Mafi yawan sigogin hoto da aka yi amfani da su don kimanta karayar radius na nesa yawanci sun haɗa da kusurwa karkatar da wuta (VTA), bambancin ulnar, da tsayin radial. Kamar yadda fahimtarmu game da tsarin halittar radius mai nisa ya zurfafa, an gabatar da ƙarin sigogin hoto kamar nisa na anteroposterior (APD), kusurwar teardrop (TDA), da capitate-to-axis-of-radius nesa (CARD) kuma an yi amfani da su a cikin aikin asibiti.
Siffofin hoto da aka saba amfani da su don kimanta karayar radius mai nisa sun haɗa da: a:VTA：b：APD;c：TDA：d：CARD.
Yawancin sigogin hoto sun dace da ƙarin karaya na radius na nesa, kamar tsayin radial da bambancin ulnar. Duk da haka, ga wasu ɓarna a cikin jiki, kamar ɓarna na Barton, sigogin hoto na al'ada na iya rasa ikonsu na tantance alamun tiyata daidai da ba da jagora. An yi imani da cewa alamar tiyata don wasu ɓangarorin intra-articular yana da alaƙa da kusanci da mataki na haɗin gwiwa. Don tantance matakin ƙaurawar ɓarna a cikin articular, malamai na kasashen waje sun ba da shawarar sabon ma'auni: TAD (Tilt After Displacement), kuma an fara bayar da rahoto don kimanta raunin malleolus na baya tare da ƙaurawar tibial mai nisa.
A ƙarshen ƙarshen tibia, a lokuta na raunin malleolus na baya tare da raguwa na talus na baya, haɗin haɗin gwiwa yana samar da arcs guda uku: Arc 1 shine gaban haɗin gwiwa na gaba na tibia mai nisa, Arc 2 shine haɗin gwiwa na ɓangaren malleolus na baya, kuma Arc 3 shine saman talus. Lokacin da guntuwar malleolus na baya tare da raguwa na baya na talus, tsakiyar da'irar da Arc 1 ya kafa a kan gefen haɗin gwiwa na gaba yana nuna alamar T, kuma tsakiyar da'irar da Arc 3 ya kafa a saman talus yana nuna alamar A. Nisa tsakanin waɗannan cibiyoyin guda biyu shine TAD (Tilt).
Manufar tiyata ita ce cimma ƙimar ATD (Tilt After Displacement) na 0, wanda ke nuna raguwar yanayin jikin haɗin gwiwa.
Hakazalika, a yanayin faɗuwar Barton:
Rarrabuwar da aka raba da muhallansu sun zama Arc 1.
Facet ɗin lunate yana aiki azaman Arc 2.
Bangaren dorsal na radius (kashi na yau da kullun ba tare da karaya ba) yana wakiltar Arc 3.
Kowane ɗayan waɗannan baka uku ana iya ɗaukar su azaman da'ira. Tun lokacin da fuskar lunate da gutsutsun ƙasusuwan ƙashi suka rabu tare, Circle 1 (a cikin rawaya) ya raba cibiyarsa tare da Circle 2 (a cikin fari). ACD tana wakiltar nisa daga wannan cibiyar da aka raba zuwa tsakiyar Circle 3. Manufar tiyata ita ce mayar da ACD zuwa 0, yana nuna raguwar jiki.
A cikin aikin likitancin da ya gabata, an yarda da shi sosai cewa matakin haɗin gwiwa na haɗin gwiwa na <2mm shine ma'auni don raguwa. Duk da haka, a cikin wannan binciken, Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararru (ROC) na ma'auni na hoto daban-daban ya nuna cewa ACD yana da mafi girman yanki a ƙarƙashin lanƙwasa (AUC). Yin amfani da ƙimar yankewa na 1.02mm don ACD, ya nuna ƙwarewar 100% da ƙayyadaddun 80.95%. Wannan yana nuna cewa yayin aiwatar da raguwar karaya, rage ACD zuwa cikin 1.02mm na iya zama ma'auni mafi dacewa.
fiye da na gargajiya misali na <2mm haɗin gwiwa surface mataki-kashe.
ACD yana da alama yana da mahimmancin tunani don tantance ƙimar ƙaura a cikin ɓarnawar ɓarna da ke tattare da haɗin gwiwa. Baya ga aikace-aikacensa wajen tantance karaya plafond na tibial da faɗuwar radius kamar yadda aka ambata a baya, Hakanan ana iya amfani da ACD don kimanta karyewar gwiwar hannu. Wannan yana ba masu aikin asibiti kayan aiki mai amfani don zaɓar hanyoyin magani da kuma tantance sakamakon raguwar raguwa.
Lokacin aikawa: Satumba 18-2023
