ʻO ka lāʻau lapaʻau maʻamau no nā haki radius distal ʻo ia ke ʻano volar Henry me ka hoʻohana ʻana i nā papa laka a me nā wili no ka hoʻopaʻa ʻana i loko. I ka wā o ke kaʻina hana hoʻopaʻa kūloko, ʻaʻole pono e wehe i ka capsule hui radiocarpal. Hoʻokō ʻia ka hōʻemi ʻana o ka hui ma o kahi ʻano hana hoʻopunipuni waho, a hoʻohana ʻia ka fluoroscopy intraoperative e loiloi i ke kūlike o ka ʻili hui. I nā hihia o nā haki intra-articular depressed, e like me nā haki Die-punch, kahi paʻakikī ka hōʻemi ʻana a me ka loiloi ʻole pololei, pono paha e hoʻohana i kahi ala dorsal e kōkua me ka ʻike pololei a me ka hōʻemi (e like me ka mea i hōʻike ʻia ma ke kiʻi ma lalo).
ʻO nā ligaments extrinsic a me nā ligaments intrinsic o ka hui radiocarpal ua manaʻo ʻia he mau ʻano koʻikoʻi no ka mālama ʻana i ke kūpaʻa o ka hui pulima. Me nā holomua i ka noiʻi anatomical, ua ʻike ʻia, ma lalo o ke kūlana o ka mālama ʻana i ka pono o ka ligament radiolunate pōkole, ʻo ka ʻoki ʻana i nā ligaments extrinsic ʻaʻole ia e hopena i ka paʻa ʻole o ka hui pulima.
No laila, i kekahi mau kūlana, i mea e ʻike maikaʻi ai i ka ʻili o ke hono, pono paha e ʻoki hapa i nā ligaments extrinsic, a ua ʻike ʻia kēia ʻo ke ʻano o ka puka makani volar intraarticular extended (VIEW). E like me ka mea i hōʻike ʻia ma ke kiʻi ma lalo nei:
Kiʻi AB: Ma ke ʻano kuʻuna o Henry no ka hōʻike ʻana i ka ʻili iwi radius distal, i mea e hiki ai i kahi haki māhele o ka radius distal a me ka facet scaphoid, ua ʻoki mua ʻia ke capsule hui pulima. Hoʻohana ʻia kahi retractor e pale i ka ligament radiolunate pōkole. Ma hope iho, ua ʻoki ʻia ka ligament radiolunate lōʻihi mai ka radius distal a i ka ʻaoʻao ulnar o ka scaphoid. I kēia manawa, hiki ke hoʻokō ʻia ka ʻike pololei ʻana o ka ʻili hui.
Kiʻi CD: Ma hope o ka hōʻike ʻana i ka ʻili hui, hana ʻia ka hoʻemi ʻana o ka ʻili hui i hoʻohaʻahaʻa ʻia i ka mokulele sagittal ma lalo o ka nānā pololei ʻana. Hoʻohana ʻia nā mea hoʻokiʻekiʻe iwi e hoʻoponopono a hoʻemi i nā ʻāpana iwi, a hiki ke hoʻohana ʻia nā uea Kirschner 0.9mm no ka hoʻopaʻa manawa pōkole a hope paha. Ke hoʻemi pono ʻia ka ʻili hui, hahai ʻia nā ʻano maʻamau no ka hoʻopaʻa ʻana i ka pā a me ka wili. ʻO ka hope loa, ua humuhumu ʻia nā ʻoki i hana ʻia ma ka ligament radiolunate lōʻihi a me ka capsule hui pulima.
ʻO ke kumu kumumanaʻo o ke ʻano VIEW (volar intraarticular extended window) aia ma ka hoʻomaopopo ʻana ʻaʻole pono ka ʻoki ʻana i kekahi mau ligament extrinsic o ka hui pulima e hopena i ka paʻa ʻole o ka hui pulima. No laila, ua ʻōlelo ʻia no kekahi mau haki radius distal distal comminuted intra-articular paʻakikī kahi e paʻakikī ai ka hoʻemi ʻana o ka ʻili o ka hui fluoroscopic a i ʻole ke loaʻa nā step-offs. Ua ʻōlelo ikaika ʻia ke ʻano VIEW e hoʻokō i kahi ʻike pololei maikaʻi aʻe i ka wā o ka hoʻemi ʻana i ia mau hihia.
Ka manawa hoʻouna: Sep-09-2023
