ʻO nā haʻihaʻi radius distal kekahi o nā mea maʻamaunā haʻihaʻima ka hana lapaʻau.No ka hapa nui o nā haʻihaʻi maʻamau, hiki ke loaʻa nā hopena therapeutic maikaʻi ma o ka pā pālima palmar a me ka hoʻopaʻa ʻana i loko.Eia kekahi, aia nā ʻano ʻokoʻa kūikawā o nā haʻihaʻi radius distal, e like me Barton fractures, Die-punch fractures,Nā haʻihaʻi o ka Chauffeur, etc., pono kēlā me kēia i nā ala lapaʻau kūikawā.Ua ʻike ka poʻe naʻauao haole, i kā lākou noiʻi ʻana i nā laʻana nui o nā hihia haʻihaʻi radius distal, i ʻike ʻia kahi ʻano o kahi ʻāpana o ka ami e pili ana i kahi haʻihaʻi radius distal, a ua hana nā ʻāpana iwi i kahi conical me kahi kumu "triangular" (tetrahedron), i kapa ʻia ʻo ke ʻano "tetrahedron".
Manaʻo o "Tetrahedron" Type Distal Radius Fracture: Ma kēia ʻano o ka haʻihaʻi radius distal, loaʻa ka haki i loko o kahi ʻāpana o ka hui, e pili ana i nā ʻaoʻao palmar-ulnar a me radial styloid facets, me kahi hoʻonohonoho triangular transverse.Hoʻonui ka laina haʻihaʻi i ka hopena o ka radius.
Hōʻike ʻia ka ʻokoʻa o kēia haʻihaʻi i nā hiʻohiʻona ʻokoʻa o nā ʻāpana iwi ʻaoʻao palmar-ulnar o ka radius.Ma kekahi ʻaoʻao, ʻo ka fossa lunar i hoʻokumu ʻia e kēia mau ʻāpana iwi ʻaoʻao palmar-ulnar i kākoʻo kino i ka dislocation volar o nā iwi carpal.ʻO ka nalo ʻana o ke kākoʻo mai kēia hale ka hopena i ka dislocation volar o ka hui lima.Ma ka ʻaoʻao ʻē aʻe, ma ke ʻano he ʻāpana o ka radial articular surface o ka ami radioulnar distal, ʻo ka hoʻihoʻi ʻana i kēia ʻāpana iwi i kona kūlana anatomical he mea pono ia no ka loaʻa hou ʻana o ka paʻa i ka hui radioulnar distal.
Hōʻike ke kiʻi ma lalo nei i ka hihia 1: Hōʻike kiʻi kiʻi o kahi haʻihaʻi radius maʻamau "Tetrahedron".
Ma kahi noiʻi i ʻelima makahiki, ʻehiku mau hihia o kēia ʻano haʻihaʻi i ʻike ʻia.E pili ana i nā hōʻailona hōʻailona, no ʻekolu mau hihia, me ka hihia 1 ma ke kiʻi ma luna, kahi i loaʻa ʻole ai nā haʻihaʻi i hoʻoneʻe ʻole ʻia, ua koho mua ʻia ka mālama conservative.Eia nō naʻe, i ka wā o ka hahai ʻana, ua ʻike nā hihia ʻekolu i ka haʻihaʻi ʻana, e alakaʻi ana i ke kaʻina hoʻoponopono kūloko.Hōʻike kēia i kahi kiʻekiʻe o ka paʻa ʻole a me kahi pilikia nui o ka hoʻololi hou ʻana i nā haʻihaʻi o kēia ʻano, e hoʻoikaika ana i kahi hōʻailona ikaika no ka hana ʻoki.
