Distal radius fractures: Ɲɛfɔli dafalen min bɛ bɔ farikolo yɔrɔw la ka se opereli ma .

Distal radius fractures bɛ kɛ 75% ye bolokɔniw kari la ani u ka ca kɛrɛnkɛrɛnnenya la dɔgɔtɔrɔso la. Nin barokun in kɔnɔ, an ye farikolo yɔrɔw, danfara, furakɛli fɛɛrɛw, ani opereli fɛɛrɛw lisɛli lajɛ ka ɲɛsin yɔrɔjan radiyali karilenw ma aw ka kunnafoni kama.

Kuma surun .

Distal radius kariw ye bolokɔni karilenw yɔrɔ dɔ ye. bɛ 'saba-koloma teori' se ka bolokɔni karilenw ka banako kɛcogo ɲɛfɔ ka ɲɛ, min kɔnɔ, kolosinsinnan radiyali, min bɛ kɛ ni tubero radiyali ye ani navicular fossa, o nafa ka bon bolokɔni joli sabatili sabatili la.

Distal radius fractures bɛɛ, n’a ma fɔ avulsion (avulsion) ka kariw ye radius (radius) kɔkanna margin (kɔfɛ) ye, tiɲɛ na, o bɛ sɔrɔ fariya fɛ min bɛ kɛ ka tɛmɛ a dan kan. Bolo bɛ sigi cogo wɛrɛ la ni kɛnɛma fanga ye a kɛ, wa kɛnɛma fanga nɔfɛkow tɛ kelen ye.

1.Fɔliya bɛ se ka kɛ sababu ye ka joli-sira-funu-kɔnɔ-banaw bɔ u ka yɔrɔw la minnu bɛ bɔ u ka yɔrɔw la walima minnu tɛ se ka bɔ u nɔ na ni fanga dɔgɔman joginw ye i n’a fɔ binw.

2.Shear stress bɛ se ka kɛ sababu ye ka joli-sira-funu-yɔrɔw jiginni yɔrɔ dɔw labɔ bolokɔni fan fɛ o cogo la min bɛ na ni basigibaliya ye.

3.Ni fanga caman bɛ jogin na, degunw bɛ caya ka tɛmɛ ani doni tali kojugu bɛ na ni joli-sira-funu-yɔrɔ kolo degunni ye.

4.Karili jiginni fɛɛrɛ fɔlɔ ye avulsion joginni ye min na a ka c’a la, kolo girinya avulsé bɛ kɛ kolotugudaw siriyɔrɔ ye.

Anatomie radiologique de la radius distal .

1.Anteroposterior films (a janya la, ulnar deviation, ulnar varus)

2. Filimu minnu bɛ kɛ kɛrɛfɛ (Palmar ka ŋaniya) .

Fernandez ka danfara .

suguya fɔlɔ metafiziyali flexion fracture .

A suguya II ye joli ye ani a kari kari .

suguya III degun kari ka bɔ joli-sira-funu na .

Avulsion type IV avulsion de la monde radial, dislocation .

suguya V kari ɲagaminenw (avulsion fractures en énergétiques) .

Opereli taamasiɲɛw .

Distal radius fractures fanba bɛ furakɛ ni frein ye jigin dagalen kɔfɛ, bɔnɛ ye a ye ko nin kari caman bɛna bɔ u nɔ na walima jigin tɛna sɔn ni kɔlɔlɔ jugu ye.

Fɛn duuru minnu bɛ mɔgɔ bali ka baara kɛ, olu jirala Lafontaine et al fɛ:

1 A daminɛ na, a kɔkanna sɔgɔli > 20° (Palmar jiginni);

1 A ka kan ka kari ka bɔ kɔfɛ epifisi la;

3 kari joli la ;

1 ulnar kari min bɛ tali kɛ o la ;

3 Banabagatɔ si hakɛ > san 60.

Sariya walima laadilikan dafalen si tɛ yen min bɛ se ka furakɛli ɲɛminɛ, wa furakɛli bolodalenw bɛ kɛ ka jateminɛ kɛ fɛn caman na, i n’a fɔ joginni fɔlɔ cogoya, jateminɛ kɛli a sigicogo kura kɔfɛ, banabagatɔ si hakɛ, a kolo cogoya, a banabagatɔ ka ɲininiw, ani a ka sɔrɔ ɲininenw.

Walasa ka kariw dɔgɔyali dabila ni u sabatili bɛ siga la, o kɔfɛ, u bɛ se ka tugu ɲɔgɔn kɔ. A nafa ka bon k’a dɔn ko ni sɛgɛsɛgɛli kɛlen kɔfɛ, ni fɛn dɔw bɛ bɔ ɲɔgɔn na, o bɛ basigibaliya walima jiginni kɔfɛ, o tuma na, furakɛli caman bɛ se ka kɛ. Ni a karili bɛ se ka sabati, o tuma na, arajolakalanw ka kan ka ta ka jateminɛ kɛ fo ka se kari ka kɛnɛya ani ka sabati.

Furakɛli min bɛ kɛ ni kɔrɔlen ye .

Kari sabatilenw bɛ se ka bɔ yɔrɔ la ka ɲɛ ani ka furakɛ ni frein ye, a daminɛ na ni sɔgɔli ye ani kɔfɛ ni tubulu ye, ni dɔgɔkun o dɔgɔkun radiyografu bɛ se dɔgɔkun 3 ma.

