Njira yotsogozedwa ndi Ultrasound "yokulitsa zenera" imathandizira kuchepetsa kuphulika kwa distal radius pa volar mbali ya olowa.

Chithandizo chodziwika bwino cha distal radius fractures ndi njira ya volar Henry pogwiritsa ntchito mbale zokhoma ndi zomangira zokhazikika mkati.Panthawi yokonza mkati, sikofunikira kutsegula kapisozi wa radiocarpal joint.Kuchepetsa kophatikizana kumatheka kudzera mu njira yosinthira kunja, ndipo intraoperative fluoroscopy imagwiritsidwa ntchito poyesa kulumikizana kwapamtunda.Pazochitika za intra-articular depressed fractures, monga Die-punch fractures, kumene kuchepetsa kwachindunji ndi kuwunika kumakhala kovuta, zingakhale zofunikira kugwiritsa ntchito njira ya dorsal kuti ithandize kuwonetsera mwachindunji ndi kuchepetsa (monga momwe tawonetsera m'munsimu).

Mitsempha yakunja ndi minyewa yapakatikati ya cholumikizira cha radiocarpal imawonedwa ngati zinthu zofunika kwambiri kuti dzanja likhale lolimba.Ndi kupita patsogolo kwa kafukufuku wa anatomical, zapezeka kuti, pansi pa chikhalidwe cha kusunga umphumphu wafupipafupi wa radiolunate ligament, kudula mitsempha ya kunja sikungopangitsa kuti dzanja likhale losakhazikika.

Choncho, muzochitika zina, kuti muwone bwino malo ogwirizanitsa, pangakhale kofunikira kuti muchepetse mitsempha ya kunja, ndipo izi zimatchedwa volar intraarticular extended window approach (VIEW).Monga momwe chithunzi chili pansipa:

Chithunzi AB: Mu njira yodziwika bwino ya Henry yowonetsera fupa la distal radius, kuti athe kupeza kugawanika kwa mbali ya distal radius ndi scaphoid facet, kapisozi wolowa m'manja amayikidwa poyamba.Retractor imagwiritsidwa ntchito kuteteza mitsempha yayifupi ya radiolunate.Pambuyo pake, ligament yayitali ya radiolunate imadulidwa kuchokera kumtunda wakutali kupita ku mbali ya ulnar ya scaphoid.Panthawiyi, kuyang'ana kwachindunji kwa malo ophatikizana kungatheke.

Chithunzi CD: Pambuyo powulula malo olowa, kuchepetsedwa kwa ndege ya sagittal yofooketsa malo olowa kumachitidwa poyang'ana mwachindunji.Ma elevator a mafupa amagwiritsidwa ntchito kuwongolera ndi kuchepetsa zidutswa za fupa, ndipo mawaya a 0.9mm Kirschner angagwiritsidwe ntchito kukonza kwakanthawi kapena komaliza.Malo olowawo akachepetsedwa mokwanira, njira zokhazikika zopangira mbale ndi zomangira zimatsatiridwa.Pomaliza, zodulira zomwe zidapangidwa mu ligament yayitali ya radiolunate ndi kapsule yolumikizana pamanja ndi sutured.

Maziko ongoyerekeza a njira ya VIEW (volar intraarticular extended window) agona pakumvetsetsa kuti kudula minyewa yakunja kwa dzanja sikutanthauza kusagwirizana kwa dzanja.Choncho, tikulimbikitsidwa kuti pakhale zovuta zina za intra-articular comminuted distal radius fractures komwe kuchepetsa malo olumikizana ndi fluoroscopic kumakhala kovuta kapena ngati pali zotsika.Njira ya VIEW imalimbikitsidwa kwambiri kuti ikwaniritse kuwonetseratu kwachindunji panthawi yochepetsera zochitika zoterezi.