Kuphulika kwa Scaphoid: Zomwe Muyenera Kudziwa Zokhudza Dzanja Losweka

Zamkati

• Kodi scaphoid ndi chiyani?
• Kodi chimachitika ndi chiani kuphulika kwa scaphoid?
• Nchiyani chimayambitsa kusweka kwa scaphoid?
• Kodi kuphulika kwa scaphoid kumapezeka bwanji?
• Kodi chithandizo cha fracture ya scaphoid ndi chiani?
• Kutaya
• Opaleshoni
• Kukopa kwamfupa
• Kodi malingaliro a anthu omwe ali ndi vuto lophulika ndi otani?

Kodi scaphoid ndi chiyani?

Fupa la scaphoid ndi amodzi mwa mafupa asanu ndi atatu a carpal m'manja mwanu. Ili pa chala chachikulu cha dzanja lanu pansi penipeni pa utali wozungulira, limodzi la mafupa akulu akulu patsogolo panu. Zimakhudza kusuntha ndi kukhazikika dzanja lanu. Dzinalo lakale ndi fupa la navicular.

Mutha kupeza fupa lanu la scaphoid mwa kunyamula chala chanu chakumwamba mutayang'ana kumbuyo kwa dzanja lanu. Kulumikizana kwamakona atatu komwe kumapangidwa ndi tendon ya chala chanu chachikulu kumatchedwa "anatomic snuffbox." Scaphoid yanu ili pansi pa katatu iyi.

Kodi chimachitika ndi chiani kuphulika kwa scaphoid?

Malo a scaphoid pambali pa dzanja lanu ndi kukula kwake kwakukulu zimapangitsa kukhala pachiwopsezo chovulala kapena kusweka. M'malo mwake, ndimafupa a carpal omwe amang'ambika pafupipafupi, omwe amawerengera pafupifupi zophulika za carpal.

Scaphoid ili ndi magawo atatu:

• proximal mzati: mapeto ake ali pafupi kwambiri ndi chala chanu chachikulu
• m'chiuno: pakati pobowola fupa lomwe lili pansi pa anatomic snuffbox
• mzati wa distal: mathero oyandikira pafupi ndi mkono wako

Pafupifupi 80 peresenti ya zophulika za scaphoid zimachitika m'chiuno, 20% pamapolo oyandikira, ndipo 10% pamtunda wotalikirapo.

Tsamba lomwe lathyoledwa limakhudza momwe lidzachiritsire. Zovulala mu mzati ndi m'chiuno mozungulira nthawi zambiri zimachira mwachangu chifukwa zimakhala ndimagazi abwino.

Mitengo yambiri yozungulira imakhala ndi magazi osavomerezeka omwe amadulidwa mosavuta pakaphulika. Popanda magazi, fupa limafa, lomwe limatchedwa avascular necrosis. Kupasuka kwa mtengo wozungulirako sikumachiranso kapena mwachangu.

Nchiyani chimayambitsa kusweka kwa scaphoid?

FOOSH amatanthauza "kugwera padzanja lotambasuka." Ndiwo magwiridwe kumbuyo kwamiyendo yambiri yamiyendo yakumtunda.

Mukawona kuti mwatsala pang'ono kugwa, mwachibadwa mumachitapo kanthu mwakulumikiza dzanja lanu ndikutambasula dzanja lanu kuti muyese kugwa ndi dzanja lanu.

Izi zimateteza nkhope yanu, mutu wanu, ndi msana wanu kuti zisakuvulazeni, koma zikutanthauza kuti dzanja lanu ndi dzanja lanu ndizomwe zimakhudza zonse. Ikapangitsa dzanja lanu kubwerera mmbuyo kuposa momwe limafunira kupita, kuphulika kumatha kuchitika.

Kutalika kwa dzanja lako likamagunda pansi kumakhudza komwe kumachitika. Kutali kwambiri dzanja lanu likugwada, ndikotheka kuti fupa lanu la scaphoid lidzasweka. Dzanja lanu likakhala locheperako, fupa la utali wozungulira limakhudza kwambiri zomwe zimapangitsa kuti pakhale kuwonongeka kwapadera (Colles 'kapena Smith fracture).

Kuvulala kwa FOOSH kumakhudza scaphoid chifukwa ndikulumikizana kwakukulu pakati pa dzanja lanu ndi mkono wanu. Mukagwa padzanja lanu, mphamvu zonse zopangidwa dzanja lanu likamenya pansi zimapita kutsogolo kwanu kudzera pa scaphoid. Mphamvuyo imapanikiza kwambiri fupa laling'onoli, lomwe lingayambitse kusweka.

Kuvulala kwa FOOSH kumachitika m'masewera ambiri, makamaka zinthu monga kutsetsereka, kutsetsereka, ndi kutsetsereka pachipale chofewa. Kuvala walonda pamanja ndi njira yosavuta yoletsera kuvulala uku.

Kuchita nawo masewera omwe amatsindika mobwerezabwereza mafupa anu a scaphoid, monga kuwombera kapena masewera olimbitsa thupi, amathanso kuyambitsa kuphwanya kwa scaphoid. Zina mwazifukwa zimaphatikizapo kugunda molunjika molunjika kumanja ndi ngozi zamagalimoto.

Kodi kuphulika kwa scaphoid kumapezeka bwanji?

Ma fracture a Scaphoid nthawi zambiri samadziwika nthawi zonse ndipo zimakhala zovuta kuwazindikira.

Chizindikiro chofala kwambiri ndikumva kuwawa komanso kukoma mtima pa bokosi la zida za anatomic. Ululu nthawi zambiri umakhala wofatsa. Zitha kukulirakulira ndikutsina ndi kugwira.

