Kuvunika Hoffa ni uguvunika indege ya coronal ya femoral cingyle. Byasobanuwe bwa mbere na Busch Friedrich Busch mu 1869, kandi byatunguriwe Albert Hoffa mu 1904, maze amwitirirwa. Mugihe kuvunika mubisanzwe bibaho mu ndege ya horizontal, kuvunika ibihori bibaho mu ndege kandi ntibisanzwe, kuburyo bakunze kubura mugihe cyagenwe na raglogisi.
Ni ryari kuvunika Hoffa bibaho?
FFOFA FFARE YATANZWE N'IHARE YO GUKORA FOMORKLERAL TONYLE KU IVUMWE. Ibikomere byingufu nyinshi akenshi bitera guhuza intercondy na supracondy of Femur ya kure. Uburyo busanzwe burimo ibinyabiziga bifite moteri no guhangayikishwa n'ibinyabiziga bigwa. Lewis et al. yerekanye ko abarwayi benshi bafite ibikomere bifitanye isano byatewe n'ingaruka zitaziguye kurongora femoral femoral mugihe ugenda moto hamwe na piage yahindutse kugeza kuri 90 °
Ni ubuhe buryo bwo kwigaragaza bwa hoffa buvunika?
Ibimenyetso by'ingenzi byo kuvunika Hoffa ni effision na Hemarthrosise, kubyimba, na genu slum cyangwa ubwitonzi bworoheje cyangwa ihungabana. Bitandukanye na intercondy racketry na Sucracondylar, kuvunika Hoffa birashoboka cyane ko byavumbuwe muburyo bwo gutekereza. Kubera ko imiterere myinshi ya Hoffa ituruka ku bikomere by'ingufu, igitunguru cyahujwe n'igifu, Pelimur, Patella, Tibia, ibinyomoro by'amavi, kandi ibikoresho bya pome bigomba kuvaho.
Iyo gucika intege gukekwa, nigute umuntu akwiye gufata x-imirasire kugirango abuze kwisuzumisha?
Anteropostes ya Anterophip hamwe na Radio yatinze irakorwa, kandi ibitekerezo bya kiloba bikozwe mugihe bibaye ngombwa. Iyo kuvunika ntabwo byimuwe cyane, akenshi biragoye kubimenya kuri radiografiya. Kumwanya wuruhande, kutirukana gato umurongo uhuriweho numuyoboro wa rimwe na rimwe ugaragara, hamwe cyangwa udafite ubumuga bukomeye bitewe na condile yabigizemo uruhare. Ukurikije imiterere ya femur, guhagarika cyangwa gutera intambwe kumurongo wavunika birashobora kugaragara kubitekerezo byuruhande. Ariko, kubitekerezo nyabyo, inkingi ya femoral isa nkaho idakarenganye, mugihe niba inkingi igufi kandi yimuwe, irashobora guhuzagurika. Kubwibyo, kubona nabi ivi risanzwe rirashobora kuduha ibitekerezo byibinyoma, bishobora kugaragazwa nibitekerezo bya oblique. Kubwibyo, CT Isuzuma ni ngombwa (Ishusho 1). Magnetic Ressonance Imaging (MRI) irashobora gufasha gusuzuma imyenda yoroshye ikikije ivi (nka ligaments cyangwa menisci) ibyangiritse.
Igishushanyo 1 CT yerekanaga ko umurwayi yari afite ubwoko bwa lefya ya Hoffa
Ni ubuhe bwoko bw'imiterere ya Hoffa?
Gucikamo Hoffa bigabanyijemo ubwoko B3 nandika 33.b3.2 muri Ao / OTA BIKURIKIRA ukurikije ibyiciro bya muller. Nyuma, lentennene et al. igabanyijemo kumeneka muburyo butatu bushingiye ku ntera yumurongo wavunitseho igitsina kuva inyuma ya cortex yinyuma ya femur.
Igishushanyo2 Umugenzuzi witondera kuvunika Hoffa
Andika I:Umurongo wavuza uherereye kandi uhwanye na cortex yinyuma ya shaft femoral.
Ubwoko bwa II:Intera kuva kumurongo wavunitse kumurongo winyuma wa femur ugabanijwemo imashini iia, IB na IIC ukurikije intera kuva kumagufwa corterior. Andika Iia yegereye inyuma ya cortex yinyuma yumuyoboro wa femoral, mugihe iic iri kure ya cortex yinyuma yimyenda yimyenda.
