Cov kev sib txuas lus tom qab yog txoj hauv kev yog cov txheej txheem rau kev phais mob ntawm kev kho mob calcaneal. Txawm hais tias kev kis tau yog meej, txoj kev phais yog ntev thiab cov nqaij mos yog cov teeb meem ntau dua li cov teeb meem me me xws li qeeb muag cov nqaij mos mos, Necrosis, thiab kis tau mob. Coupled nrog lub koom haum tam sim no kev ua kom qis dua kev ua kom qis qis, txo qis kev phais mob ntawm kev phais mob calcaneal tau qhuas. Kab lus no tau suav 8 lub tswv lus.
Nrog rau txoj kev txuas ntxiv mus, qhov ntsug ntawm phais mob me ntsis mus rau qhov taub ntawm fibula thiab anterior rau achilles tendon. Qib ntawm kev phais yog tsim los nyob deb rau cov tawv nqaij uas muaj ntsej muag ci ntsa iab ua ke los ntawm cov leeg nqaij daim tawv ntoo Ob ntu txuas nrog ntawm cov pob taws ua ib qho kev nkhaus me ntsis txoj cai sab xis. Tau qhov twg los: Campbell Orthopedic phais.
Percutaneous poking txo
Xyoo 1920, Böhler tau tsim cov qauv kev kho mob tsawg tsawg ntawm kev txo qis hauv kev tawm tsam hauv kev kho mob ntawm kev kho mob ntawm Cacaneus.
Nws yog qhov tsim nyog rau cov pob txha uas tsis tshua muaj ntawm cov thooj nyob hauv lub subtalar sib koom ua ke, xws li Sanders Hom II thiab qee cov xuab zeb III lingual III lingual III lingual III lingual
Rau cov Sanders Hom III thiab ua kom cov xuab zeb ntaus ntawv IV thiab nws yog qhov nyuaj rau kev txo qis ntawm qhov chaw sab nrauv ntawm cov calcaneus.
Nws yog qhov nyuaj rau rov ntsuas qhov dav ntawm cov calcaneus, thiab kev deformity tsis tuaj yeem raug kho tau zoo. Nws feem ntau tawm ntawm phab ntsa tom qab ntawm cov calcaneus nyob rau hauv sib txawv ntawm cov pej xeem, kev hloov pauv ntawm lub pob zeb hauv qab no, thiab kev yaum ntawm tus peroneal tendon. Syndrome, calcaneal impingement mob, thiab peroneus lub npe ntev ua rau mob hlwb.
Westhues / essex-loptoresi cov txheej txheem. A. Tom qab fluoroscopy paub tseeb tias tus nplaig sib tsoo-puab tawg; B. Kab rov tav kab rov tav CT scan pom ib tug sandess hom iic pob txha lov. Lub anterior feem ntawm cov cab no tau ua raws li cov duab. S. Nqa qhov deb sai.
C. Kev phais kab mob tom qab yuav siv tsis tau vim tias cov nqaij mos kub offing thiab blistering; D. Tom qab fluoroscopy uas qhia txog cov tshuaj tua kab mob articular (dotted kab) thiab Talar Collapse (kab kab).
E thiab F. Ob lub HOLDOLY cov xaim qhia cov xaim tau muab tso rau thaum nyob qis ntawm tus nplaig-puab tawg, thiab cov kab dotted yog cov kab sib koom ua ke.
G. Flex lub hauv caug sib koom ua ke, pry tus nqais tus pin, thiab tib lub sijhawm canfoot yog tsau ntsia hlau kom muaj kev txo qis vim muaj kev ua kom muaj calterior. Source: mann nqes thiab pob taws phais.
SInus tarsi phais
Kev phais yog ua rau 1 cm distal mus rau qhov ntxeev ntawm Fibula mus rau lub hauv paus ntawm plaub metatarsal. Xyoo 1948, Palmer thawj qhia txog kev phais me me hauv lub Sinus Tarsi.
