Ku phatluka ka extensor tendon endzhaku ka volar plate fixation switshama swiri xiphiqo lexikulu eka ku lunghisiwa ka distal radius fractures. Tendon leyi khumbekaka ngopfu i extensor pollicis longus (EPL) tendon, tani hileswi yi pfaleriwaka endzeni ka groove ya EPL. Ku humelela loku vikiweke ka ku phatluka ka EPL tendon endzhaku ka volar plating i 0.29%–5.7%.
Khombo ra ku hlwela ka ku phatluka ka EPL tendon ri engeteleka eka vukona bya dorsal screw protrusion, ku vaviseka ku suka eka ku bora hi ku kongoma ka le ndzeni ka vuhandzuri, na swiphemu swa le henhla swa le ndzhaku, ngopfu-ngopfu eka ku tshoveka ka xihlala xa Lister’s tubercle. Ku kamberiwa ka radiographic ka ku humelela ka swikwirikiri eka ku tshoveka ka radius ya le kule swa tika hikwalaho ka geometry yo rharhangana ya radius ya le kule na vuswikoti bya ku tshoveka ka dorsal loku nga na minete. Dorsal tangential view hi yona ntsena leyi kotekaka ya intravital view ya dorsal radial cortex ku kuma nkambisiso wo tshembheka wa mpfhuka exikarhi ka tip ya screw na dorsal cortex.
Tithekiniki to papalata ku vaviseka ka extensor tendon ti katsa ku tirhisiwa ka swikwirikiri swa monocortical na ku papalata ku nghena ka le henhla ka dorsal; Hambiswiritano, tindlela leti ti nga ha hunguta ku tiya ka michini ya ku lunghisa ku tshoveka ka marhambu. Hikwalaho, ku khomiwa ka bicortical minkarhi yin’wana swa laveka. Ku hunguta khombo ra ku vaviseka ka extensor tendon, tipakani to sungula ta ku khomiwa hi ku tshoveka na ku tshamiseka a ti fanelanga ku tekeriwa ehansi.
Maendlelo Lamantshwa Ya Vuhandzuri .
Hi hlamusela thekiniki ya novhele ku hunguta khombo ra ku phatluka ka EPL tendon endzhaku ka volar plate fixation ya distal radius fractures handle ko pfuxeta ku leha ka screw kumbe ku susa swiphemu swa dorsal roof. Hi ku komisa, endlelo leri ri katsa ku pfula xiphemu xa vunharhu hi ku tirhisa xiphemu lexitsongo xa le ndzhaku.
Loko xikurufu a xi nghene eka dorsal cortex xi tlhela xi humela ehandle eka xiyenge xa vunharhu: hi susile EPL tendon eka groove ya yona ivi hi pfala xivandla hi ku rhungiwile retinaculum yi siya EPL tendon eka retinaculum leyi lunghisiweke.
Loko xikurufu xi nga andlali eka xiyenge xa vunharhu: hi siya EPL tendon eka xiyenge xa vunharhu. Xikombiso xa thekiniki ya hina i eka vavabyi lava nga na ku tshoveka ka radius ya le kule loku tshunguriweke hi tipuleti to pfala ta volar, ku tshoveka hi swiphemu swa dorso-parietal kumbe swikwirikiri leswi nga nghenaka eka dorsal cortex kumbe ku onha EPL tendon ku rhendzela tubercle ya lister. Eka vavabyi lava nga na ku tshoveka ka distal radius na swiphemu swa dorsomedial, hi bora timbobo ku nghena eka dorsal cortex na ku hlawula swikwirikiri swa ku leha loku eneleke ku lulamisa swiphemu swa dorsomedial leswi nga tshamisekangiki.
Ku avelana ka timhaka .
Hi avelana mhaka leyi eka yona EPL tendon yi susiweke eka xiyenge xa vunharhu hikwalaho ka ku humelela ka xikurufu eka xiyenge xa vunharhu hi nkarhi wa ku vekiwa ka plate ya comminuted distal radius fracture na swiphemu swa dorsomedial. Hi tiyisisile leswaku EPL tendon a yi nga onhakanga 7 wa malembe endzhaku ka vuhandzuri, hambi leswi xikurufu a xi vonaka ngopfu eka xiyenge xa vunharhu.
