Ukulimala Kwenye Yezimbongolo Ezincane Ze-Wrist
I-bone phofu isinye samathambo amancane ayisishiyagalombili esihlakaleni, okuthiwa amathambo e-carpal. Lawa mathambo avumela ukunyakaza okunamandla, kodwa okwesibindi kwesandla nesandla. Amathambo e-carpal afana phakathi kwethambo le-forearm nesandla. I-scaphoid ihlezi ngaphansi kwesithupha, futhi ifakwe njengobhontshisi bezinso.
I-scaphoid fractures yizinto ezivame ukuqhuma kwamathambo e-carpal.
Ukulawulwa kwendabuko kwesifo se-scaphoid, ikakhulukazi uma kuqhathaniswa ne-fractures engekho emakhaya, kunesimo sokuthi singasebenzi kahle. Kodwa-ke, ukuphulukiswa kwama-scaphoid fractures kungathatha isikhathi eside, futhi ngezinye izikhathi ithambo aliphili ngokuphelele, isimo esibizwa ngokuthi singenasabelo. Ngakho-ke, izincomo zokwelapha ze-scaphoid fractures zingahluka futhi ngezinye izikhathi zibandakanya ukwelashwa okuhlinzekwayo.
Ukugeleza kwegazi ku-Scaphoid
Into ezithakazelisayo ngethambo le- scaphoid yilokho elinempilo yokubuyisela igazi. Lokhu kusho ukuthi ukugeleza kwegazi kuvela emkhunjini omncane ongena ezingxenyeni ezikude kakhulu zethambo futhi ugeleza emuva emathanjeni ukuze unike ukudla okunomsoco kumasethini amathambo.
Lokhu kugeleza okungavamile kwegazi ku-scaphoid kubonisa inkinga uma uqhubeka ukuphulwa kwesimo se-scaphoid. Ngenxa yegazi elincane, ukuphuka kwesifo se-scaphoid kungaphazamisa ukugeleza kwegazi futhi kumeke ukulethwa kwe-oksijeni nezakhi ezidingekayo kumaseli amathambo.
Uma lokhu kwenzeka, ukuphulukiswa kungancipha, futhi ukuphuka kwesifo se-scaphoid kungenzeka kungaphululi nhlobo.
Izimpawu ze-Scaphoid Fracture
Izimpawu zesifo se-scaphoid zihlanganisa:
- ubuhlungu esifundeni sesithupha
- ukuvuvukala nokulimaza phansi kwesithupha
- ubunzima obuthinta izinto
Iziguli eziningi zitholwa ukuthi zine- wrist sprain , lapho zikhona khona zinezifo zesifo se-scaphoid ephukile.
Ukuxilongwa kunzima ngoba ama-x-ray athathwa ngemuva kokulimala angabonisi ukungajwayelekile uma amathambo engekho esimweni. Ukuphuka kwesifo se-scaphoid esingasetshenzisiwe kungabonakala ku-x ray emva kokuphulukiswa sekuqalile, okungaba amasonto amabili emva kokulimala. Ngenxa yalokhu, kuyinto evamile ukuphatha ukulimala kwesibindi ngesimo sokungasebenzi (njengokungathi ukuhlukumeza kwe-scaphoid ) isonto noma amabili bese uphinda ama-x-ray ukuze ubone ukuthi ithambo liphukile. I-MRI ingasetshenziselwa ukuxilonga lokhu kulimala, ngaphandle kokulinda ukuphinda i-x ray.
Ukungahlangani kwama-Scaphoid Fractures
Uma ukuphazamiseka kwesifo se-scaphoid kuphulukisa kancane kancane (ukubambisana), noma kungaphilisi nhlobo ( ukungaboni ngaso sonke isikhathi ), ukulimala kungase kuhlale kubuhlungu, futhi ngokuhamba kwesikhathi, isifo samathambo esiba khona singase senzeke. Ingozi yokuthuthukisa ukungaboni ngaso sonke isikhathi kwe-scaphoid incike kakhulu kubaluleke kakhulu lapho kuqhuma khona ithambo. Ezinye izici ezingasiza ekungabambiseni ukubhema, imithi ethile kanye nokutheleleka.
