Dɛn ne metacarpal akisikuru?

Nnianimu

Metacarpal fracture yɛ nsa a wɔtaa pira a ɛka nnompe atenten a ɛwɔ nsa mu no. Nhwehwɛmu ne ayaresa a ɛfata ho hia na ama wɔasiw ɔhaw ahorow a ɛtra hɔ kyɛ te sɛ nea ɛma obi tumi nantew anaa ɛyaw a enni sabea no ano. Sɛ wo nsa yɛ wo yaw wɔ adwenemhaw akyi a, adeyɛ a ɛyɛ ne bere mu de ho hia kɛse.

Biomechanics a ɛfa metacarpal a ɛpaapae ho .

Sɛ yɛhwɛ biomechanical a, wɔde metacarpal nnompe no hyɛ axial loading, bending forces, ne rotational stress ase bere a wɔde di dwuma da biara da no. Sɛ abɔnten so tumi boro dompe no anohyeto a ɛyɛ den no so a, mpaapaemu bi ba.

Nneɛma pii nya mpaapaemu nhyehyɛe so nkɛntɛnso:

• Tumi kwan ne ne kɛseyɛ .

• Nsa gyinabea wɔ nkɛntɛnso mu .

• Nnompe a ɛyɛ den ne mfe a obi adi .

• Ntini twetwe fi nsa ntini a ɛwɔ mu ne nea ɛwɔ akyi mu .

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

Nneɛma a ɛfa fixation nhyehyɛe ho: Metacarpal mprɛte a wɔde si hɔ ho nhyehyɛe ahorow – Czmeditech .

rotational deformity – asɛm a ɛho hia nanso ɛtaa pae .

Nea ɛnte sɛ angulation no, ebia rotational deformity renna adi wɔ x-ray imaging so. Wɔ ayaresabea mu no, eye sɛ wobehu no denam nsateaa a wɔde hwɛ sɛnea ɔyarefo no de ne nsa bɔ so no so.

Sɛ wɔdannan wɔn ho kakraa bi mpo a, ebetumi ama:

• Nsateaa a ɛka bom .

• Grip a ɛyɛ adwuma yiye no so atew .

• Dwumadi mu ɔhaw bere tenten .

Esiane eyi nti, wobu no sɛ ɛyɛ ɔkwan a wɔfa so di akɔneaba no sɛ ɛyɛ sɛnkyerɛnne a emu yɛ den ma oprehyɛn mu nteɛso, sɛ ɛda adi sɛ akisikuru no atumi atutu kakraa bi wɔ radiography mu mpo a.

Saa ayaresabea mu nsɛm nketenkete yi ma nsonsonoe kɛse da animdefo nnompe mu nhwehwɛmu ne mfitiase fracture management ntam.

Nneɛma a ɛkyerɛ sɛ obi bɛyɛ oprehyɛn de ne ho ahyɛ mu .

Bere a wobetumi asa metacarpal mu akisikuru pii wɔ ɔkwan a ɛyɛ katee so no, wɔkamfo kyerɛ sɛ wɔnyɛ no oprehyɛn wɔ tebea horow a edidi so yi mu:

• Angulation a wontumi nnye ntom a ɛboro dwumadi mu abodwokyɛre so .

• Degree biara a ɛkɔ so wɔ rotational mu .

• Metacarpal a ɛpaapae pii .

• Open fractures .

• Ntini a ɛwɔ nipadua no mu no ho a ɛde ne ho hyɛ mu .

• Sɛ wɔtew so a, ɛyɛ huammɔ .

Oprehyɛn botae titiriw ne nipadua mu a ɛne ne ho hyia a ɛwɔ fixation a ɛyɛ den, na ɛma wotumi kanyan no ntɛm bere a ɛtew nsɛnnennen so.

Fixation akwan ne ayaresabea ho nsusuwii .

Mprɛte ne skru a wɔde hyɛ mu .

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

• Ntini a ɛyɛ comminit a ɛyɛ mmerɛw .

• Shaft a ɛpaapae .

• Mmubui ahorow pii .

Nanso, mprɛte no hia sɛ wɔde ahwɛyiye di ntini a ɛyɛ mmerɛw ho dwuma na amma ntini no ayɛ hyew.

Kirschner waya (K-wire) a wɔde hyɛ mu .

Ɔkwan a wɔfa so yɛ ade a ɛnyɛ den pii a wɔtaa de di dwuma:

• kɔn mu akisikuru .

• Mmofra ho nsɛm .

• Bere tiaa mu a wɔbɛma agyina hɔ bere tiaa bi .

