Dɛn ne metacarpal fracture?

Nnianimu

Metacarpal fracture yɛ nsa a ɛtaa pira a ɛka nsa no nnompe atenten no. Ɛho hia sɛ wohu yare no yiye na wɔsa no yare na wɔasiw nsɛnnennen a ɛtra hɔ kyɛ te sɛ sɛnea obi ntumi nkɔ baabiara a ɛso tew anaasɛ ɛyaw a enni sabea ano. Sɛ wo nsa mu yaw wɔ ahodwiriw akyi a, ɛho hia sɛ wode wo ho bɛhyɛ mu wɔ bere ano.

Biomechanics a ɛfa Metacarpal Fractures ho

Sɛ yɛhwɛ biomechanical a, wɔde metacarpal nnompe hyɛ axial loading, bending forces, ne rotational stress ase bere a wɔde nsa di dwuma da biara da no. Sɛ ahoɔden a efi dompe no mu boro dompe no a ɛyɛ den no so a, ɛpaapae.

Nneɛma pii nya sɛnea abubu no so nkɛntɛnso:

• Ahoɔden no kwankyerɛ ne ne kɛse

• Nsa gyinabea bere a ɛrebɔ no

• Nnompe a ɛyɛ den ne mfe a obi adi

• Ntini a ɛtwetwe fi nsa ntini a ɛwɔ nipadua no mu ne nea ɛwɔ akyi no mu

Sɛ nhwɛso no, metacarpal kɔn a ɛto so anum no a ɛpaapae no taa da volar angulation adi esiane interossei ne lumbrical ntini no twetwe a ɛnsɔre ntia nti.

Fixation nhyehyɛe ahorow a ɛfa ho: Metacarpal Mprɛte a Wɔde Siesie Nneɛma – CZMEDITECH

Rotational Deformity – Ɔsɛmpɔw a Ɛho Hia nanso Ɛtaa Pam

Nea ɛnte sɛ angulation no, ebia rotational deformity renda adi wɔ X-ray mfoninitwa mu. Wɔ ayaresabea no, wotumi hu no yiye denam nsateaa a ɛne ne ho hyia a wobɛhwɛ bere a ɔyarefo no reyɛ akuturuku no so.

Sɛ wɔkyinkyin digrii kakraa bi mpo a, ebetumi ama:

• Nsateaa a ɛka bom

• Grip a wɔde di dwuma yiye no so tew

• Dwumadi mu ɔhaw a ɛtra hɔ kyɛ

Esiane eyi nti, wobu dɛmdi a ɛkyinkyini sɛ ɛyɛ sɛnkyerɛnne a emu yɛ den a ɛkyerɛ sɛ oprehyɛn siesie, sɛ ɛte sɛ nea akisikuru no ntumi nkɔ baabiara kɛse mpo wɔ radiographic mu a.

Saa ayaresabea mu nsɛm nketenkete yi ma nsonsonoe kɛse wɔ animdefo nnompe mu nhwehwɛmu ne mfitiase akisikuru ho dwumadie ho.

Nsɛnkyerɛnne a Ɛfa Oprehyɛn Ho

Bere a wobetumi asa atiridiinini pii a abubu no wɔ ɔkwan a ɛnyɛ den so no, wɔkamfo kyerɛ sɛ wɔnyɛ oprehyɛn wɔ tebea horow a edidi so yi mu:

• Angulation a wonnye ntom a ɛboro dwumadi mu abodwokyɛre so

• Deformity biara a ɛwɔ rotational deformity mu

• Metacarpal a ɛpaapae pii

• Nneɛma a abubu a wɔabue

• Intra-articular a wɔde wɔn ho hyɛ mu

• Di nkogu a ɛbae wɔ closed reduction

Oprehyɛn botae titiriw ne sɛ wɔbɛma nipadua no ahyia ne nea wɔde si hɔ pintinn, na ama wɔatumi akanyan wɔn ho ntɛm bere a ɛtew nsɛnnennen so no.

Fixation Techniques ne Ayaresa mu Nsusuwii

Plate ne Screw a Wɔde Siesie Nneɛma

Ɛma ahoɔden a ɛyɛ den a ɛyɛ den na ɛma ɛne ne ho hyia pɛpɛɛpɛ, a mfaso wɔ so titiriw ma:

• Akisikuru a ɛyɛ mmerɛw

• Shaft a ɛpaapae

• Abubuw ahorow pii

Nanso, ɛsɛ sɛ wɔde ahwɛyiye di mprɛte ho dwuma wɔ ntini a ɛyɛ mmerɛw ho na amma ntini no anhaw.

Kirschner Nhama (K-Wire) a Wɔde Siesie Nneɛma

Ɔkwan a ɛnyɛ den pii a wɔtaa de di dwuma ma:

• Kɔn mu a ɛpaapae

• Mmofra ho nsɛm

• Bere tiaa mu a wɔde gyina pintinn

Intramedullary a Wɔde Siesie Nneɛma a Wɔde Si Hɔ

Ɔkwan a agye din kɛse a ɛkari pɛ wɔ sɛnea nneɛma gyina pintinn ne ntini a ɛyɛ mmerɛw a wɔsɛe no kakraa bi.

