. Dukurikije imfashanyigisho ya AO, birasabwa gushyiramo tibiofibular ya kure ya cm 2 cyangwa cm 3,5 hejuru yuburebure bwa tibial articular artular, ku mfuruka ya 20-30 ° kugera ku ndege itambitse, kuva fibula kugera kuri tibia, hamwe n'amaguru. mu mwanya utabogamye. "
Kwinjiza intoki za tibiofibular ya kure akenshi bivamo gutandukana aho binjirira no mu cyerekezo, kandi kuri ubu, nta buryo bunoze bwo kumenya icyerekezo cyo kwinjiza ayo mashanyarazi. Kugira ngo iki kibazo gikemuke, abashakashatsi b’abanyamahanga bakoresheje uburyo bushya - 'angice bisector method.
Ukoresheje amashusho yerekana amashusho kuva 16 asanzwe yibirenge, hakozwe moderi 16 zacapwe 3D. Ku ntera ya cm 2 na cm 3,5 hejuru yubuso bwa tibial articular, insinga ebyiri za mm 1,6 za Kirschner zisa nuburinganire bwazo zashyizwe hafi yimbere ninyuma yinyuma ya tibia na fibula. Inguni iri hagati y'insinga ebyiri za Kirschner yapimwe hifashishijwe protrator, hanyuma biti ya mm 2,7 ikoreshwa mu gucukura umwobo ku murongo wa bisector, hanyuma hakurikiraho gushyiramo umugozi wa mm 3,5. Nyuma yo gushiramo imigozi, umugozi waciwe muburebure bwarwo ukoresheje icyuma kugirango usuzume isano iri hagati yicyerekezo cya screw na axe yo hagati ya tibia na fibula.
Ubushakashatsi bwikigereranyo bwerekana ko hariho guhuza kwiza hagati ya axe yo hagati ya tibia na fibula n'umurongo wa bisector umurongo, kimwe no hagati ya axe hagati nicyerekezo cya screw.
mubyukuri, ubu buryo bushobora gushyira neza umugozi kumurongo wo hagati wa tibia na fibula. Ariko, mugihe cyo kubagwa, gushyira insinga za Kirschner hafi yimbere ninyuma yinyuma ya tibia na fibula bitera ibyago byo kwangiza imiyoboro yamaraso nimitsi. Byongeye kandi, ubu buryo ntabwo bukemura ikibazo cya malrogene ya iatrogène, kubera ko guhuza tibiofibular ya kure bidashobora gusuzumwa bihagije mbere yo gushyiramo imashini.
Igihe cyo kohereza: Nyakanga-30-2024
