Ivunika rya Radiyo Yitaruye: Gusuzuma, Gutondeka no Kuvura

Incamake ya Clinical · Kuvugurura uburezi

Ivunika rya radiyo ya kure ni ukuruhuka hafi yintoki za radiyo. Umuti urashobora gutandukana uhereye kumutwe cyangwa guterwa kugeza kumapine ya percutaneous, gukosora hanze, cyangwa gukosora isahani. Gahunda ikwiye iterwa no guhuza kuvunika no gutuza, uruhare hamwe, imiterere yoroheje-tissue, ubwiza bwamagufwa, imyaka, ibikenewe mumikorere, hamwe nibyifuzo byabarwayi.

Gusuzuma Kwipimisha kwa Clinical hamwe na radiografi yintoki byerekana uburyo bwo kuvunika, kwimurwa, no kubigiramo uruhare.

Ubuvuzi Ivunika rihamye rishobora kuvurwa nta kubaga; kuvunika kudahindagurika cyangwa kudahujwe neza birashobora gusaba gukosorwa.

Ibizavamo Imyaka yonyine ntabwo ihitamo kuvurwa. Icyifuzo gikora, imyitwarire ivunika, hamwe no gufata ibyemezo bisangiwe ni ngombwa.

Ivunika rya Radiyo Yitaruye Niki?

Iradiyo ya kure ikora igice kinini cyikorera umutwaro kuruhande rwintoki. Kuvunika mubisanzwe bibaho muri santimetero nkeya zifatanije na radiocarpal kandi birashobora kuba bidasanzwe, bigera mu gihimba, cyangwa bikagira uruhare runini rwa radioulnar. Ulnar styloid hamwe na ligaments zifasha nazo zirashobora gukomereka.

Kugwa ku kiganza kirambuye ni uburyo busanzwe. Kugabanuka kwingufu nkeya mubisanzwe mubantu bakuze bafite imbaraga zamagufwa, mugihe ibikomere bya siporo, impanuka zo mumuhanda, no kugwa muburebure bishobora kubyara ingufu nyinshi mubarwayi bakiri bato.

Incamake ya radiyo ivunaguye yerekana amaboko ya anatomy nuburyo bwo kuvunika — Ivunika rya radiyo itandukanye iratandukanye mu cyerekezo, gutangira, kwimurwa, no kugira uruhare mu kuboko.

Kuki anatomy ifite akamaro

Iradiyo ya kure ifite ubuso bwagutse kandi ishyigikira scaphoide na lunate. Inzira zegeranye zirimo imitsi ya median, flexor na extensor tendons, imiyoboro ya radial, intera ya radioulnar ya kure, hamwe na fibrocartilage ya mpandeshatu. Kugarura guhuza ingirakamaro mugihe urinze izi nzego nintego nyamukuru yo kuvura.

Ibimenyetso nibimenyetso bikeneye isuzuma ryihuse

Ibimenyetso bisanzwe birimo ububabare bwamaboko ako kanya, kubyimba, gukomeretsa, ubwuzu, kugabanya umuvuduko, no gufata nabi. Ivunika ryimuwe rishobora kubyara ubumuga bugaragara. Umuganga asuzuma kandi uko uruhu rumeze, kuzenguruka urutoki, kumva, imikorere ya tendon, hamwe n’imvune zijyanye.

Shakisha ubuvuzi bwihutirwa kugirango igikomere gifunguye, igufwa rigaragara binyuze mu ruhu, ukuboko kwijimye cyangwa gukonje, kwiyongera kunanirwa, kudashobora kugenda intoki, kwiyongera vuba kubyimba, cyangwa ububabare bukabije butagenzurwa. Ibyavuye mu bushakashatsi birashobora kwerekana kuvunika gukinguye, ubwonko bw'amaraso, cyangwa umuvuduko ukabije uri mu ngingo.

Gusuzuma no gusuzuma Radiografiya

Amashusho asanzwe ya posteroanterior hamwe nuruhande rwamaboko ya radiografi akoreshwa mukumenya kuvunika no gusuzuma iyimurwa. Ibitekerezo bidasubirwaho birashobora gufasha mubibazo byatoranijwe. Kubara tomografiya irashobora gutanga ibisobanuro birambuye mugihe kuvunika imbere-arctular bigoye cyangwa mugihe igenamigambi rikorwa risobanura neza ibisobanuro.

