Jajabka tibial plateau oo ay weheliso jabka tibial ipsilateral ayaa badanaa lagu arkaa dhaawacyada tamarta sare leh, iyadoo 54% ay yihiin jajab furan.Daraasado hore ayaa lagu ogaaday in 8.4% ee jabka tibial plateau ay la xiriiraan jabka jaban ee tibial-ka, halka 3.2% bukaannada jaban ee tibial-ka ay leeyihiin jabka tibial plateau.Waxaa cad in isku-dhafka ipsilateral ee tibial plateau iyo jabka jaban aan caadi ahayn.
Sababtoo ah dabeecadda tamarta sare ee dhaawacyadan oo kale, waxaa inta badan jira dhaawac daran oo jilicsan.Aragti ahaan, habka saxanka iyo nidaamka qulqulku wuxuu leeyahay faa'iidooyin ku saabsan hagaajinta gudaha ee jabka plateau, laakiin haddii unugyada jilicsan ee maxalliga ah ay u dulqaadan karaan hagaajinta gudaha ee saxanka iyo nidaamka furaha sidoo kale waa tixgelin caafimaad.Sidaa darteed, hadda waxaa jira laba ikhtiyaar oo caadi ahaan loo isticmaalo hagaajinta gudaha ee jabka tibial plateau oo ay weheliso jabka tibial:
1. MIPPO (Ugu Yar ee Invasive Plate Osteosynthesis) farsamo leh saxan dheer;
2. Cidiyaha intramedullary + boolal plateau.
Labada ikhtiyaarba waxaa lagu soo warramey suugaanta, laakiin hadda ma jiraan wax la isku raacsan yahay oo ka sarreeya ama ka hooseeya marka la eego heerka bogsashada jabka, wakhtiga bogsashada jabka, isku dhejinta lugaha hoose, iyo dhibaatooyinka.Si taas wax looga qabto, aqoonyahanno ka socda cusbitaal jaamacadeed oo Kuuriyaan ah ayaa sameeyay daraasad is barbar dhig ah.
Daraasada waxaa ku jiray bukaanada 48 ee jabka tibial plateau oo ay weheliso jabka tibial.Waxaa ka mid ah, 35 kiis ayaa lagu daweeyay farsamada MIPPO, iyada oo la geliyo dhinaca dambe ee saxan bir ah oo loogu talagalay hagaajinta, iyo 13 kiis ayaa lagu daaweeyay boolal plateau oo ay weheliso habka infrapatellar ee hagaajinta ciddiyaha intramedullary.
v Kiis 1: Lateral MIPPO birta saxan gudaha hagaajinta.Nin 42 jir ah, oo ku lug lahaa shil baabuur, ayaa lagu soo bandhigay jabka jaban ee tibial-ka furan (nooca Gustilo II) iyo jabka jabka tibial plateau ee dhexdhexaadka ah (nooca Schatzker IV).
v Case 2: Tibial plateau screw + suprapatellar intramedullary ciddiyaha gudaha hagaajinta.Nin 31 jir ah, oo ku lug lahaa shil baabuur, ayaa lagu soo bandhigay jabka jaban ee tibial-ka furan (nooca Gustilo IIIa) iyo jabka tibial plateau lateral (nooca Schatzker I).Ka bacdi nabarka ka saarida iyo daawaynta boogta cadaadiska taban (VSD), nabarka ayaa la tallaalay maqaarka.Laba boolal 6.5mm ah ayaa loo isticmaalay dhimista iyo hagaajinta taagga, oo ay ku xigto hagaajinta ciddiyaha intramedullary ee shafka tibial iyadoo loo marayo hab suprapatellar ah.
Natiijooyinku waxay muujinayaan in aysan jirin farqi weyn oo u dhexeeya labada hab ee qalliinka marka la eego wakhtiga bogsashada jabka, heerka bogsashada jabka, toosinta lugaha hoose, iyo dhibaatooyinka.
Si la mid ah isku-dhafka jajabyada tibial-ka ee jabka canqowga ah ee laf-dhabarka canqowga ama xuubka laf-dhabarka oo leh jajab qoorta femoral, jabka tibial ee tamarta sare leh ayaa sidoo kale keeni karta dhaawacyo ka soo baxa jilibka ku xiga.Dhaqdhaqaaqa bukaan-socodka, ka-hortagga ogaanshaha khaldan waa walaaca koowaad ee ogaanshaha iyo daaweynta.Intaa waxaa dheer, doorashada hababka hagaajinta, in kasta oo cilmi-baarista hadda jirta aysan soo jeedin wax farqi ah oo la taaban karo, waxaa weli jira dhowr qodob oo loo baahan yahay in la tixgeliyo:
1. Xaaladaha jabka tibial plateau ee jaban halkaasoo hagaajinta furaha fudud ay tahay mid adag, mudnaanta ayaa la siin karaa isticmaalka saxan dheer oo leh hagaajinta MIPPO si ay si waafi ah u xasiliso taagga tibial, dib u soo celinta isku xirnaanta dusha wadajirka ah iyo toosinta addimada hoose.
2. Kiisaska jabka jaban ee tibial plateau, oo la jeexay ugu yar, hoos u dhigista waxtarka leh ayaa la gaari karaa.Xaaladahan oo kale, mudnaanta ayaa la siin karaa hagaajinta birta oo ay ku xigto hagaajinta ciddiyaha suprapatellar intramedullary ee usheeda dhexe ee tibial.
Waqtiga boostada: Mar-09-2024
