"10% by'imvune z'akaguru ziherekezwa n'imvune ya tibiofibular syndesmosis yo mu gice cya kure. Ubushakashatsi bwagaragaje ko 52% by'utugozi twa tibiofibular two mu gice cya kure bigabanya cyane syndesmosis. Gushyiramo utugozi twa tibiofibular two mu gice cya kure ku gice cya kure ni ngombwa kugira ngo hirindwe malreduction iterwa n'iy’utugozi. Dukurikije amabwiriza ya AO, birasabwa gushyiramo utugozi twa tibiofibular two mu gice cya kure kuri cm 2 cyangwa cm 3.5 hejuru y'ubuso bwa tibiofibular bwo mu gice cya kure, ku nguni ya 20-30° kugera ku murongo utambitse, kuva kuri fibula kugera kuri tibia, aho akaguru kari mu mwanya utagira aho kabogamiye."
Gushyiramo vis za tibiofibular n'intoki akenshi bitera gutandukana mu gice cy'imbere n'icyerekezo, kandi ubu nta buryo nyabwo bwo kumenya icyerekezo cy'izi vis. Kugira ngo iki kibazo gikemuke, abashakashatsi b'abanyamahanga bakoresheje uburyo bushya—uburyo bwa 'angle bisector method'.
Hakoreshejwe amakuru y’ishusho yavuye mu ngingo 16 zisanzwe z’akaguru, hakozwe moderi 16 zacapwe mu buryo bwa 3D. Ku ntera ya cm 2 na cm 3.5 hejuru y’ubuso bwa tibial articular, insinga ebyiri za Kirschner za mm 1.6 zijyanye n’ubuso bw’ihuriro zashyizwe hafi y’inkombe z’imbere n’inyuma za tibi na fibula, uko zikurikirana. Inguni iri hagati y’insinga ebyiri za Kirschner yapimwe hakoreshejwe protractor, maze hakoreshwa drill bit ya mm 2.7 mu gucukura umwobo ku murongo wa bisector y’inguni, hagakurikiraho screw ya mm 3.5. Nyuma yo gushyira screw, screw yaciwe ku burebure bwayo hakoreshejwe urukero kugira ngo harebwe isano iri hagati y’icyerekezo cya screw n’umurongo wo hagati wa tibi na fibula.
Igerageza ryakozwe mu buryo bw'ingero ryerekana ko hari uburinganire bwiza hagati y'umurongo wo hagati wa tibia na fibula n'umurongo wa bisector w'inguni, ndetse no hagati y'umurongo wo hagati n'icyerekezo cya screw.
Mu buryo bw’impinduka, ubu buryo bushobora gushyira neza screw ku murongo wo hagati wa tibia na fibula. Ariko, mu gihe cyo kubaga, gushyira insinga za Kirschner hafi y’impande z’imbere n’inyuma za tibia na fibula biteza ibyago byo kwangiza imitsi n’imitsi. Byongeye kandi, ubu buryo ntibukemura ikibazo cyo kugabanuka kw’amaraso mu buryo bukabije, kuko imiterere ya tibiofibular idashobora gusuzumwa neza mbere yo gushyirwaho screw.
Igihe cyo kohereza: 30 Nyakanga-2024
