"10% nke ọkpụkpụ nkwonkwo ụkwụ na-esonyere distal tibiofibular syndesmosis mmerụ ahụ. Nnyocha egosiwo na 52% nke skru distal tibiofibular na-eme ka mbelata na-adịghị mma nke syndesmosis. Ịtinye ihe nkedo distal tibiofibular screw perpendicular na syndesmosis nkwonkwo elu dị mkpa iji zere iatrogenic malreduction. Dị ka akwụkwọ ntuziaka AO si kwuo, a na-atụ aro ka ịtinye ihe nkedo distal tibiofibular 2 cm ma ọ bụ 3.5 cm n'elu elu nke tibial articular elu, na akụkụ nke 20-30 ° na ụgbọelu kwụ ọtọ, site na fibula ruo na tibia, na nkwonkwo ụkwụ. n'ọnọdụ na-anọpụ iche."
Ntinye aka nke skru tibiofibular distal na-ebutekarị ntụgharị na ntinye na ntụziaka, na ugbu a, ọ dịghị usoro ziri ezi maka ikpebi ntinye ntinye nke kposara ndị a. Iji lebara okwu a anya, ndị nchọpụta si mba ọzọ ewerela usoro ọhụrụ—usoro ‘angle bisector method.
N'iji data eserese sitere na nkwonkwo nkwonkwo ụkwụ 16 nkịtị, e mepụtara ụdị 16 3D e biri ebi. N'ebe dị anya nke 2 cm na 3.5 cm n'elu elu nke tibial articular, a na-etinye wires Kirschner abụọ 1.6 mm na njikọ dị n'akụkụ ihu na azụ nke tibia na fibula, n'otu n'otu. A na-atụle akụkụ dị n'etiti wires Kirschner abụọ site na iji protractor, na 2.7 mm drill bit na-agbanye oghere n'akụkụ eriri bisector angle, na-esote ntinye nke 3.5 mm screw. Mgbe ịtinye ihe nkedo, a na-egbutu ihe nkedo ahụ n'ogologo ya site na iji ihe nlele iji nyochaa mmekọrịta dị n'etiti ntụziaka ịghasa na etiti etiti nke tibia na fibula.
Nnwale ihe atụ na-egosi na enwere ezigbo ngbanwe n'etiti etiti etiti nke tibia na fibula na ahịrị bisector angle, yana n'etiti etiti etiti na ntụzịaka ịghasa.
N'ụzọ doro anya, usoro a nwere ike idowe ịghasa n'akụkụ etiti axis nke tibia na fibula. Otú ọ dị, n'oge ịwa ahụ, itinye wires Kirschner nso na ihu na azụ azụ nke tibia na fibula na-etinye ihe ize ndụ nke imebi arịa ọbara na irighiri akwara. Tụkwasị na nke a, usoro a anaghị edozi nsogbu nke iatrogenic malreduction, n'ihi na a pụghị ịlele nhazi nke tibiofibular dị anya nke ọma na intraoperative tupu etinye ya.
Oge nzipu: Jul-30-2024