Mhaka leyi a ku ri ya xisati ya malembe ya 67 hi vukhale leyi nga na vukamberi bya intra-articular unstable distal radius fracture na right dorsal medial fracture (Xifaniso 1A-E). Ku hava matimu ya ku dzaha fole, vuvabyi bya chukele kumbe ku nwa byala. Swi nga famba handle ka mufambi wihi na wihi.
![Ku tshoveka ka radius ya le kule .]()
Xifaniso 1. Ku tekiwa ka swifaniso swa le mahlweni ka vuhandzuri swi kombisile ku tshoveka ka le ndzeni ka xirho xa le ndzeni ka khwiri loku ringanaka ka radius ya le kule.
A na B: X-rheyi ya le mahlweni ka vuhandzuri, .
C na D: swivono swa sagittal na axial swa swifaniso swa tomography leswi hlayiweke, .
E: Xifaniso xa 3D xa xivumbeko xa tomography. Swiphemu swa dorsal medial lunate facet na swiphemu swa dorsal apical (white asterisks) swa vonaka.
thekiniki ya vuhandzuri .
Hi khome fambiselo leri ra ku tshoveka hi volar locking plate. Hi ku tirhisa vuhandzuri, hi borile hi le ka dorsal cortex ivi hi hlawula xikurufu xo leha ku ringana ku tiyisisa dorsal cortex hikuva xiphemu xa dorsomedial a xi nga tshamisekanga (Xifaniso 2).
Vuhandzuri byi endliwile ku pfula xiyenge xa vunharhu endzhaku ko khomiwa hi swikwirikiri.
Tanihi leswi xikurufu xi ngheneke eka xiyenge xa vunharhu naswona xi humeke (Xifaniso 3a), pfula hi ku helela xiyenge xa vunharhu ivi u susa EPL tendon eka groove ya xona (Xifaniso 3B).
Kutani xiyenge xa vunharhu xi pfariwile hi ku rhunga retinaculum (Fig. 3C,D), naswona EPL tendon yi vekiwile ehenhla ka retinaculum leyi lunghisiweke (Fig. 3 E).
Endzhaku ka vuhandzuri, muvabyi u ye etliliniki ya vavabyi lava nga le handle ka xibedlhele xa hina kukondza marhambu ma hola. Muvabyi a nga swi lavi ku susa hardware.
Ku hola endzhaku ka vuhandzuri .
Endzhaku ka malembe ya nkombo ku endliwe vuhandzuri, muvabyi u tlhelele exibedlhele leswaku a ya kamberiwa nakambe hikwalaho ka ku tsana ka marhambu. Voko ra xinene a ri nga ri na vulema. Xifaniso xa X-rheyi lexi kombisaka ku tshoveka loku hanyeke hi ku humela ehandle ka dorsal ka distal locking screw. Xikunwana xa muvabyi a xi andlariwile hi ku helela, naswona EPL tendon a yi nga ri na ntambhu ya vurha leyi nga erivaleni.
Hi xitsundzuxo xa hina, muvabyi u pfumerile ku susa hardware ni ku kambisisa ti- extensor tendon. Hi ku tirhisa vuhandzuri, hi kambisisile EPL tendon hi ku tirhisa dorsal incision naswona hi xiphemu hi pfule xiyenge xa vunharhu na xa vumune.
EPL tendon a yi ri ehandle ka xiyenge xa vunharhu eka xiyimo lexi fanaka ni xa ntirho lowu hundzeke, naswona tendon a yi hlundzukisiwanga.
Hi tiyisisile leswaku xikurufu xi nghene eka xiyenge xa vunharhu loko ti extensor tendons ta tintiho ti tlheriseriwa endzhaku.
Eku heteleleni, hi lulamise swirhangiso swa nseketelo ivi hi susa hardware. Eka nkambisiso wo hetelela wa tin’hweti ta 2 endzhaku ko susiwa ka hardware, muvabyi a a nga ri na switlhavi naswona a a ri na ku engeteriwa ka xikunwana lexi heleleke.
