Okwangoku, zininzi iindlela zonyango zokwenza irediyo yerediyo, ezinjengokulungiswa kwendawo, ukuncitshiswa okukhulu kunye nokulungiswa kwangaphakathi, kodwa kukho iingxelo zoncwadi, njl njl. Njl. Nangona kunjalo, ukuba ipleyiti yentsimbi ikhethiwe ngokufanelekileyo, izehlo zeengxaki zinokuncitshiswa ngokufanelekileyo. Eli phepha lishwankathela ngokufutshane iimpawu, izibonakaliso, iindlela zokuziphakamisa, kunye neendlela zokuthintela i-surgeral plates iqhekeza leradiyo.
1. Zimbini izibonelelo eziphambili zeplate yesecaleni
A.it ingenzi cala icandelo lamandla okubulala. Ukulungiswa kunye nezikrelemnqa ezine-ang Inokufumana inkxaso yenkunkuma ngokufanelekileyo. Le nkqubo yeplace ayinakho ukulungisa i-discy ye-disral ye-disral, kodwa inokubuyisela ngokufanelekileyo ukwakhiwa kwe-Aatomical yethambo le-Intra-Archoicral Prichobur Primarral Subhondral Frivarral kwi-Peg / Screw "fan" Ngeendlela ezininzi zeRadius raides uqhekezo, olu hlobo lwenkqubo lubonelela ngokuzinza okukhulu kokusebenza kwasekuqaleni.
Umfanekiso woku-1, a, emva kokwakhiwa ngokutsha kwezintathu zokuphuma kwerediyo ye-Directed Draining, nikela ingqalelo kumgangatho woxinzelelo lwe-dorsal; B, ukunciphisa ukuqhekeka, isiphene kufuneka silungiswe kwaye sixhaswe yiplate; C, ukujonga emva kwexesha emva kokulungiswa kwe-DVR, i-arrow ibonisa ukuhanjiswa komthwalo.
Impembelelo ye-B.S ngaphandle kwezicubu ezithambileyo: I-Burala yokulungisa iphantsi komgca onamanzi, xa kuthelekiswa neplate ye-dorsal, inokunciphisa ukucaphukisa i-tendon, kwaye kukho indawo ekhoyo, enokuphepha ngakumbi i-tendon. uqhagamshelo ngqo. Ukongeza, uninzi lokufakwa lunokugutyungelwa ngumphathi we-pronator quadratus.
2. Izalathiso kunye nokuchasana nonyango lonyango lwe-distal radius ngeplate ye-volar
I-A.USHICONIT: Ukusilela ukuncitshiswa okuvaliweyo zeqhekeza lohlobo olungaphezulu, ezi meko zilandelayo zisenzeka ngaphezulu kwe-20mm enkulu kuno-3mm, i-Darsal Deatsument engaphezulu kwe-3mm enkulu kune-2mm; Ukususwa kwephuli yangaphakathi ingaphezulu kwe-2 mm; Ngenxa yoxinano lwethambo eliphantsi, kulula ukubangela ukufudukela ngokutsha, ke ngoko kunjalo kufanelekile ngakumbi kubantu abadala.
b. Ukuphikisana: Ukusetyenziswa kwee-anesthetics zasekhaya, izifo zasezikolweni okanye zenkqubo, imeko yolusu oluhle kwicala lesango le-vurst; I-Bone Mass kunye nohlobo lokuqhekeka kwindawo yokuqhekeka, uhlobo lwe-dorsal qungraure enje nge-Barton Fractures, iRadiocarpal ye-radionaid yenkqubo yokuqhekeka, i-radional ye-radionad ye-ralar.
Kwizigulana ezinobungozi obuphezulu onjengokuqhekeka kakhulu kwe-intra-tartures okanye ilahleko yethambo kakhulu, uninzi lwabaphengululi lungangqinisisanga ukusetyenziswa kwe-varcular, kuba ezo zinto zityumkileyo zithambekele kwi-vascular ne-vacrosis. Kwizigulana ezinamaqhekeza amaninzi aqhekekileyo kunye nokususwa okukhulu kunye ne-osteoporosis eqatha, iplate yolwandle kunzima ukusebenza. Kunokubakho iingxaki kwinkxaso yenkunkuma kwi-discraires, ezinjengokukrazula ungene kwi-cavity edibeneyo. Uncwadi lwakutshanje luye lwaxelwa ukuba xa amatyala angama-42 e-Intra atyhutyha amaplanga asebusweni, akukho sikroba sobugcisa esingena kwi-Articular Cavity cavity, enxulumene ikakhulu kwisikhundla seepleyiti.
