Klinik ɔvaviu · Dɛn dɔn ɔpdet ɛdyukeshɔn gayd
distal rayus frakshכ n na we i brok nia di wrist εnd fכ di rayus. Di tritmɛnt kin kɔmɔt frɔm splint ɔ kast to pin dɛn we dɛn kin yuz fɔ mek yu bɔdi, fɔ fiks am na do, ɔ fɔ fiks plet. di aprכpriet plan dipכnt pan di frakshכn alaynsmεnt εn stεbiliti, jכyn involvmεnt, sכft-tisu kכndishכn, bon kwaliti, ej, fכnshכnal nid, εn di pasεnt prεfrεns.
Wetin Na Distal Radius Fraktrɔs?
di distal rayus de fכm di men lod-bεrin sεf na di tכmb sayd na di wrist. frakshכn kin apin insay fכ sεntimita frכm di rεdiokarpal jכint εn i kin bi εkstra-atikul, εkstendi insay di jכint, כ involv di distal rεdyulnar jכint. di ulnar styloid εn di sכpכt ligament dεm kin injuri bak.
We pɔsin fɔdɔm pan an we i stret na tin we bɔku pipul dɛn kin du. Fɔdɔm we nɔ gɛt bɛtɛ ɛnaji na tin we kin apin to ol pipul dɛn we nɔ gɛt bɛtɛ bon trɛnk, we spɔt injuri, rod trafik insidɛnt, ɛn fɔdɔm frɔm ayt kin mek yɔŋ pipul dɛn gɛt ay ɛnaji patɛn.
Wetin mek di bɔdi impɔtant
di distal rayus gεt wan brayt artikul sεf εn i de sכpכt di skafoyd εn lunate. di strכkchכ dεm we de nia de inklud di mεdian nεv, di flekshכn εn εkstensכr tεndon dεm, di raydial atεri, di distal rεdyulnar jכint, εn di triangul fכbכkartilaj kכmpleks. Fɔ mek yusful alaynɛshɔn kam bak we yu de protɛkt dɛn strɔkchɔ ya na wan sɛntral gol fɔ tritmɛnt.
Simptom ɛn Sayn dɛm we nid fɔ asɛs kwik kwik wan
Di sayn dɛm we kin sho se yu gɛt pen wantɛm wantɛm na yu an, yu kin swel, yu kin brus, yu kin gɛt sɔri-at, yu nɔ kin muv bɛtɛ, ɛn i nɔ kin izi fɔ ol yu an. wan fraktכs we dεn displace kin prodyuz difכmiti we yu kin si. Wan dɔktɔ kin chɛk bak aw di skin de, aw di finga dɛn de go ɔlsay, aw i de fil, aw di tɛndon dɛn de wok, ɛn di injury dɛn we gɛt fɔ du wit am.
Go to dɔktɔ kwik kwik wan fɔ yu wund we opin, yu bon we yu kin si tru di skin, yu an we dɔn shayn ɔ we kol, we yu nɔ ebul fɔ muv, we yu nɔ ebul fɔ muv di finga dɛn, we yu de swel kwik kwik wan, ɔ we yu de fil bad bad wan we yu nɔ ebul fɔ kɔntrol. dis tin dεm we dεn fכnshכn kin sho se i opin fכ brok, nyurovaskul kכmprכmis, כ denja prεshכn insay di tisu dεm.
Diagnosis ɛn Rediograf Asɛsmɛnt
stεndad posteroanterior εn lateral wrist raydiograf dεn de yuz fכ no di frakshכn εn ases di displεsmεnt. Oblique views kin ɛp pan sɔm kes dɛm we dɛn dɔn pik. kכmpyuta tכmografi kin gi mכr ditel we intra-atikul frakshכn kכmpleks כ we כpεraytiv planin nid fכ difεn di fragmεnt dεm klia wan.
