Amapharamitha wokucabanga asetshenziswa kakhulu okuhlola ukuhlukana kwerediyasi ekude ngokuvamile ahlanganisa i-volar tilt angle (VTA), ukuhluka kwe-ulnar, nobude be-radial.Njengoba ukuqonda kwethu i-anatomy ye-distal radius sekujule, kuhlongozwa futhi kwasetshenziswa imingcele yokucabanga eyengeziwe njengebanga le-anteroposterior (APD), i-teardrop angle (TDA), kanye nebanga le-capitate-to-axis-of-radius (CARD). umkhuba womtholampilo.
Amapharamitha wokucabanga asetshenziswa kakhulu ekuhloleni ukuphuka kwerediyasi ekude afaka: a: VTA;b:APD;c:TDA;d:CARD.
Amapharamitha amaningi wokucabanga afanele ukuqhekeka kwerediyasi ye-extra-articular distal, njengobude be-radial nokuhluka kwe-ulnar.Kodwa-ke, kokunye ukuphuka kwe-intra-articular, njengokuphuka kuka-Barton, imingcele yendabuko yokucabanga ingase intule emandleni abo okunquma ngokunembile izinkomba zokuhlinzwa kanye nokunikeza isiqondiso.Ngokuvamile kunenkolelo yokuthi inkomba yokuhlinzwa yokuphuka kwe-intra-articular ihlobene eduze nesinyathelo sokusuka endaweni ehlangene.Ukuze kuhlolwe izinga lokususwa kokuphuka kwe-intra-articular, izazi zakwamanye amazwe ziphakamise ipharamitha yokulinganisa entsha: I-TAD (I-Tilt After Displacement), futhi yabikwa okokuqala ngokuhlolwa kokuphuka kwe-posterior malleolus okuhambisana nokugudluka kwe-distal tibial.
Ekupheleni kwe-distal ye-tibia, ezimweni zokuphuka kwe-malleolus yangemuva nge-posterior dislocation ye-talus, indawo ehlangene yenza ama-arcs amathathu: I-Arc 1 iyindawo ehlangene yangaphambili ye-distal tibia, i-Arc 2 iyindawo ehlangene ye-posterior malleolus. ucezu, futhi i-Arc 3 ingaphezulu kwe-talus.Uma kukhona ucezu lwe-posterior malleolus fracture oluhambisana nokugudluka ngemuva kwe-talus, isikhungo sendilinga esakhiwe yi-Arc 1 endaweni ehlangene yangaphambili sichazwa njengephoyinti T, futhi isikhungo sendilinga esakhiwe yi-Arc 3 phezulu i-talus ichazwa njengephoyinti A. Ibanga phakathi kwalezi zikhungo ezimbili yi-TAD (Tilt After Displacement), futhi uma ukususwa kukhudlwana, likhulu inani le-TAD.
Inhloso yokuhlinzwa ukuzuza inani le-ATD (Tilt After Displacement) elingu-0, elibonisa ukuncipha kokwakheka kwendawo ehlangene.
Ngokufanayo, esimweni sokuphuka kwe-volar Barton:
Izingcezu ze-articular ezisuswe indawo ngokwengxenye zakha i-Arc 1.
I-lunate facet isebenza njenge-Arc 2.
Isici se-dorsal ye-radius (ithambo elivamile elingenalo ukuphuka) limele i-Arc 3.
Ngayinye kulawa ma-arcs amathathu ingathathwa njengemibuthano.Njengoba i-lunate facet kanye ne-volar bone fragment zisuswa ndawonye, Umbuthano 1 (ophuzi) wabelana maphakathi nendawo noMbuthano 2 (omhlophe).I-ACD imele ibanga ukusuka kulesi sikhungo esabelwe ukuya enkabeni Yombuthano wesi-3. Inhloso yokuhlinzwa ukubuyisela i-ACD ku-0, okubonisa ukuncipha kwe-anatomical.
Emisebenzini yangaphambilini yomtholampilo, kuye kwamukelwa kabanzi ukuthi igxathu elihlangene lendawo engu-<2mm liyindinganiso yokunciphisa.Kodwa-ke, kulolu cwaningo, ukuhlaziywa kwejika le-Receiver Operating Characteristic (ROC) yemingcele ehlukene yokucabanga kubonise ukuthi i-ACD inendawo ephakeme kakhulu ngaphansi kwejika (AUC).Isebenzisa inani elinqunyiwe elingu-1.02mm ku-ACD, ibonise ukuzwela okungu-100% kanye nokucaciswa okungu-80.95%.Lokhu kuphakamisa ukuthi ohlelweni lokunciphisa ukuphuka, ukwehlisa i-ACD ibe phakathi kuka-1.02mm kungase kube umbandela onengqondo kakhudlwana.
kunendinganiso evamile ye-<2mm indawo ehlangene yokusuka.
I-ACD ibonakala inokubaluleka kwereferensi okubalulekile ekuhloleni izinga lokufuduka ekwaphukeni kwe-intra-articular okubandakanya amalunga agxile.Ngaphezu kokusebenza kwayo ekuhloleni ukuphuka kwe-tibial plafond kanye nokuphuka kwe-distal radius njengoba kushiwo ngaphambili, i-ACD ingase futhi isetshenziswe ekuhloleni ukuphuka kwendololwane.Lokhu kunikeza odokotela bezokwelapha ithuluzi eliwusizo lokukhetha izindlela zokwelapha nokuhlola imiphumela yokunciphisa ukuphuka.
Isikhathi sokuthumela: Sep-18-2023
