Mawonedwe: 175 Wolemba: Site Editor Nthawi Yosindikiza: 2022-08-27 Origin: Tsamba
Kuphulika kwa calcaneal ndi kuvulala kovutirapo komwe kumaphatikizapo fupa la chidendene, lomwe nthawi zambiri limayambitsidwa ndi kuvulala kwamphamvu kwamphamvu monga kugwa kuchokera kutalika kapena ngozi za galimoto. Chifukwa calcaneus imagwira ntchito yofunika kwambiri pakulemetsa, kuyamwa modzidzimutsa, ndi njira zamakanika, njira zamankhwala ziyenera kuthana ndi kubwezeretsedwa kwa anatomical komanso kuchira kwanthawi yayitali.
Kusamalira bwino kwa fractures ya calcaneal kumafuna kumvetsetsa bwino za machitidwe ophwanyika, minofu yofewa, ndi zofuna za odwala.
calcaneus ndiye fupa lalikulu kwambiri la tarsal ndipo limapanga maziko a hindfoot. Kuthyoka kwa fupali nthawi zambiri kumasokoneza biomechanics ya phazi, zomwe zimayambitsa kupweteka, kupunduka, ndi kusayenda bwino ngati sizikuchitidwa moyenera.
Zolinga zazikulu za chithandizo ndi kubwezeretsa kutalika kwa calcaneal, m'lifupi, ndi kuyanjanitsa, kusunga mgwirizano, ndi kuchepetsa zovuta zomwe zimakhalapo nthawi yayitali monga kuuma kapena nyamakazi yoopsa. Zosankha za chithandizo sizimayendetsedwa kokha ndi zotsatira za radiographic komanso ndi mawonekedwe a minofu yofewa komanso ziyembekezo za odwala.
Ma fractures a Calcaneal nthawi zambiri amagawidwa m'magulu a intra-articular ndi extra-articular. Kusiyanitsa kumeneku ndi kofunikira, chifukwa kumakhudza mwachindunji kukonzekera kwamankhwala ndi kuneneratu.
Mitsempha ya intra-articular imaphatikizapo mgwirizano wa subtalar ndipo imayimira milandu yambiri. Kuvulala kumeneku kumapangitsa kuti pakhale kusagwirizana kophatikizana komanso kuchepa kwa nthawi yayitali ngati kuchepa kwa anatomical sikutheka. Kuphulika kowonjezera kwa articular, mosiyana, kumateteza pamwamba pamtunda ndipo nthawi zambiri kumakhala ndi chidziwitso chabwino.
Kuwongolera kwa intra-articular calcaneal fractures kumadalira zinthu monga kusamuka kwa fracture, articular surface kugwa, kugwirizanitsa kwathunthu, ndi msinkhu wa zochitika za odwala. Kujambula kwapamwamba nthawi zambiri kumagwiritsidwa ntchito poyesa kutenga nawo mbali limodzi ndikuwongolera kusankha chithandizo.
Chithandizo chosagwira ntchito nthawi zambiri chimangoperekedwa kwa anthu othyoka popanda kusunthika kwambiri, kuvulala kopitilira muyeso, kapena odwala omwe opaleshoni amaika chiopsezo chosavomerezeka.
Kuwongolera kokhazikika kumayang'ana kwambiri kuteteza fracture ndikusunga kusuntha kwa mgwirizano ndikupewa zovuta zachiwiri.
Chithandizo choyambirira chimaphatikizapo kusasunthika pogwiritsa ntchito nsapato yoponya kapena kuyenda, ndondomeko zolimba zosalemetsa, ndi kukwera kuti muchepetse kutupa. Minofu yofewa ikayamba kusintha, kuchita masewera olimbitsa thupi koyambirira kumalimbikitsidwa kuti achepetse kuuma komanso kulimbikitsa kuchira.
Kuchita opaleshoni kumaganiziridwa pamene zothyoka zikuwonetsa kusamuka kwakukulu, kusagwirizana kwamagulu, kapena kupunduka komwe kumasokoneza zimango za phazi. Nthawi ya opaleshoni imakonzedwa mosamala kuti kutupa kwa minofu yofewa kuchepetse, kuchepetsa chiopsezo cha zovuta zabala.
