Metacarpal fracture ye mun ye?

Daminɛ kuma

Metacarpal fracture ye bolo joginni ye min ka teli ka kɛ bolo kolo janw na. Sɛgɛsɛgɛli ni a furakɛli ka ɲɛ, o nafa ka bon walasa ka gɛlɛya kuntaalajanw bali i n’a fɔ taamabaliya walima dimi basigilen. Ni aw ye bolo dimi sɔrɔ joginda kɔfɛ, a nafa ka bon kosɛbɛ ka aw sen don a la waati bɛnnen na.

Biomecanique de la fractures métacarpales (Kɔrɔsili karilenw).

Ni an y’a lajɛ biyomekaniki siratigɛ la, kɔkolo kolotugudaw bɛ doni axial, bending forces ani rotational stress kɛ bolo don o don baara kɛtuma na. Ni kɛnɛma fanga tɛmɛna kolotuguda la, a bɛ kari.

Fɛn damadɔ bɛ nɔ bila kari cogoya la:

• Fanga sira ni a bonya

• Bolo jɔcogo ni a bɛ gosi

• Kolow girinya ni u si hakɛ

• Farikolo samali ka bɔ bolo fasaw kɔnɔna ni kɛnɛma

Misali la, a ka c’a la, kɔkolo duurunan karilenw bɛ volar angulation jira ka da interossei ni lumbrical muscles samali kan min tɛ kɛlɛ.

Fixation systems minnu bɛ tali kɛ o la: Metacarpal plate fixation systems – CZMEDITECH. Bamako, Mali

Rotational Deformity – Ko gɛlɛnba don nka a ka teli ka tɛmɛ a kan

A tɛ i n’a fɔ angulation, rotational deformity bɛ se ka kɛ a tɛ ye X-ray ja la. Dɔgɔtɔrɔso la, a bɛ dɔn ka ɲɛ ni bolokɔniw labɛncogo kɔlɔsili ye ni banabagatɔ bɛ bolokɔni kɛ.

Hali ni jiginni degere damadɔw bɛ se ka kɛ sababu ye ka:

• Fiɲɛw bɛ ɲɔgɔn da ɲɔgɔn kan

• Dɔgɔyara minɛcogo ɲuman na

• Baarakɛbaliya min bɛ mɛn sen na

O de kama, jiginni degun bɛ jate taamasiɲɛ barikama ye opereli latilenni na, hali ni a bɛ i n’a fɔ a karilen ma bɔ a nɔ na dɔɔnin rezow fɛ.

Nin kɛnɛyaso nuance in bɛ danfaraba don dɔnnikɛlaw ka koloci jateminɛ ni kariw furakɛli jɔnjɔn na.

Opereli kɛcogo taamasiɲɛw

Hali ni senkɔniw karilen caman bɛ se ka furakɛ ni u tɛ se ka furakɛ, opereli ka kan ka kɛ nin cogo ninnu na:

• Angulation min tɛ sɔn ka tɛmɛ baarakɛcogo muɲuli kan

• Yɛlɛma-yɛlɛma-dɛsɛ hakɛ o hakɛ

• Metacarpal karilen caman

• Kari dafalenw

• Segin-ka-bɔnye min bɛ kɛ farikolo kɔnɔ

• Dɛsɛ min bɛ kɛ ka dɔgɔya da tugu

Opereli kuntilenna fɔlɔ ye farikolo yɔrɔw labɛnni ye ni fiɲɛbɔ sabatilen ye, o bɛ a to mobilizasiyɔn joona ka sɔrɔ ka gɛlɛyaw dɔgɔya.

Fixation Techniques ani kɛnɛyako jateminɛw

Plaque ni Vis Fixation

A bɛ sabatili gɛlɛn ni ɲɔgɔndan tigitigi di, kɛrɛnkɛrɛnnenya la, nafa bɛ a la:

• Kari minnu bɛ sɔrɔ kari

• Shaft karilenw

• Kari caman bɛ kɛ

Nka, platiw ka kan ka farikolo yɔrɔ nɔgɔlenw minɛ ka ɲɛ walasa u kana sɔgɔsɔgɔninjɛ dimi.

Kirschner Wire (K-Wire) Labɛnni

Sugandili min tɛ fɛn caman kɛ, a bɛ kɛ tuma caman na:

• Kɔkolo karilenw

• Denmisɛnw ka banaw

• Waati dɔɔnin sabatili

Fixation intramedullaire (furakisɛw kɔnɔna na

Fɛɛrɛ min bɛ ka caya ka taa a fɛ, min bɛ sabatili ni farikolo yɔrɔ nɔgɔlenw tiɲɛni dɔgɔyali balansi.

