Gufata imbere hakoreshejwe igufwa
Guhuza akaguru n'ibipande n'amapine ni uburyo busanzwe bwo kubaga muri iki gihe. Guhuza imbere mu gipande byakoreshejwe cyane mu guhuza akaguru n'ibipande. Muri iki gihe, guhuza igice cy'aguru n'ibipande by'imbere n'ibipande by'aguru n'ibipande by'imbere.
Ifoto iri hejuru igaragaza amashusho ya X-ray mbere na nyuma yo kubagwa kwa osteoarthritis y'akaguru iteye inkeke hamwe n'icyuma gifunga imbere mu kaguru, ihuriro ry'ingingo z'akaguru.
1. Uburyo bwo gukora imbere
Uburyo bwo imbere ni ugukata igice cy'imbere cy'ubugari giherereye ku gice cy'ingingo z'akaguru, ugakata igice ku kindi, hanyuma ukinjira mu mwanya w'imitsi; ugakata agapfukamunwa k'ingingo, ugashyira ahagaragara ingingo ya tibiotalar, ugakuraho agapfukamunwa n'igufwa rya subchondral, hanyuma ugashyira igice cy'imbere ku gice cy'imbere cy'akaguru.
2. Uburyo bwo ku ruhande
Uburyo bwo ku ruhande ni ugukata osteotomy nko kuri cm 10 hejuru y'isonga rya fibula hanyuma ugakuraho igishishwa cyose. Igishishwa cy'igufwa gikurwamo kugira ngo gitereke amagufwa. Isosi y'igufwa irarangira ikagezwa, hanyuma isahani igashyirwa inyuma y'akaguru.
Akamaro ni uko imbaraga zo gufunga ziba nyinshi kandi gufunga bikaba bikomeye. Bishobora gukoreshwa mu gusana no kongera kubaka ubumuga bukomeye bwa varus cyangwa valgus ku ngingo y'akaguru n'ubusembwa bwinshi bw'amagufwa nyuma yo gusukurwa. Ingano yakozwe mu buryo bw'imiterere ifasha kugarura imiterere isanzwe y'ingingo y'akaguru. Aho iherereye.
Ingorane ni uko periosteum nyinshi n'ingingo zoroshye mu gice cyo kubagwa bigomba gukurwamo, kandi icyuma kiba kinini, ibyo bikaba byoroshye gukurura imitsi ikikije. Icyuma gishyirwa imbere biroroshye kugikoraho munsi y'uruhu, kandi hari ibyago runaka.
Gufata inzara mu nda y'umugongo
Mu myaka ya vuba aha, gukoresha uburyo bwo kuvura indwara ya ankle arthritis mu buryo bwa retrograde intramedullary mu kuvura ankle arthritis mu cyiciro cya nyuma byagiye bikoreshwa buhoro buhoro mu buvuzi.
Muri iki gihe, uburyo bwo gukata imisumari mu gice cy'akaguru cyangwa igice cya kabiri cy'inyuma cy'inyuma cy'inyuma cy'inyuma cy'inyuma mu gusukura ubuso bw'igufwa cyangwa gushyiramo amagufwa. Urufuro rw'igufwa rushyirwa mu gice cya calcaneus rujya mu gice cya tibial medullary, ibyo bikaba ingirakamaro mu gukosora imiterere y'amagufwa no guteza imbere imikoranire y'amagufwa.
Indwara yo kuvura indwara ya osteoarthritis mu kaguru hamwe n’indwara ya rubagimpande yo mu gice cya kabiri cy’umubiri. Isuzuma rya X-ray mbere yo kubagwa ryagaragaje ko ingingo ya tibiotalar n’ingingo ya kabiri by’umubiri byangiritse cyane, igice cya talus cyangiritse, ndetse n’imiterere y’uturemangingo hirya no hino ku ngingo (kuva ku ipaji ya 2)
Inguni yo gushyiramo vis ihuza ibirenge by'inyuma ihuza ibirenge by'inyuma ni uguhuza ibyuma mu buryo bwinshi, bishobora guhuza ingingo runaka igomba guhuzwa, naho impera y'inyuma ikaba umwobo ufunganye, ushobora kurwanya gukata, kuzunguruka no gukururwa, bigagabanya ibyago byo gukuramo vis.
Urugingo rwa tibiotalar n'urugingo rwa subtalar byagaragaye kandi bitunganywa binyuze mu buryo bwa transfibular lateral, kandi uburebure bw'aho igisebe cyari ku muryango w'uruyoya rwa plantar intramedullary bwari cm 3.
Umunyu wo mu nda ukoreshwa nk'icyuma gifata hagati, kandi stress yawo ikwirakwira cyane, ibyo bikaba bishobora kwirinda ingaruka zo kurinda stress kandi bihuye cyane n'amahame ya biomekanike.
Nyuma y'ukwezi kumwe n'ukwezi kumwe nyuma yo kubagwa, icyuma cya X-ray cyakozwe inyuma n'inyuma cyagaragaje ko umurongo w'ikirenge cy'inyuma wari mwiza kandi ko inzara zo mu nda y'umugongo zari zihamye neza.
Gushyira inzara za retrograde intramedullary ku ngingo z'akaguru bishobora kugabanya kwangirika kw'ingingo zoroshye, kugabanya kwangirika k'uruhu, kwandura indwara n'izindi ngorane, kandi bishobora gutanga uburyo buhamye bwo gufata neza hatabayeho gufata neza inyuma y'inyuma nyuma yo kubagwa.
