Iziphuzo ezinzima zamazinyo ezidinga ukuhlinzwa
Umzimba wezinyosi lapho amathambo omlenze (i-tibia ne-fibula) ahlangana namathambo ku-hindfoot (talus) ukuze enze inhlanganisela evumela ukuthi unyawo luguqe phansi. Ukuhlanganiswa kwe-ankle kungalimala futhi uhlobo olulodwa lokulimala lubizwa ngokuthi i- ankle fracture . Ama-fracture ama-ankle angatholakala ezinhlobonhlobo eziningi zokuhlukunyezwa kufaka phakathi ama-slips eqhweni, ukuwa kwezitebhisi, ukulimala kwezemidlalo, nokulimala kwemoto.
Lapho abantu bekhuluma ngama-fracture ama-ankle, ngokuvamile babhekisela ekulimazeni amathambo we-tibia ne-fibula. Amaphethelo alawa mathambo ngokuvamile abizwa ngokuthi i-malleolus yomzimba (ekugcineni kwe-tibia) kanye ne-lateral malleolus (ekugcineni kwe-fibula), yizimpumputhe ezinamahloni ozizwayo ngaphakathi nangaphandle kwe-ankle. Ngenkathi amanye amathambo azungeze umjoqo we-ankle angalimala futhi, ukuqhuma kwe-ankle okuvamile kwenzeka ekupheleni kwe-tibia kanye / noma ekupheleni kwe-fibula.
Kunezinhlobo ezahlukene zama-fracture angama-ankle angase avele, futhi enye yezinhlobo ezimbi kakhulu zibizwa ngokuthi i-bimalleolar ankle fracture - ukulimala kokubili kwangaphakathi nangaphandle kwesikhumba. I-bimalleolar ye-ankle iphuka cishe idinga njalo ukwelashwa. Kuzimo ezingavamile kuphela, ngokuvamile ngenxa yezempilo empofu noma umsebenzi olinganiselwe, ingabe i-bimalleolar ankle fracture ingaphathwa ngaphandle kokuhlinzwa.
I-Bimalleolar Ankle Fractures
Uma kwenzeka i-bimalleolar yangenqamukile, ukulimala kokubili kumalleolus omaphakathi (ohlangothini lwangaphakathi lwangaphakathi) kanye ne- lateral malleolus (eceleni kwe-ankle).
Ngenxa yokuthi izinhlangothi zombili zalimala, ukujoyina kwe-ankle kuyaqina. Ukulimala okungazinzile kwenzeka lapho ukuphuka kuphazamisa ubuqotho besakhiwo se-ankle (okuhlangene). Ngenxa yokuthi ukujoyina okungazinzile, kungabangela umonakalo kanye nesifo se-ankle ekuqaleni uma kungashiywanga. Ngakho-ke, ukwelashwa okujwayelekile ukulungisa ngokucophelela ukuphuka ukuze kuqiniswe ukujoyina ama-ankle.
I-Bimalleolar Equivalent i-Ankle Fractures
I-subset eyodwa ekhethekile yalezi zinyama zibizwa ngokuthi i-bimalleolar efana ne-fracture efanayo. Lokhu kubonakala lapho kwenzeka ukuhlukana kwe-malleolus lateral kanye nokulimala kwesiguli engxenyeni yangaphakathi ye-ankle (i-deltoid ligament ). Nakuba lo ukulimala okwehlukile akubandakanyi ukulimala kwamathambo engxenyeni yangaphakathi ye-ankle, ukulimala komgogodla okwenzekile kubangele ukuthi umjoqo wezinyosi ungaguquki futhi udinga ukwelapha okuhlinzekwa ukuqinisa ukujoyina.
Ama-fracture alinganayo e-Bimalleolar adingeka ukuba acatshangelwe noma kunini lapho kwenzeka khona ukuphulwa kwe-malleolus lateral. Uma kukhona ubuhlungu noma ukuvuvukala engxenyeni yangaphakathi ye-ankle, kungenzeka ukuthi i-bimalleolar angle fracture ikhona. Ama-x-rays akhethekile, okuthiwa ukucindezeleka x-ray, angenziwa ukuze afune izimpawu zokungazinzi kokujoyina ama-squares.
