Mgwirizano wa Volkmann

Mgwirizano wa Volkmann ndikulephera kwa dzanja, zala, ndi dzanja chifukwa chovulala minofu yakutsogolo. Matendawa amatchedwanso Volkmann ischemic contracture.

Mgwirizano wa Volkmann umachitika pakakhala kuchepa kwa magazi (ischemia) kumtunda. Izi zimachitika pakakhala kupanikizika kowonjezereka chifukwa cha kutupa, vuto lotchedwa compartment syndrome.

Kuvulala kwa mkono, kuphatikiza kuvulala kapena kuphwanya, kumatha kubweretsa kutupa komwe kumakakamiza mitsempha yamagazi ndikuchepetsa magazi kutambasula. Kutsika kwakanthawi kwamagazi kumavulaza mitsempha ndi minofu, kuwapangitsa kukhala ouma (zipsera) ndikufupikitsa.

Minofu ikafupika, imakoka cholumikizira kumapeto kwa minofu monga momwe zimakhalira ngati nthawi zambiri imadwala. Koma chifukwa ndi yolimba, cholumikizacho chimakhala chopindika komanso cholimba. Vutoli limatchedwa mgwirizano.

Mu mgwirizano wa Volkmann, minofu yakumapiko idavulala kwambiri. Izi zimabweretsa kufooka kwa zala, dzanja, ndi dzanja.

Pali magawo atatu azovuta mu mgwirizano wa Volkmann:

• Kufatsa - mgwirizano wa zala ziwiri kapena zitatu zokha, osataya mtima kapena kuchepa
• Wotsogola - zala zonse ndizopindika (kusinthasintha) ndipo chala chachikulu chakakamira pachikhatho; dzanja limatha kupindika, ndipo nthawi zambiri pamakhala kutaya kwa dzanja
• Zolimba - minofu yonse patsogolo pake yomwe imasinthasintha ndikutambasula dzanja ndi zala; Izi ndizolemetsa kwambiri. Pali kusuntha kochepa kwa zala ndi dzanja.

Zinthu zomwe zingayambitse kupanikizika kumtunda zikuphatikizapo:

• Kuluma nyama
• Kuthyola mkono
• Kusokonezeka kwa magazi
• Kutentha
• Jekeseni wa mankhwala ena nkono
• Kuvulala kwamitsempha yamagazi kutsogolo
• Opaleshoni pamanja
• Kuchita masewera olimbitsa thupi kwambiri - izi sizingayambitse mgwirizano waukulu

Zizindikiro za mgwirizano wa Volkmann zimakhudza mkono, dzanja, ndi dzanja. Zizindikiro zimaphatikizapo:

• Kuchepetsa kuchepa
• Khungu khungu
• Kufooka kwa minofu ndi kutayika (atrophy)
• Kupunduka kwa dzanja, dzanja, ndi zala zomwe zimapangitsa dzanja kukhala ndi mawonekedwe ngati omenyera

Wopereka chithandizo chamankhwala ayesa thupi, moyang'ana mkono wokhudzidwayo. Ngati wothandizirayo akukayikira mgwirizano wa Volkmann, adzafunsidwa mwatsatanetsatane za kuvulala kwakale kapena zomwe zidakhudza mkono.

Mayeso omwe angachitike ndi awa:

• X-ray ya mkono
• Kuyesedwa kwa minofu ndi minyewa kuti muwone momwe ikugwirira ntchito

Cholinga cha chithandizo ndikuthandiza anthu kuti apezenso zina kapena kugwiritsa ntchito mokwanira mkono ndi dzanja. Chithandizo chimadalira kuuma kwa mgwirizano:

• Pochita mgwirizano wofatsa, kutambasula minofu ndikuthyola zala zomwe zakhudzidwa kumatha kuchitika. Kuchita opaleshoni kungakhale kofunikira kuti ma tendon akhale aatali.
• Pochita mgwirizano wapakati, opareshoni imachitika kuti akonze minofu, minyewa, ndi minyewa. Ngati pakufunika, mafupa am'manja amafupikitsidwa.
• Pogwiritsa ntchito mgwirizano wamphamvu, opareshoni imachitidwa kuti ichotse minofu, minyewa, kapena mitsempha yomwe imakhuthala, zipsera, kapena kufa. Izi zimalowetsedwa m'malo ndi minofu, minyewa, kapena minyewa yomwe imasamutsidwa kuchokera kumadera ena. Ma tendon omwe akugwirabe ntchito angafunike kupangidwa motalika.

Momwe munthu amachitila bwino zimadalira kuopsa kwake ndi gawo la matenda panthawi yomwe mankhwala amayambitsidwa.

Zotsatira zimakhala zabwino kwa anthu omwe ali ndi mgwirizano wofatsa. Atha kupezanso mphamvu yanthawi zonse yamanja ndi yamanja. Anthu omwe ali ndi mgwirizano wofatsa kapena wovuta omwe amafunikira opaleshoni yayikulu sangathenso kugwira ntchito.

Popanda kuchitapo kanthu, mgwirizano wa Volkmann umapangitsa kuti dzanja ndi dzanja ziwonongeke pang'ono kapena kwathunthu.

Lumikizanani ndi omwe amakupatsani nthawi yomweyo ngati mwavulala m'zigongono kapena m'manja ndipo mwayamba kutupa, kuchita dzanzi, ndi kupweteka kumakulirakulira.

Ischemic contracture - Volkmann; Matenda a chipinda - mgwirizano wa Volkmann ischemic

Jobe MT. Matenda a chipinda ndi mgwirizano wa Volkmann. Mu: Azar FM, Beaty JH, Canale ST, eds. Opaleshoni ya Campbell. Wolemba 13. Philadelphia, PA: Elsevier; 2017: mutu 74.

Netscher D, Murphy KD, Fiore NA. Opaleshoni m'manja. Mu: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 69.

Stevanovic MV, Sharpe F.Compartment syndrome ndi Volkmann ischemic contract. Mu: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS, olemba. Opaleshoni ya Dzanja la Green. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 51.