Download - Anatomy Distal Radius
-
7/21/2019 Anatomy Distal Radius
1/32
Nontmdn jie rnjgm jgstne y sus gdpegbnbgmoispnrn ie trntndgiotm ji ens arnbturns
B`rgstgno Judmotgir, DJ, S`J
Lunjiemupi
Srisiotntgmo gs nvngenfei nt
www.jgub`grurlgidngo.mrl
http://www.diuchirurgiemain.org/ -
7/21/2019 Anatomy Distal Radius
2/32
@ns nontmdy b`nolij ribiotey =
@gppmbrnti uo-ribmlogzij t`i arnbturi;
t`i kmgot jgsembntis
igt`ir dijgneey mr entirneey
Kino-Emugs Sitgt (>st jisbrgptgmo fy Smutinu (>:); ...Z`i gokury...`ns omt...fiio jisbrgfij...; gojiij t`i amrd ma t`ibnrpne ixtridgty ma t`i rnjgus wmuej rnt`ir gobegoi us tm quistgmo gts figol egnfei
tm n arnbturi. Z`i nfsiobi ma bripgtus noj mt`ir bmddmo sydptmds ma
arnbturi tmlit`ir wgt` t`i swieegol, w`gb` gostnotey nrgsis go t`gs, ns go mt`ir
gokurgis ma t`i wrgst, riojir t`i jgabuety ma nsbirtngogol t`i rine onturi ma t`i
bnsi viry bmosgjirnfei....
@gppmbrntiBenuji
Smutinu
Nfrn`nd
BmeeisLugeenudi
Jupuytrio
Kmsip`
ArnomgsDnelngloi
-
7/21/2019 Anatomy Distal Radius
3/32
Om, w`nt `nvi b`nolij nri;
Z`i ipgjidgb ma mstimpmrmsgs;
YRN; >:% dneis & :3% aidneis ? 93 yrs
wgee `nvi n pmrmtgb Ax.
Enti `inegol wgt` n pmmr dib`nogbne qunegty
ma t`i bneeus
Eiss stnfgegty ma t`i bneeus (`nrjwnri
angeuri)
!rgsh ma sibmojnry jgspenbidiot
Z`i gobrinsij ariquioby ma JVA
Ariquioby ma JVA gobrinsis anstir t`no t`ipmpuentgmo nlgol (63 tm 93% nbbmrjgol tm
sirgis)
Duetgpegij fy >33 amr aidneis mejir t`no :3
yinrs mej. Y
p tm >9% ma w`gti aidneis mvir
93 wgee `nvi n JVA
-
7/21/2019 Anatomy Distal Radius
4/32
Om, w`nt `nvi b`nolij nri;
Z`i (bemsi) rientgmo fitwiio ristgtutgmo ma n omrdne
nontmdy noj t`i begogbne mutbmdis
Ixpirgdiotne stujgis `nvi s`mwo;
Gobrinsi prissuri noj suranbi bmotnbt nrin
wgt` rnjgus s`mrtiogol
Zrnosentgmo ma suranbi bmotnbt nrin wgt` jmrsne
noluentgmo
Regjgol ma gostnot biotir ma rmtntgmo wgt`
s`mrtiogol noj jmrsne noluentgmo
Begogbneey; Jmrsne noluentgmo wgt` bnrpne
dnenegloidiot siids tm fi t`i dmst prijgbtgvi
anbtmr ma t`i auobtgmone risuets
Ysi ma embhgol pentis
-
7/21/2019 Anatomy Distal Radius
5/32
