tailieunhanh - Dự đoán của các khớp cổ tay

Có xương giống hình chiếc thuyền nonunique kết quả trong một mô hình Dự đoán của các khớp cổ tay. Để giảm thiểu tỷ lệ khớp, mục tiêu của điều trị nên bị hợp nhất của gãy xương với có xương giống hình chiếc thuyền trong sự liên kết giải phẫu. Chụp X quang và cộng hưởng từ quét đánh giá viện trợ CDN của cổ tay sụp đổ | Management of Scaphoid Nonunions Thomas E. Trumble MD Peter Salas MD Traci Barthel MD and Kearny Q. Robert III MD Abstract Scaphoid nonunions result in a predictable pattern of wrist arthrosis. To minimize the incidence of arthrosis the goal of treatment should be consolidation of the fracture with the scaphoid in anatomic alignment. Computed tomography and magnetic resonance imaging scans can aid evaluation of carpal collapse scaphoid collapse scaphoid nonunion bone loss and detection of osteonecrosis. Nonunion of the scaphoid waist may result in a humpback deformity increasing the chances of further collapse and arthrosis. This collapse deformity must be approached volarly with an intercalary bone graft and internal xation. A dorsal approach to proximal scaphoid nonunions allows easier access for removing the necrotic bone from the proximal pole and applying accurate screw or pin xation. Vascularized bone graft is recommended to manage scaphoid nonunions with osteonecrosis. J Am Acad Orthop Surg 2003 11 380-391 Scaphoid nonunions are rarely symptomatic in the early stages and the success rate of management decreases with the duration of the Scaphoid nonunions occur when fractures are not diagnosed and managed initially or when they have not healed with cast immobilization within 6 months of injury. Fractures that do not show signs of radiographic healing after 6 to 8 weeks of cast immobilization and fractures diagnosed 6 weeks after injury are less likely to heal. After an even longer duration unmanaged scaphoid nonunions frequently cause wrist pain and lead to progressive 6 Because it is not usually possible to determine how long a nonunion has been present or how many patients with asymptomatic nonunions occur in a particular population the natural history of scaphoid nonunions has not been clearly Consequently the risk for developing wrist arthrosis from a scaphoid nonunion cannot be calculated. However a growing body of