Uburyo busanzwe bwo kwiyegereza nuburyo bwa kera bwo kuvura bukururwa bukururwa bwa calcaneal. Nubwo imurika ryuzuye, gutemangira igihe kirekire kandi tissue yoroshye yambuwe ibirenze ubumwe nko gutinda muri tissue yoroshye, necrosis, no kwandura. Hamwe na societe iriho ikurikirana ryingengabiro idakura, ubukungu bwibajije iteye ubwoba yo kuvura caday yashizweho cyane. Iyi ngingo yakusanyije inama 8.
Hamwe nuburyo bukabije bwikiruhuko, igice gihagaritse cyagutse gitangira gusoza gato kugeza kuri fibula no imbere kuri Achillendo. Urwego rwaciwe gusa kuruhu rwakomeretse rwagaburiwe nububiko bwa Calcaneal kuruhande rwibanze hanyuma ushiremo inyuma ya Metatarsal ya gatanu. Ibice byombi bihujwe na HEEL kugirango ikore angle igoramye gato. Inkomoko: Kubaga amagufshi.
PKugabanuka
Mu myaka ya za 1920, Böhler yateje imbere uburyo bukabije bwo kugabanya ubutunzi bwo gukururana, kandi igihe kinini cyo kugabanuka mu gukopera, kugabanuka kw'ibitego bibaye uburyo bwo gukurungura buba uburyo bwo kuvura Calcane.
Birakwiriye kuvunika hamwe no kwihererekanya ibice byamazi muri suctaarticular mu ruganda rwa subtaralar, nka sanders Ubwoko bwa II na Sanders ya III.
Kuri Sanders Ubwoko bwa III kandi byemejwe Ubwoko bwa IV Kuvura Inyenzi Zikabije Zisenyutse, Kugabanya Ububiko Bukomeye biragoye kandi biragoye kugera ku kugabanya Anatoomical articular
Biragoye kugarura ubugari bwa Calcaneus, kandi ubumuga ntibushobora gukosorwa neza. Bikunze gusiga urukuta rwa Calcaneus muri dogere zitandukanye, bikaviramo ingaruka za malleolus yo hepfo hamwe na rukuta rwa Calcaneus, cyangwa kwimura Tendon ya Perune. Syndrome, ububabare bwa Calcaneal, na Perunesi Longtis Mandasonis.
WesthUes / Essex-Lopresti. A. BLOOROSCOPY BLOOROSCOPY YAZEYE URUKUNDO RW'INGENZI; B. Indege itambitse CT Scan yerekanaga ivuza rya sandess. Igice cyimbere cya Calcaneus cyakozwe neza mumashusho yombi. S. Gutwara intera gitunguranye.
C. Gukuramo kuruhande ntibishobora gukoreshwa kubera imitego yoroshye yoroshye kubyimba no guhubuka; D. Fluoroscopy itagaragara yerekana ubuso bwa articular (umurongo utudomo) na talar gusenya (umurongo ukomeye).
E na F. Imisumbe ibiri yo kuyobora imisunga yashyizwe kumurongo wo hepfo yigice cyo hepfo yimiterere, kandi umurongo utudomo nu murongo uhuriweho.
G. Flex Ivi, Pry hejuru ya PIN, kandi icyarimwe igicapo cyo munsi yo kugabanya imiyoboro ya cuboid hamwe ninsinga za cuboid hamwe ninsinga ebyiri za cuboid hamwe ninsinga ebyiri za Cuboid zarinze kugabanuka kubera ko yinjira muri Calcaneus. Inkomoko: Ikirenge cya Mann na Ankle kubaga ibirenge.
SInus Tarsi
Guhagarika bikozwe na cm 1 kurikirana hejuru ya fibula kugera inyuma ya metatarsal ya kane. Mu 1948, Palmers yabanje gutangaza ko hatomozwa gato muri sinus Tarsi.
Muri 2000, Ebmheim et al. yakoresheje uburyo bwa siteli buteye imbere mubuvuzi bwo kuvunika ca calcaneal.
o Irashobora kwerekana byimazeyo ibikorwa bya subtalar, hejuru yinyuma yubuso bwa arterolatio hamwe no kuvunika ibinyaminitse;
o Irinde bihagije imiyoboro y'amaraso yaka umuriro;
O nta mpamvu yo kugabanya imvura ya Calcaneofibume na retinaculum na subperoneal, kandi umwanya uhuriweho urashobora kwiyongera no kwiyongera gukwiye mugihe cyo gukora, gifite ibyiza byo gutemaka no kuva amaraso make.
Ibibi nuko guhura biragaragara ko bidahagije, bigarukira kandi bigira ingaruka kugabanuka no gushyiramo gukosorwa imbere. Birakwiriye gusa kubwoko bwa sanders I hamwe no kwandika II Calcaneal II Calcaneal.
Oblique ntoya
Guhindura Sinus Tarsi, hafi cm 4 z'uburebure, cm 2 zibanze munsi ya malleolus kuruhande rwa malleolus kuruhande rwa malleolus na parallel kumurongo winyuma.
Niba imyiteguro yabanjirije kandi ihagije kandi irashobora kandi kugira igabanuka kandi igakosora kuri sanders ubwoko bwa sanders II na III intera ya Calcaneal; Niba subtarelar guhuriza hamwe bisabwa mugihe kirekire, gutemagura bimwe birashobora gukoreshwa.
PT Peroneal Tendon. PF inyuma yinyuma ya Calcaneus. S sinus tarsi. AP Calcaneal Protrusion. .
Inyuma yinyuma
Guhera hagati yumurongo hagati yumurongo wa Achillendo na Malleolus kuruhande, itanga ihagaritse kuri talar agamije ka talar, ifite uburebure bwa cm 3,5.
