Dɔgɔtɔrɔso lajɛ · Kalan gafe kura
Distal radius fracture ye kari ye radius bolokɔni dakun kɛrɛfɛ. Furakɛli bɛ se ka daminɛ ni sɔgɔsɔgɔninjɛ walima sɔgɔli ye ka taa a bila farikolojidɛsɛ la, kɛnɛma sirili, walima plati sirili. Labɛn bɛnnen bɛ bɔ kariw labɛncogo n’u sabatili la, kolotugudaw sendoncogo, farikolo yɔrɔ nɔgɔlenw cogoya, kolo cogoya, si hakɛ, baarakɛcogo magow, ani banabagatɔ diyanyekow.
Distal Radius Fracture ye mun ye?
Distal radius bɛ doni-ta-yɔrɔba Kɛ bolokɔni bolokɔnincinin fan fɛ. A ka ca a la, kari bɛ kɛ santimɛtɛrɛ damadɔ kɔnɔ ka bɔ radiocarpal joint la ani a bɛ se ka kɛ articular extra-articular ye, ka taa fo kolotuguda la, walima ka kɛ distal radioulnar joint ye. Ulnar styloïde ni a dɛmɛnanw fana bɛ se ka jogin.
Bin bolo kɔrɔtalen kan, o ye fɛɛrɛ ye min bɛ kɛ tuma caman na. Fanga dɔgɔyali binni bɛ kɛ baliku kɔrɔbaw la minnu kolo fanga dɔgɔyara, ka sɔrɔ farikoloɲɛnajɛ joginw, sirabakan-ko, ani binni ka bɔ sanfɛ, o bɛ se ka kɛ sababu ye ka fanga caman sɔrɔ banabagatɔ fitiniw na.
Mun na farikolo-ɲɛnajɛ nafa ka bon
Distal radius bɛ ni articulaire surface belebele ye ani a bɛ scaphoid ni lunate dɛmɛ. Kɛrɛfɛ-yɔrɔw ye cɛmancɛ-nɛrɛ, flexor ani extensor tendons, radial artery, distal radioulnar joint ani triangular fibrocartilage complex ye. Ka ɲɔgɔndan nafamaw segin u cogo kɔrɔ la ka sɔrɔ ka o fɛnw lakana, o ye furakɛli kuntilenna jɔnjɔn ye.
Taamasiɲɛw ni taamasiɲɛ minnu ka kan ka jateminɛ joona
A taamasiɲɛw ye bolokɔnidimi ye joona, funu, kurukuruni, sɔgɔsɔgɔninjɛ, lamaga dɔgɔyali, ani minɛ gɛlɛya. Kari min bɔra yɔrɔ wɛrɛ la, o bɛ se ka kɛ sababu ye ka fɛn ye min bɛ se ka ye. Dɔgɔtɔrɔ bɛ fari cogoya, bolokɔnincininw, dusukunnataw, senkɔniw baara ani joginw fana lajɛ minnu bɛ tali kɛ o la.
Aw bɛ teliya ka dɔgɔtɔrɔso ɲini joginda dabɔlen na, kolo min bɛ ye fari fɛ, bolo jɛman walima nɛnɛ, sɔgɔsɔgɔninjɛ min bɛ juguya, bolokɔniw lamagabaliya, funu min bɛ caya joona, walima dimi jugumanba min tɛ se ka kunbɛn. Nin sɔrɔlen ninnu bɛ se ka a jira ko farikolo karilen dabɔlen don, farikolojidɛsɛbanakisɛ, walima degun faratilen farikolo yɔrɔw kɔnɔ.
Sɛgɛsɛgɛli ani jateminɛ kɛli ni radiyo ye
bolokɔni kɔfɛla ni kɔfɛla jateminɛcogo jɔnjɔnw bɛ kɛ walasa ka kari karilen dɔn ani ka a jiginni jateminɛ. Oblique views bɛ se ka dɛmɛ don ko sugandilenw na. Tomografi min bɛ kɛ ni ɔridinatɛri ye, o bɛ se ka kunnafoni caman di ni joli siraw kɔnɔna karilen ka gɛlɛn walima ni opereli bolodacogo bɛ a ɲini ka a yɔrɔw ɲɛfɔ ka jɛya.
