Ukuvuleka kwezinto ezivulekileyo kukulimala kwithambo eqhubekayo xa ithambo ephukile libonakaliswe kumzimba kwiindawo ezikufutshane. Iintlobo ezivulekileyo , ngamanye amaxesha zibizwa ngokuthi i-fracture, zenzeke xa kuncinci kunqunywe kwesikhumba edibanisa nokuqhekeka, okanye kunokuthi kubekho ukulimala okwenzakalayo okubangela ukuba kusinde isilungu.
Ngomgudu wokwenza ingqiqo yale nzakalo, ngokuqhelekileyo ihlelwa ngokuxhomekeka kwayo.
Inkqubo eqhelekileyo yokuhlenga iziqheko ezivulekileyo ngokuhambelana nenkqubo yokwahlula i-Gustilo-Anderson.
Amabanga amaFleji avulekileyo
- Bakala I Vula ukuhlukana
I-grade I open fracture ivela xa kukho inxeba yesikhumba edibanisa ne-fracture elingaphantsi kweyentimitha enye. Ngamanye amaxesha kunzima ukuvavanya ukuba i-fracture ivulekile (kuchaza ukuba isilonda sidibanisa nethambo ephukile), kodwa oku kungagqitywa ngokufaka i-fluid kwisayithi yokuphuka, kwaye ubona ukuba umbane uphuma kwilonda. - IBanga lesi-II ivuliwe
Ukulimala kweBakala II kunobungozi obukhulu bokuzilimaza, ukulinganisa ngaphezu kweyentimitha enye. - IBanga III iVlection Open
Izahlulelo ezivulekileyo zeBakala III zimelele ukulimala kakhulu kwaye zibandakanya ezintathu zentlobo zenzakalo zokulimala:- IBanga IIIA: Iintlobo zee-3A eziyingozi zibandakanya ukuphuka kwamandla aphezulu njengokuba kuboniswe ukulimala kwamathambo amaninzi (amaqhekeza ahlukeneyo okanye ahlukeneyo) kunye / okanye ezinkulu, zihlala zingcolile, zihlazo. Uninzi lwagqirha luchaza i-fractures high-energy njenge-3A nangona isilonda sesikhumba asikhulu.
- IBanga IIIB: Iingqungquthela ze-3B zinomonakalo obonakalayo-tissue / loss for such bone, kwaye ukuhlaziywa kungadinga ukutshintshwa kwezicubu ezincinci (i-flap) ezenzelwe ukukhusela isilonda.
- IBakala IIIC: Ukuhlukana kwe-3C ngokukhethekileyo kufuna ukungenelela kwe-vascular njengoko i-fracture idibene nokulimala kwe-vascular ukuya ekupheleni.
Indlela UkuGqala Kukusetyenziswa Kanjani
Inkqubo yokwahlula i-Gustilo-Anderson inokubaluleka kakhulu ukunika iincwadana ezimbini zolwazi: luyintoni amathuba okuphuhlisa isifo, kwaye kuza kube nini ixesha lokuphulukana nokuphulukiswa kuthatha. Njengoko ibakala likhuphuka, izinga lokutheleleka liphakama ngokukhawuleza, kwaye ixesha lokuphulukana nokuphulukiswa likhula.
I-Bakala I ivula ukulimala kwe-fracture ye-tibia ingaphantsi kwe-2% yezinga lokusuleleka (kunye neyonyango olufanelekileyo), kwaye uthathe isilinganiso seminyaka engama-4-5 yokuphilisa. Izabelo zeBakala IIIB kunye ne-IIIC zifikelela kumazinga angama-50% okusuleleka kwintsholongwane kwaye zithatha umyinge weenyanga ezi-8-9 zokuphulukisa amathambo.
Udidi lwe-Gustilo-Anderson lwapapashwa ngokuqala ngee-1970 kwaye luye lwafumana utshintsho oluninzi. Ingundoqo yenkqubo yohlengahlengiso kukubonelela ngeemeko zokulimala ngokusekelwe kwinqanaba labo. Ukusuka kule nkcazelo, iifracture zingabelana ngezizathu zophando, kwaye ulwazi lunokusetyenziswa kwenzakala elitsha ngokusekelwe kuphando oluye lwenziwe.
Imida yeNkqubo
Kukho imida emininzi yenkqubo yokuhlenga i-Gustilo-Anderson ekufuneka iqondwe:
- Oogqirha abavame ukungavumelaniyo: Izifundo zibonise ukuba oogqirha bamazinyo, owaziyo inkqubo yokuhlelwa kakuhle, bavuma kuphela kwi-bracture grade malunga ne-60% yexesha. Ngako oko, yintoni enye into eyenza ugqirha ejonga ngayo i-grade I, eya kuthiwa yi-grade IIIA yenye. Oku kukuthelekisa idatha kumngeni.
- Ayilungiselelwe zonke iiFracture ezivulekileyo: ngelixa ugqirha abaninzi babhekisela kule nkqubo yokuhlengahlengisa ukuchaza naluphi na ulwaphulo oluvulekileyo, okokuqala luyilungiselelwe ukuchaza i-tibia fractures evulekile, kwaye emva koko, ukuvuleka kwexesha elivulekileyo. Oko akutshoyo akukwazi ukusetyenziswa ukuchaza ezinye ukulimala, kodwa akusiyo indlela le nkqubo yokuhlengahlengiswa ngayo.
Kwizigulane ezigcina ukuphulwa okuvulekile, isitshixo kwisiphumo esiyimpumelelo ngonyango oluphuthumayo. Ukunyangwa kwephulo evulekileyo kufuna ukuphanda ngokukhawuleza kunye nokucoca kwilonda, unyango olufanelekileyo lwe-antibiotic, kunye nokuzinza kwephulwa.
Umthombo:
Zalavras CG kunye nePatzakis MJ. "Vula amaFractures: Uvavanyo kunye noLawulo" J Am Acad Orthop Surg ngoMeyi / Juni 2003; 11: 212-219.