| Radiographic feature | Wetin i de diskraib | Wetin mek i impɔtant |
|---|---|---|
| Radial ayt we pɔsin kin gɛt | di lεngth fכ di distal rayus rilitiv to rεfrεns pכynt dεm na di jכyn sεf. | we yu lכs di ayt kin chenj di lod transmishכn εn di ulnar vεryans. |
| Radial inklinshɔn we pɔsin kin gɛt | di slop fכ di distal raydial artikulכr sεf pan di PA vεyus. | di ridyus inklin kin sho se i kolכp כ di lateral displεsmεnt. |
| Volar/dorsal tilt we de mek yu fil | di sajital כryenteshכn fכ di artikulכr sεf pan di lateral vεyu. | di dכsal כ volar tilt pasmak kin afekt di wrist mεkanik. |
| Atikul step-ɔf ɔ gap | Lɔs ɔf smol alaynɛshɔn na di jɔyn sɔfays. | I de ɛp fɔ difayn intra-atikul displeysmɛnt ɛn tritmɛnt gol dɛm. |
| Ulnar vεryans | di rilitiv lεngth fכ di distal ulna εn di rayus. | kin chenj we di rayus sכt εn infכlכw di ulnocarpal loading. |
Aw Dɛn kin Klas di Distal Radius Fraktrɔs
diskriptiv tεm dεm lεk Colles , Smith , εn Barton frakshכn de kכmyuniket kכntribyushכn displεsmεnt patεn, bכt dεn nכ de kapchכ εvri injuri. di mכdan asesmεnt de rεkכd bak if di frakshכn opin כ klos, εkstra-atikul כ intra-artikul, displεs כ nכ displεs, stebul כ nכ stebul, εn simpul כ kכminit.
Fɛnandez klasification bay mɛkanism
di Fɛnandez sistεm de grup fraktכs akɔdin to di dominant injuri mεkanism. I kin ɛp di wan dɛn we de wok na di klinik fɔ tink bɔt di injuri we gɛt fɔ du wit sɔft-tisu ɛn fikseshɔn strateji, bɔt dɛn nɔ kin pik di tritmɛnt frɔm di klasification nɔmɔ.
Aw Dɛn De Pik di Tritmɛnt
Di aim nɔto fɔ jɔs mek ɛkstrem rayt luk nɔmal. Tritmɛnt de luk fɔ wan kɔmfyut, stebul, funkshɔnal wrist we de balans di risk dɛm fɔ anestezi, ɔpreshɔn, immobilization, stiffness, ɛn lɔs fɔ ridyus. Wan disayd we dɛn ɔl tu fɔ disayd fɔ du, fɔ tink bɔt:
- frakshכn displεsmεnt, kכminushכn, jכyn involvmεnt, εn stεbiliti afta rεdukshכn;
- opin injuri, nerve simptom, sirkuleshɔn, ɛn sɔft-tisu kɔndishɔn;
- di pesin in ej as prכksi—nכto sכbstityuyt—fכ fysiolojikal stetכs εn fכnshכnal dimand;
- bon kwaliti, ɔda injury, mɛrɛsin kɔndishɔn, wok, ɛn an dominans;
- ebul fɔ atɛnd fɔlɔp ɛn tek pat pan rihabiliteshɔn;
- di pɔsin in gol ɛn di tolɛreshɔn fɔ di bɛnifit ɛn risk dɛm fɔ ɛni opshɔn.
Gaydlain kɔntɛks: AAOS/ASSH gayd de sɔpɔt ɔpreshɔn fikseshɔn insay bɔku nɔ-jɛriatrik pasɛnt dɛn we, afta ridyushɔn, raydial shɔtin pas 3 mm, dɔsal tilt pas 10°, ɔ intra-atikul displeysmɛnt/stɛp-ɔf pas 2 mm. Fɔ di wan dɛn we dɔn ol—we dɛn kin ripresent insay stɔdi dɛn bay we dɛn ol 65 ia ɔ pas dat—ɔpreshɔn jɔs nɔ kin ɛp fɔ mek di tin dɛn we di sikman ripɔt fɔ lɔng tɛm bɛtɛ we yu kɔmpia am wit di kia we dɛn nɔ de du ɔpreshɔn. dis thrεshold dεm de infכm, bכt nכ de riples, individyual klinik jכjmεnt.
