Tibial ncej tawg yog ib qho kev raug mob uas tshwm sim. Intramedullary ntsia thawv sab hauv fixation muaj qhov zoo biomechanical ntawm minimally invasive thiab axial fixation, ua rau nws tus qauv kev kho mob phais. Muaj ob txoj kev nailing tseem ceeb rau tibial intramedullary ntsia thawv fixation: suprapatellar thiab infrapatellar nailing, nrog rau cov parapatellar mus kom ze siv los ntawm qee cov kws tshawb fawb.
Rau cov pob txha ntawm qhov sib thooj ntawm 1/3 ntawm tibia, vim tias txoj hauv kev infrapatellar xav tau lub hauv caug flexion, nws yog ib qho yooj yim uas yuav ua rau cov pob txha tawg rau lub kaum sab xis thaum lub sijhawm ua haujlwm. Yog li, suprapatellar mus kom ze feem ntau pom zoo rau kev kho mob.
▲ Daim duab qhia txog qhov chaw ntawm lub caj dab cuam tshuam los ntawm txoj hauv kev suprapatellar
Txawm li cas los xij, yog tias muaj contraindications rau suprapatellar mus kom ze, xws li cov nqaij mos hauv zos ulceration, txoj kev siv infrapatellar yuav tsum tau siv. Yuav ua li cas kom tsis txhob angulation ntawm pob txha tawg thaum lub sij hawm phais yog ib qho teeb meem uas yuav tsum tau ntsib. Qee cov kws tshawb fawb siv cov hlau me me los kho cov anterior cortex ib ntus, lossis siv cov ntsia hlau thaiv los kho cov angulation.
▲ Daim duab qhia txog kev siv thaiv cov ntsia hlau los kho lub kaum sab xis.
Yuav kom daws tau qhov teeb meem no, cov kws tshawb fawb txawv teb chaws tau siv cov txheej txheem minimally invasive. Cov kab lus tsis ntev los no tau luam tawm hauv phau ntawv xov xwm "Ann R Coll Surg Engl":
Xaiv ob lub 3.5mm tawv screws, ze rau ntawm qhov kawg ntawm qhov tawg, ntxig ib lub ntsia hlau rau pem hauv ntej thiab rov qab mus rau hauv cov pob txha tawg ntawm ob qho kawg ntawm qhov tawg, thiab tawm ntau tshaj 2cm sab nraum daim tawv nqaij:
Clamp qhov txo forceps kom tswj tau qhov txo qis, thiab tom qab ntawd ntxig rau cov ntsia hlau intramedullary raws li cov txheej txheem. Tom qab cov ntsia hlau intramedullary muab tso rau, tshem tawm cov ntsia hlau.
Cov txheej txheem no yog tsim nyog rau cov xwm txheej tshwj xeeb uas tsis tuaj yeem siv cov txheej txheem suprapatellar lossis parapatellar, thiab tsis raug pom zoo. Qhov kev tso ntawm cov ntsia hlau no tuaj yeem cuam tshuam rau qhov chaw ntawm lub ntsiab ntsia hlau, lossis tej zaum yuav muaj kev pheej hmoo ntawm cov ntsia hlau tawg. Nws tuaj yeem siv los ua ib qho kev siv hauv cov xwm txheej tshwj xeeb.
Post lub sij hawm: May-21-2024
