Ibanga lesikhungo se-ARC: Amapharamitha wesithombe wokuhlola ukuthunyelwa kokuqhekeka kukaBarton ohlangothini lwe-Palmar

Amapharamitha wokucabanga asetshenziswa kakhulu wokuhlola ama-distal radius fractures ngokujwayelekile afaka i-volar tilt angle (VTA), ukuhlukahluka kwe-ulnar, nokuphakama kwemisebe. Njengoba ukuqonda kwethu i-anatomy ye-distal radius kukhulise, amapharamitha angeziwe wokucabanga afana nebanga le-anteroposter (APD), ne-capday-to-to-axis ibanga (ikhadi)

Amapharamitha asetshenziswayo asetshenziswa ngokuhlola ama-distal radius fractures afaka: A: VTA; B: APD; C: TDA; D: ikhadi.

Amapharamitha amaningi wokucabanga alungele ukuqhekeka okungaphezulu kwe-distal radius distal radius, njengokuphakama kwemisebe nokuhlukahluka kwe-ulnar. Kodwa-ke, kokunye ukuqhekeka kwe-Intra-articular, njenge-barton's fractures, amapharamitha endabuko wendabuko angahle anciphe emandleni abo okunquma kahle izinkomba zokuhlinzwa ngokunembile futhi anikeze umhlahlandlela. Ngokuvamile kuzwakala ukuthi inkomba yokuhlinzwa kwamanye ama-intra-articular fractures ahlobene kakhulu nesinyathelo sokuhlangane. Ukuze uhlole izinga lokukhishwa kwezinga lokukhishwa kwezinto ezihlaselwa yi-Intra-articular, i-lacters activation iphakamise iparamitha entsha yokulinganisa: I-TAD (ukutsheka ngemuva kokufuduka), futhi ekuqaleni kwabikwa ngokuhlolwa kwama-malleolus fractures ahambisana nokuthuthwa kwe-malleolus.

Esikhathini esisekupheleni kweTibia, ezimweni zokuqhekeka kwangemuva kweMalleolus ngokusatshalaliswa kwangemva kweTalus, i-Arc 1 indawo ehlanganyelwe ye-malleolus crament, i-arc 2 yi-arc 3 ingaphezulu kweTalus. Lapho kunengxenye yangemuva ye-Malleolus Fracture ehambisana nokusatshalaliswa kwangemuva kweTalus, maphakathi nombuthano owakhiwa i-arc 1 engxenyeni ye-ARC ephakeme ye-ARC (kanye nebanga eliphakeme), futhi kukhudlwana indawo enkulu, inani elikhulu kakhulu.

Inhloso yokuhlinza ukufeza i-atd (ukutsheka ngemuva kokufuduka) inani le-0, elibonisa ukuncishiswa kwe-anatomical kwendawo ehlanganisiwe.

Ngokufanayo, endabeni yokuqhekeka kukaVerar Barton:

Izingcezwana ze-Acticular ezingasuswanga ziyi-arc 1.

I-Lunate Facet isebenza njenge-ARC 2.

Isici se-dorsal se-radius (ithambo elijwayelekile ngaphandle kokuqhekeka) limelela i-arc 3.

Elinye lalawa ma-arc amathathu lingabhekwa njengemibuthano. Kusukela i-Lunate Focet kanye ne-volar bone France kuhlangene ndawonye, ​​isiyingi 1 (ephuzi) sabelana esikhungweni saso ngombuthano 2 (emhlophe). I-ACD imele ibanga ukusuka kulesi sikhungo esabiwe esikhungweni se-Circle 3. Injongo yokuhlinzwa ukubuyisa i-ACD ku-0, okubonisa ukuncishiswa kwe-anatomical.

Emsebenzini wangaphambilini wemitholampilo, kuye kwamukelwe kabanzi ukuthi ukuhlukaniswa okuhlangene kwe- <2mm kuyindinganiso yokuncipha. Kodwa-ke, kulolu cwaningo, ukuhlaziya okusebenzayo okusebenzayo (ROC) Ukuhlaziywa kwe-Curve kwamapharamitha ahlukile wokucabanga akhombisa ukuthi i-ACD yayinendawo ephezulu kakhulu ngaphansi kwejika (AUC). Usebenzisa inani le-cutoff le-1.02mm le-ACD, kwakhombisa ukuzwela okungu-100% kanye nokucaciswa kwama-80.95%. Lokhu kusikisela ukuthi enqubweni yokuncipha kokuphuka, ukunciphisa i-ACD ku-1,02mm kungaba yisikhombisi esinengqondo ngokwengeziwe

kunezinga lendabuko le- <2mm elihlanganisiwe lokungena.

I-ACD ibonakala inesithenjwa esibalulekile sokuhlola izinga lokufuduka ekuqhekekeni kwama-intra-articular fractures ahilela amalunga agxilile. Ngaphezu kohlelo lokusebenza lwayo ekuhlolweni kweTibial Plafond Fractures kanye ne-distal radius fractures njengoba kushiwo ngaphambili, i-ACD nayo ingaqashwa ekuhlolweni kokuhlaziywa kwe-elbow. Lokhu kunikeza ochwepheshe bezokwelapha ngethuluzi eliwusizo lokukhetha izindlela zokwelashwa kanye nokuhlola imiphumela yokunciphisa.