Ubwoko bwa III:Kuvunika oblique.
Nigute Gutegura Gahunda yo kubaga nyuma yo gusuzuma?
1. Guhitamo imbere muri rusange byizeraga ko kugabanya gufungura no gukosora imbere ni ibintu bya zahabu. Kubwububiko bwa Hoffa, guhitamo imbaraga zikwiye ni bike. Igice cya Trafled ya Compression Hollow nibyiza byo gukosorwa. Amahitamo adashira harimo 3.5mm, 4mm, 4.5mm na 6.5mm 3MB yambaye igice cyigice cya compression Iyo bibaye ngombwa, bikwiye kurwanya ibyapa byo kurwanya slip birashobora kandi gukoreshwa hano. Jarit yabonetse binyuze muri Cadaver biomenical yiga ni ko Porogaramu ya pog ya pog ihagaze neza kuruta imigozi yimbere-inyuma yinyuma. Ariko, uruhare ruyobowe niyi mezi mu gikorwa cy'amavuriro ntirasobanutse.
2. Ikoranabuhanga ryo kubaga igihe imvura ya Hoffa yabonetse guherekezwa n'inganda z'imiryango n'ikoranabuhanga, igomba kwitabwaho bihagije, kubera ko gahunda yo kubaga no guhitamo gukosora imbere bishingiye ku bihe byavuzwe haruguru. Niba igice cyagaburindi cyacitsemo ibice, kubaga kubaga bisa nkibyavugije. Ariko, ntabwo ari ubwenge gukoresha imigozi y'imigozi idahwitse, hamwe nisahani ya anatomique, isahani ya condy cyangwa plate ya liss igomba gukoreshwa mugukosora aho. Igice cyo hagati kiragoye gukosora binyuze mu guca igihe. Muri uru rubanza, inyongera yinyongera yashinjwaga kugabanya no gukosora kuvunika Hoffa. Ibyo ari byo byose, ibice byose binini byamagufwa bigarukira hamwe na lag screw nyuma yo kugabanya anatomical.
- Uburyo bwo kubaga umurwayi ari mumwanya utanga uburiganya ku buriri bwa flueroscopique hamwe na tourniquet. Bolster ikoreshwa mugukomeza inguni ya pireyifi ya 90 °. Kubwububiko bworoshye bwo hagati, umwanditsi ahitamo gukoresha umunyamahanga hamwe nuburyo bwo hagati bwa parapatellar. Ku miterere ya Hoffal, hakoreshwa gutemba. Abaganga bamwe bavuga ko uburyo bwa parapatellar bwicarure nabwo ari amahitamo yumvikana. Iyo kuvunika impera zigaragaye, ubushakashatsi busanzwe burakorwa, hanyuma kuvunika impera zisukuwe na lirette. Muburyo butaziguye, kugabanuka bikorwa ukoresheje ingufu zigabanya ingingo. Nibiba ngombwa, "Joystick" insinga za kirsclone ikoreshwa mugushira, hanyuma insinga za kirsclone zikoreshwa mugushira no gukumira kwimura kwimurwa, ariko insinga za kirsclener ntishobora kubangamira kwimura izindi migozi (Ishusho ya 3). Koresha byibuze imigozi ibiri kugirango ugere ku gukosora no kwikuramo interineti. Gucukura perpendicular kuri kuvunika no kure yipato. Irinde gucukura mu kayira kegereye imyanya, nibyiza hamwe na C-ART Fluoscopy. Imigozi ishyirwa hamwe cyangwa utarakaye nkuko bikenewe. Imiyoboro igomba kuba irindwa kandi yuburebure buhagije bwo gukosora karitsiye. Ku itara, ivi ryagenzuwe mu bikomere, ituze, ndetse no kugenda, hamwe no kuhira neza bikorwa mbere yo gufunga ibikomere.
Igicapo 3 Kugabanya by'agateganyo no gukosora bicondylar Hofda hamwe na Kirchner insinga mugihe cyo kubagwa, ukoresheje Kirschner Insies yo Gushyiramo amagufwa
Igihe cyohereza: Werurwe-12-2025
