Ihe onyonyo onyonyo a na-ejikarị maka ịlele mgbaji radius dị anya na-agụnyekarị volar tilt angle (VTA), variance ulnar, na radial elu.Dika nghota anyi banyere anatomi nke radius distal na-abawanyewanye, echerela ma tinye ihe onyonyo onyonyo dika anteroposterior distance (APD), teardrop angle (TDA), na capitate-to-axis-of-radius distance (CARD) ma tinye ya n'ọrụ. omume ụlọ ọgwụ.
Ihe onyonyo a na-ejikarị eme ihe maka ịlele mgbaji radius dị anya gụnyere: a:VTA;b: APD;c:TDA;d:CARD.
Imirikiti ihe onyonyo dabara adaba maka mgbaji radius dịpụrụ adịpụ, dị ka ịdị elu radial na mgbanwe nhụsianya.Otú ọ dị, maka ụfọdụ mgbaji ọkpụkpụ dị n'ime-articular, dị ka ọkpụkpụ Barton, ihe ngosi ihe ngosi omenala nwere ike ọ gaghị enwe ike ikpebi ihe ngosi ịwa ahụ nke ọma na inye nduzi.A na-ekwenyekarị na ihe ngosi ịwa ahụ maka ụfọdụ ọkpụkpụ intra-articular nwere njikọ chiri anya na nkwụsị nke elu nkwonkwo.Iji chọpụta ogo nke nchụpụ nke mgbawa intra-articular, ndị ọkà mmụta mba ọzọ ewepụtala usoro nha ọhụrụ: TAD (Tilt After Displacement), na mbụ a kọrọ ya maka nleba anya nke ọkpụkpụ azụ malleolus na-esonyere nchụpụ tibial distal.
N'ebe dị anya nke tibia, n'ọnọdụ nke mgbaji malleolus dị n'azụ na nkwụsị azụ nke talus, nkwonkwo elu ahụ na-emepụta arcs atọ: Arc 1 bụ nkwonkwo ihu ihu nke tibia distal, Arc 2 bụ nkwonkwo elu nke azụ malleolus. iberibe, na Arc 3 bụ n'elu talus.Mgbe enwere mgbaji malleolus nke dị n'azụ na-esonyere ya na mgbaka azụ nke talus, etiti gburugburu nke Arc 1 guzobere na elu nkwonkwo ihu na-egosi dị ka ebe T, na etiti gburugburu nke Arc 3 guzobere n'elu. A na-akọwa talus dị ka ebe A. Ebe dị anya n'etiti ebe abụọ a bụ TAD (Tilt After Displacement), na nnukwu nchụpụ ahụ, na-abawanye uru TAD.
Ebumnuche ịwa ahụ bụ iji nweta uru ATD (Tilt After Displacement) nke 0, na-egosi mbelata anatomical nke elu nkwonkwo.
N'otu aka ahụ, n'ihe gbasara mgbawa nke Barton:
Iberibe elu akụkụ articular nke a chụpụrụ n'akụkụ akụkụ bụ Arc 1.
The lunate facet na-eje ozi dị ka Arc 2.
Akụkụ azụ nke radius (ọkpụkpụ nkịtị na-enweghị mgbaji) na-anọchite anya Arc 3.
Enwere ike were nke ọ bụla n'ime arc atọ a dị ka okirikiri.Ebe ọ bụ na a na-akwagharị akụkụ akụkụ lunate na akụkụ ọkpụkpụ volar ọnụ, Circle 1 (na edo edo) na-ekerịta etiti ya na Circle 2 (na ọcha).ACD na-anọchi anya ebe dị anya site na etiti a na-ekekọrịta ruo etiti Circle 3. Ebumnuche ịwa ahụ bụ iweghachi ACD na 0, na-egosi mbelata anatomical.
N'ime usoro ọgwụgwọ gara aga, a nabatala nke ọma na nkwụsị elu nkwonkwo nke <2mm bụ ụkpụrụ maka mbelata.Otú ọ dị, n'ime ọmụmụ ihe a, nyocha nke onye na-enweta ihe na-arụ ọrụ (ROC) nke usoro ihe ngosi dị iche iche gosiri na ACD nwere ebe kachasị elu n'okpuru usoro (AUC).N'iji uru nkwụsị nke 1.02mm maka ACD, ọ gosipụtara 100% uche na 80.95% nkọwa.Nke a na-egosi na n'ime usoro nke mbelata mgbawa, ibelata ACD n'ime 1.02mm nwere ike ịbụ ihe ezi uche dị na ya.
karịa ọkọlọtọ ọdịnala nke <2mm nkwonkwo elu nzọụkwụ-apụ.
ACD na-egosi na ọ nwere uru ntụaka bara uru maka ịlele ogo nchụpụ na mgbaji intra-articular metụtara nkwonkwo concentric.Na mgbakwunye na ngwa ya n'ịtụle mgbaji tibial plafond na mgbaji radius dị anya dị ka ekwuru na mbụ, ACD nwekwara ike ịrụ ọrụ maka ịlele mgbaji ụkwụ.Nke a na-enye ndị na-ahụ maka ụlọ ọgwụ ngwá ọrụ bara uru maka ịhọrọ usoro ọgwụgwọ na ịlele nsonaazụ mbelata mgbaji.
Oge nzipu: Sep-18-2023
