Imvune ya Ankle ni igikomere rusange cya siporo kibaho hafi 25% yimvune zigera kuri 25%, hamwe na ligamel ligetike yinyuma (LCL) ibikomere (LCL) bikomeretsa. Niba ibintu bikomeye bidafashwe mugihe, biroroshye kuganisha ku masoko asubirwamo, kandi hazagirana imanza zikomeye bizagira ingaruka kumikorere ya Akle. Kubwibyo, ni asobanura cyane gusuzuma no kuvura ibikomere by'abarwayi mu cyiciro cya mbere. Iyi ngingo izibanda kubuhanga bwo gusuzuma bushingiye ku bushakashatsi bwakozwe ku gice cy'intoki z'igifuniko gifasha abaganga kunoza ukuri kwisuzumisha.
I. Anatomy
Ingoma yimbere ya Taripaire (ATFL): Byahinduwe, byahujwe na capsule ya papsule, gutangiza imbere kuri fibula no kurangiza imbere kumubiri wa talus.
Lige ya Calcaneofibular (CFL): Igiti-gifatika, gikomoka ku mupaka wuruhande rwa Malileolus ya kure ya Mainleolus no kurangiza muri Calcaneus.
Isosiyete yinyuma ya Tapotwiish (PTFL): ikomoka hejuru yuburi hagati ya Mainleolus kuruhande rwa Mainleolus irangira inyuma ya Talus.
ATFL yonyine yabazwe hafi 80% by'imvune, mu gihe Atfl yahujwe n'imvune za CFL zatewe na 20%.
Igishushanyo cya Schematic hamwe nigishushanyo cya anatomique cyinteko ya ingwate kuruhande rwibirenge
II. Uburyo bwo gukomeretsa
Kuvukaho ibikomere: imvugo yimbere ya marterior
Gukomeretsa Calcaneofibular Imvune: Calcaneofibumer
III. Gukomeretsa
Icyiciro I: Kungurana ibitekerezo, nta bufatanye bugaragara, ni gake kubyimba cyangwa ubwuzu, kandi nta kimenyetso cyo gutakaza imikorere;
Icyiciro cya II: Gukuramo igice cya Macroscopique ya ligamenti, ububabare buciriritse, buciriritse, kubyimba, no guturagura, no kudatera ubwoba imikorere ihuriweho;
Icyiciro cya III: Ligament irasenyutse rwose kandi itakaza ubusugire bwayo, iherekejwe no kubyimba cyane, kuva amaraso n'ubwuzu, biherekejwe no gutakaza imikorere no kwigaragaza.
IV. Isuzuma rya Clinical Imbere yikizamini
Umurwayi yicaye hamwe n'ivi kandi impera y'inyana irangirira, kandi ushinzwe ibizamini afite tibia mu kiganza kimwe hanyuma agasunika ikirenge imbere y'urutingo hamwe n'undi.
Ubundi, umurwayi agura cyangwa yicaranye n'ivi ritiriwe kuri dogere 60 kugeza kuri 90, agatsinsino kashyizwe hasi, kandi usuzuma akoresha igitutu cyingenzi kuri tibia yinyuma.
Gutembera neza gutobora ligamene yimbere.
IKIZAMANIRE CY'IKIZAMANIRE
Amaguru ya Proximad yahagaritswe, kandi imihangayiko ya vartus yakoreshejwe kuri marike ya kure kugirango isuzume talus.
Ugereranije n'impande zinyuranye,> 5 ° ni byiza, na> 10 ° ari byiza; cyangwa kugenzurwa> 15 ° ari byiza.
Uwahanuye neza muri CalcaneofibuUlar Rupture.
Ibizamini
X-Imirangire ya siporo isanzwe ya siporo
X-Imirasire ni mbi, ariko MRI yerekana amarira yinjira muri colopibular na Calcaneofibubument ligaments
Ibyiza: X-ray nuburyo bwambere bwo gusuzuma, ubukungu kandi bworoshye; Umwanzuro w'imvune ucirwa urubanza no gucira urubanza impamyabumenyi. Ibibi: Kwerekana nabi imiterere yoroshye, cyane cyane inzego za ligamentous zingenzi mugukomeza gushikama.
MRI
Igishushanyo.1 20 ° Umwanya wa Oblique werekanye imvugo nziza yimbere yimbere (ATFL); Igishushanyo.2 Umurongo wa ATFL
MRI amashusho yibyorezo bitandukanye byimbere bya colopibular byerekanwe ko: (a) imvugo yimbere yimbere yijimye kandi edema; (B) amarira ya colopibular colopibular; (C) guturika kw'indimi nkuru y'imbere; .