| Radiographie feature | A bɛ min ɲɛfɔ | Mun na a nafa ka bon |
|---|---|---|
| Kɔrɔya radiyali | Distal radius janya ka kɛɲɛ ni reference points ye joint surface kan. | Kɔrɔya bɔnɛ bɛ se ka doni tali ni ulnar variance Changer. |
| Inclination radiale (yɔrɔ min bɛ wele ko radial inclination). | Distal radial articular surface (yɔrɔjan radiyali) jiginni PA filɛli kan. | Ni jiginni dɔgɔyara, o bɛ se ka kɛ sababu ye ka a bin walima ka a bila kɛrɛfɛ. |
| Volar/dorsal jiginni | Articulaire surface sagittal orientation (yɔrɔ min bɛ kɛ ni sagittal) ye kɛrɛfɛla lajɛ kan. | Kɔnɔbara walima kɔkolo kɔrɔta kojugu bɛ se ka nɔ bila bolokɔni mekanikiw la. |
| Artikulaire step-off walima gap | A bɛ bɔnɛ a la ka kɛɲɛ ni ɲɔgɔn ye kolotuguda yɔrɔ la. | A bɛ dɛmɛ ka joli-sira-funu ni furakɛli kuntilenna ɲɛfɔ. |
| Ulnar variance (Ulnar variance) ye | Ulna distal ni radius janya danfaralen. | A bɛ se ka Changé ni radius surunyara ani ka nɔ bila ulnocarpal loading la. |
Distal Radius Fractures bɛ tila cogo min na
Ɲɛfɔli daɲɛw i n’a fɔ Colles , Smith , ani Barton karilenw bɛ kumaɲɔgɔnya kɛ ni fɛnw jiginni cogoyaw ye minnu bɛ kɛ cogoya la, nka u tɛ jogin bɛɛ minɛ. Bi jateminɛ fana b’a sɛbɛn ni kari dabɔlen don walima ni a datugulen don, ni a bɛ bolokɔni kɔkan walima ni a bɛ a kɔnɔ, ni a bɔra yɔrɔ wɛrɛ la walima ni a ma bɔ yɔrɔ wɛrɛ la, ni a sabatilen don walima ni a tɛ sabati, ani ni a nɔgɔn don walima ni a tigɛlen don.
Fernandez ka danfara ka kɛɲɛ ni fɛɛrɛ ye
Fernandez ka sigida bɛ karilenw kuluw kulu ka kɛɲɛ ni jogincogo fangama ye. A bɛ se ka dɔgɔtɔrɔw dɛmɛ u ka miiri joginda nɔgɔlenw ni u jɔcogo fɛɛrɛw la minnu bɛ tali kɛ ɲɔgɔn na, nka furakɛli tɛ sugandi ka bɔ danfara dɔrɔn na.
Furakɛli bɛ sugandi cogo min
O laɲini tɛ dɔrɔn ka X-ray kɛ i n’a fɔ a bɛ cogo min na. Furakɛli bɛ bolokɔni lafiyalen ɲini, min sabatilen don, min bɛ baara kɛ, ka sɔrɔ ka anestezi, opereli, a lamagacogo, a gɛlɛyali ani a dɔgɔyali bɔnɛ faratiw balansi. Desizɔn min bɛ kɛ ɲɔgɔn fɛ, o ka kan ka jateminɛ kɛ:
- karilenw jiginni, u sɔgɔli, kolotugudaw sendonli, ani sabatili dɔgɔyali kɔfɛ;
- jogin dafalen, farikolojidɛsɛ taamasiɲɛw, joli-sira-funu, ani farikolo yɔrɔ nɔgɔlenw cogoya;
- banabagatɔ si hakɛ ye proxy ye — a tɛ kɛ a nɔnabila ye — farikolo cogoya ni baarakɛcogo ɲinini na;
- kolo cogoya, jogin wɛrɛw, furakɛli cogoya, baara, ani bolo fanga;
- se ka taa tuguni kɛli la ani ka sen don kɛnɛyako la;
- banabagatɔ ka laɲiniw ni a ka muɲuli sugandi kelen-kelen bɛɛ nafa ni a faratiw la.
