I-Tibial Shaft Fracture iyingozi kakhulu kwaye idinga ukuphanda
I-tibia yinkomo enkulu ye-shin ephakathi kwamadolo kunye neenyawo. Le nxalenye yomzimba ibizwa ngokuba ngamayeza-umlenze, kunye kunye nomlenze nomlenze ube ngumgca ongaphantsi (umlenze empeleni kuphela yecandelo phakathi kwamadolo kunye neenyawo, nangona abantu abaninzi bebiza umnqweno ophantsi njengoko 'umlenze').
Kukhona amathambo amabini omlenze, i-tibia kunye ne-fibula.
I-tibia yithambo elikhulu abantu abahlala bebhekisela kuyo njengesifo se-bone. Uninzi lwesisindo somzimba luxhaswa yi-tibia. I-fibula ithambo elincinci elisekho ngaphandle komlenze kwaye aluxhasi ubunzima bomzimba, nangona lusebenza imisebenzi ebalulekileyo emadolweni nasekunxinxeni kwesikhumba kunye nokuxhamla kwemizi kunye nemigqa.
Ukulimala kwe-tibial shaft kungenzeka emva kokuwa, izingozi zeemoto, ukulimala kwezemidlalo kunye neminye imisebenzi. I-shaft ye-tibia yiyona nxalenye ephambili yethambo, kungekhona ukuphela kwethambo elisezantsi ngaphantsi kweedolo okanye ngaphezulu kweenyawo. Igama lonyango le-shaft ye-tibia yi-diaphysis yethambo. I-shaft ye-tibia yi-tube engenamanzi, nangona i-shape ine-triangular imo kunye ne-tibia crest ibe yinqaba ephezulu phambi kwe-shin. Iifractures ziyakwenzeka kwakhona phezulu kwisifuba le-shin ( i-tibia fractures ) okanye phantsi kwe-bone (bone distraction ).
Ngaphakathi kwendawo ephakathi kwethambo le-shin ngumngxoworho we-bone. Ingxenyana yangaphandle yethambo ilukhuni kwaye iyanzima; Oku kubizwa ngokuba yi-cortex yethambo kwaye kunika amandla e-tibia. Xa kuqhuma i- tibia , ithambo liphazamiseka, kwaye ukuzinza komlenze kuyonakaliswa. I-Tibia fractures ivame ukulimala, kwaye ngokubanzi ifuna unyango oluphuthumayo.
Iimpawu ze-Tibial Shaft Fractures
I-Tibia i-fracture ibonakala yingozi, kodwa ngamanye amaxesha amaninzi angaphantsi komhlaba, awanakudluli kwiindawo ezikhungathekileyo zingabunzima ukubona. Iimpawu eziqhelekileyo ze-tibia fracture ziquka:
- Intlungu ephezulu ekupheleni
- Ukuguqulwa komlenze
- Ukuphatheka ngokuthe ngqo kwithambo
- Ukungakwazi ukubeka ubunzima emlenzeni
Xa kukho inkxalabo malunga nokuhlukana kwe-shabial shaft, i-x-ray iya kufumaneka ukuqinisekisa ukuba ithambo lonakaliswe. Ngokuqhelekileyo uvavanyo lwe-x-ray lwanele ukwenzela ukuba ukuxilongwa, nangona kunjalo, kwiimeko ezinjengeengxaki zokuxinwa kweengxaki , kunokuhlala kube nombuzo malunga nobukhulu bokulimala, kwaye i-MRI okanye i-scan scan ingenziwa xa kukhanyeka kwaye ii-x-ray ziqhelekileyo.
Uninzi lwe-tibia ulwaphuka lunokuphathwa njengonyango oluphuthumayo okanye ngokuzinzileyo olulandelayo olulandelwe ukulibaziseka unyango oluchanekileyo. Nangona kunjalo, kukho imeko apho i-tibia ephukayo idinga unyango lwangxamisekileyo. Esinye sezi zizathu kukuqhekeka okuvulekileyo apho ithambo le-tibia liye langena esikhumbeni. Ngenxa yentsholongwane xa ithambo lingena esikhumbeni, ezi zintluko ziphathwa ngokugqithiseleyo njengesiphumo soxinzelelo .
