- Tilmaamaha
1) Jabka daran ee jaban ayaa leh barokac muuqda, iyo dusha articular ee raadiyaha fog waa la burburiyaa.
2) Dhimista buug-gacmeedka ayaa ku guuldareysatay ama hagaajinta dibadda ayaa ku guuldareysatay inay ilaaliso dhimista.
3) .Jajab duug ah.
4) .Jajab xun ama midnimo la'aan.lafaha dal iyo dibadba jooga
- Contraindications
Bukaannada da'da ah ee aan ku habboonayn qalliinka.
- Hagaajinta gudaha (habka volar)
Diyaarinta qalliinka ka hor ee joogtada ah.Suuxinta waxaa lagu sameeyaa iyadoo la isticmaalayo suuxinta brachial plexus ama suuxinta guud
1) Bukaan-socodka ayaa la dhigayaa meel dhabarka ah iyadoo la afduubay addimada ay dhibaatadu saameysey waxaana lagu dhejiyaa qaabka qalliinka.Jeexdin 8cm ah ayaa la sameeyaa inta u dhaxaysa xididdada radial ee cududda hore iyo murqaha radial carpi flexor oo la fidiyay ilaa lafaha curcurka.Tani waxay si buuxda u soo bandhigi kartaa jabka waxayna ka hortagi kartaa qandhada nabarrada.Jeexintu uma baahna inay gasho calaacasha gacanta (Jaantuska 1-36A).
2) Raac jeexjeexa galka jeebka ee flexor carpi radialis (Jaantuska 1-36B), fur galka seedaha, googa gunta hoose ee bamboo fascia si aad u soo bandhigto flexor pollicis longus ulnar dhinaca, oo qayb ka xorow flexor pollicis longus.Caloosha muruqa ayaa si buuxda u soo gaadhay muruqa quadratus pronator (Jaantuska 1-36C)
3) Samee jeexitaan qaabaysan oo “L” ah oo ku teedsan dhinaca shucaaca ee radius si aad u muujiso muruqa quadratus pronator, ka dibna ka fuji raadiyaha diiriye si aad u soo bandhigto dhamaan xariiqda laalaabka bamboo (Jaantuska 1) -36D, Jaantuska 1-36E)
4) Geli furaha ama mindi lafo yar oo ka soo baxa khadka jaban, oo u isticmaal kabaal si aad u yareyso jabka.Geli furaha ama mindida maqas yar ee xariiqda jaban ilaa kiliyaha dambe ee lafta si aad u yarayso jajabinta oo aad u yarayso jajabka fog, oo isticmaal faraha si aad u cadaadiso jajabka dhabarka si aad u yareyso jajabka dhabarka.
Marka jabka radial styloid uu jabo, way adagtahay in la yareeyo jabka radial styloid sababtoo ah jiidashada muruqa brachioradialis.Si loo yareeyo xoogga jiidista, brachioradialis waa la maamuli karaa ama waa laga gooyn karaa raadiyaha fog.Haddii loo baahdo, jajabka fogaanta waxaa si ku meel gaar ah loogu hagaajin karaa jajabka u dhow ee fiilooyinka Kirschner.
Haddii habka ulnar styloid uu jabo oo la barokiciyo, iyo wadajirka radioulnar ee fog yahay mid aan degganeyn, hal ama laba fiilooyin Kirschner ayaa loo isticmaali karaa hagaajinta joogtada ah, iyo habka ulnar styloid dib ayaa loo dejin karaa habka volar.Jabka yaryar inta badan uma baahna daawaynta gacanta.Si kastaba ha ahaatee, haddii wadajirka radioulnar ee fog uu yahay mid aan degganeyn ka dib hagaajinta radius, jajabka styloid waa la gooyn karaa oo cidhifyada kakanaanta fibrocartilage ee saddex-geesoodka ah ayaa lagu tolay habka ulnar styloid ee leh barroosinno ama xariiro xariir ah.
5) .Iyadoo la kaashanayo jiidashada, kaabsal wadajirka ah iyo ligament waxaa loo isticmaali karaa in la sii daayo isdhexgalka oo la yareeyo jabka.Ka dib jabka si guul leh loo dhimo, go'aami booska meelaynta saxanka birta volar iyadoo la raacayo hagida raajada fluoroscopy oo ku marooji godka oval ama daloolka silbashada si loo fududeeyo hagaajinta booska (Jaantus 1-36F).Isticmaal dalool 2.5mm ah oo dalool ah si aad u qoddo badhtamaha daloolka oval-ka ah, oo geli 3.5mm caarada is-taajinta.
Jaantuska 1-36 Jeexitaanka maqaarka (A);Jeexitaanka galka jilicsan ee carpi radialis galka seedaha (B);oo laga siibo qayb ka mid ah jilibka jilicsan si loo muujiyo muruqa quadratus pronator (C);kala qaybinta murqaha quadratus pronator si uu u muujiyo raadiyaha (D);soo bandhigida khadka jabka (E);dhig saxanka volar oo ku fur furka kowaad (F)
6) Isticmaal C-arm fluoroscopy si aad u xaqiijiso meelaynta saxanka ah.Haddii loo baahdo, u riix saxanka fog ama u dhow si aad u hesho meelaynta furaha fog ee ugu fiican.
7) Isticmaal daloolin 2.0mm ah si aad u qoddo godka ugu dambeeya ee saxanka birta, cabbir qoto dheer oo ku fur furka qufulka.Ciddidu waa in ay ka gaaban tahay 2mm masaafada la cabbiray si looga ilaaliyo in furku soo galo oo ka soo baxo kiliyaha dhabarka.Guud ahaan, dabool 20-22mm ah ayaa ku filan, iyo kan lagu hagaajiyay habka styloid radial waa inuu gaaban yahay.Ka dib markaad ku xidhid furaha fog, marooji Geli furka u dhow ee soo hadhay.
Sababtoo ah xagasha furka ayaa loo qaabeeyey, haddii saxanka la dhigo meel aad ugu dhow dhammaadka fog, daboolku wuxuu geli doonaa wadajirka gacanta.Ka soo qaad jeexjeexyo tangential ah ee lafaha articular subchondral oo ka soo baxa coronal iyo jagooyinka sagittal si aad u qiimeyso haddii ay gasho kala-goysyada, ka dibna raac tilmaamaha Hagaaji taarikada birta iyo/ama boolal
(Jaantus 1-37) Jaantuska 1-37 Hagaajinta jabka fog ee radius oo leh saxan lafta volar A. Filinka raajada ee anteroposterior iyo lateral ee jabka radius fog ka hor inta aan la hawlgalin, oo muujinaya barokaca dhamaadka fog ee dhinaca volar;B. Filim raajada anteroposterior iyo lateral ee jabka qalliinka kadib, muujinaya jabka hoos u dhigis wanaagsan iyo nadiifinta wadajirka curcurka oo wanaagsan
8) Suture pronator quadratus muruqa oo leh tolmo aan la nuugi karin.Ogsoonow in muruqa uusan si buuxda u dabooli doonin saxanka.Qaybta fog waa in la daboolaa si loo yareeyo xidhiidhka ka dhexeeya seedaha dabacsan iyo saxanka.Tan waxaa lagu gaari karaa in la tolo quadratus pronator ilaa cidhifka brachioradialis, la xidho lakabka la jeexay, oo lagu hagaajiyo balastar haddii loo baahdo.
Waqtiga boostada: Sebtembar-01-2023
