Distal radius fractures: Anatomy atanga surgery thlenga hrilhfiahna kimchang tak

Distal radius fractures hi forearm fracture 75% a ni a, clinic-ah hian a bik takin a tam hle. He thuziak-ah hian i reference atan distal radius fractures-a taksa peng hrang hrang, classification, treatment strategies, leh surgical approach te list kan siam a ni.

Summarize rawh .

Distal radius a fracture te hi wrist fracture atanga lo chhuak a ni. wrist 'three-column theory' hian fractures pathological mechanism chu a hrilhfiah tha zawk thei a, chutah chuan radial column, radial tuberosity leh navicular fossa awmna chu wrist joint stability vawng reng turin a pawimawh hle.

Distal radius fracture zawng zawng, radius dorsal margin-a avulsion fractures tih loh chu, a nihna takah chuan overextension violence vang a ni. Kut chu pawn lam thiltihtheihnain a thawh chuan a dinhmun a danglam a, pawn lam thiltihtheihnate nghawng chu a danglam a ni.

1.Flexion violence hian dorsally displaced intra- or extra-articular fractures in low-energy injury, falls ang chi te a thlen thei.

2.shear stress hian palmar lam a articular surface te chu a then a displacement thei a, chu chuan instability a thlen thei.

3.Energy high-energy-ah chuan compression violence a tam zawk a, axial loading tam lutuk chuan articular surface bone compression a thlen thin.

4.Fracture dislocation awm dan bulpui ber chu avulsion injury a ni a, chutah chuan avulsed bone mass chu ligament pakhata bony attachment point a ni tlangpui.

A rilru a buai em em a, a rilru a hah em em bawk a. Distal radius .

1.Anteroposterior films (radial height, ulnar deviation, ulnar varus)

2. Lateral films (Palmar inclination) .

Fernandez-a chi hrang hrangte thliar hranna .

Type I Metaphyseal Flexion A chhe thei lo .

Type II articular leh shear fracture .

Type III compression fracture chu articular surface a ni.

Type IV avulsion fracture chu radial wrist a ni a, dislocation a awm bawk.

Type V mixed fractures (high energy avulsion fractures) .

Surgery neih theihna tur indication .

Distal radius fracture tam zawk hi closed reduction hnua braking hmanga enkawl a ni a, vanduaithlak takin heng fracture tam tak hi a inthlak danglam dawn a, a nih loh leh a reduction chu a chhuahna tha lo nen pawm theih a ni dawn lo.

Lafontaine et al: te chuan destabilizing factor panga an hmuchhuak a, chungte chu:

1 A tir lamah chuan dorsal angulation > 20° (Palmar tilt);

2 comminuted fracture chu dorsal epiphysis-ah a awm a;

3 Joint-a ruh tliak;

4 a kaihhnawih ulnar a hliam;

⑤ Damlo kum > Kum 60.

Enkawlna kaihhruaina tur standard emaw kaihhruaina chiang tak a awm lo va, enkawlna tur ruahmanna siam a ni a, chung zingah chuan thil tam tak ngaihtuah a ni a, chung zingah chuan a tir lama hliam ziarang, repositioning hnua calibration, damlo kum, ruh quality, damlo mamawh, leh a rah chhuah duhthusam te pawh a tel a ni.

Stability nia rinhlelh nei fractures closed reduction atan chuan close follow-up neih a tha. Reduction hnua X-ray series-in instability emaw displacement emaw a thlen chuan enkawlna inthlak danglam a ngai mai thei tih hriat a pawimawh hle. Fracture chu a nghet lo thei a nih chuan radiographs te chu lak a, fracture a dam leh a stabilise hma loh chuan evaluate tur a ni.

Conservative taka enkawlna .

Stable fractures chu hlawhtling taka khar theih a ni a, braking hmanga enkawl theih a ni a, a tirah chuan splinting hmangin leh a hnuah tubular cast hmangin enkawl theih a ni a, kar tin radiographs kar 3 thleng a awm thei bawk.

Radial length, palmar inclination, emaw ulnar deviation-a inthlak danglamna nasa tak a awm chuan surgical treatment ngaihtuah a ngai a ni.

Frail leh low-demand patient-ah chuan closed treatment hi a remchang fo thin a, operation tih a nih pawhin.

Closed reset percutaneous needle fixation a awm bawk.

Closed reduction zawhah percutaneous pinning leh fixation hi distal radius fracture-ah a tangkai hle a, metaphyseal instability emaw simple intra-articular fractures emaw a ni.

Step hmasa ber chu anatomical repositioning a ni a, chutah chuan stabilization chu gram pins nen pek a ni. A tlangpuiin pin hmasa ber chu radial styloid atanga radial metaphysis medial ah diaphysis ah a kal thin.

Orthogonal leh lateral position-a stable repositioning tling tak pek nan pin 2 aia tlem lo hman a ni a, duh chuan lunate facet chu pin theih a ni bawk.

Intrafracture pinning (Kapanji technique) hian dorsal support a pe a. Splint-a postoperative immobilization chu kar 2 chhung hman a ni a, rotation control leh pin irritation tih tlem nan, chu mi hnuah chuan soft forearm cast hmangin thlak theih a ni.

Closed-replacement pawn lam fixation bracket fixation .

External fixation braces hi distal radius fracture bik a initial emaw adjunctive treatment atan a tangkai hle.

External fixator hian forearm muscle group-te contraction laiin distal radius-a thawk axial stresses chu a neutralize a ni. Fixation chu a kutphah sir velah a awm thei a, a awm lo thei bawk a, a nih loh leh additional fixation pawh a dah belh thei bawk.

Parallel traction hian palmar inclination a siam tha tawk lo a, mahse neutral position erawh pawm theih a ni thung. Postoperative-ah chuan a kutphah chu tubular cast-ah ni 10 chhung rotated posterior position-ah braced a ni a, a natna leh edema a reh thlengin.

Plate fixation leh incision leh repositioning te .

1、Dorsal plate chhunga distal radius fracture a fixation .

Lister node-ah chuan straight incision siam a ni a, distal end chuan radial carpal joint line a pel a, second metacarpal wrist joint base-ah cm 1 proximal a tawp a ni. Proximal end chu radial stem zawh zawngin cm 3 atanga 4 vel a inzar pharh a, extensor interval pathumna base hmangin middle column chu a pholang a ni.

2、Palm Plate Distal radius fracture chhunga a chhunga fixation .

A longitudinal incision chu radial carpal flexor tendon-ah siam a ni a, bunion flexor tendon chu radial carpal flexor tendon thuk takah a awm a, chu chu retracted ulnarly a ni a, anterior rotator ani muscle chu expose turin, anterior ani muscle chu a severed of the begining the beginning of the radial endered ulnar leh retracted ulna leh retracted A radius chu a ni.

Case 1 a ni a.

Case 2 a ni a.

Case 3 100 a ni.

3. Traction plate fixation chu distal radius fracture a ni.

- 4-cm longitudinal incision chu metacarpal pathumna stem-ah dorsal-in siam a ni a, middle finger-a extensor tendon chu metacarpal pathumna pholan nan contract a ni a

- 4-cm incision pahnihna chu comminuted radius-ah 4 cm dorsal tal siam a ni a;

- 2-cm dorsal incision pathumna chu lister node-ah extensor hallucis longus tendon pholanna atan siam a ni.

Distal incision atang chuan traction plate chu extensor tendon (dorsal compartment palina), joint capsule leh periosteum inkar plane zawhin proximally-in an dah a. Extensor tendon hi a tul chuan sawn theih a ni.

4. TRIMED system hmanga distal radius a comminuted fractures te individualized fixation .