Ibipimo bya posteroanterior amaboko ya radiografi mubice bya radiyo ya kure — Kubireba PA, abaganga basuzuma uburebure bwa radiyo, impagarike ya radiyo, itandukaniro rya ulnar, hamwe nubusabane.

Uruhande rwamaboko ya radiografi yerekana volar na dorsal tilt gupima — Kuruhande rwinyuma, volar cyangwa dorsal tilt hamwe na carpal guhuza birasuzumwa.

Ikiranga radiografiya	Icyo gisobanura	Impamvu ari ngombwa
Uburebure bwa radiyo	Uburebure bwa radiyo ya kure ugereranije ningingo zifatika hejuru yubuso.	Gutakaza uburebure birashobora guhindura imitwaro yoherejwe na ulnar itandukanye.
Impengamiro	Umusozi wuburebure bwa radiyo ya kure hejuru ya PA reba.	Kugabanuka kugabanuka birashobora kwerekana gusenyuka cyangwa kwimuka kuruhande.
Volar / dorsal tilt	Icyerekezo cya sagittal yubuso bwa arctular hejuru kuruhande.	Kurenza urugero cyangwa guhindagurika birashobora kugira ingaruka kumukanishi.
Intambwe-ntambwe cyangwa icyuho	Gutakaza guhuza neza hejuru yubuso.	Ifasha gusobanura intego yo kwimura no kuvura intego.
Ulnar	Uburebure bugereranije bwa ulna ya kure na radiyo.	Birashobora guhinduka mugihe radiyo igufi kandi ikagira ingaruka kuri ulnocarpal.

Uburyo Imvune ya Radius Itandukanijwe

Amagambo asobanura nka Colles , Smith , na Barton yavunitse yerekana uburyo bwo kwimura ibintu, ariko ntibifata ibikomere byose. Isuzumabumenyi rigezweho kandi ryandika niba kuvunika gufunguye cyangwa gufunze, birenze-articular cyangwa intra-articular, bimuwe cyangwa bidafite aho bihuriye, bihamye cyangwa bitajegajega, kandi byoroshye cyangwa byatangiye.

Ibyiciro bya Fernandez kuburyo

Amatsinda ya sisitemu ya Fernandez avunika ukurikije uburyo bwimvune bwiganje. Irashobora gufasha abaganga gutekereza kubijyanye no gukomeretsa byoroheje-tissue hamwe ningamba zo gukosora, ariko kuvura ntabwo byatoranijwe mubyiciro byonyine.

Ubwoko bwa Fernandez I intera ya radiyo yunamye igereranya — **Ubwoko I:** kuvunika kuvunika, akenshi hamwe na metafhyseal cortical gutsindwa.

Ubwoko bwa Fernandez bwa II intera ya radiyo yogosha ibice — **Ubwoko bwa II:** gukomeretsa kogosha, harimo kuvunika-gutandukana.

Ubwoko bwa Fernandez bwa III intera ya radiyo yogusenyuka kuvunika — **Ubwoko bwa III:** gukomeretsa kwikuramo hamwe ningaruka zifatika.

Ubwoko bwa Fernandez bwa IV intera ya radiyo avulsion ivunika — **Ubwoko bwa IV:** igikomere cya avulsion kirimo imigereka.

Ubwoko bwa Fernandez V bwahujwe na intera ya radiyo ivunika — **Ubwoko bwa V:** gukomeretsa ingufu nyinshi hamwe nuburyo bwinshi.

Uburyo bwo Kuvurwa

Intego ntabwo ari ugukora X-ray gusa. Umuti ushakisha intoki nziza, itajegajega, ikora mugihe uringaniza ingaruka ziterwa na anesteziya, kubagwa, ubudahangarwa, gukomera, no gutakaza kugabanuka. Icyemezo gisangiwe kigomba gusuzuma:

kuvunika kuvunika, gutangira, uruhare hamwe, no gutuza nyuma yo kugabanuka;
gukomeretsa kumugaragaro, ibimenyetso byumutima, kuzenguruka, nuburyo bworoshye-tissue;
imyaka y'abarwayi nka proksi-ntabwo isimburwa-kumiterere ya physiologique nibisabwa bikora;
amagufwa meza, izindi nkomere, ubuzima bwubuvuzi, akazi, no kuganza amaboko;
ubushobozi bwo kwitabira gukurikirana no kugira uruhare mu gusubiza mu buzima busanzwe;
intego z'umurwayi no kwihanganira inyungu n'ingaruka za buri cyiciro.

