He kaiwhakakata rongonui a Peretānia a Terry Thomas, e mōhiotia whānuitia ana mō tōna āhua ataahua, arā, te āputa i waenganui i ōna niho o mua.
Mō ngā whara o te ringaringa, he momo whara kei te āhua rite ki te āputa niho o Terry Thomas te tirohanga X-ray. I tapaina tēnei e Frankel ko te "tohu Terry Thomas," e mōhiotia ana hoki ko te "tohu āputa niho karekau."
Āhua o te Irahiko: Ina he wehenga scapholunate me te haehae o te ligament scapholunate interosseous, ko te tirohanga anteroposterior o te ringaringa, ko te tirohanga coronal rānei i te CT e whakaatu ana i te āputa nui ake i waenga i ngā wheua scaphoid me te lunate, he rite ki te āputa niho taratara.
Tātari Tohu: Ko te wehenga o te scapholunate te momo kore pumau o te ringaringa, e mōhiotia ana ko te scaphoid rotary subluxation. Ko te tikanga ka puta mai i te whakakotahitanga o te toronga, te pekapeka ulnar, me te kaha o te supination e pā ana ki te taha nikau ulnar o te ringaringa, ka puta te pakaru o ngā hononga e whakau ana i te pou proximal o te scaphoid, ka arahi ki te wehenga i waenga i ngā wheua scaphoid me te lunate. Tērā pea ka haehaea te hononga radial collateral me te hononga radioscaphocapitate.
Ko ngā mahi whakahou, ngā whara hopu me te hurihuri, te ngoikore o te hononga whānau, me te rerekētanga kino o te ulnar e hono ana ki te wehenga scapholunate.
Whakamātautau Whakaahua: X-ray (me te whakataurite i ngā taha e rua):
1. E whakapaetia ana te wehenga o te āputa scapholunate > 2mm; ki te neke atu i te 5mm, ka taea te tautuhi.
2. Te tohu mowhiti cortical scaphoid, ko te tawhiti i waenga i te rohe o raro o te mowhiti me te mata hononga proximal o te scaphoid he < 7mm.
3. Te whakapoto o te kaki scaphoid.
4. Te pikinga o te koki scapholunate: I te nuinga o te wā, he 45-60°; ko te koki radiolunate > 20° e tohu ana i te Dorsal Intercalated Segment Instability (DISI).
5. Tohu "V" o te nikau: Ki te titiro taha noa o te ringaringa, ka hanga he āhua "C" ngā taha nikau o ngā wheua metacarpal me te radial. Ina he piko rerekē o te scaphoid, ka honoa tōna taha nikau ki te taha nikau o te radial styloid, ka hanga he āhua "V".
Wā tuku: Pipiri-29-2024
