Distal radius fracture te tan closed needle insertion hman dan leh technique te

Distal radius fracture hi thlasik laiin vur chunga tlak hnua fracture awm fo a ni a, closed reduction leh Kirschner wire fixation te hi enkawl dan tlangpui a ni.

He thuziak hian K-Wiring Principles and Techniques hmangin closed pinning hmanga surgical technique te a tarlang a ni.

Wire thum fixation technique hi wire thum fixation technique hmanlai ber a ni

Pakhat chu lister tubercle kaltlangin.

Pakhat chu radial styloid process hmangin a ni.

Lunate fossa bone block kaltlangin pakhat.

If: severe comminuted fractures leh osteoporosis a awm a nih chuan Kirschner wire dang hman theih a ni.

1. Surgery tih dan tur

Pakhatnaah chuan fracture chu closed reduction an ti a, slow leh continuous traction an nei a, dorsal leh radial displacement chu palmar flexion leh ulnar deviation hmangin siamthat a ni. Reduction hnuah kut chu rolled sheet-ah dah a ni a, palmar flexion leh ulnar deviation (Figure 2a, b) vawng rengin, percutaneous Kirschner wire pathum tal hmangin fix a ni.

K-wire hmasa ber chu Lister’s tubercle-ah dah a ni a, 45°-ah angle-in, radius-a long axis-a proximal bone fragment-a palmar cortex-ah dah a ni. Insertion point chu Lister’s tubercle ulnar lam a nih chuan extensor pollicis tendon a hliam thei.

K-wire pahnihna chu radial styloid process atanga 0.5 cm distal-ah dah a ni a, K-wire chu radial axis nen 60° angle-ah dah a ni a, fracture hnaih ber ulnar cortex-ah a lut a ni.

K-wire pathumna chu lunate fossa bone fragment-ah wrist joint line atanga cm 0.5 distal-ah dah a ni a, extensor compartment palina leh pangana inkar a ni. K-wire hi a hnuaia Figure a leh b-a kan hmuh ang hian radius-a palmar side-ah 45° angle-ah dah a ni.

Classic percutaneous Kirschner wire fixation hmanga distal radius fracture te chu a hnuaia Figure ae ah hian kan hmu a.

 

Percutaneous Kirschner wire fixation hnua finger movement chu a hnuaia Figures ad ah hian kan hmu a.

2. Surgery atana fimkhur dan leh technique hrang hrang

1.K-wire chu contralateral cortex chhunga lut lovin medullary cavity chhungah a tlan lut a nih chuan K-wire a luh dawna tilt lutuk vang a ni thei. Chutiang a nih chuan miten an kut an phar chhuak duh a, tilt tihtlem nan an hmang thin. Mahse a nihna takah chuan a kalh zawng a ni. K-wire hi angle leh bent a ni ang a, concave angin a awm ang a, chu chuan K-wire puncture a tichhia ang. Chu ai chuan K-wire contour angin chunglam hawiin zawi zawiin a inzawm tur a ni a, a hnuaia lem a kan hmuh ang hian.

K-wire chu convexly chunglam hawia dah a nih chuan axial pressure awm lovin distal cortex-ah entry point siam a ni a, distal cortex chhungah a lut thei a ni. A dang pawhin insertion point chu thlak a, a tir atanga tan tur a ni (A hnuaia Figure ae).

2.Kapandji technique-ah chuan K-wire pahnih atanga pathum vel chu fracture site-ah dahin distal fracture fragment te chu duhna hmunah tihtlem leh siamthat a ni. Vawikhat tihtlem a nih chuan K-wire te chu proximal fragment-ah an kal chho ta a ni (A hnuaia Figure af).

3.Kirschner wire entry leh exit point te chu fracture hnaih takah a awm chuan fixation failure a awm thei. Dorsal Kirschner wire pahnih hi palmar cortex kal tlangin level inangah a kal tur a ni lo va, palmar exit point chu fracture site atanga cm 2 vela hlaah a awm tur a ni. A hnuaia Figures ac hi en rawh.

4. Dorsal cortex a comminuted lutuk chuan distal bone fragment fracture site-ah lut lo turin bei la, hei hian fixation failure a thlen thei a ni. Figures ae a hnuaia mi hi a ni.

5. Osteoporosis na tak tan chuan Kirschner wire pali atanga panga hmanga ruh tliak chu siam that a tha ber. A châng chuan radius sei zawng vawng reng tûrin transverse Kirschner wire hmangin distal radius bone block chu distal ulna-ah an fix ṭhin.

6. Epiphyseal end-a long segment fracture-ah chuan fixation atan Kirschner wire lian tak inclined hman theih a ni. Mahse, Kirschner wire hi medullary cavity chhungah a lut thei a, siamthat a harsa hle (Figures ad below).

7. Intra-articular bone fragment chu hawn a ni a, cartilage hnuaiah transverse Kirschner wire hmangin an fix hmasa a, chutah chuan percutaneous Kirschner wire pathum hmangin a tlangpuiin an fix leh a (Figures ad below).

8. Distal radius-a comminuted fracture na tak, shortening leh collapse nena inzawm chuan radius san zawng vawng reng turin ulna kaltlangin transverse Kirschner wire dang a mamawh a ni. Kirschner wire hi styloid process-a palm lam atanga ulna dorsal lam thlenga dah a tha ber a, a hnuaia Figure a leh b-a kan hmuh ang hian.

9. Radial styloid fracture a awm a, a hnungzang a inthlak bawk. Reduction hnuah radial styloid Kirschner wire pahnih hmangin fix rawh: pakhat chu dorsal side-ah leh pakhat chu palmar side-ah styloid tip thlengin. (A hnuaia lem a leh b te)

10. Distal radius atanga hmun li a inthen a, dorsal displacement leh palmar lam atanga lunate fossa inthen. Kirschner wire hi dorsal cortex atang hian proximal atanga distal metacarpal bone fragment thlengin oblique takin a fix thei a ni. (A hnuaia lem a leh b te hi).

. (A hnuaia lemziak ah hian)

12. Closed reduction hmanga tihtlem theih loh, obviously displaced distal radius fracture tan chuan 3 mm Kirschner wire hmangin distal fracture fragment chu a hnunglam atanga chawi chhuakin reduction neih theih a ni (A hnuaia Figure ah).

13. Distal radius-a comminuted fractures enkawl nan external fixators hmang ang che. External fixators hi distal radius-a comminuted fracture na tak, swelling lian tak, open fracture, emaw local skin condition-a internal fixation (plate fixation ang chi) phal lohna (plate fixation ang chi) te nen a tha hle (A hnuaia Figure ad).

3. Harsatna awm thei tur ven

1.Unstable fixation ven nan a hnuaia operation te hi ngaihven rawh

Bicortical fixation hi ngaihven rawh.

Distal needle exit point chu a fracture hnaihah dah loh tur.

Force concentrate turin Kirschner wire zawng zawng distal end-a inzawmkhawm zawng zawng kha pumpelh rawh.

Kirschner wire i ben dawnin loose rotation awm lo turin fimkhur rawh.

Osteoporosis a awm chuan Kirschner wire fixation dang tih belh a ngai a ni.

2. Needle tract infection laka invenna atana hmalakna

A hmasa berin vun chu tan la, ruh thlenga soft tissue chu vascular clamp hmangin then la, Kirschner wire hmangin.

Thermal necrosis awm loh nan zawi zawiin drill rawh.

Vawi tam tak operation tih nawn fo loh tur.

Kirschner wire hian vunah a pressure tihhniam rawh.