ʻO ka pane i kēia nīnau, ʻaʻohe haki kuʻekuʻe e pono ai ke grafting iwi ke hana i ka hoʻoponopono kūloko.
Ua ʻōlelo ʻo Sanders
Ma 1993, Sanders et al [1] i hoʻopuka i kahi ʻāina i ka mōʻaukala o ka mālama ʻana i nā haʻihaʻi calcaneal ma CORR me kā lākou CT-based classification of calcaneal fractures.ʻO ka mea hou aku nei, ua hoʻoholo ʻo Sanders et al [2] ʻaʻole pono ka grafting iwi a i ʻole nā papa laka i nā haʻi kuʻekuʻe wāwae 120 me ka hahai lōʻihi o 10-20 mau makahiki.
ʻO ka CT kikokiko ʻana i nā haʻihaʻi kuʻekuʻe wāwae i paʻi ʻia e Sanders et al.ma CORR i ka makahiki 1993.
ʻElua kumu nui o ka grafting iwi: ʻo ka grafting structural no ke kākoʻo mechanical, e like me ka fibula, a me ka grafting granular no ka hoʻopiha a me ka hoʻoulu ʻana i ka osteogenesis.
Ua ʻōlelo ʻo Sanders ʻo ka iwi kuʻekuʻe he pūpū cortical nui e hoʻopuni ana i ka iwi cancellous, a hiki ke hana hou ʻia nā haʻihaʻi intra-articular o ka iwi kuʻekuʻe e ka iwi cancellous me ka trabecular structure inā hiki ke hoʻonohonoho hou ʻia ka pūpū cortical.Palmer et al. 3] ʻo ia ka mea mua i hōʻike e pili ana i ka grafting iwi i ka makahiki 1948 ma muli o ka nele o nā mea hoʻoponopono kūloko kūpono e mālama ai i ka haʻihaʻi o ka ʻili i kēlā manawa.Me ka hoʻomau mau ʻana o nā mea hoʻoponopono kūloko e like me nā pā posterolateral a me nā ʻūlū, ʻaʻole pono ke kākoʻo i ka mālama ʻana i ka hoʻēmi ʻana ma o ke kālai iwi.Ua hōʻoia ʻia kēia manaʻo i kāna mau haʻawina lapaʻau lōʻihi.
Hoʻoholo ka haʻawina hoʻomalu kino ʻaʻole pono ke kālai iwi
Ua alakaʻi ʻo Longino et al [4] a me nā poʻe ʻē aʻe i kahi noiʻi hoʻokele manaʻo o 40 i hoʻoneʻe ʻia i loko o ke kuʻekuʻe wāwae me ka liʻiliʻi o 2 mau makahiki o ka hahai ʻana a ʻaʻohe ʻokoʻa koʻikoʻi ma waena o ka grafting iwi a ʻaʻohe iwi grafting e pili ana i ke kiʻi a i ʻole ka hana. nā hualoaʻa.Gusic et al [5] i alakaʻi i kahi noiʻi hoʻomaluʻia o 143 i hoʻoneʻeʻia i loko o ka'āpana o ka kuʻekuʻe wāwae me nā hopena like.
Ua alakaʻi ʻo Singh et al [6] mai ka Mayo Clinic i kahi haʻawina retrospective o nā maʻi 202 a ʻoiai ʻoi aku ka maikaʻi o ka grafting iwi ma ke ʻano o ke kihi o Bohler a me ka manawa i ka lawe ʻana i ke kaumaha piha, ʻaʻohe ʻokoʻa nui i nā hopena hana a me nā pilikia.
ʻO ka grafting iwi ma ke ʻano he kumu pilikia no nā pilikia ʻeha
Ua alakaʻi ʻo Professor Pan Zhijun a me kāna hui ma Zhejiang Medical Second Hospital i kahi loiloi systematic a me meta-analysis ma 2015 [7], i hoʻokomo ʻia i nā palapala āpau i hiki ke kiʻi ʻia mai nā ʻikepili uila e like me 2014, me 1651 fractures i 1559 mau maʻi, a Ua hoʻoholo ʻo ia ʻo ka grafting iwi, diabetes mellitus, ʻaʻole kau ʻana i kahi kahawai, a me nā haʻihaʻi koʻikoʻi e hoʻonui nui i ka hopena o nā pilikia traumatic postoperative.
I ka hopena, ʻaʻole pono ka hoʻopili ʻana i ka iwi i ka wā o ka hoʻopaʻa ʻana i loko o nā haʻihaʻi kuʻekuʻe wāwae a ʻaʻole kōkua i ka hana a i ʻole ka hopena hope, akā e hoʻonui i ka pilikia o nā pilikia traumatic.
1. Sanders R, Fortin P, DiPasquale T, et al.ʻO ka hoʻomaʻamaʻa ʻana i ka 120 i hoʻoneʻe ʻia i nā ʻeha calcaneal intraarticular.Nā hualoaʻa me ka hoʻohana ʻana i ka hoʻokaʻawale ʻana o ka tomography scan prognostic.Clin Orthop Relat Res.1993;(290):87-95.
2.Sanders R, Vaupel ZM, Erdogan M, et al.ʻO ka hoʻomaʻamaʻa ʻana i nā haʻihaʻi calcaneal intraarticular i hoʻoneʻe ʻia: ʻo ka wā lōʻihi (10-20 Makahiki) ka hopena i 108 mau haki me ka hoʻohana ʻana i ka prognostic CT classification.J Orthop Trauma.2014;28(10):551-63.
3.Palmer I. ʻO ka hana a me ka mālamaʻana i nā haʻihaʻi o ka calcaneus.J Iwi Huipuia Surg Am.1948;30A:2–8.
4.Longino D, Buckley RE.ʻO ka hoʻopili ʻana i ka iwi ma ka mālama ʻana i nā haʻihaʻi calcaneal intraarticular i hoʻoneʻe ʻia: he mea kōkua?J Orthop Trauma.2001;15(4):280-6.
5.Gusic N, Fedel I, Darabos N, et al.ʻO ka hoʻomaʻamaʻa ʻana i nā haʻihaʻi calcaneal intraarticular: Anatomical a me ka hopena hana o nā ʻano hana hana ʻekolu.ʻeha.2015;46 Suppl 6:S130-3.
6.Singh AK, Vinay K. ʻO ka mālama ʻana i nā haʻihaʻi calcaneal intra-articular i hoʻoneʻe ʻia: pono anei ke grafting iwi?J Orthop Traumatol.2013;14(4):299-305.
7. Zhang W, Chen E, Xue D, et al.ʻO nā kumu pilikia no ka hōʻeha ʻana i nā hōʻeha o ka calcaneal fractures i pani ʻia ma hope o ke kaʻina: kahi loiloi ʻōnaehana a me ka meta-analysis.Scand J Trauma Resusc Emerg Med.2015;23:18.
Ka manawa hoʻouna: Dec-07-2023
