Konke malunga neFracfracc Fracture
Ukulimala kwe-Lisfranc kukulimala kwiigaments ezidibanisa amathambo e-midfoot kunye ne-forefoot. Ngamanye amaxesha, ukulimala kukuchithwa okulula ( ukulimala kwegilisi ), kwaye ngamanye amaxesha i-bone ephukile ivela, i-Lisfranc isahluko / ukuchithwa. Ukutshatyalaliswa kwenzeka xa kukho ukwahlukana kokulungelelaniswa ngokuqhelekileyo kokubambisana phakathi kwe-forefoot kunye ne-midfoot. Xa kukho i-fracture, ithambo eliphukile lihlala lisebenza emathanjeni.
Unyawo luhlukaniswe kwiindawo ezintathu eziphambili. Indawo engaphambili yezinto ezenziwe ngezwane; i- midfoot eyenziwe ngamathambo amancinci abizwa ngokuba yi-navicular, cuneiform kunye ne-cuboid; kunye ne- hindfoot equkethe i-talus (iqhosha elingaphantsi) kunye ne-calcaneus (isithende). Ukuhlanganisana kwe-Lisfranc kukukhonkxa kwamathambo e-forefoot kunye ne-midfoot.
Iingxaki zeLisfanc Injury
Inxeba yaseLisfranc ibizwa ngokuba nguvulindlela waseFrance uJacques Lisfranc emkhosini kaNapoleon. Ukulimala kwasekuqaleni okuchazwe yiLisfranc kwakwenzeka njalo xa ijoni liwe ehashe lakhe, kodwa unyawo lwakhe aluzange lukhulule kwi-stirrup, okanye ke ibali lihamba. Namhlanje, amaninzi amanxeba angaphakathi kweso sithuba senzeke ngenxa yesinyathelo esingenakwenzeka kwimimandla engalinganiyo, ukulimala kwezemidlalo okanye ukushayisana kwemoto.
I-Lisfranc Injury Diagnosis
Kubalulekile ukuba usenokukrokra okukhulu kwi-Lisfranc ukulimala xa kukho intlungu kunye nokuvuvukala kwi-midfoot. Ezi nzakala zingenzima ukuxilonga, kwaye ngaphandle kokonyango olufanelekileyo, kukho iziphumo ezimbi.
Naliphi isigulane esinempawu zengozi yaseLisfranc kufuneka ihlolwe ngugqirha.
Ukulimala kwe-Lisfranc kubandakanya
- Ubuhlungu phakathi kweenyawo
- Ukuvuvukala nokutyumla
- Ubuhlungu ngokuhamba / ukuma
Ukulimala kwe-Lisfranc kungabonakali ngokubonakala kwe-x-ray. Ukuze kube lula ukucacisa ukulimala, ngamanye amaxesha kuyimfuneko ukufaka amandla enyawo ukuze ugxininise ukulungelelaniswa okungavumelekanga.
Kuqhelekile ukuba wenze umboniso we-x woluhlu oluqhelekileyo kunye neenyawo ezingaqhelekanga ukuze kulungiswe kakuhle ukulimala. Ukuba kukho umbuzo wengozi, ukuvavanywa okuqhubekayo kuquka ne- CT scan okanye i-MRI inganconywa.
Ngelishwa, uninzi lwale nzakala alubonakali ngaphandle kokufumana uvavanyo olufanelekileyo. Amanxeba amaninzi aseLisfranc aqondwa kakubi njengokuba unyawo lwentliziyo.
Ukwelashwa kweeLisfranc
Uninzi lwamaxesha amaninzi unyango lwe-Lisfranc lugqirha, nangona ukulimala okungaphantsi kunokunyangwa ngokungagqirha. Ukuba kukho ukwahlukana okuncinci kwamathambo, ukuphosa okusikhuni okufakiweyo kufakwe iiveki ezisibhozo kuyona efanelekileyo. Nangona kunjalo, unyango oluqhelekileyo lukukhusela amathambo aphuhliweyo kunye nama-internal (screws) okanye zangaphandle (izikhonkwane) ukulungiswa.
Ugqirha lujoliswe ekubuyiseleni ukulungelelaniswa okuqhelekileyo kwamalungu, kwaye ukugcina amathambo kule ndawo efanelekileyo. Ukulungiswa okuqinileyo kudla ngokuba neenxeba ezininzi zetsimbi, kufakwa ngamathambo ahlukeneyo ukukhusela i-midfoot kwi-forefoot ngokulungelelaniswa okufanelekileyo. Ukubuyiselwa okuqhelekileyo kubandakanya iiveki ezi-6-8 kungekho bunzima kwinqanaba. Unyawo luvame ukukhuselwa kwisiqhelo sokuhamba ngeeveki eziliqela, kwaye izikhwama zisuswa emva kweenyanga ezi-4-6.
Ukugqiba ngokuqhelekileyo kuthatha iinyanga ezi-6-12, kwaye ukulimala okungakumbi kunokukhokelela kwiingxaki zenyawo ezingunaphakade.
Inkxalabo eqhelekileyo yengozi yaseLisfranc yi-arthritis yonyawo. Isifo se-arthritis esisemva kwesifo sichaza ukuguquka kwe-arthritis, kodwa ikhosi yayo ikhawuleza ngenxa yokulimala kwinqabunga elihlangeneyo. I-arthritis ingakhokelela ekubuhlungu okungapheliyo kwi-joint joint. Ukuba kukho intlungu engapheliyo ngenxa yesifo se-arthritis esisemva kwesifo, inqubo yokuhlinzwa ebizwa ngokuba yi- fusion ingaba yimfuneko.
Enye ingxaki enokwenzeka yengozi yaseLisfranc ibizwa ngokuba yi-compartment syndrome. Isifo sesiganeko senzeke xa ukulimala kubangelwa ukuvuvukala okukhulu kwinxalenye ebalulekileyo yomzimba.
Ukuba uxinzelelo olusuka ekuvufuseni luphakanyiswa ngokwaneleyo kwindawo engqongileyo, ukunikezelwa kwegazi kuloo mmandla kunokuthi kungancinci, kwaye kunokukhokelela kwiimeko ezinzima.
Watson TS, et al. "Unyango lwe-Lisfranc Joint Injury: Iingcamango zangoku" J Am Acad Orthop Surg ngoDisemba 2010; 18: 718-728.