Ladilikan kɔnɔko : AAOS/ASSH ka bilasiralikan bɛ opereli jɔli dɛmɛ banabagatɔ caman na minnu tɛ mɔgɔkɔrɔbaw ye ni, dɔgɔyali kɔfɛ, radiyali surunyali tɛmɛna milimɛtɛrɛ 3 kan, kɔfɛla jiginni tɛmɛna milimɛtiri 10 kan, walima ni bolokɔniw kɔnɔna jiginni/sen bɔli tɛmɛna milimɛtɛrɛ 2 kan. Banabagatɔ kɔrɔbaw fɛ — a ka c’a la, u bɛ jira kalanw kɔnɔ ni u si bɛ san 65 la walima ka tɛmɛ o kan — a ka c’a la, opereli tɛ banabagatɔw ka jateminɛ kuntaalajanw ɲɛnabɔ ni i ye u suma ni ladonni ye min tɛ opereli ye. O dantigɛliw bɛ kunnafoni di, nka u tɛ u nɔ bila, mɔgɔ kelen-kelen bɛɛ ka kɛnɛyako kiritigɛcogo la.
Furakɛli min tɛ opereli ye
Kari sabatilen min ma wuli ka bɔ yɔrɔ wɛrɛ la walima min bɛ sɔn ka kɛ a cogo la, o bɛ se ka ɲɛnabɔ ni sɔgɔlan walima fɛn dɔ ye min bɛ kɛ ni fɛn dɔ ye. Kari min bɔra yɔrɔ wɛrɛ la, o bɛ se ka fɔlɔ ka dɔgɔya da tugulen na, o kɔfɛ, a bɛ se ka lamaga. Sɛgɛsɛgɛli tuguni ni arajoli bɛ boloda ka kɛɲɛ ni kari kɛcogo ye ani dɔgɔtɔrɔ ka jateminɛ ye barisa kari dɔw bɛ se ka bɔnɛ u ka ɲɔgɔn na ni funu bɛ dɔgɔya.
- Lakanali fɔlɔ : sɔgɔsɔgɔninjɛ bɛ yɔrɔ di funu joona ma; kɔrɔtacogo ni bolokɔni lamagacogo bɛ se ka laadi.
- Dɔgɔyali ni a mago bɛ a la: kari bɛ labɛn kokura ni dimimadafura walima anestezi bɛnnen ye.
- Lamaga-lamagali ni seginnkanni: cast fit, circulation, sensation, ani alignment bɛ jateminɛ kokura.
- Labɛnni : bolokɔni ni bolokɔni lamaga bɛ don a la ni kɛnɛya ni sabatili bɛ sira di.
Opereli bɛ se ka jateminɛ tuma jumɛn?
Opereli bɛ se ka baro kɛ ni ɲɔgɔndɛmɛ bɛ se ka kɛ walima ni a tɛ se ka to sen na, ni kolotuguda yɔrɔ bɛ wuli kosɛbɛ, ni kolotuguda karilen dabɔra, ni kolotuguda ma sabati, walima ni joginda cogoya tɛ to ka sabati fɛn dɔ kɔnɔ. Opereli ni a doncogo bɛ sugandi ka kɛɲɛ ni a yɔrɔ kɛrɛnkɛrɛnnenw cogoya ni banabagatɔ ye—a tɛ sugandi dɔrɔn ka kɛɲɛ ni a sɛgɛsɛgɛli sɛbɛn ye.