Ukwelashwa kweThial Shaft Fractures
Ukuphulwa kwe-shabial shaft kungaphathwa ngeendlela eziliqela kuye kuxhomekeke kuhlobo lokuphulwa kunye nokulungelelanisa ithambo.
Ngokwesiko, ininzi ye-tibia yaphuka iphathwa nge-cast application okanye i-braces. Nangona kunjalo, ngoku kutshanje, umkhangeli uye watshintshelwa unyango olongezelelekileyo ngononophelo olusisigxina lomzimba ophukile. Isizathu sokuba utyando luya kuba luqhelekileyo kukuba iziplani kunye nobugcisa bokuphucula ziphuculisile ukwenza ingozi yokuhlinzwa ngokuncinci kunye neenzuzo zokuphulukiswa okungakumbi kokulimala.
Iinkqubo eziqhelekileyo zonyango kwi-tibia shaft ephukile ziquka:
- Ukugxotha
Iphosa lifanelekile i-tibial fractures fractures ezingenakudlulelwa ngokufudumele kwaye zilungelelene kakuhle. Izigulane zifuna ukuba ziphoswe ezihamba ngaphaya kweedolo nangaphantsi kwe-ankle (umlenze omde uqhubekileyo). Inzuzo yokuphosa kukuba ezi zintluko zivame ukuphulukisa kakuhle kwaye zikhuphe izingozi ezinokwenzeka zokuhlinzwa ezifana nesifo. Izigulane ezinama-casts maziqwalaselwe ngenyameko ukuqinisekisa ukunyanga okwaneleyo kwe-tibia kunye nokuqinisekisa ukuba amathambo agcina ukulungelelaniswa kwawo. Ixesha eliqhelekileyo x-ray liqhutshwa ngokubanzi ukuqinisekisa ukuba ukuphilisa kuyaqhubeka njengoko kulindeleke.
- I-Intrameduallary (IM) I-Rodding
I-intrameduallary rodding yinkqubo yokubeka intonga yomdaka phantsi kwinqanaba le-tibia ukubamba ukulungelelanisa ithambo. I-rodbial rodding yinkqubo yokugqirha ehlala malunga neyure nesiqingatha kwaye idlalwa phantsi kwe-anesthesia jikelele. Izigulane ziya kuba ne-incision phezu kwamadolo, kunye nokubonwa okuncinane ngaphantsi kweedolo nangaphezulu kweenyawo. Ukongezelela, ezinye iintsimbi zingadinga ukutsalwa kweso sithuba sokutshatyalaliswa kwamathambo. Iimbolo ze-IM zikhuselekile ngaphakathi kwithambo ngokukhangela zombini ngasentla nangaphantsi kwephuka. Izikhonkwane zensimbi kunye nentonga ingasuswa ukuba zibangele iingxaki, kodwa zingashiywa endaweni kwindawo yobomi. I-rodbi ye-Tibial inikeza ukulungiswa kakuhle kunye nokulungelelanisa amathambo. Umngcipheko oqhelekileyo wokuhlinzwa uphethwe ubuhlungu emadolweni, kwaye inkoliso eninzi malunga noxinzelelo isifo. Ukukhulelwa kwentonga kunokufuna ukuba ususwe intonga ukuze uphilise intsholongwane. - Iiplati kunye neeScreen
Iiplati kunye nezikrini zingasetyenziswa ngokuqhelekileyo, kodwa zinceda kwezinye iintlobo zokuphuka, ikakhulukazi ezo zisondele kumadolo okanye amajoyini angamaqanda (bona ulwazi kwi-plateau ne-tibial fractures fractures). Uninzi lwagqirha lukhetha intonga ye-IM ye-tibial fractures fractures ngaphandle kokuba i-fracture isondele kakhulu kumxube ukuvumela ukufakwa kwetata le-IM. Kulezi ziqhekeza eziseduze nomhlaba odibeneyo, isitya kunye neentloko zingayona ndlela efanelekileyo yokulungisa. - Fixator yangaphandle
Isilungiselelo sangaphandle sinokukunceda nakwezinye iintlobo zokuphuka. Izilungiso zangaphandle zihlala zisetyenziselwa ukugqithisa kakhulu, ngokukodwa imivumba evulekileyo kunye ne-lacerations edibeneyo kunye nomonakalo onobuchopho. Kule meko, ukufakwa kwee-rod okanye iiplathi ze-IM akunakwenzeka ngenxa yokulimala kweethambo. Xa kukho ukulimala okubalulekileyo kwisisu, isilungiselelo sangaphandle singabonelela ngokukhawuleza xa sivumela ukubeka iliso kunye nonyango lwama-soft tissue ezijikelezayo.