I-3. Izakhono zokuThumela
Uninzi lwegqirha lusebenzisa ukulungiswa kwe-voralar plate kumhlaba we-diredius phuckiqe ngeendlela ezifanayo kunye neendlela zendlela. Nangona kunjalo, ukuphepha ngokufanelekileyo ukuvela kwezicelo zendawo, ubuchule bokuthintela i-Supergical kuyadingeka, umzekelo, ukuncitshiswa kunokufunyanwa ngokukhulula ibhloko yethambo le-phracked kunye nokubuyisela ukuqhubeka kwethambo lethambo. Ukulungiswa okwethutyana kunye neengcingo ze-kirschner kungasetyenziswa. Ngokuphathelele kweyiphi indlela yokusebenzisa, umbhali ucebisa i-pcr (i-frexor carpialis) ukwandisa indlela ye-bula.
i-a, ukulungiswa okwethutyana kunye neengcingo ezimbini zeKirschner, qaphela ukuba utyekelo lwe-bular kunye nomgangatho wobugcisa awuzange ubuyiselwe ngokupheleleyo ngeli xesha;
B, i-wirchner ucire ngokuthintela okwethutyana iplate, nikela ingqalelo kulungiso lwesiphelo seradiyo ngeli xesha (i-distal physiment yendlela yokuqhekeka), inxenye ye-proximal ye-rable itsaliwe ukubuyisela utyekelo lwe-radial ukubuyisela utyekelo lwemitha.
C, indawo ye-articular ihle phantsi kwe-arthroscopy, i-discial disw / i-PIN ifakwe, kwaye irediyo ye-proximal ekugqibeleni incitshisiwe kwaye ilungiswe.
Amanqaku aphambiliYendlela: Isikhuselo se-distal siqala eluswini esongelelani i-Wrist, kwaye ubude baso bungagqitywe ngohlobo lokuqhekeka. I-Slexor Carpis Fardis tendon kunye nehekes yayo ayichithwanga kwithambo le-caripal kwaye libe yi-proximal njengoko kunokwenzeka. Ukutsala i-Slexor Carpis Fidaisis kwicala le-ilnar kukhusela i-median nerve kunye ne-flexor thendoon. Indawo yeParona ityhilwe, kunye nomphathi we-quadratus ophakathi kwe-clexor harlucis lous (ilnar) kunye nobugcisa obuthile (i-radial). I-Icunt yenziwa kwicala le-pronator quadratus, lishiya inxenye eqhotyoshelwe kwiradiyo yokwakha kamva. Ukudonsa i-quadrator i-quadratus kwicala le-ilnar ngakumbi ivele i-angler yolwandle ye-radius.
Uhlobo lwesahlulo oluntsonkothileyo, kucetyiswa ukukhupha ukufakelwa kwesibini kwe-brachioradis miscle, enokuthintela ukutsalwa kwayo kwinkqubo ye-radyloid. Ngeli xesha, igumbi lokuphumla le-dorsal le-dorsal linokusikwa ukubhenca ibhloko ye-diadial rade kunye ne-radial staid shaft yokwahlulahlula ibhloko ye-gerchner ukunciphisa ibhloko ye-Intra ye-Intra. Ngobugcisa be-Intra enzima, i-arthroscopy inokusetyenziselwa ukunceda ukuncitshiswa, uvavanyo, kunye nokucocwa kakuhle kwezinto eziqhekezayo.
Emva kokuncitshiswa kugqityiwe, iplate yesarlar ifakwe rhoqo. Iplate kufuneka isondele nje kumanzi, kufuneka igubungele inkqubo ye-Ulnar, kunye nesiphelo seplatemal yeplate kufuneka ifike kwindawo ephakathi ye-radial shaft. Ukuba le mibandela ingentla ayifezekiswanga, ubungakanani beplate ayifanelekanga, okanye ukuncitshiswa akulunganga, ukusebenza akukafezekisi.
Iingxaki ezininzi zinokwenza into eninzi ekufuneka yenziwe kuyo iplate. Ukuba iplate ifakwe ngokupheleleyo, iingxaki ezinxulumene ne-tleolor ronucis lores zixelwe kwangaphambili; Ukuba iplate ibekwe kufutshane nomgca onamanzi, iClexor Digithetium AlfUnugus inokuba isemngciphekweni. Ukuncitshiswa kwe-Fraction kwi-Fular Shormphose Officturety kunokubangela ipleyiti yentsimbi ukuya kwi-protrude ukuya kwi-Voolar Play kwaye ngokuthe ngqo uqhakamshelane ne-Flexor Tendon, ekugqibeleni kukhokelela kwi-tetinitis okanye i-testinitis okanye i-testinitis.
