Mugihe uhitamo gahunda yo kuvura kuri kurebire mbi, gukosora hanze birashobora gukoreshwa nkibicuruzwa byigihe gito kugirango bivuruke hamwe nibikomere bikabije.
Ibimenyetso:
"Kurwanya ibyangiritse" bikosora by'agateganyo hamwe n'imvune zikomeye zo mu kirere, nko kuvunika cyangwa kuvunika hamwe no kubyimba byoroshye.
Kuvura burundu ibiranga byanduye, byanduye, cyangwa kuvunika hamwe nibikomere bikabije.
EXamine:
Imiterere yoroshye ya tissue: ①PeNPEN; ② Spevere yoroheje ya Tissue, imibyimba yoroshye. Reba imiterere ya neurovascular hanyuma wandike witonze.
Gutekereza: Anteroposition na X-Imirasire ya Tibia, na anteroposition, ibishushanyo bya anteroposition, bikaze kandi binini bya akle hamwe. Niba kuvunika ibihangano bikekwa, ct scan yo muri Tibial Vault igomba gukorwa.
ANYAMOMY:·
Agace ka Anatomique "gaze gariba" kugirango ushyireho ikosora byasobanuwe hakurikijwe urwego rutandukanye rwigice.
Metaphysis ya Tibia atanga 220 ° zone ya arc-arc-arc imeze ahantu hashyizwemo ibice byo gukosora hanze.
Ibindi bice bya Tibia bitanga ahantu hinjiza abashitsi mu rwego rwo kwinjiza umutekano mu gice cya 120 ° ~ 140 °.
STekinike Yukuri
Umwanya: Umurwayi aryamye kuri ameza ya X-ray, nibindi bintu nkumusego cyangwa igikoma gishyirwa munsi yumuntu wangiritse kugirango ufashe uhagaze. Gushyira padi munsi yibumba ryikirere kizunguruka ingingo yimbere nta kuzunguruka cyane.
APRIPIACH
Mubihe byinshi, ibiteganyo bito, Calcaneus, na Metatarsal ya mbere kugirango ashyire amapine yo hanze. ··
Fibula ibipimo byoroshye uhereye kumupaka wa palputane wo munsi.
Kuvunika kwa tibial birimo guhuriza hamwe birashobora gukosorwa buri kintu. Niba ibintu byoroshye byimiterere, nibiba ngombwa, uburyo busanzwe cyangwa uburyo bwo hagati burashobora gukoreshwa mugukosora. Niba gukosora hanze bikoreshwa gusa nkigipimo cyo gukosora by'agateganyo, aho byinjira byinjira by'agateganyo biteganijwe gushyirwaho hagomba kuba kure y'agace ka nyuma wo gukosora kwanduza indwara zoroheje. Gukosora hakiri kare fibula na intra-ibishushanyo mbonera byorohereza gukosorwa gukosorwa.
Ingamba
Witondere ikosora rya PIN kugirango ukemure neza neza umurima ugabanywa, nkuko Tissue yanduye izazaga byanze bikunze biganisha ku bigo bya nyuma. Uburyo buri gihe cyangwa hagati yubudozi hamwe na tissue yoroshye yoroheje birashobora kandi kuganisha ku ngorane zikomeye zo gukiza ibikomere.
Kugabanya no gukosora fibula kuvunika fibula:
Igihe cyose imiterere yoroshye ya tissue, fibula octrares irafatwa mbere. Kuvunika Fibular bigabanuka kandi bikosorwa ukoresheje fibular ya fibular, mubisanzwe hamwe na 3.5mm lag screw na 3.5mm l / 3 plate, cyangwa 3.5m lcdc. Nyuma ya fibula igabanuka kandi ikosowe, irashobora gukoreshwa nkibisanzwe byo kugarura uburebure bwa tibia no gukosora uburyo bwo kuzunguruka.
Ingamba
Kubyimba byoroshye byoroheje cyangwa igikomere gifunguye gishobora kandi gukumira ibyangombwa bya fibula. Witondere kudakosora ibiranga fibulal kandi witondere gukomeretsa indwara ya peroneal.
Kuvunika Tibial: Kugabanya no gukosorwa imbere
Kuvunika-urubuga rwibisobanuro bya tibial bigomba kugabanuka muburyo butaziguye binyuze mubyerekezo bya ateroteral cyangwa uburyo bwo hagati bwa tibia ya marike, cyangwa binyuze mu kugabanya intoki mu buryo butaziguye munsi ya flueroscopy.