Ukubuyisela emva kokulimala
Ukuphulukiswa kwexesha emva kwesahluko se-tibial fracture kunokuxhomekeke kakhulu kuhlobo lokuphuka, ubunzima bokulimala kunye nendlela yokonyangwa ekhethiweyo. Ngokuqhelekileyo, i-tabiyo ye-shabi fractures iza kuthatha ubuncinane beenyanga ezi-3 zokuphilisa, kwaye akuqhelekanga ukuba iifracts ithathe iinyanga ezi-4 ukuya kwezi-6 ukufumana ngokupheleleyo. Ukuva oku kungabangela uxinzelelo, kodwa khumbula ukuba kuxhomekeke kwiimeko zakho ezikhethekileyo unako ukwenza okukhawuleza.
Isixa sobunzima esingasetyenziselwa ekugqibeleni sinokutshintsha kakhulu. Kwezinye iimeko kunye neziqhekeza ezizinzileyo ezigcinwe endaweni enezixhobo zentsimbi, ukunyamezela ngokukhawuleza kunokuvunyelwa. Kwezinye iimeko apho kukho inkxalabo malunga nokulungelelaniswa kweqhekeza okanye ukuzinza, ubunzima bunokuthi lubekwe umda kuze kufikelelwe ukuphilisa.
Enye inkxalabo ye-tibia fractures ibizwa ngokuba yi- nonunion , imeko apho ithambo lingakwazi ukuphilisa ngokupheleleyo. Iimanyano aziqhelekanga kubo bonke abantu-zixhaphake kakhulu emva kokulimala kanzima kunye nokuvuvukala okuvulekileyo, okanye kubantu abaneempawu zonyango ezingaphazamisa ukuphulukiswa kwamathambo. Esinye sezizathu eziqhelekileyo zokungabandakanyekanga kukusetyenziswa kotywala , apho ukusetyenziswa kwe-nicotine kubangela ukulibaziseka ukuphulukiswa kwethambo lokuphuka, ngoko kubalulekile ukuba ugweme ukutshaya kunye nezinye iintlobo zokutya icuba. Ingxoxo kunye nogqirha wakho kukulungele ukuqonda ukuba yiyiphi indlela efanelekileyo yeyona nyathelo.
> Imithombo:
> Tejwani N, Polonet D, Wolinsky PR. "Iingxabano kwi-intramedullary nailing ye-proxiimal and distal tibia fractures" J Am Acad Orthop Surg. 2014 Oct; 22 (10): 665-73.
> Bedi A, LeTT, Karunakar MA. "Unyango olusandululweyo lwe-nonaltic distal tibia fractures" J Am Acad Orthop Surg. 2006 Julayi; 14 (7): 406-16.
> Bono CM, et al. I-Nonarticular Proximal Tibia Fractures: Iinketho zokonyango kunye nokwenza isigqibo "J Am Acad Orthop Surg ngoMeyi / Juni 2001; 9: 176-186.