I-Direas Ridius Fratures: Ingcaciso ebanzi evela kwi-anatomy ukuze ihluleke

I-distal radius fists i-akhawunti ye-75% yefrandare ye-Wallorm kwaye ixhaphake kakhulu ekliniki. Kweli nqaku, saqulunqa uluhlu lwe-anatomy, ukwahlula-hlulwa, iindlela zonyango, kunye neendlela zokuhlinzwa kwirediyo yerediyo yerediyo.

Shwankathela

Ukuqhekezwa kweRadius yase-Drides yinxalenye yeqhekeza lesandla. Ithiyori yekholamu emithathu 'ingekacacaphico ' ingangcono ichaze indlela ye-pathoikiso ye-charicial, apho ikholamu ye-radial, equka i-tuberasity ye-radial tubes kunye ne-thsariur fossa, ibalulekile ekugcineni uzinzo lwe-wirist edibeneyo.

Onke i-diredius racius quares, ngaphandle kwe-aviulsion qushurensi yomda we-dorsal weradiyo, eneneni ibangelwa bubundlobongela obuxhaswayo. Isandla sibekwe ngendlela eyahlukileyo xa sisebenza ngamandla angaphandle, kwaye imiphumo yemikhosi yangaphandle yahlukile.

I-1.Flexion Ubundlobongela bunokubangela ukuba basuswe i-Intra- okanye iqhekeza elongezelelweyo lobugcisa kwizenzo zokulimala eziphantsi njengokuwa.

2.Shear uxinzelelo lunokubangela ukufuduka kwenxalenye yendawo ye-articular kwicala lezinto ezikhokelela ekungazinzini.

3.Ukuba nobungozi bamandla aphezulu, ubundlobongela obuphambili bubekamileyo kunye nokulayisha okugqithisileyo kukhokelela ekuqulunqweni kwethambo lomphezulu wobugcisa.

I-4.indlela yokuqala yokukhupha i-fectores kukulimala kwe-aviulsion apho ubunzima bethambo i-Anusvint ihlala iyindawo ye-Byny.

I-anatomy ye-radiologic ye-distal radius

I-1.Nanteroposterior Fizerms (ukuphakama kwe-radial, ukuphambuka kwe-rannar, i-ilnar valus)

I-2. Iifilimu ze-Lateral (i-Palmar yoTitshala)

Ukuhlelwa kweFernandez

Chwetheza i-metaphyseal fastxion foraction

Chwetheza ii-II ze-II ze-articular kunye ne-shear phraction

Uhlobo lwe-III IIO PROORTRAM YOKUGQIBELA YOKUGQIBELA

Chwetheza i-IV Avalsion yokuqhekeka kwe-radial sharsist, discouration

Chwetheza i-v isaphulelo exutywe (i-avalsion yamandla aphezulu)

Izalathiso zotyando

Uninzi lwerediyo le-diadius quares liphathwa gadalala emva kokuncitshiswa okuvaliweyo, ngelishwa uninzi lwezi ntlungu ziya kushiywa okanye ukuncitshiswa akuyi kwamkelekanga ngesiphumo esibi.

Izinto ezintlanu zokwazisa zachongwa yiLafontiine et al:

① I-angations yokuqala ye-dorsal> 20 ° (i-palmar ye-palmar);

② Ukuqhekeka kwento yokuqhekeka kwe-dorsal epiphysis;

③ phrature kwiNtlawulo;

④ unxulumene ne-Ulnar uprafti;

⑤ Iminyaka yobudala yoMguli> Iminyaka engama-60.

Akukho migangatho ichazayo okanye izikhokelo zokukhokela unyango, kwaye izicwangciso zonyango zenziwa zithathele ingqalelo inani elikhulu lezinto, kubandakanya iimpawu zokulimala okokuqala, ukulinganisa emva kokubeka endaweni, iimfuno zesigulana, iimfuno ezinqwenelekayo.

Ukuncitshiswa okuvaliweyo Kubalulekile ukuba uqaphele ukuba ukuba uthotho lwee-X-rays emva kokucutha iphakamisa ukungazinzi okanye ukufuduswa, emva koko utshintsho kunyango lungafuneka. Ukuba ukuqhekeka kungazinzanga, emva koko i-radiography kufuneka ithathiwe kwaye ihlolwe de kuqhekezwe i-phracture kwaye uzinze.

Unyango lolondolozo

Stable fractures can be successfully closed-displaced and treated with braking, initially with splinting and later with a tubular cast, with weekly radiographs up to 3 weeks.

