I-Maisonneuve fracture uhlobo oluthile lokuphuka kwezinsiza olwenzekayo lapho i-ankle iphoqelelwa ngaphandle (ukuzungeza kwangaphandle). Ukuphuka kubalulekile ngoba ukwelashwa cishe kudinga njalo ukuhlinzwa, futhi ngaphandle kokuhlolwa ngokucophelela kwe-ankle (negulo), kungenzeka ukuphuthelwa leli phethini lokulimala.
Umsuka
I-Maisonneuve yaqhekeka yabizwa ngokuthi udokotela ohlinzayo waseFrance ogama lakhe linguJules Germain Maisonneuve.
UDkt Maisonneuve (obizwa ngokuthi u-MAY-son-OU-ve) uchaze le ndlela yokulimala kanye nokuhlangana kwayo nokulimala okubangela ukujikeleza kwangaphandle okunamandla kokujoyina kwe-ankle. UDkt Maisonneuve wayeyisigqila sikaDkt. Dupuytren, omunye odokotela ohlinzayo waseFrance onomzimba obaluleke kakhulu wama-orthopedic ngenxa yesimo asichaze.
Namuhla, igama likaDkt. Maisonneuve lisasetshenziselwa ukuchaza le ndlela yokulimala ethize. Ngenkathi lokhu kuyindlela engavamile yokuphulwa kwe-ankle , kubalulekile ngoba ngaphandle kokubheka ngokucophelela, lokhu kungase kubonakale kukulimala okungathí sina. Uma kungatholakali kahle, kungase kube nezinkinga zesikhathi eside ezihlangene ze-ankle, kufaka phakathi i- arthritis yangaphambili .
Izimpawu
Kunezibonakaliso ezimbalwa ezibalulekile okufanele zibheke lokho okungase kubonise ukuthi ukulimala kwe-ankle kungaba ukuhlukana kwe-Maisonneuve. Okokuqala, ukuqonda indlela yokulimala njengoba iziguli ezisekela i-Maisonneuve ukuqubuka ngokuvamile zinekhono eliphambene kakhulu le-ankle.
Lokhu kungase kube ukulimala kwezemidlalo noma kungase kwenzeke ekuweleni ukwenza imisebenzi evamile. Ezinye izimpawu zalokhu kulimala zihlanganisa:
- Ubuhlungu nokuvuvukala nxazonke ezingxenyeni zangaphakathi ze-ankle (ezungeze i -malleolus engaphakathi )
- Ukuthambekela okuzungeze uhlangothi lwangaphandle lwamadolo (i- fix proximal)
- Ukuhlukunyezwa kwamathole ne-shin ( ukulimala kwe-syndesmosis )
Iziguli ziyoba nemibala engu-x ukucacisa iphethini lokulimala, futhi uma kukhona ukukhathazeka ukuthi ukulimala kungukuqhekeka kwe-Maisonneuve, khona-ke ama-ray emadolo kufanele atholakale. Kwezinye iziguli, kukhona ukulimala okunomsoco okunamandla okungaqeda ukwelashwa. Isikhumba kufanele sihlolwe ngamabhuleki okuphuka kanye nezinye izibonakaliso zokulimala okunamandla okunamathelayo.
Ukwelapha
Ukwelashwa okuhlinzekwayo kuyindlela yokwelapha ejwayelekile ye-Maisonneuve yokuqhekeka, nakuba kwezinye iziguli ezingenakho ukufuduka kwe-fracture noma i-ankle joint, noma ezigulini eziphuthumayo zokugula (iziguli ezigugile noma ezigulayo), ukuphathwa ngokweqile kungacatshangelwa. Kodwa-ke, ukwelashwa okuvamile kwe-Maisonneuve ukuphuka kwenziwa ukuhlinza ukubuyisela ukuzinza kokujoyina kwe-ankle.
Lapho kulungiswa i-Maisonneuve yama-ankle, ihlangothi elingaphakathi (elingaphakathi) lilungiswa, futhi i-syndesmosis ilungiswa. Kodwa-ke, i-fibula iphuka nxazonke emadolweni akudingeki ukuba iqhutshwe ngokuhlinzwa. Isakhiwo esibucayi esidinga ukugcinwa esimweni siyi-syndesmosis (i-ligament exhuma amathambo ama-shin). I-syndesmosis isilungiswa nge-screws noma izinto ezilukhuni kakhulu ze-suture, amamentimitha ambalwa ngaphezu kwehlanganiso lezinyosi.
I-Rehab From Surgery
I-Rehab ngemuva kokuqhekeka kwe-Maisonneuve yinqubo enyangeni eningana futhi incike ebukhulu bokulimala, kanye nemikhombandlela yakho yokuhlinza.
Odokotela abaningi abahlinzayo bayomisa iminyango emasontweni angu-4-6 emva kokuhlinzwa, futhi bagweme isisindo esiphelweni samasonto ayisithupha kuya ku-12 emva kokuhlinzwa. Ngaphezu kwalokho, abanye odokotela abahlinzayo bancoma ukuhlinzekwa kwesibili ukususa i-hardware esetshenziselwa ukulungisa isifo se-syndesmosis ngaphambi kokuba kuvunyelwe isisindo sosindo. Lokhu kuyinkinga futhi kungaboniswa nodokotela wakho ohlinzayo.
Imithombo:
UMichelson JD "Ama-Ankle Fractures aphumela ekulimaleni kokushintshanisa" J Am Acad Orthop Surg November / December 2003; 11: 403-412.