Sigogi na hoto da aka fi amfani da su don tantance karyewar radius na nesa yawanci sun haɗa da kusurwar karkatar da volar (VTA), bambancin ulnar, da tsayin radial. Yayin da fahimtarmu game da tsarin jikin radius na nesa ya zurfafa, an gabatar da ƙarin sigogin hoto kamar nesa anteroposterior (APD), kusurwar teardrop (TDA), da nesa capitate-to-axis-of-radius (CARD) kuma an yi amfani da su a aikin asibiti.
Sigogi na hoto da aka saba amfani da su don kimanta karyewar radius na nesa sun haɗa da: a：VTA；b：APD；c；TDA；d；CARD。
Yawancin sigogin hoto sun dace da karyewar radius na distal na extra-articular, kamar tsayin radial da bambancin ulnar. Duk da haka, ga wasu karyewar radius na intra-articular, kamar karyewar Barton, sigogin hoto na gargajiya na iya rasa ikon tantance alamun tiyata daidai da kuma ba da jagora. Gabaɗaya ana tsammanin cewa alamar tiyata don wasu karyewar partition yana da alaƙa da matakin hawa saman haɗin gwiwa. Domin tantance matakin ƙaura na karyewar partition na intra-articular, masana ƙasashen waje sun gabatar da sabon ma'aunin aunawa: TAD (Tilt Bayan Ficewa), kuma an fara bayar da rahotonsa don tantance karyewar partition na posterior malleolus tare da ficewar tibial na distal.
A ƙarshen tibia, idan aka sami karyewar malleolus na baya tare da rugujewar talus na baya, saman haɗin gwiwa yana samar da baka uku: Arc 1 shine saman haɗin gaba na tibia na baya, Arc 2 shine saman haɗin gwiwa na ɓangaren malleolus na baya, kuma Arc 3 shine saman talus. Idan akwai guntun karyewar malleolus na baya tare da rugujewar talus na baya, tsakiyar da'irar da Arc 1 ya samar akan saman haɗin gaba ana nuna shi a matsayin maki T, kuma tsakiyar da'irar da Arc 3 ya samar akan saman talus ana nuna shi a matsayin maki A. Nisa tsakanin waɗannan cibiyoyin biyu shine TAD (Tilt Bayan Rushewa), kuma girman juyawar, mafi girman ƙimar TAD.
Manufar tiyata ita ce a cimma ƙimar ATD (Tilt After Displacement) ta 0, wanda ke nuna raguwar yanayin jikin saman haɗin gwiwa.
Haka kuma, idan aka samu karaya a cikin ƙashin bayan Barton:
Guraben saman haɗin gwiwa da aka cire sun samar da Arc 1.
Fagen lunate yana aiki azaman Arc 2.
Bangaren baya na radius (ƙashi na yau da kullun ba tare da karyewa ba) yana wakiltar Arc 3.
Kowanne daga cikin waɗannan baka uku za a iya ɗaukarsa a matsayin da'ira. Tunda ɓangaren lunate da ɓangaren ƙashin volar sun haɗu, Da'ira 1 (a rawaya) tana raba tsakiyarta da Da'ira 2 (a fari). ACD tana wakiltar nisan da ke tsakanin wannan cibiyar da aka raba zuwa tsakiyar Da'ira 3. Manufar tiyata ita ce a mayar da ACD zuwa 0, wanda ke nuna raguwar yanayin jiki.
A cikin aikin asibiti da ya gabata, an yarda da shi sosai cewa matakin haɗin gwiwa na <2mm shine ma'aunin ragewa. Duk da haka, a cikin wannan binciken, nazarin lanƙwasa na Mai karɓar Halayen Aiki (ROC) na sigogin hoto daban-daban ya nuna cewa ACD yana da mafi girman yanki a ƙarƙashin lanƙwasa (AUC). Ta amfani da ƙimar yankewa na 1.02mm don ACD, ya nuna 100% na ji da kuma takamaiman 80.95%. Wannan yana nuna cewa a cikin tsarin rage karyewa, rage ACD zuwa cikin 1.02mm na iya zama ma'auni mafi dacewa.
fiye da mizanin gargajiya na matakin haɗin gwiwa <2mm.
Da alama ACD yana da mahimmancin ma'ana don tantance matakin ƙaura a cikin karyewar ƙashi a cikin haɗin gwiwa mai ma'ana. Baya ga amfani da shi wajen tantance karyewar ƙashi na tibial plafond da karyewar radius na nesa kamar yadda aka ambata a baya, ana iya amfani da ACD don kimanta karyewar gwiwar hannu. Wannan yana ba wa likitocin asibiti kayan aiki mai amfani don zaɓar hanyoyin magani da tantance sakamakon rage karyewar ƙashi.
Lokacin Saƙo: Satumba-18-2023