Fixation a wɔpaw no gyina sɛnea abubu no, oduruyɛfo a ɔyɛ oprehyɛn no pɛ, ne ɔyarefo no dwumadi dodow so.

Oprehyɛn Akyi Nneɛma a Wɔde Di Dwuma ne Nsa Ho Ayaresa

Oprehyɛn a edi mu no gyina oprehyɛn akyi ahosiesie so kɛse. Kankyee a wɔhwɛ so ntɛm boa ma wɔasiw ntini a ɛyɛ den ne ntini a ɛbata ho no ano.

Mpɛn pii no, nhyehyɛe a wɔahyehyɛ a wɔde bɛsan asiesie wɔn ho ne:

• Edema a wɔde siw ano

• Apɔw-mu-teɛteɛ a wɔde nkakrankakra yɛ a ɛma obi tumi keka ne ho

• Ahoɔden a wɔde ma nkakrankakra

• Dwumadi mu ntetee a wɔsan de ma

Oduruyɛfo a ɔyɛ oprehyɛn ne nsa ho ɔyaresafo ntam nkitahodi a emu yɛ den ho hia na ama obi ho atɔ no yiye.

Nneɛma Titiriw a Ɛsɛ sɛ Wosusuw Ho Wɔ Ayarefo Akuw Ahorow Mu

Agumadifo

Mpɛn pii no agumadifo hwehwɛ sɛ:

• Faster san kɔ agodie mu

• Stable fixation a ɛma kwan ma wɔde kankyee ntɛm

• Nhama a ɛbɔ obi ho ban bere a obi ho retɔ no

 Nsaano Adwumayɛfo

Wɔ adwumayɛfo a wɔde wɔn ho to ahoɔden a wɔde kura mu so fam no, ayaresa de di kan:

• Mfiri a wɔde gyina pintinn

• Bere tenten a ɛtra hɔ kyɛ

• Ɛyaw a enni sabea a wosiw ano

Ayarefo a Wɔanyinyin

Nnompe su ne nyarewa a ɛka ho no nya ayaresa a wɔpaw ne bere nhyehyɛe a wɔde sa yare nyinaa so nkɛntɛnso.

Nea Efi Mu Ba Bere Tenten ne Nkɔmhyɛ

Sɛ wɔde nhyehyɛe a ɛfata di dwuma a:

• Ayarefo dodow no ara san nya nsa dwumadi a ɛkame ayɛ sɛ ɛyɛ nea ɛfata

• Ahoɔden a wɔde kura mu no taa san kɔ >90% wɔ mfitiaseɛ no mu

• Mmofra a wɔadi dɛm bere tenten nyɛ nea ɛtaa ba

Mpɛn pii no, nea efi mu ba a enye no ne sɛ wɔkyɛ sɛ wobehu yare no, akisikuru a ɛkyinkyini a wɔansa, anaasɛ wontumi nsiesie no yiye.

Nea Enti a Metacarpal Fracture Ho Dwumadi Hyɛ Ahokokwaw Titiriw

Ɛwom sɛ metacarpal a ɛpaapae abu so de, nanso sɛnea wɔhwɛ so no hwehwɛ sɛ wɔte nipadua no mu nneɛma ase pɛpɛɛpɛ na wobu dwumadi ho atɛn. Mfomso nketenkete a ɛba wɔ sɛnea wɔde nneɛma hyia mu no betumi anya nkɛntɛnso kɛse wɔ nsa adwumayɛ so.

Eyi nti na nnɛyi adwenemhaw ho hwɛ si so dua sɛ:

• Nhwehwɛmu a edi mu

• Adanse a egyina fixation so

• Nnipa a wɔboaboa wɔn ano ntɛm

FAQ Ɔfã

Abubu su bɛn na ɛkyerɛ denneennen sɛ wɔde oprehyɛn si hɔ?

Oprehyɛn a wɔde si hɔ no yɛ nea wɔkyerɛ titiriw denam ɛkyinkyini a ɛyɛ mmerɛw, anim a entumi nnyina, metacarpal pii a ɛde ne ho hyɛ mu, abubu a ɛbue, intra-articular extension, anaasɛ closed reduction a entumi nyɛ yiye. Wɔ eyinom mu no, wobu rotational malalignment sɛ nea ɛho hia sen biara wɔ dwumadi mu.

Angulation dodow ahe na wogye tom wɔ dwumadi mu wɔ metacarpal fractures mu?

Angulation a wogye tom no gu ahorow wɔ digit biara mu. Mpɛn pii no, wotumi gyina anim a ɛkɔ soro kɛse ano wɔ ulnar metacarpals no mu sen radial metacarpals no. Nanso, wontumi nnye ntom sɛnea ɛkyinkyini no yɛ nea wontumi nnye ntom, ɛmfa ho sɛnea angulation tolerance te.

Dɛn nti na wobu rotational deformity sɛ ɛho hia kɛse sen angulation?

