Uhlobo lokuphuka lungase lube nzima ukusetha futhi ukuzinza
Ukuhlanganiswa kwe-ankle kuyinkimbinkimbi yamathambo amathathu ebizwa ngokuthi i-fibula, tibia, ne-talus. I-tibia ivame ukubizwa ngokuthi ithambo le-shin, kuyilapho i-fibula iyisithambo esincane esingasemlenzeni esiseduze nayo. I-talus, okwamanje, iyithambo eliphakathi kwe-tibia, i-fibula, nesithende esakha ukuxhumana okuyinhloko phakathi komlenze nomlenze ophansi futhi kubalulekile ukuhamba nokulinganisela.
Ngenxa yokuthi i-ankle isengozini yokuhlupha nokucindezela, ukuphuka kwamathambo akuvamile futhi ngezinye izikhathi kunzima ukuwelapha.
I-Anatomy ye-Ankle Fracture
Lapho abantu abaningi bechaza ukuqhuma kwe-ankle, ngokuvamile kusho ukuthi kufaka izingxenye eziphansi ze-tibia kanye / noma i-fibula. Amanye ama-fracture afaka kokubili amathambo; ezinye zithinta eyodwa kuphela. I-fracture ngokwayo iyokwenzeka emaphethelweni amaningi amathambo eyaziwa ngokuthi i-malleoli, ehlanganisa:
- I -malleolus engaphakathi ehlangothini lwangaphakathi le-ankle ekupheleni kwe-tibia
- I -malleolus yangasese engaphandle kwe-ankle ekupheleni kwe-fibula
- I-malleolus e-posterior esezingeni elingezansi ngemuva kwe-tibia
Kulezi, i-malleolus yangemva kokuyisakhiwo isakhiwo esingenakwenzeka ukuba siphume ngokwayo. Ama-breaks ase-Isolated ajwayelekile, futhi, lapho enza, ajwayele kunzima ukunciphisa (ukusetha kabusha) nokulungisa (ukuzinza).
I-posterior Malleolus Fractures
I-posterior malleolus fractures ingaba inselele kumzimba wamazinyo kusukela iphethini lokuphuka ngokuvamile kuvamile.
Bangakwazi ukungena ezinqabeni eziningi futhi ngokuvamile kunzima ukuyihlolisisa. Ngaphezu kwalokho, akukho ukuvumelana okuncane mayelana nokuthi kungcono kanjani ukuqiniswa kwesisindo uma sekusethwe kabusha.
Ngokuvamile, lezi zingozi zichazwa ngokuthi yi- tibial fractures (i- plafond ebhekisela engxenyeni ye-tibia lapho kuhlanganiswa khona).
Futhi ngenxa yokuthi izicubu zincane kakhulu, akuyona into engavamile ukuba nephukile evulekile (eyodwa lapho isikhumba siphukile).
Konke okukhulunywe ngakho, ukuhlukanisa i-posterior malleolus fractures i-akhawunti engaphezulu kwamaphesenti angu-0.5 azo zonke ukulimala okuphansi.
Ngokuvamile, ama-breaks azokwenzeka lapho ama-malleolus aphakathi nendawo ahambisana nawo. Lokhu kuvame ukubizwa ngokuthi i-trimalleolar fracture lapho zonke izakhiwo zethambo ezintathu ziphukile. Kubhekwa njengokulimala okujulile okuvame ukuhambisana nomonakalo wegigament kanye nokuxoshwa kwe-ankle.
Ukwelashwa nokuxilongwa
Ngenxa yokuthi ukuhlukunyezwa okuhlukile kwalolu hlobo kuyinto engavamile, ukuxilongwa ngezinye izikhathi kuphuthelwa noma kungabonakali. Uma kucatshangwa, ukuskena kwe- computed tomography (CT) ngokuvamile kukhethwa ngaphezu kwe-X-ray noma i-MRI. I-CT scan ivumela udokotela ohlinzayo ukuba abone ngokucacile ukuthi zingaki iziqhekeko ezikhona futhi kusiza ukunquma ukuthi i-fragment enkulu ikhona kuphi. Kuzoba yincenye lapho imizamo yokulungisa izogxila khona.
Kuzovame ukuhlinzwa ukuze kuqinisekiswe ukuthi izingxenye zifakwa kahle. Uma kuthiwa, kukhona ukuphikisana mayelana nokuthi kulungile nini. Ngokuvamile, odokotela abahlinzayo baye bahlinzekwa isikhathi eside uma kunamaphesenti angaba ngu-25 e-malleoli.
Izinto zihluke manje manje ezinogqirha eziningi ezihlinza ukuthi ubukhulu be-fragment akuyona into ebalulekile. Esikhundleni salokho, ukuhlinzeka kufanele kwenziwe uma i-posterior malleolus ephukile idala ukuphazamiseka kokuhlanganiswa kwe-ankle, kungakhathaliseki ukuthi isayizi noma indawo ye-fracture.
Ngokuvamile, indlela engcono kakhulu yokubeka kabusha ithambo iwukuba umshini ngemuva kwe-ankle. Lokhu kuvumela udokotela wakho ohlinzayo ukuba aphinde ahlukanise iziqephu futhi azivikele ngamapuleti nezikuluzi. Kwezinye izimo, ithambo ngeke lidingeke libekwe kabusha, futhi le fragment ingagcinwa ngaphandle kokuhlinzwa.
Ukuvuselelwa
Ukuvuselelwa kufana nalokhu okusetshenziselwa ezinye izinhlobo zezintambo zokuphuka.
Ngokuvamile, odokotela abahlinzayo bayophazamisa isikhumba futhi bavumele ukucubungula ngaphambi kokuqala ukwelashwa ngokomzimba. Kodwa-ke, ngokungafani nokuhlukana kwe-malleolar engokwemvelo kanye neyesikhashana, ukuhlukana kwe-malleolar ngemuva kokuhamba kalula kungasuswa kalula ngokuhamba kalula kwe-ankle. Yingakho ukunakekelwa kwe-postoperative kuzovame ukuthi kudinga ukuthi i-ankle ingabi nesisindo samasonto ayisithupha.
Isigaba sokuqala se-rehab sizogxila ekubuyiseleni ukuhamba ngokuhlanganyela kwe-ankle, okulandelwa izivivinyo ezithwala isisindo uma sekuqalile ukuhlukana. Isikhathi sokubuyisela esiphezulu sivela phakathi kwezinyanga ezine kuya kweziyisithupha, nakuba kungathatha isikhathi eside ukulimala kakhudlwana.
Kwezinye izimo, abantu bangase badinge ukuthi bahlinzekwe ukuze kube khona i- hardware yokuhlinzwa esuswe kamuva emuva komgwaqo.
> Umthombo:
> Irwin, T .; Amanga, J .; noKadakia, R. "Ukuphulwa kwe-Malleolus Posterior." J Am Acad Orthop Surg. Januwari 2013; 21: 32-40.