Tritmɛnt we Nɔ De Ɔspitul
wan stebul frakshכn we nכ displεs כ akseptabl alaynd kin mεnεj wit splint כ kכst. wan displεs frakshכn kin fכs כnda kכlos rεdukshכn, fכlכ immobilizεshכn. Dɛn kin schedul fɔ fala di ɛgzam ɛn rediograf akɔdin to di fraktrɔs bihayvya ɛn di klinik in jɔjmɛnt bikɔs sɔm fraktrɔs kin lɔs alaynɛshɔn as di swɛlin de dɔŋ.
- Fɔs protɛkshɔn: wan splint de alaw rum fɔ swel kwik; dεn kin advays fכ εlevεshכn εn fכ muv di finga dεm.
- Ridyus we nid de: dɛn kin rialayn di fraktrɔs bay we dɛn de yuz di rayt analjɛsia ɔ anestezi.
- Immobilizεshכn εn rivyu: dεn de riases di kast fit, sirkulεshכn, sεns, εn alaynsmεnt.
- Rihabiliteshכn: dεn de introdכks di wrist εn fכram muvmεnt we di hεl εn stεbiliti alaw.
Ustɛm dɛn kin tink bɔt fɔ du ɔpreshɔn?
dεn kin tכk bכt כpεrayshכn we dεn nכ kin ebul כ mεnten akseptabl alaynsmεnt, di jכyn sεf dεn dכn sכmtεm sכmtεm, di frakshכn opin, di kכpas nכ stebul, כ di injuri patεn nכ go stεbul insay wan kכst. Dɛn kin pik di ɔpreshɔn ɛn di implant fɔ di patikyula fragmɛnt patɛn ɛn di pɔsin we sik—nɔto jɔs fɔ di diagnostik lɛbl.
Sɔj Opshɔn fɔ Distal Radius Fraktrɔs
| Di we aw dɛn | kin du am Kɔmɔn wok | Impɔtant tin dɛn we pɔsin nɔ ebul fɔ du ɔ di prɔblɛm dɛn we kin apin |
|---|---|---|
| Pɛrkyutanɛs K-way fikseshɔn | Sεlekt rεdusibl frakshכn dεm we dεn kin stεbyul wit pin εn suplimentary immobilizεshכn. | Pin-trakt infεkshכn, waya maygrεshכn, lכs fכ rεdukshכn, εn nid fכ pin kεriכn. |
| Fikseshɔn we de na do | Sεlekt injuri dεm we nכ stebul, we opin, we kכmכt bכku, כ we sכft tisu kכmprכmis; i kin bi fɔ shɔt tɛm ɔ i kin bi sɔntin we go apin. | Pin-trakt prɔblɛm, stiffness, nerve/tendon iritation, ɛn lɔs alaynɛshɔn. |
| Volar lɔk plet | bכku כnstεbul εkstra-atikul εn intra-atikul patεn dεm we nid dayrekt rεdukshכn εn fiks-εngl sכpכt. | Fleksa tεndon iritashכn כ rupchכ, nεv simptom, skru pεnεtreshכn, infεkshכn, εn hadwae simptom. |
| Dɔrɔsal plet | sεlekt dכsal rim כ dכsal shia fragmεnt dεm we nכ kכntro fayn fayn wan frכm di volar sayd. | Ekstensכr tεndon iritashכn εn hadwae prominεns. |
| Dorsal brij plet | frakshכn dεm we kכmכt bכku bכku wan usay di plet de span di an εn de yuz ligamentotaxis. | Fɔ sɔm tɛm i kin mek di an nɔ muv ɛn bɔku tɛm i kin nid fɔ pul di plet leta. |
| Fragment-spɛsifi k fikseshɔn | komplex patεn dεm we wan wan artikulכr kכlכm dεm כ rim fragmεnt dεm nid tכgεt sכpכt. | mכr implant εn aprכch kin inkrεs di sכft-tisu kכmplisiti. |
AAOS/ASSH evidens sho se no big lכng tεm autkam difrεns bitwin fiksεshכn tεknik fכ כnstebul כ komplit artikul frakshכn, pan כl we volar lכk plet kin gi fכs fכnshכnal rεkכvεshכn insay di fכs tri mכnt. Faynal teknik selekshɔn dipen pan di fraktrɔs ɛn di ɔspitul ɛkspɛriɛns.
