Nukae nye metacarpal ƒe gbagbã?

Kpɔkplɔyiɖeme

Metacarpal ƒe gbagbã nye asi ƒe abi si bɔ si gblẽa nu le ƒu didi siwo le asi me ŋu. Dɔlélewo didi nyuie kple wo dada le vevie be woatsɔ axe mɔ ɖe kuxi siwo anɔ anyi ɣeyiɣi didi abe ʋuʋu si dzi ɖe kpɔtɔ alo vevesese atraɖii ene nu. Ne èse asi me vevesese le nuveviwɔame megbe la, nudede eme le ɣeyiɣi nyuitɔ dzi le vevie ŋutɔ.

Metacarpal ƒe gbagbãƒewo ƒe biomechanics .

Le biomechanical nukpɔsusu nu la, wotsɔa metacarpal bones dea axial loading, bending forces, kple rotational stress me le gbesiagbe asi zazã me. Ne gotagomeŋusẽ wu ƒu ƒe seɖoƒe si te ŋu trɔna la, ƒu ƒe gbagbã dzɔna.

Nu geɖe kpɔa ŋusẽ ɖe gbagbã ƒe nɔnɔme dzi:

• Mɔfiame kple ŋusẽ ƒe lolome .

• Asi ƒe nɔnɔme le ŋusẽkpɔɖeamedzi .

• Ƒu ƒe kpekpeme kple ƒexɔxɔ .

• Lãmetsiwo ƒe hehe tso asi ƒe lãmeka siwo le wo ɖokui si kple esiwo le gota gome gbɔ .

Le kpɔɖeŋu me, zi geɖe la, metacarpal kɔ atɔ̃lia ƒe gbagbã ɖea volar angulation fiana le interossei kple lumbrik lãmekawo ƒe hehe si wometsi tre ɖe wo ŋu o ta.

Fixation Systems siwo do ƒome kplii: Metacarpal Plate Fixation Systems – CZMEDITECH .

Rotational Deformity – nya vevi aɖe gake wòtoa eme zi geɖe .

To vovo na angulation la, rotational deformity ate ŋu madze ƒã le X-ray imaging dzi o. Le atikewɔnyawo gome la, anyo wu be woakpɔe to asibidɛwo ƒe sɔsɔ ɖe wo nɔewo ŋu me ne dɔnɔa le asi ƒom.

Trɔtrɔ le dzidzenu ʋɛ aɖewo gɔ̃ hã ate ŋu ana:

• Asibidɛwo ƒe ƒoƒo ɖe wo nɔewo ŋu .

• Ðe asiléle nyuie dzi ɖe kpɔtɔ .

• Dɔwɔwɔ ƒe gbɔdzɔgbɔdzɔ si nɔa anyi didi .

Le susu sia ta la, wobua tɔtrɔ ƒe nɔnɔme madeamedzi be enye dzesi sesẽ aɖe na amekoko ƒe ɖɔɖɔɖo, ne edze abe ƒumegbãƒea dze abe ɖe woɖe eɖokui ɖa vie le fotoɖeɖe me ene gɔ̃ hã.

Dɔdaƒe ƒe nu vovovo sia dea vovototo ƒu ƒe ƒumeŋutinunya me numekuku nyuie kple gɔmedzenuwo dzi kpɔkpɔ me ŋutɔ.

Nusiwo woatsɔ awɔ amekoko ƒe nudede nyawo me .

Togbɔ be woate ŋu ada metacarpal fractures geɖe le mɔ si me woɖea mɔ ɖe nu ŋu le hã la, wokafui be woawɔ dɔ na ame le nɔnɔme siwo gbɔna me:

• Angulation si dzi womate ŋu alɔ̃ ɖo o si gbɔ dɔwɔwɔ ƒe mɔɖeɖe ŋu .

• Trɔtrɔ ƒe nɔnɔme ɖesiaɖe ƒe agbɔsɔsɔme .

• Metacarpal ƒe gbagbã geɖe .

• Gɔmeɖoanyi siwo le ʋuʋu ɖi .

• Nuwɔwɔ ɖe ƒunukpeƒewo ŋu le ƒunukpeƒewo .

