Markaad dooranayso qorshe daaweyn ah oo loogu talagalay jabka fobis fog, hagaajinta dibedda waxaa loo istcimaali karaa sidii hagaajin ku-meel-gaar ah oo loogu talagalay jabka leh dhaawacyo unug oo daran.
Tilmaamaha:
"Khasaaraha burburka" hagaajinta ku-meel-gaarka ah ee jabka oo leh dhaawac unug oo jilicsan, sida jajabka furan, sida jajabka furan ama jabka xiran ee bararka jilicsan ee jilicsan.
Daaweynta murugada ee wasakhaysan, jabka cudurka, ama jabka leh dhaawac unug jilicsan oo daran.
EXamine:
Xaaladda unugyada jilicsan: ①Epen boog; Canshuuraha unugyada jilicsan, bararka unugyada jilicsan. Ka hubi heerka neurovascularl oo si taxaddar leh u qor.
I sawirista: raajooyinka dambe ee raajada iyo raajada dambe ee tibia, iyo akoon-dajiska, geeska dambe iyo canqawga iyo canqawga iyo canqawga oo ah isku-darka canqowga. Haddii jab jabka intra-tuhmanaha lagu tuhmo, skaanka CT ee cobial vault waa in la sameeyaa.
ANATTOMY:·
Aagga anatomical "aag nabdoon" ee meelaynta pin-ka dib-u-haynta waxaa lagu qeexay iyadoo loo eegayo heerar kala duwan oo ka dhex dhaca qaybta-qaybta.
Metaphsis-ka uurjiifka ah ee tibia wuxuu bixiyaa 220 ° aagag-qaabeynta arc-qaabeeya ee arc-qaabeeya ee arc-qaabeeya ee arc-u-nasashada oo loo meelayn karo biinanka hagaajinta dibedda.
Qaybaha kale ee tibia waxay bixiyaan irbad aamin ah oo badbaado leh oo loo yaqaan 'ayel aut' oo kala duwan oo ah 120 ° ° °.
SFarsamada Degdega ah
Booska: Bukaanku wuxuu ku sujuudaa iftiinka shucaaca ee xiji, iyo waxyaabo kale sida barkinta barkinta ama shelf waxaa lagu meeleeyaa addinka adag ee ay dhibaatadu saameysey si ay uga caawiyaan joojinta booska. Gelitaanka suufka hoosta ku yaal miskaha IPSLaratarly wuxuu ku wareegaa addinka ay dhibaatadu saameysey gudaha iyada oo aan lahayn wareejin dibadeed oo xad dhaaf ah.
Approach
Xaaladaha badankood, jeexiyaha yar yar ayaa laga sameeyaa tibia, Calcianeus, iyo metatastal-ka koowaad si loo dhigo biinanka hagaajinta dibedda. ·
Jabanjarooyinka Fibula ayaa si fudud looga xalliyaa xadka hooska hooska ee hoos lagu dhejiyay.
Jab-jabka huur-jeexyada taayirrada ah ee ku lug leh laabatada ayaa loo hagaajin karaa marba mar ahaantaa. Haddii xaaladaha unugyada jilicsan uu oggolaado, iyo haddii loo baahdo, qaab joogto ah ama qaab caadi ah ayaa loo isticmaali karaa hagaajinta. Haddii hagaajinta dibedda loo isticmaalo oo keliya sida cabir lagu gaaro ku-meel-gaar ah, oo ah meesha laga soo galo irbadyada dib-u-dhiska ee loo qorsheeyay in la dhigo waa inay ka fogaadaan aagga xallinta cidlada ugu dambeysa si looga hortago faddaraynta unugyada jilicsan. Hagaajinta hore ee FIBLula iyo jajabyada farshaxanka ee farshaxanka ayaa fududeynaya hagaajinta qeexan ee xigta.
Ka taxadaritaan
Si ka digtoonida ka ah hagaajinta dib-u-haynta dib-u-dhiska ee dib-u-dhigista PIN-ka ee ku xigta ee ku xigta goobta qalliinka, maaddaama unugyada wasakhaysan ay si lama filaan ah u horseedi doonto dhibaatooyinka ka dambeeya. Habka joogtada ah ee maqaarka ama meheradda leh bararka unugyada jilicsan ee jilicsan ayaa waliba horseedi kara dhibaatooyin daran oo ku saabsan bogsashada dhaawaca.
Yaraynta iyo hagaajinta jahwareerka Fiblula:
Markasta oo xaaladaha unugyada jilicsan uu oggolaado, jabka Fibula ayaa marka hore la daaweeyaa. Jab-jabka filoulka ayaa la dhimay oo la hagaajiyaa iyadoo la adeegsanayo meesha la jeexjeexay ee dambe, sida caadiga ah leh boolal-jeexjeexyada iyo 3.5mm l / 3 tuubbada tuubada, ama 3.5mm lcdc iyo boolal. Ka dib markii Firula-ka uu yaraado oo la hagaajiyo, waxaa loo istcimaali karaa sidii halbeeg lagu soo celinayo dhererka tibiyada iyo saxitaanka cibaadooyinka wareejinta jabka.
Ka taxadaritaan
Barar jilicsan oo jilicsan oo barar jilicsan ama boog furan oo daran ayaa waliba ka hortegi kara hagaajinta koowaad ee fibula. Ka taxaddar inaadan xallin jabinta jajaban ee dhallaanka ah oo ka taxaddar inaad dhaawici karto dareemaha suptimimal ee ugu dhow ee 'Peroneaal'.
