Unyango oluqhelekileyo lwe-distal radius fractures yi-volar Henry indlela kunye nokusetyenziswa kwamacwecwe okutshixa kunye nezikrufu zokulungiswa kwangaphakathi. Ngexesha lenkqubo yokulungiswa kwangaphakathi, ngokuqhelekileyo akukho mfuneko yokuvula i-capsule ye-radiocarpal joint capsule. Ukunciphisa ngokudibeneyo kufezekiswa ngendlela yokukhwabanisa yangaphandle, kwaye i-fluoroscopy ye-intraoperative isetyenziselwa ukuvavanya ukulungelelaniswa kwendawo edibeneyo. Kwiimeko ze-intra-articular depressed fractures, ezifana ne-Die-punch fractures, apho ukunciphisa ngokungathanga ngqo kunye nokuhlola kuyinselele, kunokuba kuyimfuneko ukusebenzisa indlela ye-dorsal ukuncedisa ukubonwa ngokuthe ngqo kunye nokunciphisa (njengoko kuboniswe kumfanekiso ongezantsi).
I-extrinsic ligaments kunye ne-intrinsic ligaments ye-radiocarpal joint zibhekwa njengezakhiwo ezibalulekileyo zokugcina uzinzo lwe-wrist joint. Ngenkqubela phambili yophando lwe-anatomical, kuye kwafunyaniswa ukuba, phantsi kwemeko yokugcina ingqibelelo ye-radiolunate ligament emfutshane, ukusika i-extrinsic ligaments akubangeli ukungazinzi kwe-wrist joint.
Ngoko ke, kwiimeko ezithile, ukuphumeza umbono ongcono wendawo edibeneyo, kunokufuneka ukuba udibanise ngokuyinxenye i-ligaments yangaphandle, kwaye oku kwaziwa ngokuba yi-volar intraarticular extended window approach (VIEW). Njengoko kubonisiwe kulo mfanekiso ungezantsi:
Umzobo AB: Kwindlela yesiqhelo kaHenry yokubonisa i-distal radius bone surface, ukuze ufikelele kwiqhekeza le-distal radius kunye ne-scaphoid facet, i-capsule ye-wrist joint incised ekuqaleni. I-retractor isetyenziselwa ukukhusela i-radiolunate ligament emfutshane. Emva koko, i-radiolunate ligament ende ihlanjululwa ukusuka kwiradiyasi ekude ukuya kwicala le-ulnar le-scaphoid. Ngeli xesha, ukuboniswa ngokuthe ngqo kwendawo edibeneyo kunokufezekiswa.
Umzobo we-CD: Emva kokubonakalisa indawo edibeneyo, ukunciphisa i-sagittal plane ecinezelekileyo indawo edibeneyo yenziwa phantsi kokubonwa ngokuthe ngqo. Izinyusi zethambo zisetyenziselwa ukuphatha kunye nokunciphisa amaqhekeza amathambo, kunye neengcingo ze-0.9mm Kirschner zingasetyenziselwa ukulungiswa okwethutyana okanye okokugqibela. Emva kokuba indawo edibeneyo iyancipha ngokwaneleyo, iindlela eziqhelekileyo zokulungiswa kweplate kunye ne-screw zilandelwa. Ekugqibeleni, izithintelo ezenziwe kwi-radiolunate ligament ende kunye ne-capsule ye-wrist joint is sutured.
Isiseko sethiyori ye-VIEW (i-volar intraarticular extended window) ixhomekeke ekuqondeni ukuba ukusika i-wrist joint extrinsic ligaments akuthethi ukuba kubangele ukungazinzi kwe-wrist joint. Ngoko ke, kucetyiswa ukuba kusetyenziswe i-intra-articular comminuted distal radius fractures apho ukunciphisa umphezulu odibeneyo we-fluoroscopic kungumngeni okanye xa kukho ukunyathela. Indlela ye-VIEW icetyiswa ngamandla ukuphumeza ukubonwa okuthe ngqo okungcono ngexesha lokunciphisa kwiimeko ezinjalo.
Ixesha lokuposa: Sep-09-2023