Nyuma y'umwaka umwe wo kubagwa, filime za X-ray zigaragaza uburemere n'uburemere bw'ingingo zagaragaje ko ingingo ya tibiotalar n'ingingo ya subtalar byahujwe n'amagufwa, kandi ibirenge by'inyuma byari bihagaze neza.
Umurwayi ashobora kuva mu buriri agakira ibiro hakiri kare, ibyo bigatuma umurwayi yihanganira indwara kandi ubuzima bwe bugakomeza kuba bwiza. Ariko, kubera ko ingingo ya subtalar igomba gukosorwa icyarimwe, ntabwo byemewe ku barwayi bafite ingingo ya subtalar nziza. Kubungabunga ingingo ya subtalar ni ingenzi mu kwishyura imikorere y'ingingo ya subtalar ku barwayi bafite ingingo ya ankle.
gufunga imbere mu cyuma
Gufata imbere mu nsingo ya percutaneous screw ni uburyo busanzwe bwo gufata mu gihe cy'arthrodesis y'akaguru. Bufite ibyiza byo kubagwa mu buryo budakunze gukoreshwa nko gukata gato no gutakaza amaraso make, kandi bushobora kugabanya kwangirika kw'ingingo zoroshye.
Ishusho ya X-ray yo mu gice cyo hejuru n'inyuma cy'akaguru kihagaze mbere yo kubagwa yagaragaje indwara ikomeye ya osteoarthritis yo mu kaguru k'iburyo hamwe n'ubumuga bwa varus, kandi inguni iri hagati y'ubuso bwa tibiotalar articular yapimwe ikaba 19° varus.
Ubushakashatsi bwagaragaje ko gufunga byoroshye hakoreshejwe vis 2 kugeza kuri 4 bishobora gutuma bikomera kandi bigakomera neza, kandi igikorwa cyoroshye kandi igiciro ni gito cyane. Ni bwo buryo bwa mbere abahanga benshi muri iki gihe bahitamo. Byongeye kandi, gusukura ingingo z'akaguru mu buryo budakunze kugaragara bishobora gukorwa hifashishijwe arthroscopy, kandi vis zishobora gushyirwamo hifashishijwe vis à l'une. Ihungabana ryo kubagwa ni rito kandi ingaruka zo kuvura zirashimishije.
Mu gihe cyo gupima arthroscopy, hagaragara agace kanini k'ubusembwa bw'imitsi; mu gihe cyo gupima arthroscopy, igikoresho cya microfracture cy'inyuma gikoreshwa mu kuvura ubuso bw'imitsi.
Abanditsi bamwe bemeza ko gufunga vis 3 bishobora kugabanya ibyago byo kudafunga nyuma yo kubagwa, kandi ukwiyongera k'umuvuduko wo gufunga vis bishobora kuba bifitanye isano no gukomera k'ugufunga vis 3.
Filimi ya X-ray ikurikiraho nyuma y'ibyumweru 15 nyuma yo kubagwa yagaragaje ko amagufwa yahujwe. Amanota ya AOFAS yari 47 mbere yo kubagwa n'amanota 74 nyuma y'umwaka umwe nyuma yo kubagwa.
Iyo hakoreshejwe vis eshatu zo gufunga, aho vis ebyiri za mbere zishyirwa ziturutse ku mpande za tibia zigana imbere n'inyuma, zikanyura ku buso bw'ingingo zijya ku mubiri wa talar, naho vis ya gatatu ishyirwa ku ruhande rw'inyuma rwa tibia ikagera ku ruhande rwo hagati rwa talus.
Uburyo bwo gufunga inyuma
Ibikoresho byo gufunga inyuma ni byo byakoreshejwe bwa mbere mu kuvura arthrodesis y'akaguru kandi byagiye bihinduka kuva mu myaka ya 1950 kugeza kuri Ilizarov, Hoffman, Hybrid na Taylor space frame (TSF) ubu.
Gukomereka ku kaguru biturutse ku ndwara yanduriye mu gihe cy'imyaka 3, arthrodesis y'akaguru nyuma y'amezi 6 yo kurwanya indwara
Ku ndwara zimwe na zimwe zigoye zo kuvura rubagimpande ku kaguru hamwe n’indwara zisubiramo, kubagwa kenshi, uruhu rwo mu gace runaka n’ingingo zoroshye, inkovu zivutse, inenge z’amagufwa, osteoporosis n’ibisebe by’indwara zo mu gace runaka, icyuma cya Ilizarov ring external fixator gikoreshwa cyane mu buvuzi kugira ngo gifatanye ingingo y’akaguru n’izindi.
Igikoresho cyo gufunga inyuma gifite ishusho y'uruziga gishyizwe ku gice cy'umurambararo n'igice cy'umurambararo, kandi gishobora gutanga ingaruka nziza zo gufunga. Mu ntangiriro z'urugendo rwo kwikorera imizigo, kizashyira igitutu ku mpera y'aho imvune ivunitse, gitere imbaraga mu kurema kwa callus, kandi kikongera umuvuduko wo gufunga. Ku barwayi bafite ubumuga bukomeye, igikoresho cyo gufunga inyuma gishobora gukosora ubumuga buhoro buhoro. Birumvikana ko gufunga inyuma kw'ikirenge bizagira ibibazo nko kugorana kwambara abarwayi ndetse n'ibyago byo kwandura urushinge.
Umuntu wo kuvugana nawe:
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Igihe cyo kohereza: Nyakanga-08-2023