Cholinga chachikulu cha opaleshoni ndikubwezeretsanso mawonekedwe a anatomical ndi mgwirizano wapamtunda ndikusunga minofu yofewa yozungulira.
Kuchepetsa kotseguka ndi kukonza kwamkati kumakhalabe njira yomwe imagwiritsidwa ntchito kwambiri pakuwonongeka kwa intra-articular fractures. Njirayi imalola kuwonetsetsa kwachindunji kwa kuthyoka ndi kubwezeretsedwa kolondola kwa malo olowa pansi, zomwe zimathandiza kuti pakhale zotsatira zogwira ntchito bwino zikachitika pansi pazifukwa zoyenera.
Njira zochepetsera zocheperako zapeza kutchuka pamilandu yosankhidwa. Njirazi zimayang'ana kuchepetsa kupwetekedwa kwa minofu yofewa ndikukwaniritsa kuchepetsedwa kovomerezeka kwa fracture, makamaka m'miphuno yopanda comminution kapena morphology yabwino.
Chisamaliro cha postoperative chimakhala ndi gawo lalikulu pakuzindikira zotsatira za nthawi yayitali. Ma protocol okonzanso okonzedwa ndi ofunikira kuti abwezeretse mphamvu, kuyenda, ndi makina oyenda.
Kuyenda koyang'aniridwa koyambirira kumathandizira kupewa kuuma kwamagulu, pomwe kunyamula zolemetsa mosamalitsa kumathandizira kuchira kwa fracture ndi kuchira.
Kulemera pang'ono kumayamba pakati pa masabata asanu ndi atatu kapena khumi pambuyo pa opaleshoni, kutengera umboni wa machiritso. Kulemera kwathunthu kumayambiranso pang'onopang'ono pokhapokha kuphatikizika kokwanira kwa fracture kutsimikiziridwa, nthawi zambiri kumafuna miyezi ingapo ya kukonzanso.
Ngakhale kuti ali ndi chithandizo choyenera, fractures ya calcaneal ingayambitse mavuto a nthawi yaitali monga kuuma kwa subtalar, kupweteka kwa chidendene chosatha, kapena matenda a nyamakazi. Ziwopsezozi zimakhala zokulirapo pakuthyoka kwa intra-articular komanso milandu yokhala ndi zotsalira zosagwirizana.
Zotsatira za nthawi yayitali zimadalira kuopsa kwa fracture, ubwino wa chithandizo, ndi kutsata ndondomeko zokonzanso.
Palibe chithandizo choyenera chapadziko lonse cha fractures zonse za calcaneal. Zotsatira zabwino zimadalira kukonzekera kwamankhwala payekha komwe kumayenderana ndi mikhalidwe ya fracture, zofuna za odwala, komanso ukadaulo wopezeka pa opaleshoni.
Kugawana zisankho pakati pa dokotala wochiza ndi wodwala ndikofunikira kuti tigwirizane ndi zolinga zachipatala ndi ziyembekezo zenizeni.
Sikuti fractures zonse za calcaneal ndizoyenera chithandizo chokhazikika. Kuphulika kwapang'onopang'ono komwe kumaphatikizapo mgwirizano wa subtalar nthawi zambiri kumafuna kuchitidwa opaleshoni kuti abwezeretse thupi ndi ntchito.
Kuchira nthawi zambiri kumachokera miyezi isanu ndi umodzi mpaka khumi ndi iwiri, kutengera mtundu wa fracture, njira yochiritsira, ndi kupita patsogolo kwa kukonzanso.
Odwala ambiri amathanso kuyenda ndikuchita ntchito za tsiku ndi tsiku, ngakhale kuti kuphulika kwakukulu kwa intra-articular kungayambitse kuuma kotsalira kapena kupweteka.
Nthawi zambiri maopaleshoni amalimbikitsidwa ngati zothyoka zipangitsa kuti mafupa asokonezeke kwambiri, kutayika bwino, kapena kusakhazikika kwa magwiridwe antchito.
Matenda a nyamakazi a post-traumatic ndi ofala kwambiri potsatira fractures ya intra-articular calcaneal, makamaka ngati kuchepa kwa thupi sikukwanira.
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