Opereli suganditaw ka ɲɛsin distal Radius Fractures ma
| Fɛɛrɛ Jɔrɔ | min bɛ kɛ tuma bɛɛ | Danyɔrɔ nafamaw walima faratiw |
|---|---|---|
| K-wire sirili farikolo la | Kari minnu bɛ se ka dɔgɔya, olu sugandilenw minnu bɛ se ka sabati ni piniw ye ani ni fɛn wɛrɛw ye minnu bɛ se ka lamaga. | Pinɛ-sira banakisɛ, nɛgɛw jiginni, dɔgɔyali bɔnɛ, ani mago bɛ pinɛ ladonni na. |
| Kɛnɛma fiɲɛ bilali | Jogindaw sugandilenw minnu tɛ sabati, minnu dabɔlen don, minnu bɛ sɔgɔsɔgɔ kosɛbɛ, walima minnu farikolo yɔrɔ nɔgɔlenw bɛ tiɲɛ; a bɛ se ka kɛ waati dɔɔnin dɔrɔn ta ye walima a bɛ se ka kɛ ko dafalen ye. | Pin-tract gɛlɛyaw, gɛlɛya, nɛrɛ/sɔgɔsɔgɔninjɛ ŋɛɲɛ, ani ɲɔgɔndan bɔnɛ. |
| Volar ka bɔgɔdaga plati | Articular extra-articular ani intra-articular pattern caman minnu tɛ sabati, minnu bɛ dɔgɔya tilennen ni dɛmɛni fixe de wajibiya. | Flexor tendon dimi walima a kari, farikolojidɛsɛ taamasiɲɛw, kuru doncogo, banakisɛw sɔrɔli, ani fɛnɲɛnamafagalan taamasiɲɛw. |
| Kɔrɔlen plati | Kɔnɔbara dakun sugandilenw walima kɔkolo sɔgɔli yɔrɔ minnu ma kɔlɔsi ka ɲɛ ka bɔ volar fan fɛ. | Extensor tendon irritation ani fɛnɲɛnamafagalanw bɔli. |
| Kɔrɔlen pont plati | Kari minnu tigɛlen don kosɛbɛ, yɔrɔ minnu na plati bɛ bolokɔni da ani ka ligamentotaxis kɛ. | A bɛ dan sigi bolokɔni lamagacogo la waati dɔɔni ani a ka ca a la a bɛ kɛ sababu ye ka kɔfɛ plati bɔ. |
| Fixation (fixation) min bɛ kɛ ni fragment kɛrɛnkɛrɛnnenw ye | Jateminɛ gɛlɛnw minnu na, kolotugudaw kelen-kelen bɛɛ walima bolokɔniw yɔrɔ kelen-kelenw mago bɛ dɛmɛ laɲininen na. | Ni fɛn caman donna farikolo yɔrɔw la ani ka u kɛcogo caman kɛ, o bɛ se ka dɔ fara farikolo yɔrɔ nɔgɔlenw ka gɛlɛya kan. |
AAOS/ASSH daliluw b’a jira ko danfaraba tɛ kuntaalajan kɔlɔlɔw la fixation techniques ni articular fractures sabatibali walima dafalenw na, hali ni volar locking plates bɛ se ka baarakɛcogo kɛnɛya joona kalo saba fɔlɔw kɔnɔ. Fɛɛrɛ laban sugandili bɛ bɔ kari ni operelikɛla ka dɔnniya la.
Pin fixation percutanée
Dɔgɔyali dafalen kɔfɛ walima da wulilen danma, Kirschner ka nɛgɛ nɔgɔlenw bɛ se ka yɔrɔ sugandilenw minɛ. Fluoroscopie bɛ dɔgɔyali ni fili jɔyɔrɔ dafa. Pinɛw bɛ se ka to fari kɔkan walima ka u su, ka kɛɲɛ ni fɛɛrɛ ye, wa a ka ca a la, bolokɔni bɛ lakana ni sirilan walima fɛn dɔ ye min bɛ kɛ ni fɛn dɔ ye.
Kɛnɛma fiɲɛ bilali
Kɛnɛma fiɲɛbɔlan bɛ baara kɛ ni piniw ye minnu bilalen don kariyɔrɔ kɔkan ani minnu sirilen don kɛnɛma karamɔgɔ dɔ la. Bololabaarakɛminɛn min bɛ bolokɔniw tigɛ, o bɛ se ka janya ni a labɛncogo mara ligamentotaxis fɛ. A bɛ se ka fara ɲɔgɔn kan fana ni nɛgɛw ye, ni tabali misɛnniw ye, walima ni kolotugudaw ye joginda gɛlɛnw na. Aw ye misali dɔ lajɛ a bolokɔni kɛnɛma fixatɛri ani jateminɛba dɔ kolotugudaw kɛnɛma fixation systems.