Iyo utwaye ibibatsi, igice cyo kuvunika kigomba gukemurwa hamwe na kirscner wirk insinga.
Kugabanya hakiri kare no gukosora imivurungano ya intra-Articular yemerera ubuhanga buteye ubwoba kandi byoroshye guhinduka muburyo bwa kabiri. Ibihe bitameze neza-tissue nko kubyimba cyangwa byangiritse cyane-tissue birashobora gukumira ikosora hakiri kare.
Kuvunika Tibial: Gukosora Igicuruzwa cyo hanze
Umukiriya wambukiranya ibicuruzwa byo hanze birashobora gukoreshwa.
Dukurikije ibisabwa muburyo bwa kabiri busobanutse neza, ibice bibiri 5mm igice cyo gukosora hanze yashyizwemo inyungu cyangwa binyuze mubuso buto kuri tibia ku mpera ya paraxime.
Banza utandukana hejuru yububiko, hanyuma urinde ibice bikikije ibinyabiziga byoroshye kurinda ibiryo byoroshye, hanyuma ukingire, kanda, hanyuma utware unyuze mu ntoki.
Amapine yo gukosora hanze ku mpera za kure zivunika zirashobora gushyirwa mu gice cya kure cya kure, Calcaneus na metatarsalis, cyangwa ijosi rya Talus.
Amapine yo hanze yo hanze agomba gushyirwa kuri tuberority ya Calcaneal yerekeza kure kugirango wirinde kwangirika kugirango wirinde kwangiriza imiryango yo hagati.
Gukosora hanze PIN ya Metatarsal yambere igomba gushyirwa hejuru ya anteromedial yisi ya metatarsal yambere.
Rimwe na rimwe, pin yo hanze irashobora gushyirwa muburyo bunyuze muri sinesiyo ya tarsal.
Noneho, Tibia ya kure yagasubiwemo kandi umurongo w'ingufu wahinduwe binyuze mu maraso adasanzwe, kandi filime yo hanze yarateraniye.
Mugihe uhindura ibyakosowe hanze, fungura clip clip, kora clicting clip, kora traction ndende, hanyuma ukore kugabanuka kwubwitonzi munsi ya flushroscopi kugirango uhindure umwanya wo gucika intege. Umukoresha noneho akomeza umwanya mugihe umufasha ahangana amashusho ahuza.
Main ingingo
Niba gukosorwa hanze atari ubuvuzi busobanutse, umushinyaguzi wo hanze ugomba kubikwa kure yubuko bwo gukosora mugihe cyo gutegura ibikorwa, kugirango utanduza imikorere yukuri. Guhagarara byo gukosora hanze birashobora kwiyongera no kongera imikono kuri buri rubuga rwagati, rwongera imitwe yibyorezo, yongeraho igenamiterere ryinshi ryaka, kandi ryongera indege yo gukosora cyangwa gushyira indege yo gukosora cyangwa gukoresha impeta ya filime yo hanze. Guhuza bihagije bigomba gukekwa binyuze mumasoto yinyuma kandi yijimye.
Kuvunika Tibial: No-Span-Articular yo hanze
Rimwe na rimwe, ni uburyo bwo gukoresha ibicuruzwa byo hanze bidatera ingingo. Niba igice cya kure cyane ari kinini bihagije kugirango ukemure igice-cyintoki zoherejwe hanze, fixtor yoroshye yo hanze irashobora gukoreshwa. Ku barwayi bafite imiterere mito ya metaphyseal, fixtor yo hanze igizwe na pin-yijimye yinyuma ya pin hamwe na kirscral nziza yintwari ningirakamaro nkubuhanga bwo kuvura by'agateganyo cyangwa bwuzuye. Icyitonderwa kigomba gukoreshwa mugihe ukoresheje ibitari byiza-articulator yo hanze kugirango ivurure hamwe na tissue yoroshye. Gukuraho iyi tissue yanduye, debrideement yurushuro, no guhindagurika kwurubasha mukibazo cyiza kugeza gukiza neza ibikomere bikenewe mbere yuko imyigaragambyo isobanutse.
Sichuan Chenanhui Technologwe Colonce Coup, Ltd
Twandikire: Yoyo
Whatsapp: +8615682071283
Email: liuyaoyao@medtechcah.com
Igihe cyagenwe: Feb-10-2023