Imirongo ngenderwaho: Ubuyobozi bwa AAOS / ASSH bushigikira gukosora ibikorwa kubarwayi benshi badafite ubumuga mugihe, nyuma yo kugabanuka, kugabanuka kwa radiyo kurenga mm 3, guhindagurika kwa dorsal kurenga 10 °, cyangwa kwimura imbere-articular / kwimuka kurenga mm 2. Ku barwayi bakuze-bakunze kugaragazwa n’ubushakashatsi bafite imyaka 65 cyangwa irenga - kubaga muri rusange ntibishobora kunoza ibisubizo by’igihe kirekire byavuzwe n’umurwayi ugereranije n’ubuvuzi budasanzwe. Izi mbago zimenyesha, ariko ntizisimbuza, urubanza rwihariye rwa clinique.

Ubuvuzi budasanzwe

Kudavunika cyangwa kwemerwa kuvunika gutekanye kurashobora gucungwa hamwe na spint cyangwa cast. Ivunika ryimuwe rishobora kubanza kugabanuka gufunze, hagakurikiraho ubudahangarwa. Ikizamini cyo gukurikirana hamwe na radiografi byateganijwe ukurikije imyitwarire yamenetse hamwe nubuvuzi bwa muganga kuko kuvunika bimwe bishobora gutakaza guhuza uko kubyimba kugabanuka.

Kurinda kwambere: gucamo bituma habaho kubyimba hakiri kare; kuzamuka no kugenda urutoki birashobora kugirwa inama.
Kugabanuka mugihe bikenewe: kuvunika kwakozwe hakoreshejwe analgesia ikwiye cyangwa anesthesia.
Immobilisation no gusubiramo: gukina neza, kuzenguruka, kumva, no guhuza byongeye gusuzumwa.
Gusubiza mu buzima busanzwe: ukuboko kwamaboko nintoki bitangirwa mugihe gukira no gutuza byemewe.

Nonoburgical immobilisation ya radiyo ya kure — Immobilisation irashobora kuba nziza mugihe guhuza byemewe kandi kuvunika bikaguma bihamye.

Ni ryari dushobora kubagwa?

Kubaga birashobora kuganirwaho mugihe guhuza kwemerwa bidashobora kugerwaho cyangwa kubungabungwa, ubuso buhuriweho bwimuwe cyane, kuvunika gukinguye, carpus ntigihungabana, cyangwa uburyo bwo gukomeretsa ntibishobora kuguma bihagaze neza mubakinnyi. Igikorwa noguteramo byatoranijwe kubice byihariye no kwihangana - ntabwo ari kubirango bisuzumwa.

Amahitamo yo kubaga ya radiyo ya kure

Uburyo	Uruhare Rusange	Inzitizi zingenzi cyangwa ingaruka
Gukosora K-wire	Ihitamo ryatoranijwe rishobora kugabanywa hamwe na pin hamwe na immobilisation yinyongera.	Indwara ya pin-tract, kwimuka kwinsinga, gutakaza kugabanuka, no gukenera pin.
Gukosora hanze	Byahiswemo bidahindagurika, bifunguye, bikabije, cyangwa ibikomere byoroheje-byangiritse; birashobora kuba by'agateganyo cyangwa bisobanutse.	Ibibazo bya pin-tract, gukomera, nervice / tendon kurakara, no gutakaza guhuza.
Isahani yo gufunga	Byinshi bitajegajega bidasanzwe-byimbere-byimbere-bigabanya kugabanuka gutaziguye no gushyigikirwa.	Flexor tendon kurakara cyangwa guturika, ibimenyetso byubwonko, kwinjira kwa screw, kwandura, nibimenyetso byibyuma.
Isahani	Ibyatoranijwe byatoranijwe cyangwa ibice byogosha bitagenzuwe bihagije kuruhande rwa volar.	Kwagura tendon kurakara no kumenyekanisha ibyuma.
Ikiraro cya Dorsal	Ivunika ryinshi cyane aho isahani izengurutse intoki kandi ikoresha ligamentotaxis.	Kugabanya by'agateganyo icyerekezo cy'intoki kandi mubisanzwe bisaba gukuraho nyuma.
Igice cyihariye cyo gukosora	Ibishushanyo bigoye aho buri nkingi ya arctular cyangwa ibice bikeneye inkunga igenewe.	Ibindi byatewe hamwe nuburyo bushobora kongera ibintu byoroshye.

