Konke Mayelana nokuhlukana kwe-Lisfranc
Ukulimala kwe-Lisfranc kungukulimala emigogodeni ehlanganisa amathambo we-midfoot ne-frontfoot. Ngezinye izikhathi, ukulimala kuyisimo esilula ( ukulimala komgogodla ), futhi ngezinye izikhathi ithambo eliphukile livela, i-Lisfranc ihlukana / i-dislocation. I-dislocation yenzeka uma kuhlukaniswa ukuhlanganiswa okujwayelekile okuhlangene phakathi kwe-forefoot kanye ne-midfoot. Uma kukhona futhi ukuphuka, ithambo eliphukile ngokuvamile livela emathanjeni angaphakathi.
Unyawo luhlukaniswe izingxenye ezintathu eziyinhloko. Indawo engaphambili yezinzwane; i- midfoot eyenziwe ngamathambo amancane okuthiwa i-navicular, i-cuneiform ne-cuboid; kanye ne- hindfoot equkethe i-talus (i-ankle ephansi) ne-calcaneus (isithende). Umhlanganiso we-Lisfranc usekuhlanganiseni kwamathambo we-forefoot ne-midfoot.
Izimbangela ze-Lisfanc Injury
Ukulimala kukaLisfranc kubizwa ngokuthi udokotela ohlinzayo waseFrance uJacques Lisfranc ebutho likaNapoleon. Ukulimala kwasekuqaleni okuchazwe yiLisfranc kuvame kwenzeka lapho isosha liwela ehhashi lakhe, kodwa unyawo lwakhe aluzange lukhulule esitokisini, noma indaba iya. Namuhla, ukulimala okuningi kwenzeni ye-midfoot kwenzeka ngenxa yesinyathelo esingahambi kahle ezindaweni ezingalingani, ukulimala kwezemidlalo, noma ukushayisana kwemoto.
I-Lisfranc Ukulimala Ukulimala
Kubalulekile ukusola okuphezulu ukulimala kwe-Lisfranc noma kunini lapho ubuhlungu nokuvuvukala phakathi kwe-midfoot. Lokhu kulimala kungaba nzima ukuyihlolisisa, futhi ngaphandle kokwelashwa okufanele, ngokuvamile kuvame imiphumela.
Noma yisiphi isiguli esinezimpawu zokulimala kwe-Lisfranc kufanele sihlolwe udokotela.
Ukulimala okuvamile kwe-Lisfranc kufaka phakathi
- Ubuhlungu phakathi kwezinyawo
- Ukuvuvukala nokulimaza
- Ubuhlungu ngokuhamba / ukuma
Ukulimala kwe-Lisfranc kungaba okucashile ekubukeni kwe-x-ray. Ukuze kube ngcono ukucacisa ukulimala, ngezinye izikhathi kubalulekile ukusebenzisa amandla ezinyaweni ukuze ugcizelele ukulungiswa okungavamile.
Okunye okuvamile ukwenza umbono we-x-ray wezinyawo ezijwayelekile kanye nozinyawo ezingavamile ukuze kuchazwe kangcono ukulimala. Uma kukhona umbuzo wokulimala, ukuhlolwa okuqhubekayo kufaka phakathi i- CT scan noma i-MRI inganconywa.
Ngeshwa, eziningi zalezi zingozi aziqapheli ngaphandle kokuthola ukuhlolwa okufanele. Ukulimala okuningi kwe-Lisfranc akuqondwa kabi njengenyawo.
Ukwelashwa kokulimala kwe-Lisfranc
Ngokuvamile ukwelashwa kokulimala kwe-Lisfranc kuhlinzeka, nakuba ukulimala okuncane kungelashwa ngaphandle kokuhlinzwa. Uma kukhona ukwehlukana okuncane kwamathambo, ukuxoshwa okuqinile okuhambayo okusetshenziselwa amaviki ayisishiyagalombili kungenye indlela efanele. Kodwa-ke, ukwelashwa okuvame kakhulu ukuvikela amathambo aphukile futhi ahlukaniswe ngesikhatsi sangaphakathi (izikhonkwane) noma ukulungiswa kwangaphandle (izikhonkwane).
Ukwelashwa kuhloswe ukubuyisela ukulungiswa okuvamile kwamalungu, bese uthola amathambo kule ndawo efanele.Ukulungiswa okuqine kakhulu kuvamise izigxobo eziningi zensimbi, ezibekwa ngamathambo ahlukene ukuze zivikele i-midfoot kuze kube yilapho kulungiswa kahle. Ukutakula okuvamile kuhilela amasonto angu-6-8 ngaphandle kwesisindo ezinyaweni. Unyawo luvame ukuvikelwa ebhuthini lokuhamba ngamasonto amaningana, futhi izikrini zivaliwe emva kwezinyanga ezingu-4-6.
Ukuphumula okuphelele kuthatha izinyanga ezingu-6-12, futhi ngokulimala kakhudlwana kungabangela izinkinga zonyawo unomphela.
Ukuhlukunyezwa okuvame kakhulu kokulimala kwe-Lisfranc kungumuthi wezinyawo. I-arthritis ehamba ngemva kokuthungatha imenza i-arthritis igqoke futhi ichithe, kodwa inkambo yayo iyasheshisa ngenxa yokulimala ku- cartilage ehlangene. I-arthritis ingabangela ubuhlungu obungapheli ku-joint joint. Uma kukhona ubuhlungu obungapheli ngenxa yesifo samathambo esiphuthumayo, inqubo yokuhlinzwa ebizwa ngokuthi i- fusion ingaba yadingeka.
Enye inkinga yokulimala kwe-Lisfranc ibizwa ngokuthi i-compartment syndrome. I- compartment syndrome kwenzeka lapho ukulimala kubangela ukuvuvukala okukhulu endaweni equkethe umzimba.
Uma ingcindezi yokuvuvukala iphakanyiswa ngokwanele ngaphakathi kwendawo evinjiwe, ukunikezwa kwegazi kuleyo ndawo kungancipha, futhi kungaholela ezinkingeni ezinkulu.
Watson TS, et al. "Ukwelashwa kwe-Lisfranc Joint Injury: Imiqondo yamanje" J Am Acad Orthop Surg December 2010; 18: 718-728.