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Qalabka Hagaajinta Dibadda - Farsamada Hagaajinta Dibadda ee Tibia Distal

Markaad dooranayso qorshaha daaweynta ee jabka tibial-ka fog, hagaajinta dibadda ayaa loo isticmaali karaa sidii ku-meel-gaar ah oo loogu talagalay jabka leh dhaawacyo jilicsan oo jilicsan.

Tilmaamaha:

"Xakamaynta dhaawaca" hagaajin ku meel gaar ah oo jabka leh dhaawac jilicsan oo jilicsan, sida jabka furan ama jabka xiran oo leh barar jilicsan oo jilicsan.

Daawaynta saxda ah ee jabka wasakhaysan, jabka qaba, ama jabka leh dhaawac jilicsan oo daran.

Examine:

Xaaladda unugyada jilicsan: ①Nabar furan;② Jeex-jeexid daran oo jilicsan, barar jilicsan.Hubi heerka neerfaha oo si taxadar leh u diiwaan geli.

Sawirka: Raajooyinka anteroposterior iyo lateral ee tibia, iyo anteroposterior, lateral iyo acupoints canqowga ee wadajirka canqowga.Haddii la tuhmo jabka gudaha articular, CT scan ee godka tibial waa in la sameeyaa.

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Anatomy:·

Anatomical "aagga nabdoon" ee meelaynta biin-goynta dibadda waxaa lagu qeexay iyadoo loo eegayo heerarka kala duwan ee qaybta isku-tallaabta.

Metaphysis-ka u dhow ee tibia waxay bixisaa 220 ° aag nabdoon oo qaabaysan oo hore ah halkaas oo biinanka hagaajinta dibadda la dhigi karo.

Qaybaha kale ee tibia waxay bixiyaan meel irbad la geliyo oo badbaado leh oo anteromedial ah oo u dhaxaysa 120 ~ 140°.

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Sfarsamada degdega ah

Booska: Bukaanku wuxuu ku seexanayaa raajada miiska qalliinka ee hufan, iyo waxyaabo kale sida barkin ama shelf ayaa la dhigayaa hoosta addinka ay saameysay si ay gacan uga geystaan ​​sii wadista booska.Dhigista suufka hoostiisa sinta ipsilateral waxay ku rogtaa xubinta ay saamaysay gudaha iyada oo aan la rogin dibadda oo xad dhaaf ah.

Aisu dhawaansho

Inta badan, jeexyo yaryar ayaa lagu sameeyaa tibia, calcaneus, iyo metatarsal marka hore si loo dhigo biinanka hagaajinta dibadda.··

Jabka Fibula ayaa si fudud looga go'i karaa xudduudda dabadeed ee la dareemi karo.

Jebinta godka tibial ee ku lug leh wadajirka ayaa si toos ah loo hagaajin karaa.Haddii xaaladaha unugyada jilicsan ay oggolaadaan, iyo haddii loo baahdo, hab anterolateral ama dhexdhexaad ah oo joogto ah ayaa loo isticmaali karaa hagaajinta.Haddii hagaajinta dibadda loo isticmaalo oo kaliya qiyaasta hagaajinta ku-meel-gaadhka ah, meesha irbadda laga soo galo ee cirbadda dibadda loo qorsheeyay in la dhigo waa in ay ka fogaato aagga cirridka ugu dambeeya si looga hortago wasakheynta unugyada jilicsan.Hagaajinta hore ee fibula iyo jajabyada articular-ku waxay fududeeyaan hagaajinta xiga.

Ka taxadaritaan

Ka digtoonow dariiqa toosinta dibadda ee hagaajinta xiga ee goobta qalliinka, maadaama nudaha wasakhaysan ay lama huraan u horseedi doonaan dhibaatooyin qalliinka kadib.Hababka anterolateral ama dhexdhexaadka ah ee joogtada ah ee leh bararka unugyada jilicsan ayaa sidoo kale u horseedi kara dhibaatooyin halis ah bogsashada dhaawaca.

Yaraynta iyo hagaajinta jabka fibula:

Mar kasta oo xaaladaha unugyada jilicsan ay oggolaadaan, jabka fibula ayaa marka hore la daweeyaa.Jajabka xuubka waa la dhimay oo la hagaajiyaa iyada oo la isticmaalayo jeexitaan fibular ah, badanaa leh 3.5mm boolal dib u dhac ah iyo 3.5mm l/3 saxan tuubo, ama 3.5mm saxan LCDC ah iyo boolal.Ka dib marka fibula si ahaan loo dhimo oo la hagaajiyo, waxaa loo isticmaali karaa sidii caadiga ahayd dib u soo celinta dhererka tibia iyo hagaajinta qallafsanaanta wareega ee jabka tibia. 

Ka taxadaritaan

Bararka jilicsan ee muhiimka ah ama nabar furan oo daran ayaa sidoo kale laga yaabaa inay ka hortagaan hagaajinta asaasiga ah ee fibula.Ka taxadar inaadan hagaajin jabka fibular ee u dhow kana taxaddar inaad dhaawacdo dareemaha sare ee peroneal.

Jebinta Tibial: Dhimista iyo Hagaajinta Gudaha

Jabka gudaha articular ee vault tibial waa in la yareeyaa aragtida tooska ah iyada oo loo marayo habka anterolateral ama dhexdhexaadka ah ee tibia fog, ama iyada oo hoos u dhigista buug-gacmeedka aan tooska ahayn ee fluoroscopy.

