Pεrkyuta K-way fiksεshכ n na wan pan di sεvεra mεtכd dεm we dεn kin yuz fכ mεnten rεdukshכn insay sεlekt distal rεdyus frakshכn dεm. dεn kכl am bak klos rεdukshכn εn pεrkyutan pinin, di tεknik de yuz Kirschner waya fכ stεbyul di frakshכn fragmεnt dεm afta dεn dכn rεstכr di alaynsmεnt.
I nɔto yunivasal sɔlvishɔn fɔ ɛvri brok an. Frakshכn patεn, rεdukshכn stεbiliti, artikul involvmεnt, bon kwaliti, sכft-tisu kכndishכn, pasεnt prayorities εn di fikseshכn opshכn dεm we de כl infכlכw tritmεnt sεlεkshכn. dis gayd de εksplen di prinsipul dεm εn di limitεshכn dεm fכ distal rayus K-wayr fikseshכn we nכ de riples fכmal sכjεkshכnal trenin כ wan divays-spεsifi k tεknik gayd.
Ki tin dɛn we dɛn kin tek fɔ tek
K-way fikseshכn dεn kin jεnarali kכnsidrε afta frakshכn rεdukshכn we adishכnal stεbilizεshכn nid fכ εn di fragmεnt dεm kin kכntro wit waya.
raydial staylכyd, dכsal, fragmεnt-spεsifi k εn intrafokal kכnfigureshכn dεm de dεskrεb difrεn prinsipul dεm pas wan mandatory pin patεn.
Waya nɔmba, dayamita, trajektɔri ɛn immobilizayshɔn strateji na kes- ɛn divays-spɛsifi k; dɛn nɔ fɔ pik dɛn frɔm wan jenɛral makɛt atikul.
di tin dεm we kin kכnsyus na fכ lכs di rεdukshכn, pin-trakt infεkshכn, waya mכv, sכft tisu iritashכn, tεndon כ nεv injuri εn wrist stiffness.
K-ways, volar plet ɛn ɛksternal fikseshɔn ɛvri wan gɛt difrɛn trade-ɔf. di pruf dεm we de naw nכ de sכpכt wan fikseshכn mεtכd as universally supεriכr fכ εvri כnstεbul כ komplit artikul frakshכn.
Wetin Na K-Waya Fikseshɔn fɔ Distal Radius Fraktrɔs?
wan distal rayus frakshכn de apin nia di wrist εnd fכ di rayus. We dɛn pul wan fraktrɔs, di wan dɛn we de wok na di klinik kin asɛs if dɛn kin mek di alaynɛshɔn we dɛn kin gri fɔ kam bak ɛn mek dɛn kɔntinyu fɔ de. Klos ridyushɔn de tɔk bɔt fɔ mek di alaynɛshɔn kam bak we yu nɔ opin di say we di frakt. dεn we dεn kin pin pan di skin kin put wan כ mכr sכft waya dεm tru sכm sכm sכm pat dεm we de kכmכt na di skin fכ ol di sεlekt pat dεm we dεn de hεl.
di mεdikal tεm we dεn kin fכs na klos rεdukshכn εn pεrkyutan pin , nכto 'klos nidul insεshכn.' Kirschner waya na fikseshכn divays pas injεkshכn nidul. So di atikul fɔ yuz K-way, waya, pin ɛn fikseshɔn tɛminɔlɔji kɔnsistɛntli.
Aw K-Waya dɛn De Mentɛn Ridyushɔn
Waya kin krɔs wan fraktrɔs ɛn gɛt bay bay na wan stebul pat pan di rayus, ɔ dɛn kin sɔpɔt wan wan fragmɛnt dɛn insay wan kɔnfigyushɔn we dɛn pik fɔ di fraktrɔs patɛn. Mekanikal stebiliti dipen pan mɔ pas di nɔmba fɔ di waya dɛn. divεrjεns, fragmεnt kכntrכl, kכtikal bay, waya dayamita, bon kwaliti εn supliment imכbilizεshכn כl kin afekt di kכnstrכkt.
K-Wire Fixation Na Wan Tritmɛnt Opshɔn
sכm distal rayus frakshכn dεm kin mεnεj witout כpεrayshכn, we כda wan dεm kin trit wit pεrkyutan pin, volar כ dכsal plet, εksternal fiksεta כ kכmbayn stratεji. Fɔ si mɔ ɔvaviu, si XC Medico in gayd fɔ di diagnosis, klasifikasiכn εn tritmεnt fכ distal rayus frakshכn.