• Dodokpɔ si wotu ɖe edzi ƒe kpododonu .

Amekoko ƒe taɖodzinu vevitɔe nye ŋutilã ƒe wɔwɔme ƒe sɔsɔ kple fixation si li ke, si wɔnɛ be woate ŋu aƒo wo nu ƒu kaba esime woɖea kuxiwo dzi kpɔtɔna.

Mɔnu siwo wozãna tsɔ léa ŋku ɖe nu ŋu kple atikewɔnyawo ŋu bubu .

Plɛti kple Screw ƒe Ðoɖowɔwɔ .

Enaa liƒo sesẽ kple ɖoɖowɔwɔ pɛpɛpɛ, si ɖea vi ŋutɔ na:

• gbagbã siwo wowɔ ɖekae .

• Shaft ƒe gbagbãƒewo .

• Fractures geɖe .

Gake agbawo hiã na lãkusi falɛfalɛwo ŋu nyuie be woaƒo asa na lãkusi ƒe dzikudodo.

Kirschner ka (K-ka) ƒe nuléle .

Tiatia si me wowɔa nu boo aɖeke le o si wozãna zi geɖe na:

• Kɔ ƒe gbagbãƒewo .

• Ðeviwo ƒe dɔlélewo .

• Ɣeyiɣi kpui aɖe ƒe liƒolili .

Intramedullary fixation .

Mɔnu si va le bɔbɔm ɖe edzi si da sɔ le liƒo me kple lãkusi falɛfalɛwo ƒe tɔtɔ sue aɖe ko.

Tiatia si woawɔ be woatsɔ aɖo wo ɖokui me la nɔ te ɖe eƒe gbagbã ƒe nɔnɔme, amekola ƒe didi, kple dɔnɔa ƒe dɔwɔna ƒe seƒe dzi.

Dɔwɔwɔ le dɔwɔwɔ vɔ megbe kple asidada ɖe ame dzi .

Amekoko me tsonu dzidzedzetɔewo nɔa te ɖe amekoko megbe gbugbɔgaɖɔɖo dzi vevie. Ʋuʋu si dzi woɖuna kaba kpena ɖe ame ŋu be wòaxe mɔ ɖe sesẽ kple lãkusi ƒe ƒoƒo nu.

Zi geɖe la, ɖoɖo si wowɔ ɖe ɖoɖo nu ƒe ɖoɖowɔɖi si woɖo ɖe ɖoɖo nu la lɔa:

• Edema ƒe dziɖuɖu .

• Kamedede si me woɖea nu le vivivi .

• Ŋusẽdodo vivivi .

• Dɔwɔwɔ ƒe hehenana si wɔa dɔ .

Amekola kple asidɔdala dome nuwɔwɔ aduadu kplikplikpli le vevie hafi woate ŋu ahaya nyuie wu.

Nu tɔxɛ siwo ŋu woabu le dɔnɔwo ƒe hatsotso vovovowo me .

Kamedefefewɔlawo .

Zi geɖe la, kamedefefewɔlawo biaa:

• Trɔ yi fefe me kabakaba wu .

• Stable fixation si ɖea mɔ na ʋuʋu kaba .

• Ametakpɔnu ƒe aŋe le hayahaya me .

 Asinuwɔlawo .

Le dɔwɔla siwo ɖoa ŋu ɖe asiléƒe ƒe ŋusẽ ŋu gome la, atikewɔwɔ naa:

• Mɔ̃ɖaŋununya ƒe liƒo .

• Ɣeyiɣi didi ƒe anyinɔnɔ .

• Mɔxexe ɖe vevesese atraɖii nu .

Dɔnɔ tsitsiwo .

Ƒu ƒe nyonyome kple comorbidities kpɔa ŋusẽ ɖe atikewɔwɔ ƒe tiatia kple gbedada ƒe ɣeyiɣiɖoɖo siaa dzi.

Nusiwo dona tso eme ɣeyiɣi didi kple nyagblɔɖi .

kple dɔdzikpɔkpɔ si sɔ:

• Dɔnɔ akpa gãtɔ gakpɔa asi ƒe dɔwɔwɔ si sɔ kloe .

