Nhungamiro nyowani dze volar plate kugadziriswa kwe distal radius fractures

Kubviswa kweiyo Extnsor Tendon mushure meVelol Plate Fixation inoramba iri dambudziko rakakura mukugadziriswa kweiyo distal radius fantures. Iyo inowanzo kukanganiswa tendon ndiyo yekupedzisira iyo Policis Longus (EPL) Tendon, sezvo ichivharidzirwa mukati meEPL Groove. Chiitiko chakataurwa che EPL Tendon chapton mushure me volar plating ndeye 0.29% -5.7%.

Njodzi yekunonoka EPL Tendon Kuparadza muHurumende yeDorsal Screw Screza Radiographic ongororo ye screw protrusion mune distal radius fantures yakaoma nekuda kweiyo yakaoma geometry yeiyo distal radius uye mukana wekutungamira madhiri. Maonero anoita dorsal tangenti ndiyo chete inogona chete kukurudzira maonero eiyo dorsal radial cortic cortex yekuwana ongororo yakavimbika yedivi pakati pe screw tip uye dorsal cortix.

Maitiro ekudzivirira Extnsor kukuvara kweToin kunosanganisira kushandiswa kwemwedzi monocortical screws uye kudzivirirwa kwekupinda kwemvura; Nekudaro, idzi nzira dzinogona kuderedza michina kugadzikana kwekugadziriswa kwekukanganisa. Naizvozvo, bicortical gadziriso dzimwe nguva inodiwa. Kuti uderedze njodzi yekuwedzera tendon kukuvara, zvinangwa zvekutanga zveKugadziriswa kwekugadziriswa uye kugadzikana hakufanirwe kukanganiswa.

Nhungamiro dzeMatsva

Isu tinotsanangura hunyanzvi hwekurerutsa njodzi ye EPL Tendon kuputika mushure meVhidhiyo yekugadziriswa kweLatal Fraw radius kana kubvisa zvidimbu zvezvipenga zvehembe. Pfupi, hunyanzvi hunosanganisira kuvhura komisheni yechitatu kuburikidza nediki dorsal incision.

Kana iyo screw yakanga yapinda muDorsal Cortex uye yakabuda mukamuri yechitatu: Takabvisa iyo EPL Tendon kubva kuGroove yayo uye yakavhara compartment nekutsvenesa iyo petinaculum ichisiya iyo EPL tendon pane yakagadziriswa retinaculum.

Kana iyo screw isingasungirire mukamuri yechitatu: Isu tinosiya iyo EPL Tendon mune yechitatu compartment. Chiratidzo chehunyanzvi hwedu pane varwere vane dzimba dzeradius radius radust Mune varwere vane distal radius fractures ine zvidimbu zve drosomdial, isu tinomisa maburi kuti tiratidze cortex cortex uye sarudza zviyero zvehurefu hwakakwana kugadzirisa zvidimbu zvisina kugadzikana.

Nyaya yekugovana

Isu tinogovana nyaya iyo EPL Tendon kubva kune yechitatu compartment nekuda kwekupindirana kwechidimbu mukamuri yechitatu panguva yekugadziriswa kwerudzi rwekirabhu yeriya. Isu takasimbisa kuti EPL Tendon aive makore ane makore manomwe ekutanga, kunyangwe banga raive rakakurumbira mukamuri yechitatu.

Mhosva iyi yaive yemakore makumi matanhatu nematanhatu neyekuongororwa kweiyo intra-articular isina kugadzikana distal radius prcract yeDreta medu (Mufananidzo 1a-e). Hapana nhoroondo yekuputa, chirwere cheshuga kana doro kunwa. Inogona kufamba isina chero inofamba.

Mufananidzo 1. Kufungidzira kwekufungidzira kwakaratidza kufambidzana kunopindirana kweltra-lracular kupwanya kweiyo distal radius.

A uye B: Exeperative X-Rays,

C uye D: Sagittal uye axial maonero ezvienzaniswi mifananidzo yemitambo,

E: 3D computt tomography mufananidzo. Dorsal Medial Lunate Facet Facgment uye Dorsal Apical Fradgs (White Asterisks) inoonekwa.

Kuvhiya maitiro

Takabata izvi zvakaputsika system ne adolar yekuvhara ndiro. Intraaopelaratily, takachema kuburikidza neDorrel Cortex uye yakasarudzwa screw kwenguva yakareba kuti tidzorere dortil cortox nekuti iyo dorsomdial Fragment yakanga isina kugadzikana (Mufananidzo 2).

