Ultrasound iyobowe na "kwagura idirishya" tekinike ifasha mukugabanya kuvunika kwa radiyo ya kure kuruhande rwa volar kuruhande

Uburyo bukunze kuvurwa kumenwa ya radiyo ya kure ni volar Henry uburyo bwo gukoresha amasahani yo gufunga hamwe na screw kugirango bikosorwe imbere.Mugihe cyimbere yo gukosora imbere, mubisanzwe ntabwo ari ngombwa gufungura radiocarpal ihuriweho na capsule.Kugabanya gufatanya kugerwaho hifashishijwe uburyo bwo gukoresha manipuline yo hanze, kandi fluoroscopy intraoperative ikoreshwa mugusuzuma guhuza ubuso.Mugihe habaye kuvunika kwimbere-arctular, nko kuvunika kwa Die-punch, aho kugabanya no gusuzuma bitaziguye, birashobora kuba ngombwa gukoresha inzira ya dorsal kugirango ifashe muburyo bwo kubona no kugabanya (nkuko bigaragara mumashusho hepfo).

Ligaments zo hanze na ligaments zo mu nda za radiocarpal zifatwa nkinzego zingenzi zo gukomeza guhuza ingingo.Hamwe niterambere ryubushakashatsi bwa anatomique, byavumbuwe ko, muburyo bwo kubungabunga ubusugire bwururimi rugufi rwa radiolunate, guca imitsi yo hanze ntibisobanura byanze bikunze guhungabana kwamaboko.

Kubwibyo, mubihe bimwe na bimwe, kugirango tugere ku kureba neza hejuru yubuso, birashobora kuba nkenerwa gucamo igice igice cyo hanze, kandi ibi bizwi nka volar intraarticular yagutse idirishya (VIEW).Nkuko bigaragara ku gishushanyo gikurikira:

Igicapo AB: Muburyo busanzwe bwa Henry bwo kwerekana amagufwa ya radiyo ya kure, kugirango ugere kumeneka yacitsemo ibice bya radiyo ya kure hamwe na scaphoide, capsule yintoki yabanje guterwa.Retractor ikoreshwa mukurinda imiyoboro ngufi ya radiolunate.Ibikurikira, ligamente ndende ya radiolunate ikozwe kuva kuri radiyo ya kure yerekeza kuruhande rwa ulnar kuruhande rwa scaphoid.Kuri iyi ngingo, amashusho ataziguye yubuso bushobora kugerwaho.

Igicapo CD: Nyuma yo kwerekana ubuso buhuriweho, kugabanya indege ya sagittal yihebye hejuru yubuso bikozwe muburyo butaziguye.Hejuru yamagufa akoreshwa mugukoresha no kugabanya ibice byamagufwa, kandi insinga za Kirschner 0.9mm zirashobora gukoreshwa mugukosora byigihe gito cyangwa cyanyuma.Iyo ubuso buhuriweho bumaze kugabanuka bihagije, uburyo busanzwe bwo gukora plaque na screw gukurikizwa.Hanyuma, ibice byakozwe muri ligamenti ndende ya radiolunate hamwe na capsule yintoki.

Ishimikiro ryuburyo bwa VIEW (volar intraarticular idirishya ryagutse) rishingiye mubwumvikane ko gukata intoki zimwe zifatanije nudusanduku ntago byanze bikunze biviramo guhungabana kwamaboko.Kubwibyo, birasabwa kubintu bimwe bigoye bigoye hagati yimiterere ya radiyo yamenetse aho kugabanuka kwa fluoroscopique bigoranye cyangwa mugihe intambwe ihari.Uburyo bwa VIEW burasabwa cyane kugirango tugere kumashusho meza mugihe cyo kugabanya ibibazo nkibi.