Hauv 2000, ebmheim li al. Siv cov tarsal Sinus mus kom ze rau hauv kev kho mob ntawm calcaneal pob txha lov.
o Tau tag nrho cov subtalar sib koom ua ke, posterior articular nto thiab anterolateral bacture thaiv;
o Zam kev zam dhau rau cov hlab ntshav calcaneal;
o Tsis tas yuav txiav lub calnanefibular lingent thiab subperonal retinaculum, thiab cov khoom sib koom ua ke thaum lub sijhawm ua haujlwm me me thiab tsawg dua los ntshav.
Qhov tsis zoo yog tias kev raug xwm txheej yog pom tseeb tsis txaus, uas txwv thiab cuam tshuam rau kev txo qis thiab qhov kev tso pauv ntawm kev kho sab hauv. Nws tsuas yog tsim nyog rau Sanders hom I thiab hom II calcaneal pob txha lov.
OBlique Me In phais
Kev hloov kho ntawm lub Sinus Tarsi phais, kwv yees li 4 cm nyob rau hauv ntev, nruab nrab 2 cm hauv qab no txuas ntxiv malleolus thiab parallel rau sab tom qab articular nto.
Yog tias kev npaj preokerative prepingative txaus Yog tias subtalar sib koom ua ke yog qhov yuav tsum tau nyob rau hauv lub sij hawm ntev, tib qho kev phais yuav siv tau.
PT ib leeg pendon. PF sab laug sab Articular saum npoo ntawm cov calcaneus. S sinus tarsi. AP Calcaneeal protrusion. Cov.
Sab laug tshaj tawm ntev kev phais
Pib los ntawm nruab nrab ntawm txoj kab nruab nrab ntawm cov achilles tendon thiab qhov ntxeev ntawm lub malleolus, nws txuas mus rau Talar Lees Sib Koom Tes, nrog lub sijhawm ntev txog 3.5 cm.
Tsawg dua kev phais yog ua nyob rau hauv cov ntaub so mos, yam tsis muaj kev puas tsuaj loj heev, thiab cov npoo tom qab yog raug zoo. Tom qab percutaneive kev xaiv thiab txo qis, ib qho kev taw qhia anatomical tau tso raws li qhov kev taw qhia ntawm lub tswv yim hauv kev pom zoo, thiab cov ntsia hlau percutaneous tau tapped thiab tsau nyob rau hauv siab.
Txoj kev no tuaj yeem siv rau Sanders Hom I, II, thiab III, tshwj xeeb tshaj yog rau kev sib cais sab nraud lossis tuberosity pob txha lov.
Herringbone txiav
Kev Hloov Kho ntawm Sinus TARSI kev phais. Txij 3 cm saum toj no lub ntsis ntawm malleolus, raws tus poj koob yawm txwv ciam teb ntawm Fibula mus rau qhov taub ntawm Malleolus, thiab tom qab ntawd mus rau lub hauv paus ntawm plaub me me. Nws tso cai rau kev txo qis thiab kev txhim kho ntawm cov xuab zeb hom II thiab III Calcaneal pob txha tsis tau, thiab tuaj yeem txuas ntxiv yog tias tsim nyog los ua rau cov transfibula, talus, lossis sab tom qab ntawm ko taw.
LM tom qab luj taws. Mt metatarsal sib koom ua ke. Spr Supra Fibula Retinaculum.
AKev Pab Rthoscopically Rthroscopically Rthruction
Xyoo 1997, rammelt tau npaj siab tias subtalar arthroscopy tuaj yeem siv los txo cov txheej txheem sab nrauv ntawm cov calcaneus nyob rau hauv kev pom kev ncaj qha. Xyoo 2002, rammelt ua ntej ua yeeb yam arthroscopically txo thiab ntsia hlau kho rau cov xuab zeb hom i thiab II pob txha lov.
Subtalar arthroscopy feem ntau yog kev saib xyuas thiab lub luag haujlwm. Nws tuaj yeem saib cov xwm txheej ntawm lub subtalar articular nto nyob rau hauv ncaj qha ncaj qha, thiab pab ntsuas kev txo thiab txhim kho sab hauv. Yooj yim subtalar sib koom ua ke dissection thiab pepteelophyte kev resection kuj tseem tuaj yeem ua tau.
