Tam sim no, feem ntau siv phais txoj hauv kev rau calcaneal fractures suav nrog kev kho sab hauv nrog phaj thiab ntsia hlau los ntawm txoj kev nkag mus rau qhov sinus tarsi.Lub lateral "L" zoo li nthuav dav mus kom ze yog tsis nyiam nyob rau hauv kev kho mob kev kho mob vim muaj mob ntau dua qhov mob.Lub phaj thiab ntsia hlau kho qhov system, vim nws cov yam ntxwv ntawm biomechanical ntawm eccentric fixation, muaj kev pheej hmoo siab dua ntawm varus malalignment, nrog rau qee cov kev tshawb fawb qhia txog qhov tshwm sim tom qab ua haujlwm ntawm theem nrab varus txog 34%.
Raws li qhov tshwm sim, cov kws tshawb fawb tau pib kawm txog kev kho cov txheej txheem intramedullary rau calcaneal fractures los daws cov teeb meem cuam tshuam nrog lub qhov txhab thiab qhov teeb meem ntawm qhov mob thib ob varus malalignment.
01 Nail central nailing txheej txheem
Cov txheej txheem no tuaj yeem pab txo qis los ntawm qhov sinus tarsi nkag mus los yog nyob rau hauv kev taw qhia arthroscopic, yuav tsum tau txo qis cov ntaub so ntswg xav tau thiab muaj peev xwm txo tau lub sij hawm mus pw hauv tsev kho mob.Txoj hauv kev no yog xaiv tau rau hom II-III pob txha, thiab rau qhov nyuaj comminuted calcaneal fractures, nws yuav tsis muab kev saib xyuas kom muaj zog ntawm kev txo qis thiab tej zaum yuav xav tau kev kho cov ntsia hlau ntxiv.
02 Single-plane intramedullary ntsia thawv
Tus ntsia thawv ib leeg-plane intramedullary ntsia thawv nta ob lub ntsia hlau ntawm qhov sib thooj thiab qhov xaus, nrog rau lub ntsiab ntsia hlau uas tso cai rau cov pob txha grafting los ntawm cov ntsia hlau loj.
03 Multi-plane intramedullary ntsia thawv
Tsim los ntawm peb-dimensional structural morphology ntawm calcaneus, qhov kev txhim kho sab hauv no suav nrog cov ntsia hlau tseem ceeb xws li cov kabmob load-bearing protrusion screws thiab posterior txheej txheem screws.Tom qab txo qis los ntawm txoj kev nkag mus rau qhov sinus tarsi, cov ntsia hlau tuaj yeem muab tso rau hauv qab pob txha mos rau kev txhawb nqa.
Muaj ntau qhov kev tsis sib haum xeeb txog kev siv cov ntsia hlau intramedullary rau calcaneal pob txha:
1. Kev tsim nyog raws li cov pob txha tsis yooj yim: Nws yog debated seb puas yooj yim tawg tsis tas yuav tsum tau intramedullary rau tes thiab complex fractures tsis haum rau lawv.Rau Sanders hom II / III fractures, cov txheej txheem ntawm kev txo qis thiab ntsia hlau kho los ntawm txoj kev nkag mus hauv qhov sinus tarsi yog qhov paub tab, thiab qhov tseem ceeb ntawm cov ntsia hlau tseem ceeb yuav raug nug.Rau cov pob txha nyuaj, qhov zoo ntawm "L" zoo li kev nthuav dav txoj hauv kev tseem tsis tuaj yeem hloov tau, vim nws muab qhov txaus txaus.
2. Qhov tsim nyog ntawm cov kwj dej medullary: Lub calcaneus ib txwm tsis muaj kwj dej medullary.Kev siv cov ntsia hlau loj loj tuaj yeem ua rau muaj kev raug mob ntau dhau los yog poob ntawm pob txha loj.
3. Kev tshem tawm tsis yooj yim: Hauv ntau qhov xwm txheej hauv Suav teb, cov neeg mob tseem raug tshem tawm kho vajtse tom qab kho pob txha.Tus ntsia thawv kev koom ua ke nrog cov pob txha loj hlob thiab embedding ntawm lateral screws nyob rau hauv cov pob txha cortical tuaj yeem ua rau muaj teeb meem hauv kev tshem tawm, uas yog ib qho kev xav hauv kev siv tshuaj kho mob.
Post lub sij hawm: Aug-23-2023
