Ukwaphuka esandleni: Iimpawu, diagnosis and Treatment

Akakho umntu ugonyiwe ukulimala, kuquka kakhulu. Ngoko ke abemi akasoloko ukumisela ubukhulu bomonakalo isiphumo, nto leyo ibalulekileyo ukuze unyango ngexesha. Ukwaphuka brush ayikho umnyinyiva, kuba maxa wambi ixhoba akayiqondi ukuba ithambo yaphulwe. Ngenxa yesi sizathu, kubalulekile ukuba ukuhlolisisa iimpawu ukuyila iqhosha.

Umongo ngxaki

Ebusika okanye xa yokuphila asebenzayo ngeke ngaphandle wawa nkqi, ugxininise brush. Kwakhona igalelo kakhulu nga tirhisiwaka kule ndawo esandleni, umzekelo, kwi imveliso.

Kule iintlobo yeziphumo ayikwazi lilawulwe ibrashi zaphuka.

Ukwenzakala yale hlobo ukuze abe mathathu:

• kwamathambo amathambo metacarpal;
• phalanges (i ixhaphakileyo);
• amathambo sosana.

Asinako ngoyaba isibakala sokuba ezinjengokwaphuka maxa wambi ikhatshwe shift, nto leyo izaliswe iingxaki ezongezelelweyo, ngoko ukuba naziphi na iziphumo brush, nto leyo ebangela ubuhlungu, kufuneka ubone ugqirha.

nokubekwa kwezifo

Mhlawumbi ayingabo bonke uyayazi loo nto, kodwa endle yamayeza kukho uhlobo ngamazwe izifo. Kule nkqubo, i-data kwezifo nganye kunye neentlobo zayo unikwe ikhowudi ethile, eboniswe nombolo ezininzi kunye nonobumba.

I-ICD sosana eziintsalu zibekwe kwindawo S00-T98 (imixholwana kwi 60 ukuya we-69), nto leyo luzinikele kukwenzakala, ityhefu kunye nezinye iziphumo nempembelelo lwangaphandle. Kule nxalenye yokuhlela ngamazwe kubhalwe zonke ezifanelekileyo iintlobo kwizaphuko, izihlahla zonxinzelelo kwaye isandla (yokuqala, ithambo yesibini metacarpal, nobhontsi, elimele, njalo njalo).

Ngezi data kusenokwenzeka ukufumanisa ngokuchanileyo uhlobo oluthile ngokwaphulwa, wabeka abanobuchule sifo, oluchanekileyo.

iimpawu

Ukwaphuka brush kunzima ukungayi, kodwa esiyibiza iimpawu ezithile abayi kuvunyelwa ukuba ukudida kunye ukwenzakala.

Okokuqala, makhe ukuchaza iimpawu eziphambili:

• xa uzama yokulungisa iminwe kukhona ubuhlungu obukhulu;
• kwicala emva kwasekwa ukufukuka obonakalayo;
• Ukuba trauma kakhulu ukuze mandundu imeko yeli ixhoba sifunyenwe;
• e ibhrashi deformation buqapheleke.

Kulo mzekelo, isikhumba uba oluhlaza, kunye neentlungu obungqingqwa nje kuphela ukwandiswa iminwe, kodwa xa ikhona, nkqu minor, iintshukumo.

Navicular and metacarpals

Emva umonakalo kwezi amacandelo brush emva kwethuba kwabonakala nokudumba wenze nayiphi na intshukumo eziyingxaki. Ukuba intloko baba ithambo eziintsalu metacarpal, kwaye deformation ukudumba iya kuvela ngasemva ngesandla, ngqo nesiza yokwenzakala.

Kodwa iwotshi ezophukileyo scaphoid kungakhokelela kubunzima ezongezelelweyo ukongeza kwiziphumo eziphambili yokwenzakala. Kwiimeko ezininzi, loo umonakalo ngenxa yokuwa, apho wagxininisa isandla owenzakeleyo. Ngenxa yoko, iintlungu kwenzeka kwi kwisiseko brush ukusuka kwicala ubhontsi. Kulo mzekelo, iintlungu ingachazwa ayeqaqanjelwa, rhoqo, umthamo ophantsi. Deformation kwi ukwenzakala loo nto, yaye ukudumba, nangona kukho kodwa incinane. Ilapha koyena le ngxaki.

Xa ixhoba emva kokuwa akuthethi zintlungu kakhulu kwaye akukho zimpawu le deformation ngesandla, xesha kude kwingqiqo ethi ezinjengokwaphuka yenzekile. Ngenxa yoko, yonke into kungancitshiswa lokuzimela baphethwe ngaphandle uncedo lobungcali kumagqirha abafanelekayo. Kwezinye iimeko, ixhoba ugqiba ukutyelela ugqirha emva kweenyanga ezimbalwa ukusuka kwixesha xa iwotshi eyaphukileyo kwafunyanwa. Ukonakala kwezinye amathambo, ukongeza scaphoid kunye metacarpal, ebhalwe kunqabile kakhulu.

