I-distal radius fracture: Ukuchazwa okuningiliziwe kokulungiswa kwangaphakathi kwamakhono we-SITH PITH nemibhalo!

1. Izinkomba

1.)

2)

3) .Bhekisa.

4) .Fractrure Malonion noma unnonion. Ithambo elikhona ekhaya nakwamanye amazwe

1. Contraindications

Iziguli ezikhulile ezingakulungele ukuhlinzwa.

1. Ukulungiswa kwangaphakathi (indlela ye-volar)

Ukulungiselela okungcono kakhulu. I-anesthesia yenziwa kusetshenziswa i-brachial plexus anesthesia noma i-anesthesia ejwayelekile

1) I-8cm incision yenziwa phakathi kwe-radial artery ye-forearm kanye nemikhuba ye-flexor carpi radialis umsipha futhi inwebelwe i-crease yesandla. Lokhu kungadalula ngokuphelele ukwaphuka futhi kuvikele inkontileka yesikebhe. Ukuvela akudingi ukuya entendeni yesandla (Umdwebo 1-36a).

2) Isisu semisipha sivezwa ngokuphelele kumsipha we-Quadratus we-Proadratus (Umdwebo ongu-1-36c)

3) .Kukani.

4) .insert stripper noma ummese omncane wamathambo kusuka kulayini we-fracture, bese uyisebenzisa njenge-lever ukunciphisa ukuqhekeka. Faka umcibisholo noma ummese omncane weScissor emgqeni we-fracture kuya kwi-aateral bone cortex ukuze unciphise ukucindezelwa futhi unciphise i-distal fracture Fragment, bese usebenzisa iminwe ukucindezela isiqephu sokuphuka kwe-dorsal fracture.

Lapho i-radial styloid fracture ikhubazekile, kunzima ukunciphisa ukuqhekeka kwe-radial styloid ngenxa yokudonsa kwemisipha ye-brachioradialis. Ukunciphisa amandla okudonsa, i-brachioladialis ingashintshwa noma ihlukaniswe kwi-distal radius. Uma kunesidingo, isiqeshana se-distal singalungiswa okwesikhashana kwingxenye yeProximal ne-Kirschner izintambo.

Uma inqubo ye-tyloid ye-ulnar yehlaselwe futhi ichithwe, futhi i-distal radioulnar ehlanganisiwe ingazinzile, izintambo ze-kirschner eyodwa zingasetshenziselwa ukulungiswa kwe-tycotaneous, futhi inqubo ye-stynaid ye-ulnar ingahle isethwe kabusha yi-volar indlela. Ama-fractures amancane ngokuvamile awadingi ukwelashwa ngesandla. Kodwa-ke, uma i-distal radioulnar ehlanganisiwe ingazinzile ngemuva kokulungiswa kwerediyo, i-styloid Fragment inganakwa kanye nemiphetho ye-fibrocartilage eyinxantathu etholwe kwinqubo ye-ulnar styloid enezikhonkwane noma ngemicu ye-silk.

I-5) Ngemuva kokuncishiswa kwe-Fracture, thola isikhundla sokubekwa kwepuleti yensimbi ephansi ngaphansi kokuholwa yi-x-ray fluoroscopy bese ulungisa isikulufa emgodini oval noma umgodi oshelelayo ukwenza lula ukulungiswa kwesikhundla (Umdwebo 1-36f). Sebenzisa umgodi wokushayela we-2.5mm ukuze ushayele isikhungo somgodi we-oval, bese ufaka isikulufa sokuzishaya nge-3.5mm.

Umdwebo 1-36 Ukuvela kwesikhumba (a); ukuvela kwe-flequor Carpi radialis tendon sheath (b); Ukucisha ingxenye ye-tendon tendon ukudalula imisipha ye-Quadratus (C); Ukuhlukanisa izicubu zomsebenzisi we-Quadratus ukuze kuveze iRadius (D); ukudalula umugqa we-fracture (e); beka ipuleti ye-volar nesikulufa kusikulufa sokuqala (f)
6). Faka i-C-arm fluoroscopy ukuze uqinisekise ukubekwa okufanele kwepuleti. Uma kunesidingo, cindezela ipuleti ngokude noma ngempumelelo ukuze uthole ukubekwa kwesikulufa okungcono kakhulu.

7) Isipikili kufanele kube mfushane nge-2mm kufushane kunebanga elilinganisiwe ukuvikela isikulufa kusuka ekungeneni nasekutholeni kusuka ku-cortex ye-dorsal. Ngokuvamile, isikulufa se-20-22mm sanele, futhi ohlelwe kwinqubo ye-styloid ye-radial kufanele abe mfushane. Ngemuva kokuhlanza isikulufa distal, screw ifaka isikulufa esisele se-proxilal.

Ngoba i-angle yesikulufa yakhelwe, uma ipuleti libekwe eduze nasekupheleni kwe-distal, isikulufa sizongena ekuhlanganiseni kwesandla. Thatha izingcezu ze-tangelial ze-articular subchondral ithambo kusuka ezikhundleni ze-coronal kanye nama-sagittal ukuze uhlole ukuthi ngabe kungena yini okuhlanganisiwe, bese ulandela imiyalo ilungisa amapuleti ensimbi kanye / noma izikulufa

. B. I-Anteropostereoriner kanye ne-X-ray filfilimu ye-postoperative fracture, ekhombisa ukuncishiswa okuhle nokuvuselelwa okuhlangene kwe-Wrist
8) .sungula izicubu zomsebenzisi we-Quadratus ezinama-sutures angabonakali. Qaphela ukuthi izicubu ngeke zimboze ngokuphelele ipuleti. Ingxenye ye-distal kufanele imbozwe ukunciphisa ukuxhumana phakathi kwe-tendor tendon nepuleti. Lokhu kungatholakala ngokubheka i-Quadratus Projrator emaphethelweni e-brachioradialis, ukuvala isendlalelo se-incision ngesendlalelo, nokukulungisa ngodaka uma kunesidingo.