders et al [2] sun kammala cewa babu gyaran kashi ko kulle faranti da suka zama dole a cikin raunin diddige na 120 tare da dogon lokaci na 10-20 shekaru.
Buga CT na raunin diddige wanda Sanders et al.CORR a cikin 1993.
Gyaran kasusuwa yana da manyan dalilai guda biyu: tsarin dasawa don tallafin injina, kamar a cikin fibula, da grafting granular don cikawa da haifar da osteogenesis.
Sanders ya ambata cewa kashin diddige ya ƙunshi babban harsashi na cortical wanda ke rufe kasusuwa mai lalacewa, kuma cewa gurɓacewar intra-articular na kashin diddige za a iya sake gina shi da sauri ta hanyar soke kashi tare da tsarin trabecular idan harsashi na cortical zai iya zama ɗan sake saitawa.Palmer et al. 3] sun kasance na farko da suka bayar da rahoto game da gyaran kashi a cikin 1948 saboda rashin ingantattun na'urori masu gyarawa na ciki don kula da fashewar bango a wurin a lokacin.Tare da ci gaba da ci gaba na na'urorin gyarawa na ciki irin su faranti na baya da sukurori, goyon bayan goyon bayan ragewa ta hanyar dasawa ya zama ba dole ba.Nazarin asibiti na dogon lokaci ya tabbatar da wannan ra'ayi.
Nazarin kulawa na asibiti ya ƙare da cewa dashen kashi ba lallai ba ne
Longino et al [4] da sauransu sun gudanar da binciken bincike mai yiwuwa na 40 da aka yi gudun hijira na intra-articular fractures na diddige tare da aƙalla shekaru 2 na biyo baya kuma ba su sami wani bambanci mai mahimmanci tsakanin gyaran kashi ba kuma babu kashin kashi dangane da hoto ko aiki. sakamakon.Gusic et al [5] sun gudanar da bincike mai sarrafawa na 143 da aka yi watsi da raguwa na intra-articular na diddige tare da irin wannan sakamako.
Singh et al [6] daga Mayo Clinic sun gudanar da bincike na baya-bayan nan game da marasa lafiya na 202 kuma kodayake gyaran kashi ya kasance mafi girma dangane da kusurwar Bohler da lokaci zuwa cikakken nauyin nauyi, babu wani bambanci mai mahimmanci a sakamakon aiki da rikitarwa.
Gyaran kasusuwa a matsayin abin haɗari ga rikice-rikicen rauni
Farfesa Pan Zhijun da tawagarsa a Asibitin Kiwon Lafiya na biyu na Zhejiang sun gudanar da wani tsari na kimantawa da nazari a cikin 2015 [7], wanda ya hada da duk wallafe-wallafen da za a iya dawo da su daga bayanan lantarki har zuwa 2014, ciki har da 1651 karaya a cikin marasa lafiya 1559, da kuma ya kammala cewa grafting kashi, ciwon sukari mellitus, rashin sanya magudanar ruwa, da karaya mai tsanani yana ƙara haɗarin rikice-rikice masu rauni bayan tiyata.
A ƙarshe, ƙaddamar da kasusuwa ba lallai ba ne a lokacin gyaran ciki na ƙwanƙwasa diddige kuma baya taimakawa wajen aiki ko sakamako na ƙarshe, amma yana ƙara haɗarin haɗari masu haɗari.
1.Sanders R, Fortin P, DiPasquale T, et al.Magani mai aiki a cikin ɓangarorin ɓangarorin ɓangarorin jijiyoyi 120 da aka raba.Sakamako ta amfani da rarrabuwar sikanin sikanin hoto.Clin Orthop Relat Res.1993; (290):87-95.
2.Sanders R, Vaupel ZM, Erdogan M, et al.Yin aiki na ɓarnawar ɓarna na intraarticular calcaneal: na dogon lokaci (Shekaru 10-20) yana haifar da karaya 108 ta amfani da rarrabuwar CT mai fa'ida.J Orthop Trauma.2014;28 (10): 551-63.
3.Palmer I. Na'ura da kuma maganin karaya na calcaneus.J Kashi Joint Surg Am.1948; 30A: 2–8.
4.Longino D, Buckley RE.Gyaran kasusuwa a cikin aikin aikin jiyya na karaya na intraarticular calcaneal: yana da taimako?J Orthop Trauma.2001; 15 (4): 280-6.
5.Gusic N, Fedel I, Darabos N, et al.Magani mai aiki na karaya na kashin baya na intraarticular: Sakamakon aikin jiki da na aiki na dabaru daban-daban na aiki guda uku.Raunin2015; 46 Suppl 6: S130-3.
6.Singh AK, Vinay K. Yin aikin tiyata na ɓarkewar ɓarna a cikin hanji: shin dashen kashi ya zama dole?J Orthop Traumatol.2013; 14 (4): 299-305.
7. Zhang W, Chen E, Xue D, da dai sauransu.Abubuwan haɗari don rikice-rikicen rauni na rufaffiyar ƙwayar ƙwayar ƙwayar cuta bayan tiyata: nazari na yau da kullun da meta-bincike.Scand J Trauma Resusc Emerg Med.2015; 23:18.
Lokacin aikawa: Dec-07-2023