Ibimenyetso bya AAOS / ASSH byerekana ko nta tandukanyirizo ryigihe kirekire ryibisubizo hagati yubuhanga bwo gukosora kuvunika kutanyeganyega cyangwa kuzuye, nubwo ibyapa bifunga volar bishobora gutanga imikorere yambere mumezi atatu yambere. Guhitamo tekinike yanyuma biterwa no kuvunika nubuhanga bwo kubaga.

Gukosora pin

Nyuma yo gufunga cyangwa kugabanuka-gufungura, insinga za Kirschner zishobora gufata ibice byatoranijwe. Fluoroscopy yemeza kugabanuka nu mwanya wa wire. Amapine arashobora gusigara hanze yuruhu cyangwa gushyingurwa, bitewe nubuhanga, kandi intoki ikingirwa mubice cyangwa guta.

Percutaneous Kirschner wire ikosora ya radiyo ya kure — Insinga zidasanzwe zishobora kuzuza igabanuka rihamye muburyo bwatoranijwe.

Gukosora hanze

Ikosora yo hanze ikoresha pin yashyizwe hanze yakarere kavunitse kandi ihujwe nikintu cyo hanze. Kwubaka intoki birashobora gukomeza uburebure no guhuza binyuze muri ligamentotaxis. Irashobora kandi guhuzwa ninsinga, amasahani mato, cyangwa igufwa ryamagufwa mubikomere bikomeye. Reba urugero rwa a intoki yo hanze ikosora hamwe nincamake ya orthopedic sisitemu yo gutunganya sisitemu.

Intoki-izunguruka hanze yo gukosora kumeneka ya radiyo ya kure — Ikirangantego gishobora kugarura uburebure no gushyigikira guhuza.

Radiografi yo gukosora hanze ituza radiyo ya kure — Gukurikirana radiografiya isuzuma guhuza ibice hamwe na pin umwanya.

Icyapa cya Dorsal

Uburyo bwa dorsal butanga uburyo bwatoranijwe bwa dorsal articular uduce hamwe nogosha. Ibigezweho bigezweho-bigabanya kugabanya byinshi, ariko imitekerereze ya extensor ikomeza kuba hafi yibyuma kandi igomba kurindwa. Amashusho akurikira yerekana ibitekerezo byo gukosora aho gukurikiranwa kwisi yose.

Dorsal yegereye anatomy ya radiyo ya kure ikosora — Kugaragara kwa Dorsal bisaba gucunga neza ibice byagutse.

Gushyira isahani ya dorsal kumeneka ya radiyo ya kure — Inkunga igenewe dorsal irashobora kugenzura ibice bya dorsal.

Radiografi nyuma yisahani ya dorsal ikosora ya radiyo ya kure — Kugenzura amashusho yanyuma kugabanya, umwanya wibisahani, hamwe nuburebure bwa screw.

Icyuma gifunga icyapa

Isahani ya Volar ikoreshwa cyane kuko irashobora gushyigikira igufwa rya subchondral kuva kuruhande rwikigazi mugihe wirinze gushyirwa munsi yumurongo wa extensor. Flexor carpi radialis intera ninzira isanzwe. Ikibanza cya plaque, kugarura ubuso bwahujwe, uburebure bwa intera ndende, hamwe na flexor tendon clearance bisaba kugenzurwa neza.