\`y nontmdy ma jgstne rnjgus sm gdpmrtnot ga wi usi embhgol pentis =
@iorys npprmnb` `ns omt b`nolij
Z`i wny ymu dnonli t`i prmontmr
qunjrntus dusbei `ns om begogbnebmosiquiobis
Srmfeid gs wgt` t`i fmoy nontmdy
O`m K@ it ne. Ixndgontgmo ma t`i prmontmr qunjrntus dusbei jurgol `nrjwnri ridmvne prmbijuris natir vmenr pentgol amr jgstne rnjgus arnbturis. Bego
Mrt`mp Rurl. 63>: Rip81(2);6116 Rip82010-
-
7/21/2019 Anatomy Distal Radius
6/32
Embhgol pentis `nvi fgmdib`nogbne
njvnotnjlis
Gotirone xntmr (B``nfrn) "om
oiij tm fi stubh tm fmoi
Yogqui rglgj systid - Inb` sbriw
njjs stnfgegty tm t`i w`mei systid
Ixpirgdiotne wmrhs sullist t`no
ipgp`ysine sbriws nri omt rglgj
iomul` tm sustngo t`i emnjs go n
pmrtgbm rnjgus ipgp`ysgs
Ixpirgdiots sullist t`i supirgmrgty
ma embhij pentis (tm bmoviotgmone) go
pmrmtgb fmois
Bmoviotgmone
Embhgol
-
7/21/2019 Anatomy Distal Radius
7/32
@mwivir; Z`i usi ma embhgol pentis jmis omt neemw
us tm amrlit t`i prgobgpeis ma mstimsyot`isgs
Fmoi arnldiots dust fi go
bmotnbt tm mftngo `inegol
noj rijubij fiamri xntgmo
Rbriws dust lm t`rmul`
fmt` bmrtgbis (mr nt einst
. Bmroiee, B. O.; Agxntgmo bmosgjirntgmos go mstimpmrmtgb fmoi arnbturis. Burr Mpgo Mrt`mp, 63398 >1; 2.
6. Jrmfitz @ it ne. Qmenr xij-nolei pentgol ma jgstne rnjgus ixtiosgmo arnbturis ; gostuiobi ma penti pmsgtgmo mo sibmojnry emss
ma rijubtgmo ; n fgmdib`nogb stujy go n bnjnvirgb dmjie. K @noj Rurl Nd 63318 2> ; 1>9-66.
2. \nee EF it ne. Z`i i"ibts ma sbriw eiolt` mo stnfgegty ma sgduentij mstimpmrmtgb jgstne rnjgus arnbturis xij wgt` vmenr
embhgol pentis. K @noj Rurl Nd. 63>682
-
7/21/2019 Anatomy Distal Radius
8/32
Ariquioby ma bmdpegbntgmos natir
JVA =; 6>-6,9 tm 6,1%
nri rientij tm t`i jivgbi, wgt`
3->6 % ma tiojgomus rupturis
Ma 623 sbriws bmotrmeeij wgt`
smomlrnp`y, t`i tgp ma 97 wns
3,9 dd mr mvir t`i jmrsne bmrtix(tiomsyomvgtgs >0 bnsis, rupturis
6 bnsis)
Gotrn-nrtgbuenr sbriws wiri
ripmrtij go >6 tm :9% ma bnsis
bmotrmeeij wgt` nrt`rmsbmpy
>. Rlo ZR it ne. Rbriw prmdgoiobis rientij tm pnednr embhgol pentgol ma jgstne rnjgus. K @noj Rurl Iur Qme 63>> 21;
263-26:.
