Eqenjini le-HEVBTP, i-32% yeziguli zahlanganiswa nezinye izicubu noma ukulimala kwesakhiwo, futhi iziguli ze-3 (12%) zazinokulimala kwe-popliteal vascular okudinga ukulungiswa kokuhlinzwa.
Ngokuphambene, kuphela i-16% yeziguli eqenjini elingeyona i-HEVBTP yayinokulimala okunye, futhi i-1% kuphela idinga ukulungiswa kwe-popliteal vascular.Ngaphezu kwalokho, i-16% yeziguli ze-EVBTP zazinokulimala okuyingxenye noma okuphelele kwe-peroneal nerve futhi i-12% yayine-calf compartment syndrome, uma kuqhathaniswa ne-8% ne-10% yeqembu lokulawula, ngokulandelana.
Izinhlelo zendabuko zokuhlukaniswa kwe-tibial plateau fracture, njengezigaba ze-Schatzker, Moore, ne-AO/OTA, zenzelwe ukusiza odokotela abahlinzayo ukukhomba ukulimala okuhlobene futhi bathuthukise izinhlelo zokwelapha.
Lezi ziphuka ngokuvamile zihlukaniswa njenge-AO C kanye ne-Schatzker V noma i-VI
Kodwa-ke, imininingwane yalolu hlobo lokuphuka ingase inganakwa yilokhu kuhlukaniswa, okungase kushiye ezinye iziguli zinesifo esingadingekile lapho kukhona izinkinga ezinzima ze-neurovascular.
Indlela yokulimala ye-HEVBTP ifana neye-anteromedial tibial plateau fracture ehlanganiswe nokulimala okuyinkimbinkimbi kwangaphandle kanye nokuphuka kwe-posterior cruciate ligament
Ngakho-ke, ngokuphuka kwe-anteromedial tibial plateau, ukunakwa kufanele kukhokhwe ekulimazeni kwe-posterolateral side of the knee joint.
Esifundweni samanje, ukulimala okuchazwe esimweni sethu kwakuvame ukufana nokuphulwa kokucindezela kwe-tibial plateau.Kodwa-ke, ngokungafani nokulimala kwezicubu ezithambile ze-posterolateral noma i-posterior cruciate ligament, ukulimala kulezi zimo kungamathambo futhi kubhekwa njengokuhlukana kwengcindezi ku-metaphysis noma i-lateral plateau.
Ngokusobala, ukuhlonza amaphethini okulimala yilokho okuvumela odokotela abahlinzayo ukuthi baphathe kahle iziguli eziphukile.Ukuhlonza kwenziwa kube nokwenzeka ngokutholwa ngesikhathi esisodwa kwe-imaging ye-multiplanar kanye ne-computed tomography ukuze kunqunywe ubuqili bokulimala.
Kubalulekile ukuqaphela ukubaluleka kwalokhu kulimala, okuwukulimala okuhlobene okubalulekile.
U-Moore waqaphela ukuthi izinhlobo ezithile zokulimala kwe-tibial plateau azihlukanisiwe kodwa zimelela inqwaba yokulimala okuhlanganisa ukulimala kwe-ligamentous kanye ne-neurovascular.
Ngokufanayo, kulolu cwaningo, i-hyperextension kanye ne-varus tibial plateau bicondylar fractures itholakale ihlotshaniswa nengozi ephakeme ye-32% yokulimala okunye, okuhlanganisa ukulimala komkhumbi we-popliteal, ukulimala kwe-peroneal nerve, kanye ne-compartment syndrome.
Ekuphetheni, i-hyperextension kanye ne-varus bicondylar tibial plateau fractures iyiphethini eyingqayizivele ye-tibial plateau fractures.Izici zokuthwebula zale modi ziyi
(1) Ukulahlekelwa kwethambeka elivamile langemuva phakathi kwendiza ye-sagittal kanye ne-tibial articular surface
(2) Ukuphuka kwengcindezi ye-posterior cortex
(3) Ukucindezelwa kwe-cortex yangaphambili, ukukhubazeka kwe-varus ekubukeni kwe-coronal.
Odokotela abahlinzayo kufanele baqaphele ukuthi lokhu kulimala kungase kwenzeke ngemva komshini wokulimala ophansi wamandla kubantu abadala asebekhulile abanezinga eliphezulu lokulimala kwe-neurovascular.Amasu okunciphisa kanye ne-immobilization achazwe angasetshenziswa ukwelapha le ndlela yokulimala.
Isikhathi sokuthumela: May-16-2022