Pakadali pano pakusintha kwamkati kwa ma radius a radius, pali mitundu yosiyanasiyana ya matatomical yokhotakhota yomwe imagwiritsidwa ntchito kuchipatala. Zosintha zamkatizi zimapereka njira yabwinoko yamitundu ina yovuta kuwonongeka, ndipo muwonjezere njira zina zosonyezera zopaleshoni zosakhazikika pazosakhazikika, makamaka iwo omwe ali ndi mafupa. Pulofesa Jupiter kuchokera ku Massachusetts Holly Holly Holly Horsert of JBJs pa zomwe apeza pa zomwe adapeza potuta zamiyala yopaka ndi njira zopatsirana. Nkhaniyi ikunena za kuwongolera kwa opaleshoni kuti mukonzekere zosokoneza bongo zochokera pakusintha kwamkati kwa chotchinga.
Njira Zopaleshoni
Malingaliro atatu ophatikizira, kutengera ma biomechal a komanso otomical a radius ya ulnar, ndiye maziko a chitukuko ndi matenda a chitukuko cha 2.4mm plate. Kugawika kwa mizere itatu kumawonetsedwa mu Chithunzi 1.
Mkuyu. 1 chiphunzitso chofanana ndi cholumikizira cha ulnar.
Mbali yofananira ndi theka la radius yofalitsira, kuphatikizapo mwana wakhanda wa Navpal, yemwe amathandizira mafupa a Carpal pazenera ndipo ndikuyambiranso ma ligial ena omwe amakhazikika.
Nyanja yapakati ndi theka la gawo logawika ndipo limaphatikizaponso fossate (yolumikizidwa ndi nthose) ndi sigmoid nonch (yolumikizidwa ndi ulna wapamwamba) pamtunda wa ulna. Nthawi zambiri odzaza, katundu kuchokera ku fossa fossa amafalikira pa radius kudzera pa fossate fossa. ULNAR yotsatira gawo la ulnar, lomwe limaphatikizapo kusokonekera kwa ulna, ulusi wa ulnar-radial, umanyamula mapyala a ulnar carpal komanso kuchokera ku zotsatira za ulnar-radiwal ndipo ali ndi mphamvu yolimba.
Njira yochitidwa pansi pa brachial slexus mankhwala opaleshoni ndi intrative C-mkono X-ray ndiyofunikira. Maantibayotiki am'mimba adaperekedwa osachepera mphindi 30.
Kukhazikika kwa Plmar
Kwa kutchuka kwambiri, njira za Palmar zitha kugwiritsidwa ntchito powona pakati pa zotupa za carpal ndi maluso owoneka bwino. Pambuyo pozindikiritsa ndikutha kuvota Feraxr Carpi Radis Futus, mawonekedwe akuya a minofu ya tes amawoneka ndi "L" kulekanitsidwa kumachotsedwa. M'magazi ovuta kwambiri, tendochi ya brachioradials ikhoza kutulutsidwa kuti ithandizire kuchepetsa kuchepa kwa moto.
Pini ya Kirschner imayikidwa mu radial carpal yolumikizira, yomwe imathandizira kutanthauzira malire a radius. Ngati misa yaying'ono yopanda pake ilipo, palmar 2,4m steel mbale ikhoza kuyikidwa malire pamphepete mwa radius yokonzekera. Mwanjira ina, kuchuluka kakang'ono kazinthu zamphamvu kwa ronate kungathandizire ndi 2.4mm "l" kapena "mbale, monga tikuonera Chithunzi 2.
Chifukwa cha zowonjezera zowonjezereka zowonjezera, ndizothandiza kudziwa mfundo zotsatirazi. Choyamba, ndikofunikira kuti mubwezeretse kwakanthawi kusokonekera kuti muwonetsetse kuti palibe minofu yofewa yomwe ili kumapeto. Kachiwiri, odwala popanda osteoperosis, kuwonongeka kwa mbale: Choyamba, malingaliro otsetsereka amasandukanso, kenako, zomangira zina zimachepetsedwa
Chithunzi 3 Zowonjezera-zolimba kwambiri za radius yosungirako zosasowa ndalama zimachepetsedwa ndikukhazikika kudzera pamwambo wa Palmar. Chithunzi 3-AD Mukamaliza kuwonetsedwa kudzera mu radial carpal komanso masiketi owoneka bwino, pini yosalala ya maklechner imayikidwa mu plapal carpal. Chithunzi cha 3-B chomwe chimadana ndi cortecalpal kuti chizikonzanso.
Chithunzi 3-C ndi Chithunzi 3-da osalala materschner pini ya radial kudzera pamzere wowoneka bwino kuti muchepetse kutha kwakanthawi.
Mkuyu. 3-e wowoneka bwino wa mundawo umakwaniritsidwa pogwiritsa ntchito cholembera chisanachotseko. Chithunzi 3-f Kufatsa mzere wokhomerera kumayikidwa pafupi ndi fupa la subchondral kumapeto kwa khola.
Chithunzi 3-g x-ray fluoroscopy iyenera kugwiritsidwa ntchito kutsimikizira mawonekedwe a zomata ndi zopumira. Chithunzi 3-H Chithunzi 3-ndimalimbikimbitsa cholembera cholembedwachi kuti mukonzenso za Palmar. Chotsani pini ya Kirschner isanafike polimba.
Ziwerengero za 3-j ndi 3-k intratiatic radiographic zithunzi zimatsimikizira kuti kuwonongeka kumayambiriro ndipo zonunkhira za mbalezi zidakhazikitsidwa mokhutiritsa.