6. Qnrgtgdgjgs RI it ne. Zrintdiot ma gotrn-nrtgbuenr arnbturis ma t`i jgstne rnjgus; stumrmsbmpgb mr nrt`rmsbmpgb rijubtgmo=K Fmoi Kmgot Rurl 6330873F;
-
7/21/2019 Anatomy Distal Radius
9/32
Nontmdy ma t`i notirgmr suranbi ma t`i rnjgus
Z`i notirgmr suranbi gs
stnt up tm > bd nfmvi
t`i kmgot egoi
g.i. up tm t`i jgstne eivie
ma t`i prmontmr
qunjrntus (>> dd nfmvi t`i
euontud amssn, >2 dd nfmvit`i sbnp`mgj amssn)
-
7/21/2019 Anatomy Distal Radius
10/32
Z`io bmobnvi notirgmrey up tm
t`i dmst notirgmr pnrt bneeij
t`i wntirs`ij egoi (t`i
dmst prmdgoiot pnrt)
Gs n penti prmkibts jgstneey tm t`i
wntirs`ij egoi, stixmr tiojmos
nri go jnolir ma nfutdiot noj
gt gobrinsis t`i rgsh ma gotrn-
nrtgbuenr sbriw penbidiot
AJSg & ASE nri 6.6 dd
notirgmr tm rnjgus, 2 dd
nfmvi t`i wntirs`ij egoi
Nontmdy ma t`i notirgmr suranbi ma t`i rnjgus
Nloiw RS it ne. Jnolir [mois amr Aeixmr Ziojmos go Qmenr Sentgol ma Jgstne Vnjgus Arnbturis. K @noj Rurl 63>9 (go priss)
-
7/21/2019 Anatomy Distal Radius
11/32
X 6
. . .
. . . .
.
.
@mwivir, t`i embntgmo ma t`i wntirs`ij egoi gs
`gl`ey vnrgnfei
Fitwiio gojgvgjunes
Fitwiio t`i rnjgne noj
ueonr sgji ma t`i ipgp`ysgs
Gdntnog it ne. No nontmdgbne stujy ma t`i wntirs`ij egoi mo t`i vmenr jgstne nspibt ma t`i rnjgus. K @noj Rurl 63>68 2993-:
-
7/21/2019 Anatomy Distal Radius
12/32
\ntirs`ij egoi gs jgaairiot armd prmontmr
qunjrntus gosirtgmo
Qiry bemsi tm t`i jgstne S^
entirneey (rij jmttij egoi),
Dmri jgstneey dijgneey
(feui jmttij egoi)
-
7/21/2019 Anatomy Distal Radius
13/32
X 6
. . .
Gdpmrtnot vnrgntgmos ma t`i s`npi ma t`i jgstne
rnjgus
Z`i ueonr sgji vnrgis go
sgzi noj s`npi
Gobegontgmo gs >:9 nt
t`i euonti amssn, vs
>99 mvir t`i sbnp`mgj
amssn (nvirnli >93)
Nee pentis nri jisgloij
wgt` n >99 nolei
X 9
. ..
X 2
-
7/21/2019 Anatomy Distal Radius
14/32
Mo t`i rnjgne sgji
Z`iri gs n pnepnfei virtgbne rgjli
N tmm entirne penti wgee fi prmontijnoj pnepnfei t`rmul` t`i shgo
-
7/21/2019 Anatomy Distal Radius
15/32
Z`i rnjgne styemgj
Gs omt go t`i sndi penoi
ns tm t`i notirgmr suranbima t`i rnjgus
Sentis s`muej gobeuji n
spibgne mrgiotntgmo amr t`isbriws go t`i rnjgne styemgj
-
7/21/2019 Anatomy Distal Radius
16/32
Ns n bmosiquiobi
Dmst ma t`i jisgloijembhgol pentis jm omt t
wgt` t`i nontmdy
(Fitwiio 2 tm 1% ma
bmotnbt zmois)
Fuzziee KI, \ighirt JV, \ntsmo KZ, Eii J@. Sribmotmurij xij-nolei vmenr jgstne rnjgus pentis; n
bmdpnrgsmo ma nontmdgb t. K @noj Rurl Nd 6330822;>>::96.