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Markaad wadeyso furaha dib u dhaca, jajabka jabka waa in lagu hagaajiyaa siliga Kirschner marka hore.

Yaraynta hore iyo hagaajinta jabka gudaha articular waxay u oggolaaneysaa farsamooyinka ugu yar ee wax-ka-qabashada iyo dabacsanaanta weyn ee hagaajinta heerka labaad.Xaaladaha jilicsan ee aan fiicneyn sida bararka calaamadeysan ama dhaawaca jilicsan ee jilicsan ayaa laga yaabaa inay ka hortagaan hagaajinta hore ee jajabyada gudaha.

Jebinta Tibial: Qalabaynta Dibadda ee Transarticular

Qalabka dibadda ah ee isku-dhafan ayaa la isticmaali karaa.

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Marka loo eego shuruudaha habka hagaajinta heerka labaad ee qeexitaanka, laba 5mm oo ah biinanka dibedda ee nuska ah ayaa la geliyey si toos ah ama iyada oo loo marayo jeexjeexyo yaryar oo ku yaal dhinaca dhexe ama dusha sare ee tibia ee dhammaadka u dhow ee jabka.

Marka hore si bareer ah u kala saar oogada lafta, ka dibna ku ilaali nudaha ku hareeraysan shaati ka ilaalin unug jilicsan, ka dibna dalool, taabo, oo ku wad furka gacanta.

Biinanka hagaajinta dibadda ee dhamaadka fog ee jabka waxaa lagu dhejin karaa jajabka tibial-ka fog, calcaneus iyo metatarsal ugu horreeya, ama qoorta talus.

Biinanka hagaajinta dibadda ee transcalcaneal waa in lagu dhejiyaa tuberosity calcaneal min dhexdhexaad ilaa lateral si looga hortago dhaawac soo gaara dhismayaasha neerfaha xididada dhexdhexaadka ah.

Birta hagaajinta dibadda ee metatarsal-ka koowaad waa in lagu dhejiyaa dusha anteromedial ee saldhigga metatarsal-ka koowaad.

Mararka qaarkood biinka hagaajinta dibadda ayaa la gelin karaa gees ahaan iyada oo la marinayo jeexitaan sinuska dabada.

Ka dib, tibia fogaa dib ayaa loo dajiyay oo xariiqda xoogga ayaa lagu hagaajiyay iyada oo loo marayo fluoroscopy intraoperative, iyo qalabeeyaha dibadda ayaa la isku daray.

Markaad hagaajinayso qalabeeyaha dibadda, dabciso fiilada isku xirta, samee jiidashada dhererka, oo samee hoos u dhigista buug-gacmeedka hoosta fluoroscopy si aad u hagaajiso booska jajabka.Kaaliyaha ayaa markaa ilaalinaya booska halka kaaliyaha uu adkeynayo xirmooyinka isku xira.

Mdhibic

Haddii hagaajinta dibadda aysan ahayn daaweyn qeexan, marinka cirbadda hagaajinta dibadda waa in laga fogeeyaa aagga saxda ah inta lagu jiro qorsheynta hawlgalka, si aysan u wasakheynin goobta hawlgalka mustaqbalka.Xasiloonida hagaajinta dibadda ayaa lagu kordhin karaa iyadoo la kordhinayo kala fogaanshaha biinanka hagaajinta ee goob kasta oo jaban, kordhinta dhexroorka biinanka, kordhinta tirada biinanka hagaajinta iyo isku xirka isku xirka, ku darida dhibcaha hagaajinta ee wadajirka canqowga, iyo kordhinta hagaajinta diyaarad ama codsanaya giraanta dibadda hagaajinta .Sixitaan ku filan waa in la hubiyaa iyada oo loo marayo wejiyada hore, danbe iyo dambe.

Jajabka tibial: hagaajin dibadda ah oo aan fiicneyn

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Mararka qaarkood waa ikhtiyaar in lagu dabaqo qalab dibadda ah oo aan soo dhaafin wadajirka.Haddii jajabka tibial-ka fog uu weyn yahay si uu u daboolo biinanka hagaajinta dibadda ee dunta nuska ah, qalab dibadda ah ayaa la isticmaali karaa.Bukaanka leh jajab yar oo jajab ah oo metaphyseal ah, qalabeeyaha dibadda ah ee isku-dhafka ah ee ka kooban pin-ka-fidinta dibadda ee semi-threaded iyo fiilada Kirschner ee ganaaxa ayaa faa'iido leh sida farsamada daaweynta ku-meel-gaadhka ah ama qeexan.Taxaddar waa in la sameeyaa marka la isticmaalayo qalabyada dibadda ee aan span-articular ee jabka leh wasakheynta unugyada jilicsan.Ka saarida nudahan wasakhaysan, baabi'inta marinka irbadda, iyo dhaqdhaqaaqa kabka ee cirifka cirifka ilaa laga bogsado nabarka wanaagsan inta badan waa lagama maarmaan ka hor inta aan dhaqdhaqaaq dhab ah la samayn.

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La xiriir: Yoyo

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Waqtiga boostada: Febraayo-10-2023