Pɛrkyutanɛs pin fikseshɔn
Afta klos ɔ limited-open ridyushɔn, smol smol Kirschner waya dɛn kin ol sɔm pat dɛn we dɛn dɔn pik. Fluoroscopy de kכnfכm rεdukshכn εn waya posishכn. Dɛn kin lɛf di pin dɛn na do na di skin ɔ bɛr dɛn, i kin dipen pan di we aw dɛn de du am, ɛn dɛn kin protɛkt di an wit splint ɔ kas.
Fikseshɔn we de na do
wan ekstenal fikseta de yuz pin dεm we dεn put ausayd di frakshכn zon εn we dεn kכnekt to wan ekstenal fכm. wan kכnstrכkt we de spayn di an kin mεnten di lεngth εn alaynsmεnt tru ligamentotaxis. I kin kam bak wit waya, smɔl plet, ɔ bon graft insay kɔmpleks injuri. Si wan ɛgzampul bɔt a wrist ekstenal fixator ɛn wan ɔvaviu fɔ כtכpidik εksternal fikseshכn sistεm dεm.
Fikseshɔn fɔ di dorsal plet
wan dכsal apכch de gi akses to sεlekt dכsal artikul fragmεnt dεm εn shia patεn dεm. di mכdan lכw prכfayl implant dεm de ridyus bכku, bכt di εkstensכr tεndon dεm de stil de nia di hadwae εn dεn fכ protεkt. di imej dεm we de kam biεn de sho di dכsal fikseshכn kכnsεpt dεm pas wan yunivεsal sכjεkshכn sikεns.
Volar lok plet fikseshɔn
vכla pletin dεn de yuz am bכku bכku wan biכs i kin sכpכt di sכbkכndral bon frכm di palma sayd we i de avכyd dairekt plesmεnt bכn di εkstensכr tεndon dεm. di flexor carpi radialis intaval na wan kכmכn we fכ du am. di plet posishכn, ristכreshכn fכ di jכyn sεf, distal skru lεngth, εn fεkshכn tεndon kliarεns nid fכ tek tεm vεrifikεshכn.
XC Medico ɛgzampul dɛn inklud a 7-hol distal rayus lɔk plet , a 6-ol distal rayus lɔk plet , ɛn a DVR distal rayus lɔk plet . Dɛn prodak link ya na fɔ divays infɔmeshɔn; implant selekshɔn stil de di rispɔnsibiliti fɔ di klinik pipul dɛn we tren.
Dorsal brij (distrakshɔn) pletin
wan brij plet de span frכm di rayus to wan mεtakarpal εn i de wok lεk intanεt distrakt. i kin yusful fכ sεlekt hεli kכmminut injuri dεm we nכ kin sכpכt rili bay wan kכvεshכnal distal plet. Bikɔs i kin krɔs di an fɔ sɔm tɛm, bɔku tɛm dɛn kin nid fɔ du sɛkɔn tin we dɛn dɔn plan fɔ pul di plet afta i dɔn wɛl.
Fragment-spɛsifi k fikseshɔn
komplex artikul frakshכn kin gεt raydial staylכyd, volar rim, dכsal rim, εn impak sεntri fragmεnt dεm. fragmεnt spεsifi k sistεm dεm de yuz sכm sכm implant dεm we dεn posishכn fכ bכt di kכmכpכnεnt dεm we nid dayrekt kכntrכl. Dɛn kin yuz dɛn wan ɔ wit ɔda we fɔ fiks.
Rikɔvayshɔn, Rihabiliteshɔn, ɛn Posisibul Kɔmplikeshɔn dɛn
Bɔku tɛm dɛn kin ɛnkɔrej di finga dɛn fɔ muv kwik kwik wan if di wund ɛn di tritmɛnt alaw am. di εksεsayz dεm na di an εn fכ an kin bigin akɔdin to di stεbiliti, di wund kכndishכn, εn rεdyografik hεl. Strɔng, dexterity, ɛn endurance kin wɛl sloslo pas basic motion, ɛn sɔm swel ɔ stiffness kin kɔntinyu fɔ mɔnt. Rihabiliteshɔn kin bi na os ɔ dɛn kin supavayz am dipen pan wetin di pɔsin nid ɛn di lokal prɛktis.
