Lithaba tsa Tibial fractures tse kopantsoeng le li-fractures tsa ipsilateral tibial shaft li atisa ho bonoa likotsing tse matla haholo, 'me 54% e le fractures e bulehileng.Liphuputso tse fetileng li fumane hore 8.4% ea fractures ea tibial plateau e amahanngoa le fractures ea tibial shaft fractures, athe 3.2% ea bakuli ba fracture ea tibial ba na le fractures ea tibial plateau fractures.Ho totobetse hore ho kopana ha sepakapaka sa ipsilateral tibial plateau le shaft fractures ha se ntho e tloaelehileng.
Ka lebaka la matla a phahameng a likotsi tse joalo, hangata ho na le tšenyo e matla ea lisele tse bonolo.Ho ea ka khopolo, "plate le screw system" li na le melemo ea ho lokisa ka hare bakeng sa fractures ea plateau, empa hore na lesela le bonolo la sebakeng seo le ka mamella ho lokisa ka hare ka poleiti le "screw system" le eona ke taba ea kliniki.Ka hona, hona joale ho na le likhetho tse peli tse sebelisoang hangata bakeng sa ho lokisa ka hare ho fractures ea tibial plateau e kopantsoeng le fractures ea tibial shaft:
1. Mokhoa oa MIPPO (Minimally Invasive Plate Osteosynthesis) o nang le poleiti e telele;
2. Intramedullary Nail + plateau screw.
Likhetho tsena ka bobeli li tlalehoa libukeng, empa hajoale ha ho na tumellano ea hore na ke efe e phahameng kapa e tlase ho latela sekhahla sa pholiso ea fracture, nako ea ho folisa ea fracture, ho tsamaisana le maoto a tlase, le mathata.Ho rarolla bothata bona, litsebi tse tsoang sepetleleng sa univesithi ea Korea li ile tsa etsa phuputso ea ho bapisa.
Phuputso e ne e kenyelletsa bakuli ba 48 ba nang le fractures ea tibial plateau e kopantsoeng le fractures ea tibial shaft.Har'a bona, linyeoe tse 35 li ile tsa phekoloa ka mokhoa oa MIPPO, ka ho kenngoa ka morao ha poleiti ea tšepe bakeng sa ho lokisa, 'me linyeoe tse 13 li ne li tšoaroa ka li-screw tsa plateau tse kopantsoeng le mokhoa oa infrapatellar bakeng sa ho lokisa lipekere tsa intramedullary.
▲ Taba ea 1: Lateral MIPPO steel plate fixation ka hare.Monna ea lilemo li 42, ea amehileng kotsing ea koloi, o hlahisitsoe ka sekhahla se bulehileng sa tibial shaft fracture (mofuta oa Gustilo II) le fracture ea khatello ea methapo ea methapo ea methapo (mofuta oa Schatzker IV).
▲ Nyeoe ea 2: Tibial plateau screw + suprapatellar intramedullary Nail fixation ka hare.Monna ea lilemo li 31, ea amehang kotsing ea koloi, o hlahisitsoe ke ho robeha ha shaft ea tibial e bulehileng (mofuta oa Gustilo IIIa) le fracture ea lateral tibial plateau (mofuta oa Schatzker I).Ka mor'a ho senyeha ha leqeba le phekolo e mpe ea leqeba la khatello (VSD), leqeba le ile la hlomathiseletsoa letlalo.Li-screws tse peli tsa 6.5mm li ne li sebelisetsoa ho fokotsa le ho lokisa sehlaba, ho lateloa ke ho lokisa lipekere tsa intramedullary tsa tibial shaft ka mokhoa oa suprapatellar.
Liphello li bontša hore ha ho na phapang e khōlō ea lipalo-palo pakeng tsa mekhoa e 'meli ea ho buuoa mabapi le nako ea ho folisa fracture, sekhahla sa pholiso ea ho robeha, ho tsamaisana le maoto a tlaase, le mathata.
Ho tšoana le ho kopana ha li-tibial shaft fractures tse nang le fractures ea maqaqailaneng ea maqaqailana kapa ho robeha ha molamu oa botšehali ka ho robeha ha molala oa botšehali, ho senyeha ha matla a matla a matla a matla ho ka boela ha lebisa likotsing tse haufi le lengole.Ts'ebetsong ea bongaka, ho thibela ho hlahlojoa hampe ke ntho e ka sehloohong e amehang tabeng ea ho hlahlojoa le ho phekoloa.Ho phaella moo, khethong ea mekhoa ea ho lokisa, le hoja lipatlisiso tsa morao-rao li bontša hore ha ho na phapang e kholo, ho ntse ho e-na le lintlha tse 'maloa tse lokelang ho nahanoa:
1. Maemong a comminuted tibial plateau fractures moo ho lokisa sekoti se bonolo ho leng thata, ho ka 'na ha fanoa ka pele ho tšebeliso ea poleiti e telele e nang le MIPPO fixation ho tsitsisa ka ho lekaneng sehlaba sa tibial, ho tsosolosa motsoako oa holim'a metsi le ho lumellana ha maoto a tlaase.
2. Maemong a fractures e bonolo ea tibial plateau, tlas'a li-incisions tse fokolang, ho fokotsa ka katleho le ho lokisa sekoti ho ka finyelloa.Maemong a joalo, ho ka 'na ha fanoa ka pele ho screw fixation e lateloa ke suprapatellar intramedullary Nail fixation ea tibial shaft.
Nako ea poso: Mar-09-2024