Kɔrɔnfɛla plati fixation
Kɔnɔbara taabolo bɛ se ka kɛ kɔfɛla bolokɔniw yɔrɔ sugandilenw ni sɔgɔsɔgɔninjɛ cogoyaw la. Bi bi in na, fɛn minnu bɛ don mɔgɔ kɔnɔ minnu tɛ fɛnba ye, olu bɛ dɔ bɔ fɛn caman na, nka extenseur tendons bɛ to ka surunya fɛnɲɛnamafagalanw na, wa u ka kan ka lakana. Nin ja ninnu bɛ kɔkolo jɔli hakilinaw jira sanni ka kɛ opereli kɛcogo ye min bɛ kɛ diɲɛ bɛɛ kɔnɔ.
Volar locking plate fixation (plate de blocage volar) sirili
Volar plating bɛ kɛ ka caya barisa a bɛ se ka subchondral kolo dɛmɛ ka bɔ bolokɔni fan fɛ ka sɔrɔ ka a yɛrɛ tanga a bilali tilennen ma extensor tendons jukɔrɔ. Flexor carpi radialis interval ye fɛɛrɛ ye min bɛ kɛ tuma caman na. Plati jɔcogo, joli yɔrɔ seginni, kuru janya min bɛ yɔrɔjan, ani flexor tendon clearance, o bɛ a ɲini ka sɛgɛsɛgɛli kɛ ka ɲɛ.
XC Medico misaliw ye a 7-hole distal radius locking plate , a. Bamako, Mali 6-hole distal radius locking plate , ani a DVR distal radius da tuguli plati . Nin fɛn dilannenw ladɛrɛsiw ye minɛnw kunnafoniw ye; fɛnw doncogo sugandili tora dɔgɔtɔrɔ kalanlenw ka baara ye.
Kɔnɔbara basigilen (distraction) plating
Bridge plate bɛ daminɛ radius la ka taa metacarpal la ani a bɛ baara kɛ i n’a fɔ kɔnɔnafililan. A bɛ se ka kɛ nafa ye joginda sugandilenw na minnu tigɛlen don kosɛbɛ, minnu tɛ se ka dɛmɛ ni dannaya ye ni yɔrɔjan plati kɔrɔlen ye. Ikomi a bɛ bolokɔni tigɛ waati dɔɔni, a ka ca a la, fɛɛrɛ filanan bolodalen ka kan ka kɛ walasa ka tasa bɔ a kɛnɛyali kɔfɛ.
Fixation (fixation) min bɛ kɛ ni fragment kɛrɛnkɛrɛnnenw ye
Articules fractures complexes bɛ se ka kɛ radial styloïde, volar rim, dorsal rim ani impacted central fragments ye. Sistɛmu minnu bɛ kɛ yɔrɔ kɛrɛnkɛrɛnnenw na, olu bɛ baara kɛ ni fɛn misɛnninw ye minnu bilalen don walasa ka fɛnw sabati minnu ka kan ka kɔlɔsi tigitigi. U bɛ se ka kɛ u kelen na walima ni u siricogo wɛrɛ ye.
Kɛnɛya, kɛnɛya sabatili ani gɛlɛya minnu bɛ se ka sɔrɔ
A ka ca a la, bolokɔniw lamagacogo bɛ dusu don mɔgɔ kɔnɔ joona ni joginda ni furakɛli bɛ sira di. Bolo ni bolokɔni degeliw bɛ daminɛ ka kɛɲɛ ni a sabatili ye, joginda cogoya ani kɛnɛyali ye ni rezow ye. Fanga, seko ni dɔnko ani muɲuli bɛ kɛnɛya dɔɔni dɔɔni ka tɛmɛ lamaga basigilen kan, wa funu walima gɛlɛya dɔw bɛ se ka to kalo caman kɔnɔ. Labɛnni bɛ se ka kɛ so kɔnɔ walima ka kɔlɔsili kɛ ka kɛɲɛ ni banabagatɔw magow ye ani sigida baarakɛcogo ye.
Gɛlɛya minnu bɛ se ka sɔrɔ olu ye dɔgɔyali ye, jɛɲɔgɔnyabaliya, jɛɲɔgɔnyabaliya, gɛlɛya, jolidɛsɛ kɔfɛ, farikolojidɛsɛ taamasiɲɛw, sigida dimi gɛlɛnw, senkɔniw dimi walima a kari, banakisɛ, pinɛ-sira gɛlɛyaw, ani taamasiɲɛw fɛnɲɛnamafagalanw. Farikoloɲɛnajɛ kura, dimi min bɛ ka caya, sumaya, ji bɔli, walima bolokɔni lamagacogo bɔnɛnen taamasiɲɛ ye, o bɛ kɛ sababu ye ka dɔgɔtɔrɔso lajɛ.
