Abstract: Pahuhopu: E noiʻi i nā mea pili i ka hopena o ka hana ʻana o ka hoʻohana ʻana i ka pale kila i loko o ka hoʻoponopono ʻana e hoʻihoʻi i kahaʻihaʻi pāpū tibial. Ke Kaʻina Hana: 34 mau maʻi me ka tibial plateau fracture i hoʻohana ʻia me ka hoʻohana ʻana i ka pā kila i loko o ka ʻaoʻao hoʻokahi a i ʻole ʻelua ʻaoʻao, hoʻihoʻi i kā lākou tibal plateau anatomical structure, paʻa paʻa, a lawe i ka hana mua ma hope o ka hana. Ka hopena: Ua ukali ʻia nā maʻi āpau no 4-36 mau mahina, awelika 15 mahina, e like me ka helu Rasmussen, 21 nā mea maʻi i maikaʻi loa，8 i ka maikaʻi，3 i ʻae ʻia，2 i ka ʻilihune. ʻO ka lakio maikaʻi loa he 85.3%. Ka hopena: E hopu i nā manawa hana kūpono, e hoʻohana i nā ala kūpono a lawe i nā hoʻomaʻamaʻa hana mua, e hāʻawi iā mākou i nā hopena hana maikaʻi loa i ka mālama ʻana.tibiahaʻihaʻi pāpū.
1.1 ʻIke Nui: ua loaʻa i kēia hui he 34 mau maʻi me 26 kāne a me 8 wahine. ʻO ka poʻe maʻi he 27 a hiki i 72 me ka awelika makahiki o 39.6. He 20 mau hihia o ka ulia pōpilikia, 11 mau hihia o ka hāʻule ʻana a me 3 mau hihia o ka ʻeha nui. ʻO nā hihia āpau i pani ʻia me ka ʻole o nā ʻeha vascular. Aia he 3 mau hihia o ka hōʻeha ligament cruciate, 4 mau hihia o nā hōʻeha ligament collateral a me 4 mau hihia o ka meniscus injuries. Hoʻokaʻawale ʻia nā haʻihaʻi e like me Schatzker: 8 mau hihia o ke ʻano I, 12 mau hihia o ke ʻano II, 5 mau hihia o ke ʻano III, 2 mau hihia o ke ʻano IV, 4 mau hihia o ke ʻano V a me 3 mau hihia o ke ʻano VI. Ua nānāʻia nā maʻi a pau e ka X-ray, CT scan o ka tibial plateau a me ka hana houʻana iʻekolu-dimensional, a ua nānāʻia kekahi mau maʻi e MR. Eia kekahi, ʻo ka manawa hana ʻo 7 ~ 21d ma hope o ka hōʻeha, awelika 10d. Ma loko o kēia, he 30 mau maʻi e ʻae ana i ka lāʻau grafting iwi, 3 mau maʻi e ʻae ana i ka hoʻopaʻa papa pālua, a ʻo nā mea maʻi ʻē aʻe e ʻae i ka hoʻoponopono kūloko unilateral.
1.2 Hana ʻokiʻoki: hana ʻiaiwi kuamoʻoanesthesia a i ʻole intubation anesthesia, aia ka mea maʻi ma ke kūlana supine, a hana ʻia ma lalo o ka tourniquet pneumatic. Ua hoʻohana ʻia ka ʻoki ʻana i ke kuli anterolateral, anterior tibial a i ʻole lateralami kuliʻoki hope. Ua ʻoki ʻia ka ligament coronary ma ka Incision ma ka ʻaoʻao haʻahaʻa o ka meniscus, a hōʻike ʻia ka ʻili o ka ʻili o ka tibial plateau. E ho'ēmi i nā haʻihaʻi pāpū ma lalo o ka ʻike maka. Ua hoʻopaʻa mua ʻia kekahi mau iwi me nā pine Kirschner, a laila hoʻopaʻa ʻia e nā papa kūpono (paʻa kolepa, pā-L, pā-T, a i ʻole i hui pū ʻia me ka pā medial buttress plate). Ua hoʻopiha ʻia nā hemahema o ka iwi me ka iwi allogenic (mua) a me ka grafting iwi grafting. I ka hana, ua ʻike ke kauā i ka hōʻemi anatomical a me ka hōʻemi anatomical proximal, mālama ʻia ka axis tibial maʻamau, hoʻopaʻa paʻa i loko, hoʻopili ʻia ka iwi iwi a me ke kākoʻo pololei. E hoʻāʻo i ka ligament kuli a me ka meniscus no ka hōʻoia mua ʻana a i ʻole nā hihia i manaʻo ʻia intra-operative, a hana i ke kaʻina hana hoʻoponopono kūpono.
1.3 Hoʻomaʻamaʻa ma hope o ka hana: pono e hoʻopaʻa pono ʻia ka limb elastic bandage postoperative, a ua hoʻokomo ʻia ka ʻoki hope ʻana me ka paipu wai, pono e wehe ʻia i ka 48h. ʻO ka analgesia maʻamau postoperative. Ua lawe ka poʻe maʻi i nā hoʻomaʻamaʻa ʻiʻo o nā lālā ma hope o 24h, a lawe i nā hoʻomaʻamaʻa CPM ma hope o ka wehe ʻana i ka paipu wai no nā haʻihaʻi maʻalahi. Hoʻohui ʻia ka ligament collateral, hope cruciate ligament hihia ʻeha, hoʻoneʻe ikaika a passively i ke kuli ma hope o ka hoʻoponopono ʻana i ka plaster a i ʻole ka brace no hoʻokahi mahina. Wahi a nā hualoaʻa hoʻokolokolo X-ray, alakaʻi ke kauka lapaʻau i nā mea maʻi e lawe mālie i nā hoʻoikaika kaumaha o nā lālā, a pono e hana ʻia ka hoʻouka kaumaha ʻana ma ʻehā mahina ma hope.
Ka manawa hoʻouna: Jun-02-2022