• Grip strength zi geɖe la, ehayana va ɖoa >90% le gɔmedzedzea me .

• Nuwɔametɔnyenye si nɔa anyi didi la mebɔ o .

Zi geɖe la, emetsonu gbegblẽwo do ƒome kple dɔlélewo didi ƒe megbetsitsi, tɔtrɔ ƒe nɔnɔme madeamedzi si womewɔ atike na o, alo gbugbɔgaɖɔɖo si mesɔ o.

Nusita metacarpal fracture management bia be woawɔ dɔ tɔxɛ aɖe .

Togbɔ be metacarpal fractures bɔ hã la, wo dzi kpɔkpɔ bia ŋutilã ƒe ŋutilã ƒe gɔmesese kple dɔwɔwɔ ŋuti ʋɔnudɔdrɔ̃ si sɔ pɛpɛpɛ. Vodada suesuesue siwo le ɖoɖowɔwɔ ɖe ɖoɖo nu me ate ŋu akpɔ ŋusẽ ɖe asi ƒe dɔwɔwɔ dzi wòagbɔ eme.

Esia tae egbegbe nuveviwɔame dzi kpɔkpɔ te gbe ɖe edzi be:

• Dzodzro si sɔ pɛpɛpɛ .

• Kpeɖodzi siwo wotu ɖe kpeɖodziwo dzi .

• Amewo ƒe ƒuƒoƒo kaba .

Nyabiase siwo wobiaa amewo .

Kakɛ ƒe nɔnɔme kawoe ɖee fia vevie wu be amekoko ƒe nuléle ɖe ame ŋu ƒe nɔnɔme le?

Amekoko ƒe fixation koŋue ɖea tɔtrɔ ƒe nɔnɔme madeamedzi, angulation si meli ke o, metacarpal ƒe gomekpɔkpɔ le eme zi geɖe, ʋuʋu le ʋuʋu me, intra-articular extension, alo kpododonu le closed reduction me fiana. Le esiawo dome la, wobua tɔtrɔ ƒe gbegblẽ be enye nusi ɖe dzesi wu le dɔwɔwɔ me.

Angulation agbɔsɔsɔme kae woxɔna le dɔwɔwɔ me le metacarpal fractures me?

Angulation si dzi woda asi ɖo la toa vovo le xexlẽdzesiwo nu. Zi geɖe la, woɖea mɔ ɖe ʋukawo ƒe ʋuʋu ŋu le ulnar metacarpals me wu radial metacarpals. Gake womate ŋu alɔ̃ ɖe tɔtrɔ ƒe nɔnɔme ƒe nɔnɔme ɖesiaɖe dzi o, metsɔ le alesi woawɔ nu ɖe ​​alesi afɔwo le nu ŋu me o.

Nukatae wobua tɔtrɔ ƒe nɔnɔme madeamedziwo be wole vevie wu angulation?

Tɔtrɔ ƒe nɔnɔme madeamedziwo hea asibidɛwo ƒe ƒoƒo ɖe wo nɔewo ŋu le alesi wobɔbɔna me, si gblẽa nu le asiléƒe ƒe mɔ̃ɖaŋununya kple asi ƒe dɔwɔwɔ ŋu vevie. Trɔtrɔ suetɔ kekeake gɔ̃ hã ate ŋu ahe dɔwɔwɔ ƒe gbɔdzɔgbɔdzɔ si mesɔ o vɛ eye ƒunukpeƒe siwo te ɖe wo nɔewo ŋu mexea fe na wo nyuie o.

Viɖe vevi kawoe le plate fixation ŋu le metacarpal fractures me?

Plate fixation na:

• Liliɖe sesẽ .

• Anatomical ƒe ɖoɖo si sɔ pɛpɛpɛ .

• Amewo ƒe ƒuƒoƒo kaba .

• Afɔku si le evelia ƒe ʋuʋu me dzi ɖe kpɔtɔ .

Eɖea vi ŋutɔ le shaft ƒe gbagbã, nɔnɔme siwo wotsɔ ƒo ƒui, kple metacarpal ƒe abi geɖe me, togbɔ be ehiã be woawɔ dɔ nyuie le lãkusi falɛfalɛwo ŋu be woaɖe lãkusi ƒe dzikudodo dzi akpɔtɔ hã.

