Distal radius kupwanya: Tsananguro yakadzama yeiyo yemukati gadziriso yekuvhiya hunyanzvi Sith mifananidzo uye zvinyorwa!

1. Zviratidzo

1)

2)

3) .old fractures.

4) .Fracture malunion kana nonunion. pfupa riripo kumba uye kunze kwenyika

1. Kukanganisa

Varwere vakura vasina kukodzera kuvhiyiwa.

1. Yemukati Fixation (YOLLATER YOKUTI)

Maitiro ekugadzirira kugadzirira. Anesthesia inoitwa uchishandisa Brachial plexus anesthesia kana general anesthesia

1) Iyo 8CM incision inogadzirwa pakati peiyo radial artery yechigaro uye iyo flexor carpi radialis tsandanyama uye yakawedzera kune ruoko rwechiWrist. Izvi zvinogona kufumura zvakakwana kupwanya uye kudzivirira bata chibvumirano. Iyo incision haidi kuenda muchanza cheruoko (Mufananidzo 1-36A).

2) Iyo bellowing dumbu rinofumurwa zvakakwana kune iyo Pronator Quadratus Muscle (Mufananidzo 1-36C)

3) .Make "

4) Isa dissector kana diki scissor banga kune iyo lrage Bone cortic corcongement uye kuderedza chigunwe chekukanda chidimbu, uye shandisa zvigunwe zvekumanikidza chidimbu cheDorgment kuti uderedze chidimbu cheDorgment.

Kana iyo radial styloid bractured, zvakaoma kuderedza iyo radial styloid bracture nekuda kwekudhirowa kweBrachioradialis tsandanyama tsandanyama. Kuti uderedze simba rekudhirowa, brachioradialis inogona kunyengedzwa kana kubvumidzwa kubva kune iyo distal radius. Kana zvichidikanwa, chidimbu che distal chinogona kuve chakarongedzwa kwenguva pfupi kune iyo proximal chidimbu chine kirschner waya.

Kana iyo Ulnar Styloid process yakamiswa uye yakadzingwa, uye disal radioulnar yakabatanidzwa, imwe kana maviri mairaya anogona kushandiswazve kuti ishandiswe. Zvidiki zvidiki kazhinji hazvidi zvekurapa. Nekudaro, kana iyo distal radioulnar yakabatanidzwa mushure mekugadziriswa kweradius, chidimbu cheStyloid chingabvumidzwa uye nemichero yemativi fibroctilage maitiro eUlnar styloid uye mashira kana silk tambo.

5) Mushure mekupwanya kwakabudirira kuderedzwa, sarudza nzvimbo yekuiswa kweiyo vhorosi simbi pasi pekutungamirirwa kwe x-ray fluoroscopy Shandisa gomba re2,5mm drill yekukwevera pakati pegomba reoval, uye isa 3.5mm kuzviratidza-thafeta screw.

Mufananidzo 1-36 Ganda Incision (A); incision yeiyo flexor carpi radialis tendon sheath (b); Peeling kubva kune chikamu cheiyo flexor Tendon kufumura iyo pronator quadratus tsandanyama (c); kupatsanura iyo pronator quadratus tsandanyama kufumura radius (d); kufumura mutsara wetsetse (e); isa iyo vhoti ndiro uye screw mune yekutanga screw (f)
6) Kana zvichidikanwa, sundira ndiro kure kana padhuze kuti uwane iyo yakanyanya kunaka disrew screw kuiswa.

7) Chikombama chinofanira kunge chiri 2mm kupfupika pane iyo yakayerwa chinhambwe kudzivirira iyo screw kubva penzombe uye inotangira kubva kuDorsal cortex. Kazhinji, screw inosvika 20-22mm yakaringana, uye iyo yakagadzirirwa pane radial styloid maitiro inofanira kunge ipfupi. Mushure mekuputika mune iyo distal screw, skrew inoisa iyo yakasara proximal screw.

Nekuti kona yechikepe chakagadzirwa, kana ndiro yacho ichiiswa padhuze pedyo nekuguma kweKrisiki, iro ganda rinopinda muchiuno. Tora zvidimbu zveTangeni

. B. anteroposter
8) Ziva kuti tsandanyama haizofukidze zvakakwana ndiro. Chikamu che distal chinofanira kufukidzwa kuti uderedze kusangana pakati peiyo flexor tendon uye ndiro. Izvi zvinogona kuwanikwa nekutsiva iyo pronator quadatus kumucheto kweBrachiortialis, kuvhara iyo incisional layer neaya, uye kuigadzirisa neplaster kana zvichidikanwa.