Habka caadiga ah ee lateral L waa habka caadiga ah ee daaweynta qalliinka ee jabka calcaneal.Inkasta oo soo-gaadhistu ay tahay mid dhammaystiran, jeexitaanku waa dheer yahay oo nudaha jilicsan ayaa la sii daayaa, taas oo si sahlan u keenta dhibaatooyin sida midaynta unugyada jilicsan, necrosis, iyo caabuq.Marka lagu daro raadinta bulshada hadda jirta ee bilicda ugu yar ee qallafsan, daawaynta ugu yar ee qalliinka ee jabka calcaneal ayaa aad loo ammaanay.Maqaalkani waxa uu soo ururiyay 8 talo.
Iyada oo hab ballaaran oo dhinaca dambe ah, qaybta toosan ee la jeexiddu waxay ka bilaabataa wax yar oo u dhow caarada fibula iyo hore ee jilibka Achilles.Heerka jeexitaanku waxa uu fogaanayaa maqaarka nabarka leh ee uu quudiyo halbowlaha calcaneal ee dambaysta ah waxaana la geliyaa saldhigga metatarsalka shanaad.Labada qaybood waxay ku xiran yihiin ciribta si ay u sameeyaan xagal qumman oo xoogaa qalloocan.Xigasho: Qalliinka Lafaha ee Campbell.
Phoos u dhigista xumbada
Sannadihii 1920-aadkii, Böhler waxa uu soo saaray habka ugu yar ee daawaynta ee lagu dhimayo calcaneus-ka hoostiisa, muddo dheer ka dib, hoos u dhigista jeexjeexa ee hoos u dhaca ayaa noqday habka caadiga ah ee daaweynta jabka calcaneus.
Waxay ku habboon tahay jabka leh barokaca yar ee jajabyada intraticular ee wadajirka hoose, sida Sanders nooca II iyo qaar ka mid ah jabka afka Sanders III.
Nooca Sanders nooca III iyo jabniinka Sanders nooca IV ee leh jabka dusha sare ee articular subtalar daran, hoos u dhigista poking way adagtahay wayna adagtahay in la gaaro hoos u dhigista anatomical ee dusha sare ee articular ee calcaneus.
Way adag tahay in dib loo soo celiyo ballaca calcaneus, naafonimadana si fiican looma sixi karo.Waxay inta badan ka tagtaa darbiga dambe ee calcaneus heerar kala duwan, taas oo keenta saamaynta malleolus lateral ee hoose ee derbiga lateral ee calcaneus, barokaca ama cadaadinta xuubka dheer ee peroneus, iyo xannibaadda xuubka peroneal.Syndrome, xanuunka kalyaha oo xanniba, iyo peroneus longus tendonitis.
Farsamada Westhues/Essex-lopresti.A.fluoroscopy lateral ayaa xaqiijiyay jajabkii carrabka u eg ee burburay;B. Sawirka CT-ga ee diyaaradda jiifa ayaa muujiyay jabka nooca Sandess ee IIC.Qaybta hore ee calcaneus ayaa si cad loogu qeexay labada sawir.S. Qaadashada fogaan kedis ah.
C. Jeexitaan dambe lama isticmaali karo sababtoo ah barar iyo finan jilicsan oo daran;D. fluoroscopy-ga dambe oo muujinaya dusha articular (xariiq dhibco leh) iyo dunta talar (xariiq adag).
E iyo F. Laba fiilood oo haga ciddiyaha godan ayaa la barbardhigay qaybta hoose ee jajabka carrabka u samaysan, iyo xariiqda dhibicda leh waa xariiqda wadajirka ah.
G. Isku laab laabta jilibka, kor u saar biinka hagaha, isla markaana jeexjeexa lugta dhexe si aad u yarayso jabka: H. Mid ka mid ah furaha daasadaha ah ee 6.5 mm ayaa lagu hagaajiyay lafta cuboid iyo laba 2.0 mm Kirschner fiilooyin ayaa hoos loo dhigay joogteeyo hoos u dhaca sababtoo ah comminution hore ee calcaneus.Xigasho: Mann Foot iyo Qaliinka Anqawga.
Sjeexitaan inus tarsi
Jeexitaanka ayaa la sameeyaa 1 cm fogaan ah cidhifka fibula ilaa salka metatarsalka afraad.Sannadkii 1948-kii, Palmer ayaa markii ugu horreysay ka warbixisay jeex yar oo laga jeexay sinus tarsi.
