Yintoni i-metacarpal fracture?

Intshayelelo

I-metacarpal fracture yinto eqhelekileyo yokulimala kwesandla echaphazela amathambo amade esandleni. Ukuxilongwa ngokufanelekileyo kunye nonyango kubalulekile ukukhusela iingxaki zexesha elide ezifana nokunciphisa ukuhamba okanye intlungu engapheliyo. Ukuba ufumana intlungu yesandla emva kokuphazamiseka, ukungenelela ngexesha elifanelekileyo kubalulekile.

I-Biomechanics ye-Metacarpal Fractures

Ukusuka kumbono we-biomechanical, amathambo e-metacarpal aphantsi komthwalo we-axial, amandla okugoba, kunye noxinzelelo olujikelezayo ngexesha lokusetyenziswa kwesandla semihla ngemihla. Xa amandla angaphandle edlula umda we-elastic wethambo, ukuphuka kwenzeka.

Izinto ezininzi zinefuthe kwipateni yokwaphuka:

• Isalathiso kunye nobukhulu bamandla

• Indawo yesandla kwimpembelelo

• Ukuxinana kwamathambo kunye nobudala

• Ukutsalwa kwemisipha ukusuka kwizihlunu zezandla zangaphakathi nezingaphandle

Ngokomzekelo, iifractures zentamo yesihlanu ye-metacarpal ngokuqhelekileyo ibonisa i-volar angulation ngenxa yokutsalwa okungenakuphikiswa kwe-interossei kunye nezihlunu ze-lumbrical.

Iinkqubo ezihambelanayo zokulungisa: IiNkqubo zokuLungisa i-Metacarpal Plate - CZMEDITECH

Ukukhubazeka okujikelezayo-Ngumba oBalulekileyo kodwa osoloko uphoswa

Ngokungafaniyo ne-angulation, ukukhubazeka okujikelezayo kunokungabonakali kumfanekiso we-X-reyi. Ngokonyango, ibonwa ngcono ngokujonga ukulungelelaniswa kweminwe xa isigulana senza inqindi.

Namaqondo ambalwa okujikeleza angabangela:

• Ukudibana kweminwe

• Ukunciphisa ukusebenza kakuhle

• Ukuphazamiseka kokusebenza kwexesha elide

Ngenxa yesi sizathu, ukukhubazeka okujikelezayo kuthathwa njengophawu oluqinileyo lokulungiswa kotyando, nokuba i-fracture ibonakala ikhutshwe kancinane kwi-radiographically.

Le nuance yeklinikhi yahlula kakhulu uvavanyo lwengcali yamathambo ukusuka kulawulo olusisiseko lokuqhekeka.

Izalathiso zokuNgenelela ngoCando

Ngelixa i-metacarpal fractures ezininzi zinokunyangwa ngokucokisekileyo, utyando luyacetyiswa phantsi kwezi meko zilandelayo:

• I-angulation engamkelekanga ngaphaya kokunyamezela ukusebenza

• Naliphi na iqondo lokukhubazeka okujikelezayo

• Iifracture ezininzi ze-metacarpal

• Vula iifractures

• Ukubandakanyeka kwe-intra-articular

• Ukungaphumeleli kokunciphisa okuvaliweyo

Injongo ephambili yotyando kukulungelelaniswa kwe-anatomical kunye nokulungiswa okuzinzileyo, ukuvumela ukuhlanganiswa kwangethuba ngelixa kuncitshiswa iingxaki.

Iindlela zokuLungisa kunye neeNgqwalaselo zeKlinikhi

Ipleyiti kunye neScrew Fixation

Ibonelela ngozinzo oluqinileyo kunye nolungelelwaniso oluchanekileyo, oluluncedo ngakumbi:

• Ukuqhekeka okungapheliyo

• Ukuqhekeka kwe-shaft

• Iifracture ezininzi

Nangona kunjalo, iiplate zifuna ukuphathwa ngokucokisekileyo kwezicubu ezithambileyo ukuphepha ukucaphuka kwe-tendon.

