Ukwelashwa okuvame kakhulu kokuqhekeka kwe-distal radius yindlela ye-volar Henry esebenzisa amapuleti okukhiya nezikulufo zokubopha kwangaphakathi. Ngesikhathi senqubo yokubopha kwangaphakathi, ngokuvamile akudingeki ukuvula i-capsule yejoyinti ye-radiocarpal. Ukunciphisa amalunga kufezwa ngendlela yokuphatha yangaphandle, futhi i-fluoroscopy yangaphakathi kokuhlinzwa isetshenziswa ukuhlola ukuhambisana kobuso bamalunga. Ezimweni zokuqhekeka okucindezelekile kwangaphakathi, njengokuqhekeka kwe-Die-punch, lapho ukunciphisa nokuhlola okungaqondile kuyinselele, kungadingeka ukusebenzisa indlela ye-dorsal ukusiza ngokubona ngqo nokunciphisa (njengoba kuboniswe esithombeni esingezansi).
Imisipha yangaphandle kanye nemisipha yangaphakathi yelunga le-radiocarpal kubhekwa njengezakhiwo ezibalulekile zokugcina ukuqina kwamalunga esihlakala. Ngokuthuthuka kocwaningo lwe-anatomical, kutholakale ukuthi, ngaphansi kwesimo sokugcina ubuqotho be-ligament emfushane ye-radiolunate, ukusika imisipha yangaphandle akusho ukuthi kungabangela ukungazinzi kwamalunga esihlakala.
Ngakho-ke, ezimweni ezithile, ukuze kutholakale umbono ongcono wobuso bamalunga, kungadingeka ukuhlikihla kancane imisipha yangaphandle, futhi lokhu kwaziwa ngokuthi indlela yefasitela enwetshiwe ye-volar intraarticular (VIEW). Njengoba kuboniswe esithombeni esingezansi:
Umfanekiso AB: Ngendlela evamile kaHenry yokuveza ubuso bethambo le-distal radius, ukuze kufinyelelwe ekuqhekekeni okuhlukene kwe-distal radius kanye ne-scaphoid facet, i-wrist joint capsule iyaqala ukunqunywa. I-retractor isetshenziswa ukuvikela i-short radiolunate ligament. Ngemva kwalokho, i-long radiolunate ligament iyanqunywa kusukela ku-distal radius iye ohlangothini lwe-ulnar lwe-scaphoid. Kuleli qophelo, ukubonakala okuqondile kobuso be-joint kungafinyelelwa.
I-CD Yesithombe: Ngemva kokudalula ubuso obuhlangene, ukuncishiswa kobuso obuhlangene obucindezelwe yi-sagittal plane kwenziwa ngaphansi kokubona okuqondile. Izinyusi zamathambo zisetshenziselwa ukuphatha nokunciphisa izingcezu zamathambo, kanti izintambo ze-Kirschner ezingu-0.9mm zingasetshenziswa ukubopha okwesikhashana noma kokugcina. Uma ubuso obuhlangene sebuncishisiwe ngokwanele, kulandelwa izindlela ezijwayelekile zokubopha ipuleti kanye nezikulufo. Ekugcineni, ukusikwa okwenziwe ku-ligament ende ye-radiolunate kanye ne-capsule yejoyinti yesandla kuyathungwa.
Isisekelo semfundiso yendlela ye-VIEW (volar intraarticular extended window) sisekuqondeni ukuthi ukusika ama-ligaments athile angaphandle kwe-joint joint akusho ukuthi akubangeli ukungazinzi kwe-joint joint. Ngakho-ke, kunconywa ukuqhekeka kwe-distal radius okuyinkimbinkimbi kwe-intra-articular lapho ukunciphisa ubuso be-joint fluoroscopic kuyinselele noma lapho kukhona ukunyathela. Indlela ye-VIEW inconywa kakhulu ukuze kufezwe umbono oqondile ongcono ngesikhathi sokunciphisa ezimweni ezinjalo.
Isikhathi sokuthunyelwe: Septhemba-09-2023