Sannadkii 2000, Ebmheim et al.loo isticmaalo habka sanbabada tarsal ee daaweynta kiliinikada ee jabka calcaneal.
o Waxay si buuxda u soo bandhigi kartaa kala-goysyada subtalar-ka, oogada dambe ee articular iyo xannibaadda jabka anterolateral;
o Si ku filan uga fogow xididdada dhiigga ee calcaneal;
o Looma baahna in la gooyo seedaha calcaneofibular iyo retinaculum subperoneal, booska wadajirka ah waxaa lagu kordhin karaa rogitaan sax ah inta lagu jiro qalliinka, taas oo leh faa'iidooyinka jeexitaan yar iyo dhiig-bax yar.
Khasaaraha ayaa ah in soo-gaadhista ay si cad u tahay mid aan ku filnayn, taas oo xaddidaysa oo saameynaysa dhimista jabka iyo meelaynta hagaajinta gudaha.Waxay ku habboon tahay kaliya Sanders nooca I iyo nooca II ee jabka calcaneal.
Ojeex yar oo blique ah
Wax ka bedel lagu sameeyo jeexida tarsi sinus, oo ku dhawaad 4 sentimitir dhererkeedu yahay, oo udub dhexaad u ah 2cm oo ka hooseeya malleolus lateral oo barbar socda oogada dambe ee articular.
Haddii diyaarinta qalliinka ka hor ay ku filan tahay oo shuruudaha oggol yihiin, waxay sidoo kale yeelan kartaa hoos u dhac wanaagsan iyo saameyn ku yeelashada Sanders nooca II iyo III jabka gudaha articular;Haddii fiyuuska wadajirka ah ee subtalar loo baahan yahay muddada dheer, isla jeexitaan ayaa la isticmaali karaa.
PT Peroneal tendon.PF Dusha dambe ee articular ee calcaneus.S sinus tarsi.AP Calcaneal protrusion..
Jeexitaanka dheer ee dambe
Laga bilaabo barta dhexe ee xariiqda u dhaxaysa seedaha Achilles iyo cidhifka malleolus ee dambaysta ah, waxay si toos ah u fidaysaa ilaa labka ciribta dheer, oo dhererkeedu yahay ilaa 3.5 cm.
Jeexdin yar ayaa lagu sameeyaa unugyada jilicsan ee fog, iyada oo aan waxyeello loo geysan dhismayaasha muhiimka ah, iyo dusha sare ee articular si fiican ayaa loo soo bandhigay.Ka dib markii la jeexjeexay oo la dhimay, loox anatomical ah ayaa la geliyey iyada oo la raacayo hagidda aragtida qalliinka, iyo furka furaha ayaa la taabtay oo lagu hagaajiyay cadaadis.
Habkan waxaa loo isticmaali karaa nooca Sanders I, II, iyo III, gaar ahaan meelaha la barokacay ee dusha sare ee articular ama jabka tuberosity.
Herringbone gooyay
Wax ka beddelka jeexida tarsi ee sinus.Laga soo bilaabo 3 cm oo ka sarreysa caarada malleolus lateral, oo ku taal soohdinta dambe ee fibula ilaa cidhifka malleolus lateral, ka dibna ilaa saldhigga metatarsal afraad.Waxay u ogolaataa hoos u dhigista iyo hagaajinta nooca Sanders nooca II iyo III jabka calcaneal, waxaana la kordhin karaa haddii loo baahdo si loo muujiyo transfibula, talus, ama tiirka dambe ee cagta.
LM canqowga lateral.MT metatarsal wadajir.SPR Supra fibula retinaculum.
Adhimista rthroscopically caawiyay
Sannadkii 1997, Ramelt waxa uu soo jeediyay in arthroscopy-ga subtalar loo isticmaali karo si loo yareeyo korka dambe ee articular ee calcaneus ee aragtida tooska ah.Sannadkii 2002dii, Ramelt wuxuu markii ugu horreysay sameeyay dhimis arthroscopically caawiyay iyo hagaajinta jabka Sanders nooca I iyo II.
Subtalar arthroscopy waxay inta badan ka ciyaartaa la socodka iyo doorka caawimada.Waxay ilaalin kartaa xaaladda dusha sare ee articular subtalar ee aragtida tooska ah, waxayna ka caawin kartaa la socodka dhimista iyo hagaajinta gudaha.Kala-goysyada wadajirka ah ee fudud ee subtalar-ka iyo dib-u-soo-celinta osteophyte sidoo kale waa la samayn karaa.
