Distal Radius Fractures: Ɲɛfɔli caman bɛ bɔ farikolo yɔrɔw la ka taa a bila opereli la

Distal radius fractures bɛ kɛ 75% ye bolokɔniw karilenw na, wa a ka ca kɛrɛnkɛrɛnnenya la dɔgɔtɔrɔso la. Nin barokun in kɔnɔ, an ye farikolo yɔrɔw, u danfara, furakɛli fɛɛrɛw ani opereli fɛɛrɛw lisɛli labɛn ka ɲɛsin yɔrɔjan karilenw ma walasa aw ka se k’u lajɛ.

Kuma surun kɛ

Distal radius karilenw ye bolokɔni karilenw dɔ ye. bɛ 'kolo saba miiriya' se ka bolokɔni karilenw banacogo ɲɛfɔ ka ɲɛ, o min na, kolosinsinnan min bɛ kɛ ni tuberosité radiale ni navicular fossa ye, o nafa ka bon bolokɔni kolotuguda sabatili sabatili la.

Distal radius fractures bɛɛ, n’a ma fɔ avulsion fractures of the dorsal margin of the radius, tiɲɛ na, o bɛ sɔrɔ overextension violence fɛ. Bolo bɛ jɔ cogo wɛrɛ la ni kɛnɛma fanga ye a waleya, wa kɛnɛma fanga nɔw tɛ kelen ye.

1.Flexion violence bɛ se ka kɛ sababu ye ka kɔkolo karilenw kɛ kɔkolo kɔnɔ walima farikolo kɔkanna joginw na minnu fanga ka dɔgɔn i n’a fɔ binkanni.

2.Shear stress bɛ se ka kɛ sababu ye ka articular surfaces yɔrɔ dɔw wuli ka bɔ bolokɔni fan fɛ o la, o bɛ na ni basigibaliya ye.

3.Jogin minnu fanga ka bon, degun fariya bɛ caya ani doni axial kojugu bɛ na ni degun ye kolotuguda sanfɛla kolo la.

.

Anatomie radiologique de la radius distal

1.Filimu minnu bɛ ɲɛfɛla kɔfɛ (kɔlɔn radiyali, ulnar deviation, ulnar varus) .

2. Filimu minnu bɛ kɛ kɛrɛfɛ (boloci) .

Fernandez ka danfara

Sugu fɔlɔ Metafisiyali flexion fracture

Type II Articular ani Shear Fracture ka kari

Type III Compression Fracture de la surface articulaire

Avulsion type IV fracture de la wrist radiale, dislocation

Kari suguya V ɲagaminenw (Kari minnu bɛ kɛ ni fanga caman ye) .

Opereli taamasiɲɛw

Distal radius kari fanba bɛ furakɛ ni frein ye dɔgɔyali dagalen kɔfɛ, a fɔ man di nka o kari caman bɛna wuli walima dɔgɔyali tɛna sɔn ni kɔlɔlɔ jugu ye.

Fɛn duuru minnu bɛ mɔgɔ sabati, olu jirala LaFontaine ni a ɲɔgɔnnaw fɛ:

1 Kɔnɔbara basigilen fɔlɔ > 20° (bolokɔni jiginni);

2 Kɔnɔbara basigilen karilen dɔɔni;

3 kolotuguda karilen;

4 Ulnar kari min bɛ tali kɛ ɲɔgɔn na;

5 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 joginda fɔlɔ cogoyaw, a jateminɛcogo a bilali kɔfɛ, banabagatɔ si hakɛ, kolo cogoya, banabagatɔ ka magow, ani a sɔrɔcogo ɲininen.

Ni kariw dɔgɔyali dagalen don ni siga bɛ a la ko u sabatilen don, o tuma na, a ka ɲi ka tugu ɲɔgɔn kɔ kosɛbɛ. A nafa ka bon ka a dɔn ko ni rezow kɛra ka tugu ɲɔgɔn na dɔgɔyali kɔfɛ, o b’a jira ko a tɛ basigi walima ko a bɛ taa yɔrɔ wɛrɛ la, o tuma na, furakɛli caman bɛ se ka Changer. Ni kari bɛ se ka kɛ a tɛ sabati, o tuma na, aw ka kan ka rezow ta ka jateminɛ kɛ fo kari ka kɛnɛya ani ka sabati.

Furakɛli min bɛ kɛ ni kɔrɔlen ye

Kari minnu sabatilen don, olu bɛ se ka datugu ka ɲɛ ani ka furakɛ ni frein ye, a daminɛ na ni sɔgɔli ye ani kɔfɛ ni tubabufura ye, ni dɔgɔkun o dɔgɔkun fotota ye fo dɔgɔkun 3.

Ni fɛn caman Changements significatifs (Yɛlɛmaba) kɛra radial janya la, bolokɔni jiginni na, walima ulnar deviation la, opereli furakɛli ka kan ka jateminɛ.

Banabagatɔ minnu fanga ka dɔgɔn ani minnu man ca, furakɛli dafalen bɛ kɛ tuma caman na, hali ni opereli ka kan ka kɛ.

