Okwangoku ukulungiswa kwangaphakathi kwerediyo yerediyo ye-Direas, kukho iinkqubo zokutshixwa kwe-anatomical avelting esetyenzisiweyo ekliniki. Ezi zilungiso zangaphakathi zibonelela ngesisombululo esingcono sezinto ezinzima zokuqhekeka, kwaye kwezinye iindlela zandise iimpawu zokwenza utyando kwimithombo yerediyo engazinzanga engathandekiyo, ngakumbi ezo zine-osteoporosis. Unjingalwazi Jupiter ovela kwisibhedlele seMassachusetts kunye nabanye bapapashe uluhlu lwamanqaku kwi-jbjs kwiziphumo zokutshintshwa kwe-radius procures kunye neendlela ezinxulumene noko. Eli nqaku ligxile kwindlela yokuhlinzwa yokulungisa i-diadius radius ye-diadis ngokusekwe kulungiso lwangaphakathi lwebhloko ethile ye-phracred.
Iindlela zoqhaqho
Ithiyori emithathu yekholamu, esekwe kwiimpawu ze-biomechachachacal kunye ne-anatomical ye-distar radius radius, sisiseko sophuhliso kunye nenkqubo yekliniki yenkqubo ye-2.4mm ye-2.4mm. ICandelo leeKholamu ezintathu ziboniswe kumzobo 1.
Umzobo 1 ithiyori yekholamu ezintathu ze-distar radius radius.
Ikholamu ye-Lateral yindawo yerediyo ye-distal, kubandakanya ne-Navicular fossa kunye ne-tuberosity ye-radial, exhasa amathambo e-radial, exhasa amathambo e-radial kwicala le-radial kwaye yimvelaphi yenye ye-ligalings enza ukuzinza kwesanti.
Ikholamu ephakathi sisiqingatha seMedial yeRadius Rare kwaye ibandakanya ifossate fossa (enxulumene ne-leunate) kunye ne-seigmoid i-nolch (inxulumene ne-digic) kumhlaba wobugcisa. Ngokwesiqhelo ilayishwe, umthwalo ovela kwi-fasate fossa idluliselwa kwiradiyo nge-fossa ye-lunate fossa. Ikholamu ye-Ulnar ye-Ulnar, equka i-rina ye-distal, i-triangrilage fitnar ye-radnar-rad-radial i-radial yamathambo amathambo e-ilnar kunye ne-radial radial radial kwaye inesiphumo sokuzinzisa.
Inkqubo yenziwa phantsi kwe-braxial anesthesia kunye ne-intraoperad c-arm c-ray ray ibalulekile. I-intibiotics ye-intravenous yaqhutywa ubuncinci imizuzu engama-30 ngaphambi kokuqala kwenkqubo kunye ne-pneumatic tortatic yayisetyenziselwa ukunciphisa ukopha.
Ukulungiswa kweplater yePalmar
Ngobuninzi befraction, indlela yePalmar inokusetyenziselwa ukubona phakathi kwe-rabial carsor clexor kunye nobugcisa obuqhelekileyo. Emva kokuchonga kunye nokubuyisa i-Slexor Carpira ye-Austo, umphezulu onzulu womphathi uqhubela phambili kwaye u "l" wahlulelwe ukwahlulwa kwemisipha. Kwisahlulo esikhulu ngakumbi, i-thechioradis thendon inokukhutshwa ngakumbi ukulungiselela ukuncitshiswa kwesando.
IPIN ye-kirchner ifakwe kumdibaniso we-raidpal, onceda ukuchaza imida ye-diad yeradiyo. Ukuba isixa esincinci sokuqhekeka kwindawo ye-Articul Stopgic sikhona, i-Palmar 2.4mm iplate yentsimbi inokubekwa ngaphezulu komda we-diericus weradiyo ngokulungisa. Ngamanye amagama, isixa esincinci sesandla kumhlaba wobugcisa we-leunate sinokuxhaswa yi-2.4mm "l" okanye "t" okanye "i-2.
