ʻO nā haʻihaʻi o ka hui kuʻekuʻe wāwae i hana ʻia e nā ikaika rotational a kūpaʻa paha, e like me Pilon fractures, pili pinepine i ka malleolus hope. Loaʻa ka hōʻike ʻana o ka "malleolus posterior" i kēia manawa ma o ʻekolu mau hana hoʻokalakupua nui: ka hoʻokokoke ʻaoʻao hope, ka ʻaoʻao medial hope, a me ke ʻano medial hope i hoʻololi ʻia. Ma muli o ke ʻano o ka haʻihaʻi a me ka morphology o nā ʻāpana iwi, hiki ke koho ʻia kahi ala kūpono. Ua alakaʻi nā haumāna haole i nā haʻawina hoʻohālikelike e pili ana i ka hōʻike ʻana o ka malleolus hope a me ka ʻāʻī ʻana ma nā puʻupuʻu vascular a me nā neural o ka hui kuʻekuʻe wāwae e pili ana i kēia mau ala ʻekolu.
ʻO nā haʻihaʻi o ka hui kuʻekuʻe wāwae i hana ʻia e nā ikaika rotational a kūpaʻa paha, e like me Pilon fractures, pili pinepine i ka malleolus hope. Loaʻa ka hōʻike ʻana o ka "malleolus posterior" i kēia manawa ma o ʻekolu mau hana hoʻokalakupua nui: ka hoʻokokoke ʻaoʻao hope, ka ʻaoʻao medial hope, a me ke ʻano medial hope i hoʻololi ʻia. Ma muli o ke ʻano o ka haʻihaʻi a me ka morphology o nā ʻāpana iwi, hiki ke koho ʻia kahi ala kūpono. Ua alakaʻi nā haumāna ʻē aʻe i nā haʻawina hoʻohālikelike e pili ana i ka laulā o ka malleolus hope a me ka haʻalulu
ma nā puʻupuʻu vascular a me neural o ka hui kuʻekuʻe wāwae e pili ana i kēia mau ala ʻekolu.
1. ʻO ke ala waena o hope
ʻO ke ala hope medial e komo i waena o ka flexor lōʻihi o nā manamana wāwae a me nā moku tibial hope. Hiki i kēia ala ke hōʻike i ka 64% o ka malleolus hope. ʻO ka ʻāʻī ʻana ma nā puʻupuʻu vascular a me nā neural pūpū ma ka ʻaoʻao o kēia ala e ana ʻia ma 21.5N (19.7-24.1).
▲ ʻO ka ʻaoʻao waena o hope (Yellow Arrow). 1. ʻAiʻi o ka tibial hope; 2. ʻO ke aʻa lōʻihi lōʻihi o nā manamana wāwae; 3. Na moku tibia hope; 4. ʻO ke aʻalolo kuʻi; 5. Achille tendon; 6. Flexor hallucis longus tendon. AB=5.5CM, hope malleolus hōʻike laulā (AB/AC) he 64%.
2. ʻO ke ala hope ma hope
ʻO ke ala hope hope e komo ana ma waena o ka peroneus longus a me ka brevis tendon a me ka flexor hallucis longus tendon. Hiki i kēia ala ke hōʻike i ka 40% o ka malleolus hope. Ua ana ʻia ka ʻāʻī ʻana ma nā puʻupuʻu vascular a me neural ma ka ʻaoʻao o kēia ala ma 16.8N (15.0-19.0).
▲ ʻO ka ʻaoʻao ʻaoʻao hope (Puʻa Melemele). 1. ʻAiʻi o ka tibial hope; 2. ʻO ke aʻa lōʻihi lōʻihi o nā manamana wāwae; 4. Na moku tibia hope; 4. ʻO ke aʻalolo kuʻi; 5. Achille tendon; 6. Flexor hallucis longus tendon; 7. ʻAiʻo Peroneus brevis; 8. Peroneus longus tendon; 9. Liʻiliʻi saphenous vein; 10. Aʻalolo fibular maʻamau. AB=5.0CM, hope malleolus hōʻike laulā (BC/AB) he 40%.
3. Hoʻololi ʻia ʻo Posterior Medial Approach
ʻO ke ala hope medial i hoʻololi ʻia e komo i waena o ke aʻalolo tibial a me ka flexor hallucis longus tendon. Hiki i kēia ala ke hōʻike i ka 91% o ka malleolus hope. ʻO ka ʻāʻī ʻana ma nā puʻupuʻu vascular a me neural ma ka ʻaoʻao o kēia ala e ana ʻia ma 7.0N (6.2-7.9).
▲ Hoʻololi ʻia ʻo Posterior Medial Approach (Yellow Arrow). 1. ʻAiʻi o ka tibial hope; 2. ʻO ke aʻa lōʻihi lōʻihi o nā manamana wāwae; 3. Na moku tibia hope; 4. ʻO ke aʻalolo kuʻi; 5. Flexor hallucis longus tendon; 6. Achille tendon. AB=4.7CM, hope malleolus hōʻike laulā (BC/AB) he 91%.
Ka manawa hoʻouna: Dec-27-2023
