Ukuqhekeka kweradius distal yenye yezona ziqhelekileyoukwaphukakwimisebenzi yeklinikhi.Ubuninzi be-distal fractures, iziphumo ezilungileyo zonyango zinokufumaneka nge-palmar approach plate kunye ne-screw fixation yangaphakathi.Ukongeza, kukho iindidi ezikhethekileyo zokwaphuka kweradius distal, ezinje ngoBarton fractures, Die-punch fractures,Iifracture zomqhubi, njl., ngalinye lifuna iindlela ezithile zonyango.Abaphengululi bamazwe angaphandle, kwizifundo zabo zeesampulu ezinkulu ze-distal radius fracture cases, baye bachonga uhlobo oluthile apho inxalenye yokudibanisa ibandakanya i-distal radius fracture, kwaye iziqwenga zamathambo zenza isakhiwo se-conical kunye nesiseko "sonxantathu" (tetrahedron), ebizwa ngokuba luhlobo lwe "tetrahedron".
Ingcamango ye "Tetrahedron" Uhlobo lwe-Distal Radius Fracture: Kulolu hlobo lwe-distal radius fracture, i-fracture yenzeke ngaphakathi kwendawo edibeneyo, ebandakanya zombini i-palmar-ulnar kunye ne-radial styloid facets, kunye ne-transverse triangular configuration.Umgca wokuqhekeka ufikelela ekupheleni kwe-radius.
Ukungafani kwesi siqhekeza kubonakaliswa kwiimpawu ezihlukeneyo ze-palmar-ulnar side fragments of the radius.Ngakolunye uhlangothi, i-lunar fossa eyenziwe ngala maqhekeza amathambo e-palmar-ulnar isebenza njengenkxaso yomzimba ngokuchasene nokuchithwa kwe-volar yamathambo e-carpal.Ukulahlekelwa kwenkxaso evela kwesi sakhiwo kubangela ukuchithwa kwe-volar ye-wrist joint.Kwelinye icala, njengenxalenye ye-distal radioulnar joint's radial articular surface, ukubuyisela eli qhekeza lethambo kwindawo yalo ye-anatomical yimfuneko yokufumana kwakhona uzinzo kumdibaniso we-distal radioulnar.
Lo mfanekiso ungezantsi ubonisa i-Case 1: Ukubonakaliswa kwemifanekiso yohlobo lwe "Tetrahedron" ye-distal radius fracture.
Kuphononongo oluthatha iminyaka emihlanu, iimeko ezisixhenxe zolu hlobo lokuphuka zachongwa.Ngokuphathelele izibonakaliso zotyando, kwiimeko ezintathu, kubandakanywa i-Case 1 kumfanekiso ongentla, apho kwakukho i-fractures engabonakaliyo, unyango olulondolozayo lukhethwe ekuqaleni.Nangona kunjalo, ngexesha lokulandelwa, zonke iimeko ezintathu ziye zafumana ukuchithwa kwe-fracture, okukhokelela kukuhlinzwa kwangaphakathi kokulungiswa kwangaphakathi.Oku kuphakamisa izinga eliphezulu lokungazinzi kunye nomngcipheko omkhulu wokutshintshwa ngokutsha kwiifractures zolu hlobo, kugxininisa isibonakaliso esinamandla sokungenelela ngokuhlinzwa.
Ngokuphathelele unyango, amatyala amabini ekuqaleni ahamba ngendlela yendabuko ye-volar kunye ne-flexor carpi radialis (FCR) yeplate kunye ne-screw fixation yangaphakathi.Kwesinye sezi meko, ukulungiswa kwahluleka, okubangele ukufuduka kwethambo.Emva koko, kwasetyenziswa indlela ye-palmar-ulnar, kwaye ukulungiswa okuthe ngqo kunye neplate yekholomu yenzelwe ukuhlaziywa kwekholomu ephakathi.Emva kokwenzeka kokungaphumeleli kokulungiswa, iimeko ezintlanu ezilandelayo zonke ziye zahamba ngendlela ye-palmar-ulnar kwaye zalungiswa nge-2.0mm okanye i-2.4mm plates.
Ityala le-2: Ukusebenzisa indlela ye-volar eqhelekileyo kunye ne-flexor carpi radialis (FCR), ukulungiswa ngeplate yesundu kwenziwa.Emva kokuhlinzwa, ukuchithwa kwangaphambili kwe-wrist joint kwabonwa, kubonisa ukungaphumeleli kokulungiswa.
Kwi-Case 2, ukusebenzisa indlela ye-palmar-ulnar kunye nokuhlaziywa kunye neplate yekholomu kubangele indawo eyanelisayo yokulungiswa kwangaphakathi.
Ukuqwalasela ukusilela kwiipleyiti eziqhelekileyo ze-distal radius fracture ekulungiseni le nxalenye ethile yamathambo, kukho imiba emibini ephambili.Okokuqala, ukusetyenziswa kwendlela ye-volar kunye ne-flexor carpi radialis (FCR) kunokubangela ukubonakaliswa okunganeleyo.Okwesibini, ubungakanani obukhulu bezikrufu zepleyiti yokutshixa i-palmar busenokungakhuseli ngokuchanekileyo amaqhekeza amancinane amathambo kwaye kunokubanakho ukuwasusa ngokufaka izikrufu kwizithuba phakathi kwamaqhekeza.
Ngoko ke, abaphengululi bacebisa ukusetyenziswa kwe-2.0mm okanye i-2.4mm yokutshixa iipleyiti zokulungiswa okuthe ngqo kweqhekeza lethambo lekholomu ephakathi.Ukongeza kwipleyiti exhasayo, ukusebenzisa izikhonkwane ezibini ukulungisa iqhekeza lethambo kunye nokungathathi hlangothi kwepleyiti ukukhusela izikrufu kukwayenye indlela yokulungisa yangaphakathi.
Kule meko, emva kokulungiswa kweqhekeza lethambo kunye nezikhonkwane ezimbini, ipleyiti yafakwa ukukhusela i-screws.
Isishwankathelo, uhlobo lwe "Tetrahedron" uhlobo lwedistal radius fracture lubonisa ezi mpawu zilandelayo:
1. Iziganeko eziphantsi kunye nezinga eliphezulu lokuxilongwa kwefilimu ecacileyo yokuqala.
2. Umngcipheko ophezulu wokungazinzi, kunye nokuthambekela kokutshintshwa ngexesha lonyango olulondolozayo.
3. Iipleyiti eziqhelekileyo zokutshixa i-palmar kwi-distal radius fractures zinamandla okulungisa obuthathaka, kwaye kucetyiswa ukuba kusetyenziswe iipleyiti zokutshixa i-2.0mm okanye i-2.4mm yokulungiswa okuthe ngqo.
Ukunikezelwa kwezi mpawu, kuqeqesho lwezonyango, kuyacetyiswa ukuba kwenziwe i-CT scans okanye iimvavanyo zamaxesha athile kwizigulana ezineempawu ezibalulekileyo zesihlahla kodwa ii-X-reyi ezingalunganga.Kuba olu hloboukwaphuka, ukungenelela kwangaphambili kotyando kunye ne-column-specific plate kunconywa ukukhusela iingxaki kamva.
Ixesha lokuposa: Oct-13-2023
