Uburyo bwo kubaga

Incamake: Intego: Gukora iperereza ku bintu bifitanye isano bifasha mu mikorere yo gukoresha uburyo bwo gufunga imbere mu cyuma kugira ngo gisubizehokuvunika kw'ikibaya cy'umugongoUburyo: Abarwayi 34 bavunitse igituza cya tibial babazwe hakoreshejwe uburyo bwo gufata imbere mu cyuma uruhande rumwe cyangwa ebyiri, basana imiterere y'umubiri wa tibial, bashyiraho uburyo bwo gufata neza, kandi bakora imyitozo ngororamubiri hakiri kare nyuma yo kubagwa. Ibisubizo: Abarwayi bose bakurikiranwe mu mezi 4-36, impuzandengo y'amezi 15, hakurikijwe amanota ya Rasmussen, abarwayi 21 bari mu bihe byiza cyane, 8 bari mu bihe byiza, 3 bari mu bihe byemewe, 2 bari mu bihe bibi. Igipimo cyiza cyane cyari 85.3%. Umwanzuro: Fata amahirwe yo kubagwa akwiye, koresha uburyo bukwiye kandi ukore imyitozo ngororamubiri mbere, biduha ingaruka nziza zo kubagwa mu kuvura.igishishwa cy'umugongokuvunika kw'ikibaya.

1.1 Amakuru Rusange: Iri tsinda ryari rifite abarwayi 34, harimo abagabo 26 n'abagore 8. Abarwayi bari hagati y'imyaka 27 na 72, bafite imyaka 39.6. Hari 20 bakomeretse mu mpanuka zo mu muhanda, 11 bakomeretse mu kugwa n'abantu 3 bakomeretse cyane. Abantu bose bari bakomeretse mu mitsi badakomeretse. Hari 3 bakomeretse mu mitsi, 4 bakomeretse mu mitsi n'abantu 4 bakomeretse mu mitsi. Abakomeretse mu mitsi bashyizwe mu byiciro hakurikijwe Schatzker: 8 bakomeretse mu mitsi yo mu bwoko bwa I, 12 bakomeretse mu bwoko bwa II, 5 bakomeretse mu bwoko bwa III, 2 bakomeretse mu bwoko bwa IV, 4 bakomeretse mu bwoko bwa V n'abantu 3 bakomeretse mu bwoko bwa VI. Abarwayi bose basuzumwe hakoreshejwe X-ray, CT scan ya tibial plateau no kongera kubakwa mu buryo butatu, kandi bamwe mu barwayi basuzumwe na MR. Uretse ibyo, igihe cyo kubagwa cyari hagati y'iminsi 7 na 21 nyuma y'imvune, impuzandengo ya 10. Muri abo, hari abarwayi 30 bemeye kuvurwa no guterwa amagufwa, abarwayi 3 bemeye guterwa ibyuma bibiri, abandi barwayi bemeye guterwa imbere mu ruhande rumwe.

1.2 Uburyo bwo kubaga: bwakozweumugongoikinya cyangwa ikinya cyo mu muyoboro w'amaraso, umurwayi yari aryamye mu ntebe ye, kandi yabazwe hakoreshejwe uburyo bwo gukaraba uruhu. Kubaga byakoreshejwe mu ivi rya anterolateral, anterior tibial cyangwa lateral.ingingo y'iviIcamo ry'inyuma. Icamo ry'umutima ryaciwe ku ruhande rw'Icamo ku nkengero yo hasi ya meniscus, maze rigaragaza ubuso bw'ingingo y'ikibaya cya tibial. Kugabanya imvune za plateau mu gihe cyo kureba neza. Amagufwa amwe yabanje gushyirwaho imigozi ya Kirschner, hanyuma ashyirwaho plaque zikwiye (golf-plate, L-plates, T-plate, cyangwa hamwe na medial buttress plate). Ubusembwa bw'amagufwa bwuzuyemo allogeneic bone (hakiri kare) na allograft igufwa grafting. Mu kubaga, umuganga wabaga yabonye ko allogeneity igabanuka kandi agabanya proximal anatomial resolution, akomeza tibial axis isanzwe, akomera imbere, atsindagiye amagufwa kandi ashyigikiwe neza. Yasuzumye ligament y'ivi na meniscus kugira ngo amenye niba hari ibimenyetso mbere yo kubagwa cyangwa niba hari abakekwaho kubagwa, kandi akora inzira ikwiye yo gusana.

1.3 Uburyo bwo kuvura nyuma yo kubagwa: igitambaro cyo gufunga amaguru nyuma yo kubagwa kigomba gupfundikirwa neza, hanyuma hagashyirwamo agace gafunganye n'umuyoboro w'amazi nyuma y'amasaha 48. Gutera ububabare buri gihe nyuma yo kubagwa. Abarwayi bakoze imyitozo ngororamubiri nyuma y'amasaha 24, kandi bakora imyitozo ya CPM nyuma yo gukuramo umuyoboro w'amazi kugira ngo bavunike byoroshye. Bahuje imitsi y'amaraso, imitsi y'inyuma, bazunguza ivi mu buryo bufatika kandi butagira aho buboga nyuma yo gushyiraho plaster cyangwa brace mu gihe cy'ukwezi kumwe. Dukurikije ibyavuye mu isuzuma rya X-ray, umuganga w'inzobere mu kubaga yayoboye abarwayi gukora imyitozo yo gushyiramo ibiro buhoro buhoro, kandi imitsi yuzuye igomba gukorwa nibura nyuma y'amezi ane.