Kuphulika kwa Tibial Plateau fractures wamba wa periarticular fractures
Bicondylar fractures ndi zotsatira za kuvulala kwakukulu kwamphamvu kwambiri
(J Orthop Trauma 2017; 30: e152-e157)
Barei DP, Nork SE, Mills WJ, et al.Zovuta zomwe zimagwirizanitsidwa ndi kukonza kwamkati kwamphamvu kwambiri ya bicondylar tibial plateau fractures pogwiritsa ntchito njira ziwiri zopangira.J Orthop Trauma.2004; 18:649-657.
Barei DP, O'Mara TJ, Taitsman LA, et al.Mafupipafupi ndi fracture morphology ya posteromedial fragment mu bicondylar tibial plateau fracture pattern.J Orthop Trauma.2008; 22:176-182.
Magulu omwe amagwiritsidwa ntchito kwambiri a Schatzker, Moore, ndi AO/OTA amaphimba pafupifupi zophulika zonse.
Koma mitundu ina ya fractures si yoyenera
Mitundu yamitundu ina yosweka imasonyeza kuvulala komwe kungakhale koopsa, monga kuthyoka-kugwedezeka kwa bondo, komwe kungakhale ndi mavuto aakulu ngati sakuzindikiridwa.
Bennett ndi Browner, Schatzker et al anazindikira kusweka kwa mapiri apakati awa.
(Bennett WF, Browner B. Tibial plateau fractures: kafukufuku wokhudzana ndi kuvulala kwa minofu yofewa.J Orthop Trauma.1994; 8:183–188.
Reza Firoozabadi wochokera ku United States adapeza kuti hyperextension ndi varus tibial plateau bicondylar fractures (HEVBTP) sizitchulidwa kawirikawiri m'mabuku ndipo sizikuphatikizidwa mumagulu omwe amagwiritsidwa ntchito kawirikawiri.
Olembawo akuwonetsa kuti njira yovulaza ya HEVBTP ndi yofanana ndi ya masewera olimbitsa thupi a hyperextension ndi varus kupsyinjika komwe kumapangitsa kuti anteromedial alowe fractures ya proximal tibia ndi kuwonongeka kwa ngodya ya posterolateral ndi / kapena posterior cruciate ligament, kupatulapo kuti yoyamba ndi yotsalira. chigawo cha proximal tibia.Kuphwanyidwa kwapakati ndi kupanikizana kwapakatikati, zomwe zimapangitsa kuti sagittal apunduke m'munsi / tibia (kuchepetsedwa kapena kutembenuzidwa kwa tibial posterior tilt)
Paley D, Herzenberg JE.Kulumikizana kwabwino kwa miyendo ndi mayendedwe olumikizana.Mu:Mfundo Zowongolera Zowonongeka.New York: Springer-Verlage Berlin Heidelberg;2002:14-16.
Njira Zovulaza - Hyperextension ndi Varus
Anterior medial tibial plateau fracture kuphatikizapo posterior kunja zovuta kuvulala
Njira yovulaza: hyperextension kwambiri ndi varus wa bondo
Mawonekedwe: Olekanitsa fracture zidutswa anteromedially
Kuphwanyika kwa Anteromedial Tibial Plateau Yogwirizana ndi Kuvulala Kwambiri kwa Posterolateral: Nkhani Yophunzira ndi Kubwereza Zolemba.
Olembawo adasanthula odwala a 208 (mbali za 212) ndi bicondylar fractures ya tibial plateau pakati pa May 2000 ndi August 2011, ndipo adawonetsa milandu ya 23 (milandu 25) yomwe inali yogwirizana ndi makhalidwe a HEVBTP pambuyo poyesedwa ndi CT scan ndi anterior and lateral X. - mafilimu ang'onoang'ono.side) fracture ya tibial plateau, ndipo zotsalira za 187 tibial plateau fractures zinagwiritsidwa ntchito ngati gulu lolamulira.
A-Lateral X-ray ya mawondo olowa kuti awone kupendekeka kwapambuyo kwa tibia ndi kupanikizana kwapambuyo, ndi X-ray yakutsogolo yowonetsa kuwonongeka kwa coronal varus.
B-Coronal ndi sagittal CT zithunzi pambuyo trans-articular kunja fixation
C- Anterior and lateral X-ray fluoroscopy imasonyeza kuti mphamvu zochepetsera kuphulika kwapambuyo ndi zomangira ziwiri (anterior distal to posterior proximal direction) zimachepetsa ndi kukonza kachigawo kakang'ono ka tibia;
D-Postoperative anterior and lateral X-ray ikuwonetsa cholumikizira chimodzi chosatsekera ndi chotsekera chimodzi chotsekera, pomwe mbale yapakatikati ili pamtunda wamtunda wa tibial.
E-lateral X-ray plain film inasonyeza kuti preoperative tibial retroversion angle inali -9 °, postoperatively, inali 10 °, ndipo njira yokonza opaleshoni inali 19 °.
Nthawi yotumiza: Apr-26-2022