ʻenehana ʻoki kino

ʻŌlelo Pōkole: Pahuhopu: E noiʻi i nā mea pili i ka hopena hana o ka hoʻohana ʻana i ka hoʻopaʻa ʻana o loko o ka papa kila e hoʻihoʻi i kaka haki ʻana o ka tibial plateauʻAno Hana: Ua ʻoki ʻia he 34 mau maʻi me ka haki tibial plateau ma ka hoʻohana ʻana i ka hoʻopaʻa kūloko o ka papa kila i hoʻokahi a ʻelua paha ʻaoʻao, hoʻihoʻi i ke ʻano anatomical o ka tibal plateau, hoʻopaʻa paʻa, a lawe i ka hoʻoikaika kino mua ma hope o ke ʻoki ʻana. Hopena: Ua hahai ʻia nā maʻi āpau no 4-36 mau mahina, ʻo ka awelika he 15 mau mahina, e like me ka helu Rasmussen, he 21 mau maʻi i maikaʻi loa, 8 i maikaʻi, 3 i ʻae ʻia, 2 i maikaʻi ʻole. ʻO ka lakio maikaʻi loa he 85.3%. Hopena: E hopu i nā manawa kūpono e hana ai, e hoʻohana i nā ʻano kūpono a lawe i nā hoʻoikaika kino mua, e hāʻawi iā mākou i nā hopena hana maikaʻi loa i ka mālama ʻana.ʻūhāhaki pālahalaha.

1.1 ʻIke Laulā: he 34 mau maʻi o kēia hui me 26 mau kāne a me 8 mau wahine. ʻO nā maʻi he 27 a 72 mau makahiki me ka awelika o 39.6 mau makahiki. He 20 mau hihia o nā ʻeha ulia kaʻa, 11 mau hihia o nā ʻeha hāʻule a me 3 mau hihia o ka ʻūlū nui. ʻO nā hihia a pau he mau haki pani ʻia me ka ʻole o nā ʻeha vascular. He 3 mau hihia o nā ʻeha ligament cruciate, 4 mau hihia o nā ʻeha ligament collateral a me 4 mau hihia o nā ʻeha meniscus. Ua hoʻokaʻawale ʻia nā haki 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 nānā ʻia nā maʻi a pau e X-ray, CT scan o ka tibial plateau a me ke kūkulu hou ʻana i ʻekolu-dimensional, a ua nānā ʻia kekahi mau maʻi e MR. Eia kekahi, ʻo ka manawa hana he 7 ~ 21d ma hope o ka ʻeha, ʻo ka awelika he 10d. No kēia, he 30 mau maʻi i ʻae i ka lāʻau hoʻopili iwi, 3 mau maʻi i ʻae i ka hoʻopaʻa ʻana i ka papa pālua, a ʻo ke koena o nā maʻi i ʻae i ka hoʻopaʻa kūloko ʻaoʻao.

1.2 ʻAno hana ʻoki kino: i hana ʻiaiwi kuamoʻoanesthesia a i ʻole intubation anesthesia, aia ka mea maʻi ma ke kūlana supine, a hana ʻia ma lalo o ka pneumatic tourniquet. Ua hoʻohana ke ʻoki ʻana i ke kuli anterolateral, anterior tibial a i ʻole lateralhui kuliʻoki hope. Ua ʻoki ʻia ka ligament Coronary ma ke kihi o ka Incision ma ka lihi haʻahaʻa o ka meniscus, a hōʻike i ka ʻili articular o ka tibial plateau. E hōʻemi i nā haki plateau ma lalo o ka ʻike pololei. Ua hoʻopaʻa mua ʻia kekahi mau iwi me nā pine Kirschner, a laila hoʻopaʻa ʻia e nā papa kūpono (golf-plate, L-plate, T-plate, a i ʻole i hui pū ʻia me ka medial buttress plate). Ua hoʻopiha ʻia nā kīnā iwi me ka iwi allogenic (mua) a me ka allograft bone grafting. I ka hana, ua ʻike ke kauka ʻoki i ka hōʻemi anatomical a me ka hōʻemi anatomical proximal, mālama i ka axis tibial maʻamau, ka paʻa paʻa kūloko, ka hoʻopili iwi compacted a me ke kākoʻo pololei. Ua nānā i ka ligament kuli a me ka meniscus no ka hōʻailona preoperative a i ʻole nā ​​​​hihia i manaʻo ʻia intra-operative, a hana i ke kaʻina hana hoʻoponopono kūpono.

1.3 Ka Lapaʻau Ma hope o ke ʻoki ʻana: pono e kāʻei pono ʻia ke kāʻei elastic lālā postoperative, a ua hoʻokomo ʻia ka ʻoki hope me ka paipu hoʻokahe, pono e wehe ʻia ma 48h. ʻO ka analgesia postoperative maʻamau. Ua lawe nā mea maʻi i nā hoʻomaʻamaʻa ʻiʻo lālā ma hope o 24h, a ua lawe i nā hoʻomaʻamaʻa CPM ma hope o ka wehe ʻana i ka paipu hoʻokahe no nā haki maʻalahi. I hui pū ʻia me ka ligament collateral, nā hihia hōʻeha ligament cruciate posterior, neʻe ikaika a passively i ke kuli ma hope o ka hoʻopaʻa ʻana i ka plaster a i ʻole ke kākoʻo no hoʻokahi mahina. Wahi a nā hopena o ka hoʻokolokolo X-ray, ua alakaʻi ke kauka lapaʻau i nā mea maʻi e lawe mālie i nā hoʻomaʻamaʻa hoʻouka kaumaha lālā, a pono e hana ʻia ka hoʻouka kaumaha piha ma ka liʻiliʻi he ʻehā mahina ma hope.