46% nke mgbaji ụkwụ na-atụgharị na-esonyere ya na mgbaji malleolar azụ. Ụzọ azụ azụ maka ịhụ anya ozugbo na nhazi nke malleolus dị n'azụ bụ usoro ịwa ahụ a na-ejikarị eme ihe, na-enye uru biomechanical ka mma ma e jiri ya tụnyere mbelata mechiri emechi na ndozi ihe nkedo anteroposterior. Otú ọ dị, maka nnukwu ọkpụkpụ ọkpụkpụ malleolar dị n'azụ ma ọ bụ ọkpụkpụ azụ malleolar nke na-agụnye colliculus na-esote nke medial malleolus, ụzọ posteromedial na-enye echiche ịwa ahụ ka mma.
Iji tụnyere mkpughe nke malleolus dị n'azụ, esemokwu na ngwugwu neurovascular, na anya dị n'etiti mbepụ na ngwugwu neurovascular gafee ụzọ atọ dị iche iche posteromedial, ndị nchọpụta mere nchọpụta cadaveric. E bipụtara nsonaazụ ya n'oge na-adịbeghị anya na akwụkwọ akụkọ FAS. A chịkọtara ihe nchoputa ahụ dị ka ndị a:
Ugbu a, e nwere ụzọ atọ bụ isi posteromedial maka ikpughe malleolus azụ:
1. Medial Posteromedial Approach (mePM): Ụzọ a na-abanye n'etiti azụ azụ nke medial malleolus na tibialis azụ azụ (Njirimara 1 na-egosi eriri azụ tibialis).
2. Modified Posteromedial Approach (moPM): Ụzọ a na-abanye n'etiti akwara azụ azụ tibialis na mkpịsị aka nke digitorum longus (Nyocha 1 na-egosi eriri azụ azụ tibialis, na eserese 2 na-egosi flexor digitorum longus tendon).
3. Posteromedial Approach (PM): Ụzọ a na-abanye n'etiti etiti etiti nke eriri Achilles na flexor hallucis longus tendon (Nyocha 3 na-egosi eriri Achilles, na Figure 4 na-egosi flexor hallucis longus tendon).
Banyere esemokwu dị na ngwugwu neurovascular, ụzọ PM nwere obere esemokwu na 6.18N ma e jiri ya tụnyere mePM na moPM, na-egosi obere ohere nke mmerụ ahụ traction intraoperative na ngwugwu neurovascular.
N'ihe gbasara mkpughe nke malleolus dị n'azụ, ụzọ PM na-enyekwa ohere ka ukwuu, na-enye ohere maka 71% visibiliti nke azụ malleolus. N'iji ya tụnyere, ụzọ mePM na moPM na-enye ohere maka 48.5% na 57% mkpughe nke malleolus azụ, n'otu n'otu.
● Eserese a na-egosi mkpughe nke malleolus dị n'azụ maka ụzọ atọ ahụ. AB na-anọchi anya mkpokọta nke malleolus dị n'azụ, CD na-anọchi anya oke ekpughere, na CD/AB bụ oke mkpughe. Site n'elu ruo ala, a na-egosi ọkwa mkpughe maka mePM, moPM na PM. O doro anya na ụzọ PM nwere oke mkpughe kachasị.
N'ihe gbasara ebe dị n'etiti mbepụ ahụ na ngwugwu neurovascular, ụzọ PM nwekwara nnukwu anya, na-atụ 25.5mm. Nke a dị ukwuu karịa mePM's 17.25mm na moPM's 7.5mm. Nke a na-egosi na ụzọ PM nwere ike ịdị ala nke mmerụ ahụ n'úkwù neurovascular n'oge ịwa ahụ.
● Eserese a na-egosi ebe dị anya n'etiti mbepụ ahụ na ngwugwu neurovascular maka ụzọ atọ ahụ. Site n'aka ekpe gaa n'aka nri, a na-egosi ebe dị anya maka nso nso mePM, moPM na PM. O doro anya na ụzọ PM nwere ebe dị anya site na ngwugwu neurovascular.
Oge nzipu: Mee-31-2024