Le go kawo me la, wodina be woalɔ̃ Kirschner-kawo?

Wozãa K-ka ƒe fixation zi geɖe na:

• Metacarpal kɔ ƒe gbagbãƒewo .

• Fracture ƒe nɔnɔme siwo me kɔ boo o .

• Ɣeyiɣi kpui aɖe ƒe liƒolili .

• Ðeviwo ƒe dɔlélewo alo esiwo me womebiaa nya boo aɖeke le o .

Togbɔ be womedea nu eme boo o hã la, zi geɖe la, K-kawo hiãa ɣeyiɣi didi ƒe ʋuʋu ne wotsɔe sɔ kple plate fixation.

Akpa kae intramedullary fixation wɔna le egbegbe metacarpal fracture treatment me?

Intramedullary fixation naa dadasɔ le liƒo kple soft-tissue ƒe tɔtɔ suetɔ kekeake dome. Eɖea mɔ na ʋuʋu do ŋgɔ wu pecutaneous pinning esime wòƒoa asa na kuxi aɖewo siwo do ƒome kple plate, si wɔe be wòsɔ na shaft kple kɔ ƒe gbagbã tiatia.

Aleke amewo ƒoƒo ƒu kaba kpɔa ŋusẽ ɖe nusiwo dona tso eme ɣeyiɣi didi dzi?

Amewo ƒe ƒuƒoƒo si dzi woɖuna kaba ɖea edzi:

• ƒunukpeƒe ƒe sesẽ .

• lãkusi ƒe ƒoƒo ɖe wo nɔewo ŋu .

• Lãmetsiwo ƒe dɔmawɔmawɔ nyuie .

Fixation si li ke si ɖea mɔ na ʋuʋu kaba nye nu vevi aɖe si dea dzesi dɔwɔwɔ ƒe hayahaya, vevietɔ le dɔnɔ siwo wobiaa nu geɖe me.

Kuxi kawoe wòle be amekolawo nalé ŋku ɖe dɔwɔwɔ vɔ megbe ƒe kuxiwo ŋu nyuie?

Kuxi siwo bɔ dometɔ aɖewoe nye:

• Malunion alo Nonunion .

• Hardware ƒe dzikudodo .

• Tendon adhesion .

• Ŋusẽ si dzi woɖe kpɔtɔ le asiléƒe .

• Dɔlékuiwo ƒe dɔléle le gbagbãƒe siwo le ʋuʋu ɖi me .

Dɔwɔwɔ ƒe gbɔdzɔgbɔdzɔ siwo nɔa anyi didi ƒe akpa gãtɔ do ƒome kple nuwo ƒe sɔsɔ ɖe wo nɔewo ŋu nyuie alo wo gbugbɔgaɖɔɖo si wohe ɖe megbe.

Aleke atikewɔwɔmɔnu to vovo na kamedefefewɔlawo kple asinudɔwɔlawoe?

Le kamedefefewɔlawo kple dɔwɔla siwo wɔa dɔ kple asi me la, wotsɔa nu ɖoa nɔƒe gbãtɔ be:

• Stable fixation .

• Trɔ yi dɔwɔwɔ me kaba .

• Ɣeyiɣi didi ƒe anyinɔnɔ .

Amekoko ƒe dzidzenuwo ate ŋu aɖiɖi le ameha siawo me le dɔwɔwɔ ƒe didi si lolo wu ta.

Nukawoe kpɔa ŋusẽ ɖe dɔwɔwɔ ƒe nyagblɔɖi si nɔa anyi didi wu dzi wu?

Nu vevi siwo le ŋgɔ yim la dometɔ aɖewoe nye:

• Afɔkpodzi dzi ɖeɖe kpɔtɔ ƒe nyateƒetoto .

• Fixation ƒe liƒo .

• Gbugbɔgaɖɔɖo kaba .

• Trɔtrɔ ƒe nɔnɔme mademade .

Ne wowɔ nu siawo wònyo wu la, dɔnɔ akpa gãtɔ ɖoa ​​asi ƒe dɔwɔwɔ si sɔ kloe gbɔ.