Izinketho zokwelashwa kwe-Broken Shin Bone
I-tibia iyithambo elikhulu le-shin elisemkhatsini wamadolo ne-ankle. Le ngxenye yomzimba ibizwa ngokuthi (ngemibandela yezokwelapha) umlenze, futhi kanye nomlenze nethanga, yakha umkhawulo ophansi (umlenze empeleni kuphela ingxenye phakathi kwamadolo nezinyawo, nakuba abantu abaningi babhekisela emkhawulweni ophansi njengoba 'umlenze'). Kukhona amathambo amabili omlenze, i-tibia kanye ne-fibula.
I-tibia yithambo elikhulu abantu abavame ukubhekisela kulo njengethambo le-shin. Iningi lesisindo somzimba lisekelwa yi-tibia. I-fibula ithambo elincanyana elisendaweni engaphandle komlenze, futhi alisekeli isisindo esikhulu somzimba, nakuba sisebenzela imisebenzi ebalulekile ekuhlanganyeleni kwamadolo nezinyawo futhi kuhlanganiswa kwemisipha nemigqa.
Ama-Fractures we-Tibia
I-Tibial shaft fractures yingozi kakhulu eyenzeka ngemva kokuwa, izingozi zemoto, ukulimala kwezemidlalo, neminye imisebenzi ephezulu. I-shaft ye-tibia yiyona ingxenye ephakathi yethambo, hhayi ukuphela kwethambo eliphezu kwesigca noma ngaphezulu kwe-ankle. Igama lezokwelapha lomuthi we-tibia yi-diaphysis yethambo. I-shaft ye-tibia yi-tube engenalutho, nakuba inomumo oyingqayizivele ongaphansi kwe-tibia crest ibe yi-ridge evelele ngaphambili kwe-shin. I-top of the tibia ibizwa ngokuthi i- tibial plateau , kanti phansi kwethambo kuthiwa yi- tibial cefond .
Ngaphakathi kwesigxobo esingenalutho sethanga umsele wamangcwaba emathambo. Ingxenye yangaphandle yethambo ibanzi futhi iqine; lokhu kubizwa ngokuthi i-cortex yethambo futhi inikeza amandla we-tibia. Njengoba kukhonjisiwe, ukwehlukana kwalesi sigaba se-tibia ngokuvamile kulimala kakhulu kwamandla okwenzeka ngemva kwezehlakalo ezibalulekile .
Kunezimo lapho ithambo lingabuthakathaka ngokweqile, futhi ukuphuka kungahle kwenzeke ngokulimala okuncane kakhulu. Lezi zibizwa ngokuthi i- pathologic fractures , futhi zenzeka lapho ithambo libuthakathaka ngenxa ye-osteoporosis, isisu, ukutheleleka, noma ezinye izimo.
Izimpawu ze-Tibial Shaft Fractures
I-tibial shaft fractures ngokuvamile ivela ngokulimala okuphawulekayo. Izimpawu ezijwayelekile zalezi ziphuka zihlanganisa:
- Ubuhlungu phezu kwe-shin
- Ukukhubazeka komlenze
- Ukuvuvukala nokulimala eduze kwe-shin
- Ukungakwazi ukubeka isisindo emlenzeni
I-tibial shaft fractures kufanele ihlolwe endaweni yokuphuthumayo. Ngesikhathi ukulimala kungase kubonakale kuvelele, kubalulekile ukuhlola yonke indawo ekuhloleni nje ukuhlola i-tibia, kodwa futhi nokulimala okuhlobene nomkhawulo. Abantu abalondoloza lezi zingozi kufanele babe nokuhlolwa komzimba okugcwele, njengoba kungase kube nezinye ukulimala okwenzeka okungase kungabonakali ngenxa yobuhlungu emlenzeni.
Iningi le-tibia fractures lingabuyekezwa ngokugcwele nezivivinyo ze-x-ray. Ukuphazamiseka kwengcindezi yethambo kungabonakali kwi-x ray, futhi lokhu kulimala kungabonakala kuphela ekuvivinyeni okunjenge-MRI noma scan scan. Nokho, indlela evamile yokuhlola i-x-ray ukuqala.
Izinketho zokwelapha ze-Tibial Shaft Fractures
Ukuphuka kwe-shabial shaft kungaphathwa ngezindlela eziningana kuye ngokuthi uhlobo lokuphulwa nokulungiswa kwethambo.