Igishushanyo cya3
Igishushanyo cya 4. CFL Scanning Azimuth
Amarira akingubu, yuzuye ya ligamen ya CalcaneofibuUlar
Igishushanyo 5: Reba Coronal yerekana imvugo nziza yinyuma ya taliof igana (PTFL);
FIG.6 PTFL Scan Azimuth
Amarira igice cya ligamele yinyuma
Gutanga disikuru:
Icyiciro I: Nta byangiritse;
Icyiciro II: Kwishima kwa Ligamesi, Ibyiza Gukomeza, Bwiriza Ama ligaments, HyPechogenity, Edema yimpapuro zikikije;
Icyiciro cya III: Igishushanyo mbonera cya Lilophode, Kuroroshye cyangwa Guhungabana Igice
Icyiciro cya IV: Guhagarika byuzuye birakomeza kubaho, bishobora guherekezwa no kuvunika avulsire, bigoramiye amavuta, kandi byiyongereye ibimenyetso byaho cyangwa byoroshye ibimenyetso byaho.
Ibyiza: Icyemezo cyo gukemura hejuru yimyenda yoroshye, kureba neza ubwoko bwimvune; Irashobora kwerekana ibyangiritse bya Cartilage, ubukungu, hamwe nubuzima rusange bwo gukomeretsa.
Ibibi: Ntibishoboka kumenya neza niba ibivuzaga hamwe no kwangiza ibimenyetso bya karitsiye. Bitewe no kugorana kwamaguru, imikorere yikizamini ntabwo ari hejuru; Bihenze kandi bitwara igihe.
Ultrassound
Igishushanyo 1a: Gukomeretsa byingenzi bya karokibilar, amarira igice; Igishushanyo 1b: imvugo yimbere yimbere irashirwaho rwose, igishyitsi kirabyibuwe, kandi effsion nini igaragara mumwanya wuruhande rwimbere.
Igishushanyo 2a: Gukomeretsa Calcaneofibule, amarira igice; Igishushanyo 2b: Gukomeretsa Calcaneofibule, Rupture yuzuye
Igishushanyo 3a: Ligamenti yimbere yimbere: ishusho ya ultrasound yerekana imiterere yuburyo bwa sinahuri; Igishushanyo
Igishushanyo 4a: Amarira igice cyamagambo yimbere yimbere kuri ultrasound ishusho ya ultrasound; Igishushanyo 4B: Amarira yuzuye ya ligamen ya Calcaneofibular kumashusho ultrasound
Gutanga disikuru:
Stowsion: Amashusho ya acoustic yerekana imiterere yimiterere, yijimye kandi yabyimbye ligaments; Amarira igice: Muri Ligede hari kubyimba, harakomeje guhungabana bahoraho, cyangwa fibre zinanutse. Scanic scan yagabanutse cyane cyane yacika intege cyane, kandi ligament yoroheje kandi yiyongereye kandi delastike yagabanutse kubijyanye na valgus cyangwa vatusi.
Amarira yuzuye: rwose kandi rwose yahagaritse gutandukanya manda, scan dinamic yerekana ko nta amarira ya ligamen cyangwa yongereye amarira, kandi muri valitus cyangwa vartus, nta gaciro, nta gaciro hamwe na hamwe.
Ibyiza: Igiciro gito, byoroshye gukora, kudatera; Imiterere yoroshye ya buri gice cya tissue ya subcutaneous igaragara neza, zifasha kwitegereza ibikomere bya musculoskeletal. Ikizamini kidasanzwe, ukurikije umukandara wa ligament kugirango ugaragaze inzira yose ya ligament, aho imvune yo kwikomeretsa
Ibibi: Gukora ibintu byoroheje-tissue ugereranije na MRI; Shingira kubikorwa bya tekiniki yabigize umwuga.
Kugenzura Arthroscopy
Ibyiza: Witondere neza imiterere ya Malleolus ya Mainleolus na Hindfoot (nka ligament ya talig, ligameni yimbere, nibindi) gusuzuma ubusugire bwa ligamengement no gufasha kubaga.
Ibibi: Gutera, birashobora gutera ingorane zimwe, nkangiza imitsi, kwandura, nibindi byafatwa nkibisanzwe byo gusuzuma imvura nyinshi kandi bigakoreshwa ahanini mugufata ibikomere bya ligamen.
Igihe cyohereza: Sep-29-2024
