Ukwelashwa okuvame kakhulu kwe-distal radius fractures kuyindlela ye-volar henry indlela yokusebenzisa amapuleti okukhiya nezikulufo zokulungiswa kwangaphakathi. Ngesikhathi senqubo yangaphakathi yokulungiswa, imvamisa ayidingekile ukuvula i-radiocarpal copsule ehlanganisiwe. Ukuncishiswa okuhlanganyelwe kutholakala ngendlela yangaphandle yokukhohlisa, futhi i-fluoroscopy ye-intraperaterative isetshenziselwa ukuhlola ukuqondanisa okuhlangene. Ezimweni zokuqhekeka okucindezelekile kwe-Intra-acticular okucindezelekile, okufana nokufakelwa kokufa, lapho ukuncishiswa nokuhlolwa okungaqondile kuyinselele, kungahle kudingeke ukusebenzisa indlela eqondile yokusiza ngokubona okuqondile kanye nokuncishiswa (njengoba kukhonjisiwe kwisibalo esingezansi).
Ama-ligaments angemuva kanye nama-ligaments ajwayelekile we-radiocarpal Joint abhekwa njengezinhlaka ezibalulekile zokugcina ukuqina kokuhlangene kwesandla. Ngentuthuko ngocwaningo lwe-anatomical, sekutholakele ukuthi, ngaphansi kwesimo sokugcina ubuqotho be-radiolunate ligament emfushane, ukusika ama-ligaments angemuva akubangelwa ukungaziphathi kahle kwesandla.
Ngakho-ke, kwezinye izimo, ukufeza umbono ongcono wendawo ehlanganisiwe, kungahle kudingeke ukuvumelanisa kancane kancane ama-ligaments angemuva, futhi lokhu kwaziwa njenge-volar intraarticular yewindi lendida (ukubuka). Njengoba kukhonjisiwe kwisibalo esingezansi:
Umdwebo B: Esendleleni ejwayelekile ye-henry yokudalula indawo ye-distal radius bone ebusweni, ukuze ufinyelele ekuqhekekeni kwe-radius radius kanye ne-scaphoid Focut, i-wrist ehlanganisiwe ye-capsule ekuqaleni incane. I-retractor isetshenziselwa ukuvikela i-radiolunate ligament emfushane. Kamuva, i-radiolunate ligament ende ye-radiounounate ifakwa emsakazweni we-distal maqondana nohlangothi lwe-ulnar lwe-scaphoid. Ngalesi sikhathi, ukubonwa okuqondile kwendawo ehlanganyelwe kungatholakala.
Umdwebo CD: Ngemuva kokudalula indawo ehlanganyelwe, ukuncishiswa kwendiza ye-sagittal Plane ecindezelekile kwenziwa ngokuhlangene kwenziwa ngaphansi kokubuka okuqondile. Ama-Bone Elevitors asetshenziselwa ukukhohlisa futhi anciphise izingcezwana zamathambo, kanye no-0.9mm Kirchner izintambo zingasetshenziselwa ukulungiswa kwesikhashana noma kokugcina. Lapho indawo ehlanganyelwe yehliswe ngokwanele, izindlela ezijwayelekile zePlate kanye nokulungisa isikulufa ziyalandelwa. Ekugcineni, izinhlaka ezenziwe nge-radiolunate ligament ende ye-radiolunate kanye ne-wrist ehlanganisiwe i-capsule ehlanganisiwe.
Isisekelo se-theoretical of the mbono (i-volar intraarticular extended windows) indlela yokuqonda ukuthi ukusika izihlakala ezihlangene ezihlangene ze-artinsic akwenzile ukungazinzi kokuhlaziywa kwe-Wrist. Ngakho-ke, kunconyelwa ukutholakala kwe-distal radius ethile ethile eyinkimbinkimbi ye-distal ye-distal radius distal Indlela yokubuka inconywe ngokuqinile ukuze kufinyelelwe ngeso lengqondo eqondile ngesikhathi sokuncishiswa ezimweni ezinjalo.
Isikhathi sePosi: Sep-09-2023
