Ihe ndị a na-ejikarị eme ihe n'inyocha mgbawa radius distal na-agụnyekarị akụkụ volar tilt (VTA), mgbanwe ulnar, na elu radial. Ka nghọta anyị banyere anatomi nke radius distal na-akawanye njọ, a tụpụtala ma tinye paramita onyonyo ndị ọzọ dịka anya anteroposterior (APD), akụkụ teardrop (TDA), na anya capitate-to-axis-of-radius (CARD) n'ọrụ ahụike.
Ihe ndị a na-ejikarị ese foto maka ịtụle mgbawa radius distal gụnyere: a：VTA；b：APD；c；TDA；d；CARD。
Ọtụtụ paramita onyonyo dabara adaba maka mgbawa radius distal extra-articular, dịka elu radial na mgbanwe ulnar. Agbanyeghị, maka ụfọdụ mgbawa intra-articular, dịka mgbawa Barton, paramita onyonyo ọdịnala nwere ike ọ gaghị enwe ike ịchọpụta ihe ngosi ịwa ahụ nke ọma ma nye nduzi. A na-ekwenyekarị na ihe ngosi ịwa ahụ maka ụfọdụ mgbawa intra-articular nwere njikọ chiri anya na nkwụsị nke elu nkwonkwo. Iji chọpụta ogo mgbanwe nke mgbawa intra-articular, ndị ọkà mmụta mba ofesi atụpụtala paramita nha ọhụrụ: TAD (Tilt After Displacement), a kọkwara ya na mbụ maka nyocha nke mgbawa posterior malleolus yana distal tibial displacement.
N'akụkụ nsọtụ nke tibia, n'ihe gbasara mgbawa azụ malleolus na mgbapụ azụ nke talus, elu nkwonkwo na-emepụta arcs atọ: Arc 1 bụ elu nkwonkwo ihu nke tibia dị n'ihu, Arc 2 bụ elu nkwonkwo nke iberibe malleolus dị n'azụ, Arc 3 bụkwa elu nke talus. Mgbe enwere iberibe mgbawa azụ malleolus nke ya na mgbapụ azụ nke talus, etiti okirikiri nke Arc 1 kpụrụ n'elu nkwonkwo ihu na-apụta dị ka isi T, etiti okirikiri nke Arc 3 kpụrụ n'elu talus na-apụta dị ka isi A. Anya dị n'etiti etiti abụọ a bụ TAD (Tilt After Displacement), ebe mgbanwe buru ibu karị, otú ahụ ka uru TAD ka ukwuu.
Ebumnuche ịwa ahụ bụ inweta uru ATD (Tilt After Displacement) nke 0, nke na-egosi mbelata anatomical nke elu nkwonkwo.
N'otu aka ahụ, n'ihe gbasara mgbawa nke volar Barton:
Mpekere akụkụ nke akụkụ akwara ndị a gbanwere agbanwe na-etolite Arc 1.
Akụkụ lunate na-eje ozi dị ka Arc 2.
Akụkụ azụ nke radius (ọkpụkpụ nkịtị na-enweghị mgbawa) na-anọchite anya Arc 3.
A pụrụ iwere nke ọ bụla n'ime arc atọ ndị a dị ka okirikiri. Ebe ọ bụ na akụkụ lunate na iberibe ọkpụkpụ volar na-agbakọta ọnụ, Circle 1 (nke dị odo) na-ekerịta etiti ya na Circle 2 (nke dị ọcha). ACD na-anọchite anya anya site na etiti a na-ekerịta ruo etiti Circle 3. Ebumnuche ịwa ahụ bụ iweghachi ACD ka ọ bụrụ 0, na-egosi mbelata anatomical.
N'ọrụ ahụike gara aga, a nabatala nke ọma na nkwụsịtụ elu nkwonkwo nke <2mm bụ ọkọlọtọ maka mbelata. Agbanyeghị, n'ọmụmụ ihe a, nyocha nke usoro Receiver Operating Characteristic (ROC) nke paramita onyonyo dị iche iche gosiri na ACD nwere mpaghara kachasị elu n'okpuru usoro (AUC). Site na iji uru mbepụ nke 1.02mm maka ACD, o gosipụtara mmetụta 100% na nkọwapụta 80.95%. Nke a na-egosi na n'usoro mbelata mgbawa, ibelata ACD ruo n'ime 1.02mm nwere ike ịbụ ihe ezi uche dị na ya karịa.
karịa ọkọlọtọ ọdịnala nke <2mm steepụ elu nkwonkwo.
O yiri ka ACD nwere uru dị mkpa maka inyocha oke mgbanwe na mgbawa akwara dị n'ime akwara nke gụnyere nkwonkwo concentric. Na mgbakwunye na ojiji ya n'inyocha mgbawa nke tibial plafond na mgbawa nke distal radius dịka ekwuru na mbụ, enwere ike iji ACD mee ihe maka inyocha mgbawa ikpere aka. Nke a na-enye ndị dọkịta ọgwụ ngwaọrụ bara uru maka ịhọrọ ụzọ ọgwụgwọ na inyocha nsonaazụ mbelata mgbawa.
Oge ozi: Sep-18-2023