I-Kirschner Wire (K-Wire) Ukulungiswa

Ukhetho olungenelelayo oluncinci oluhlala lusetyenziselwa:

• Ukwaphuka kwentamo

• Iimeko zabantwana

• Uzinzo lwexeshana

Ukulungiswa kwe-Intramedullary

Ubuchule obuxhaphakileyo obulungelelanisa ukuzinza kunye nokuphazamiseka okuncinci kwezicubu ezithambileyo.

Ukukhethwa kokulungiswa kuxhomekeke kwipatheni yokuphuka, ukhetho logqirha, kunye nenqanaba lomsebenzi wesigulane.

Ulawulo lwasemva kokusebenza kunye noNyango lwezandla

Iziphumo zotyando eziyimpumelelo zixhomekeke kakhulu ekubuyiselweni kwimeko yesiqhelo emva kotyando. Ukunyakaza okulawulwayo kwangaphambili kunceda ukukhusela ukuqina kunye nokunamathela kwe-tendon.

Iprothokholi ecwangcisiweyo yokubuyisela kwisimo sangaphambili ibandakanya:

• Ulawulo lwe-Edema

• Ukuzilolonga ngokuthe ngcembe

• Ukuqiniswa okuqhubekayo

• Uqeqesho ngokutsha olusebenzayo

Ulungelelwaniso olusondeleyo phakathi kogqirha wotyando kunye nomnyangi wezandla luyimfuneko ekuchacheni ngokupheleleyo.

Iingqwalasela ezikhethekileyo kumaQela eZigulana ahlukeneyo

Iimbaleki

Iimbaleki zihlala zifuna:

• Ukubuya ngokukhawuleza ukuya kudlala

• Ukulungiswa okuzinzileyo kuvumela intshukumo kwangethuba

• Ukuqhekeka okukhuselekileyo ngexesha lokubuyisela

 Abasebenzi bezandla

Kubasebenzi abaxhomekeke kumandla okubamba, unyango lubeka phambili:

• Ukuzinza komatshini

• Ukuqina kwexesha elide

• Ukuthintela intlungu engapheliyo

Abaguli Abalupheleyo

Umgangatho wamathambo kunye ne-comorbidities ichaphazela ukhetho lonyango kunye nexesha lokuphilisa.

Iziphumo zeXesha elide kunye nePrognosis

Ngolawulo olufanelekileyo:

• Uninzi lwezigulana ziphinda zisebenze kufutshane nesiqhelo

• Amandla okubamba abuyela kwi>90% yesiseko

• Ukukhubazeka kwexesha elide akuqhelekanga

Iziphumo ezibi zidla ngokunxulunyaniswa nokulibaziseka kokuxilongwa, ukukhubazeka okujikelezayo okungaphathwayo, okanye ukubuyisela kwisimo sangaphambili okungonelanga.

Kutheni iMetacarpal Fracture Management ifuna ubuNgcali obukhethekileyo

Nangona i-metacarpal fractures ixhaphakile, ulawulo lwabo lufuna ukuqonda okuchanekileyo kwe-anatomical kunye nesigwebo esisebenzayo. Iimpazamo ezincinci kukulungelelaniswa zinokuba neziphumo ezingaphezulu ekusebenzeni kwesandla.

Kungenxa yoko le nto ukhathalelo lwangoku lokwenzakala lugxininisa:

• Uvavanyo oluchanekileyo

• Ukulungiswa okusekelwe kubungqina

• Ukuhlanganisa kwangethuba

FAQ Icandelo

Zeziphi iimpawu zokwaphuka ezibonisa kakhulu ukulungiswa kotyando?

Ukulungiswa kokuhlinzwa kuboniswa ngokuyinhloko ngokukhubazeka okujikelezayo, i-angulation engazinzanga, ukubandakanyeka kwe-metacarpal ezininzi, iifractures ezivulekileyo, ukwandiswa kwe-intra-articular, okanye ukungaphumeleli kokunciphisa okuvaliweyo. Phakathi kwezi, ukungahambi kakuhle kokujikeleza kuthathwa njengowona msebenzi ubalulekileyo.

