Dabarar "taga fadada" mai jagorancin duban dan tayi yana taimakawa wajen rage raguwar radius mai nisa a yanayin juzu'i na haɗin gwiwa.

Mafi na kowa magani ga m radius fractures shi ne volar Henry tsarin tare da yin amfani da kulle faranti da sukurori domin ciki gyarawa.A lokacin aikin gyaran ciki, yawanci ba lallai ba ne a buɗe capsule na haɗin gwiwa na rediyocarpal.Ana samun raguwar haɗin gwiwa ta hanyar hanyar magudi na waje, kuma ana amfani da fluoroscopy na ciki don tantance daidaitawar haɗin gwiwa.A cikin lokuta na raunin da ya faru na intra-articular depressed fractures, irin su Die-punch fractures, inda rage kai tsaye da kimantawa ke da kalubale, yana iya zama dole a yi amfani da tsarin dorsal don taimakawa tare da hangen nesa da raguwa (kamar yadda aka nuna a cikin adadi a ƙasa).

Hanyoyin haɗin gwiwa da haɗin gwiwa na haɗin gwiwa na rediyocarpal ana daukar su mahimman tsari don kiyaye kwanciyar hankali na wuyan hannu.Tare da ci gaba a cikin bincike na jiki, an gano cewa, a ƙarƙashin yanayin kiyaye mutuncin guntun rediyolunate, yanke ligaments na waje ba dole ba ne ya haifar da rashin kwanciyar hankali a wuyan hannu.

Sabili da haka, a wasu yanayi, don cimma kyakkyawan ra'ayi game da haɗin gwiwa, yana iya zama dole don ƙaddamar da ƙananan ligaments na waje, kuma an san wannan a matsayin hanyar haɗin intraarticular Extended window (VIEW).Kamar yadda aka nuna a hoton da ke ƙasa:

Hoto AB: A tsarin tsarin Henry na al'ada don fallasa saman radius mai nisa, don samun damar tsagawar radius mai nisa da facet na scaphoid, an fara ƙera capsule na haɗin gwiwa na wuyan hannu.Ana amfani da retractor don kare gajeriyar ligament na rediyolunate.Daga bisani, an yanke dogon ligament na rediyolunate daga radius mai nisa zuwa gefen ulnar na scaphoid.A wannan lokaci, ana iya samun hangen nesa kai tsaye na farfajiyar haɗin gwiwa.

Hoto CD: Bayan fallasa fuskar haɗin gwiwa, ana yin raguwar sagittal jirgin sama mai rauni na haɗin gwiwa a ƙarƙashin gani kai tsaye.Ana amfani da lif na kashi don sarrafa da rage gutsuttsuran kashi, kuma ana iya amfani da wayoyi Kirschner na 0.9mm don gyarawa na wucin gadi ko na ƙarshe.Da zarar haɗin haɗin gwiwa ya ragu sosai, ana bin daidaitattun hanyoyin faranti da gyaran gyare-gyare.A ƙarshe, an ɗora ƙasusuwan da aka yi a cikin dogon ligament na rediyolunate da capsule na haɗin gwiwar hannu.

Tushen ka'idar VIEW (taga mai tsawo na intraarticular) ya ta'allaka ne a cikin fahimtar cewa yanke wasu igiyoyin haɗin gwiwa na wuyan hannu ba lallai ba ne ya haifar da rashin zaman lafiyar haɗin gwiwar hannu.Saboda haka, ana ba da shawarar ga wasu hadaddun intra-articular comminuted distal radius fractures inda fluoroscopic haɗin gwiwa rage saman yana da ƙalubale ko lokacin da matakai ke samuwa.Hanyar VIEW ana ba da shawarar sosai don cimma ingantacciyar gani kai tsaye yayin raguwa a irin waɗannan lokuta.