A na-ahụkarị ihe mgbawa nke tibial plateau gbajiri agbaji na tibial shaft ipsilateral na mmerụ ahụ dị elu, na 54% bụ mgbaji na-emeghe. Nnyocha ndị gara aga achọpụtala na 8.4% nke tibial plateau fractures na-ejikọta ya na nkwonkwo ụkwụ tibial na-ejikọta ọnụ, ebe 3.2% nke ndị ọrịa na-agbaji tibial na-enwe mgbagwoju anya. O doro anya na nchikota nke tibial plateau ipsilateral na ọkpụkpụ ọkpụkpụ abụghị ihe ọhụrụ.
N'ihi ike dị elu nke mmerụ ahụ dị otú ahụ, a na-enwekarị mmebi anụ ahụ dị nro siri ike. Na tiori, efere efere na screw usoro nwere uru na n'ime ime ndozi maka mgbaji dị larịị, ma ma anụ ahụ dị nro nke mpaghara nwere ike ịnagide nhazi nke ime ya na efere na screw system bụkwa ihe nyocha ụlọ ọgwụ. Ya mere, enwere nhọrọ abụọ a na-ejikarị eme ihe maka imezi mgbaji tibial plateau gbajiri agbaji na tibial traft fractures:
1. MIPPO (Opekempe Osteosynthesis Plate Osteosynthesis) Usoro na ogologo efere;
2. Intramedullary ntu + Plateau kposara.
A na-akọ nhọrọ abụọ ahụ na akwụkwọ akụkọ, mana ugbu a enweghị nkwenye na nke dị elu ma ọ bụ dị ala n'ihe gbasara ọnụọgụ ọgwụgwọ mgbaji, oge ọgwụgwọ mgbaji, nhazi ụkwụ dị ala, na mgbagwoju anya. Iji dozie nke a, ndị ọkà mmụta si n'ụlọ ọgwụ mahadum Korea mere ọmụmụ ihe atụnyere ya.
Ọmụmụ ihe ahụ gụnyere ndị ọrịa 48 nwere ọkpụkpụ tibial plateau fractures jikọtara ya na ọkpụkpụ ọkpụkpụ tibial. N'ime ha, a na-emeso ikpe 35 na usoro MIPPO, na ntinye n'akụkụ nke efere ígwè maka nhazi, na ikpe 13 na-ejikọta ya na skru plateau jikọtara ya na usoro infrapatellar maka ntinye ntu intramedullary.
▲ Ikpe 1: MIPPO ígwè efere n'ime ime ndozi. Otu nwoke dị afọ 42, tinyere aka n'ihe mberede ụgbọ ala, gosipụtara ya na mgbaji tibial oghere (ụdị Gustilo II) na mgbagwoju anya nke tibial plateau compression concomitant (ụdị Schatzker IV).
▲ Ikpe 2: Tibial plateau screw + suprapatellar intramedullary ntu ime ime. Otu nwoke dị afọ 31, tinyere aka n'ihe mberede ụgbọ ala, gosipụtara mgbaji ọkpụkpụ tibial (ụdị Gustilo IIIa) na mgbaji tibial plateau na-ejikọta ọnụ (ụdị Schatzker I). Mgbe mmebi ọnya na ọgwụgwọ ọnya na-adịghị mma (VSD), a nyadokwa ọnya ahụ. A na-eji skru 6.5mm abụọ mee ihe maka mbelata na nhazi nke ala dị larịị, na-esote ntinye ntu intramedullary nke tibial shaft site na ụzọ suprapatellar.
Nsonaazụ na-egosi na ọ nweghị ọdịiche dị ịrịba ama dị n'etiti ụzọ abụọ ịwa ahụ na-abịaru nso n'ihe gbasara oge ọgwụgwọ mgbaji, ọnụ ọgụgụ ọgwụgwọ mgbaji, nhazi ụkwụ ala, na nsogbu.
Dị ka nchikota nke tibial shaft fractures na nkwonkwo nkwonkwo ụkwụ ma ọ bụ ọkpụkpụ femoral femoral na-agbaji n'olu femoral, ike na-eme ka ọkpụkpụ tibial na-eme ka ike dị elu nwekwara ike ime ka mmerụ ahụ dị n'akụkụ ikpere ikpere. Na omume ụlọ ọgwụ, igbochi nchọpụta na-ezighị ezi bụ isi nchegbu na nchọpụta na ọgwụgwọ. Na mgbakwunye, na nhọrọ nke ụzọ ndozi, ọ bụ ezie na nyocha ugbu a na-egosi enweghị ọdịiche dị ịrịba ama, a ka nwere ọtụtụ isi ihe ị ga-atụle:
1. N'ihe gbasara mgbaji tibial plateau mebiri emebi bụ ebe ndozi ihe nkedo dị mfe na-esiri ike, enwere ike ibute ụzọ iji ogologo efere dị ogologo na MIPPO na-edozi nke ọma nke ọma na ala ala tibial, na-eweghachi njikọ elu elu ọnụ na nhazi ụkwụ ala.
2. N'ihe gbasara mgbaji tibial plateau dị mfe, n'okpuru nbibi dị ntakịrị, a ga-enweta mbelata dị irè na nhazi nke screw. N'ọnọdụ ndị dị otú a, enwere ike ibute ụzọ n'ịgbado screw na-esote ntu ntu intramedullary suprapatellar nke ogwe tibial.
Oge nzipu: Mar-09-2024
