Uburyo bwo gupima "expansion window" bukoreshwa na ultrasound bufasha mu kugabanya imvune za radius ya distal ku gice cy'ingingo

Uburyo bukunze kugaragara bwo kuvura imvune zo mu gice cya kure ni uburyo bwa volar Henry bukoresha ibyuma bifunga n'amakuru kugira ngo bifatanye imbere. Mu gihe cyo gufunga imbere, ubusanzwe si ngombwa gufungura agapfukamunwa ka radiocarpal. Kugabanya ingingo bigerwaho binyuze mu buryo bwo gukora isuku, kandi fluoroscopy ikoreshwa mu kubaga kugira ngo hamenyekane uko ubuso bw'ingingo buhagaze. Mu gihe imvune zo mu gice cya kure zigwa, nka imvune za Die-punch, aho kugabanya no gusuzuma mu buryo butaziguye bigoye, bishobora kuba ngombwa gukoresha uburyo bwo mu gice cya nyuma kugira ngo bifashe mu kureba no kugabanya (nk'uko bigaragara ku ishusho iri hepfo).

Imitsi yo hanze n'imitsi y'imbere y'ingingo ya radiocarpal bifatwa nk'imiterere y'ingenzi mu kubungabunga ingingo z'ukuboko. Hamwe n'iterambere mu bushakashatsi ku miterere y'umubiri, byagaragaye ko, mu gihe habayeho kubungabunga ubusugire bw'imitsi migufi ya radiolunate, guca imitsi yo hanze ntibituma ingingo z'ukuboko zidakomera.

Kubwibyo, mu bihe bimwe na bimwe, kugira ngo umuntu arebe neza ubuso bw'ingingo, bishobora kuba ngombwa gukata igice cy'imitsi yo hanze, kandi ibi bizwi nka volar intraarticular extended window approach (VIEW). Nkuko bigaragara ku ishusho iri hepfo:

Ishusho ya AB: Mu buryo busanzwe bwa Henry bwo kugaragaza ubuso bw'amagufwa ya distal radius, kugira ngo harebwe aho radius ya distal na scaphoid facet icikamo ibice, capsule y'urukuta rw'ukuboko ibanza gucibwamo ibice. Hakoreshwa retractor kugira ngo harinde ligament ngufi ya radiolunate. Nyuma yaho, ligament ndende ya radiolunate icibwamo ibice kuva kuri radius ya distal kugera ku ruhande rw'inyuma rwa scaphoid. Muri iki gihe, kureba neza ubuso bw'ingingo bishobora kugerwaho.

Ishusho CD: Nyuma yo gushyira ahagaragara ubuso bw'ingingo, kugabanya ubuso bw'ingingo bugabanutseho plane ya sagittal bikorwa hifashishijwe uburyo bwo kureba neza. Ascenseur y'amagufwa ikoreshwa mu guhindura no kugabanya ibice by'amagufwa, kandi insinga za Kirschner za 0.9mm zishobora gukoreshwa mu gufata by'agateganyo cyangwa ibya nyuma. Iyo ubuso bw'ingingo bugabanutse bihagije, hakurikizwa uburyo busanzwe bwo gufata plate na screw. Amaherezo, gukata bikozwe mu mitsi miremire ya radiolunate na capsule y'urutoki birasukwa.

Ishingiro ry’uburyo bwa VIEW (volar intraarticular extended window) ni uko guca imitsi imwe n’imwe yo hanze y’urutoki bidatuma ingingo z’urutoki zidakomera. Kubwibyo, birasabwa ku mvune zimwe na zimwe zo mu gice cy’urutoki aho kugabanya ubuso bw’ingingo biba bigoye cyangwa iyo habayeho gutera intambwe. Uburyo bwa VIEW burasabwa cyane kugira ngo haboneke uburyo bwiza bwo kureba mu buryo butaziguye mu gihe cyo kugabanya muri bene ibyo bihe.