Qhov qhia tau yog nqaim: tsuas yog rau Sanders ntaus ⅱ nrog kev sib tw me ntawm cov articular ntawm cov articular thiab Ao / ETA hom 83-C2 pob txha lov; Thaum lub sijhawm Sanders ⅲ, ⅳ thiab Ao / OTA Hom 83-C3 pob zeb nrog Apicular Deg ntawm xws li 83-C4 yog qhov nyuaj dua ua haujlwm.
Lub Cev Txoj Haujlwm
b. Posterior pob zeb arthroscopy. c. Kev nkag mus rau hauv cov pob txha lov thiab subtalar sib koom ua ke.
Schantz screws tau muab tso rau.
e. Rov pib dua thiab kho ib ntus. f. Tom qab pib dua.
g. Ib ntus kho cov articular deg pob txha pob txha thaiv. h. Kho nrog screws.
Kuv. Postperative Sagittal CT scan. j. Postoperative axial pom.
Tsis tas li ntawd, lub subtalar sib koom chaw yog nqaim, thiab kev sib tw lossis cov nkhaus yog xav tau los txhawb qhov chaw sib koom ua ke los pab txhawb qhov kev tso kawm ntawm arthroscope; Qhov chaw rau intera-artlicular manipulation yog me me, thiab deness manipulation yooj yim tuaj yeem ua kom yooj yim ua rau iatrogenic pob txha mos puas tsuaj; Cov txheej txheem phais mob phais tau zoo rau kev raug mob hauv cheeb tsam.
Percutaneous zais pab angiopley
Hauv xyoo 2009, Bano ua ntej tau thov zais cov nyiaj zais pa rau kev kho mob ntawm calcaneal pob txha lov. Rau Sanders Hom II Kab Txaj, feem ntau ntawm cov ntaub ntawv feem ntau suav nrog cov nyhuv yuav tsum tau meej. Tab sis lwm hom pob txha lov yog qhov nyuaj dua.
Thaum tus pob txha xis infiltrates rau hauv subtalar sib koom chaw thaum lub sijhawm ua haujlwm, nws yuav tsis muaj kev sib tw sib luag.
Kev tso pauv ntawm Cannula thiab taw qhia hlau nyob rau hauv fluoroscopy
Cov duab ua ntej thiab tom qab airbag inflation
Xoo hluav taws xob thiab CT cov duab ob xyoos tom qab phais tas.
Tam sim no, cov kev tshawb fawb tshawb fawb ntawm cov zais pa tawm feem ntau me me, thiab feem ntau ntawm cov pob txha me me yog tshwm sim los ntawm kev ua phem tsawg. Cov kev tshawb fawb ntxiv yog tseem xav tau rau Calcaneal pob txha lov nrog hnyav hnyav. Nws tau raug coj tawm rau lub sijhawm luv luv, thiab kev ua tau zoo ntev thiab muaj teeb meem tseem tsis meej.
CAlcaneal intramed cliply ntsia hlau
Xyoo 2010, lub calcaneal intramed classuldy tawm los. Xyoo 2012, m.Goldzak Tsawg Tsawg Txoj Kev Kho Mob Tsis Txaus Siab ntawm Calcaneal Slactures nrog Intramed Cliping. Nws yuav tsum tau hais txog qhov kev txo qis tsis tuaj yeem ua tiav nrog kev ntsia hlau zoo nkauj.
Ntxig Kev Qhia Txog Lub Chaw Haujlwm PIN, Fluoroscopy
Repositioning lub subtalar sib koom
Tso lub chaw tso cai, tsav lub qhov muag ntsia hlau, thiab kho nws nrog ob 5 hli cannulated screws
Kev pom tom qab pom kev tom qab nthuav cov ntsia thawv ntsia thawv.
Intramed cliping tau pom tias muaj kev vam meej nyob rau hauv kev kho cov xuab zeb ntawm hom II thiab III pob zeb ntawm cov calcaneus. Txawm hais tias qee cov kws kho mob tau sim thov nws mus rau Sanders IV Tsheb pob tawg, kev txo cov haujlwm txo qis yog qhov nyuaj thiab tsis muaj peev xwm txo qis.
Tus Neeg Hu: Yoyo
WA / TEL: +8615682071283
Lub Sijhawm Post: Lub Tsib Hlis-31-2023