-
7/21/2019 Anatomy Distal Radius
17/32
Mo t`i entirne sgjiZ`i rnjgne siptud gs dnji fy t`i
>st bmdpnrtdiot noj t`i jgstne
tiojmo ma t`i frnb`gmrnjgnegs
Gt egdgts t`i surlgbne ixtiosgmo
entirneey
Go JVAx, t`i jgstne ipgp`ysgs gs
pueeij go supgontgmo noj prmxgdneeyfy t`i frnb`gmrnjgnegs tiojmo
\`io usgol notirgmr pentis, t`i
FV tiojmo dust fi igt`ir but mr
eiolt`io tm bmrribtey rijubi nojx t`i ipgp`ysgs noj t`i rnjgne
siptud dust fi jgvgjij (w`gb`
`ns om begogbne bmosiquiobis mo
t`i striolt` go supgontgmo)
-
7/21/2019 Anatomy Distal Radius
18/32
Qnsbuenr nontmdy
Qnsbuenrgzntgmo ma t`i jgstne ipgp`ysgs gs
dnji fy frnob`is ma t`i notirgmr noj
pmstirgmr gotirmssimus nrtirgis
Nvmgj gokurgis tm t`i dijgne pnrt ma t`i
rnjgus
-
7/21/2019 Anatomy Distal Radius
19/32
Jmrsne sgji
@gl`ey bmotmurij s`npi ma t`i
jmrsne sgji
Ixtiosmr tiojmos nri embntijgotm luttirs
Z`i `igl`t ma Egstirs tufirbei
vnrgis armd 2,2 tm 1,1 dd,noj t`i jipt` ma t`i luttir ma
t`i ISE dny fi ns jiip ns
2,6 dd !
-
7/21/2019 Anatomy Distal Radius
20/32
Qnrgntgmos go t`i jipt` ma t`i rnjgus armd
dijgne tm entirne
Z`i wgjt` ma t`i rnjgus nt t`i eivie ma
Egstirs tufirbei gs 66 +/- 6 dd (jm omt
usi sbriw emolir t`no 63 dd nt t`nt eivie)
Ekuolqugst HE it ne.Srijgbtgol n Rnai Rbriw Eiolt` amr Qmenr Senti Agxntgmo ma Jgstne Vnjgus Arnbturis;Euonti Jipt` ns n Dnrhir amr Jgstne Vnjgus Jipt`. K @noj Rurl Nd. 63>98:3(9);7:3i7::.
-
7/21/2019 Anatomy Distal Radius
21/32
Rurlgbne bmosiquiobis
N sbriw dust fi 1,9 dd
emolir t`no t`i bmrtgbne fmoi
go t`i rnjgne sgji, noj 2 dd
go t`i ueonr sgji tm fi siiomo t`i entirne vgiw !
Ga ymu jm entirne vgiw wgt`
prmontgmo noj supgontgmo, nsbriw s`muej fi nt einst 6-2
dd emolir t`no t`i bmrtgbne
fmoi tm fi siio
>. Dnsb`hi RJ it ne. Vnjgmlrnp`gb ivneuntgmo ma jmrsne sbriw pioitrntgmo natir vmenr xij-nolei pentgol ma t`i jgstne rnjgus;
n bnjnvirgb stujy. @noj 633:: >93.
-
7/21/2019 Anatomy Distal Radius
22/32
Rurlgbne bmosiquiobis
Ysi spibgne stumrmsbmpgb gobgjiobis
Rhyegoi vgiw (63>3).
Riosgfgegty, spibgbgty noj jgnlomstgb
pribgsgmo wns 02% amr sbriw emolir
t`no > dd (bmdpnrij tm . Vgjjgbh NS it ne. Nbburnby ma t`i shyegoi vgiw amr jitibtgol jmrsne bmrtgbne pioitrntgmo jurgol vmenr jgstne rnjgus
xntgmo. K. @noj Rurl. (Iur. Qme.) 63>68 2.
