Distal radius fractures ndeimwe yeakajairikakutyokamumakiriniki maitiro.Kune ruzhinji rwe distal fractures, yakanaka yekurapa mibairo inogona kuwanikwa kuburikidza nepalmar nzira ndiro uye screw yemukati kugadzirisa.Pamusoro pezvo, kune akasiyana akakosha marudzi edistal radius fractures, senge Barton fractures, Die-punch fractures,Kutyoka kweChauffeur, nezvimwewo., imwe neimwe inoda nzira dzekurapa dzakananga.Nyanzvi dzekune dzimwe nyika, muzvidzidzo zvavo zvemasamples makuru e distal radius fracture cases, dzakaratidza rudzi rwakati apo chikamu chejoinhi chinosanganisira distal radius fracture, uye zvimedu zvemapfupa zvinoumba conical structure ine "triangular" base (tetrahedron), inonzi "tetrahedron" mhando.
Pfungwa ye "Tetrahedron" Rudzi rweDistal Radius Fracture: Murudzi urwu rwe distal radius fracture, kutsemuka kunoitika mukati mechikamu chejoinhi, zvinosanganisira ese palmar-ulnar uye radial styloid facets, ine transverse triangular configuration.Mutsara wekuputsika unosvika kumagumo eredhiyo.
Iyo yakasarudzika yekutyoka uku inoratidzwa mumhando dzakasiyana dzepalmar-ulnar side bone zvimedu zveradius.Kune rumwe rutivi, iyo lunar fossa inoumbwa neizvi palmar-ulnar side bone zvidimbu inoshanda serutsigiro rwemuviri kurwisa volar dislocation ye carpal mapfupa.Kurasikirwa kwerutsigiro kubva kune ichi chimiro kunoguma nevolar dislocation ye wrist joint.Nekune rimwe divi, sechikamu cheiyo distal radioulnar joint's radial articular surface, kudzoreredza ichi chimedu chebhonzo panzvimbo yayo yeanatomical chinhu chinodiwa kuti udzore kugadzikana mune distal radioulnar joint.
Mufananidzo uri pazasi unoratidza Nyaya yekutanga: Kufungidzira kuratidzwa kweyakajairwa "Tetrahedron" mhando distal radius fracture.
Muchidzidzo chakatora makore mashanu, zviitiko zvinomwe zverudzi urwu rwekutsemuka zvakaonekwa.Nezve zviratidzo zvekuvhiya, kune zviitiko zvitatu, kusanganisira Nyaya 1 mumufananidzo uri pamusoro, apo paive nekutanga kusina kubviswa fractures, kurapwa kwekuchengetedza kwakatanga kusarudzwa.Nekudaro, panguva yekutevera, ese ari matatu zviitiko zvakasangana nekutyoka kusimuka, zvichitungamira kunotevera kuvhiyiwa kwemukati kwekugadzirisa.Izvi zvinoratidzira hupamhi hwekusagadzikana uye njodzi huru yekudzokazve mukuputsika kwemhando iyi, kusimbisa chiratidzo chakasimba chekupindira kwekuvhiya.
Panyaya yekurapa, nyaya mbiri dzakatanga dzakaitwa chinyakare volar nzira neflexor carpi radialis (FCR) yendiro uye screw yemukati kugadzirisa.Mune imwe yezviitiko izvi, kugadzirisa kwakakundikana, zvichiita kuti pfupa rifambe.Mushure mezvo, nzira yepalmar-ulnar yakashandiswa, uye kugadzirisa kwakananga nendiro yekoramu yakaitwa yepakati pembiru yekudzokorora.Mushure mekuitika kwekutadza kugadzirisa, zviitiko zvishanu zvakazotevera zvese zvakapinda palmar-ulnar uye zvakagadziriswa ne 2.0mm kana 2.4mm mahwendefa.
Case 2: Kushandisa nzira yakajairika yevolar ne flexor carpi radialis (FCR), kugadzirisa neplate yemichindwe yakaitwa.Mushure mekushanda, kuparadzaniswa kwepamberi kwekubatana kwemaoko kwakaonekwa, zvichiratidza kukanganisa kwekugadzirisa.
Panyaya yechipiri, kushandisa nzira yepalmar-ulnar uye kudzokorodza necolum plate yakakonzera chinzvimbo chinogutsa chekugadzirisa mukati.
Tichifunga nezvekukanganisa kweakajairwa distal radius fracture mahwendefa mukugadzirisa iyi chaiyo chidimbu chepfupa, pane nyaya huru mbiri.Kutanga, kushandiswa kwemaitiro evolar ne flexor carpi radialis (FCR) kunogona kukonzera kusakwana.Chechipiri, ukuru hukuru hwepalmar-locking plate screws hunogona kusanyatso chengetedza zvidimbu zvebhonzo zvidiki uye zvinogona kuzozvibvisa nekuisa masiruu mumapaka pakati pezvimedu.
Naizvozvo, nyanzvi dzinokurudzira kushandiswa kwe2.0mm kana 2.4mm mahwendefa ekukiya kuitira kunyatsogadziriswa kwepakati mbiru bone fragment.Pamusoro peplate inotsigira, kushandisa screws maviri kugadzirisa pfupa chidimbu uye neutralizing ndiro kudzivirira screws zvakare imwe yemukati kugadzirisa sarudzo.
Muchiitiko ichi, mushure mekugadzirisa chidimbu chepfupa nemakumbo maviri, ndiro yacho yakaiswa kuti idzivirire zviputi.
Muchidimbu, iyo "Tetrahedron" mhando distal radius fracture inoratidza anotevera maitiro:
1. Chiitiko chakaderera nechiyero chepamusoro chekutanga plain film misdiagnosis.
2. Dambudziko guru rekusagadzikana, nemaitiro ekugadzirisa zvakare panguva yekurapa kwekuchengetedza.
3. Mahwendefa echigadziko ekuvhara mahwendefa e distal radius fractures ane simba rekugadzirisa risina simba, uye zvinokurudzirwa kushandisa 2.0mm kana 2.4mm mahwendefa ekuvhara kwekugadzirisa zvakananga.
Tichifunga nezve hunhu uhu, mukuita kwekiriniki, zvinokurudzirwa kuita CT scans kana nguva nenguva kuongororazve varwere vane zvakakosha wrist zviratidzo asi zvakaipa X-rays.Kurudzi urwukutyoka, kupindira kwekutanga kwekuvhiya nekoramu-yakananga ndiro inokurudzirwa kudzivirira matambudziko gare gare.
Nguva yekutumira: Oct-13-2023