Fixation sugandili bɛ bɔ kari cogoya la, operelikɛla ka fɛɛrɛ ani banabagatɔ ka baara hakɛ la.

Opereli kɔfɛ furakɛli ni bololabaara

Opereli ɲɛtaa bɛ bɔ opereli kɔfɛ kɛnɛyako la kosɛbɛ. Lamaga min bɛ kɔrɔsi joona, o bɛ dɛmɛ ka gɛlɛya ni senkɔniw nɔrɔli bali.

A ka c’a la, kɛnɛya sabatili sariyasun min sigilen don, o bɛ kɛ ni ninnu ye:

• Ɲɛgɛnɛsiraw kunbɛnni

• Degeliw minnu bɛ kɛ dɔɔni dɔɔni ka taa yɔrɔ wɛrɛw la

• Barikadon min bɛ taa ɲɛ

• Baarakɛcogo kura kalanni

Operelikɛla ni bololabaarakɛla cɛ jɛɲɔgɔnya ɲuman nafa ka bon walasa ka kɛnɛya cogo ɲuman na.

Jateminɛ kɛrɛnkɛrɛnnenw banabagatɔ kuluw danfaralenw na

Fɛnɲɛnɛmakɛlaw

Tuma caman na, farikoloɲɛnajɛlamɔgɔw b’a ɲini:

• Segin teliya la tulonkɛ la

• Fixation stable min bɛ sira di lamaga joona ma

• Lakanali sɔgɔsɔgɔninjɛ kɛnɛyali waati

 Bololabaarakɛlaw

Baarakɛlaw minnu bɛ u jigi da minɛ fanga kan, furakɛli bɛ fɔlɔfɔlɔ:

• Masina sabatili

• Muɲuli kuntaalajan

• Dimi basigilen kunbɛnni

Banabagatɔ kɔrɔbaw

Kolow cogoya ni bana wɛrɛw bɛ nɔ bila furakɛli sugandili ni kɛnɛya waati bɛɛ la.

Kuntaalajan kɔlɔlɔw ni a ɲɛfɔli

Ni ɲɛnabɔli bɛnnen don:

• Banabagatɔ fanba bɛ bolo baara kɛ kokura min bɛ se ka kɛ a cogo kɔrɔ la

• A ka ca a la, minɛ fanga bɛ segin ka se >90% ma a daminɛ na

• Nalomaya kuntaalajan tɛ teli ka kɛ

A ka ca a la, a kɔlɔlɔ juguw bɛ tali kɛ bana sɛgɛsɛgɛli latɛmɛni na, fɛn min bɛ wuli ka wuli, o min ma furakɛ, walima ni a ma se ka a yɛrɛ labɛn ka ɲɛ.

Mun na Metacarpal Fracture Management ka kan ka kɛ ni dɔnniya kɛrɛnkɛrɛnnen ye

Hali ni senkɔniw karilen ka teli, u furakɛli bɛ farikolo yɔrɔw faamuyali tigitigi ni baarakɛcogo jateminɛ de wajibiya. Misali misɛnnin minnu bɛ kɛ ɲɔgɔndan na, olu bɛ se ka nɔba bila bolo baara la ka tɛmɛ.

O de y’a to bi joginda ladonni bɛ sinsin nin kan:

• Jateminɛ tigitigi

• Fixation min sinsinnen bɛ daliluw kan

• Mobilizasiyɔn joona

Ɲininkaliw Ɲininkaliw Dakun

Kari cogoya jumɛnw bɛ opereli sirili jira kosɛbɛ?

Opereli fixation bɛ jira fɔlɔ ni jiginni degun ye, ni a kɛli tɛ sabati, ni a bɛ kɛ ni senkɔni caman ye, ni a dabɔra kari, ni a bɛ se ka a janya, walima ni a dɔgɔyali dagalen don. Olu cɛma, ɲɔgɔndanbaliya bɛ jate baarakɛcogo la min nafa ka bon kosɛbɛ.

Angulation hakɛ jumɛn bɛ Sɔn baarakɛcogo la metacarpal fractures (karibolo karilenw) la?

Angulation min bɛ Sɔn, o bɛ Yɛlɛma ka Kɛɲɛ ni jatebla ye. A ka ca a la, angulation (kɛrɛnkɛrɛnnenya la) ka bon, o bɛ muɲu ulnar metacarpals la ka tɛmɛ radial metacarpals kan. Nka, jiginni dɛsɛ hakɛ o hakɛ tɛ Sɔn, k’a sɔrɔ a ma Kɛ ni angulation muɲuni ye.

Mun na jiginni bɛ jate ko a nafa ka bon ka tɛmɛ angulation kan?