Kubalulekile ukwazi ukuba evela kuziphuko zendalo kunye kucel bambalwa a mpawu aqhelekileyo: ukudumba kwaye ezibukhali okanye ezibuhlungu intlungu. Ngoko ke, emva kokuwa okanye enye amandla lwangaphandle kuyimfuneko nayiphi na imeko ukutyelela esibhedlele.

Ukuba ezinjengokwaphuka ndakutywina ibrashi offset, kusenokwenzeka ukuba kufuneka ungenelelo lwentsebenziswano, ezizezi nitrogen kunye nokubeka. Le nyaniso kanye kwakhona ugxininisa imfuneko moshilongo ngexesha.

Amanqaku kwamathambo abantwana

Ekuqaleni, kufuneka sinikele ingqalelo yokuba oganikhi khompawundi emathanjeni sabantwana ngaphezulu kakhulu kunokuba abantu abadala. Ngenxa yoko, iqokobhe ekhusela ithambo (periosteum), naye ibe lukhuni engcono kunye luthambe. Ezi mpawu ukuvumela abantwana ukuba baphathe isandla eyaphukileyo ngendlela eyahlukileyo.

Ezi umahluko zilandelayo ezisuka ukulimala kubantu abadala:

1. Izigulane abaselula iqela ubudala emva ukwenzakala kunokuba icala eyintsalela self-ukulungisa. Oku kuchazwe yi isakhono eminye esebenzayo ezifana izihlunu kunye nokukhula ngokukhawuleza esiqwini ithambo.

2. Fabrics kunye nezakhiwo ezonakeleyo abantwana Nokubuyiselwa kakhulu ngokukhawuleza kwaye kulula kakhulu abantu eliqina ngenxa inkangeleko olukhawulezisiweyo of calluses kunye kwinqanaba eliphezulu ejikeleza periosteal.

Ukophuka 3. Abantwana bakaThixo azakubalulwa into yokuba nenxeba ngakumbi kufana ugoba okanye ukwaphuka ithambo. Ngenxa yesi sizathu, ukuhamba kancinane amaqhekeza ithambo kunye iintsalela.

Xa kuhlukunyezwa onjalo umntwana uya ukulila ahlale yimincili ngokuphawulekayo. Amanye amalungu isandla emva ngokwaphulwa ebantwaneni na utshintsho efanayo abadala (ukudumba, ukungabi ukuhamba, nesilima, iintlungu, ukudumba, njalo njalo).

Kuyabonakala ukuba umzimba lo mntwana bokulungisa kukwenzakala lula ngakumbi, kodwa oku akuthethi ukuba baziphathe olova umbuzo konyango. -Nxaxheba kumagqirha kulo mzekelo, ngokuyimfuneko, kwaye ngokukhawuleza kangangoko kunokwenzeka.

lokuqala zoncedo

Ukuba emva kokuba ukwenzakala wabonisa iimpawu uphawu ezinjengokwaphuka, simele sibe ukulungele enze amanyathelo ezimbalwa ezilula, kodwa kubalulekile.

Okokuqala kubalulekile ukuba ixhoba uthathe ntlungu, emva koko kuya kufuneka ukuba ukulungisa brush. isenzo esinjalo ukukhusela endaweni elimele ukusuka umonakalo ezongezelelweyo ngenxa iintshukumo esicalanye. Xa kufuneka sijongane kunye ukwaphuka evulekileyo zomsebenzi yokuqala ekufuneka wenziwe - kukunqanda ukopha, kwaye ngokukhawuleza.

Enye into ebalulekileyo - ukususwa ibhrashi eyonakeleyo nayiphi na intombi izivatho. amanyathelo zinokwenzeka ngenxa yokuba ukuphazamiseka yokugaya kusasazwe emakhonkcweni okanye nezacholo uxinzelelo. Ukongeza, xa kuya kubakho ukudumba, susa imihombiso kuya kuba nzima kakhulu.

Ukuba kukho ukwaphuka nangomnwe brush, kufuneka isicelo ukuya kwindawo ezonakeleyo kubanda yaye ngaloo ndlela isantya imbonakalo nokudumba. Eli nyathelo liza kunciphisa kuyabuya intlungu.

ekuxilongweni

Ukuze ubone ngeempawu wokwenzakala kufuneka ekuqaleni babuyele kwi ngugqirha umothuko oyaziyo isigulane ngenxa yokwenzakala, kuhlolisisa ngesandla emva Ngokucofa ngqo kwi iimviwo radiographic.

