Fɛɛrɛ kɔrɔw ni fɛɛrɛw minnu bɛ kɛ ka pikirijikɛlan datugulen don ka ɲɛsin yɔrɔjan karilenw ma

Distal radius fracture ye kari ye min ka teli ka kɛ nɛnɛ kan nɛnɛ waati, wa a dabɔlen dɔgɔyali ni Kirschner wire fixation ye furakɛli fɛɛrɛw ye minnu ka teli ka kɛ.

Nin barokun bɛ kuma K-Wiring sariyakolow ni fɛɛrɛw kan walasa ka opereli fɛɛrɛw jira minnu bɛ kɛ ni pini dagalen ye.

Filɛ saba sirili fɛɛrɛ ye klasiki sirili fɛɛrɛ ye

Kelen bɛ tɛmɛ lister tubercle fɛ.

Kelen bɛ tɛmɛ radiyali styloïde kɛcogo fɛ.

Kelen bɛ tɛmɛ lunate fossa kolo bloki fɛ.

Ni: kari jugumanba ni koloci kɛra, Kirschner ka nɛgɛ wɛrɛw bɛ se ka kɛ.

1. Opereli kɛcogo

Fɔlɔ, karilen dɔgɔyali dagalen bɛ kɛ, ni a samali ye dɔɔni dɔɔni ni a bɛ to sen na, ani kɔkolo ni kɔfɛla jiginni bɛ latilen ni bolokɔni kuruli ni senkɔni jiginni ye. Dɔgɔyali kɔfɛ, bolo bɛ bila sɛbɛnfura kurulen dɔ kan, ka bolokɔni kurulen ni ulnar deviation mara (Jaa 2a, b), ka sɔrɔ ka a siri ni Kirschner nɛgɛ saba ye minnu bɛ bɔ farikolo la a dɔgɔyalenba la.

K-filɛri fɔlɔ bɛ don Lister ka tubercle la, a bɛ kɛ kɛrɛ fɛ 45° la, ka ɲɛsin kolotuguda yɔrɔ kɛrɛfɛla bolokɔnincinin ma min bɛ radius janya la. Ni donyɔrɔ bɛ Lister ka tubercle ulnar fan fɛ, extenseur pollicis tendon bɛ se ka jogin.

K-wire filanan bɛ don santimɛtɛrɛ 0,5 la ka bɔ radiyali styloïde kɛcogo la, K-wire bɛ kɛ 60° kɛrɛ la ni radial axis ye, ka don ulnar cortex proximal to the fracture.

K-wire sabanan bɛ siri lunate fossa kolo yɔrɔ la min bɛ santimɛtɛrɛ 0,5 bɔ bolokɔni kolotugudaw la, o bɛ sɔrɔ extensor yɔrɔ naaninan ni duurunan cɛ. K-wire bɛ siri radiyali bolokɔni fan fɛ ni 45° ye, i n’a fɔ a jiralen bɛ cogo min na ja a ni b la jukɔrɔ.

Kirschner wire fixation classique percutanée de la radius distal fractures jiralen don ja ae la duguma.

 

Bolo lamagacogo Kirschner ka nɛgɛ sirili kɔfɛ farikolo la, o jiralen don ja ninnu na minnu bɛ duguma.

2. Opereli kɛcogo ni fɛɛrɛw

1.Ni K-filɛri bɛ sɛgɛn ka don ɲɛgɛnɛsira la ka sɔrɔ a ma don kɔkolo kɔkanna na, o bɛ se ka kɛ sababu ye ka a kɔrɔta kojugu ni K-filɛri donna. O cogo la, mɔgɔw ka teli k’u tɛgɛ kɔrɔta walasa ka dɔ bɔ a kɔrɔtalen na. Nka tiɲɛ yɛrɛ la, o kɔfɛko ye tiɲɛ ye. K-wire bɛna kɛ kɛrɛ ye ani ka kɔrɔta cogo la min bɛ kɛ ni sɔgɔsɔgɔ ye, o bɛ na ni K-wire sɔgɔli dɛsɛ ye. O nɔ na, ​​a ka kan ka wuli dɔɔni dɔɔni sanfɛ ka kɛɲɛ ni K-wire contour ye, i n’a fɔ a jiralen bɛ cogo min na ja in na.

Ni K-wire ɲɛsinnen don sanfɛ ka ɲɛ, dondaw bɛ kɛ yɔrɔjan kɔri la ni degun tɛ aksidan na, wa a bɛ se ka don yɔrɔjan kɔri la. Ni o tɛ, a doncogo ka kan ka Changé ka daminɛ ka bɔ a daminɛ na (Ja ae duguma).

2.Kapandji fɛɛrɛ la, K-wire fila fo saba bɛ don kariyɔrɔ la walasa ka kari yɔrɔjan yɔrɔw dɔgɔya ani k’u latilen ka se u jɔyɔrɔ ɲininen ma. Ni a dɔgɔyara, K-filɛriw bɛ taa ɲɛ ka don a kɛrɛfɛyɔrɔw la (Ja af bɛ duguma).

3.Ni Kirschner ka nɛgɛ dondaw ni bɔyɔrɔw ka surun kosɛbɛ kariyɔrɔ la, fixation failure bɛ se ka kɛ. Kirschner kɔfɛla fila man kan ka tɛmɛ bolokɔnincinin fɛ ni hakɛ kelen ye, wa bolokɔni bɔyɔrɔ ka kan ka kɛ santimɛtɛrɛ 2 ye ka bɔ a kariyɔrɔ la. Aw ye Jaaw lajɛ ac jukɔrɔ.

