Ke koho ʻana i kahi helu komo no Intramedullary of Tibial Fractures

ʻO ke koho ʻana i kahi helu komo no Intramedullary of Tibial Fractures kekahi o nā ʻanuʻu koʻikoʻi i ka kūleʻa o ka mālama ʻana.ʻO kahi wahi komo maikaʻi ʻole no ka Intramedullary, inā ma ka suprapatellar a infrapatellar paha, hiki ke hopena i ka nalowale o ka hoʻonohonoho hou ʻana, ka deformity angular o ka hopena haʻihaʻi, a me ka hōʻeha i nā hale koʻikoʻi o ke kuli a puni ka wahi komo.

E wehewehe ʻia nā ʻano 3 o ka tibial intramedullary nail insertion point.

He aha ke kiko hoʻokomo nail intramedullary tibial maʻamau?

He aha nā hopena o ka nail intramedullary tibial deviated?

Pehea e hoʻoholo ʻia ai ka wahi kūpono o ke komo ʻana ma ka intraoperative?

I. He aha ke kiko maʻamau no ke komo ʻanaTibialIntramedullary?

Aia ke kūlana orthotopic ma ke kikowaena o ka mechanical axis o ka tibia a me ka tibial plateau, ka ʻaoʻao medial o ka spine intercondylar lateral o ka tibia, a ʻo ke kūlana ʻaoʻao aia ma ka ʻaoʻao wai ma waena o ka pāpū tibial a me ka neʻe ʻana o ke kumu tibial. ʻāpana.

Ka laulā o ka wahi palekana ma ka helu komo

22.9±8.9mm, ma kahi e hiki ai ke hookomo i ka nila me ka poino ole i ka iwi o ka ACL a me ke kino meniscus.

II.He aha nā hopena o kahi haʻaleleTibialIntramedullary Nail?

Ma muli o ka proximal, middle, a me Distal Tibial Fractures, ʻoi aku ka maikaʻi o ka haʻihaʻi ʻana o ka tibial proximal, ʻoi aku ka liʻiliʻi o ka haʻihaʻi waena, a ʻo ka hopena hope loa e pili ana i ke kūlana a me ka repositioning o ka Distal intramedullary nail.

# Nā ʻAha ʻAi ʻAi Kūʻē

# Haʻi ʻia ʻo Tibial Waena

He liʻiliʻi ka hopena o ka helu komo i ka neʻe ʻana, akā ʻoi aku ka maikaʻi o ka hoʻokomo ʻana i ke kui mai ka wahi maʻamau o ke komo ʻana.

# Nā ʻAi ʻAi ʻAi ʻAi ʻĀpana

Pono ka helu komo e like me ka haʻihaʻi kokoke, a ʻo ke kūlana o ka nail intramedullary distal e pono e loaʻa ortholaterally ma ka waena waena o ka fornix distal.

Ⅲ.HPehea e hoʻoholo ai inā pololei ke komo ʻana o ka nila?

Pono mākou i ka fluoroscopy e hoʻoholo inā pololei ka wahi komo o ka nila.He mea nui ka lawe ʻana i kahi orthopantomogram maʻamau o ke kuli intraoperatively, no laila pehea e lawe ʻia ai?

ʻO ka laina orthopantomogram maʻamau-parallel o ke poʻo fibular

Hana ʻia ka axis mechanical o ka ortho-x-ray i laina pololei, a ua hana ʻia kahi laina like o ka axis mechanical ma ka ʻaoʻao ʻaoʻao o ka pā tibial, kahi e hoʻokaʻawale i ke poʻo fibular ma ka ortho-x-ray.Inā loaʻa kekahi o ia x-ray, hōʻoia ʻia ua lawe pololei ʻia.

Inā ʻaʻole maʻamau ka ortho-slice, no ka laʻana, inā hānai ʻia ke kui mai ka wahi hānai maʻamau, i ka wā i lawe ʻia ai ke kūlana hoʻololi o waho, e hōʻike ʻia ka mea hānai i waho, a e hōʻike ke kūlana o loko e hōʻike i ka Aia ka wahi hānai i loko, kahi e hoʻopilikia ai i ka hoʻoholo ʻokiʻoki.

Ma ka ʻaoʻao x-ray maʻamau, ʻo nā condyles femoral medial a me ka ʻaoʻao o ka femoral condyles e uhi nui loa a ʻo ka medial a me ka ʻaoʻao tibial plateau i uhi nui ʻia, a ma ka ʻaoʻao ʻaoʻao, aia ka wahi e komo ai ma ka ʻauwai ma waena o ka pāpū a me ke kumu tibial.

IV.Hōʻuluʻulu manaʻo

ʻO ka maʻamau o ka tibial intramedullary nail e komo i ka orthogonally ma ka ʻaoʻao medial o ka ʻaoʻao intercondylar spine o ka tibia a ma ka ʻaoʻao ma ka ʻaoʻao wai ma waena o ka pāpū tibial a me ka ʻāpana neʻe o ka tibial stem.

He liʻiliʻi loa ka wahi palekana ma ka helu komo, ʻo 22.9 ± 8.9 mm wale nō, a hiki ke hoʻokomo ʻia ka nila ma kēia wahi me ka ʻole o ka hōʻino ʻana i ka iwi o ka ACL a me ka ʻiʻo meniscal.

Pono e lawe ʻia nā orthopantomographs maʻamau a me nā radiograph lateral o ke kuli, ʻo ia ke kī e hoʻoholo ai inā pololei a ʻaʻole paha ka helu komo o ka nila.