Dabarar "tagar faɗaɗawa" da aka yi wa jagora ta hanyar duban dan tayi tana taimakawa wajen rage karyewar radius mai nisa a ɓangaren volar na haɗin gwiwa

Mafi yawan maganin karyewar radius na nesa shine hanyar volar Henry tare da amfani da faranti da sukurori don gyara ciki. A lokacin aikin gyara ciki, yawanci ba lallai bane a buɗe kapsul ɗin haɗin radiocarpal. Ana samun raguwar haɗin gwiwa ta hanyar hanyar sarrafawa ta waje, kuma ana amfani da fluoroscopy a cikin tiyata don tantance daidaiton saman haɗin gwiwa. A cikin yanayin karyewar haɗin gwiwa, kamar karyewar Die-punch, inda raguwa da kimantawa a kaikaice ke da ƙalubale, yana iya zama dole a yi amfani da hanyar dorsal don taimakawa tare da gani kai tsaye da raguwa (kamar yadda aka nuna a cikin hoton da ke ƙasa).

Jijiyoyin waje da jijiyoyin ciki na haɗin radiocarpal ana ɗaukar su a matsayin muhimman tsare-tsare don kiyaye daidaiton haɗin wuyan hannu. Tare da ci gaba a cikin binciken ilimin halittar jiki, an gano cewa, a ƙarƙashin yanayin kiyaye daidaiton gajeriyar hanyar haɗin radiolunate, yanke jijiyoyin waje ba lallai bane ya haifar da rashin daidaiton haɗin wuyan hannu.

Saboda haka, a wasu yanayi, domin a sami kyakkyawan hangen nesa na saman haɗin gwiwa, yana iya zama dole a ɗan rage jijiyar waje, kuma ana kiran wannan da hanyar taga mai faɗi ta volar intraarticular (VIEW). Kamar yadda aka nuna a cikin hoton da ke ƙasa:

Siffa ta AB: A cikin hanyar da aka saba amfani da ita ta Henry don fallasa saman ƙashin radius na distal, don samun damar samun karyewar radius na distal da ɓangaren scaphoid, da farko ana yanke kaskon haɗin wuyan hannu. Ana amfani da mai ja don kare gajeren jijiyar radiolunate. Daga baya, ana yanke dogon jijiyar radiolunate daga radius na distal zuwa gefen ulnar na scaphoid. A wannan lokacin, ana iya samun damar ganin saman haɗin kai kai tsaye.

Hoto na CD: Bayan fallasa saman haɗin gwiwa, ana yin rage saman haɗin gwiwa mai rauni a ƙarƙashin hangen nesa kai tsaye. Ana amfani da lif na ƙashi don sarrafa da rage gutsuttsuran ƙashi, kuma ana iya amfani da wayoyi na Kirschner na 0.9mm don gyara na ɗan lokaci ko na ƙarshe. Da zarar an rage saman haɗin gwiwa yadda ya kamata, ana bin hanyoyin da aka saba amfani da su don gyara faranti da sukurori. A ƙarshe, ana ɗinka yanke-yanke da aka yi a cikin dogon jijiyar radiolunate da kuma kapsul ɗin haɗin wuyan hannu.

Tushen ka'idar hanyar VIEW (volar intraarticular extended window) ya ta'allaka ne akan fahimtar cewa yanke wasu jijiyoyin waje na haɗin wuyan hannu ba lallai bane ya haifar da rashin kwanciyar hankali na haɗin wuyan hannu. Saboda haka, ana ba da shawarar ga wasu rikice-rikice na karyewar radius na nesa na ciki inda rage saman haɗin fluoroscopic ke da ƙalubale ko lokacin da aka sami matakan hawa. Ana ba da shawarar hanyar VIEW sosai don cimma mafi kyawun gani kai tsaye yayin raguwa a irin waɗannan yanayi.