Ukwelashwa kwe-scaphoid ukuphulwa
Kunezindlela ezimbili ezijwayelekile zokwelashwa kwesifo se-scaphoid: ukugxeka ukungena noma ukuqiniswa okuhlinzekwayo .
Uma nje ukuqhuma kwesifo se-scaphoid kungasuswa endaweni yokuhlala (ngaphandle kwesimo), ukuxoshwa kwe-immobilization kuyinkinga enengqondo kakhulu.
I-cast kumele inwebe ngaphezu kwesithupha sakho ukuze unciphise ukuhamba kwesithupha sakho. Yeka ukuthi ukuphakanyiswa kwe-cast (ngenhla noma ngaphansi kwesigqoko) kuncike ekuthandweni kodokotela. Udokotela wakho uzoqhubeka nokuqapha isibindi kokubili ngokuhlolwa nokuhlola kwe-x-ray ukuqinisekisa ukuthi kukhona ukuphulukiswa kwethambo. Ukuphulukiswa kwesifo se-scaphoid ngokuvamile kuthatha amasonto ayishumi kuya kwangu-12.
Uma ukuhlukumeza kwesifo se-scaphoid kususwa, ingozi yokungabambiswanga iphakeme, futhi udokotela wakho uzongcoma ukuthi uhlinzekwe ukubuyisela amathambo, futhi ubambe ngokuqinile ngokuvumelana kahle. Ukuhlinzwa ngokuvamile kuhilela ukusebenzisa i-screw eyodwa yokubamba ithambo ndawonye endaweni efanele.
Kukhona ukungqubuzana mayelana nokusebenzisa ukuhlinza njengokwelapha kokuqala kokuphuka okungesikho esimweni. Inzuzo yukuthi kukhona ingozi encane yokungaboni ngaso sonke isikhathi futhi isikhathi sokukhulelwa singanciphisa kakhulu. Ukulimala ukuthi ukuhlinzeka njalo kunengozi, kanti ngenkathi izinga lokucindezeleka lokuhlinzwa kwesifo se-scaphoid lincane, kungenzeka ukuthi kunezinkinga ezibandakanya ukutheleleka, nokulimala kwe-cartilage noma izintambo ezizungeze isikhalazo. Abagijimi abaningi noma izisebenzi zomsebenzi bakhetha ukuhlinzwa ukuze kuvunyelwe ngokushesha.
Uma kungabikho ukuhlangana kwephulwa, ukuhlinzeka ngokuvamile kuvunyelwe ukuvuselela amathambo ukuze aphulukise. I-graft yamathambo ivame ukusetshenziselwa ukukhuthaza ukuphulukiswa endaweni yesakhiwo. Lokhu kulimala kungaba yinkimbinkimbi, futhi kudinga ukwelashwa okude ukuze uthole ithambo lokuphulukisa. Ngaphandle kokwelashwa okufanele, i- arthritis yesandla kungenzeka ikhule kamuva.
Izwi elivela
I-scaphoid fractures yilezi ezilimalayo zesikhumba, futhi ukwelashwa kungase kuxhomeke eziningana zezici. Ukwehlisa imishini kugwema ukwelapha okuhlinzekwayo kanye nezingozi zokutheleleka nokulimala kwe-cartilage, kodwa kungadinga ukungalingani isikhathi eside futhi kuholele ekuqineni kombuthano. Ukwelashwa kokuhlinzwa kunezingozi ezihlobene, kodwa kunganikeza ukuphulukiswa okungenakwenzeka. Kunezici ezifana nobudala besiguli, izinga lomsebenzi, indawo yokuqhekeka nokuthayipha okungathi konke kuthonya ukwelashwa okunconyiwe.
Imithombo:
> Moon ES, Dy CJ, Derman P, Vance MC, Carlson MG "Ukulawulwa kokungabambiswanga emva kokuphathwa kokuhlinzwa kwama-scaphoid fractures: imiqondo yamanje" J Am Acad Orthop Surg. 2013 Sep; 21 (9): 548-57.