4. Ni kɔkolo sɔgɔlen don kosɛbɛ, aw bɛ aw jija aw kana don kolotuguda yɔrɔjan kariyɔrɔ la, barisa o bɛ se ka kɛ sababu ye ka a sirili dɛsɛ. Jatew ae duguma.

5. Ni koloci jugumanba don, a ka fisa aw ka Kirschner nɛgɛ naani fo duuru kɛ walasa ka koloci karilen labɛn. Tuma dɔw la, walasa ka radiyali janya mara, Kirschner nɛgɛ transversal bɛ kɛ ka radius distal kolo bloki siri distal ulna la.

6. Epiphyse laban yɔrɔ janw karilenw na, Kirschner nɛgɛ belebeleba dɔ bɛ se ka kɛ ka a siri. Nka, Kirschner ka nɛgɛ bɛ se ka sɛgɛn ka don ɲɛgɛnɛsira la, wa a labɛnni ka gɛlɛn (Ja ad jukɔrɔ).

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8. Ni yɔrɔjan yɔrɔ karilen jugumanba min bɛ taa ni surunyali ni bin ye, o bɛ Kirschner nɛgɛ wɛrɛ de wajibiya min bɛ tɛmɛ ulna fɛ walasa ka radiyali janya mara. Kirschner ka nɛgɛ bɛ jira ka ɲɛ ka bɔ styloïde kɛcogo bolokɔni fan fɛ ka taa ulna kɔkanna fan fɛ, i n’a fɔ a jiralen bɛ cogo min na ja a ni b la jukɔrɔ.

9. Styloïde radial fracture ni kɔkolo jiginni. Dɔgɔyali kɔfɛ, aw bɛ a labɛn ni Kirschner styloïde radiale fila ye: kelen bɛ kɛ kɔ fɛ, tɔ kelen bɛ kɛ bolokɔni fan fɛ ka taa styloïde kuncɛ la. (Ja a ni b minnu bɛ duguma)

10. Kɛrɛnkɛrɛnnenya la, yɔrɔ naani karilen don, ni kɔkolo bɛ wuli ani ka kalo yɔrɔ faranfasi ka bɔ bolokɔni fan fɛ. Kirschner ka nɛgɛ bɛ se ka siri ka bɔ kɔkolo kolotuguda la cogo la min bɛ jɛngɛ ka bɔ a kɛrɛfɛla la ka taa a bila kɔkolo yɔrɔ jan na. (Ja a ni b minnu bɛ duguma).

11. Ni aw bɛ Kirschner nɛgɛw kɛ kɔ ni bolokɔniw na walasa ka yɔrɔjan karilenw furakɛ, ni kalo yɔrɔ karilenw ma dɔgɔya opereli senfɛ, aw bɛ se ka bolokɔni kɛcogo dɔ kɛ, ka joli siraw sirili kɛ ka kolo faranfasi, o kɔ aw bɛ Kirschner nɛgɛ don kɔkolo yɔrɔ la ka bɔ bolokɔni dawolo yɔrɔ la. (Jaaw ah bɛ duguma)

12. Ni a jɛlen don ko yɔrɔjan karilenw bɛ bɔ yɔrɔ wɛrɛ la, minnu tɛ se ka dɔgɔya ni dɔgɔyali dagalen ye, Kirschner nɛgɛ min janya ye milimɛtɛrɛ 3 ye, o bɛ se ka kɛ ka yɔrɔjan karilenw kɔrɔta ka bɔ kɔfɛ walasa ka dɔgɔyali sɔrɔ (Jaw ah bɛ duguma).

13. Aw bɛ kɛnɛma fiɲɛbɔlanw kɛ ka yɔrɔjan karilenw furakɛ. Kɛnɛma fiɲɛbɔlanw bɛnnen don yɔrɔjan karilenw karilen jugumanw ma minnu bɛ taa ni funuba ye, kari dafalenw, walima sigida fari cogoyaw minnu tɛ sira di kɔnɔna sirili ma (i n’a fɔ plati sirili) (Ja ad jukɔrɔ).

3. Aw bɛ gɛlɛyaw bali

1.Walisa ka fiɲɛ sabatibali bali, aw bɛ aw janto nin baara ninnu na

Aw bɛ aw janto bicortical fixation la.

Aw bɛ aw yɛrɛ tanga pikirijikɛlan bɔyɔrɔ yɔrɔjan bilali ma ka surun a kariyɔrɔ la.

Aw bɛ aw yɛrɛ tanga Kirschner ka filiw bɛɛ ma minnu bɛ ɲɔgɔn sɔrɔ yɔrɔjan dakun na walasa ka fanga lajɛ.

Aw bɛ aw janto aw kana wuli ka wuli ni aw bɛ Kirschner ka nɛgɛ kɔrɔta.

Ni koloci don, a ka kan ka Kirschner ka nɛgɛ sirili wɛrɛ kɛ.

2. Fɛɛrɛ minnu bɛ kɛ walasa ka pikirijikɛlan banakisɛw bali

Aw bɛ fɔlɔ ka fari tigɛ, ka farikolo yɔrɔ nɔgɔlenw fara ɲɔgɔn kan fo ka se kolo ma ni joli siraw sirilan ye, o kɔ aw bɛ Kirschner nɛgɛ kɛ.

Aw bɛ a sɔgɔ dɔɔni dɔɔni walasa ka funteni nekɔrɔsi bali.

Aw bɛ aw yɛrɛ tanga opereli segin-seginw ma siɲɛ caman.

Aw bɛ Kirschner ka nɛgɛ degun dɔgɔya fari la.