Imithi ejwayelekile kakhulu ihlanganisa:
- Ukushaywa: I-cast isifanele ukuhlukana kwe-shabial shaft engasebenzi kahle futhi ihambelana kahle. Iziguli zidinga ukuba zibe esitokisini esihamba ngenhla emadolweni nangaphansi kwesigqoko (umlenze omude owedlule). Inzuzo yokukhipha ukuthi lezi ziphuka zivame ukuphulukisa kahle nokugxila kugwema izingozi ezingase zibe khona zokuhlinzwa ezifana nokutheleleka. Iziguli ezinama-casts kumele zihlolwe ukuqinisekisa ukuphulukiswa okwanele kwe-tibia nokuqinisekisa ukuthi amathambo agcina ukulungiswa kwawo.
- I-intrameduallary (IM) I-Rodding: I- intrameduallary rodding yinkqubo yokubeka induku yomdanso phansi phakathi kwe-tibia ukugcina ukufana kwethambo. I-rodbial rodding yinkqubo yokuhlinzwa ehlala cishe ihora nehafu futhi ivame ukwenza ngaphansi kwe-anesthesia ejwayelekile. Iziguli ziyoba nomshini phezu kwehlangothini lamadolo, kanye nokucubungula okuncane ngaphansi kwamadolo nangaphezulu kwesikhumba. Ngaphezu kwalokho, amanye amafracture angadinga ukuxubana eduze kwe-fracture ukuze kulungiswe amathambo. Izinduku ze-IM zivikelekile ngaphakathi kwethambo ngokufaka izikuluzi zombili ezingenhla nangaphansi kwe-fracture. Izikhonkwane zensimbi kanye nenduku zingasuswa uma zidala izinkinga, kodwa zingashiyelwa endaweni yokuphila. I-rodbi ye-tibial inikeza ukulungiswa okuhle kwamathambo. Ingozi ejwayelekile kunazo zonke yokuhlinza ibuhlungu emadolweni, futhi okuphathelene nokucindezeleka kunesifo. Ukungena kwenduku kungadinga ukukhipha induku ukuze uphulukise ukutheleleka.
- Amapulangwe Nezikulufa: Ama-Plates kanye nezikuluvu zivame ukusetshenziselwa kakhulu, kepha ziyasiza kwezinye izinhlobo zokuphuka, ikakhulukazi lezo eziseduze namadolo noma ama-ankle (bheka ulwazi oluthile lwe-plateau ne-tibial fractures fractures). Odokotela abaningi abahlinzayo bakhetha i-IM rod ye-tibial shaft fractures ngaphandle kokuthi ukuphulwa kuseduze kakhulu nokujoyina ukuvumela ukufakwa kwe-IM rod. Kule fractures eduze kwendawo ehlangene, ipuleti nezikuluzi zingahle kube yindlela enhle yokulungisa.
- I-Fixator yangaphandle: I- fixator yangaphandle ingase ibe usizo nakwezinye izinhlobo ezithile zokuphulwa. Izilungisi zangaphandle zivame ukusetshenziselwa ukuhlukumeza okukhulu, ikakhulukazi ukuvuvukala okuvulekile okuphazamiseka okuhambisana nokulimala komzimba. Kulezi zimo, ukufakwa kwezinduku ze-IM noma amapuleti angeke kwenzeke ngenxa yokulimala kwezicubu. Uma kukhona ukulimala okuphawulekayo kwesikhumba, i-fixator yangaphandle inganikeza ukukhubazeka okuhle kakhulu ngenkathi ivumela ukuqapha nokwelashwa kwezicubu ezincane eziseduze.
Izwi elivela
Izingozi zeTibia ngokuvamile zimele kakhulu. I-tibia yithambo elikhulu, elinamandla elisekela sonke isisindo somzimba wethu. Ngokuvamile lokhu kulimala kungenxa yengozi enkulu. Ngenxa yalesi sizathu, i-tibia fractures ingadinga ukwelashwa okungahleliwe ukuqinisekisa ukuthi ukusebenza kwethambo kubuyela evamile. Ngaphandle kokwelashwa okufanele, kunezinkinga ezingase zinde isikhathi eside ezingase zibe nomkhawulo wokusebenza okujwayelekile komkhawulo. Abantu abanezinkinga zesikhathi eside ngemuva kokuhlukana kwe-tibia shaft bangase babe nobunzima bokuhamba ngendlela evamile.
> Imithombo:
> Melvin JS, Dombroski DG, Torbert JT, Kovach SJ, Esterhai JL, Mehta S. "I-shabhu evulekile evulekile: I. Ukuhlolwa nokuphathwa kokuqala kwezilonda" J Am Acad Orthop Surg. 2010 Jan; 18 (1): 10-9.
> Mashru RP, Herman MJ, Pizzutillo PD. "I-tibial shaft ihlukana nabantwana kanye nentsha" J Am Acad Orthop Surg. 2005 Sep; 13 (5): 345-52.