Distal radius fractures ndi imodzi mwazofala kwambirizothyokam'machitidwe azachipatala.Pazowonongeka zambiri za distal, zotsatira zabwino zochizira zimatha kupezeka kudzera pa mbale ya palmar ndi kukulunga mkati.Kuphatikiza apo, pali mitundu ingapo yapadera yama fractures a distal radius, monga Barton fractures, Die-punch fractures,Kusweka kwa oyendetsa galimoto, etc., chilichonse chimafuna njira zapadera zochiritsira.Akatswiri akunja, m'maphunziro awo a zitsanzo zazikulu za milandu ya distal radius fracture, apeza mtundu wina umene gawo la mgwirizanowu limaphatikizapo kupasuka kwa distal radius, ndipo zidutswa za mafupa zimapanga mawonekedwe a conical ndi "triangular" maziko (tetrahedron), amatchedwa "tetrahedron" mtundu.
Lingaliro la "Tetrahedron" Mtundu wa Distal Radius Fracture: Mu mtundu uwu wa distal radius fracture, fracture imapezeka mkati mwa gawo la mgwirizano, kuphatikizapo mbali zonse za palmar-ulnar ndi radial styloid, ndi kusintha kozungulira katatu.Mzere wosweka umafikira kumapeto kwa utali wa radius.
Kuphatikizika kwa fracture iyi kumawonekera m'magawo osiyanitsa a palmar-ulnar mbali za mafupa a radius.Kumbali imodzi, fossa ya mwezi yomwe imapangidwa ndi zidutswa za mafupa am'mbali za palmar-ulnar zimakhala ngati chithandizo chakuthupi polimbana ndi kusuntha kwa mafupa a carpal.Kutayika kwa chithandizo kuchokera ku kamangidwe kameneka kumapangitsa kuti volar asokonezeke pamgwirizano wa dzanja.Kumbali ina, monga gawo la distal radioulnar joint articular surface, kubwezeretsa chidutswa cha fupa ichi m'malo mwake ndi chofunikira kuti mubwezeretsenso kukhazikika kwa distal radioulnar joint.
Chithunzi chomwe chili pansipa chikuwonetsa Mlandu 1: Mawonekedwe amtundu wa "Tetrahedron" wamtundu wa distal radius fracture.
Pakufufuza kwa zaka zisanu, milandu isanu ndi iwiri ya mtundu uwu wa fracture idadziwika.Ponena za zizindikiro za opaleshoni, pazochitika zitatu, kuphatikizapo Mlandu wa 1 mu chithunzi pamwambapa, kumene poyamba kunali fractures zosasunthika, chithandizo chodziletsa chinasankhidwa poyamba.Komabe, panthawi yotsatiridwa, milandu itatu yonseyi idasokonezeka, zomwe zinachititsa kuti achite opaleshoni yokonza mkati.Izi zikusonyeza kusakhazikika kwakukulu komanso chiopsezo chachikulu cha kubwezeretsedwa kwa fractures zamtunduwu, kutsindika chisonyezero champhamvu cha opaleshoni.
Pankhani ya chithandizo, milandu iwiri poyambirira idadutsa njira yachikhalidwe ya volar ndi flexor carpi radialis (FCR) ya mbale ndi wononga mkati.Mu imodzi mwazochitikazi, kukonza kunalephera, zomwe zinachititsa kuti mafupa asamuke.Pambuyo pake, njira ya palmar-ulnar idagwiritsidwa ntchito, ndipo kukonza kwapadera komwe kumakhala ndi mbale yazazambiri kudachitika kuti iwunikenso gawo lapakati.Pambuyo pa kulephera kwa fixation, milandu isanu yotsatira yonse idadutsa njira ya palmar-ulnar ndipo idakhazikitsidwa ndi mbale za 2.0mm kapena 2.4mm.
Mlandu wa 2: Pogwiritsa ntchito njira yowonongeka ya volar ndi flexor carpi radialis (FCR), kukonza ndi mbale ya palmar kunachitika.Pambuyo pa opaleshoni, kusuntha kwapambuyo kwa mgwirizano wa dzanja kunawonedwa, kusonyeza kulephera kukonza.
Mlandu wachiwiri, kugwiritsa ntchito njira ya palmar-ulnar ndikukonzanso ndi mbale yazazambiri kunapangitsa kuti pakhale malo abwino okonzekera mkati.
Poganizira zofooka za mbale zothyoka za distal radius pokonza kachidutswa ka mafupa, pali zinthu ziwiri zazikulu.Choyamba, kugwiritsa ntchito njira ya volar ndi flexor carpi radialis (FCR) kungayambitse kuwonekera kosakwanira.Kachiwiri, kukula kwakukulu kwa zomangira zokhoma mbale za palmar sikungateteze ndendende tiziduswa ta mafupa ang'onoang'ono ndipo ting'onoting'ono ting'onoting'ono ting'onoting'ono ting'onoting'ono ting'onoting'ono ting'onoting'ono ting'onoting'ono ting'onoting'ono ting'onoting'ono ting'onoting'ono ting'onoting'ono ting'onoting'ono ting'onoting'ono polowetsa zomangira pakati pa zidutswazo.
Choncho, akatswiri amati agwiritse ntchito mbale zokhoma za 2.0mm kapena 2.4mm pofuna kukonza chigawo chapakati cha fupa.Kuphatikiza pa mbale yothandizira, kugwiritsa ntchito zomangira ziwiri kukonza fupa la fupa ndi kusokoneza mbale kuti muteteze zitsulo ndi njira ina yowonjezera mkati.
Pamenepa, mutatha kukonza fupa la fupa ndi zomangira ziwiri, mbaleyo inayikidwa kuti iteteze zitsulo.
Mwachidule, mtundu wa "Tetrahedron" distal radius fracture umawonetsa izi:
1. Kuchepa kwapang'onopang'ono koyambitsa matenda olakwika afilimu.
2. Chiwopsezo chachikulu cha kusakhazikika, ndi chizoloŵezi chothamangitsidwa panthawi ya chithandizo chokhazikika.
3. Ma mbale otsekera a palmar okhazikika a distal radius fractures amakhala ndi mphamvu zokhazikika zofooka, ndipo tikulimbikitsidwa kugwiritsa ntchito mbale zokhoma 2.0mm kapena 2.4mm kuti zikhazikike.
Potengera makhalidwe amenewa, m’zachipatala, ndi bwino kupanga sikani ya CT kapena kuyezanso nthawi ndi nthawi kwa odwala omwe ali ndi zizindikiro zazikulu za m’manja koma ma X-ray oipa.Kwa mtundu uwu wakusweka, kulowetsedwa koyambirira kwa opaleshoni ndi mbale yeniyeni ya khola kumalimbikitsidwa kuti tipewe zovuta pambuyo pake.
Nthawi yotumiza: Oct-13-2023
