Kunyanya kurapwa kwe distal radius fractures ndiyo volar Henry nzira nekushandiswa kwekuvhara mahwendefa uye screws yekugadzirisa mukati.Munguva yekugadziriswa kwemukati, hazviwanzo kudikanwa kuvhura iyo radiocarpal joint capsule.Joint kuderedza kunowanikwa kuburikidza nekunze kwekugadzirisa nzira, uye intraoperative fluoroscopy inoshandiswa kuongorora kubatana kwepamusoro kurongeka.Muzviitiko zve-intra-articular depressed fractures, zvakadai seDie-punch fractures, apo kuderedzwa kusina kunanga uye kuongorora kunonetsa, zvingave zvakakosha kushandisa dorsal nzira yekubatsira nekuona zvakananga uye kuderedza (sezvinoratidzwa mumufananidzo uri pasi apa).
Iyo extrinsic ligaments uye intrinsic ligaments yejoint radiocarpal inoonekwa seyakakosha zvimiro zvekuchengetedza wrist joint kugadzikana.Nekufambira mberi mukutsvakurudza kweanatomical, zvakaonekwa kuti, pasi pemamiriro ekuchengetedza kutendeseka kwepfupi reradiolunate ligament, kucheka maronda ekunze hakurevi kuti chiuno chinokonzera kusagadzikana.
Nokudaro, mune mamwe mamiriro ezvinhu, kuti uwane maonero ari nani epamusoro pekubatana, zvingave zvakafanira kupinza zvishoma zvinyorwa zvekunze, uye izvi zvinozivikanwa se volar intraarticular extended window approach (VIEW).Sezvinoratidzwa mumufananidzo uri pasi apa:
Mufananidzo AB: Munzira yakajairwa naHenry yekufumura distal radius bone surface, kuitira kuti uwane kupatsanurwa kwe distal radius uye scaphoid facet, wrist joint capsule inotanga kuchekwa.Retractor inoshandiswa kuchengetedza pfupi radiolunate ligament.Mushure meizvozvo, iyo refu radiolunate ligament inochekwa kubva kune distal radius yakananga kune ulnar side ye scaphoid.Panguva ino, kuona kwakananga kwechiso chekubatana kunogona kuwanikwa.
Mufananidzo CD: Mushure mekufumura nzvimbo yakabatana, kuderedzwa kweiyo sagittal ndege yakaora mwoyo yejoint surface inoitwa pasi pekuona kwakananga.Mabhonzo ekusimudza anoshandiswa kushandura uye kuderedza zvimedu zvemapfupa, uye 0.9mm Kirschner waya dzinogona kushandiswa kwenguva pfupi kana yekupedzisira kugadzirisa.Kana iyo yejoint surface yadzikiswa zvakakwana, nzira dzakajairwa dzeplate uye screw fixation dzinoteverwa.Chekupedzisira, iwo akachekwa akaitwa murefu radiolunate ligament uye wrist joint capsule inosudururwa.
Iyo theoretical hwaro hweiyo VIEW (volar intraarticular yakawedzera hwindo) nzira iri mukunzwisisa kuti kucheka mamwe wrist joint extrinsic ligaments hazvirevi hazvo kuti wrist joint instability.Naizvozvo, zvinokurudzirwa kune mamwe akaomarara intra-articular comminuted distal radius fractures apo fluoroscopic joint surface kuderedza kunonetsa kana kana nhanho-offs iripo.Iyo VIEW nzira inokurudzirwa zvakasimba kuti iwane zviri nani zvakananga kuona panguva yekuderedza mumamiriro ezvinhu akadaro.
Nguva yekutumira: Sep-09-2023