Kanela
Eka maendlelo ya hina, endzhaku ka volar plate fixation ya distal radius fractures, hi pfule xiphemu xa xiyenge xa vunharhu hi ku tirhisa incision kwalomu ka 2 cm yo leha ulnar eka tubercle ya lister. Hi kumile hi ku kongoma EPL tendon na fuloro ya xiyenge xa vunharhu xa extensor hi ku tlherisela endzhaku hi vukheta EPL tendon.
Loko xikurufu xi nghene eka dorsal cortex eka xiyenge xa vunharhu kumbe xi ri na Dorso-Parietal Debris, a hi endlanga ku cinciwa ka swikwirikiri swa le ndzeni ka vuhandzuri kumbe ku tsemiwa ka swirho swa miri, kambe hi pfule hi ku helela xiyenge xa vunharhu ivi hi susa EPL tendon eka groove ya xona. Hiloko hi pfala xigwitsirisi hi ku rhunga retinaculum loko hi ri karhi hi tlhela hi veka EPL tendon eka xiyenge xa vunharhu.
Loko xikurufu xi nga anamanga xi nghena eka xiyenge xa vunharhu, hi siye EPL tendon eka xiyenge xa vunharhu lexi pfuriweke hi xiphemu.
Thekiniki ya hina ya vuhandzuri yi pfumelela ku kamberiwa ko olova ka ku vaviseka ka EPL tendon hi ku vona hi ku kongoma hi ku kongoma hi timinete ti nga ri tingani ta 10. Loko EPL tendon yi vavisekile, yi nga lunghisiwa hi ku kongoma. Endlelo leri ri pfuneta ku sivela ku phatluka ka secondary EPL tendon endzhaku ka distal radial plate fixation. EPL tendon bowstring yinga humelela, kambe ayi humelelanga eka mhaka ya hina.
Hi ku gimeta .
Hi vile na mhaka leyi eka yona EPL tendon a yi nga onhakanga 7 years postoperatively, hambi leswi swikwirikiri leswi tirhisiweke ku lulamisa volar plate a swi vonaka ngopfu eka xiyenge xa vunharhu. Thekiniki ya hina ya vuhandzuri yi hunguta khombo ra ku phatluka ka EPL tendon endzhaku ka volar plate fixation eka distal radius fractures.
Ndlela Yo Xava Switirhisiwa Swa Marhambu Na Switirhisiwa Swa Marhambu.
Swa CzMediTech , hi na layini ya swikumiwa leyi heleleke swinene ya switirhisiwa swa vuhandzuri bya marhambu na switirhisiwa leswi fambelanaka na swona, switirhisiwa ku katsa na . Swilo leswi nghenisiwaka hi nkolo ., Swipikiri swa le ndzeni ka khwiri ., Xiphepherhele xa khombo ., Xiphepherhele xo pfala ., Cranial-maxillofacial ., Prosthesis ., Switirhisiwa swa Matimba ., Vahlayisi va le handle ., Arthroscopy ., Nkhathalelo wa Swiharhi na tisethi ta vona ta switirhisiwa swo seketela.
Ku engetela kwalaho, hi tiyimiserile ku ya emahlweni hi tumbuluxa swikumiwa leswintshwa na ku ndlandlamuxa milayeni ya swikumiwa, leswaku hi ta fikelela swilaveko swa vuhandzuri bya madokodela yo tala na vavabyi, na ku tlhela hi endla leswaku khamphani ya hina yi phikizana swinene eka indasitiri hinkwayo ya misava hinkwayo ya marhambu ya marhambu na switirhisiwa.
Hi rhumela ehandle emisaveni hinkwayo, leswaku u ta kota ku . Tihlanganisi na hina eka adirese ya email song@orthopedic-china.com ku kuma xikombelo xa mahala, kumbe u rhumela rungula eka WhatsApp ku kuma nhlamulo ya xihatla +86- 18112515727 .
Loko u lava ku tiva vuxokoxoko byo tala,Tiklika . CzMediTech ku kuma vuxokoxoko byo tala.
