Ivunika rya Tibial plateau rifatanije hamwe no kuvunika kwa tibial shaft bikunze kugaragara mubikomere byingufu nyinshi, 54% bikaba byavunitse.Ubushakashatsi bwakozwe mbere bwerekanye ko 8.4% byavunitse bya tibial plateau bifitanye isano no kuvunika kwa tibial shaft, mugihe 3,2% byabarwayi bavunika tibial shaft bafite ibice byavunitse bya tibial plateau.Biragaragara ko guhuza ibice bibiri bya tibial plateau hamwe no kuvunika kwa shaft ntibisanzwe.
Bitewe nimbaraga nyinshi zimvune nkiyi, akenshi habaho kwangirika kwinyama zoroshye.Mubyigisho, sisitemu ya plaque na screw bifite ibyiza mugukosora imbere imbere kuvunika ibibaya, ariko niba inyama zoroheje zaho zishobora kwihanganira gukosorwa imbere hamwe na plaque na sisitemu nabyo birasuzumwa mubuvuzi.Kubwibyo, kuri ubu hariho uburyo bubiri bukoreshwa muburyo bwo gukosora imbere kuvunika kwa tibial plateau ivanze hamwe no kuvunika kwa tibial shaft:
1. Tekinike ya MIPPO (Minimally Invasive Plate Osteosynthesis) ifite isahani ndende;
2. Imisumari yimbere + umugozi wa plateau.
Amahitamo yombi avugwa mubitabo, ariko kuri ubu nta bwumvikane burenze cyangwa buri munsi ukurikije igipimo cyo gukira kuvunika, igihe cyo gukira kuvunika, guhuza ingingo zo hepfo, hamwe nibibazo.Kugira ngo iki kibazo gikemuke, intiti zo mu bitaro bya kaminuza zo muri Koreya zakoze ubushakashatsi bugereranya.
Ubushakashatsi bwarimo abarwayi 48 bafite imvune ya tibial plateau ihujwe no kuvunika tibial shaft.Muri bo, imanza 35 zavuwe hakoreshejwe tekinike ya MIPPO, hashyizwemo icyapa cy’icyuma kugira ngo gikosorwe, naho 13 zavuwe n’imigozi ya plateau hamwe n’uburyo bwa infrapatellar bwo gukosora imisumari.
▲ Urubanza 1: Icyuma cya MIPPO icyuma cyerekana imbere.Umugabo w'imyaka 42, wagize impanuka y'imodoka, yerekanwe kuvunika tibial shaft (ubwoko bwa Gustilo II) hamwe no kuvunika hagati ya tibial plateau compression (ubwoko bwa Schatzker IV).
Urubanza 2: Tibial plateau screw + suprapatellar intramedullary imisumari imbere.Umugabo w'imyaka 31, wagize impanuka y'imodoka, yerekanwe kuvunika tibial shaft (ubwoko bwa Gustilo IIIa) hamwe no kuvunika kwa tibial plateau plateau (Ubwoko bwa Schatzker I).Nyuma yo gukomeretsa ibikomere hamwe no kuvura ibikomere bibi (VSD), igikomere cyatewe uruhu.Imiyoboro ibiri 6.5mm yakoreshejwe mu kugabanya no gutunganya ikibaya, hakurikiraho gukomeretsa imisumari yimbere ya tibial shaft ikoresheje uburyo bwa suprapatellar.
Ibisubizo byerekana ko nta tandukanyirizo rishingiye ku mibare riri hagati yuburyo bubiri bwo kubaga ukurikije igihe cyo gukiza kuvunika, igipimo cyo gukira kuvunika, guhuza ingingo zo hepfo, hamwe ningorane.
Kimwe no guhuza kuvunika kwa tibial shaft hamwe no kuvunika amaguru cyangwa kuvunika kwa femorale hamwe no kuvunika ijosi ryigitsina gore, kuvunika imbaraga nyinshi zatewe na tibial shaft shaft nabyo bishobora gukomeretsa mumyanya ivi yegeranye.Mubikorwa byubuvuzi, kwirinda indwara mbi ni ikibazo cyibanze mu gusuzuma no kuvura.Byongeye kandi, muguhitamo uburyo bwo gukosora, nubwo ubushakashatsi bugezweho bwerekana ko nta tandukaniro rigaragara, haracyari ingingo nyinshi zo gusuzuma:
1. Mugihe havunitse tibial plateau yamenetse aho gukosora byoroheje bigoye, harashobora gushyirwa imbere mugukoresha isahani ndende hamwe na MIPPO kugirango ihagarike bihagije ikibaya cya tibial, kugarura guhuza hamwe no guhuza ingingo zo hepfo.
2. Mugihe habaye imvune yoroshye ya tibial plateau, munsi yibitero byibasiwe, kugabanuka neza no gukosora imigozi birashobora kugerwaho.Mu bihe nk'ibi, hashobora gushyirwa imbere gukosora screw ikurikirwa na suprapatellar intramedullary imisumari ya tibial shaft.
Igihe cyo kohereza: Werurwe-09-2024