Intramedullary fixation .

Ɔkwan a ɛrenya nkɔanim a ɛma nneɛma gyina pintinn a ɛma ntini a ɛyɛ mmerɛw no nsɛe kakraa bi.

Fixation a wɔpaw no gyina fracture pattern, surgeon preference, ne patient activity level so.

Oprehyɛn akyi dwumadie ne nsa a wɔde sa yareɛ .

Oprehyɛn a edi mu a efi mu ba no gyina oprehyɛn akyi a wɔbɛsan asiesie so kɛse. Nneɛma a wɔde di dwuma ntɛm no boa ma wosiw stiffness ne tendon a ɛbata ho no ano.

Mpɛn pii no, nea ɛka ho ne:

• Edema sohwɛ .

• Apɔw-mu-teɛteɛ a ɛkɔ so nkakrankakra .

• Nkɔso a ɛkɔ so nkakrankakra .

• Dwumadi mu retraining .

Nkitahodi a emu yɛ den a ɛda oduruyɛfo a ɔyɛ oprehyɛn ne nsa ho ɔyaresafo ntam no ho hia na ama ne ho atɔ no yiye.

Nneɛma titiriw a ɛsɛ sɛ wosusuw ho wɔ ayarefo akuw ahorow mu .

Agumadifo .

Agumadifo taa hwehwɛ sɛ:

• Faster san kɔ play so .

• Stable fixation a ɛma kwan ma ɛkɔ so ntɛm .

• Ahobanbɔ a ɛbɔ ho ban bere a ne ho retɔ no .

 Nsaano adwumayɛfo a wɔyɛ adwuma wɔ hɔ .

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

• Mfiridwuma mu pintinnyɛ .

• Bere tenten a ɛtra hɔ kyɛ .

• Ɛyaw a enni sabea a wosiw ano .

Ayarefo a wɔn mfe akɔ anim .

Nnompe pa ne comorbidities nya ayaresa a wɔpaw ne ayaresa bere nhyehyɛe nyinaa so nkɛntɛnso.

Nea ebefi mu aba bere tenten ne nea ɛbɛba daakye .

ne dwumadie a ɛfata:

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

• Grip ahoɔden taa nya ahoɔden kɔ >90% wɔ mfiase .

• Mmofra a wɔadi dɛm bere tenten nyɛ nea ɛtaa ba .

Mpɛn pii no, nea efi mu ba a enye no ne yare a ɛma obi tumi hu ade a ɛkyɛ, ɔkyinkyini a ɛkyinkyini a wɔansa no yare, anaasɛ nea ontumi nsiesie no yiye no wɔ abusuabɔ.

Nea enti a metacarpal fracture management hwehwɛ sɛ wonya nimdeɛ soronko .

Ɛwom sɛ metacarpal fractures abu so de, nanso wɔn sohwɛ hwehwɛ sɛ wonya nipadua no mu ntease a ɛyɛ pɛpɛɛpɛ ne dwumadi mu atemmu. Mfomso nketenkete a ɛwɔ alignment mu no betumi anya nkɛntɛnso a ɛboro so wɔ nsa adwumayɛ so.

Eyi nti na nnɛyi apirakuru ho ɔhwɛ si so dua sɛ:

• Nhwehwɛmu a ɛyɛ pɛpɛɛpɛ .

• Adanse a egyina so fixation .

• Nnipa a wɔboaboa wɔn ano ntɛm .

FAQ Ɔfa .

Mmubui su bɛn na ɛkyerɛ sɛ oprehyɛn no mu yɛ den sen biara?

Oprehyɛn a wɔde si hɔ no yɛ nea ɛkyerɛ titiriw ne sɛnea ɛkyinkyini, angulation a entumi nnyina, metacarpal a ɛde ne ho hyɛ mu mpɛn pii, mpaapaemu a ɛbue, ntini no mu ntrɛwmu a ɛkɔ so wɔ ntini no mu, anaasɛ nea ɛma ɛyɛ mmerɛw sɛ ɛbɛtew so. Wɔ eyinom mu no, wobu rotational malalignment sɛ ɛyɛ nea ɛho hia sen biara wɔ dwumadi mu.

Angulation dodow ahe na ɛyɛ adwuma wɔ dwumadi mu wɔ metacarpal fractures mu?

Angulation a wogye tom no gu ahorow wɔ digit so. Mpɛn pii no, wɔma angulation kɛse wɔ ulnar metacarpals no mu sen radial metacarpals no. Nanso, sɛnea ɛkyinkyini no mu dɛmdi biara nyɛ nea wogye tom, a angulation tolerance mfa ho.

