Ko ngā whati o te radius distal tētahi o ngā whati tino noangā whatii roto i te mahi haumanu. Mō te nuinga o ngā whati o te pito tawhiti, ka taea te whakatutuki i ngā hua rongoā pai mā te whakapiri i te pereti whakatata nikau me te whakapiri ā-roto o te tīwiri. Hei tāpiri, he maha ngā momo whati motuhake o te radius tawhiti, pērā i ngā whati Barton, ngā whati Die-punch,Ngā whati o te taraiwa, me ētahi atu., ia mea e hiahia ana ki ngā huarahi maimoatanga motuhake. I roto i ā rātou rangahau i ngā tauira nui o ngā whati o te radius distal, kua tautuhia e ngā tohunga o tāwāhi tētahi momo motuhake kei reira tētahi wāhanga o te hononga e pā ana ki te whati o te radius distal, ā, ka hangaia e ngā kongakonga wheua he hanganga kōniko me te turanga "tapatoru" (tetrahedron), e kiia nei ko te momo "tetrahedron".
Ariā o te Whati o te Momo "Tetrahedron" Radius Distal: I roto i tēnei momo whati radius distal, ka puta te whati i roto i tētahi wāhanga o te hononga, e uru ana ngā taha palmar-ulnar me te radial styloid, me te whirihoranga tapatoru whakawhiti. Ka toro atu te rārangi whati ki te pito distal o te radius.
Ko te ahurei o tēnei whati e whakaatahia ana i roto i ngā āhuatanga motuhake o ngā kongakonga wheua taha palmar-ulnar o te radius. I tētahi taha, ko te fossa lunar i hangaia e ēnei kongakonga wheua taha palmar-ulnar he tautoko tinana ki te whakakorenga volar o ngā wheua carpal. Ko te ngaronga o te tautoko mai i tēnei hanganga ka hua ake te whakakorenga volar o te hononga ringaringa. I tētahi atu taha, hei wāhanga o te mata hononga radial o te hononga radioulnar distal, ko te whakahoki i tēnei kongakonga wheua ki tōna tūranga anatomical he mea nui kia hoki mai te pumau o te hononga radioulnar distal.
Kei te whakaatuhia i raro nei te Take 1: Ngā whakaaturanga whakaahua o te whati radius distal momo "Tetrahedron".
I roto i tētahi rangahau e rima tau te roa, e whitu ngā kēhi o tēnei momo whati i kitea. Mō ngā tohu pokanga, mō ngā kēhi e toru, tae atu ki te Kēhi 1 i te ahua i runga ake nei, i reira i te tīmatanga he whati kāore i nekehia, i whiriwhiria tuatahitia te maimoatanga ā-pūmau. Heoi, i te wā o te arotakenga, i pāngia ngā kēhi e toru e te nekehanga o te whati, ā, i muri mai ka arahina ki te pokanga whakatikatika ā-roto. E whakaatu ana tēnei i te taumata teitei o te kore pumau me te mōrearea nui o te nekehia anō i roto i ngā whati o tēnei momo, e whakaatu ana i te tohu kaha mō te wawaotanga pokanga.
Mō te maimoatanga, e rua ngā kēhi i te tīmatanga i whakamahia te huarahi volar tuku iho me te flexor carpi radialis (FCR) mō te whakapiri ā-roto o te pereti me te tīwiri. I tētahi o ēnei kēhi, i rahua te whakapiri, ā, i nekehia te wheua. I muri mai, i whakamahia te huarahi palmar-ulnar, ā, i mahia he whakapiri motuhake me te pereti pou mō te whakatikatika i te pou pokapū. I muri i te rahua o te whakapiri, i whakamahia katoatia ngā kēhi e rima i muri mai ki te huarahi palmar-ulnar, ā, i whakapirihia ki ngā pereti 2.0mm, 2.4mm rānei.
Take 2: Mā te whakamahi i te huarahi volar tuku iho me te flexor carpi radialis (FCR), i mahia te whakapiringa ki te pereti nikau. I muri i te pokanga, i kitea te nekehanga o mua o te hononga o te ringaringa, e tohu ana i te korenga o te whakapiringa.
Mō te Take 2, mā te whakamahi i te huarahi nikau-ulnar me te whakahou mā te whakamahi i te pereti pou i pai ai te tūranga mō te whakapiri ā-roto.
I runga i ngā ngoikoretanga o ngā pereti whati radius distal tuku iho i roto i te whakatika i tēnei kongakonga wheua, e rua ngā take matua. Tuatahi, ko te whakamahinga o te huarahi volar me te flexor carpi radialis (FCR) ka hua ake he koretake o te whakaaturanga. Tuarua, ko te rahi nui o ngā tīwiri pereti maukati-palmar kāore pea e mau tika ngā kongakonga wheua iti, ā, ka taea pea te neke atu mā te whakauru i ngā tīwiri ki roto i ngā āputa i waenganui i ngā kongakonga.
Nō reira, e kī ana ngā tohunga kia whakamahia ngā pereti raka 2.0mm, 2.4mm rānei hei whakapiri motuhake i te kongakonga wheua o te pou waenga. Haunga te pereti tautoko, ko te whakamahi i ngā tīwiri e rua hei whakapiri i te kongakonga wheua me te whakakore i te pereti hei tiaki i ngā tīwiri he kōwhiringa whakapiri ā-roto anō hoki.
I tēnei wā, i muri i te whakapiri i te kongakonga wheua ki ngā tīwiri e rua, ka whakaurua te pereti hei tiaki i ngā tīwiri.
Hei whakarāpopototanga, ko te momo whati radius distal momo "Tetrahedron" e whakaatu ana i ngā āhuatanga e whai ake nei:
1. He iti te auau, he nui hoki te maha o ngā hē o te tātaritanga tuatahi mō te kiriata māmā.
2. He nui te mōrearea o te kore pumau, me te āhua o te nekenekehanga i te wā e rongoatia ana.
3. He ngoikore te kaha o ngā pereti raka nikau tuku iho mō ngā whati o te radius distal, ā, e taunakihia ana kia whakamahia ngā pereti raka 2.0mm, 2.4mm rānei mō te raka motuhake.
I runga i ēnei āhuatanga, i roto i te mahi haumanu, he mea tika kia mahia he matawai CT, he tirotiro anō rānei i ia wā mō ngā tūroro he nui ngā tohu o te ringaringa engari he kino ngā hihi-X. Mō tēnei momowhati, e taunakihia ana te pokanga wawe me te whakamahi i tētahi pereti motuhake ki te pou hei ārai i ngā raruraru a muri ake nei.
Wā tuku: Oketopa-13-2023