Di prɔblɛm dɛn we kin apin na fɔ lɔs di ridɔkshɔn, malunion, nɔ union, stiffness, post-traumatic arthritis, midyan nɛv simptom, kɔmpleks rijinol pen sindrom, tɛndon iritashɔn ɔ rupchɔ, infɛkshɔn, pin-trakt prɔblɛm, ɛn simptomatic hadwae. Nyu swɛt, pen we de go ɔp, fiva, drenaj, ɔ mak lɔs fɔ finga muvmɛnt fɔ mek dɛn rivyu am na di klinik.
Bɔn wɛlbɔdi impɔtant: if pɔsin we dɔn ol in an brok we nɔ gɛt bɔku ɛnaji, dat kin bi wɔnin sayn fɔ ɔstioporosis. Di sik pipul dɛn kin aks dɛn klinik if i fayn fɔ asɛs di risk fɔ brok di bon, fɔ tɛst di bon-density, fɔ mek i nɔ fɔdɔm, fɔ ebul fɔ no vaytamɛn D, ɔ ɔda tin dɛn fɔ du fɔ mek di bon gɛt wɛlbɔdi.
Kwɛstyɔn dɛn we Dɛn Kin Aks Bɔku tɛm
Yu tink se ɛvri displaced distal radius fracture nid ɔpreshɔn?
Nɔ, sɔm fraktrɔs dɛn kin ridyus ɛn dɛn kin kɔntinyu fɔ alaynɛd fayn fayn wan insay wan kast. Stebiliti, joyn displεsmεnt, ej, fכnshכnal dimand, hεlth, εn di pasεnt prεfrεns כl de infכlכw di disishכn.
Aw lɔŋ distal rayus fraktrɔs kin tek fɔ wɛl?
di bon dεm we de hεl kwik kin kכmכn fכ lεk siks wik, bכt di tεm layn kin difrεn. Di muvmɛnt, trɛnk, swel, ɛn kɔnfidɛns kin kɔntinyu fɔ bɛtɛ fɔ sɔm mɔnt ɔ lɔng pas dat.
Yu tink se volar plet na di bɛst ɔpreshɔn ɔltɛm?
Nɔ wan implant nɔ de we bɛtɛ fɔ ɛni frakshɔn. di volar lכk plet dεm na kכmכn εn i kin sכpכt fכ fכnshכn fכ sכt tεm bifo, bכt pin, εksternal fiks, dכsal fiks, brij plet, כ fragmεnt-spεsifi k implant kin bεtε fכ mach sכm patεn dεm.
Yu tink se dɛn fɔ pul wan distal rayus plet leta?
Nɔto ɔltɛm i nid fɔ pul di tin dɛn we dɛn de du ɔltɛm. Dɛn kin tink bɔt fɔ pul am fɔ di tɛndon iritashɔn, prominɛnt ɔ simptomatic hadwae, infɛkshɔn, ɔ ɔda klinik rizin. Bɔku tɛm, dɛn kin plan fɔ pul brij plet bikɔs i kin span di an.
Ustɛm dɛn kin yuz di an nɔmal wan bak?
Yuz am sef wan dipen pan di frakshɔn stebul, tritmɛnt, raydiografik hiling, pen, ɛn di aktiviti we de insay. Bɔku tɛm, layt wok dɛn we yu kin du ɛvride kin kam bak bifo yu fos yu fɔ ol yu, es yu es ɔp, yu fɔ kɔntakt yu spɔt, ɔ yu fɔ du ebi ebi wok. Fɔ fala di tin dɛn we di dɔktɔ we de trit yu fɔ du.
Rilat XC Medico Risos dɛn
di intanεt risכs dεm we de kam biεn de gi spεsifikεshכn fכ implant, instrכmεnt, εn rilat trauma sistεm dεm we dεn mεnshכn na dis gayd.
Rifrɛns ɛn Ɛditorial Besis
- Amɛrikan Akademi fɔ Ɔtpidik Sɔjɔn dɛn. Manejmɛnt fɔ Distal Radius Fraktrɔs Klinik Praktis Gaydlain.
- AAOS ƆtoInfɔmeshɔn. Distal Radius Fraktrɔs (Broken wrist).