Ukususwa kwe-dorsilly efudukayo eyongezelelweyo yobugcisa, kuyanceda ukuqaphela la manqaku alandelayo. Okokuqala, kubalulekile ukuba usete kwakhona okwethutyana ukuqinisekisa ukuba akukho tishu ithambileyo ethambileyo ekupheleni kwesaphulelo. Okwesibini, kwizigulana ngaphandle kwe-osteoporosis, iqhekeza lingancitshiswa ngoncedo lweplate: Okokuqala, i-Screw Screw incitshisiwe kwiplate yeplate, kwaye ekugqibeleni, ezinye izikrikhi zibekwe ngokulandelelana
Umzobo o-3 owongezelelweyo-owongezelelekileyo wokuqhekeka kwe-dorrs Umzobo 3 - Emva kokugqitywa kokuvezwa nge-radial cersor kunye ne-radicial pirchnery, i-pirchner ye-kirschner ifakwe kwi-rabial carpal edibeneyo. Umzobo we-3-B Ukuqhekeka kobuqhetseba kwe-metacarpan efudukayo ye-cortex ukuyibuyisela kwakhona.
Umzobo 3-C kunye nomzobo we-3-da ye-kirschner ye-kirschner ifakwe kwisiqu se-radial ngentambo yokuqhekeka okwethutyana.
Umzobo 3-Ukufunyanwa okwaneleyo kwendawo ye-opative ufezekiswa ngokusebenzisa umbuyisi ngaphambi kokubekwa kweplate. Umzobo we-3-F Right ye-screws kheck ibekwe kufutshane nethambo le-subchotral ekugqibeleni.
Umzobo we-3-g x-ray fluoroscopy kufuneka isetyenziselwe ukuqinisekisa isikhundla seplate kunye nesikrweqe esikhulu. Umzobo we-3-H Inxalenye yeProximal yeplate ifanele ihlawulwe ngokuchanekileyo (i-10 degree Angle) ukusuka kwi-diaphsesis ukuze ipleyiti ilungiswe kwibhloko ye-diaphsere yokuqhekeka. Umzobo 3-ndiqinisa isikrelemnqa sokuphakamisa ukuphinda ndisebenzise utyekelo lwe-Palmar. Susa i-pirchner pin ngaphambi kwe-screw iqine ngokupheleleyo.
Amanani 3-J kunye ne-3-k Intramopeed Imifanekiso yeRadiographic iqinisekisa ukuba i-phract iphinde yaphinda yaphinda yafunyanwa kunye ne-screws ye-plate.
I-Dorsal Plateation Inkqubo yoNyango yokubonisa inqaku le-Dorsal lerediyo le-distal ixhomekeke ikakhulu kuhlobo lokuqhekeka, kwaye imeko ye-Intra ye-Intrature ye-Intrature, injongo ye-Intra ye-Artial ikakhulu ingakumbi. Intreyimu, iibhendi zenkxaso zandiselweyo kufuneka zikhutshwe ngeendlela ezimbini eziphambili: Zide kwi-2nd kunye ne-3 yezahlulo, kunye nokuhlaselwa kwesahlulo se-4 okanye inkxaso yesibini yenkxaso yesibini phakathi kweqela le-4 neye-5 lokwandiswa ukuze ibhenca ezi kholamu ezimbini ngokwahlukeneyo (Fig. 4).
Ukuqhekeka kuyandiswa kwaye kuhlelwe okwethutyana kunye nePIN ye-kirschner engafundanga yeKirschner, kunye nemifanekiso yeRadiographic kuthathelwe ingqalelo ukuba ukwaphuka kutyelwe kakuhle. Emva koko, i-dornal il enkulu (iKholam ephakathi) icala le-radius lizinzile nge-2.4 mm "l" okanye "t" okanye "t" t ". Iplate ye-dorsal yol enkulu yenziwa ukuqinisekisa ukuba ifanelekile i-dornar icala le-Daster Ordius radius. Iipleyiti zinokubekwa kufutshane nendawo ye-dorsate ye-distate kangangoko kunokwenzeka, njengoko i-roops ehambelana neplate nganye ivumela iipleyiti ukuba zenze imingxunya kwimingxunya ye-screw (Fig. 5).