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

Rotational deformity ma nsateaa bom bere a flexion, a ɛma grip mechanics ne nsa dwumadi sɛe kɛse. Sɛ wɔdannan no kakraa bi mpo a, ebetumi ama dwumadi no asɛe a ɛnsɛ na nkwaa a ɛbɛn no tua ho ka yiye.

Mfaso titiriw bɛn na ɛwɔ mprɛte a wɔde si hɔ so wɔ metacarpal abubuw mu?

Mprɛte a wɔde hyɛ mu no de ma:

• Rigid a ɛyɛ den .

• Anatomical a ɛne ne ho hyia pɛpɛɛpɛ .

• Nnipa a wɔboaboa wɔn ano ntɛm .

• Asiane a ɛwɔ hɔ sɛ wobetu afi baabi a ɛto so abien no so atew .

Ɛyɛ nea mfaso wɔ so titiriw wɔ shaft a ɛpaapae, nsusuwso a wɔayɛ no comminet, ne metacarpal apirakuru pii mu, ɛwom sɛ ɛho hia sɛ wɔde ahwɛyiye di dwuma wɔ ntini a ɛyɛ mmerɛw ho na ama ntini no mu ayɛ hyew kɛse de.

Wɔ nsɛm bɛn mu na wɔpɛ Kirschner nhama?

K-wire fixation na wɔtaa de di dwuma ma:

• Metacarpal kɔn mu akisikuru .

• Nneɛma a ɛnyɛ den pii .

• Bere tiaa mu a wɔbɛma agyina hɔ bere tiaa bi .

• Mmofra anaasɛ wɔn a wɔhwehwɛ wɔn pii .

Bere a ɛnyɛ den pii no, mpɛn pii no, K-wires hwehwɛ sɛ wɔde bere tenten immobilization 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 pintinnyɛ ne soft-tissue a ɛyɛ mmerɛw sɛ ɛbɛhaw kɛse no ntam. Ɛma kwan ma wotumi keka wɔn ho ntɛm sen sɛ wɔde pinning a ɛwɔ nipadua no mu no bɛhyɛ mu bere a ɛkwati ɔhaw ahorow bi a ɛfa mprɛte ho no, na ɛma ɛfata ma shaft ne kɔn mu a ɛpaapae a wɔapaw no.

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

Nneɛma a wɔde boaboa nnipa ano ntɛm no so tew:

• Nkwaa a ɛyɛ den .

• Ntini a ɛbata ho .

• Ntini a ɛyɛ mmerɛw .

Fixation a ɛyɛ den a ɛma kwan ma ɛkɔ so ntɛm no yɛ ade titiriw a ɛkyerɛ sɛnea obi ho tɔ no, titiriw wɔ ayarefo a wɔhwehwɛ wɔn kɛse no mu.

Oprehyɛn akyi haw ahorow bɛn na ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn no hwɛ so yiye?

Nsɛnnennen a ɛtaa ba no bi ne:

• Malunion anaa nea ɛnyɛ nkabom .

• Hardware a ɛyɛ hyew .

• ntini a ɛbata ho .

• Ahoɔden a ɛwɔ grip mu a ɛso atew .

• Ɔyare mmoawa a ɛwɔ akisikuru a ɛbue mu .

Dwumadi mu sintɔ dodow no ara a ɛkɔ so bere tenten no ne sɛnea ɛne ne ho nhyia yiye anaasɛ wɔtwentwɛn so sɛ wɔbɛsan asiesie wɔn ho no wɔ abusuabɔ.

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

Wɔ agumadifo ne nsaanodwumayɛfo mu no, wɔde di kan sɛ:

• Fixation a ɛyɛ den .

• San a wɔsan kɔ dwumadi mu ntɛm .

• Bere tenten a ɛtra hɔ kyɛ .

Oprehyɛn a ɛwɔ hɔ no betumi ayɛ nea ɛba fam wɔ saa nnipa dodow yi mu esiane dwumadi mu ahwehwɛde ahorow a ɛkorɔn nti.

Nneɛma bɛn na enya dwumadi ho nkɔmhyɛ a ɛbɛtra hɔ akyɛ no so nkɛntɛnso kɛse?

Nneɛma atitiriw a ɛkyerɛ nea ɛbɛba daakye no bi ne:

• Ntease a ɛyɛ pɛpɛɛpɛ a ɛma ɛso tew .

• Fixation a ɛyɛ den .

• Nsiesiei a ɛba ntɛm .

• Nneɛma a ɛkyinkyini a enni hɔ .

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