I-Trimalleolar Ankle Fractures
Okunye okuhlukile kwalolu hlobo lokulimala kubizwa ngokuthi i-trimalleolar ye-ankle fracture. Ukukhubazeka kwe-bimalleolar ejwayelekile kuhilela ukulimala kwamathambo engxenyeni yangaphakathi nangaphandle kwesikhumba. Abantu abasebenzisa i-trimalleolar ye-ankle fracture nabo banokulimala kwamathambo ngemuva kwe-tibia ( ukuphuma kwe-malleolus ngemuva ) eduze kwesigxobo se-ankle. Kuvame lokhu lokhu kungashintshi ukwelashwa okuvela ku-bimalleolar ankle fracture.
Kodwa-ke, uma ukulimala kwethambo ngemuva kwe-tibia, okuthiwa i-malleolus posterior, kubangele ukungazinzi kokuhlanganyela kwe-ankle , kungase kudingeke futhi kulungiswe ngesikhathi sokuhlinzwa .
Ukwelashwa Kwe-Complex Ankle Fractures
Ukwelashwa kwazo zonke lezi ukulimala kufana, futhi cishe njalo kudinga ukuhlinzwa. Inqubo yokuhlinzwa yenziwa ukulungisa amathambo, ngokuvamile kaningi ngezingqimba zensimbi nezikulula. Lezi zimila zilungisa amathisela ukubuyisela ukuqina kwesigxobo sezinyolo . Kubaluleke kakhulu ukulungisa amathambo ngokuhambisana kahle; uma kungenakulinganiswa kahle kunethuba eliphakeme lokuthuthukisa isifo samathambo esikhumba sokuqala.
Esinye sezikhathazo zalezi zinkimbinkimbi ze- ankle fractures ukuthi zivame ukuhambisana nokuvuvukala kwe-ankle . Ngokuvamile lokhu kuvuvukala kungaba yingozi, futhi kungase kubangele ngisho ne-blisters (okuthiwa i- fracture blisters ) ukwakha esikhumbeni. Ukuhlinzwa kuvame ukuphuza izinsuku noma amasonto uma kukhona ukuvuvukala okuphawulekayo. Ukuvuvukala okukhulu akugcini nje ukwenza kube nzima ukuhlinzwa kodwa kungandisa ukwanda kwezinkinga zokutheleleka nezinkinga zokuphulukisa ngemuva kokuhlinzwa.
Njengoba kubonisiwe, ukutheleleka kanye nezinkinga zokulimala yizinto ezikhathazayo kakhulu ezihlobene nokuhlinzwa kwe-ankle ukuphulwa. Ezinye izinkinga ezivamile zihlanganisa ukuqina nokukhukhumeza isikhathi eside. Iziguli eziningi ziqaphela ukuvuvukala emva kokuhlinzwa kwe-ankle ukuphulukana kwezinyanga eziyisithupha, futhi kungenzeka njalo ukuqhuma okukhulayo. Okunye ukukhathazeka ukuthi ngoba ithambo liqondile ngaphansi kwesikhumba, izitsha zensimbi nezikulula ngezinye izikhathi ziphazamisa futhi zidinga ukususwa . Okokugcina, ngisho nokunakekelwa okufanele, ukulungiswa kokuhlinzwa, kanye nokuvuselelwa okufanele, i-ankle arthritis ingenzeka.
Izwi elivela
Ama-bimalleolar ne-trimalleolar ama-fracture ama-ankle ama-injection ajwayelekile angadalwa afuna ukungenelela okuhlinzekwa ukuze kulungiswe ngokufanele ukulungiswa nokuqiniswa ekuhlanganyeleni kwe-ankle. Ukwelapha okuhlinzwa kungenziwa kube nzima ngevilophu elincane elincane elizungeze ukuhlangana kwe-ankle okubangelwa izinkinga ezinjengokutheleleka nezinkinga zokuphulukisa. Ngenxa yalokhu, odokotela abahlinzayo baqhubeka beqaphile, bevumela izicubu ezithambile ukuba ziqondise isikhathi sokungenelela kokuhlinzwa. Ngenkathi abantu abaningi belulame ngokugcwele, ukuhamba isikhathi eside emandleni okuhlangana kwe-ankle kungaba yinkinga ngemva kwalokhu kulimala
Imithombo:
> Anderson RB, Hunt KJ, McCormick JJ. "Ukuphathwa kwezimo ezivamile ezithinta ezemidlalo ngezinyawo nasezinyaweni" UJ Am Acad Orthop Surg. 2010 Sep; 18 (9): 546-56.