Thaum xaiv txoj kev kho mob rau kev sib txawv sib zog, txhim kho sab nraud tuaj yeem siv los ua kev kho kom zoo ib ntus nrog kev raug mob ntawm cov nqaij mos muag.
Qhia Qhia:
"Kev tswj kev puas tsuaj" kev kho kom zoo ib ntus nrog cov nqaij mos tseem ceeb, xws li qhib cov pob txha lov lossis kaw cov pob txha mos kaw nrog cov nqaij mos tseem ceeb o.
Kev kho mob los txawv, lossis pob txha uas muaj kab mob pob txha, lossis pob txha uas muaj cov nqaij mos mos hnyav.
EXayine:
Mos cov nqaij mos: ①open qhov txhab; Lub cev muag muag cov nqaij mos muag muag tsis yooj yim, cov nqaij mos o. Txheeb xyuas cov xwm txheej neurovascular thiab ua tib zoo sau.
Kev Ntsuam Xyuas: Anteroposterior thiab liglal x-rays ntawm tibia, thiab anteroposter, tom qab thiab pob luj taws acupoints ntawm pob luj taws. Yog tias muaj ib qho kev xav tsis thoob pob txha
ANatomy:·
Lub anatomical "cheeb tsam nyab xeeb" rau kev txhim kho sab nraud tus pin tso cai tau txhais raws li kev sib txawv ntawm kev sib kis.
Tus neeg ua yeeb yam metaphysis ntawm Tibia muab 220 ° exterior arc-puab qhov chaw nyab xeeb qhov twg tuaj yeem muab tso rau hauv pins sab nraud.
Lwm qhov chaw ntawm Tibia muab ib lub tsev muaj kev nyab xeeb rab koob ntxig thaj tsam hauv thaj tsam ntawm 120 ° ~ li ntawm 120 ° ~ 140 °.
SKev Kawm Ceev
Txoj Haujlwm: Tus neeg mob nyob ntawm ib qho X-PD Transparent ua haujlwm lub rooj, thiab lwm yam xws li lub ncoo lossis txee tau muab tso rau hauv qab ntawm cov ceg tawv kom pab tswj hwm txoj haujlwm. Tso rau hauv ncoo nyob rau hauv ipsilateral hip rotates tus ceg cuam tshuam rau sab hauv yam tsis muaj kev sib hloov sab nraud.
Akev nyob hoom
Feem ntau, kev phais me me yog ua nyob rau hauv tibia, calcaneus, thiab thawj zaug metatarsal rau qhov chaw sab nraud txhim kho pins ·
Fibula Cov pob txha pob tau yooj yim dua tsau los ntawm palpable tom qab sab subcutaneous ciam teb.
Kev sib tsoo ntawm cov paude vault muaj kev sib koom ua ke tuaj yeem ua tau tsau percutaneously. Yog tias cov ntaub so ntswg tso cai, thiab yog tias tsim nyog, ib txwm muaj kev sib tw lossis kev kho mob tuaj yeem siv rau kev kho kom zoo. Yog tias kev txhim kho sab nraud tsuas yog siv los ua kev ntsuas ib ntus, cov koob nkag mus yuav tsum tau muab tso rau qhov chaw sab nraud kom tiv thaiv cov nqaij mos mos los tiv thaiv cov nqaij mos mos. Thaum ntxov kho ntawm Fibula thiab Intra-articular tawg yooj yim rau kev yooj yim txhim kho.
Cov kev ceev faj
Yuav ceev faj ntawm sab nraud txhim kho tus pin taug txoj kev sib txuas ntawm cov ntawv phais pov tseg, uas yog cov ntaub qhwv tsis huv yuav ua rau rov qab cov teeb meem. Kev ua haujlwm tsis tu ncua lossis kev sib tham nrog cov nqaij mos tseem ceeb o tuaj yeem ua rau muaj kev phom sij hnyav.
Txo thiab txhim kho ntawm fibula tawg:
Thaum twg cov ntaub so ntswg mos rau, cov pob txha fibula yog kho ua ntej. Cov fibular bacture yog txo thiab tsau siv cov kab ke fibular phais, feem ntau nrog 3.5mm Lag luam screws thiab 3.5mm L / 5 raj phaj, lossis 3.5mm LCDC phaj thiab screws. Tom qab fibula yog anatomically txo thiab tsau, nws tuaj yeem siv ua tus qauv rau rov ua qhov ntev ntawm tibia thiab kho cov kev sib hloov ntawm kev sib dhos.
Cov kev ceev faj
Cov nqaij mos mos mos o tuaj o los yog qhib qhov txhab yuav tiv thaiv kev ua haujlwm txhim kho ntawm Fibula. Ceevfaj tsis txhob kho cov pob txha fibular thiab ceev faj kom raug mob rau cov neeg ua phem rau lub paj hlwb.
