1.Ndiciations
1)
2)
3) .old fractures.
4) .Fracture malunion kana nonunion. pfupa riripo kumba uye kunze kwenyika
2.contraindications
Varwere vakura vasina kukodzera kuvhiyiwa.
3. Kunze kwekugadzirisa kwekuvhiya maitiro
1. Kuyambuka-kunyengera kunze kwekunze gadzirisa distal radius fantures
Chinzvimbo uye Kugadzirira Kunoratidzira:
· Brachial plexus anesthesia
· Kunze chinzvimbo neiyo yakakanganisika limb flat pane iyo yekuona-kuburikidza ne bracket padivi pamubhedha
· Sekuru · thaturoquet kusvika 1/3 ye ruoko rwekumusoro
· Zveruzhinji Kuongorora
Kuvhiya maitiro
Metacarpal Screw Kuisa:
Iyo yekutanga screw iri pazasi yechipiri metacarpacal pfupa. Chiitiko cheganda chinogadzirwa pakati pekuwedzera tendonor yeiyo index yemunwe uye iyo dorsal interrosseous tsandanyama yefuma yekutanga. Iyo yakapfava tishu yakaparadzaniswa zvinyoro-nyoro nehurema hwekuvhiya. Iyo sleeve inodzivirira iyo yakapfava tishu, uye 3mm shanz screw yakaiswa. Screws
Kutungamirirwa kwechibheneketi ndeye 45 ° ndege yechanza, kana inogona kuenderana ndege yechanza.
Shandisa iyo gwara rekusarudza chinzvimbo chechipiri screw. Yechipiri 3mm screw yakatungamirirwa mune yechipiri metacarpaclisal.
Iyo dhayamita yeiyo metacarpal fixation pin haifanire kupfuura 3mm. Iyo fixation pini iri mune iyo proximal 1/3. Kune varwere vane osteoporosis, iyo yakanyanya proximal screw inogona kupinza matunhu matatu ecortex (yechipiri metacarpacal pfupa uye hafu cortex yeiyo yechitatu yetatu metacarpal pfupa). Nenzira iyi, iyo screw iyo refu yekugadzirisa ruoko uye yakakura kugadziriswa torque inowedzera kugadzikana kweiyo gadziriro yekugadzirisa.
Kuiswa kweiyo radial screws:
Gadzira ganda rinonzwisisika pamupendero weradius, pakati peBrachiordialis Muswe uye neTexpsor Mugumo weCracture, uye shandisa hemat kuti isimbe zvishoma nezvishoma mitezo yechipenga kune pfupa. Kuchengeta kunotorwa kuchengetedza matavi epamusoro eiyo radial nerve iyo nzira munzvimbo ino.
Pane imwe ndege sedanda reMetacarpal screws, maviri 3mm Schanz screws akaiswa pasi pekutungamirirwa kweiyo sleeve dziviriro nyoro nyoro tissue
· · Defracture kuderedza uye kugadzirisa:
· -Manyual traction kuderedzwa uye c-ruoko fluoroscopy kuti utarise kuderedzwa kwekupwanya.
· Lixnternal gadziriso mhirizhonga yakaita kuti ive yakaoma kudzorera zvachose clapar yekukanganisika, saka inogona kusanganiswa nekapandji mapini ekubatsira mukudzikisira uye kugadzirisa.
· 4For varwere vane radial styloid fractures, radial styloid kirschner waya kugadziriswa kunogona kushandiswa.
· 4huri inochengetedza kuderedzwa, batanidza iyo yekunze fixator uye isa iyo inotenderera nzvimbo yekunze fixator pane iyo axis yakafanana neyekutenderera yechiuno.
· Clearoscopy, tarisa kuti iyo radius kureba, ulnar kutsauka kona yakadzorerwa, uye gadzirisa iyo gadziriso kukona kusvikira iyo yekudzikisira kuderedzwa kugutsa.
·. Teerera kuhurongwa hwenyika kweiyo yekunze fixator, ichikonzera iatrogenic fractures kuimba yeMacarpal screws.