Usay Pɛrkyuta Pinning Fit fɔ Tritmɛnt
Nɔ-ɔpareshɔn Manejmɛnt
sεlekt stebul fraktכs כ frakshכn dεm we de rεmain akseptabl alaynεd afta rεdukshכn kin mεnεj wit kכst כ splint εn fכlכ-ap imej. Di ej we di pɔsin gɛt nɔmɔ nɔ de sho aw fɔ trit am.
Pɛrkyutanɛs K-Waya Fikseshɔn
Pinning kin gi adishonal fragment kontrכl afta rεdukshכn in sεlekt patεn dεm. I kin nid fɔ pe atɛnshɔn to di say dɛn we dɛn kin pin, fɔ mek dɛn nɔ muv ɛn leta fɔ manej di waya.
Plɛt Fikseshɔn
wan volar כ dכsal plet de gi intanεt fiksεshכn εn dεn kin sεlekt am fכ patεn dεm we nid dayrekt fragmεnt kכntrכl. XC Medico de saplae sɔm distal rayus lɔk plet opshɔn dɛn.
Fikseshɔn we de na do
wan spanning כ nonspanning frame kin εp fכ mεnten lεngth εn alaynsmεnt in sεlekt כnstebul frakshכn dεm, inklud kes dεm we sכft-tisu kכndishכn dεm de afekt intanεt fikseshכn planin.
Di AAOS/ASSH klinik prɛktis gaydlayn ripɔt nɔ signifyant difrɛns pan raydiograf ɔ pasɛnt-ripɔt autkam bitwin fikseshɔn tɛknik fɔ kɔmplit artikul ɔ ɔnstɛbul distal rayus fraktrɔs, pan ɔl we volar lɔk plet dɛn kin gi fɔs fɛnshɔnal rikavari insay di shɔt tɛm. Dis de sɔpɔt individyual sɛlɛkshɔn pas fɔ tɔk se K-ways ɔ plet dɛn bɛtɛ ɔltɛm.
Ustɛm dɛn kin tink bɔt fɔ fiks di K-Wire we dɛn kin yuz fɔ mek di bɔdi we dɛn kɔl Pɛkyutan?
Klinik disizhɔn-mɛkin kin bigin wit ɛgzamin ɛn imej. Dɛn tin ya we kwalifay pɔblisha dɛn kin tink bɔt, bɔt dɛn nɔto stand-alone indication checklist.
Frakshכn Patεn εn Ridכkshכn Stebiliti
Pin kin fayn mɔ we dɛn kin ridyus di ki pat dɛn ɛn kɔntrol dɛn bay waya dɛn we dɛn put fayn fayn wan. mak mεtaphyseal komminushכn, sכm sכm artikul fragmεnt dεm כ wan tεndens fכ kolכp kin ridyus di rilaybiliti fכ wan simpul waya kכnstrכkt εn prompt kכnsidεreshכn fכ כda כ supliment mεtכd.
Bon Kwaliti ɛn Fragmɛnt Sayz
כstioporotik bon kin gi waya bay we dεn nכ kin abop pan. If yu ad waya nɔ go du fɔ sɔlv di prɔblɛm we yu nɔ de fiks fayn, ɛn no lɔ nɔ de we ɔlman gɛt fɔ se ɛvri ɔstioporotik fraktrɔs nid fɔ gɛt 4 ɔ 5 pin. di kכnstrכkt sεlεkshכn fכ fala di frakshכn patεn, imej, aprכv tεknik εn di sכja jכjmεnt.
Patient ɛn Sɔft-Tissu Factors
di skin kondishכn, swel, opin injuri, mεdikal komorbiditi, aktiviti dimand, abiliti fכ fala pin-sayt εn immobilizεshכn instrכkshכn εn εkspεkt rihabiliteshכn כl de kכntribyut fכ tritmεnt sεlekshכn.
Ej ɛn Fɔnishɔnal Dimand
Evidɛns fɔ intaprit alongsay di pasɛnt-lɛvel factors. Di AAOS/ASSH gaydlain ripɔt se ɔpreshɔn tritmɛnt na jeriatric pipul dɛn nɔ kin jɔs impruv di lɔng tɛm pasɛnt-ripɔt autkam kɔmpia wit nɔ-ɔpareshɔn kia, ivin we raydiografik alaynɛshɔn difrɛn. Fɔ disayd fɔ du sɔntin togɛda stil impɔtant.
Klinik bɔda: wan jenɛral ɛdyukeshɔn atikul nɔ kin ebul fɔ no if wan patikyula fraktrɔs nid K-ways, plet, ɛksternal fikseshɔn ɔ nɔ-ɔparetiv tritmɛnt. Dat disishun nid fɔ asɛs di pɔsin, tek imej ɛn kwalifay mɛdikal jɔjmɛnt.
