Ikoreshwa cyane ryerekana amashusho mugusuzuma ibice bya radiyo ya kure mubisanzwe harimo volar tilt angle (VTA), ulnar variance, hamwe nuburebure bwa radiyo. Nkuko twasobanukiwe na anatomiya ya radiyo ya kure yarushijeho kwiyongera, hiyongereyeho ibipimo byerekana amashusho nka intera ya anteroposterior (APD), inguni y'amarira (TDA), hamwe na capitate-to-axis-ya-radiyo (CARD) byasabwe kandi bikoreshwa mubikorwa byubuvuzi.
Ibice bikoreshwa mumashusho mugusuzuma ibice bya radiyo ya kure birimo: a TA VTA ; b : APD ; c : TDA ; d : CARD。
Ibice byinshi byerekana amashusho birakwiriye kuvunika-kure cyane ya radiyo ivunika, nkuburebure bwa radiyo na ulnar variance. Ariko, kubice bimwe byavunitse imbere, nkibice bya Barton, ibipimo byerekana amashusho gakondo birashobora kubura mubushobozi bwabo bwo kumenya neza ibimenyetso byo kubaga no gutanga ubuyobozi. Muri rusange abantu bemeza ko kubaga ibimenyetso bimwe na bimwe bivunika imbere-bifitanye isano rya bugufi no kuva hejuru yubuso. Mu rwego rwo gusuzuma urugero rwo kwimura imvune zo mu nda, intiti z’amahanga zasabye ibipimo bishya byo gupima: TAD (Tilt After Displacement), kandi byatangajwe bwa mbere kugira ngo hasuzumwe ibice byavunitse bya malleolus biherekejwe no kwimura tibial kure.
Ku mpera ya kure ya tibia, mugihe habaye kuvunika kwa malleolus inyuma hamwe no kwimura inyuma ya talus, ubuso buhuriweho bugira arc eshatu: Arc 1 nubuso bwimbere bwimbere ya tibia ya kure, Arc 2 nubuso buhuriweho nigice cya malleolus, naho Arc 3 ni hejuru ya talus. Iyo hari agace kavunitse ka malleolus gaherekejwe no kwimura inyuma ya talus, hagati yuruziga rwakozwe na Arc 1 hejuru yinyuma yinyuma rwerekanwa nkingingo ya T, naho hagati yuruziga rwakozwe na Arc 3 hejuru ya talus rwerekanwa nkingingo A. Intera iri hagati yibi bigo byombi ni TAD (Kwimura nyuma yo kwimurwa), kandi nini nini yo kwimurwa).
Intego yo kubaga ni ukugera kuri ATD (Tilt After Displacement) agaciro ka 0, byerekana kugabanuka kwa anatomicike yubuso.
Mu buryo nk'ubwo, kubijyanye no kuvunika kwa volar Barton:
Ibice byimuwe igice cyimiterere yibice bigize Arc 1.
Igice cyamahirwe gikora nka Arc 2.
Ibice bya dorsal ya radiyo (igufwa risanzwe ridafite kuvunika) ryerekana Arc 3.
Buri kimwe muribi bitatu arc gishobora gufatwa nkuruziga. Kubera ko igice cyamahirwe nigice cyamagufwa ya volar cyimuwe hamwe, Uruziga 1 (mumuhondo) rusangira rwagati rwuruziga 2 (rwera). ACD yerekana intera iri hagati yiki kigo gisangiwe kugera hagati yuruziga 3. Intego yo kubaga ni ukugarura ACD kuri 0, byerekana kugabanuka kwa anatomique.
Mubikorwa byubuvuzi byabanje, byemewe cyane ko guhurira hamwe hejuru ya <2mm aribwo buryo bwo kugabanya. Nyamara, muri ubu bushakashatsi, isesengura rya Receiver Operating Characteristic (ROC) isesengura ryibice bitandukanye byerekana amashusho byerekanaga ko ACD yari ifite umwanya muremure munsi yumurongo (AUC). Ukoresheje igabanywa rya 1.02mm kuri ACD, ryerekanye 100% sensitivite na 80.95%. Ibi birerekana ko mugihe cyo kugabanya kuvunika, kugabanya ACD kugeza muri 1.02mm bishobora kuba ingingo yumvikana
kuruta ibipimo gakondo bya <2mm ihuriweho hejuru-intambwe.
ACD isa nkaho ifite akamaro gakomeye mugusuzuma urugero rwo kwimuka mubice byavunitse hagati yingingo zifatika. Usibye kuyikoresha mugusuzuma ibice bya tibial plafond hamwe na radiyo ya kure nkuko byavuzwe haruguru, ACD irashobora no gukoreshwa mugusuzuma kuvunika inkokora. Ibi bitanga abaganga bafite ibikoresho byingirakamaro muguhitamo uburyo bwo kuvura no gusuzuma ibizavunika.
Igihe cyo kohereza: Nzeri-18-2023