Kuvunika kwa radius ya kure ni kimwe mu bikunze kugaragara cyanekuvunikamu buvuzi. Ku ndwara nyinshi zo mu gice cya kure, ibisubizo byiza byo kuvura bishobora kuboneka binyuze mu gufata icyuma cya palmar approach na screw internal fixation. Byongeye kandi, hari ubwoko butandukanye bwihariye bw'indwara zo mu gice cya kure, nko kuvunika kwa Barton, kuvunika kwa Die-punch,Amagufwa y'umushoferi, n'ibindi., buri kimwe gisaba uburyo bwihariye bwo kuvura. Intiti z'abanyamahanga, mu bushakashatsi bwazo ku ngero nini z'abantu bavunitse impande zombi, zagaragaje ubwoko runaka aho igice cy'ingingo kiba gifite imvune y'igice cyo hagati, kandi ibice by'amagufwa bigakora imiterere y'urukiramende ifite urufatiro rw'"impandeshatu" (tetrahedron), rwitwa ubwoko bwa "tetrahedron".
Igitekerezo cy'ubwoko bwa "Tetrahedron" Distal Radius Fracture: Muri ubu bwoko bwa distal radius fracture, fracture iba mu gice cy'ingingo, irimo impande zombi za palmar-ulnar na radial styloid, ifite imiterere ya mpandeshatu inyuranamo. Umurongo w'ivunika ugera ku mpera ya radius.
Ubwiza bw'iyi mvune bugaragarira mu miterere yihariye y'uduce tw'amagufwa yo ku ruhande rwa palmar-ulnar two mu gice cy'amagufwa. Ku ruhande rumwe, fossa y'ukwezi ikorwa n'uduce tw'amagufwa yo ku ruhande rwa palmar-ulnar ikora nk'inkunga ifatika mu kurwanya kwimuka kw'amagufwa ya carpal. Kubura inkunga ituruka kuri iyi miterere bituma kwimuka kw'amagufwa yo ku rutoki bihinduka. Ku rundi ruhande, nk'igice cy'urusobe rw'amagufwa yo ku ruhande rwa distal radioulnar, gusubiza iki gice cy'amagufwa mu mwanya wacyo ni ngombwa kugira ngo hongererwe ubusugire mu rusobe rw'amagufwa yo ku ruhande rwa distal radioulnar.
Ishusho iri hepfo igaragaza Urugero rwa 1: Ishusho y'ibimenyetso by'ivunika rya radius ya distal yo mu bwoko bwa "Tetrahedron".
Mu bushakashatsi bwakozwe mu myaka itanu, hagaragaye abantu barindwi bavunitse nk'ubu. Ku bijyanye n'ibimenyetso byo kubagwa, ku bantu batatu, harimo n'Urubanza rwa 1 ku ishusho iri hejuru, aho mbere habayeho imvune zitari zavuye mu mwanya wazo, habanje gutoranywa ubuvuzi busanzwe. Ariko, mu gihe cyo gukurikirana, abantu bose uko ari batatu bavunitse, bigatuma bakurikiraho kubagwa imbere mu mubiri. Ibi bigaragaza ko hari urwego rwo hejuru rw'ihungabana n'ibyago bikomeye byo kongera kwimuka mu mvune nk'izo, bishimangira ikimenyetso gikomeye cyo kubagwa.
Mu bijyanye no kuvura, abantu babiri babanje gukoresha uburyo bwa gakondo bwo gufunga amaguru hakoreshejwe flexor carpi radialis (FCR) kugira ngo hakorwe plaque na screw internal fixing. Muri bumwe muri ubu buryo, gufunga byarananiranye, bituma amagufwa yimuka. Nyuma yaho, hakoreshejwe uburyo bwa palmar-ulnar, maze hakorwa uburyo bwihariye bwo gufunga plaque y'inkingi kugira ngo hakorwe ivugurura ry'inkingi yo hagati. Nyuma yo gufunga byananiranye, abantu batanu bakurikiyeho bose bakorewe uburyo bwa palmar-ulnar kandi bakosorwa hakoreshejwe plaque za 2.0mm cyangwa 2.4mm.
Urugero rwa 2: Hakoreshejwe uburyo busanzwe bwo gufunga amaguru hakoreshejwe flexor carpi radialis (FCR), hakozwe uburyo bwo gufunga amaguru hakoreshejwe plate ya palmar. Nyuma yo kubagwa, hagaragaye ko ingingo y'ukuboko yacitse imbere, bigaragaza ko gufunga amaguru byananiwe.
Ku rubanza rwa 2, gukoresha uburyo bwa palmar-ulnar no kuvugurura hakoreshejwe inkingi ya plaque byatumye habaho umwanya ushimishije wo gufata imbere.
Urebye inenge z’udupira tw’amagufwa dusanzwe dukoreshwa mu gusana iki gice cy’amagufwa, hari ibibazo bibiri by’ingenzi. Icya mbere, gukoresha uburyo bwa volar hamwe na flexor carpi radialis (FCR) bishobora gutuma habaho ubwisanzure budahagije. Icya kabiri, ingano nini y’udupira tw’amagufwa dufunga palmar ishobora kudafata neza uduce duto tw’amagufwa kandi ishobora kubisimbuza ukoresheje utupira mu myobo iri hagati y’udupira.
Kubwibyo, abahanga bavuga ko hakoreshwa ibyuma bifunga bya mm 2.0 cyangwa mm 2.4 mu gushyiraho igice cy'igufwa cyo hagati. Uretse icyuma gishyigikira, gukoresha vis ebyiri mu gufunga igice cy'igufwa no gufunga vis kugira ngo birinde vis nabyo ni ubundi buryo bwo gufunga imbere.
Muri iki gihe, nyuma yo gukoza igice cy'igufwa ukoresheje vis ebyiri, icyapa cyashyizwemo kugira ngo kirinde vis.
Muri make, kuvunika kwa radius yo mu bwoko bwa "Tetrahedron" kugaragaza ibi bikurikira:
1. Kugabanuka kw'icyorezo hamwe n'umubare munini w'isuzuma ry'ikosa rya mbere.
2. Ingaruka nyinshi zo kudahinduka kw'umubiri, hamwe n'uburyo bwo kongera kwimuka mu gihe cyo kuvurwa mu buryo burambye.
3. Ibyuma bisanzwe byo gufunga imikindo byo kwangirika kw'imikindo bifite imbaraga nke zo gufunga, kandi ni byiza gukoresha ibyuma byo gufunga bifite uburebure bwa mm 2.0 cyangwa 2.4 kugira ngo bifatanye mu buryo bwihariye.
Bitewe n'ibi bintu, mu buvuzi, ni byiza gukora isuzuma rya CT cyangwa gusubiramo ibizamini ku barwayi bafite ibimenyetso bikomeye byo ku kuboko ariko bafite X-ray mbi. Kuri ubu bwoko bwakuvunika, kubagwa hakiri kare hakoreshejwe icyuma gikozwe mu buryo bw'inkingi ni byiza kugira ngo hirindwe ingorane zizakurikiraho.
Igihe cyo kohereza: Ukwakira-13-2023
