Karyewar radius mai nisa yana ɗaya daga cikin mafi yawankarayaa aikin asibiti. Ga yawancin karaya ta nesa, ana iya samun sakamako mai kyau na warkewa ta hanyar amfani da farantin kusanci na palmar da kuma gyara ciki na screw. Bugu da ƙari, akwai nau'ikan karaya ta musamman na radius na nesa, kamar su karyewar Barton, karyewar Die-punch,Karyewar direba, da sauransu., kowannensu yana buƙatar takamaiman hanyoyin magani. Masana ƙasashen waje, a cikin bincikensu na manyan samfuran shari'o'in karyewar radius ta nesa, sun gano wani nau'in musamman inda wani ɓangare na haɗin gwiwa ya ƙunshi karyewar radius ta nesa, kuma gutsuttsuran ƙashi suna samar da tsarin mazugi tare da tushen "mai kusurwa uku" (tetrahedron), wanda aka sani da nau'in "tetrahedron".
Tsarin Karyewar Radius Nau'in "Tetrahedron": A cikin wannan nau'in karyewar radius na nesa, karyewar tana faruwa a cikin wani ɓangare na haɗin gwiwa, wanda ya ƙunshi fuskokin palmar-ulnar da radial styloid, tare da tsari mai siffar triangle mai ratsawa. Layin karyewar ya miƙe zuwa ƙarshen radius ɗin.
Keɓancewar wannan karyewar tana bayyana ne a cikin siffofi na musamman na gutsuttsuran ƙashi na gefen palmar-ulnar na radius. A gefe guda, fossa na wata da waɗannan gutsuttsuran ƙashi na gefen palmar-ulnar suka samar yana aiki a matsayin tallafi na zahiri akan katsewar ƙashi na carpal. Rashin tallafi daga wannan tsari yana haifar da katsewar ƙashi na haɗin wuyan hannu. A gefe guda kuma, a matsayin wani ɓangare na saman radial articular na haɗin gwiwar radioulnar na distal, dawo da wannan gutsuttsuran ƙashi zuwa matsayinsa na jiki wani sharaɗi ne na sake samun kwanciyar hankali a cikin haɗin gwiwar radioulnar na distal.
Hoton da ke ƙasa yana nuna Matsala ta 1: Bayyanar da aka gani na karyewar radius mai faɗi ta nau'in "Tetrahedron".
A wani bincike da aka yi tsawon shekaru biyar, an gano shari'o'i bakwai na wannan nau'in karaya. Dangane da alamun tiyata, a lokuta uku, ciki har da Shari'a ta 1 a cikin hoton da ke sama, inda da farko akwai karaya mara tushe, an fara zaɓar magani mai kyau. Duk da haka, a lokacin bin diddigin, dukkan shari'o'in uku sun fuskanci karkacewar karyewa, wanda ya haifar da tiyatar gyara ciki daga baya. Wannan yana nuna babban matakin rashin kwanciyar hankali da kuma babban haɗarin sake canzawa a cikin karaya irin wannan, yana mai jaddada wata alama mai ƙarfi ta shiga tsakani na tiyata.
Dangane da magani, an fara yin amfani da hanyoyin magance matsalar guda biyu ta hanyar amfani da hanyar volar ta gargajiya tare da flexor carpi radialis (FCR) don gyaran faranti da kuma sukurori na ciki. A cikin ɗaya daga cikin waɗannan lamuran, gyara ya gaza, wanda ya haifar da canjin ƙashi. Daga baya, an yi amfani da hanyar palmar-ulnar, kuma an yi wani takamaiman gyara tare da farantin ginshiƙi don gyaran ginshiƙi na tsakiya. Bayan faruwar gazawar gyara, an yi gwaje-gwaje biyar na gaba duk an yi amfani da hanyar palmar-ulnar kuma an gyara su da faranti 2.0mm ko 2.4mm.
Shari'a ta 2: Ta amfani da hanyar volar ta gargajiya tare da flexor carpi radialis (FCR), an yi gyaran da farantin palmar. Bayan tiyata, an lura da gurɓacewar haɗin gwiwar wuyan hannu a gaba, wanda ke nuna gazawar gyarawa.
Ga Mataki na 2, amfani da hanyar palmar-ulnar da kuma sake dubawa da farantin ginshiƙi ya haifar da kyakkyawan matsayi don gyarawa na ciki.
Idan aka yi la'akari da gazawar faranti na karyewar radius na gargajiya wajen gyara wannan ɓangaren ƙashi, akwai manyan matsaloli guda biyu. Na farko, amfani da hanyar volar tare da flexor carpi radialis (FCR) na iya haifar da rashin isasshen fallasa. Na biyu, girman sukurori masu kulle palmar ba zai iya ɗaure ƙananan gutsuttsuran ƙashi daidai ba kuma yana iya canza su ta hanyar saka sukurori a cikin gibin da ke tsakanin gutsuttsuran.
Saboda haka, masana sun ba da shawarar amfani da faranti masu kulle 2.0mm ko 2.4mm don takamaiman mannewa na ɓangaren ƙashi na tsakiya. Baya ga farantin tallafi, amfani da sukurori biyu don gyara ɓangaren ƙashi da kuma hana farantin kare sukurori shi ma zaɓi ne na daban na gyara ciki.
A wannan yanayin, bayan an gyara ɓangaren ƙashi da sukurori biyu, an saka farantin don kare sukurori.
A taƙaice, karyewar radius mai nisa ta nau'in "Tetrahedron" yana nuna halaye masu zuwa:
1. Ƙarancin aukuwa tare da yawan kuskuren ganewar asali na farko na fim.
2. Babban haɗarin rashin kwanciyar hankali, tare da yuwuwar sake canza wurin zama yayin magani mai ra'ayin mazan jiya.
3. Farantin kullewa na gargajiya na palmar don karyewar radius na nesa suna da ƙarfin gyarawa mai rauni, kuma ana ba da shawarar amfani da farantin kullewa na 2.0mm ko 2.4mm don takamaiman gyara.
Ganin waɗannan halaye, a aikin asibiti, yana da kyau a yi gwajin CT ko sake duba marasa lafiya da ke da alamun cutar wuyan hannu amma ba su da alamun X-ray. Ga irin wannankaraya, ana ba da shawarar yin tiyata da wuri ta amfani da faranti na musamman na ginshiƙi don hana rikitarwa daga baya.
Lokacin Saƙo: Oktoba-13-2023