Kolow kɛnɛyako nafa ka bon : ni baliku kɔrɔba dɔ karilen don ni fanga dɔgɔya ye, o bɛ se ka kɛ koloci lasɔmini taamasiɲɛ ye. Banabagatɔw bɛ se k’u ka dɔgɔtɔrɔ ɲininka ni kolo karilen farati jateminɛ, koloci sɛgɛsɛgɛli, bin kunbɛnni, witamini D jateminɛ, walima kolo kɛnɛya fɛɛrɛ wɛrɛw bɛnnen don.
Ɲininkali minnu bɛ kɛ tuma caman na
Yala distal radius fracture bɛɛ min bɛ bɔ yɔrɔ wɛrɛ la, o ka kan ka opere wa?
Ayi, kari dɔw bɛ se ka dɔgɔya ani ka to u cogo la min bɛ sɔn ka kɛ fɛn dɔ kɔnɔ. Basigi, kolotugudaw jiginni, si hakɛ, baarakɛcogo ɲinini, kɛnɛya, ani banabagatɔ ka fɛɛrɛw bɛɛ bɛ nɔ bila desizɔn na.
Distal radius fracture bɛ waati joli ta ka kɛnɛya?
A ka ca a la kolo kɛnɛyali joona bɛ kɛ dɔgɔkun wɔɔrɔ ɲɔgɔn kɔnɔ, nka a waati cogoya tɛ kelen ye. Lamaga, fanga, funu ani dannaya bɛ se ka taa a fɛ ka ɲɛ fo kalo damadɔ walima ka tɛmɛ o kan.
Yala volar plate ye opereli fɛɛrɛ ɲuman ye tuma bɛɛ wa?
Fɛn kelen min bɛ don a la, o tɛ fisaya kari bɛɛ la. Volar locking plates ka ca, wa u bɛ se ka baara kɛ waati kunkurunnin kɔnɔ ka kɔn o ɲɛ, nka pinɛw, kɛnɛma fixation, dorsal fixation, bridge plating, walima fragment-specific implants bɛ se ka bɛn cogoya dɔw ma ka ɲɛ.
Yala distal radius plate ka kan ka bɔ kɔfɛ wa?
A bɔli kɛcogo kɔrɔ tɛ wajibi ye tuma bɛɛ. A bɔli bɛ se ka jateminɛ ni senkɔniw dimi, fɛnɲɛnamafagalan minnu bɛ ye walima minnu taamasiɲɛ bɛ a la, banakisɛw, walima kɛnɛyaso kun wɛrɛw. A ka c’a la, bridge plate (bonda plati) bɛ bɔli labɛn ka ɲɛ barisa a bɛ bolokɔni da.
Tuma jumɛn na bolo bɛ se ka kɛ a cogo kɔrɔ la tuguni?
Baara kɛcogo min tɛ mɔgɔ tɔɔrɔ, o bɛ bɔ kari sabatili la, a furakɛli, a kɛnɛyali ni rezow ye, dimi, ani baara min bɛ kɛ a la. A ka c’a la, don o don baara nɔgɔmanw bɛ segin ka sɔrɔ ka minɛ ni fanga ye, ka fɛnw kɔrɔta, ka ɲɔgɔn sɔrɔ farikoloɲɛnajɛw, walima ka baara gɛlɛnw kɛ. Aw bɛ furakɛlikɛla ka dantigɛliw labato.
XC Medico ka nafolomafɛnw min bɛ tali kɛ o la
Nin kɔnɔna nafolo ninnu bɛ fɛn dɔw di fɛnw doncogo, minɛnw ani joginda minnu bɛ tali kɛ o la, olu kofɔlen don nin gafe in kɔnɔ.
Sɛbɛnw ni sɛbɛnnikɛlanw ka basigi
- Ameriki ka koloci furakɛli kalanso. Distal Radius Fractures furakɛli kɛnɛyaso baarakɛcogo ɲɛfɔli.
- AAOS OrthoInfo ka baara. Distal Radius Fractures (Bolo karilen).
