Kupwanyika kwe distal radius ndeimwe yezvakajairikakutyokamukurapa. Kune vazhinji vemavanga ekutyoka kwechiuno, mhedzisiro yakanaka yekurapa inogona kuwanikwa kuburikidza nekushandisa palmar approach plate uye screw internal fixation. Pamusoro pezvo, kune mhando dzakasiyana-siyana dzemavanga ekutyoka kwechiuno, dzakadai seBarton fractures, Die-punch fractures,Kutyoka kwemutyairi, nezvimwewo., imwe neimwe inoda nzira dzakatarwa dzekurapa. Nyanzvi dzekune dzimwe nyika, mukudzidza kwavo nezvemasampuli makuru ezviitiko zvekutyoka kwechikamu chedistal radius, vakaona rudzi rwakati apo chikamu chejoinhi chinosanganisira kutyoka kwechikamu chedistal radius, uye zvidimbu zvemapfupa zvinoumba chimiro checonical chine hwaro hwe "triangular" (tetrahedron), hunonzi rudzi rwe "tetrahedron".
Pfungwa ye "Tetrahedron" Rudzi rweDistal Radius Fracture: Murudzi urwu rwe distal radius fracture, fracture inoitika mukati mechikamu chejoinhi, inosanganisira palmar-ulnar ne radial styloid facets, ine transverse triangular configuration. Mutsetse wekutyoka unosvika kumagumo edistal eradius.
Kusiyana kwekutyoka uku kunoratidzwa muhunhu hwakasiyana hwezvidimbu zvemapfupa zveparutivi pepalmar-ulnar zveradius. Kune rumwe rutivi, lunar fossa inoumbwa nezvidimbu zvemapfupa zveparutivi pepalmar-ulnar izvi zvinoshanda sechitsigiro chemuviri pakurwisa kutyoka kwemapfupa ecarpal. Kurasikirwa nerutsigiro kubva muchimiro ichi kunoita kuti kutyoka kwejoini reruoko kubve pajoini. Kune rumwe rutivi, sechikamu chedivi redivi reradioulnar joint, kudzoreredza chidimbu ichi chepfupa panzvimbo yaro yemuviri chinhu chinodiwa kuti pave nekugadzikana mudivi redivi reradioulnar.
Mufananidzo uri pazasi unoratidza Nyaya 1: Mifananidzo yezviratidzo zvekutyoka kwe "Tetrahedron" kwakajairika.
Muchidzidzo chakaitwa kwemakore mashanu, nyaya nomwe dzerudzi urwu rwekutyoka dzakaonekwa. Nezvezviratidzo zvekuvhiyiwa, kune nyaya nhatu, kusanganisira Nyaya 1 iri mumufananidzo uri pamusoro, uko pakutanga kwaive nekutyoka kusina kubviswa panzvimbo, kurapwa kwakarongeka kwakasarudzwa pakutanga. Zvisinei, panguva yekutevera, nyaya dzese nhatu dzakasangana nekutyoka, zvichikonzera kuvhiyiwa kwemukati kwakatevera. Izvi zvinoratidza kusagadzikana kwakanyanya uye njodzi huru yekudzoserwa panzvimbo patsva kwekukuvara kwerudzi urwu, zvichisimbisa chiratidzo chakasimba chekupindira kwekuvhiyiwa.
Panyaya yekurapwa, nyaya mbiri dzakatanga dzakashandiswa nzira yechinyakare yekushandura mapfupa ne flexor carpi radialis (FCR) yekubatanidza plate ne screw internal. Mune imwe yenyaya idzi, kugadzirisa kwacho kwakakundikana, zvikaita kuti mapfupa abve. Mushure mezvo, nzira ye palmar-ulnar yakashandiswa, uye kugadzirisa kwakananga ne column plate kwakaitwa kuti kugadziriswe central column. Mushure mekukanganisa kugadzirisa, nyaya shanu dzakatevera dzese dzakaitwa nzira ye palmar-ulnar uye dzakagadziriswa ne 2.0mm kana 2.4mm plates.
Nyaya yechipiri: Pakashandiswa nzira yemazuva ano yekushandura mapfupa ne flexor carpi radialis (FCR), pakaitwa kugadzika neplate yepalmar. Mushure mekuvhiyiwa, kugadzika kwejoini reruoko kwakaonekwa, zvichiratidza kutadza kugadzika.
Panyaya yechipiri, kushandisa nzira yepalmar-ulnar uye kugadzirisa ne column plate kwakaguma nenzvimbo inogutsa yekugadzika kwemukati.
Tichifunga nezvezvikanganiso zvemaplate ekare ekupwanyika kweredhius radius pakugadzirisa chidimbu ichi chepfupa, pane matambudziko maviri makuru. Chekutanga, kushandiswa kwenzira yevolar neflexor carpi radialis (FCR) kunogona kukonzera kusaonekwa zvakanaka. Chechipiri, saizi huru yemascrews eplate anokiya palmar-locking inogona kusanyatso chengetedza zvidimbu zvidiki zvepfupa uye inogona kuzvibvisa nekuisa masikuruu munzvimbo dziri pakati pezvidimbu.
Saka, nyanzvi dzinokurudzira kushandiswa kwemapureti ekukiya e2.0mm kana 2.4mm pakunamira chidimbu chepfupa chepakati. Pamusoro peplate inotsigira, kushandisa masikuru maviri kugadzirisa chidimbu chepfupa uye kudzikamisa plate kuchengetedza masikuru ndeimwe nzira yekubatanidza mukati.
Muchiitiko ichi, mushure mekugadzirisa chidimbu chepfupa nezvikushi zviviri, ndiro yacho yakaiswa kuti idzivirire zvikushi.
Muchidimbu, kuputsika kwe "Tetrahedron" type distal radius fracture kunoratidza hunhu hunotevera:
1. Kuwanda kwechirwere ichi kushoma uye huwandu hwakawanda hwekutanga husinganyatsoonekwi zvakanaka.
2. Njodzi huru yekusagadzikana, pamwe nekatsika kekudzoserwa panzvimbo imwe panguva yekurapwa kwakachengetedzwa.
3. Maplate echinyakare echinokiya pamichindwe ekucheka zvidimbu zvedistal radius ane simba rekugadzirisa risina kusimba, uye zvinokurudzirwa kushandisa maplate ekuvhara e2.0mm kana 2.4mm pakugadzirisa kwakananga.
Zvichienderana nemaitiro aya, mukurapa, zvinokurudzirwa kuita CT scans kana kuongororwazve nguva nenguva kune varwere vane zviratidzo zvakakosha zvemaoko asi vane X-ray dzisina kunaka.kutyoka, kuvhiyiwa kwekutanga uchishandisa plate chaiyo yekoramu kunokurudzirwa kudzivirira matambudziko gare gare.
Nguva yekutumira: Gumiguru-13-2023