Closed reset percutané pikirijikɛlan sirili

Dɔgɔyali dagalen kɔfɛ ni pinning ni fixation ye farikolo la, o nafa ka bon distal radius fractures ni metaphyseal instability walima simple intra-articular fractures.

Fɛn fɔlɔ ye farikolo-ɲɛnajɛ-yɔrɔ-ko ye, o kɔfɛ, sabatili bɛ kɛ ni garamu pinɛw ye. A ka ca a la, pini fɔlɔ bɛ tɛmɛ ka bɔ styloïde radiale la ka taa metaphyse radiale la medial la ka taa diaphyse la.

A dɔgɔyalenba la, pini 2 bɛ kɛ walasa ka sigiyɔrɔma sabatilen bɛrɛbɛrɛ di yɔrɔ la min bɛ kɛ kɛrɛfɛ ani kɛrɛfɛ, wa kalo fan bɛ se ka pinɛ ni a b’a fɛ.

Intrafracture pinning (Kapanji fɛɛrɛ) bɛ kɔkolo dɛmɛni di. Opereli kɔfɛ jɔli bɛ kɛ sɔgɔsɔgɔninjɛ la dɔgɔkun 2 kɔnɔ walasa ka jiginni kunbɛn ani ka pinɛw dimi dɔgɔya, o kɔfɛ, a bɛ se ka bila a nɔ na ni bolokɔni nɔgɔlen ye.

Kɛnɛma fiɲɛbɔlan sirili dasirilen-yɔrɔ la

Kɛnɛma fiɲɛbɔlanw nafa ka bon furakɛli daminɛ na walima furakɛli faralen na yɔrɔjan kari kɛrɛnkɛrɛnnenw na.

Kɛnɛma fiɲɛbɔlan bɛ aksidan degunw neutralize minnu bɛ baara kɛ distal radius kan bolokɔni ɲɛfɛla farikolo kuluw ka sɔgɔsɔgɔli waati. Fixation bɛ se ka kɛ walima a tɛ se ka kɛ bolokɔni fan bɛɛ fɛ, walima fixation wɛrɛ bɛ se ka fara a kan.

Parallel traction tɛ bolokɔniw jiginni segin a cogo kɔrɔ la pewu, nka jɔyɔrɔ min tɛ mɔgɔ si ta ye, o bɛ sɔn. Opereli kɔfɛ, bolokɔni bɛ siri ni tubabufura ye min bɛ kɛ kɔfɛla wulilen na tile 10 fo dimi ni kirinni ka nɔgɔya.

Plate fixation ni tigɛcogo ye ani ka a bila yɔrɔ wɛrɛ la

1、Dorsal plate kɔnɔna fixation ka distal radius kari

Tigɛ tilennen bɛ kɛ Lister ka kolotuguda la, ni yɔrɔjan dakun bɛ tɛmɛ bolokɔni kolotuguda sira fɛ ka laban santimɛtɛrɛ 1 kɛrɛfɛ bolokɔni filanan da la. Kɛrɛfɛla laban bɛ janya jirisunba la fo santimɛtɛrɛ 3 fo 4, ka cɛmancɛ kolotuguda jira ka tɛmɛ janyalan sabanan cɛmancɛ basigilen fɛ.

2、Palm plate kɔnɔna fixation ka distal radius kari

Tigɛ janyalen bɛ kɛ senkɔni sɔgɔsɔgɔninjɛ radial fan fɛ, ni bunion flexor tendon bɛ sɔrɔ senkɔni sɔgɔsɔgɔninjɛ radiyali yɔrɔ juguman na, o bɛ kɔsegin kɔfɛ walasa ka ɲɛfɛla wulilen ani farikolo bɔ kɛnɛ kan, ani ɲɛfɛla wulilan ani farikolo bɛ tigɛ radial fan daminɛ na ka kɔsegin kɔfɛ walasa ka ɲɛda yɔrɔ jan bɔ kɛnɛ kan radiyali (radius) ye.

Ko 1nan

Ko 2nan

Ko 3nan

3. Traction plate fixation de la radius distal kari

- Santimɛtɛrɛ 4 janya tigɛlen bɛ kɛ kɔfɛla la ka taa bolokɔni sabanan na, ka cɛmancɛ bolokɔni janyalen sɔgɔ walasa ka senkɔni sabanan bɔ kɛnɛ kan ;

- Tigɛ filanan bɛ kɛ santimɛtɛrɛ 4 la a dɔgɔyalenba la santimɛtɛrɛ 4 kɔfɛ ka se a cɛmancɛ tigɛlen ma ;

- Kɔnɔbara tigɛ sabanan bɛ kɛ Lister ka yɔrɔ la min janya ye santimɛtɛrɛ 2 ye walasa ka extensor hallucis longus tendon bɔ kɛnɛ kan.

Ka bɔ yɔrɔjan tigɛyɔrɔ la, traction plate bɛ don kɛrɛfɛ ka kɛɲɛ ni plane ye extenseur tendon (kɔfɛyɔrɔ naaninan), joint capsule ani periosteum cɛ. Extenseur tendon bɛ se ka lamaga ni a mago bɛ a la.

4. Kari yɔrɔjan karilenw sirili kelen-kelen na ka da TriMed sitɛmu kan