5 Cov lus qhia rau intramedullary ntsia kho ntawm distal tibial pob txha lov

Ob txoj kab ntawm cov paj huam "txiav thiab teeb tsa txhim kho ntsia dav hlau ntawm cov neeg phais neeg ua haujlwm ntawm kev kho mob Tibia pob txha lov. Txog rau hnub no, nws tseem yog qhov tseem ceeb ntawm kev xav seb phaj screws lossis introedullary ntsia hlau tau zoo dua. Tsis hais leej twg zoo dua nyob rau hauv Vajtswv lub qhov muag, niaj hnub no peb mus ua ib tug saib xyuas cov lus qhia kev phais mob rau kev sib tw ntawm kev sib ntaus sib tsoo.

Preuntative "spare log" teeb

Thaum niaj hnub npaj npaj tsis tsim nyog, nws raug nquahu kom muaj qhov xwm txheej tsis zoo (piv txwv li tsis muaj teeb meem, thiab lwm yam) uas yuav tshwm sim los ntawm kev siv cov ntsia hlau tsis pom kev.

4 lub hauv paus rau kev ua tiav repositioning vam meej

Vim yog lub cev muaj oblique ntawm distal co metaphysis, yooj yim traction yuav tsis ib txwm ua rau muaj kev txo qis. Cov ntsiab lus hauv qab no yuav pab txhim kho qhov ua tiav ntawm kev rov ua tiav:

1. Nqa cov ntaub ntawv ua ntej los yog intraopantitative Orthopantomograms ntawm lub cev noj qab haus huv los sib piv thiab txiav txim siab qhov kev txiav tawm ntawm qhov sib cuam tshuam ntawm sab.

2. Siv lub hauv caug-hloov hauv lub hauv caug los pab txhawb cov ntsia hlau qhov chaw thiab fluoroscopy

3. Siv tus neeg rov ua kom lub cev tso rau hauv qhov chaw thiab ntev

4.Muaj schanz screws nyob rau hauv distal thiab ze rau pab teev rau pab hauv benacture txo.

7 cov ntsiab lus ntawm kev pab txo qis thiab immobilization

1. Tso tus PIN qhia kom raug rau hauv Tibia los ntawm kev siv cov cuab yeej pabcuam tsim nyog lossis los ntawm kev ua ntej tus lej ua ntej tso.

2. Siv cov tawv nqaij-tipped resurfacing catals los tso rau intramed ntsis ntsia hlau hauv kauv thiab oblique pob txha (daim duab 1)

3. Siv cov phaj khuam nrog monocortical fixation (tabular lossis compression phaj) hauv kev qhib kev txo kom txog thaum cov muag khoom tso tawm tau muab tso rau thaum cov ntsia hlau intramed classed

4. Nqaim ntawm intramed clips channel siv block screws los txhim kho cov kev ua tiav ntawm intramedullary ntsia thawv tso (Daim Duab 2)

5. Nyob ntawm hom pob txha lov, txiav txim siab seb puas yuav siv cov ntsia hlau txhim kho thiab thaiv kev sib tshooj ib ntus nrog Schynee lossis Kirschner pins.

6. Tiv thaiv cov pob txha tshiab tshiab thaum siv thaiv cov screws hauv cov neeg mob osteoporotic

7. Txhim kho lub Fibula ua ntej thiab tom qab ntawd tibia nyob rau hauv cov ntaub ntawv ntawm kev sib xyaw ua ke fibula satacture los pab txhawb kev ua haujlwm pubial repositioning

Daim duab 1 Percutaneous Clamp Repositioning Clositioning ClicTure uas qiv nws tus kheej rau kev ua kom zoo nkauj uas ua rau muaj kev puas tsuaj me ntsis rau cov ntaub so ntswg

Daim duab 2 Siv ntawm cov thaiv cov screws Daim duab cuav tom qab kev sib txawv ntawm kev sib txawv ntawm kev sib txawv ntawm kev ua haujlwm ntawm Sagteriation (Fig. thiab c), thiab kev ua haujlwm me me tom qab tso cov lus qhia ntxiv kom kho cov deformity deformity (Daim duab d), thaum tswj hwm sagittal equilibrium (e)
6 cov ntsiab lus rau kev txhim kho intredullary

1. Yog hais tias cov pob txha distal ntawm qhov tawg yog txaus bony, txhawm rau txhim kho qhov chaw ruaj khov ntawm ntau tus ncej), yog li txhawm rau txhim kho cov txheej txheem rigidity.
2. Siv cov ntsia hlau intramedullary uas tso cai rau cov screws kom dhau mus los ntawm thiab tsim cov qauv xauv nrog cov qauv xauv nrog cov kev ruaj khov.
3. Siv cov ntsia hlau tuab, ntau cov screws, thiab ntau cov phiaj xwm ntawm cov ntsia hlau sib distal ntawm kev txhim kho cov nyhuv txhim kho ntawm cov ntsia hlau ntsia hlau.
4. Yog tias cov ntsia thawv intramed clip tau muab tso rau ntau dhau yog tias cov kev nthuav dav ua ntej kev nthuav dav, tom qab ntawd cov tsis tau ua ntej bent guidewire lossis distal tsis siv tau.
5. Khaws cov ntsia hlau thaiv thiab lub phaj kom txog thaum lub pob txha tawg yog txo qis, tshwj tsis yog cov ntsia hlau thaiv tsis pub dhau tus pob txha lossis daim phiaj uas puas tsuaj rau cov ntaub mos muag.
6. Yog tias cov ntsia hlau intramedullary thiab cov screws tsis muab kev daws kom txaus thiab cov ntsia hlau kom tau ntxiv kom muaj kev ruaj ntseg ntawm cov ntsia hlau.

Nco

Ntau tshaj 1/3 ntawm Distal Tibia Fibia FLVOILE koom nrog kev sib koom tes. Tshwj xeeb, kev sib tsoo ntawm cov kev sib txawv ntawm cov kab nyob deb, muab cov kauv ciav pob zeb tawg, lossis cuam tshuam nrog cov kab mob sib zog sib luag, lossis cuam tshuam nrog cov kab mob sib zog sib zog sib zog. Yog tias muaj, cov pob txha intra, Articular puas yuav tsum tau tswj cais ua ntej tso rau ntawm cov ntsia hlau ntsia hlau.