Unyango oluqhelekileyo lokuqhekeka kwe-distal radius yindlela ye-volar Henry esebenzisa iipleyiti zokutshixa kunye nezikrufu zokulungisa ngaphakathi. Ngexesha lenkqubo yokulungisa ngaphakathi, akusoloko kuyimfuneko ukuvula i-capsule yejoyinti ye-radiocarpal. Ukunciphisa amalungu kufezekiswa ngendlela yokuguqulwa kwangaphandle, kwaye i-fluoroscopy yangaphakathi isetyenziselwa ukuvavanya ukulungelelaniswa komphezulu wamalungu. Kwimeko yokuqhekeka okuxinzelelweyo ngaphakathi kwe-articular, okufana nokuqhekeka kwe-Die-punch, apho ukunciphisa okungathanga ngqo kunye novavanyo kunzima, kunokufuneka ukusebenzisa indlela ye-dorsal ukunceda ekuboniseni ngokuthe ngqo kunye nokunciphisa (njengoko kuboniswe kumfanekiso ongezantsi).
Iiligaments zangaphandle kunye neeligaments zangaphakathi zejoyinti ye-radiocarpal zithathwa njengezakhiwo ezibalulekileyo zokugcina uzinzo lwamalungu esihlathi. Ngokuhambela phambili kuphando lwe-anatomical, kuye kwafunyaniswa ukuba, phantsi kwemeko yokugcina ukuthembeka kwe-ligament emfutshane ye-radiolunate, ukusika iiligaments zangaphandle akuthethi ukuba kunokubangela ukungazinzi kwamalungu esihlathi.
Ngoko ke, kwiimeko ezithile, ukuze kubonakale ngcono umphezulu wejoyinti, kunokufuneka ukuba kuqatywe kancinci i-extrinsic ligaments, kwaye oku kwaziwa ngokuba yi-volar intraarticular extended window approach (VIEW). Njengoko kubonisiwe kumfanekiso ongezantsi:
Umfanekiso AB: Kwindlela eqhelekileyo kaHenry yokuveza umphezulu wethambo le-distal radius, ukuze kufikelelwe ekuqhekekeni okwahlulwe yi-distal radius kunye ne-scaphoid facet, i-wrist joint capsule iyaqalwa i-incised. I-retractor isetyenziselwa ukukhusela i-short radiolunate ligament. Emva koko, i-long radiolunate ligament iyanqunyulwa ukusuka kwi-distal radius ukuya kwicala le-ulnar le-scaphoid. Kule ndawo, ukubonakala ngokuthe ngqo komphezulu we-joint kunokufezekiswa.
Umfanekiso weCD: Emva kokuveza umphezulu odibeneyo, ukunciphisa umphezulu odibeneyo oxinzelelweyo we-sagittal plane kwenziwa phantsi kokubona ngokuthe ngqo. Iilifti zamathambo zisetyenziselwa ukulawula nokunciphisa iziqwenga zamathambo, kwaye iingcingo zeKirschner eziyi-0.9mm zingasetyenziselwa ukuqinisa okwethutyana okanye okokugqibela. Nje ukuba umphezulu odibeneyo uncitshiswe ngokwaneleyo, iindlela eziqhelekileyo zokuqinisa ipleyiti kunye nezikrufu ziyalandelwa. Ekugqibeleni, ukunqunyulwa okwenziwe kwi-long radiolunate ligament kunye ne-wrist joint capsule kuyathungwa.
Isiseko sethiyori sendlela yeVIEW (volar intraarticular extended window) sixhomekeke ekuqondeni ukuba ukunqumla ii-ligaments ezithile ze-wrist joint akuthethi ukuba i-wrist joint ayizinzi. Ke ngoko, kuyacetyiswa kwii-distal radius fractures ezithile ezintsonkothileyo ze-intra-articular comminuted apho ukunciphisa umphezulu we-joint fluoroscopic kunzima okanye xa kukho i-step-offs. Indlela yeVIEW iyacetyiswa kakhulu ukuze kufezekiswe umbono othe ngqo ngexesha lokunciphisa kwiimeko ezinjalo.
Ixesha lokuthumela: Septemba-09-2023