Ntau lub pob txha pob zeb: txo thiab kho sab hauv
Kev-articular pob txha ntawm tibial vault yuav tsum tau txo qis ncaj qha los ntawm kev sib txawv ntawm kev sib txawv ntawm cov fluoroscopy.
Thaum tsav lub Lag Ntsia Hlau, Qhov Txhiab Fracture yuav tsum tau tsau nrog Kirschner xaim ua ntej.
Kev txo kom ntxov thiab kev txhim kho ntawm cov khoom lag luam intra-articular tso cai rau cov txheej txheem tsis txaus ntseeg thiab kev hloov pauv tau ntau dua nyob rau hauv theem nrab. Tsis muaj cov ntaub so ntswg tsis zoo xws li cim o lossis cov ntaub so ntswg muag tawv me me tuaj yeem tiv thaiv thaum ntxov ntawm cov khoom tawg.
TIBIAL SPATTATE: Transarticular Sab Nraud
Tus ntoo khaub lig-sib koom tes sab nraud kho tau tuaj yeem siv.
Raws li cov cai ntawm qib thib ob-qib tsis zoo, ob 5 hli ib nrab-fixised pins tau ntxig rau hauv tibia ntawm qhov kawg ntawm kev tawg.
Ua ntej bluntly dissect rau pob txha nto, tom qab ntawd tiv thaiv cov nqaij mos uas nrog cov ntaub so ntswg mos tiv thaiv, thiab tsav cov ntsia hlau los ntawm lub tes tsho.
Lub tsev kho sab nraud dawb nyob rau ntawm qhov kawg ntawm qhov tawg tuaj yeem tso rau ntawm cov thooj dej sib tsoo tuaj yeem tso tau rau ntawm cov ntshav sib dhos, cov kab caj ntoo thiab thawj caj dab, lossis caj dab ntawm cov talus.
Transcalcaneal sab nraud Txhim Kho Pins yuav tsum tau muab tso rau ntawm calcaneal tuberosity los ntawm Medial mus tiv thaiv kev puas tsuaj rau cov qauv kev puas tsuaj rau kev puas tsuaj.
Tus lej txhim kho sab nraud ntawm thawj metatarsal yuav tsum muab tso rau ntawm qhov chaw ua haujlwm ntawm lub hauv paus ntawm thawj metatarsal.
Qee zaum ib qho kev txhim kho sab nraud tus lej tuaj yeem muab tso rau anterolaterally los ntawm kev ua txhaum loj hlob.
Tom qab ntawd, qhov distal Tibia tau rov pib dua thiab cov kab yuam kev raug hloov kho los ntawm kev ua kom fluoroscopy intraoperative fluoroscopy, thiab tus txhim kho sab nraud tau sib dhos.
When adjusting the external fixator, loosen the connecting clip, perform longitudinal traction, and perform gentle manual reduction under fluoroscopy to adjust the position of the fracture fragment. Tus neeg teb xov tooj yog tswj hwm txoj hauj lwm thaum tus pab cuam nruj txuas cov clips sib txuas.
Mib qho taw tes ib
Yog tias kev txhim kho sab nraud tsis yog kev kho kho kom zoo, txoj kev kho lub ntsej muag txhim kho Qhov ruaj ntseg ntawm kev kho vaj tse sab nraud tuaj yeem nce ntxiv los ntawm kev txhim kho pob zeb, thiab ua kom lub dav hlau txhim kho lossis ua kom lub nplhaib txhim kho sab nraud. Ua tau raws cov kev kho kom zoo yuav tsum tau ua kom tau raws li kev ua ntu zus los ntawm kev ua ntu zus thiab tom qab.
Raws lub pob txha pob zeb: tsis-span-articular sab nraud txhim kho
Qee lub sij hawm nws yog ib qho kev xaiv los thov kho sab nraud uas tsis yog kev sib koom ua ke. Yog tias cov thooj ceev distal yog qhov loj txaus kom haum rau ib nrab xov sab nraud txhim kho pins, ib qho yooj yim sab nraud txhim kho. Rau cov neeg mob uas metaphhereal bacture, ib tug hybrid sab nraud txhim kho ntawm ib qho kev kho kom zoo nkauj sab nraud Ceev faj yuav tsum tau siv thaum siv tsis-ncua-articular sab nraud cov khoom siv sab nraud rau pob txha tsis yooj yim nrog cov nqaij mos tsis huv. Kev tshem tawm ntawm cov ntaub so ntswg no, debridement ntawm rab koob tseb, thiab immobilization ntawm lub ntsej muag kom txog thaum lub ntsej muag zoo immobitive immobitization tuaj yeem ua tau.
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Lub sijhawm Post: Feb-10-2023