Distal radius kupwanya pamwe ne distal radioulnar Joint (Druj) kupatsanurwa:
· 4post Drujs inogona kuderedzwa zvoga mushure mekudzora kweiyo distal radius.
· Druj ichiri kupatsanurwa mushure meiyo Distal radius yakaderedzwa, shandisa bhuku rekumanikidza kuderedzwa uye shandisa iyo inotevera tsvimbo tsvimbo yebhandi rekunze.
· 4ir shandisa k-waya kupinza druj mune isina kwayakarerekera kana zvishoma kusimudzwa chinzvimbo.
Fracture ye distal radius yakasanganiswa neULNAR Styloid Fracture: Tarisa kugadzikana kweDruj mune Prenation, kusarerekera uye kusaziva kwemberi. Kana kushaya simba kuripo, kubatsirwa kugadziriswa neKiriviri Wires, Kugadziriswa kweTFCC Ligament, kana kushungurudzika kwebhendi kunogona kushandiswa kune gadziriso Ulnar Styloid Process.
Ngwarira kudhonza kwakanyanya:
· Tarisa kana zvigunwe zvemurwere zvinogona kuita kuti zvifeve zvakazara uye kufamba kwekuwedzera pasina kusawirirana kuri pachena; Enzanisa iyo radiolunate yakabatanidzwa nzvimbo uye iyo midcarpal yakabatana nzvimbo.
· Tarisa kana ganda riri pachiteshi chekombi rakanyanya. Kana zvakanyanyisa, ita chakakodzera incision kudzivirira hutachiona.
Simbisai varwere kufambisa zvigunwe zvavo mangwanani, kunyanya kushanduka uye nekuwedzera kwemakumi metakafilange majoini emunwe, kushandurirwa uye kuwedzerwa chigunwe, uye kutapwa.
2..
Chinzvimbo uye kugadzirira kunokosha: zvakafanana.
Maitiro ekuvhiya:
Nzvimbo dzakachengetedzeka dzeK-WIRE Kuiswa pane Dorsal Lide yeLartal
Nenzira imwecheteyo, zviyero zviviri zve schanz zvakaiswa muRadil Shaft uye yakabatana neyakabatanidza tsvimbo.
Kuburikidza nenzvimbo yekuchengetedza, zviyero zviviri zve schanz zvakaiswa mumugodhi we disth radius kupenga, mumwe kubva kune radial scrade Iyo screw inofanira kubata iyo contralateral cortex, uye inofanira kucherechedzwa kuti chipenga chakaiswa pane radial side haikwanise kupfuura neiyo sigmoid notch uye pinda iyo distal radioulnar mubatanidzwa.
Batanidza iyo SChanz Screw paLatal Radius ine yakakombama link.
Shandisa iyo yepakati inoti inobatanidza tsvimbo yekubatanidza zvikamu zviviri zvakaputsika, uye chenjera kuti urege kukiya chuck kwenguva pfupi. Nerubatsiro rweiyo yepakati link, chidimbu che distal chinoderedzwa.
Mushure mekugadzirisa, kukiya chuck pane iyo iyo inobatanidza tsvimbo kuti upedze yekupedzisiraKugadziriswa.
Musiyano uripo pakati pekusabatana
Nekuti akawanda Scurure screws inogona kuiswa kuti upedze kuderedzwa uye kugadziriswa kwezvidimbu zvepfupa, zviratidzo zvekuvhiya zvevasina kujairika ekunze maficha akafara kupfuura idzo dzevakabatanidzwa-yekubatanidza ekunze. Kuwedzera kune yakawedzera-inyengera mapundu, ivo vanogona zvakare kushandiswa kwechipiri kune yechitatu zvikanganiso. Chidimbu Intra-Articular Fracture.
Iyo yekuyambuka-yekubatanidza yekunze ficha inogadzirisa ruoko rwechiuno uye haitenderi kutanga kwebasa rekurovedza, nepo isiri-yekubatanidza yekunze ficha inobvumira yekutanga prist inoshanda kurovedza muviri.
Kutumira Nguva: Sep-12-2023
