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Failunion after distal radius Fractures (Fonctional disorders)

سوء اندمال كسور النهاية القاصية للكعبرة (النتائج الوظيفية)

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 Publication date 2016
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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The intraarticular fracture of distal end of radius have bad returns more than extra articular fractures whereform the range of motion in flexion and extension, radial variance and ulnar variance of the joint. Shortness of the radius and the direction of articular surface of the radius should be corrected. The integrity of radial articular surface play an important rule in determining results. Displacement of the articular surface more than 1 mm cause an obstinate pain and synarthrophysis thereafter. More than 92% of the patients with disalignment of articular surfaces with space more than 2 mm end with arthrosis in the radial carpal joint. Through examening patients with union with shortness of radius more than 2 mm, we notices recuction of the wrist range of motion ) flextion-extention- pronation -supination) more than patients without shortness. Also we couldnt find sufficient statitics about the pain during motion.


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Research summary
تناول البحث دراسة سريرية لتطورات سوء اندمال كسور النهاية القاصية للكعبرة، حيث تم تحليل النتائج الوظيفية والتدبير العلاجي لهذه الحالات. أظهرت الدراسة أن كسور النهاية القاصية للكعبرة داخل المفصل تؤدي إلى نتائج وظيفية أسوأ مقارنة بالكسور خارج المفصل، من حيث مجال حركة المفصل والانحراف الكعبري والزندي. تم تقسيم المرضى إلى مجموعات بناءً على نوع الكسر ودرجة القصر في الكعبرة، وتم تحليل النتائج السريرية والشعاعية لكل مجموعة. أظهرت النتائج أن سلامة السطح المفصلي للكعبرة تلعب دورًا حاسمًا في تحديد النتائج الوظيفية، حيث أن تبدل السطح المفصلي للكعبرة بأكثر من 1 مم يؤدي إلى ألم مستمر وتطور قسط مفصلي. كما أظهرت الدراسة أن قصر الكعبرة بأكثر من 2 مم يؤدي إلى نقص في مجال حركة المفصل. تم استخدام طرق علاجية مختلفة مثل التثبيت بأسياخ كيرشنر والصفيحات والبراغي والمثبتات الخارجية، وتم تقييم النتائج الوظيفية باستخدام جهاز المانومتر لقياس قوة قبضة اليد وتقييم أشكال الخطف المختلفة. خلصت الدراسة إلى أن التدبير الجيد وإعادة الرد التشريحي الدقيق للسطوح المفصلية منذ البداية يمكن أن يقلل من مشاكل التنكس ويحسن النتائج الوظيفية للمرضى.
Critical review
دراسة نقدية: على الرغم من أن البحث قدم تحليلًا شاملًا لتطورات سوء اندمال كسور النهاية القاصية للكعبرة، إلا أنه يفتقر إلى بعض الجوانب الهامة. لم يتم توفير تفاصيل كافية حول العوامل التي قد تؤثر على نتائج العلاج مثل العمر والجنس والحالة الصحية العامة للمرضى. كما أن الدراسة لم تتناول بشكل كافٍ تأثير العوامل النفسية والاجتماعية على نتائج العلاج. بالإضافة إلى ذلك، كان من الممكن تحسين الدراسة بإجراء متابعة طويلة الأمد للمرضى لتقييم النتائج على المدى البعيد. على الرغم من هذه النقاط، فإن البحث يقدم معلومات قيمة حول أهمية إعادة الرد التشريحي الدقيق للسطوح المفصلية وتأثيره على النتائج الوظيفية.
Questions related to the research
  1. ما هي العوامل التي تؤثر على نتائج العلاج لكسور النهاية القاصية للكعبرة؟

    العوامل التي تؤثر على نتائج العلاج تشمل سلامة السطح المفصلي للكعبرة، درجة قصر الكعبرة، نوع الكسر (داخل أو خارج المفصل)، واستخدام طرق علاجية مناسبة مثل التثبيت بأسياخ كيرشنر أو الصفيحات والبراغي أو المثبتات الخارجية.

  2. ما هي النتائج الوظيفية لكسور النهاية القاصية للكعبرة داخل المفصل مقارنة بالكسور خارج المفصل؟

    النتائج الوظيفية لكسور النهاية القاصية للكعبرة داخل المفصل أسوأ مقارنة بالكسور خارج المفصل، حيث يكون هناك نقص في مجال حركة المفصل وزيادة في الألم وتطور قسط مفصلي.

  3. ما هو تأثير قصر الكعبرة على النتائج الوظيفية؟

    قصر الكعبرة بأكثر من 2 مم يؤدي إلى نقص في مجال حركة المفصل وزيادة في الألم أثناء الحركة، مما يؤثر سلبًا على النتائج الوظيفية.

  4. ما هي الطرق العلاجية المستخدمة في الدراسة وما هي نتائجها؟

    تم استخدام طرق علاجية مثل التثبيت بأسياخ كيرشنر والصفيحات والبراغي والمثبتات الخارجية. أظهرت النتائج أن التدبير الجيد وإعادة الرد التشريحي الدقيق للسطوح المفصلية منذ البداية يمكن أن يقلل من مشاكل التنكس ويحسن النتائج الوظيفية للمرضى.


References used
Axelrod T, Paley D, Green J McMurtry RY: Limited open reduction of the lunate facet in comminuted intraarticular fractures of the distal radius. J Hand Surg Am 13: (2001) 372-377
Aro HT, Koivunen T: Minor axial shortening of the radius affects outcome of Colles´ fracture treatment. J Hand Surg 16-A: (2004) 392-398
Dresing K, Peterson T, Schmidt-Neuerburg KP: Compartment pressure in the carpal tunnel in distal fractures of the radius. A prospective study. Arch Orthop Trauma Surg 113: (1994) 285-289
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