Ibipimo bikunze gukoreshwa mu gupima imvune z’urukiramende rw’inyuma akenshi birimo inguni ya volar tilt (VTA), itandukaniro ry’urukiramende, n’uburebure bwa radial. Uko dusobanukirwa imiterere y’urukiramende rw’inyuma byarushijeho kwiyongera, ibindi bipimo by’ishusho nka anteroposterior distance (APD), teardrop angle (TDA), na capitate-to-axis-of-radius distance (CARD) byatanzwe kandi bikoreshwa mu buvuzi.
Ibipimo bikunze gukoreshwa mu gupima imvune za radius ya distal birimo: a：VTA；b：APD；c：TDA；d：CARD。
Ibipimo byinshi byo gupima bikwiriye kuvunika kwa radius ya distal extra-articular, nko kureba kwa radial na variance y'inyuma. Ariko, kuri bimwe mu bivunika bya intra-articular, nka Barton's fractures, ibipimo bisanzwe byo gupima bishobora kubura ubushobozi bwo kumenya neza ibimenyetso byo kubaga no gutanga ubuyobozi. Muri rusange bikekwa ko ikimenyetso cyo kubaga cya bimwe mu bivunika bya intra-articular gifitanye isano rya hafi n'izamuka ry'ubuso bw'ingingo. Kugira ngo harebwe urwego rwo kwimuka kw'ibivunika bya intra-articular, intiti z'abanyamahanga zatanze igitekerezo gishya cyo gupima: TAD (Tilt After Displacement), kandi byatangajwe bwa mbere kugira ngo harebwe ku bivunika bya posterior malleolus biherekejwe no kwimuka kwa tibial ya distal.
Ku mpera ya tibia, mu gihe habaye kuvunika kwa malleolus inyuma hamwe no kwimuka kw'inyuma kwa talus, ubuso bw'ingingo bukora imirongo itatu: Arc 1 ni ubuso bw'imbere bw'ingingo ya tibia iri kure, Arc 2 ni ubuso bw'inyuma bw'igice cya malleolus, naho Arc 3 ni hejuru ya talus. Iyo hari igice cy'inyuma cya malleolus giherekejwe no kwimuka kw'inyuma kwa talus, hagati y'uruziga rwakozwe na Arc 1 ku buso bw'imbere bw'ingingo yerekanwa nk'ingingo T, naho hagati y'uruziga rwakozwe na Arc 3 hejuru ya talus yerekanwa nk'ingingo A. Intera iri hagati y'ibi bice bibiri ni TAD (Tilt After Displacement), kandi uko kwimuka kuba gukomeye, niko TAD iba nyinshi.
Intego yo kubaga ni ukugira ngo igipimo cya ATD (Tilt After Displacement) kibe 0, bigaragaza ko ingingo zigabanuka.
Mu buryo nk'ubwo, mu gihe cyo kuvunika kwa volar Barton:
Uduce tw'ubuso bw'ingingo twakuweho igice dukora Arc 1.
Igice cya lunate gikora nk'Umurongo wa 2.
Igice cy'inyuma cy'umurambararo (igufwa risanzwe ridafite kuvunika) kigereranya Arc 3.
Buri gice cy’utu duce dutatu gishobora gufatwa nk’uruziga. Kubera ko igice cy’umunyu n’igice cy’igufwa rya volar byimuwe hamwe, Uruziga rwa 1 (mu ibara ry’umuhondo) rusangiye hagati n’Uruziga rwa 2 (mu ibara ry’umweru). ACD ihagarariye intera iri hagati y’iki gice cy’umunyu kugeza hagati y’Uruziga rwa 3. Intego yo kubaga ni ugusubiza ACD kuri 0, bigaragaza ko imiterere y’umubiri igabanuka.
Mu buvuzi bwa kera, byari byemewe cyane ko kugabanya igice cy’ingingo kiri munsi ya mm 2 ari cyo gipimo cyo kugabanya. Ariko, muri ubu bushakashatsi, isesengura rya curve ya Receiver Operating Characteristic (ROC) ry’ibipimo bitandukanye by’amashusho ryagaragaje ko ACD yari ifite agace kari hejuru cyane munsi y’icyerekezo (AUC). Hakoreshejwe agaciro ka 1.02mm kuri ACD, byagaragaje ubushobozi bwo kwiyumvisha 100% na 80.95% by’umwihariko. Ibi bigaragaza ko mu gihe cyo kugabanya imvune, kugabanya ACD kugeza kuri mm 1.02 bishobora kuba igipimo gikwiye kurushaho.
kurusha uburyo gakondo bwo gukata igice cy'inyuma cy'ingingo kiri munsi ya mm 2.
ACD isa nkaho ifite akamaro gakomeye mu gusuzuma urwego rw'ihindagurika ry'imivune yo mu ngingo zigize umutwe. Uretse ikoreshwa ryayo mu gusuzuma imvune zo mu gice cy'imbere cy'umutwe n'imvune zo mu gice cy'imbere cy'umutwe nk'uko byavuzwe mbere, ACD ishobora no gukoreshwa mu gusuzuma imvune zo mu nkokora. Ibi biha abaganga igikoresho cy'ingirakamaro cyo guhitamo uburyo bwo kuvura no gusuzuma ibisubizo byo kugabanya imvune.
Igihe cyo kohereza ubutumwa: 18 Nzeri 2023
