I-distal radius fractures ingenye evame kakhuluamathizeloekusebenzeni kwemitholampilo. Kwabaningi bokuqhekeka okude, imiphumela emihle yokwelapha ingatholakala ngePalsar indlela Plate bese ilungisa ukulungiswa kwangaphakathi. Ngaphezu kwalokho, kunezinhlobo ezahlukahlukene ezikhethekile ze-distal radius fractures, ezinjenge-barton fractures, die-punch fractures,Ama-chauffeur's fractures, njll., ngakunye okudinga ukwelashwa okuthile. Izazi zakwamanye amazwe, ezifundweni zazo zamasampula amakhulu e-dista radium radius amacala, akhombe uhlobo oluthile lapho ingxenye yokuhlangana ifaka khona isakhiwo se-distal radius ngesisekelo "se-tretrahedron), okubizwa ngokuthi yi-" tetrahedron ".
Umqondo we- "Tetrahedron" Uhlobo lwe-distal radius fracture: kulolu hlobo lwe-distal radius distracture, ukwaphuka kwenzeka ngaphakathi kwengxenye yokuhlangana, okubandakanya ama-ticedi e-styloid ne-radial, ngokucushwa kwe-styloid eguqukayo. Umugqa we-Fracture ufinyelela ekugcineni kwe-radius.
Ubunye balokhu kuqhekeka kuboniswa ezicini ezihlukile ze-Palmar-ulnar side izingcezu ze-radius. Ngakolunye uhlangothi, i-fossa yenyanga eyakhiwe yilezi zingcezwana ze-membar-ulnar side zisebenza njengokusekelwa ngokomzimba ukuhlukaniswa kwamathambo e-carpal. Ukulahleka kokusekelwa kwalesi sakhiwo kuphumela ekuhlukaniseni i-ntacrar. Ngakolunye uhlangothi, njengengxenye ye-distal radioulnar radioulnar radical articular ebunjiwe, ibuyisela lesi siqephu sethambo esimeni sayo se-anatomical ukuthola ukuqina kokuhlangana kwe-distal radioulnar Joint.
Isithombe esingezansi sibonisa icala 1: Ukubonakaliswa kokucabanga kwe- "tetrahedron" ejwayelekile ye-distal radius gracture.
Ocwaningweni olwadlula iminyaka emihlanu, kwahlonzwa amacala ayisikhombisa alolu hlobo lokuqhekeka. Ngokuphathelene nezinkomba zokuhlinzwa, amacala amathathu, okubandakanya amacala 1 esithombeni esingenhla, lapho ekuqaleni kwakukhona ukuqhekeka okungahambi kahle, ukwelashwa okulondoloziwe ekuqaleni kwakhethwa. Kodwa-ke, ngesikhathi esilandelwayo, wonke amacala amathathu ahlangabezana nokuhanjiswa kwe-fracture, okuholela ekuhlinzweni kwangaphakathi kwangaphakathi. Lokhu kuphakamisa izinga eliphakeme lokungazinzi kanye nengozi ebalulekile yokuhlenga kabusha kokuqhekeka kwalolu hlobo, kugcizelela inkomba eqinile yokungenela okuhlinzayo.
Mayelana nokwelashwa, amacala amabili ekuqaleni asondelene nenkathi yendabuko ye-volar nge-flexor carpi radialis (FCR) yepuleti kanye nokulungiswa kwangaphakathi. Kokunye kwalezi zimo, ukulungiswa kwehlulekile, okuholela ekuchithweni kwamathambo. Kamuva, kwaqalwa indlela ye-Palmar-ulnar, futhi kwalungiswa kahle ipuleti yekholomu ngokubuyekezwa okuphakathi kwekholomu. Ngemuva kokuvela kokwehluleka kokulungiswa, amacala amahlanu alandelayo wonke awonke indlela ye-Palmar-alnar futhi ahlelwe ngamapuleti angama-2.0mm noma ama-2.4mm.
I-Case 2: Isebenzisa indlela ejwayelekile yokusondela nge-flexor carpi radialis (FCR), ukulungiswa ngeplate ye-Palmar. Ngokuzenzakalelayo, ukuhlukaniswa kwe-antereor of the Wrist Joint kwaqashelwa, kubonisa ukwehluleka kokulungiswa.
Okwe-Case 2, esebenzisa indlela ye-Palmar-ulnar futhi ukubuyekeza ngepuleti yekholomu kuholele endaweni egculisayo yokulungiswa kwangaphakathi.
Uma kucatshangelwa ukushiyeka kwama-distal radius radius fracture amapuleti ekulungiseleni lesi siqephu esithile samathambo, kunezingqinamba ezimbili eziphambili. Okokuqala, ukusetshenziswa kwendlela yokusondela nge-Flevel Carpi Radialis (FCR) kungahle kube nokuvezwa okunganele. Okwesibili, usayizi omkhulu we-Palmar-Locking Plate Screws kungenzeka angavikelekile izingcezwana ezincane zamathambo futhi angabakhulula ngokufaka izikulufa ezigandeni eziphakathi kwezikhala eziphakathi kwezikhala phakathi kwezikhala eziphakathi kwezikhala phakathi kwezikhala eziphakathi kwezikhala phakathi kwezikhala phakathi kwezikhala eziphakathi kwezikhala phakathi kwezikhala eziphakathi kwezikhala phakathi kwezikhala eziphakathi kwezikhala phakathi kwezikhala eziphakathi kwezikhala phakathi kwezikhala eziphakathi kwezikhala phakathi kwezikhala eziphakathi kwezikhala phakathi kwezikhala phakathi kwezikhala.
Ngakho-ke, izazi ziphakamisa ukusetshenziswa kwamapuleti angu-2.0mm noma ama-2.4mm okukhiya ngokulungiswa okuthile kwesiqephu samathambo e-central colom. Ngaphezu kwepuleti esekelayo, usebenzisa izikulufo ezimbili ukulungisa i-bone Fragment futhi uvikele ipuleti ukuvikela izikulufo futhi kukodwa inketho yokulungiswa kwangaphakathi.
Kulokhu, ngemuva kokulungisa isiqephu samathambo ngezikulufo ezimbili, ipuleti lifakiwe ukuvikela izikulufa.
Ngamafuphi, i- "Tetrahedron" yohlobo lwe-distal radius fracture ibonisa lezi zici ezilandelayo:
1. Izehlakalo eziphansi ngesilinganiso esiphakeme sefilimu yokuqala ye-misdiagnosis.
2. Ingozi enkulu yokungazinzi, ngokuthambekela kokuhlenga kabusha ngesikhathi sokwelashwa okulondoloziwe.
3. Amapuleti ajwayelekile e-Palmar Locking for distal radius ama-fractures anamandla okulungiswa okubuthakathaka, futhi kunconywa ukusebenzisa amapuleti okukhiya ama-2.0mm noma ama-2.4mm ngokulungiswa okuthile.
Njengoba kunikezwe lezi zici, ekusebenzeni kwemitholampilo, kungcono ukwenza ama-CT Scans noma ama-repexumin ngezikhathi ezithile ezigulini ezinezimpawu ezibalulekile zesandla kodwa ama-x-ray amabi. Ngalolu hloboukwaphuka, ukungenelela kokuhlinzwa kusenesikhathi ngepuleti eliqondene nekholomu kunconywa ukuvikela izinkinga ngokuhamba kwesikhathi.
Isikhathi sePosi: Oct-13-2023