Ma ke ʻano o ka mālama ʻana, ʻelua mau hihia i hoʻomaka mua ʻia i ke ala volar kuʻuna me ka flexor carpi radialis (FCR) no ka pā a me ka hoʻopaʻa ʻana i loko.I kekahi o kēia mau hihia, ʻaʻole i hoʻopaʻa ʻia, ka hopena i ka neʻe ʻana o ka iwi.Ma hope mai, ua hoʻohana ʻia kahi ala palmar-ulnar, a ua hana ʻia kahi hoʻoponopono kikoʻī me kahi pā kolamu no ka hoʻoponopono ʻana i ke kolamu waena.Ma hope o ka loaʻa ʻana o ka hoʻopaʻa ʻana, ʻo nā hihia ʻelima ma hope aʻe i hana ʻia i ka palmar-ulnar approach a ua hoʻopaʻa ʻia me nā papa 2.0mm a i ʻole 2.4mm.
Ka hihia 2: Ke hoʻohana nei i ke ala volar maʻamau me ka flexor carpi radialis (FCR), ua hana ʻia ka hoʻoponopono ʻana me ka pā lima.Ma hope o ka hana, ʻike ʻia ka dislocation mua o ka hui lima, e hōʻike ana i ka hemahema o ka fixation.
No ka hihia 2, ka hoʻohana ʻana i ke ala palmar-ulnar a me ka hoʻoponopono ʻana me ka pā kolamu i hopena i kahi kūlana kūpono no ka hoʻoponopono ʻana i loko.
Ke noʻonoʻo nei i nā hemahema o nā papa haʻihaʻi maʻamau maʻamau i ka hoʻoponopono ʻana i kēia ʻāpana iwi, ʻelua mau pilikia nui.ʻO ka mea mua, ʻo ka hoʻohana ʻana i ke ala volar me ka flexor carpi radialis (FCR) hiki ke hopena i ka ʻike kūpono ʻole.ʻO ka lua, ʻaʻole hiki ke hoʻopaʻa pono ʻia nā ʻāpana iwi liʻiliʻi i ka nui o nā wili paʻa paʻa lima a hiki ke hoʻoneʻe iā lākou ma ka hoʻokomo ʻana i nā wili i nā āpau ma waena o nā ʻāpana.
No laila, manaʻo ka poʻe akamai i ka hoʻohana ʻana i nā pā laka 2.0mm a i ʻole 2.4mm no ka hoʻoponopono pono ʻana i ka ʻāpana iwi kolamu waena.Ma waho aʻe o ka pā kākoʻo, ʻo ka hoʻohana ʻana i ʻelua wili e hoʻoponopono i ka ʻāpana iwi a me ka hoʻokaʻawale ʻana i ka pā no ka pale ʻana i nā wili he koho hoʻoponopono kūloko ʻē aʻe.
I kēia hihia, ma hope o ka hoʻopaʻa ʻana i ka ʻāpana iwi me nā ʻāpana ʻelua, ua hoʻokomo ʻia ka pā e pale i nā ʻili.
I ka hōʻuluʻulu ʻana, ʻo ka "Tetrahedron" type distal radius fracture e hōʻike i kēia mau ʻano:
1. Haʻahaʻa haʻahaʻa me ka kiʻekiʻe kiʻekiʻe o ka maʻamau kiʻiʻoniʻoni misdiagnosis.
2. ʻO ke kūlana kiʻekiʻe o ka instability, me ka manaʻo no ka hoʻololi hou ʻana i ka wā mālama conservative.
3. ʻO nā papa laka palmar maʻamau no nā haʻihaʻi radius distal he ikaika hoʻoponopono nāwaliwali, a ua ʻōlelo ʻia e hoʻohana i nā papa laka 2.0mm a i ʻole 2.4mm no ka hoʻoponopono kikoʻī.
Hāʻawi ʻia i kēia mau hiʻohiʻona, i ka hoʻomaʻamaʻa lapaʻau, pono e hana i nā CT scans a i ʻole ka nānā hou ʻana i kēlā me kēia manawa no nā maʻi me nā hōʻailona pulima koʻikoʻi akā nā kukui X maikaʻi ʻole.No kēia ʻanohaʻihaʻi, ʻōlelo ʻia ka hana ʻoki ʻoki mua ʻana me kahi pā kolamu i mea e pale ai i nā pilikia ma hope.
Ka manawa hoʻouna: ʻOkakopa-13-2023