Ukuba utshintsho olubalulekileyo ubude be-radial, i-palmar yotyekelo, okanye ukuphambuka kwe-Ulnar kwenzeka, unyango loqhaqho kufuneka luqwalaselwe.

Kwibuthathaka kunye nezigulana eziphantsi, unyango oluvaliweyo luhlala lufanelekileyo, nokuba utyando lubonisiwe.

Ukucocwa kwakhona kwakhona i-Incutaneous yenaliti

Ukuncitshiswa okavaliweyo kulandelwe kukucofa i-percutaneal kunye nokulungiswa kubalulekile kwi-diredius fists kunye nokungazinzi kweMetaphyseal okanye i-intra elula ye-intra.

Inyathelo lokuqala kukufunda kwakhona, emva koko ukulungiswa kubonelelwe ngemikhonkwane yegram. Ngokwesiqhelo i-PIN yokuqala idluliselwa kwi-radial staid kwi-radial metrial medical medial medial kwi-diaphysis.

Ubuncinci beziphelo ezi-2 zisetyenziselwa ukubonelela ngokutsha kwezinzile kwindawo ye-orthogonal kunye nendawo kamva, kunye nendawo ye-laseunate inokutshitshiswa ukuba ifuneke.

I-Intransure Piction (Indlela Kapanji) ibonelela ngenkxaso ye-dorsal. I-Popositive Ukuzibandakanya kwi-Splint isetyenziswa kwiiveki ezi-2 ukulawula ukujikeleza kunye nokunciphisa ukucaphukiswa kwePIN, emva koko kungathatyathwa endaweni ye-SUMP ye-SUMP.

I-Spire-Shicing-Shicingshiption Ukulungiswa kwe-Bracket yangaphandle

I-brace yokulungisa yangaphandle iluncedo kunyango lokuqala okanye oluhlanganisiweyo kwi-diredius raidius.

I-cittor yangaphandle ichasa uxinzelelo lwe-anisecal obambeleyo kwi-distal radius ngexesha lokuphumelela kwamaqela emisipha yelinga. Ukulungiswa kwe-kungenzeka okanye kusenokungabi nakuphela kwesandla, okanye ukulungiswa okukodwa kunokwenziwa.

Itratshi efanayo ayibuyi ngokupheleleyo utyekelo lwe-plmar, kodwa imeko engathathi cala yamkelekile. Ngokuzenzekelayo, i-hurst ibotshwe kwi-tubrur iphoswe kwindawo engasemva yeentsuku ezili-10 kude kube yintlungu kunye ne-Edema.

Ukulungiswa kweplate kunye ne-incavotion kunye nokubuyisela kwakhona

I-1, iplate ye-dorsal ilungiselelo langaphakathi le radius radius

Isimo esithe tye senziwe ecaleni kwendawo engu-lister, kunye nokuphela kwe-distal ukuwela umgca odibeneyo we-radial rabial racial kunye nokuphela kwe-1 cm proximal ukuya kwisiseko se-wirist yesibini ye-metacarpan. Isiphelo se-proximal sidlulisela ecaleni kwe-radial stem kangangesi-3 ukuya kwi-4 cm, eveza ikholamu ephakathi ngokusebenzisa isiseko sethutyana lesithathu.

I-2, i-Palm Plate yaNgaphakathi Ukulungiswa ngaphakathi kwe-diadius radius

Isimo sexesha elide senziwa ecaleni kwe-teralial tendon, kunye ne-bunion Flexor Tendon ekwi-terator teroler teroctor the thertotor the therpal the therpul barch kunye ne-roner rods ekupheleni kwe-radial theis.

Ityala ①

Ityala ②

Ityala ③

I-3. Ukulungiswa kwe-traction ye-dietius yerediyo ye-diast

-I-4-CM ye-cm i-cm yenziwa yenziwa i-dorsal kwisiqu sesithathu se-metacarpan, kunye ne-thessor ye-ownstor yomkhombandlela ephakathi.

-Isimo sesibini se-4-CM senziwe ubuncinci i-4 cm siye kwi-radius radition;

-I-Assion yesithathu ye-2-CM DORS yenziwa kwindawo engu-LIRE ukubhengeza i-Halsor Housis Tendon.

Ukusuka kwi-distang distal, ipleyiti yetreyini ifakwe kwiplanethi phakathi kwe-tendon yolwaphulo-mthetho (igumbi lesine le-dorsal), i-pipsule edibeneyo kunye ne-perioteum. I-Kisson yase-Ussoon inokushukunyiswa ukuba iyimfuneko.

I-4. Ukulungiswa komntu ngamnye wefratshi olwenziwe kwi-distal radius ngokusekwe kwinkqubo yomileyo