Kwizigulana ze-osteororotic, kucetyiswa ukuba ipleyiti ibe kufutshane nomgca wamanzi kangangoko kunokwenzeka, kodwa hayi kuwo. Iingcingo zeKirschner zinokusetyenziselwa ukulungisa i-subchondral ekufutshane ne-Ulna, kunye ne-birs-cingo yasecaleni kwe-eKirsKer kunye neepleyiti kunye nezikhonkwane zinokuthintela ngokufanelekileyo ukwaphuka.
Emva kokuba iplate ibekwe ngokuchanekileyo, isiphelo se-proximal simiselwe ngesikrweqe, kwaye umngxunya we-Ulnar ngasekupheleni kweplate umiselwe okwethutyana nge-wirchchner wire. I-Intraoperapeetive Fluoroscopy Anterposh-Pleoposterior InEoposterior Umbono, ukujonga kwangaphambili, ukuphakama okudibeneyo 30 Ukuba isikhundla seplate siyanelisa, kodwa i-wirchner ucingo likunye nokudibana, kuya kukhokelela ekubuyiseleni ipleyiti ye-burlar, enokusonjululwa ngokuseta iplate ngokuseta iplate ngokuseta iplate ngo-2, b).
Ukuba ihamba kunye ne-dornar ye-dornar ye-Dornar (ilnar / i-dorsal died punch) kwaye ayinakuncitshiswa ngokupheleleyo phantsi kokuvalwa, kusetyenziswe ezi ndlela zintathu zilandelayo:
1. Lalela isiphelo se-proximal yeradiyo ukuyigcina kude kwindawo yokuqhekeka, kwaye utyhale i-fossa yokuqhekeka kwi-carpus ngendlela yolondolozo lwe-PRR ngendlela ye-PRR ngendlela ye-PRR ngendlela ye-PRR ngendlela yolwandiso lwe-PRR.
2. Yenza isimo esincinci kwicala le-dorsal ye-4 ne-5th ukubhengeza isiqwenga sokuqhekeka, kwaye siyilungiselele ngesikhali seyona pleyitha ye-Ulnar ye-Ulnar yomngxunya weplate.
I-3. Ukuvalwa kwe-percutaneal okanye ukulungiswa okungahlaseli okuncinci ngoncedo lwe-arthroscopy.
Emva kokuncitshiswa kuyanelisa kwaye iplate ibekwe ngokuchanekileyo, ukulungiswa kokugqibela kubaluleke kakhulu. Ukuba i-proximal ye-proximal ye-wirchner i-wire ibekwe ngokuchanekileyo kwaye akukho zikrelemnqa zikwi-cavity edibeneyo, ukuncitshiswa kwe-anatomical kungafunyanwa.
Amava okukhetha isikhunta: Ngenxa yokuguqulelwa ngokuqatha kwithambo le-dorsal Cortical, ubude besi screw kunokuba nzima ukulinganisa ngokuchanekileyo. Izikrelemnqa ezinde zinokubangela ukucaphukisa i-tendon, kunye nezikrelemnqa ezifutshane kakhulu azikwazi ukuxhasa kwaye zilungiselele isiqwenga se-dorsal. Ngesi sizathu, umbhali ucebisa ukuba kusetyenziswe isikrelemnqa esitshixwayo kunye nezikrelemnqa zokutshixa kwi-radial staid kwinkqubo ye-radial staid kunye neyona nto icekeceke i-rod ye-rod yokutshixa kwezinye izikhundla. Sebenzisa inqaku eliqaqambileyo kuthintela ukucaphukisa i-tendon nokuba kuphume i-dorsal ukuphuma. Ukulungiswa kwe-proximal ukulungisa iplate, i-screws ezimbini ezinxibelelana + nesikhuselo esinye (ezibekwe kwi-Ellipse) inokusetyenziselwa ukulungiswa.
4. Isishwankathelo sesicatshulwa esipheleleyo:
Ukulungiswa kwepleyiti yokutshixwa kwe-ralar ye-viele ye-Diredius Fractures kunokufezekisa ukusebenza kakuhle kwekliniki, exhomekeke ikakhulu kukhetho lweempawu kunye nezakhono zotyando. Ukusebenzisa le ndlela kunokubangela ngcono ukusebenza kwangoko, kodwa akukho mehluko emsebenzini wayo kunye nokucingisisa kunye nezinye iindlela, kunye nokuncitshiswa kwe-kirschner kirschner kire, kunye nosulelo lwe-haces, inaliti. Iingxaki ze-thessor Kwizigulana ezine-osteoporosis, iplate yolwandle iselokuqala ukhetho.
IXESHA LOKUQALA:
