Ko ngā tawhā whakaahua e whakamahia whānuitia ana mō te aromatawai i ngā whati o te radius distal ko te volar tilt koki (VTA), te rerekētanga ulnar, me te teitei radial. I te hohonu haere o tō tātou māramatanga ki te hanganga o te radius distal, kua whakaarohia, kua whakamahia hoki ētahi atu tawhā whakaahua pēnei i te tawhiti anteroposterior (APD), te koki roimata (TDA), me te tawhiti capitate-to-axis-of-radius (CARD) i roto i te mahi haumanu.
Ko ngā tawhā whakaahua e whakamahia whānuitia ana mō te aromatawai i ngā whati o te radius distal ko: a：VTA；b：APD；c：TDA；d：CARD。
He pai te nuinga o ngā tawhā whakaahua mō ngā whati o te radius distal i waho o te hononga, pērā i te teitei radial me te rerekētanga ulnar. Heoi, mō ētahi whati o roto i te hononga, pērā i ngā whati a Barton, kāore pea ngā tawhā whakaahua tuku iho e āhei ki te whakatau tika i ngā tohu pokanga me te whakarato aratohu. E whakaponohia whānuitia ana ko te tohu pokanga mō ētahi whati o roto i te hononga he hononga tata ki te nekehanga o te mata o te hononga. Hei aromatawai i te nekehanga o ngā whati o roto i te hononga, kua whakaarohia e ngā tohunga o tāwāhi he tawhā ine hou: TAD (Tilt After Displacement), ā, i pūrongohia tuatahitia mō te aromatawai i ngā whati o muri o te malleolus me te nekehanga o te tibial distal.
I te pito tawhiti o te tibia, i roto i ngā take o te whati o te malleolus o muri me te nekenekehanga o te talus o muri, ka hangaia e te mata hononga e toru ngā pewa: Ko te Pewa 1 te mata hononga o mua o te tibia tawhiti, ko te Pewa 2 te mata hononga o te kongakonga malleolus o muri, ā, ko te Pewa 3 te tihi o te talus. Ina he kongakonga whati o te malleolus o muri e haere tahi ana me te nekenekehanga o te talus o muri, ko te pokapū o te porowhita i hangaia e te Pewa 1 i runga i te mata hononga o mua ka tohua ko te pūwāhi T, ā, ko te pokapū o te porowhita i hangaia e te Pewa 3 i runga i te talus o muri ka tohua ko te pūwāhi A. Ko te tawhiti i waenganui i ēnei pokapū e rua ko te TAD (Tilt After Displacement), ā, ki te nui ake te nekenekehanga, ka nui ake te uara TAD.
Ko te whāinga o te pokanga he whakatutuki i te uara ATD (Tilt After Displacement) ki te 0, e tohu ana i te whakaititanga o te tinana o te mata o te hononga.
Waihoki, i roto i te take o te whati volar Barton:
Ko ngā maramara mata hononga kua nekehia ā-wāhanga ka hanga i te Āwhata 1.
Ko te mata o te maramara te Pewa 2.
Ko te taha tuarā o te radius (he wheua noa kāore he whati) e tohu ana i te Pewa 3.
Ka taea te whakaaro ko ia o ēnei pewa e toru he porowhita. Nā te mea kua nekehia ngātahi te taha o te tinana me te kongakonga wheua volar, ka tohaina te pokapū o te Porowhita 1 (kōwhai) ki te Porowhita 2 (mā). Ko te ACD te tohu i te tawhiti mai i tēnei pokapū tiritahi ki te pokapū o te Porowhita 3. Ko te whāinga pokanga he whakahoki i te ACD ki te 0, e tohu ana i te whakaitinga o te tinana.
I roto i ngā mahi haumanu o mua, kua whakaaetia whānuitia ko te nekehanga o te mata hononga <2mm te paerewa mō te whakaiti. Heoi, i roto i tēnei rangahau, i whakaatuhia e te tātaritanga pihi Āhuatanga Whakahaere Kaiwhiwhi (ROC) o ngā tawhā whakaahua rerekē ko te ACD te mea nui rawa atu i raro i te pihi (AUC). Mā te whakamahi i te uara tapahi o te 1.02mm mō te ACD, i whakaatuhia he 100% te aro me te 80.95% te motuhake. E kī ana tēnei i roto i te tukanga whakaiti whati, ko te whakaiti i te ACD ki roto i te 1.02mm he paearu whaitake ake pea.
i te paerewa tuku iho o te whakahekenga mata hononga <2mm.
Te āhua nei he mea nui te ACD hei aromatawai i te nekehanga o ngā whati hononga-roto e pā ana ki ngā hononga porowhita. Haunga tōna whakamahinga hei aromatawai i ngā whati tibial plafond me ngā whati radius distal e ai ki te kōrero i mua ake nei, ka taea hoki te whakamahi i te ACD hei aromatawai i ngā whati tuke. Mā tēnei ka whai hua ngā kaimahi haumanu ki te whiriwhiri i ngā huarahi maimoatanga me te aromatawai i ngā putanga whakaiti whati.
Wā tuku: Hepetema-18-2023
