Gutegura mbere yimyanya nu mwanya nkuko byasobanuwe mbere ya transarticular yo hanze ikosora.
Imbere-articular kuvunika gusubiramo no gukosora：
Kugabanya kugabanuka kugarukira no gukosorwa birakoreshwa. Ivunika ry'ubuso buto bushobora kugaragara neza binyuze mu tuntu duto twa anteromedial na anterolateral incision hamwe no gutembera kuruhande rwa capsule ihuriweho na menisk.
Gukurura ingingo zanduye no gukoresha ligaments kugirango ugorore ibice binini byamagufwa, hamwe no kwikuramo hagati birashobora gusubirwamo muguhiga no gukuramo.
Witondere kugarura ubugari bwibibaya bya tibial, kandi mugihe hari inenge yamagufwa munsi yubuso bwa arctular, kora igufwa ryamagufwa kugirango ushyigikire hejuru ya arctular nyuma yo kugerageza kugirango usubize hejuru.
Witondere uburebure bwa platifike yo hagati no kuruhande, kugirango hatabaho intambwe igaragara.
Gukosora by'agateganyo hamwe no gusubiramo clamp cyangwa Kirschner pin ikoreshwa mugukomeza gusubiramo.
Gushyira imigozi idafite umwobo, imigozi igomba kuba ihwanye nubuso bwa arctular kandi iri mumagufwa ya subchondral, kugirango yongere imbaraga zo gukosora. Intraoperative X-ray fluoroscopy igomba gukorwa kugirango igenzure imigozi kandi ntizigere itwara imigozi mubice.
Epiphyseal kuvunika gusubiramo：
Gukurura bigarura uburebure hamwe nubukanishi bwingingo zanduye.
Hafashwe ingamba zo gukosora ukuzenguruka kwingingo zanduye mugukubita tibial tuberosity no kuyerekeza hagati y'amano ya mbere n'iya kabiri.
Gushyira Impeta Yegeranye
Urutonde rwumutekano muke wa tibial plateau tension wire：
Imiyoboro ya popliteal, imitsi ya popliteal na tibial nervice ikora inyuma ya tibia, naho imitsi isanzwe ya peroneal ikora inyuma yumutwe wa fibular. Kubwibyo, byombi kwinjira no gusohoka byurushinge bigomba gukorwa mbere yikibaya cya tibial, ni ukuvuga, urushinge rugomba kwinjira no gusohoka urushinge rwicyuma imbere yumupaka wo hagati wa tibia no imbere yumupaka wimbere wa fibula.
Kuruhande rwuruhande, urushinge rushobora kwinjizwa kuva kuruhande rwimbere rwa fibula hanyuma rugatambuka kuruhande rwa anteromedial cyangwa kuruhande rwo hagati; aho binjirira hagati mubisanzwe ni kuruhande rwagati rwibibaya bya tibial no kuruhande rwimbere, kugirango wirinde insinga ya tension kugirango inyure mumitsi myinshi.
Mu bitabo byavuzwe ko aho binjirira insinga ya tension igomba kuba byibura mm 14 uvuye hejuru y’umuvuduko kugira ngo wirinde insinga ya tense yinjira muri capsule ihuriweho kandi itera arthrite yanduye.
Shira insinga ya mbere ya tension:
Ipine ya elayo irashobora gukoreshwa, ikanyuzwa mumapine yumutekano ku mpeta, ugasiga umutwe wa elayo hanze yumupanga wumutekano.
Umufasha agumana umwanya wufite impeta kuburyo ihwanye nubuso bwa arctular.
Kuramo pinyo ya elayo unyuze mubice byoroshye kandi unyuze mubibaya bya tibial, witondere kugenzura icyerekezo cyayo kugirango urebe niba aho binjirira nibisohoka biri mu ndege imwe.
Nyuma yo gusohoka kuruhu kuruhande rutandukanijwe komeza usohoke urushinge kugeza umutwe wa elayo uhuye na pin umutekano.
Shyiramo insinga ya clamp slide kuruhande kandi unyuze kuri olive pin unyuze kumurongo.
Witondere kubika tibial plateau hagati yikaramu yimpeta igihe cyose mugikorwa.
Binyuze mu buyobozi, insinga ya kabiri ya tension ishyizwe mu buryo bubangikanye, nayo inyuze mu rundi ruhande rwa wire clamp slide.
Shira insinga ya gatatu ya tension, igomba kuba mumutekano muke ushoboka hamwe nubushize bwambere bwurugero rwinsinga zambukiranya impande nini, mubisanzwe ibice bibiri byinsinga zicyuma birashobora kuba inguni ya 50 ° ~ 70 °.
Preload ikoreshwa kumurongo winsinga: Kuzuza byuzuye icyuma gikomeza, unyuze hejuru yinsinga ya tense unyuze mucyuma, uhagarike urutoki, shyira preload byibuze 1200N kumurongo winsinga, hanyuma ushyireho L-hand lock.
Koresha uburyo bumwe bwo gukosora hanze kumavi nkuko byasobanuwe mbere, shyira byibuze imigozi ibiri ya Schanz muri tibia ya kure, ushyireho ibyuma bitunganya intwaro imwe, hanyuma ubihuze na fonctionnement yo hanze, hanyuma wongere wemeze ko metafhysis na stem tibial stem ni muburyo busanzwe bwa mashini hamwe no guhinduranya mbere yo kurangiza gukosora.
Niba hagikenewe gushikama, ikadiri yimpeta irashobora kwomekwa kumaboko yo gukosora hanze hamwe ninkoni ihuza.
Gufunga
Kubaga kubaga bifunze kumurongo.
Inzira y'urushinge irinzwe hamwe ninzoga ya gaze.
Ubuyobozi nyuma yubuvuzi
Indwara ya syndrome ya Fascial no gukomeretsa imitsi
Mugihe cya 48h nyuma yimvune, hagomba kwitonderwa kureba no kumenya ko syndrome ya fassique.
Witondere neza imitsi y'amaraso y'ingingo zanduye. Kubangamira amaraso cyangwa gutakaza imitekerereze ya neurologiya bigomba gucungwa neza nkibihe byihutirwa.
Gusubiza mu buzima busanzwe
Imyitozo ngororangingo irashobora gutangira kumunsi wambere wanyuma wibikorwa niba ntayindi mvune yikibuga cyangwa ibibi. Kurugero, isometrike igabanuka ya quadriceps hamwe na passiyo yimyanya ivi hamwe nigikorwa cyimikorere yibirenge.
Intego yibikorwa hakiri kare kandi byoroshye ni ukubona intera ntarengwa yo kugendana ivi mugihe gito gishoboka nyuma yo kubagwa, ni ukuvuga, kugirango ubone uburyo bwuzuye bwimikorere yibivi byamavi bishoboka muri 4 ~ Ibyumweru 6. Muri rusange, kubaga birashobora kugera ku ntego yo kongera kubaka ivi, bikemerera hakiri kare
ibikorwa. Niba imyitozo ikora itinze kubera gutegereza kubyimba kugabanuka, ibi ntibizafasha gukira neza.
Kwikorera ibiro: Gutwara ibiro kare ntabwo bisanzwe bishyigikirwa, ariko byibura ibyumweru 10 kugeza 12 cyangwa nyuma yabyo byavunitse byimbere.
Gukiza ibikomere: Witegereze neza gukira ibikomere bitarenze ibyumweru 2 nyuma yo kubagwa. Niba kwandura ibikomere cyangwa gutinda gukira bibaye, kubaga bigomba gukorwa vuba bishoboka.
Igihe cyo kohereza: Kanama-16-2024
