Uburyo bwo Kubaga | Ipsilateral Femoral Condyle Graft Internal Fixation mu kuvura kuvunika kwa Tibial Plateau

Gucika kw'ikibaya cy'inyuma cyangwa kugwa kw'ikibaya cy'inyuma ni bwo bwoko bukunze kugaragara bwo kuvunika kw'ikibaya cy'inyuma. Intego y'ibanze yo kubaga ni ukugarura uburyo ingingo zigenda neza no gushyira ku murongo igice cyo hasi. Iyo igice cy'inyuma cyaguye, iyo gisize inenge y'amagufwa munsi y'ikibaya, akenshi bisaba gushyiramo igufwa rya autogenous iliac, igufwa rya allograft, cyangwa igufwa ry'ubukorano. Ibi bifite intego ebyiri: iya mbere, gusubizaho inkunga y'imiterere y'amagufwa, iya kabiri, guteza imbere gukira kw'amagufwa.

Bitewe n'inyongera yo gukata igufwa rya iliac rikenewe ku igufwa rya autogenous iliac, bigatera imvune nyinshi zo kubagwa, ndetse n'ibyago bishobora guterwa no kwangwa no kwandura bifitanye isano n'igufwa rya allograft n'igufwa ry'ubukorano, bamwe mu bahanga batanga ubundi buryo mu gihe cyo kugabanya no gufunga imbere mu gice cy'imbere cy'ikirenge (ORIF). Batanga inama yo kongera gukata igufwa rimwe hejuru mu gihe cyo kubagwa no gukoresha agashishwa k'igufwa gashobora gukurwa mu gice cy'imbere cy'ikirenge. Raporo nyinshi z'imanza zagaragaje ubu buryo.

Ubushakashatsi bwakozwe ku bantu 12, bufite amakuru yuzuye yo gukurikirana amashusho. Ku barwayi bose, hakoreshejwe uburyo busanzwe bwo gufata igufwa ry’imbere mu gice cy’imbere cy’ikirenge cya tibial. Nyuma yo gushyira igufwa ry’ikirenge mu gice cy’imbere cy’ikirenge cya tibial, hakozwe icyuho cyongerewe hejuru kugira ngo hagaragare igufwa ry’imbere ry’ikirenge. Hakoreshejwe icyuma gikura amagufwa cya Eckman cya 12mm, kandi nyuma yo gucukura igufwa ry’inyuma ry’ikirenge cya femoral, igufwa rya cancellous ryavuye mu gice cy’imbere cy’ikirenge ryakusanyijwe inshuro enye. Ingano yabonetse yari hagati ya 20 na 40cc.

Nyuma yo kuhira umuyoboro w'amagufwa inshuro nyinshi, sponge yo mu bwoko bwa hemostatic ishobora gushyirwamo bibaye ngombwa. Igufwa ryakuwemo rishyirwa mu igufwa rifite inenge munsi y'ikibaya cy'inyuma cya tibial, hanyuma hagakurikiraho gushyirwa imbere mu buryo buhoraho. Ibisubizo bigaragaza:

① Kugira ngo imiterere y'imbere y'ikibaya cy'amagufwa ikomeze, abarwayi bose bakize imvune.

② Nta bubabare bukabije cyangwa ingorane zagaragaye aho igufwa ryakuwe mu gice cyo ku ruhande.

③ Gukira kw'igufwa aho ryasaruwe: Mu barwayi 12, 3 bagaragaje ko bakize burundu igufwa ry'umutima, 8 bakize igice, naho 1 nta gukira kugaragara kw'igufwa ry'umutima.

④ Imiterere y'amagufwa mu gice cy'isarura: Mu bihe 9, nta miterere y'amagufwa yagaragaye, kandi mu bihe 3, hagaragaye igice cy'amagufwa mu gice cy'ishusho.

⑤ Ingorane za osteoarthritis: Mu barwayi 12, 5 barwaye rubagimpande nyuma yo gukomereka mu ivi. Umurwayi umwe yasimbuwe ingingo nyuma y'imyaka ine.

Muri make, gukuramo igufwa rya cancellous mu gice cya ipsilateral lateral femoral condyle bitanga gukira neza kw'amagufwa ya tibial plateau hatabayeho kongera ibyago byo kugira ibibazo nyuma yo kubagwa. Ubu buryo bushobora gusuzumwa no kwifashishwa mu buvuzi.