Jabhada 'Tbial': Yaraynta iyo hagaajinta gudaha
Jab-farshaxa-farshaxanka ee farshaxanka ee loo yaqaan 'tobile pault' waa in lagu yareeyo hoosta aragtida tooska ah iyada oo loo marayo aqal-galka ama habka caadiga ah ee tibia, ama yareynta buugga aan tooska ahayn ee lagu yareeyo.
Markaad kaxeyso xoqidda jiirka, jajabka jajaban waa in lagu hagaajiyaa silig Kirskanner silig.
Yaraynta hore iyo hagaajinta jahwareer-farshaxanka ee farshaxanka ah waxay u oggolaaneysaa farsamooyinka ugu yar ee loo yaqaan 'iyo dabacsanaan ballaaran iyo dabacsanaan ballaaran oo lagu sameeyo hagaajinta sare. Xaaladaha jilicsan-jilicsan ee aan fiicnayn sida calaamadaha bararka ama dhaawaca unugyada jilicsan ayaa laga yaabaa inay ka hor istaagaan hagaajinta hore ee jajabyada hore ee maskaxda.
Jabhada taranka: hagaajinta dibedda ee dibedda
Gawaarida dibedda ee dibedda ee iskutallaabta ah ayaa la isticmaali karaa.
Marka loo eego shuruudaha habka hagaajinta marxaladda labaad, laba 5mm ah oo ah gogosha dib-u-go'an ee dib-u-dejinta dib-u-dhigga ayaa la galiyay isku-darka ama meelaha yar yar ee daadashada ama dusha sare ee tibia ee jajabka.
Marka ugu horreysa si tartiib tartiib ah ugu faafi dusha sare ee lafta, ka dibna ka ilaali nudaha ku xeeran gacmaha sadaqada difaaca unugyada, ka dibna qodista, taabo, oo ku wad xoqashada gacmaha.
Biinanka hagaajinta dibedda ee dhamaadka jabka waxaa lagu dhejin karaa jajabka xagjirka ah ee fogaanka, gargaarka iyo metatastal-ka koowaad, ama qoorta Talius.
Biinanka hagaajinta dibedda ee transladaneal waa in lagu meeleeyaa qashinka kalganeal ee ka imanaya medial ilaa sekal si looga hortago waxyeelada dhismayaasha dhismayaasha meurovascular.
PIN-ka xalinta ee dibedda ee metatastal-ka ugu horreeya waa in lagu dhejiyaa dusha sare ee salka salka ka ah metatastal-ka koowaad.
Mararka qaarkood PIN dib-u-habeyn ayaa si iskeed ah loogu ridi karaa meesha la qalay Tarsal Sinus.
Markaas, tibia fobis ayaa dib loo dejiyay oo khadka xoogga lagu hagaajiyey iyada oo loo marayo fluoroloscopy-ga, iyo gaadhayaha dibedda lagu soo ururiyey.
Markaad laqabsato fulinta dibedda, fur fur xarkaha isku xirka, oo fuliso jahwareerka isku xidhka, oo ku samee hoos udhaca jilicsanaanta buugga jilicsan ee hoostiisa si aad u hagaajiso booska jajabka jajabka. Xiriiriyaha ka dib wuxuu ilaaliyaa booska inta kaaliyaha adkeeyay xirmooyinka isku xidhka.
Main dhibic
Haddii hagaajinta dibedda aysan ahayn daaweyn qeexan, raadraaca irbadyada dib-u-haynta waa in laga fogaadaa aagga la hubo inta lagu gudajiro qorshaynta hawlgalka, si aysan u nicin goobta hawlgalka mustaqbalka. Xasiloonida hagaajinta dibedda ayaa lagu kordhin karaa iyadoo la kordhinayo kala dheereynta biinanka hagaajinta ee goob kasta oo jab ah, kor u qaadida tirada biinanka, oo ay ku dari karto xargaha hagaajinta, iyo kordhinta diyaaradda furitaanka ama lagu dabaqi karo fulinta dibadda. Isku-darka sixitaanka ee kufilan waa in lagu hubiyaa iyada oo loo marayo wejiyada dambe iyo gadaal.
Jabhada Guurka: Xaraashka dibedda ee aan caadiga ahayn
Mararka qaarkood waa ikhtiyaar in lagu dabaqo xafiis kale oo dibedda ah oo aan la kicin karin wadajirka. Haddii jajabkii tacabka fog yahay uu yahay mid ku filan oo lagu habeeyo biinanka hagaajinta dibedda ee dibedda, oo ah in la adeegsado fulinta fudud ee dibedda. Bukaanka qaba jajabinta jajaban ee mugdiga ah, xayawaanado dibedda ah oo ka kooban pin-pin-pin-ka dib-u-eega ee semi-seire iyo silig qallalan oo ganaax ah ayaa waxtar leh oo ah farsamada ku-meel-gaarka ah ama qeexan. Digniin waa in la adeegsadaa marka la isticmaalayo xayawaanada dib-u-dhigga ee aan caadiga ahayn ee jahwareerka loogu talagalay jabka iyada oo faddaraynta unugyada jilicsan. Ka saarida unugyadan wasakhaysan, goynta sunta faddaarka, iyo waxyaabaha ka-hortagga xagjirnimada ee kabka kabka ilaa bogsashada wanaagsan inta badan lagama maarmaan ka hor intaan la qeexi karo.
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Waqtiga Post: Feb-10-2023