Kɔmɔn K-Waya Fikseshɔn Prinsipul dɛn
sεvεra pin kכnsεpt dεm dεn dεskrεb insay כtכpεdik prεktis. Di nem dɛm we de dɔŋ ya de sho di brayt strateji dɛm; dɛn nɔ fɔ intaprit dɛn as fiks ɛntrɛ pɔynt, angul ɔ mandatory waya kɔnt.
Radial Styloid Pinning we dɛn kin yuz fɔ mek tin dɛn
wan raydial stayl waya kin dayrekt kכros di frakshכn fכ gεt bay bay na di proksimal rayus. di sεns branch fכ di raydial nεv, di tεndon dεm, di jכyn sεf εn di waya posishכn nid fכ kכnsidrε. di εksakכt trajektכri de dipכnt pan di anatomi, frakshכn mכfכlכji εn di tεknik we dεn sεlekt.
Ilustrativ distal rayus pinning konfigyushɔn. Faynal waya plesmɛnt fɔ bi bays pan fraktrɔs anatomi, fluoroscopic asɛsmɛnt ɛn di aprɔv ɔspitul tɛknik.
Dɔsal ɛn Fragmɛnt-Spɛsifi k Pinning
dכsal waya כ waya dεm we dεn dayrεkt to wan lunate facet fragmεnt kin yus we dεn fragmεnt dεm de nid fכ kכntrכl. di dכsal anatomi inklud εkstensכr kכmpartmεnt dεm εn tεndon dεm we kin irita כ injuri bay wan εntri pכynt we nכ fayn, prominεnt waya כ maygrεshכn.
Example of fragment-oriɛnted waya fikseshɔn. Di ɛgzampul de tɔk bɔt wan prinsipul, nɔto wan tɛmplat we gɛt tri waya ɔlsay na di wɔl.
Kapandji Intrafokal Pinning we yu de yuz
insay di Kapandji tεknik, dεn de introdכks waya dεm na di fraktכs sayt εn dεn de yuz dεm fכ εp fכ ridyus εn sכpכt di distal fragmεnt bifo dεn advans fכ mεnten di kכnstrכkt. Di we aw dɛn de du am difrɛn frɔm we yu jɔs krɔs di fraktrɔs frɔm wan say we de fa fawe fɔ go insay. di suitability dipכnt pan di frakshכn kכnfigureshכn εn di bon kwaliti.
Kapandji intrafokal pinning konsept. Spɛsifi k waya saiz, nɔmba ɛn dairekshɔn fɔ kɔmɔt frɔm wan validet tɛknik ɛn kes-spɛsifi k planin.
Supplemental Pinning ɛn Kɔmbayn Fikseshɔn
komplex fraktכs kin nid כda fragmεnt-spεsifi k kכntrכl כ wan kכmbayn kכnstrכkt. Bɔt mɔ waya dɛn nɔ kin mek dɛn ebul fɔ tinap tranga wan bay dɛnsɛf. di waya kכnvεgεshכn, insufisεnt spεd, pwεl kכtikal bay כ inability fכ kכntrol wan ki fragmεnt kin stil rεsult in lכs fכ rεdukshכn.
Comminution kin mek simpul pinin less reliable. supliment כ כda fikseshכn kin bi evaluate akɔdin to imej εn pasεnt fכktכr.
Imej ɛn Fikseshɔn Asɛsmɛnt
Ridyushɔn ɛn Atikul Alaynɛshɔn
imej de yuz fכ evaluate di raydial ayt, inklinshכn, tilt, artikulכr kכngruiti εn distal raydioulnar jכint rilayshכn. Di akseptabl target dipen pan di pesin ɛn di fraktrɔs. Wan waya we dɛn put wit tɛknik nɔ de kɔmpɛns fɔ ridyus we dɛn nɔ akseptabl.
Waya Pozishɔn ɛn Kɔtikal Pɔch
Fluoroscopic views de εp fכ ases if waya dεm de kכntro di fragmεnt dεm we dεn bin want, fכ avכyd di rediokarpal εn distal redioulnar jכint spεs usay i nid, εn fכ gεt fayn bay we dεn nכ gεt prכblεm prominεns. Sɔntɛm dɛn go nid fɔ si bɔku bɔku tin dɛn bikɔs waya we tan lɛk se i fayn na wan projɛkshɔn nɔ go fayn na ɔda wan.