XC Medico ingero zirimo a 7-umwobo wa radiyo ifunga isahani , a 6-umwobo wa radiyo ifunga isahani , na a DVR ya radiyo ifunga isahani . Ihuza ryibicuruzwa nibisobanuro byamakuru; guhitamo kwimikwa bikomeje kuba inshingano zabavuzi bahuguwe.

Ikibaho cyo gukosora icyuma cya radiyo ya kure — Urugero: plaque ya plaque ikosora kuvunika kutajegajega.

Nyuma yo gutangira PA radiografi ya volar intera ya radiyo isahani — PA amashusho agenzura guhuza radiyo no gukwirakwiza intera ya kure.

Nyuma yibikorwa bya radiografi ya volar intera ya radiyo isahani — Kwerekana amashusho kuruhande bisuzuma guhindagurika, kugabanuka, hamwe nu mwanya watewe.

Kumeneka kure ya radiyo mbere yo gukosora plaque — Kuvunika bigoye cyane mbere yo gukosorwa neza.

Icyapa gifunga icyuma cyubaka imbere-ya-arctular intera ya radiyo ivunika — Inkunga ihamye irashobora guhagarika ibice byinshi bya kure.

Ibisubizo bya radiografiya nyuma ya plaque ya plaque ikosora ivunika rya radiyo ya kure — Nyuma yibikorwa byerekana inyandiko ihuriweho hamwe nibikoresho byumwanya.

Ikiraro cya Dorsal (kurangaza)

Isahani yikiraro iva kuri radiyo ikagera kuri metacarpal kandi ikora nkibisamaza imbere. Irashobora kuba ingirakamaro kubihombo byatoranijwe cyane bidashobora gushyigikirwa byizewe na plaque isanzwe. Kuberako yambutse by'agateganyo intoki, gahunda ya kabiri iteganijwe irakenewe muri rusange gukuraho isahani nyuma yo gukira.

Ikiraro cya dorsal kizengurutswe na radiyo ya kure — Isahani yikiraro izenguruka ukuboko kugirango igumane uburebure no guhuza mugihe kuvunika gukira.

Igice cyihariye cyo gukosora

Ivunika rinini cyane rishobora kuba ririmo styloide ya radial, volar rim, rorsal rim, hamwe nibice byo hagati. Sisitemu yihariye ikoresha sisitemu ntoya yashizwemo kugirango igabanye ibice bisaba kugenzura bitaziguye. Bashobora gukoreshwa bonyine cyangwa nubundi buryo bwo gukosora.

Sisitemu yihariye yo gukosora sisitemu ya radiyo ya kure — Gushiramo bito birashobora kwibasira inkingi ya arctular cyangwa ibice.

Radiografi yibice byihariye bya radiyo ivunika — Ingingo nyinshi zo gukosora zirashobora gukemura ibice bigoye.

Gukira, Gusubiza mu buzima busanzwe, hamwe nibishoboka

Gutunga urutoki akenshi birashishikarizwa hakiri kare niba uruhushya rwo kuvura no kuvura. Imyitozo y'intoki n'amaboko itangira ukurikije ituze, imiterere y'ibikomere, hamwe no gukiza radiyo. Imbaraga, ubwitonzi, no kwihangana bikira buhoro buhoro kuruta icyerekezo cyibanze, kandi kubyimba cyangwa gukomera bishobora kumara amezi. Gusubiza mu buzima busanzwe bishobora kuba bishingiye ku rugo cyangwa bikagenzurwa bitewe n’ibikenerwa n’umurwayi hamwe n’imyitozo yaho.

Ingorane zishobora kubaho zirimo gutakaza kugabanuka, malunion, kudahuza, gukomera, arthrite nyuma y’ihungabana, ibimenyetso by’imitsi yo hagati, ibimenyetso by’ububabare bwo mu karere bigoye, kurakara cyangwa guturika, kwandura, ibibazo bya pin-tract, hamwe nibikoresho byerekana ibimenyetso. Kunanirwa gushya, kongera ububabare, umuriro, gutemba, cyangwa gutakaza ibimenyetso byerekana urutoki rwemeza kwisuzumisha kwa muganga.