Ukulungiswa kweplate yekholamu ye-radial ilula, njengoko umhlaba wethambo phakathi kwezahlulo zokwandiswa okokuqala kunye neyesibini iflethi kwaye inokulungiswa kwesi sikhundla ngeplate enomkhenkce. Ukuba i-pirchner i-pin ibekwe kwinxalenye egqithisileyo ye-tuberosity, isiphelo se-radial sekhompyutha esine-roove esihambelana ne-riove ehambelana nePIN yeplate, engaphazamisi iplate kwaye igcine isaphulelo endaweni (Fig 6).
I-4 Ibhendi yenkxaso ivulwa ukusuka kwi-3 ye-3 ye-3lesshini eyandisiweyo kunye ne-Insorn Houcis Tendon iyarhoxiswa.
Umzobo wesi-5 wokulungiswa kwenqaku le-dorsal kumhlaba wobugcisa wenyanga, i-dorsal "T" Nje ukuba ipleyiti ye-dorsal kumhlaba wobugcisa we-leunate ikhuselwe, iplate yekholamu ye-radial ikhuselwe (amanani 5-c). Iipleyiti ezimbini zibekwe kwi-angle ye-70 degrees omnye komnye ukuphucula uzinzo lolungiso lwangaphakathi.
Umzobo 6 Iplate yekholamu ye-radial ifakwe ngokufanelekileyo kwaye ibekwe kwikholamu ye-radial ekupheleni kweplate, evumela iplate ekuphepheni ukulungiswa kwe-kirchner ngaphandle kokuphazamisa isikhundla seplate.
Iikhonsepthi ezibalulekileyo
Izalathiso ze-methacarpal plate
I-Artacarpal ye-Intra ye-Intra ye-Intra
ishenxisiwe i-quarikos eyongezelelweyo (iiKholekhi kunye neFith Fractures). Ukulungiswa okuzinzileyo kunokufezekiswa ngeipleyiti zokukroba nangona kukho ubukho be-osteoporosis.
Ifudusiwe i-metacarpal ye-facuricular yomhlaba
Izalathiso ze-dorsal plate
Ngomsebenzi we-ligamente
I-Dorsal ye-dorsate yomhlaba
I-dorsiji ye-radial radial racker discare
Ukuphikisana kwi-Palmar Plate
Isifo se-osteoporosis esinengxaki yokusebenza
I-Dorsal radial rabrist disloure
Ubukho beemororbidis ezininzi zonyango
Ukuphikisana kulungiso lweplate ye-dorsal
I-cortobvidies yoNyango emininzi
I-Profuds
Iimpazamo ezenziwa ngokulula kwi-Palmar Plate
Isikhundla seplate sibaluleke kakhulu kuba singayixhasi kuphela iplate ixhasa isixa se-phraure, kodwa imeko efanelekileyo iphinda ithintele isikhafu sokutshixa kwe-raidpal. I-radiology ye-intraoperation ye-intraoperative, iqikelelwe kwicala elinye njengoko i-radicial tye yerediyo ye-distal, ivumela ukuboniswa ngokuchanekileyo komgangatho we-radial ye-radial ye-radial yerediyo ye-radial ye-ilnar kuqala ngexesha lokusebenza.
Ingubo yokwahlulahlula i-dorsal cortex ithwala umngcipheko wokukhuthaza i-thedoon yolwandiso kwaye ibangela ukugqobhoza i-tendon. Ukutshixa izikrelem zenza ngokwahlukileyo kwizikrelem eziqhelekileyo, kwaye akunyanzelekanga ukuba ungene kwi-dorsal cortex ngezikrelem zesikrelem.
Iimpazamo ezenziwe ngokulula ngolungelelwaniso lweplate ye-dorsal
Kuhlala kukho umngcipheko wokukroba kwi-radial radial cerpal, kwaye kufana nendlela echazwe apha ngasentla ngokunxulumene ne-Palm Pat.
Ukuba ukulungiswa kwekholamu ye-radial kwenziwa kuqala, izikrikhi kwi-tuberosity ye-radial ziya kuchaphazela uvavanyo lokulungiswa kwe-articular.
I-dissing divws ezingakhange zikhuphe ngokupheleleyo kwi-screw Hole zinokukhalimela i-tendon okanye i-tendon hlukana.
Ixesha leposi: NgoDE-28 ukuya ku-923