Kɔnstrɔkt Stebiliti
Stebiliti asesmεnt de kכnsidr di frakshכn, waya kכnfigureshכn εn plan immobilizεshכn tכgeda. di waya dεm we kכlכs insay wan rijyכn kin gi lεs rotashכnal kכntrכl pas wan kכnstrכkt we dεn distribyut fayn fayn wan, bכt wan jεnaralized spεs rul nכ fכ riples bayomεkanikal εn klinik jכjmεnt.
Waya trajektɔri ɛn fraktrɔs kɔntrol fɔ asɛs insay di rayt imej we dɛn de si bifo dɛn aksept di kɔnstrɔkshɔn.
Pɔtɛnɛshɛl Kɔmplikeshɔn ɛn Risk Kɔnsidɛreshɔn
Dɛn nɔ go ebul fɔ stɔp di prɔblɛm dɛn we kin apin ɔlsay bay we dɛn yuz chɛklist. di gol na fכ no di rilevεnt risk dεm εn fכ fala di spεsifi k implant instrכkshכn dεm, stεril protכkכl εn postכpεraytiv plan.
Di tin dɛn we pɔsin kin wɔri bɔt na:
Lɔs fɔ ridyus ɔ fikseshɔn fayl
Pin-trakt infεkshכn כ dip infεkshכn
Waya de lus, muv, brok ɔ skin iritashɔn
injuri כ iritashכn we involv di εkstensכr tεndon dεm, sεns nεv dεm כ כda sכft tisu dεm
di joyn pεnεtreshכn כ di kכtikal prominεns we nכ fayn
Wrist ɛn finga dɛn kin stiff
Malunion, post-traumatik at at sik ɔ kɔmpleks rijinal pen sindrom
Lɔs fɔ Ridyus
di kכminishכn, pwεl bon kwaliti, insufisεnt fragmεnt kכntrכl, di waya kכnfigureshכn we nכ fayn כ we nכ de imכbilizεshכn fayn kin kכntribyut to sεkכnd displεsmεnt. fכlכ-ap imej kin yus akɔdin to di trit tim in protכkכl εn di stεbiliti fכ di frakshכn.
Pin-Trakt Infεkshכn
Dɛn fɔ de wach di pin-sayt kɔndishɔn akɔdin to di instityushɔnal ɛn ɔspitul instrɔkshɔn dɛn. Fɔ mek yu gɛt rɛd rɛd, drenaj, swel, pen, fiva ɔ ɔda tin dɛn we de mɔna yu, nid fɔ mek yu ebul fɔ chɛk am na klinik. Dis atikul nɔ de prɛskrib wan yunivasal pin-keya rijim.
Tεndon, Nεv εn Sכft-Tishu Injuri
Di say we dɛn de ɛnta, di waya trajektɔri, di prominɛns ɛn maykreshɔn kin put di strɔkchɔ dɛn we de nia de pan denja. di lister in tכbakl εn di dכsal εkstensכr kכmpartimεnt dεm na klinik rilevεnt landmak dεm, we di raydial sεns nεv nid fכ kכnsidrεshכn nia di raydial-sayd εntri pכynt dεm.
Tɛmral ɛn Mɛkanikal Tisu Injuri
If yu drɔ ripit, wam pasmak, di tin dɛn we nɔ fayn ɔ di we aw dɛn nɔ de du am fayn, dat kin pwɛl di bon ɔ di sɔft tisu. Di wan dɛn we kwalifay fɔ fala di tɛknik we dɛn dɔn gri fɔ, di ikwipmɛnt instrɔkshɔn ɛn institiushɔnal protɔkɔl dɛn pas fɔ fala di jenɛrik ɔnlayn ɔpreshɔn stɛp dɛn.
Immobilizayshɔn durayshɔn, rihabiliteshɔn, waya rimɔv ɛn ritɔn to aktiviti na wan wan. Di sikman dɛn nɔ fɔ chenj splint, du ɛksɛsayz ɔ manej waya we de na do bay we dɛn jɔs yuz infɔmeshɔn we de na di intanɛt.
di finga muvmεnt εn sכft-tisu kכndishכn kin rivyu we dεn de fכlכp, we di wrist rihabiliteshכn dipכnt pan di kכnstrכkt stεbiliti εn di trit klinik in plan.
Yuz mכr dan wan mεtכd we wan singl kכnstrכkt nכ de adrεs di fraktכs fayn fayn wan.
Atikul kɔmplisiti ɛn di mɛtɔd-spɛsifi k risk dɛm; dɛn fɔ plan fɔ di wan wan fraktrɔs.