Amagufwa yubuzima bwamagufa: kuvunika kwintoki nkeya kumuntu ukuze bishobora kuba ikimenyetso cyo kuburira osteoporose. Abarwayi barashobora kubaza umuganga wabo niba isuzuma ry’imvune, gupima amagufwa, kwirinda kugwa, gusuzuma vitamine D, cyangwa izindi ngamba z’ubuzima bw’amagufwa birakwiye.

Ibibazo Bikunze Kubazwa

Ese kuvunika kwa radiyo kwitaruye gukenera kubagwa?

Oya. Ibice bimwe bishobora kugabanuka kandi bikaguma byemewe guhuzwa nabakinnyi. Guhagarara, kwimura hamwe, imyaka, icyifuzo gikora, ubuzima, nibyifuzo byabarwayi byose bigira ingaruka kumyanzuro.

Kumena radiyo ya kure bifata igihe kingana iki kugirango ukire?

Gukiza amagufwa hakiri kare bikura mugihe cibyumweru bitandatu, ariko igihe kiratandukanye. Kwimuka, imbaraga, kubyimba, nicyizere birashobora gukomeza gutera imbere mumezi menshi cyangwa arenga.

Isahani ya volar burigihe nuburyo bwiza bwo kubaga?

Nta kintu kimwe cyatewe cyiza kuri buri kuvunika. Ibyapa bifunga ibyapa birasanzwe kandi birashobora gushyigikira ibikorwa byigihe gito, ariko pin, gukosora hanze, gukosora dorsal, gushiraho ikiraro, cyangwa gushiramo ibice byihariye bishobora guhuza neza nuburyo bumwe.

Ese isahani ya radiyo ya kure igomba gukurwaho nyuma?

Gukuraho inzira ntabwo buri gihe ari ngombwa. Gukuraho birashobora gutekerezwa kubitera imitsi, ibyuma bikomeye cyangwa ibimenyetso byerekana ibimenyetso, kwandura, cyangwa izindi mpamvu zubuvuzi. Isahani yikiraro muri rusange isaba kuvanwaho byateganijwe kuko izenguruka ukuboko.

Ni ryari ikiganza gishobora gukoreshwa bisanzwe?

Gukoresha neza biterwa no kuvunika, kuvurwa, gukiza radiyo, kubabara, nibikorwa birimo. Imirimo yoroheje ya buri munsi isanzwe igaruka mbere yo gufata ku ngufu, guterura, guhuza siporo, cyangwa akazi karemereye. Kurikiza ibyo abaganga bavuza.

Bifitanye isano XC Medico Ibikoresho

Ibikoresho byimbere bikurikira bitanga ibisobanuro byatewe, ibikoresho, hamwe na sisitemu ihahamuka ivugwa muriki gitabo.

Ibikoresho bya radiyo ya kure Gushiraho ibikoresho hamwe na tray iboneza ya sisitemu ya radiyo ya kure. 7-Umuyoboro wa radiyo Ifunga Isahani Ibicuruzwa Ibipimo, guhuza screw, hamwe n'iboneza. 6-Umuyoboro Utandukanye wa Radiyo Ifunga Isahani Ubundi buryo bwo gutandukanya umutwe wa radiyo ya radiyo. DVR Ikirangantego cya Radiyo Ifunga Icyapa Ikirangantego cya volar radiyo isahani nibisobanuro bya sisitemu. Wrist External Fixator Ibikoresho byo hanze bigenewe gukoreshwa. Gitoya Igikoresho Gushiraho Igikoresho cyo gutoranya uduce duto duto twakosowe. Sisitemu yo guhahamuka Reba amasahani, imigozi, ibikoresho, nibicuruzwa byo hanze. Kugenzura Ubuziranenge Amakuru yerekeye igenzura ryakozwe nuburyo bwiza.

Ibyerekeye Ibyingenzi

Kwamagana ubuvuzi: Iyi ngingo ni iy'uburere rusange n'intego z'umwuga zigamije. Ntabwo itanga isuzumabumenyi, itanga igitekerezo cyihariye, cyangwa gusimbuza isuzuma nubuvuzi ninzobere mubuzima bwujuje ibyangombwa. Ibikoresho biboneka, ibyerekana, hamwe nuburyo bugenzurwa birashobora gutandukana nigihugu.

Imvune ya Radius Yitaruye: Gusuzuma, Gutondeka no Kuvura