Tilmaamuhu waa cidhiidhi: kaliya ee Sanders nooca Ⅱ oo leh comminution khafiif ah ee dusha articular iyo AO/OTA nooca 83-C2 jabka;halka Sanders Ⅲ, Ⅳ iyo AO/OTA nooca 83-C3 Jabka leh dusha sare ee go'an sida 83-C4 iyo 83-C4 ay aad u adag tahay in la shaqeeyo.
booska jirka
b.Arthroscopy canqowga dambe.c.Helitaanka jabka iyo kala-goysyada subtalar-ka.
Kaashashka Schantz ayaa la dhigay.
e.Dib u habeyn iyo hagaajin ku meel gaar ah.f.Ka dib dib u dejinta
g.Si ku-meel-gaar ah u hagaaji xannibaadda lafta dusha sare ee articular.h.Ku hagaaji boolal
i.Qalliinka ka dib sagittal CT scan.j.Aragtida axial postoperative.
Intaa waxaa dheer, meesha bannaan ee wadajirka ah ee subtalar waa cidhiidhi, waxaana loo baahan yahay jiidis ama dhejis si ay u taageeraan booska wadajirka ah si loo fududeeyo meelaynta arthroscope;booska manipulation intra-articular waa yar yahay, iyo khalkhalgelinta taxadar la'aanta ah waxay si fudud u keeni kartaa dhaawaca dusha carjawda iatrogenic;Farsamooyinka qalliinka ee aan xirfadda lahayn ayaa u nugul abaabulka dhaawaca maxalliga ah.
Pangioplasty buufin ercutaneous
Sannadkii 2009, Bano ayaa markii ugu horreysay soo jeediyay farsamada ballaadhinta buufin ee loogu talagalay daawaynta jabka calcaneal.Sanders nooca II jabka, badi suugaanta ayaa u arka in saameyntu ay tahay mid qeexan.Laakiin noocyada kale ee jabka ayaa aad u adag.
Marka sibidhka lafuhu uu dhex galo booska wadajirka ah ee subtalar inta lagu jiro hawlgalka, waxay keeni doontaa xidhashada dusha articular iyo xaddidaadda dhaqdhaqaaqa wadajirka ah, ballaadhinta buufinku ma dheelli doono dhimista jabka.
Meelaynta cannula iyo siliga hagaha ee fluoroscopy hoostiisa
Sawirada ka hor iyo ka dib sicir bararka barkinta shilka
Sawirada raajada iyo CT laba sano ka dib qaliinka.
Waqtigan xaadirka ah, shaybaarrada cilmi-baarista ee tignoolajiyada buufinku guud ahaan waa yar yihiin, inta badan jabka leh natiijooyin wanaagsan waxaa sababa rabshadaha tamarta yar.Cilmi-baaris dheeraad ah ayaa weli loo baahan yahay jabka kalluun ee leh barokac daran.Waxaa la fuliyay muddo gaaban, iyo waxtarka muddada dheer iyo dhibaatooyinka weli ma cadda.
Cciddiyaha intramedullary alcaneal
Sannadkii 2010-kii, ciddiyaha intramedullary calcaneal ayaa soo baxay.Sannadkii 2012, M.Goldzak daawaynta ugu yar ee jabka calcaneal ee leh ciddida intramedullary.Waa in la adkeeyo in dhimista aan lagu gaari karin ciddida intramedullary.
Geli biinka hagaha meelaynta, fluoroscopy
Dib u habeynta wadajirka hoose
Dhig qaabka meelaynta, kaxee cidiyaha intramedullary, oo ku hagaaji laba boolal 5 mm ah oo qasacadaysan
Aragtida ka dib meelaynta ciddiyaha intramedullary.
Ciddiyaha intramedullary ayaa lagu muujiyay inay ku guulaysato daawaynta Sanders nooca II iyo jabniinka III ee calcaneus.Inkasta oo dhakhaatiirta qaarkood ay isku dayeen inay ku dabaqaan jabka Sanders IV, hawlgalka dhimista ayaa ahaa mid adag oo dhimis ku habboon lama helin.
Qofka lala xiriirinayo: Yoyo
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Waqtiga boostada: Meey-31-2023