Le ndlela yokugqibela, ngasendleleni, kubaluleke kakhulu, kuba ivumela ukuba ukohlula ukuba dislocation ukwaphuka brush okanye ukwenzakala radius. Eyona nto ibalulekileyo kukuba kumqolo phezulu amathambo carpal edityaniswe kwi joint umqadi, xa kukho umonakalo anganika iintlungu esihlahleni.

Kwimeko enjalo, ukuba qondile kummandla ochaphazelekayo ngaphandle X-ray iya kuba yingxaki kakhulu. ungenza kwisigqibo ecacileyo ngokusekelwe kule nkcazelo: ukuba baphathwe ekhaya emva na ukwenzakala ngesandla kwaye brush ngakumbi - impazamo enkulu.

unyango

Kwiimeko ezininzi, ayifuneki utyando wokwenzakala ngesandla. Kuba ukululama ngempumelelo ngakumbi ngokukhawuleza amaqhekeza ithambo owenzakeleyo ayinakutshintshwa yi the band, nto leyo edla kuza ukusa engqinibeni.

kwiintsuku ezisi-7 emva kokuba nitrogen loo kwenziwa ibrashi ray. Oku kwenza kube lula ukufumanisa indlela ezimashakeleyo indawo uphilisa. Walisusa isusiwe kwiimeko ezininzi kakhulu kwiiveki 4-5.

Ukuba ngomnwe olwaludiliziwe (yokuhlasela enye) ngaphandle kokukhetha, nokubekwa tinsimbi ziya kusetyenziswa amanyathelo okulungisa.

Kwimeko xa usebenza kunye ukwaphuka wethambo yokuqala metacarpal, wenza misa kobutyobo, kwaye iintsuku ezimbini emva kokwenzakala. It ingasetyenziselwa ukulungisa udaka, nezikhonkwane ziinaliti. Ngenxa yokulimala ngaphandle ukubana ezinye ithambo metacarpal emva ukuncitshiswa iya kuba udaka ngokwaneleyo.

Ke ukwaphuka wethambo navicular, unyango yawo yeyona nto inzima. Kwiimeko ezininzi, ukulungisa ngokugqibeleleyo ukutyabeka, kodwa akubi njalo. Kubalulekile ukuphawula ukuba ukunyanga esi ukwenzakala kuba nzima kakhulu ukuba umgca ngokwaphulwa le udlula amathambo umzimba. Kulo mzekelo, ukuchacha kungalindiswa kangangeenyanga.

Ukuba kufuneka uhlonele umnwe wakho, ukuba ulungise kuphela yokuhlasela eyonakeleyo, le nkulumo ubuncinane. Indawo ngomnwe uzimisele.

Ngamanye amaxesha kufuneka uhlonele zaphuka kakhulu ngakumbi. Ilingane ibhrashi, umzekelo, unako kakhulu nzima inkqubo yokubuyisa ixesha ekuphulukenwe nalo. Eyona ndlela isebenzayo yokuba sesichengeni kule meko kwamathambo okanye elivaliweyo. Enye into nzima ukuze ube ukwaphulwa evulekileyo, apho unyango kusetyenziswa ungenelelo utyando, hayi kanye mandithi, isikhumba yokumilisela.

ukululama

izigulane abaninzi bafuna ukwazi ukuba ukugcina ibrashi yayo ukusebenza emva ngokwaphulwa zize ziphinde kamva. Isiphumo ngeendlela ezininzi kuxhomekeke kumanyathelo kumaxhoba ngokwabo. Ukuze idayisi kwakhona babe yi- phambi wokwenzakala, kufuneka baphuhlise rhoqo. Kodwa ukuqala umsebenzi enjalo ingqiqo kuphela emva kokuba ugqirha yaqinisekisa ukuba ithambo waphilisa.

Ukuqalisa inkqubo nokuvuselela umthambo ukukhanya kangcono (flexion-extension, ujikelezo Palm et al.). intshukumo ngesiquphe kanti contraindicated. Kufuneka inxaxheba kwiiveki ezimbalwa. Kwezinye iimeko, bachache ngokupheleleyo kuya kufuneka asebenze nzima phezu ubume brush kwisithuba seenyanga ezintandathu.

Oku kufuneka angaphindi phulo - yonke imisebenzi kunye namandla kunye nexesha ekufuneka livumile kunye nogqirha khona.

iziphumo

Ukwa iwotshi - oku umonakalo nokwenzakala ezimbi kakhulu, nto leyo ebangela kubenzima kakhulu imisebenzi ebalulekileyo yexhoba. Kodwa le ngxaki inokoyiswa ukuba unelungelo lokubhena amagqirha wakufanelekela ukuba ukuqala unyango.