Rotational deformity ma nsateaa no kata so bere a wɔrebɔ no, na ɛma grip mechanics ne nsa dwumadi yɛ basaa kɛse. Sɛ wɔkyinkyin kakraa bi mpo a, ebetumi ama adwumayɛ asɛe wɔ ɔkwan a ɛnsɛ so na nkwaa a ɛbɛn ho no ntumi ntua ho ka yiye.

Mfaso atitiriw bɛn na ɛwɔ mprɛte a wɔde si hɔ wɔ metacarpal a abubu mu?

Mprɛte a wɔde si hɔ no ma:

• Rigid stability a ɛyɛ den

• Anatomical a ɛne ne ho hyia pɛpɛɛpɛ

• Nnipa a wɔboaboa wɔn ano ntɛm

• Asiane a ɛwɔ hɔ sɛ obi betu afi baabi a ɛto so abien no so atew

Mfaso wɔ so titiriw wɔ ntini a abubu, nsusuwso a abubu, ne atiridiinini pii a opira mu, ɛwom sɛ ɛho hia sɛ wɔde ahwɛyiye di ntini a ɛyɛ mmerɛw ho dwuma na ama ntini a ɛyɛ mmerɛw no ayɛ ketewaa bi de.

Wɔ tebea horow bɛn mu na wɔpɛ Kirschner nhama?

Wɔtaa de K-wire fixation di dwuma ma:

• Metacarpal kɔn a ɛpaapae

• Nneɛma a ɛma nipadua no mu paapae a ɛnyɛ den pii

• Bere tiaa mu a wɔde gyina pintinn

• Mmofra anaa nsɛm a wɔhwehwɛ pii

Bere a K-nhama no ntumi nkɔ nipadua no mu kɛse no, mpɛn pii no ɛhwehwɛ sɛ wɔde bere tenten si hɔ a entumi nkɔ baabiara bere a wɔde toto mprɛte a wɔde si hɔ ho no.

Dwuma bɛn na intramedullary fixation di wɔ nnɛyi metacarpal fracture ayaresa mu?

Intramedullary fixation ma ɛkari pɛ wɔ sɛnea ɛgyina pintinn ne ntini a ɛyɛ mmerɛw a ɛnyɛ den koraa no ntam. Ɛma wotumi kankyee ntɛm sen sɛ wɔde pinning fa honam ani bere a ɛkwati nsɛnnennen bi a ɛfa mprɛte ho no, na ɛma ɛfata ma shaft ne kɔn mu akisikuru a wɔapaw.

Ɔkwan bɛn so na nnipa a wɔboaboa wɔn ano ntɛm no nya nea efi mu ba bere tenten so nkɛntɛnso?

Nnipa a wɔboaboa wɔn ano a wɔhwɛ so ntɛm no brɛ:

• Nkwaa a ɛyɛ den

• Ntini a ɛbata ho

• Ntini a ɛyɛ mmerɛw

Fixation a ɛyɛ pintinn a ɛma kwan ma wotumi keka ne ho ntɛm no yɛ ade titiriw a ɛkyerɛ sɛnea obi ho tɔ no wɔ dwumadi mu, titiriw wɔ ayarefo a wɔhwehwɛ wɔn kɛse no mu.

Oprehyɛn akyi nsɛnnennen bɛn na ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn hwɛ so yiye?

Nsɛnnennen a ɛtaa ba no bi ne:

• Malunion anaasɛ nonunion

• Hardware a ɛyɛ abufuw

• Tendon a ɛbata ho

• Ahoɔden a wɔde kura mu a ɛso tew

• Nyarewa a ɛba wɔ akisikuru a ɛda hɔ mu

Dwumadi mu sintɔ dodow no ara a ɛtra hɔ kyɛ no ne nhyiam a ɛnsɛ anaasɛ ɛkyɛ a wɔsan siesie no wɔ abusuabɔ.

Ɔkwan bɛn so na ɛsono ayaresa akwan horow ma agumadifo ne nsaanodwumayɛfo?

Wɔ agumadifo ne nsaanodwumayɛfo mu no, wɔde:

• Fixation a ɛyɛ pintinn

• San kɔ dwumadi mu ntɛm

• Bere tenten a ɛtra hɔ kyɛ

Ebia oprehyɛn a wɔde yɛ no bɛba fam wɔ nnipa dodow yi mu esiane dwumadi a wɔhwehwɛ kɛse nti.

Nneɛma bɛn na ɛwɔ bere tenten dwumadi ho nkɔmhyɛ so nkɛntɛnso kɛse?

Nneɛma atitiriw a ɛkyerɛ sɛnea ɛbɛba daakye no bi ne:

• Pɛpɛɛpɛ a wɔde tew akisikuru so

• Nneɛma a wɔde si hɔ a ɛyɛ den

• Nsiesiei a wɔyɛ no ntɛm

• Nneɛma a ɛkyinkyini a enni hɔ

Sɛ wɔyɛ saa nneɛma yi yiye a, ayarefo dodow no ara tumi yɛ nsa dwumadi a ɛkame ayɛ sɛ ɛyɛ nea ɛfata.