Kukhazikitsa Kwapa Place Kukhazikitsa Kuchita Zochita Zochita Zochita Zapamwamba za radius ya dials zimatengera mtundu wa kusokonekera, ndipo pakakhala kuwonongeka kwa ma intra-a intraal nthawi zambiri. Pakatikati, magulu othandizira owonjezera ayenera kukhala ndi ndalama zazikuluzikulu: Kutalika kwa magawo 2 ndi 3, ndi gawo lowonjezerapo, ndi gawo lowonjezerapo ku chipinda cha 4 ndikusinthanso tendon yomwe ikugwirizana; Kapenanso gulu lachiwiri lothandizira pakati pa 1th ndi 5th zowonjezera zowonjezera kuti muwonetsetse mizati iwiri payokha (mkuyu. 4).
Kuwonongeka kumangirizidwa ndikukhazikika kwakanthawi ndi pini yosawerengeka ya Killiner, ndipo zithunzi za radiographic zimatengedwa kuti kuwonongeka kumatha. Kenako, ulnar ulnar (pakati pa mzere wa radius umakhazikika ndi 2.4 mm "l" kapena "t" mbale. Pulogalamu ya dornal ulnar imapangidwa kuti iwonetsetse bwino kumbali ya dornal ulnar ulnar kumbali ya radius. Ma mbale amathanso kuyikidwa pafupi ndi gawo loyambira la nthochi momwe angathere, monga momwe mitengo yofananira pamtengo uliwonse imalola kuti mbale zisagwedezeke ndikuwononga mabowo a screw (mkuyu. 5).
Kukonzekera kwa mbale ya radial kuti ndi yosavuta, monga fupa lamkati pakati pa chipinda choyambirira ndi chachiwiri ndi lathyathyathya ndipo imatha kukhazikitsidwa ndi mbale iyi ndi mbale yometedwa bwino. Ngati pini ya Kirschner imayikidwa mu gawo lakudulidwa kwakuti, kumapeto kwa mtengo wa radial mulingo womwe umafanana ndi mapiko a Kirschner, omwe samasokoneza kwambiri.
Mkuyu. 4 kuwonekera kwa malo opangira ma radius osokoneza. Gulu la othandizira limatsegulidwa kuchokera ku chipinda chachitatu chowonjezera komanso chowonjezera chapamwamba chautali cha Haltuus abwereranso.
Mkuyu. 5 pokonzanso gawo lazomwe zangoyikidwapo, t "t" kapena "l" nthawi zambiri limapangidwa (mkuyu. 5-b). Kamodzi mbale yopanda maluso a lountate yatetezedwa, mbale ya radial atetezedwa (zithunzi 5-c kudzera 5-f). Mbale ziwirizi zimayikidwa pamalo okwanira madigiri 70 kwa wina ndi mnzake kusintha kukhazikika kwa kukonzekera kwamkati.
Mkuyu. Mafuta a radial apangidwe bwino ndikuyikidwa mu mzere wa radial, ndikuyika chikwangwani kumapeto kwa pini, zomwe zimalola kuti mbaleyo mupewe pini yopanda mapiko.
Malingaliro Ofunika
Zisonyezo za kukhazikitsidwa kwa metacarpal
Kutalika kwa metacacal intracal inracular (Bertives a Barton)
Zowonjezera zowonjezera zowonjezera (Colles ndi Smith fracrate). Kukhazikika kokhazikika kumatha kuchitika ndi ma mbale obwera ngakhale pamaso pa mafupa.
Anatulukira ku Metacarpal Lunricular Fractures
Zisonyezo za kukhazikika kwa dorsal
Ndi kuvulala kwasinthasintha kwa nthawi yayitali
Otayidwa ndi zolumikizira zolumikizira
Mobwerezabwereza amachepetsa radial carpal ophatikizidwa
Contraindication ku Phreate Kukhazikika
Zowopsa zoopsa ndi zolephera zofunikira
Dorsal radial Hist Frectocation
Kukhalapo kwa mankhwala angapo azachipatala
Contraindication ku Dorsel Plate
Mankhwala angapo azachipatala
Zopanda Zosasinthika
Zolakwika zopangidwa mosavuta mu ma plate
Malo opangira mbaleyo ndi ofunika kwambiri chifukwa samangothandiza kwambiri kuti azikhala ndi vuto la kuwonongeka, koma malo oyenera amalepheretsanso malo otsetsereka kuti asatenge gawo lokola la carpal. Ma radiograography yovuta yoyatsirana, yotsimikizika mbali yomweyo monga zongolowetsa radius ya distal, iloleni kuwoneka kolondola kwa mbali ya radial ya radius ya distal, yomwe imatha kukhala yowoneka bwino poika ma screws a Ulnar kaye.
Kulerera kwa corsel korsel corterx kumakhala ndi chiopsezo choyambitsa tendon yowonjezera ndikugwetsa tendon. Zomangira zotsekemera zimachita mosiyanasiyana kuchokera pamayendedwe abwinobwino, ndipo sizofunikira kulowa mu dortex cortex yokhala ndi zomangira.
Zolakwika zimapangidwa mosavuta ndi kukonzanso kwadongosolo
Nthawi zonse pamakhala chiopsezo cholowera chamtengo wapatali cha carpal, komanso chofanana ndi njira yomwe tafotokozayi mogwirizana ndi mbale ya palmar, kuwombera kwa oblique kuyenera kutengedwa kuti adziwe ngati malo obisika ali otetezeka.
Ngati kukonzekera kwa mzere wa radial kumachitika koyamba, zomangira mu chisamaliro cha rader chidzakhudza kuwunika kwa mawonekedwe a articular kumayambiranso.
Zomangira zosagawanika zomwe sizikukakamizidwa kwathunthu mu bowo lanu limatha kusokoneza tendon kapena chifukwa cholema.
Post Nthawi: Disembala-28-2023
