Ikhefu lephakathi kwethambo lesandla eliphezulu
Udokotela wakho uthi une-mid-shaft humerus ephukile. Lokho kusho ukuthini nokuthi kuzokwenzekani ngokulandelayo?
I-humerus yithambo elixhuma ihlombe kuya elongeni. Le ngxenye yomzimba ibizwa ngokuthi ingalo, futhi kanye nesandla kanye ne-forearm, yakha umkhawulo ophezulu. I-humerus iyithambo eliqinile elibethelwe ibhola lohlanganiso lwebhola-ne-ekhoneni elihlangene phezulu futhi linomphetho ohlangothini lwesigqoko phansi.
Imifucumfucu ye-humerus ihlukaniswe yaba izinhlobo ezintathu: i -humerus ehamba phambili ehlathini, ephakathi kwe-shaft humerus fractures, kanye ne-distal humerus ehlukana ne-elbow.
Mid-Shaft Humerus Fractures
I-middle-shaft i-humerus ihlukana ngokujwayelekile ayifaki amahlombe noma ama-elbow joints. Lolu hlobo lokuphuka lumelela cishe u-3% wazo wonke amathambo aphukile . Isizathu esivame kakhulu sokuqhaqhazela kwe-shaft ukuqhuma ukuwa, kodwa ukulimala okukhulu kwamandla (ukushayisana kwemoto, ukulimala kwezemidlalo) kanye nokuhlukunyezwa okudlulayo ( amanxeba okudubula ) nakho kungabangela lokhu kulimala. I-shaft eminingi ephahlazekayo iqhuma ngenxa yokwehliswa kwethambo ekusukeni kwe-osteoporosis .
Imifucumfucu ye-humerus ingaba yingozi, futhi ama-X-ray ngokuvamile abhekana nokuthusa iziguli. Ngoba kukhona ithambo elilodwa kuphela elixhuma ehlombe ku-elbow, iziguli zivame ukuzwa sengathi ingalo yabo ayihlanganisiwe. Iziguli kufanele ziqinisekiswe ukuthi kunezinto eziningi ezingaphezu kwethambo elibambelele engalweni nokuthi iningi laphakathi kwe-shaft humerus liphulukisa ngaphandle kokuhlinzwa.
Ukwelashwa kwe-Humeral Shaft Fractures
Kunezinketho eziningana zokwelapha kulezi zintambo, kodwa okuvame kakhulu yizokwelapha okungezona ukuhlinzwa. Ngenhlanhla, amandla adonsela phansi akwenza izimangaliso ukuvumelanisa i-humerus, futhi nje ukuvumela ingalo ukuba ihlale eceleni, ngokuvamile iyindlela engcono yokwelapha i-humerus fracture. Ngaphezu kwalokho, noma yikuphi ukwelashwa okuhlinzayo kunengozi enkulu.
Ukunciphisa ithuba lokuhlukunyezwa yisinye sezizathu zokucubungula ukwelashwa okungewona ukwelashwa.
Izizathu zokucabangela ukwelapha okuhlinzekwa zibandakanya ukuhlukana okuningi, ukuvuvukala okuvulekile , ukulimala emithonjeni yegazi noma izinzwa, nokuhluleka kokuphulukiswa ngezokwelapha okungenasidingo ( ukungaboni ngaso sonke isikhathi ).
- I-Bracing ye-Fracture: Ukwelapha okuvame kakhulu kwe-shamer fracture ebizwa ngokuthi i-shamer fracture ibizwa ngokuthi i-brace brace, ngokuvamile ebizwa ngokuthi i-bramiento brace, eqanjwe ngudokotela odumile ngale ndlela yokwelashwa. Ngokuvamisekile, ukuphuka okuphethwe nge-splint or sling for a week ukuvumela ukuvuvukala ukuba kuncishiswe, bese kuthi ukuhlukunyezwa kwegciwane kufakwe isiguli. I-brace ibonakala njengegobolondo le-clam futhi ibamba i-humerus ngokulungiswa. Inzuzo ye-brace bracelet yukuthi njengoba ukuphulukiswa kuqhubeka, iziguli zingase ziqale ukusebenzisa ihlombe nelobow.