Gutemandurwa bike bikozwe muri tissue yoroshye cyane, nta kwangiza imiterere yingenzi, kandi ubuso bwinyuma bwumuhanzi buragaragara neza. Nyuma yo gushira no kugabanuka kwinshi, inama ya anatomique yinjijwe mu buyobozi bw'ibitekerezo by'umuntu, kandi imigozi ya Perrataneous yakubiswe kandi igashyirwaho igitutu.
Ubu buryo burashobora gukoreshwa kuri sanders ubwoko bwa nde, II, na III, cyane cyane kubintu byimuwe cyangwa kuvugurura amashuri.
HerringBone yaciwe
Guhindura Sinus Tarsi. Kuva kuri cm 3 hejuru yisonga rya Malleolus kuruhande, kumupaka wimbere wa fibula kugeza kuri Malleolus kuruhande rwa Mainleolus kuruhande, hanyuma ugere inyuma ya metatarsal ya kane. Iremerera kugabanuka neza no gukosora amande ya Sanders II naI CAILCAAL TOCTINE, kandi irashobora kongerwa nibiba ngombwa gushyiramo ibisobanuro, Talus, cyangwa inkingi yikirenge.
Lm. MT Metatarsal hamwe. SP SPRA fibula retinaculum.
AKugabanya Rthroscopique
Mu 1997, Rammelt yasabye ko arttarcopi ya subharcopi yo kugabanya ubuso bwinyuma bwa Calcaneus munsi yeretswe. Muri 2002, Rammelt yabanje gukorerwa arthnarocopique igabanywa burundu kandi ikoporora ikosora kuri sanders ubwoko bwa sanders I na II kuvunika.
Subtar Arthroscopi cyane igira uruhare runini kandi ifasha. Irashobora kwitegereza imiterere yubuso bwa subtalar munsi yerekuye itaziguye, kandi ifashe mugugabana kugabanuka no gukosorwa imbere. Kurohama Byuzuye Subtarelar na Osteophyte hashobora gukorwa.
Ibimenyetso ni bigufi: gusa kuri sanders ubwoko bwa sanders ⅱ hamwe nubwitonzi bworoheje bwubuso bwa Articular na Ao / OTA Ubwoko bwa 83-C2; Mugihe kuri sanders ⅲ, ⅳ na Ao / OTA Ubwoko bwa 83-C3 kuvunika hamwe nubuso bwa articular gusenyuka nka 83-C4 na 83-c4 biragoye gukora.
umwanya wumubiri
b. Inyuma yinyuma ankle arthroscopi. c. Kugera ku kuvunika no kugabanywa.
Imigozi ya Schantz yashyizwe.
e. Gusubiramo no gukosora by'agateganyo. f. Nyuma yo gusubiramo.
g. Gukosora by'agateganyo amagufwa yubuso. h. Gukosora ukoresheje imigozi.
Njye. Nyuma ya SAGITTAL CT Scan. j. Ibitekerezo bya posita.
Mubyongeyeho, umwanya wa sundalar uhari ni muto, kandi tract cyangwa utwugarizo hakenewe kugirango ushyigikire umwanya uhuriweho kugirango woroshye gushyira ahagaragara arthroscope; Umwanya wo gucuranga amategeko ni muto, kandi utabimenyesheje manipulation irashobora gutera byoroshye Itangazo rya Cargegenic Cartilage yangiritse; Ubuhanga bwo kubaga butari bubi bukunze gukomeretsa byateguye.
Pblcutaneous balloon angioplasty
Muri 2009, Bano yasabye bwa mbere tekinike ya ballon yamugaye yo kuvura imivuza. Kuri Sanders Ubwoko bwa II kuvunika, ibyinshi mubitabo bireba ingaruka kubisobanuro. Ariko ubundi bwoko bwimivurungano buragoye.
Amagufwa amaze kwinjira mumwanya wa subtalar mugihe cyibikorwa, bizatera kwambara hejuru yicyifuzo cya articular hamwe nigikorwa cyihuse, kandi kwagura ballon ntibizashyira mu gaciro byo kugabanuka.
Gushyira urusaku no kuyobora insinga munsi ya flueroscopy
Amashusho mbere na nyuma yifaranga rya Airbag
X-ray na ct amashusho hashize imyaka ibiri kubagwa.
Kugeza ubu, ubushakashatsi bwikoranabuhanga rya tekinoroji ya ballon ni buto, kandi byinshi byo kuvunika hamwe nibisubizo byiza biterwa n'ihohoterwa rikorerwa. Ubundi bushakashatsi buracyakenewe kuvunika ca calcaneal hamwe no kwimurwa gukabije. Byakozwe mugihe gito, kandi imikorere miremire nibibazo biracyasobanutse.
CAlcaneal Intramedily Umusumari
Mu mwaka wa 2010, intera ya Calcaneal Intramediller irasohoka. Muri 2012, M.Goldzak idahuye cyane no kuvura ivuka rya Calcanesi hamwe na Intramedillary imisumari. Bikwiye gushimangirwa ko kugabanya bidashobora kugerwaho hamwe nintera imisumari.
Shyiramo Igice Cyiza PIN, FLOSROSCOPY
Gusubiramo ingingo ya subtalar
Shira umwanya wo guhagarara, utware intera umusumari, hanyuma uyikosore ukoresheje imigozi ibiri ya mm 5
Ibitekerezo nyuma yo gushira imisumari.
Inkwavu ya Intramedollary yerekanwe kugirango itsinde ivura rya Sanders Ubwoko bwa II na III. Nubwo abaganga bamwe bagerageje kubishyiramo sanders iv kuvunika iv, ibikorwa byo kugabanya byari bigoye kandi byingirakamaro ntibishobora kuboneka.
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