• Kuvhiya kwakaitwa kuvhura yechitatu compartment mushure mekugadzirisa screw kugadzirisa.

• Sezvo iyo screw yakapinda kamuri yechitatu uye protruded (nhamba 3A), vhura zvizere nzvimbo yechitatu uye kufambisa iyo EPL Tendon kubva muGroove yayo (Mufananidzo 3B).

• Iyo yechitatu kamuri yakabva yavharwa nekutsiva iyo retinaculum (fig. 3c, d), uye iyo EPL Tendon yakaiswa pane yakagadziriswa retinaculum (Fig. 3 e).

• Mushure mekuvhiyiwa, murwere akaenda kukirinari rekunze kwechipatara yedu kusvikira pfupa raporeswa. Murwere haashuve kubvisa iyo hardware.

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Postoperative kupora

Makore manomwe mushure mekuvhiyiwa, murwere akadzokera kuchipatara kuti abvunze zvakare nekuongorora. Ruoko rworudyi haruna kuremara. X-Ray mufananidzo unoratidza kupwanya kupwanyika neDorsal Protrusion yeiyo distal yekuvhara screw screw. Chigunwe chemurwere chakawedzerwa zvizere, uye iyo EPL Tendon yakanga isina uta iri pachena.

Pakurumbidza kwedu, murwere akabvuma kubvisa hardware uye ongorora tendonsoror. Intranaperatively, takaongorora EPL Tendon kuburikidza neDornal Incision uye zvishoma yakavhurwa chetatu uye chechina carming.

Iyo EPL Tendon yaive kunze kweyechitatu compartment munzvimbo imwecheteyo sekushanda kwakapfuura, uye Tendon haina kutsamwiswa.

Isu takasimbisa kuti banga racho rakapinda mukamuri yechitatu apo iyo Extensor maindhoni eminwe akaendeswa.

Pakupedzisira, isu takarongedza tambo dzekutsigira dzikabvisa hardware. Pakuongororwa kwekupedzisira mwedzi miviri mushure mekubviswa kweiyo hardware, murwere airwadziwa akasununguka uye aive aine yakazara chigunwe chekuwedzera.

Kurukura

Mukusvika kwedu, mushure me vhoti plate yekugadziriswa kwe distal radius fantures, isu takavhura kiramu yechitatu kuburikidza nechisimba chingangoita 2 cm refu ulnar kune tubercle yeLister. Isu takaratidza zvakananga iyo EPL Tendon uye pasi pechikamu chechitatu chekuwedzera kuongorora nekubika zvinyoro-nyoro kudzosera iyo EPL Tendon.

Kana iyo screw yakapinda muchirongwa cheDortal muchitokisi chechitatu kana kuti yaive nemarara-marara-parietal marara Isu takabva tavhara iyo compartment nekutsiva iyo retinaculum apo kudzosera iyo EPL tendon pane yechitatu compartment.

Kana banga racho harina kuwedzera mukamuri yechitatu, takasiya EPL tendon mukuvhura kwechitatu compartment.

Maitiro edu ekuvhiya anobvumira kuongororwa kuri nyore kwe EPL Tendon kukuvara nekwakarukwa kutaridzika mune zvishoma semaminitsi gumi. Kana iyo EPL Tendon akakuvara, inogona kugadziriswa zvakananga. Maitiro aya anobatsira kudzivirira yechipiri EPL tendon kuputika mushure meraril radial ndiro. EPL Tendon Bowstring inogona kuitika, asi haina kuitika kwatiri.

Mumhedziso

Isu takasangana neiyo EPL Tendon aive aine makore manomwe emakore, kunyangwe zviyero zvinoshandiswa kugadzirisa mapuranga emavhasi aive akakurumbira mukamuri yechitatu. Maitiro edu ekuvhiya anoderedza njodzi ye EPL tendon bvisa mushure mevhoti plate fixation ye distal radius fractures.

Matenga sei kuti utenge orthopedic mispende uye zviridzwa zveOrthopedic?

For Czmeditech​ Spine Implants, intramedullary zvipikiri, Traumal Plate, Locking Plate, cranial-maxillofacial, prostisesa, Zvishandiso zvine simba, vekunze taxators, arthroscopy, kutarisirwa kwevaterinary uye yavo inotsigira chiridzwa.

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