- Metal Plates: Ukuhlinzwa okuvame kakhulu ukwelashwa kwesifo se-humerus ukubeka ipuleti enkulu yensimbi eduze ne-humerus, futhi uyivikele nge-screws. Ukusetshenziswa kweplate kanye nezikuluvu kuyindlela ephumelela kakhulu yokuphulukisa ngokuphulukisa ukuqhuma kwe-shaft okuphazamisayo. Ukukhathazeka kokuhlinzeka ukuthi izingozi zokulimala kwamantombazane kanye nokungahlanganyeli ziphakeme kakhulu ngezinqubo zokuhlinza kunokwelapha okungewona ukwelashwa.
- Izintambo: Induku ye-intramedullary yinduku yensimbi ebeka phansi isikhungo esingenalutho sethanga. Inzuzo yenduku yensimbi ukuhlinzeka kungenasiphelo esincane, kanti udokotela ohlinzayo uhlala kude nezinzwa ezibalulekile ezihamba ngaphansi kwengalo. Ukukhathazeka ngenduku yukuthi ukuphulukiswa kwamazinga akuyona ephezulu, futhi ukungaboni ngaso sonke isikhathi kuyinkinga evamile.
Isikhathi sokuphulukisa nezinkinga ze-Fracture ye-Humeral Fracture
Ukuphulukiswa kwe-middle-shaft humerus ukuphuka kuthatha izinyanga ezimbalwa kepha ngokuvamile ukuvivinya umzimba ukuthuthukisa ukuhamba kwamalungu ehlombe kanye ne-elbow kuqaliswe ngokushesha kakhulu. Izinkinga ezimbili ezivame ukubonwa ukulimala emndenini we-radial kanye nokungahlangani kwe-fracture.
Ukulimala emndenini we-radial kwenzeka ngoba le nerve ebaluleke kakhulu igxila phakathi kwe-humerus. I-neral radial ingalimala ngesikhathi sokuphuka noma ngenkathi ukwelashwa kwe-fracture. Ukulimala kwamagciwane amakhulu kubangele ukuphazamiseka ngemuva kwesandla, futhi kunzima ukuqondisa (ukukhulisa) isibindi neminwe.
Ukulimala kakhulu kwamagundane kuzothuthuka ngesikhathi, kodwa udokotela wakho uzolandela lokhu ngokucophelela ukuze anqume ukuthi ngabe kukhona ukwelashwa okunye okudingekayo.
Ukungaboni ngaso sonke isikhathi kuyinkinga enzima futhi kwenzeka lapho ukuphuka kungaphili. Kunezizathu eziningi zokuthi kungani ukungaboni ngaso sonke isikhathi kungase kwenzeke. Ngokuthakazelisayo, esinye sezizathu ezivame kakhulu zokungaboni ngaso sonke isikhathi kungukuhlinzwa . Uma usuhlinzwa, izicubu ezithambile ezizungeze ukuqhuma ziyaqhubeka ziphazanyiswe, futhi lokhu kunganciphisa ukugeleza kwegazi kusayithi le-fracture. Esinye isizathu sokugwema ukuhlinzwa ukuvimbela ingozi yokungabambisani. Kodwa-ke, uma ukungaboni ngaso sonke isikhathi kwenzeka, khona-ke ukuhlinza kuyadingeka njalo ukugqugquzela impendulo yokuphilisa ithambo.
Umthombo:
UCarroll EA, et al. "Ukuphathwa Kwezingcingo Ze-Shaft Fractures" J Am Acad Orthop Surg July 2012 vol. 20 cha. 7 423-433.