Ukulimala kwenye yeeMpawu ezimancinci zesiKhonkwane
Ithambo le-scaphoid linye lamathambo amancinci angama-8 ekhanda, ebizwa ngamathambo e-carpal. La mathambo avumela ukunyanzelisa, kodwa kunesiphako sandla nesandla. Amathambo e-carpal afana phakathi kwethambo le-forearm kunye nesandla. I-scaphoid ihleli ngaphantsi kwesiqwenga, kwaye ifakwe njengobhontshisi bezintso.
Iintlobo zee-scaphoid zizahlukana zixhaphaka zixhaphaza amathambo e-carpal.
Ulawulo lwendabuko lwentlupheko ye-scaphoid, ingakumbi kwiifractures ezingekho phantsi kweendawo, zine-immobilization. Nangona kunjalo, ukuphulukiswa kwezizahlulo ze-scaphoid kungathatha ixesha elide, kwaye ngamanye amaxesha ithambo alinakuphilisa ngokupheleleyo, imeko ebizwa ngokuba yi-nonunion. Ngako oko, iingcebiso zonyango zokuphulwa kwesifo se-scaphoid ziyahluka kwaye ngamanye amaxesha ziquka unyango oluphambili.
Ukuphuma kweGazi kwiScaphoid
Into enomdla ngethambo le- scaphoid yinto enokubuyiswa kwegazi ngokutsha. Oku kuthetha ukuba ukuphuma kwegazi kuvela kwisitya esincinci esinga kwinxalenye yethambo kwaye siphambuka ngethambo ukuze sinike isondlo kwiiseli zethambo.
Ukugeleza okungaqhelekanga kwegazi kwi-scaphoid kubonisa ingxaki xa uqhubeka ulwaphulo lwe-scaphoid. Ngenxa yokunikezelwa kwegazi, ukuphulwa kwe-scaphoid kungaqhekeza ukuhamba kwegazi kwaye kuyeke ukuhanjiswa kwee-oxygen ezifunekayo kunye nezondlo kwiiseli zethambo.
Xa oku kwenzeka, ukuphilisa kunganciphisa, kwaye ukuphulwa kwesifo se-scaphoid asikwazi ukuphilisa nonke.
Iimpawu zeSpaphoid Fracture
Iimpawu zesifo se-scaphoid ziyahlukana:
- intlungu kwisalathisi sesithupha sekhanda
- ukuvuvukala nokutyumla kwisiseko sesithupha
- ubunzima bokuthabatha izinto
Izigulane ezininzi zifunyaniswa ukuba zinekhanda lomkhonto , xa ngokwenene zinezifuba eziphukile.
Ukuxilongwa kunzima kuba i-ray-ray ithathwe emva kokuba ukulimala kungabonakali into engafanelekanga ukuba ithambo lingekho kwindawo. Ukuqhekeka kwesifo esingazange sichithwe singabonakalisa kwi x-ray emva kokuphulukiswa kuqalile, okuya kuba yinye iveki ezimbini emva kokulimala. Ngenxa yoko, akuqhelekanga ukuphatha ingozi yesandla ngokungafihli (njengokungathi i- scaphoid fracture ) yeveki okanye ezimbini kwaye uphinda uphinde uxubushe ii-ray ukuze ubone ukuba ithambo liphukile. I-MRI ingasetyenziselwa ukuxilonga le nzakala, ngaphandle kokulinda ukuphinda i-x ray.
Ukungabambisani kweeSpaphoid Fractures
Xa i-scaphoid ephuka iphilisa ngokunyanisekileyo (inyunyana ebambezelekileyo), okanye ayiphilanga nhlobo ( ingabandakanyekanga ), ukulimala kunokuhlala kubuhlungu, kwaye ekuhambeni kwexesha, i-arthritis yesandla iya kwenzeka. Umngcipheko wokuphuhlisa ukungabandakanyekanga kwe-scaphoid kuxhomekeke kubaluleke kakhulu kwindawo yokuphulwa kwethambo. Ezinye izinto ezinokuthi zenze igalelo kwimibutho engekho emanyeni zibhema, imithi ethile kunye nosulelo.