Nthawi zambiri sipangakhale kuwonongeka kapena kutupa, kotero sikuwoneka ngati kwasweka. Kupweteka kumatha kusintha ngakhale masiku ndi masabata atatha. Pazifukwa izi, anthu ambiri amaganiza kuti ndi dzanja lokhazikika ndikuchedwa kulandira chithandizo choyenera.

Mukapanda kulandira chithandizo nthawi yomweyo, wovulalawo ukhoza kulephera. Izi zimatchedwa mgwirizano, ndipo zimatha kubweretsa zovuta zazikulu kwanthawi yayitali. Pafupifupi zophulika za scaphoid sizimagwirizana. Avascular necrosis amathanso kuyambitsa mgwirizano.

X-ray ndiye chida chachikulu chodziwira. Komabe, mpaka pa zophulika za scaphoid sizimawoneka pa X-ray atangovulala kumene.

Ngati wovulala sakuwoneka, koma dokotala akukayikirabe kuti muli nawo, dzanja lanu likhala lopunduka ndi chala chakumaso mpaka kubwereza X-ray kudzatengedwa masiku 10 mpaka 14 pambuyo pake. Pakadali pano, wovulala wayamba kuchira ndipo amawonekera kwambiri.

Ngati dokotala akuwona kuti wathyoka koma sangadziwe ngati mafupawo alumikizana bwino kapena akufunikira zambiri, CT scan kapena MRI imatha kuthandiza dokotala kuti adziwe chithandizo choyenera. Kujambula kwa mafupa kungagwiritsidwenso ntchito koma sikupezeka kwambiri ngati mayeso ena.

Kodi chithandizo cha fracture ya scaphoid ndi chiani?

Chithandizo chomwe mumalandira chimadalira:

• mayendedwe amafupa osweka: kaya mafupawo atuluka pamalo pomwepo (osokonekera atasamuka) kapena akadali oyanjanitsidwa (osasunthika osasunthika)
• nthawi pakati pa kuvulala ndi chithandizo: nthawi yochulukirapo, nthawi zambiri mgwirizano ndi
• malo osweka: Mgwirizano umachitika nthawi zambiri ndimafinya am'miyendo

Kutaya

Kuthyoka kopanda malo m'chiuno kapena pole ya scaphoid yanu yomwe imathandizidwa mutangovulala imatha kuchiritsidwa pochepetsa dzanja lanu ndi choponya kwa milungu isanu ndi umodzi kapena khumi ndi iwiri. X-ray ikawonetsa kuti kuphulika kwachiritsidwa, oponya amatha kuchotsedwa.

Opaleshoni

Ziphuphu zomwe zili pamtunda wa scaphoid, kuthawa kwawo, kapena osachiritsidwa pambuyo povulala kumafuna kukonzanso opareshoni. Cholinga ndikubwezeretsa mafupa kuti agwirizane ndikuwakhazikika kuti athe kuchira bwino.

Mukatha kuchitidwa opareshoni, mumakhala mgulu la masabata eyiti mpaka 12. Osewera amachotsedwa X-ray ikangowonetsa kuti wovulala wachira.

Paziphuphu zosagwirizana, kuchitidwa opaleshoni yolumikizidwa ndi mafupa kumafunika pakakhala nthawi yayitali pakati pakuthyoka ndi kusakumana, mafupa osweka samayandikana, kapena magazi sakhala bwino.

Nthawi yocheperako ndi yopanda mgwirizano ikakhala yocheperako, mafupa osweka amathera pafupi, ndipo magazi ndi abwino, othandizira mafupa atha kugwiritsidwa ntchito.

Kukopa kwamfupa

Kukulitsa kwamfupa kumatha kuphatikizira jekeseni wa mankhwala. Zida zovalira zimathandizanso kukula ndi kuchiritsa pogwiritsa ntchito ultrasound kapena mphamvu yamagetsi mufupa lovulala. Pazifukwa zoyenera, njira izi zitha kukhala zothandiza.

Kaya mukufuna kuchitidwa opaleshoni kapena ayi, mufunika chithandizo chakuthupi ndi kwa ntchito kwa miyezi iwiri kapena itatu kuchokera pomwe woponyayo wachotsedwa kuti apezenso nyonga ndi kuyenda m'manja ndi minofu yanu mozungulira.

Kodi malingaliro a anthu omwe ali ndi vuto lophulika ndi otani?

Kuthyoka kwa scaphoid sikuchiritsidwa nthawi yomweyo, sikungachiritse bwino. Mavuto omwe angakhalepo ndi awa:

• mgwirizano wachedwa: kuphulika sikunachiritse patatha miyezi inayi
• mgwirizano: kuphulika sikunapole konse

Izi zitha kubweretsa kusakhazikika kwa cholumikizira dzanja. Zaka zingapo pambuyo pake, olowa nthawi zambiri amakhala ndi nyamakazi.

Mavuto ena omwe angakhalepo ndi awa:

• kutayika kwa dzanja
• kutaya ntchito, monga kuchepa kwa mphamvu yogwira
• avascular necrosis, yomwe imapezeka mpaka 50 peresenti ya zophulika pamtengo woyandikira
• osteoarthritis, makamaka ngati mgwirizano kapena avascular necrosis zidachitika

Zotsatira zake zimakhala zabwino kwambiri mukawona dokotala atangotsala pang'ono kuthyoka, chifukwa chake dzanja lanu limakhala lopanda mphamvu msanga. Pafupifupi aliyense adzawona kuuma kwa dzanja pambuyo povulala kwa scaphoid, koma anthu ambiri adzayambiranso kuyenda komanso kulimba mphamvu zomwe anali nazo m'manja asanagwe.