-
7/21/2019 Anatomy Distal Radius
23/32
Ixndpei; bnjnvirgb stujy wgt` t`i shyegoi vgiw
-
7/21/2019 Anatomy Distal Radius
24/32
Z`i jmrsne `mrgzmo vgiw
Ysgol t`gs gobgjiobi, Kmsip` noj
@nrviy `nj tm b`nolij 61% ma t`igrsbriws
>. Kmsip` RK, @nrviy KO. Z`i Jmrsne @mrgzmo Qgiw; Jitibtgol Rbriw Srmtrusgmo nt t`i Jgstne Vnjgus. K @noj Rurl63>>821N;>17>>172
-
7/21/2019 Anatomy Distal Radius
25/32
Dijgne sgji; t`i JVYK
Zrmb`mj kmgot
Neemws n omrdne rmtntgmo ma >:3->93
-
7/21/2019 Anatomy Distal Radius
26/32
Z`i JVYK gs `gl`ey uostnfei
Gt prisiots fmoy
rigoamrbidiots tm risgsts
sufeuxntgol amrbis
-
7/21/2019 Anatomy Distal Radius
27/32
Z`i JVYK gs pnrt ma t`i gokury
Vnjgus noj ueon amrd n
arndi
N jgspenbij JVA gdpegis
t`nt t`iri nri eisgmos mo t`i
ueon noj/mr eglndiots
Yp tm omw, dnonlidiot ma
ueonr styemgj arnbturis gs omt
bmrrientij wgt` mutbmdis
Rmuir KR it ne. I"ibt ma no uoripngrij arnbturima t`i ueonrstyemgjfnsi mo mutbmdi natir penti-noj-sbriwxntgmo ma n jgstne rnjgne arnbturi. K FmoiKmgot Rurl Nd. 6337 Npr87>(:);023-0
-
7/21/2019 Anatomy Distal Radius
28/32
Z`i nrtgbuenr suranbi
Armotne gobegontgmo gs
nfmut 66
Rnlgttne gobegontgmo gs
3
Go t`i armotne penoi,
t`i sbnp`mgj amssn gs
dmri bmobnvi t`no
t`i euonti amssn
-
7/21/2019 Anatomy Distal Radius
29/32
Nontmdy ixpengos w`y >6-23% ma jgstne sbriws
nri gotrn-nrtgbuenr !
Zm nvmgj dgs-penbidiot ma jgstne sbriws;
Rtnrt wgt` t`i dmst dijgne sbriws
Aeumrmsbmpgb bmotrme wgt` vnrgntgmo mo t`i
noluentgmo; NS wgt` >3 ma find gobegontgmo8
entirne wgt` >3 (dijgne sgji) noj 63 ma
gobegontgmo (entirne sgji)
=
-
7/21/2019 Anatomy Distal Radius
30/32
>3 noluentgmo
`ieps tm stujyt`i nrtgbuenr
suranbi go t`i
armotne penoi
63 noluentgmo
`ieps tm stujyt`i nrtgbuenr
suranbi go t`i
snlgttne penoi
-
7/21/2019 Anatomy Distal Radius
31/32
Noj amr t`i ristgtutgmo ma nrtgbuenr
suranbis =
Z`iri gs om nontmdgbne
enojdnrhs ymu dny usi
Moey vgsunegzntgmo igt`ir wgt`
n stumrmsbmpi (nbburnby >,9
dd) mr wgt` no nrt`rmsbmpi
Vistnurntgmo ma nrtgbuenrsuranbi uojir nrt`rmsbmpgb
bmotrme gdprmvis mutbmdis
Jmg H it ne. Gotrn-nrtgbuenr arnbturisma t`i jgstnenspibt ma t`i rnjgus; nrt`rmsbmpgbneey nssgstij rijubtgmobmdpnrij wgt` mpio rijubtgmo noj gotirone agxntgmo. K Fmoi Kmgot Rurl Nd. >777 Nul80>(0);>372->>3
-
7/21/2019 Anatomy Distal Radius
32/32
Bmobeusgmos
Nontmdy `ns omt b`nolij
Fut gt gs mur sinrb` amr gdprmvgol auobtgmone mutbmdis t`nt
prmdpt us tm jisglo oiw gdpenots
Z`i usi ma t`isi oiw gdpenots `ns b`nolij mur homweijlima t`i nontmdy w`gb` gs mfvgmusey dmri bmdpeix t`no
privgmusey t`mul`t