Eksternal fikseshɔn na wan ɔltɛrnativ ɔ suplimɛnt strateji fɔ sɛlɛkɛt ɔnstɛbul distal rayus fraktrɔs. I nɔ kin chenj wit pɔrkyuta pinin insay ɛvri kes.
na di mεtכd fכ stεbyul sεlekt frakshכn fragmεnt dεm wit Kirschner waya dεm we dεn put tru sכm sכm skin εntri pכynt dεm, כltεm afta di frakshכn dεn dכn rεdכks.
Aw many K-ways dɛn kin yuz fɔ wan distal radius fraktrɔs?
No nɔmba nɔ de we de ɔlsay na di wɔl. Dɛn pik waya kɔnt ɛn kɔnfigyushɔn fɔ di fraktrɔs patɛn ɛn validet tɛknik. Evidɛns nɔ de sɔpɔt fɔ prɛzɛnt wan mandatory tri-wayr kɔnfigyushɔn fɔ ɛvri kes.
Wetin na di Kapandji teknik?
Kapandji pinning na intrafokal mεtכd we dεn de introdכks waya dεm na di frakshכn sayt fכ εp fכ ridyus εn sכpכt di distal fragmεnt. Na wan tɛknik opshɔn, nɔto wan yunivasal standad.
Wetin na di kɔmɔn risk dɛm fɔ K-way fikseshɔn?
di risk dεm we kin apin na fכ lכs di rεdukshכn, di pin-trakt infεkshכn, di waya we de lכs כ muv, sכft tisu iritashכn, tεndon כ nεv injuri, jכyn pεnεtrashכn εn stiffness.
K-wayr beta pas volar locking plet?
Nɔn pan dɛn tu we ya nɔ bɛtɛ ɔlsay na di wɔl. di gaydlain dεm we de naw de sכpכt fכ pik fikseshכn akɔdin to di frakshכn εn di sikman. di volar plet dεm kin gi fכs sכt tεm fכnshכnal rεkכvεshכn insay sכm כnstebul כ artikulכr frakshכn dεm, we di lכng tεm autkam kin bi di sem akrays fiksεshכn mεtכd dεm.
Rifrɛns dɛn
American Academy of Orthopedic Surgeons ɛn Amɛrikan Sɔsayti fɔ Ɔpreshɔn fɔ di An. Manejmɛnt fɔ Distal Radius Fraktrɔs Klinik Praktis Gaydlain. Luk di gaydlayn.
Kamal RN, Shapiro L. M., ɛn ɔda pipul dɛn. AAOS/ASSH Klinik Praktis Gaydlain Sɔma: Manejmɛnt fɔ Distal Rɛdyus Fraktrɔs. Luk di ful-tɛks sɔmari.
Shapiro L. M., Kamal R. N., ɛn ɔda pipul dɛn. Distal Radius Fracture Klinik Praktis Gaydlain—Updet ɛn Klinik Implikashɔn. Luk di PubMed rεkɔd.
Amɛrikan Akademi fɔ Ɔtpidik Sɔjɔn dɛn. Krayteria fɔ Yuz di Apɔyntmɛnt: Tritmɛnt fɔ Distal Radius Fraktrɔs. Luk di atikul we gɛt ɔl di tɛks.
Notis fɔ yuz pɔshɔnal: Dis atikul de gi jenɛral ɛdyukeshɔn to wɛlbɔdi biznɛs pipul dɛn, ɔspitul dɛn ɛn pipul dɛn we de sheb mɛrɛsin-divays. I nɔto mɛdikal advays, ɔspitul protɔkɔl ɔ sɔbstityuyt fɔ fɔmal trenin, pasɛnt-spɛsifi k asɛsmɛnt, aprɔv ɔspitul tɛknik dɔkyumentri ɔ divays instrɔkshɔn fɔ yuz. Prodak indikashɔn ɛn rigyuletɔri stetɔs kin difrɛn bay di makit.
As pɔsin we dɛn kin trɔst ɔlsay na di wɔl
Orthopedic Implants Manufacturer , XC Medico spɛshal fɔ gi ay kwaliti mɛdikal sɔlvishɔn, inklud Trauma, Spine, Jɔyn Rikɔnstrɔkshɔn, ɛn Spɔt Mɛdisin implant. Wit ova 19 ia ekspɛriɛns ɛn ISO 13485 sɛtifiket, wi de dediket fɔ saplae prɛsishɔn injinɛri ɔspitul inschrumɛnt ɛn implant to distribyushɔn, ɔspitul, ɛn OEM/ODM patna dɛn ɔlsay na di wɔl.