Yɛlɛma-yɛlɛma bɛ na ni bolokɔnincininw ka ɲɔgɔn kan kɔrɔta waati, o bɛ minɛcogo ni bolo baara tiɲɛ kosɛbɛ. Hali ni jiginni fitinin bɛ se ka kɛ sababu ye ka baarakɛcogo tiɲɛ cogo la min tɛ bɛn a ma, wa a tɛ musaka kɛ ka ɲɛ ni kolotugudaw ye minnu bɛ a kɛrɛfɛ.

Nafa jɔnjɔn jumɛnw bɛ plati sirili la senkɔniw karilenw na?

Plate fixation bɛ se ka kɛ:

• Stability (Sìgiyɔrɔma) gɛlɛn

• Anatomique alignment tigitigi

• Mobilizasiyɔn joona

• Farati bɛ dɔgɔya ka bɔ yɔrɔ filanan na

Nafa bɛ a la kɛrɛnkɛrɛnnenya la sɔgɔsɔgɔninjɛ karilenw na, a kɛcogo tigɛlenw na, ani senkɔniw joginni caman na, hali ni a ka kan ka farikolo yɔrɔ nɔgɔlenw minɛ ka ɲɛ walasa ka senkɔniw dimi dɔgɔya.

Ko jumɛnw na Kirschner ka filiw de ka fisa?

K-wire fixation bɛ kɛ ka caya:

• Metacarpal kɔkolo karilenw

• Karicogo minnu ka gɛlɛn kosɛbɛ

• Waati dɔɔnin sabatili

• Denmisɛnw ka banaw walima minnu ka ɲinini man ca

Hali ni a tɛ fɛn caman kɛ, a ka c’a la, K-filɛriw bɛ jɔli kuntaalajan de wajibiya ni i y’a suma ni plati sirili ye.

Jɔrɔ jumɛn bɛ senkɔni kɔnɔbara basigilen furakɛli la bi bi in na, senkɔniw karilen furakɛli la?

Intramedullaire fixation bɛ balansi di sabatili ni farikolo yɔrɔ nɔgɔlenw tiɲɛni dɔgɔyali cɛ. A bɛ a to lamaga ka kɔn ka tɛmɛ farikolo pinɛli kan ka sɔrɔ ka gɛlɛya dɔw bali minnu bɛ tali kɛ plati la, o b’a to a bɛnnen don jiribolo ni kɔ karilen sugandilenw ma.

Mobilizasiyɔn joona bɛ nɔ bila cogo di kuntaalajan sɔrɔli la?

Mobilizasiyɔn min bɛ kɔrɔsi joona, o bɛ dɔ bɔ:

• Jogindaw gɛlɛyali

• Tendonw ka nɔrɔli

• Farikoloɲɛnajɛ (atrophie musculaire).

Fixation sabatilen min bɛ sira di lamaga joona ma, o ye baarakɛcogo kɛnɛyali dantigɛlan jɔnjɔn ye, kɛrɛnkɛrɛnnenya la banabagatɔw la minnu ka ɲinini ka ca.

Opereli kɔfɛ gɛlɛya jumɛnw ka kan ka kɔlɔsi kosɛbɛ operelikɛlaw fɛ?

Gɛlɛya minnu ka teli ka sɔrɔ olu ye:

• Malunion walima nonunion

• Hardware irritation (Dɔgɔtɔrɔso min bɛ kɛ ni minɛnw) ye

• Tendonw ka nɔrɔli

• Minɛ fanga dɔgɔyara

• Banakisɛ sɔrɔli kari dafalenw na

Baarakɛbaliya kuntaalajan fanba bɛ tali kɛ ɲɔgɔndɛmɛbaliya la walima labɛnni kɔfɛ.

Furakɛli fɛɛrɛw tɛ kelen ye cogo di farikoloɲɛnajɛla ni bololabaarakɛlaw fɛ?

Fɛnɲɛnɛmakɛlaw ni bololabaarakɛlaw la, fɔlɔ bɛ di ninnu ma:

• Fixation sabatilen (fixation) sabatilen

• Segin baara la joona

• Muɲuli kuntaalajan

Opereli dakunw bɛ se ka dɔgɔya o jamana ninnu na ka a sababu kɛ baarakɛcogo ɲininiw caya ye.

Fɛn jumɛnw bɛ nɔ bila kosɛbɛ baarakɛcogo kuntaalajan na?

Fɛn minnu bɛ se ka kɛ sababu ye ka ko nataw ɲɛfɔ, olu jɔnjɔnw ye:

• Kariw dɔgɔyali tiɲɛni

• Fixation (fixation) sabatili

• Labɛnni joona

• Yɛlɛma-yɛlɛmabaliya tɛ yen

Ni o ko ninnu ɲɛnabɔra ka ɲɛ, banabagatɔ fanba bɛ se ka bolo baara kɛcogo ɲuman sɔrɔ.