I-Scaphoid Fracture Treatment
Kukho iindlela ezimbini eziqhelekileyo zokunyangwa kwe-scaphoid: i-immobilization okanye ukuzinzisa ukuzinza .
Ngethuba nje ukuphulwa kwe-scaphoid kungabikho ndawo (ngaphandle kwesikhundla), ukukhutshwa kwezinto ezingenakucala kukunyanga .
Ukuphosa kufuneka kwandiswe kwisithupha sakho ukuze unciphise ukuhamba kwesithupha sakho. Indlela ephakamileyo yokwandisa i-cast (ngentla okanye ngaphantsi kwe-elbow) ixhomekeke kwinqununu yonyango. Ugqirha wakho uya kuqhubeka nokubeka esweni isigxina ngokubhaliweyo kunye novavanyo lwama-x ukuqinisekisa ukuba kukho ukuphilisa ithambo. Ukuphulukiswa kwesifo se-scaphoid ngokuqhelekileyo kuthatha iiveki ezi-10 ukuya kwezi-12.
Ukuba i-scaphoid fracture ichithekile, umngcipheko wokungabandakanyekanga uphakamileyo, kwaye ugqirha wakho uya kuncomela ukuba utyunjwe ukubeka amathambo, kwaye ubambelele ngokuqinile ngokulungelelaniswa okufanelekileyo. Utyando lubandakanya ukusetyenziswa kwesinye isikhombisi sokubamba ithambo ndawonye kwindawo efanelekileyo.
Kukho ukuphikisana malunga nokusebenzisa utyando njengonyango lokuqala lwephuka elingaphandle kwesimo. Inzuzo kukuba akukho mngcipheko wokungabandakanyeki kunye nexesha lokuchithwa kwempahla kunokuncitshiswa ngokuphawulekayo. Ukungalungi kukuba utyando luhlala luba neengozi, kwaye ngelixa i-complication rate ye-scaphoid yaphulwa ukuhlinzwa, encinci inokubakho ubunzima, kubandakanywa ukusuleleka, kunye nokulimala kwi-cartilage okanye i-tendons ezijikelezayo. Abagijimi abaninzi okanye abasebenzi abanomsebenzi bakhetha ukuhlinzwa ukuba bavumele ukufumana ukukhawuleza.
Xa ukungabandakanyeki kwento ephukayo kuqhubeka, utyando luvame ukucetyiswa ukukhuthaza ithambo ukuba liphilise. I-graft grafu isetyenziselwa ukukhuthaza ukuphulukiswa kwisiza sokuphuka . Ezi nzakala zinokuba nzima, kwaye zifuna unyango olude ukwenzela ukuba ithambo liphilise. Ngaphandle kokonyango olufanelekileyo, i- arthritis yesandla inokuphuhliswa kamva ebomini.
ILizwi
Ukuphulwa kwe-scaphoid ukulimala kwamanxeba okuqhelekileyo, kwaye unyango lunokuxhomekeka kumanani amaninzi. Ukuphosa ukungabi nendawo kukugweba unyango olusetyenziswayo kunye neengozi zokusulelwa kwintsholongwane kunye nokulimala kwe-cartilage, kodwa kunokufuna ukunyanzeliswa kwexesha elide kwaye kukhokelela ekuqineni kokubambisana. Unyango oluphandwayo lunomngcipheko, kodwa lunokubonelela ngokuphulukiswa okungakumbi. Kukho izinto ezinjengexesha lesigulane, inqanaba lomsebenzi, indawo yokuqhawuka kunye nolunye uhlobo oluchaphazela unyango olucetywayo.
Imithombo:
> I-Moon ES, iDy CJ, uDerman P, uVance MC, uCarlson MG "Ukulawulwa kokungabandakanyeki emva kokulawulwa kwezicwangciso ze-scaphoid fractures: Iingcamango zangoku" J Am Acad Orthop Surg. 2013 Sep; 21 (9): 548-57.