Ni fɛn caman Changements significatifs dans le longueur radiale, inclinément de palmaine, ou de la déviation de l’ulnar, opereli furakɛli ka kan ka jateminɛ.

Banabagatɔ fangantanw ni banabagatɔ minnu ka ɲi, furakɛli dagalen bɛ bɛn tuma caman na, hali ni opereli jirala.

Dakun min bɛ se ka kɛ ka ɲɛgɛnɛsiralabanaw siri .

Jiginni dagalen kɔfɛ, pinɛni ni fixation percutané nafa ka bon distal radius fractures la ni metaphyseal basigibaliya ye walima kari nɔgɔmanw kɔnɔna na.

A fɔlɔ ye farikolo-ɲɛnajɛ-yɔrɔ-ko ye, o kɔfɛ sabatili bɛ Kɛ ni gram pins ye. A ka c’a la, pinɛ fɔlɔ bɛ tɛmɛ ka bɔ styloïde radial la ka taa radiyali metafizi cɛmancɛ la ka taa diaphysis la.

Pinɛ 2 de ka dɔgɔn ka kɛ sababu ye ka reposition (yɔrɔ) sabatilen bɛnnen di orthogonal (yɔrɔ) ni lateral (yɔrɔ) la, ani lunate facet (lunate facet) bɛ se ka pinɛ ni a b’a fɛ.

Intrafracture pinning (Kapanji fɛɛrɛ) bɛ kɔkanna dɛmɛ di. Opereli kɔfɛ lamaga-lamagali bɛ kɛ splint kɔnɔ dɔgɔkun 2 kɔnɔ walasa ka jiginni kunbɛn ani ka pin dimi dɔgɔya, o kɔfɛ a bɛ se ka bila a nɔ na ni bolokɔnincinin nɔgɔlen ye.

Dakun min bɛ kɛ ka fɛnw falen u nɔ na, ​​o ye fixation fixation ye .

Kɛnɛyaji sirilanw nafa ka bon furakɛli fɔlɔ walima furakɛli la yɔrɔjan yɔrɔjanw na.

Kɛnɛma-fiɲɛbɔlan bɛ axial streses minnu bɛ baara kɛ distal radius kan bolokɔniw farikolo yɔrɔw sɔgɔli waati. Fixation bɛ se ka kɛ walima a tɛ se ka kɛ bolokɔni fan bɛɛ la, walima fixation wɛrɛ bɛ se ka fara a kan.

Parallel traction tɛ palmar inclination (bololanɛgɛ jiginni) segin a cogo kɔrɔ la, nka jɔyɔrɔ min tɛ neutre ye, o bɛ sɔn. Opereli kɔfɛ, bolokɔni bɛ siri tubulu la kɔfɛla la min bɛ wuli ka wuli tile 10 fo ka se dimi ni kirinni ma.

Plate fixation ni incision ani repositionnement .

1、Dorrsal plate kɔnɔna na fixation distal radius fracture .

Tigɛ tilennen bɛ kɛ Lister ka node kan, ni a dakun yɔrɔjan bɛ tɛmɛ ni radiyali karɔti joli sira ye ani ka laban santimɛtɛrɛ 1 kɛrɛfɛ ka se bolokɔni filanan ma min bɛ wele ko metakarpi filanan. A dakun surun bɛ Taa ‘yɔrɔ la min bɛ Taa ‘yɔrɔ la min bɛ Taa ‘yɔrɔ la fo santimɛtɛrɛ 3 fo 4, o bɛ cɛmancɛ-yɔrɔ Bɔ ‘yɔrɔ la min bɛ Bɔ ‘yɔrɔ la min bɛ ‘yɔrɔ sabanan ‘kɔnɔ.

2、Palm plate kɔnɔna na fixation distal radius fracture .

Tigɛtigɛ janyalen bɛ kɛ ka a kɛ ni fɛnɲɛnamafagalan ye min bɛ wele ko bunion flexor tendon, o bɛ sɔrɔ karipirili fɛnɲɛnamafagalan sanfɛla jugumanba la, o min bɛ segin ka kɛ ɲɛgɛnɛsiralabanaw ye, ani ɲɛfɛla ni kɔkiliw ɲɛfɛla farikolo bɛ se ka wuli ka bɔ a nɔ na. A ka radiyali.

Case 1 .

Case 6 .

Case 3 .

3. Traction plate fixation de la fracture distal radius .

- santimɛtɛrɛ 4 janya tigɛ bɛ kɛ kɔfɛ ka taa metakaripi jirisun sabanan na, ani cɛmancɛ bolokɔnincinin extensor bɛ sɔrɔ ka metakarpal sabanan bɔ kɛnɛ kan ;

- santimɛtɛrɛ 4 tigɛ filanan bɛ kɛ santimɛtiri 4 kɔfɛ ka se fɛnɲɛnamafagalan ma ;

- Santimɛtɛrɛ 2 kɔkanna tigɛ sabanan bɛ kɛ Lister ka node la walasa ka extensor hallucis longus tendon bɔ kɛnɛ kan.

Ka bɔ yɔrɔjan tigɛyɔrɔ la, samalan bɛ don a la ka surunya a la, a bɛ kɛ cogo min na, a bɛ kɛ tendon extensor (fourth dorsal compartment), joli kapisi ni periosteum cɛ. Tendon extensor bɛ se ka lamaga ni a mago bɛ a la.

4. Distal radius ka kariw faralen ɲɔgɔn kan, u kelen-kelen bɛɛ bɛ sigi sen kan ka da u ka baarakɛcogo kan .