Njira yowunikira yotsogozedwa ndi ultrasound imathandiza kuchepetsa kusweka kwa ma radius a distal pa volar aperture ya joint.

Chithandizo chofala kwambiri cha kusweka kwa distal radius ndi njira ya volar Henry pogwiritsa ntchito ma lock plates ndi zomangira kuti zikhazikike mkati. Pa nthawi yokonza mkati, nthawi zambiri sikofunikira kutsegula kapisozi ya radiocarpal joint. Kuchepetsa mafupa kumachitika kudzera mu njira yowongolera yakunja, ndipo fluoroscopy ya mkati mwa opaleshoni imagwiritsidwa ntchito poyesa kulumikizana kwa malo olumikizirana. Pankhani ya kusweka kwa intra-articular, monga kusweka kwa Die-punch, komwe kuchepetsa ndi kuwunika kosalunjika kumakhala kovuta, kungakhale kofunikira kugwiritsa ntchito njira ya dorsal kuti ithandize kuwona mwachindunji ndi kuchepetsa (monga momwe tawonetsera pachithunzi pansipa).

Mitsempha yakunja ndi mitsempha yamkati ya cholumikizira cha radiocarpal zimaonedwa kuti ndizofunikira kwambiri pakusunga chigwirizano cha dzanja. Chifukwa cha kupita patsogolo kwa kafukufuku wa kapangidwe ka thupi, zapezeka kuti, poteteza umphumphu wa ligament yayifupi ya radiolunate, kudula mitsempha yakunja sikuti kumabweretsa kusakhazikika kwa chigwirizano cha dzanja.

Chifukwa chake, nthawi zina, kuti muwone bwino malo olumikizirana, kungakhale kofunikira kudula pang'ono ma ligaments akunja, ndipo izi zimadziwika kuti njira yotsegulira zenera (VIEW) ya volar intraarticular. Monga momwe chithunzi chili pansipa chikusonyezera:

Chithunzi AB: Mu njira yachizolowezi ya Henry yowonetsera pamwamba pa fupa la distal radius, kuti mupeze kusweka kogawanika kwa distal radius ndi scaphoid facet, kapisozi ya joint joint imadulidwa poyamba. Chobwezera chimagwiritsidwa ntchito kuteteza ligament yaifupi ya radiolunate. Pambuyo pake, ligament yayitali ya radiolunate imadulidwa kuchokera ku distal radius kupita kumbali ya ulnar ya scaphoid. Pakadali pano, kuwona mwachindunji pamwamba pa joint kumatha kuchitika.

Chithunzi CD: Pambuyo poika malo olumikizirana, kuchepetsa malo olumikizirana omwe ali pansi pa sagittal plane kumachitika poyang'ana mwachindunji. Ma elevator a mafupa amagwiritsidwa ntchito kusintha ndikuchepetsa zidutswa za mafupa, ndipo mawaya a Kirschner a 0.9mm angagwiritsidwe ntchito polumikiza kwakanthawi kapena komaliza. Malo olumikizirana akachepetsedwa mokwanira, njira zokhazikika zolumikizira mbale ndi screw zimatsatiridwa. Pomaliza, kudula komwe kumachitika mu ligament yayitali ya radiolunate ndi capsule ya joint ya dzanja kumakokedwa.

Maziko a chiphunzitso cha njira ya VIEW (volar intraarticular extended window) ali pakumvetsetsa kuti kudula ma ligaments ena akunja kwa chigongono sikuti kumabweretsa kusakhazikika kwa chigongono. Chifukwa chake, ndikofunikira pa ma fractures ena ovuta a intra-articular distal distal omwe ali mkati mwa chigongono komwe kuchepetsa pamwamba pa chigongono kumakhala kovuta kapena pamene pali ma step-offs. Njira ya VIEW ikulangizidwa kwambiri kuti ikwaniritse bwino mawonekedwe olunjika panthawi yochepetsa pazochitika zotere.