Abstract ： Intego: Gukora iperereza kubintu bifitanye isano ningaruka zikorwa zo gukoresha icyuma cyimbere imbere kugirango ugarurekuvunika tibial plateau.Uburyo: abarwayi 34 bavunitse tibial plateau babazwe bakoresheje icyuma cyimbere imbere imbere kuruhande rumwe cyangwa ebyiri, bagarura imiterere ya tibal plateau anatomical structure, gukosorwa neza, hanyuma bakora imyitozo hakiri kare nyuma yo kubagwa.Igisubizo: Abarwayi bose bakurikiranwe amezi 4-36, impuzandengo y'amezi 15, ukurikije amanota ya Rasmussen, abarwayi 21 bari beza ， 8 muri good ， 3 mu kwemeza ， 2 mu bakene.Umubare mwiza wari 85.3%.Umwanzuro: Fata amahirwe akwiye yo gukora, koresha uburyo bukwiye kandi ufate imyitozo yimikorere mbere, uduhe ingaruka nziza zo gukora mukuvuratibialkuvunika.
1.1 Amakuru rusange: iri tsinda ryari rifite abarwayi 34 bafite abagabo 26 nabagore 8.Abarwayi bari bafite imyaka 27 kugeza 72 bafite impuzandengo ya 39.6.Habayeho ibibazo 20 by'impanuka zo mu muhanda, 11 byo gukomereka no kugwa 3 bikabije.Imanza zose zafunzwe zavunitse nta gukomeretsa kw'amaraso.Habayeho imanza 3 zo gukomeretsa ligamenti zikomeye, inshuro 4 zo gukomeretsa ingwate na 4 zo gukomeretsa menisk.Ivunika ryashyizwe mu byiciro hakurikijwe Schatzker: imanza 8 zo mu bwoko bwa I, imanza 12 zo mu bwoko bwa II, imanza 5 zo mu bwoko bwa III, imanza 2 zo mu bwoko bwa IV, imanza 4 zo mu bwoko bwa IV na 4 zo mu bwoko bwa VI.Abarwayi bose basuzumwe na X-ray, CT scan yo mu kibaya cya tibial no kwiyubaka mu bice bitatu, naho abarwayi bamwe basuzumwa na MR.Uretse ibyo, igihe cyo kubaga cyari 7 ~ 21d nyuma yo gukomeretsa, ugereranije 10d.Muri ibyo, hari abarwayi 30 bemera kuvura amagufwa, abarwayi 3 bemera gukosorwa kabiri, abarwayi basigaye bemera gukosorwa imbere.
1.2 Uburyo bwo kubaga: bwakozweumugongoanesthesia cyangwa anesthesia intubation, umurwayi yari mumwanya mwiza, kandi yabaga munsi ya pneumatic tourniquet.Kubaga yakoresheje ivi ridasanzwe, imbere ya tibial cyangwa kuruhandeiviInyuma.Indwara ya Coronary yatunganijwe hafi ya Incision ku nkombe yo hepfo ya menisque, kandi igaragaza ubuso bwa arctular yibibaya bya tibial.Mugabanye ibice bya plateau munsi yicyerekezo kiboneye.Amagufwa amwe yabanje gukosorwa hamwe na pin ya Kirschner, hanyuma ashyirwaho namasahani yabigenewe (isahani ya golf, L-plaque, T-plaque, cyangwa ihujwe nicyapa cyo hagati).Inenge yamagufa yari yuzuye amagufwa ya allogenic (kare) hamwe no gushushanya amagufwa ya allograft.Muri icyo gikorwa, umuganga wabaga yatahuye kugabanuka kwa anatomique no kugabanuka kwa anatomiki, akomeza umurongo wa tibial usanzwe, gukosora imbere imbere, guhuza amagufwa hamwe no gushyigikirwa neza.Yabajije ivi na meniscus kugirango isuzume mbere yo gutangira cyangwa ikekwa kuba ikekwa, kandi ikora inzira ikwiye yo gusanwa.
1.3 Kuvura nyuma yo kubagwa: igitambaro cya elastike nyuma yo kubaga kigomba guhambwa neza, hanyuma gutinda kwinjizwamo umuyoboro wamazi, ugomba gucomeka kuri 48h.Inzira isanzwe nyuma yo kubagwa.Abarwayi bafashe imyitozo yimitsi yingingo nyuma ya 24h, hanyuma bakora imyitozo ya CPM nyuma yo gukuraho umuyoboro wamazi kugirango bavunike byoroshye.Uhujije ingwate, ingero zo gukomeretsa inyuma, kwimura ivi nyuma yo gutunganya plaster cyangwa igitereko ukwezi.Dukurikije ibyavuye mu isuzuma rya X-ray, umuganga wabaga yayoboye abarwayi gufata buhoro buhoro imyitozo yo gupakira ibiro, kandi gupakira ibiro byuzuye bigomba gukorwa nyuma y’amezi ane.
Igihe cyo kohereza: Jun-02-2022
