Uburyo bwo kubaga
Nyuma yo kwinjira, abarwayi bavuwe hakoreshejwe uburyo bwo kubaga hakoreshejwe uko ibintu bimeze.Ubwa mbere, uwatunganije hanze yarakosowe, kandi niba ibintu byoroshye byoroheje byemewe, byasimbuwe no gukosora imbere.
Abanditsi bavuze mu ncamake ubunararibonye bwabo basanga urufunguzo rwo kugabanya kuvunika no kugabanya kubungabunga ari ukugabanya kubanza kuvunika inyuma ya tibia mbere, hanyuma bagakemura ikibazo cyo kwikuramo ibice byo mu kibaya cyimbere, kugirango bagarure indege isanzwe ya sagittal umurongo.
Abanditsi barasaba ko hakoreshwa uburyo bwa tibial tibial anterolateral na posteromedial uburyo bwo kugabanya kuvunika no gukosorwa.
Uburyo bwinyuma bwinyuma burashobora gukoreshwa mugushira ahabona imiterere yinyuma ya tibia no gukora kugabanya no gufata plaque ya anteromedial mugihe cyo gukora.
Byongeye kandi, gukosora by'agateganyo kuvunika kw'inyuma ya tibial plateau irashobora kuba nk'urwego rwo kuzamura kuvunika imbere no kugabanya kwimuka kwavunitse mugihe cyo gukosora gukurikira guhuza sagittal.
Kugabanuka kuvunika kwinyuma kurangiye, hagomba gukoreshwa igikoresho cyogukosora byigihe gito kugirango gikosorwe, nka plaque ya 1/3 cyangwa icyuma cya 3.5mm kuva kumpera yimbere kugeza kumpera yinyuma.
Ibikurikira, subiza guhuza tibial plateau articular surface nindege ya sagittal.Mugihe cyo gukora, koresha igikoresho cyo kugabanya ufite inama yagutse kugirango ugabanye umuvuduko kandi wirinde kwiyongera kuvunika kwatangiye.
Kugarura impengamiro yinyuma yatangijwe hamwe na flap spacer imbere cyangwa osteotome icyarimwe (Ishusho 2).Munsi yumurongo uhuriweho, insinga nyinshi za Kirschner zinjijwemo zibangikanye kuva imbere kugeza inyuma, hanyuma tibial retroversion yagaruwe no kuzamura insinga za Kirschner, hanyuma zishyirwa kumurongo winyuma.
A- Fibular umutwe autograft;B- Akazu k'umugongo kuzuza inenge
X-ray yinyuma yerekana ubumuga bwa sagittal, na firime iburyo yerekana imbaraga zo kugabanya kugabanya imvune yinyuma yinyuma hifashishijwe urupapuro rwerekana umwanya
Hanyuma, isahani yakoreshejwe kugirango igabanye ibice byavunitse kugirango ikosore sagittal retroversion.Impera yegeranye ya plaque ya tibial plaque (gufunga cyangwa kudafunga) igomba kuba ihwanye nubuso bwa arctular, kandi impera ya kure igomba kuba inyuma gato.Isahani yashyizwe ku gice cyegeranye gifite imigozi, hanyuma isahani hamwe nigice cyegeranye cyaragabanutse kandi gishyirwa ku rufunzo rwa tibial mugukosora isahani ya kure, kugirango igarure imitekerereze isanzwe yinyuma yinyuma.
Kugabanya kuvunika bimaze kurangira, gukosora byigihe gito hamwe ninsinga za Kirschner birashobora gukoreshwa.Rimwe na rimwe, gukosora byigihe gito biragoye kubikora utabanje kugarura umurongo wingufu hamwe nigishushanyo (tricortical iliac graft, fibular head graft, etc.)
Igihe cyo kohereza: Gicurasi-09-2022