Ingakanani i-angulation eyamkelekileyo ekusebenzeni kwi-metacarpal fractures?

I-angulation eyamkelekileyo iyahluka ngokwenani. Ngokuqhelekileyo, i-angulation enkulu inyamezeleke kwii-metacarpals ze-ulnar kune-radial metacarpals. Nangona kunjalo, nayiphi na iqondo lokukhubazeka okujikelezayo ayamkelekanga, kungakhathaliseki ukunyamezela kwe-angulation.

Kutheni ukukhubazeka okujikelezayo kuthathwa njengokubaluleke kakhulu kunoxinzelelo?

Ukukhubazeka okujikelezayo kukhokelela ekugqityweni kweminwe ngexesha lokuguqa, nto leyo ibeka esichengeni ubuxhakaxhaka bokubamba kunye nomsebenzi wezandla. Nokuba ukujikeleza okuncinci kunokubangela ukonakala okungafaniyo kokusebenza kwaye kuhlawulelwa kakubi ngamalunga akufutshane.

Ziziphi iingenelo eziphambili zokulungiswa kwepleyiti kwi-metacarpal fractures?

Ukulungiswa kwepleyiti kuyabonelela:

• Uzinzo oluqinileyo

• Ulungelelwaniso lwe-anatomical oluchanekileyo

• Ukuhlanganisa kwangethuba

• Ukunciphisa umngcipheko wokufuduka okwesibini

Kuluncedo ngakumbi kwi-shaft fractures, iipateni ezidibeneyo, kunye nokulimala okuninzi kwe-metacarpal, nangona ukuphathwa ngononophelo kwezicubu ezithambileyo kuyafuneka ukuze kuncitshiswe ukucaphuka kwe-tendon.

Zeziphi iimeko apho iingcingo zaseKirschner zikhethwa?

Ukulungiswa kocingo lwe-K ngokuqhelekileyo kusetyenziselwa:

• Ukuqhekeka kwentamo yeMetacarpal

• Iipateni zokuqhekeka ezingantsonkothanga kakhulu

• Uzinzo lwexeshana

• Iimeko zabantwana okanye ezinemfuno ephantsi

Ngelixa zihlasela kancinci, iingcingo ze-K zihlala zifuna ukushukunyiswa ixesha elide xa kuthelekiswa nokulungiswa kwepleyiti.

Yiyiphi indima edlalwa ukulungiswa kwe-intramedullary kunyango lwangoku lwe-metacarpal fracture?

Ukulungiswa kwe-Intramedullary kunika ukulingana phakathi kozinzo kunye nokuphazamiseka okuncinci kwezicubu ezithambileyo. Ivumela intshukumo yangaphambili kune-percutaneous pinning ngelixa uthintela ezinye iingxaki ezinxulumene nepleyiti, iyenza ilungele ukukhetha i-shaft kunye nokwaphuka kwentamo.

Ukuhlanganisa kwangethuba kuzichaphazela njani iziphumo zexesha elide?

Ukuhlanganiswa okulawulwa kwangoko kunciphisa:

• Ukuqina okudibeneyo

• Ukubambelela kwi-tendon

• I-atrophy yezihlunu

Ukulungiswa okuzinzile okuvumela ukunyakaza kwangaphambili kukumisela okuphambili kokubuyiswa komsebenzi, ngokukodwa kwizigulane ezifunwa kakhulu.

Ziziphi iingxaki zasemva kotyando ekufuneka oogqirha botyando bazijongisise?

Iingxaki eziqhelekileyo ziquka:

• I-Malunion okanye i-nonunion

• Ukucaphukisa i-Hardware

• Ukubambelela kwi-tendon

• Amandla okubamba acuthiwe

• Usulelo kwiifractures ezivulekileyo

Uninzi lweentsilelo ezisebenzayo zexesha elide zinxulunyaniswa nokungalungelelanisi ngokwaneleyo okanye ukulibaziseka kokubuyisela kwisimo sangaphambili.

Izicwangciso zonyango zahluke njani kwiimbaleki kunye nabasebenzi bezandla?

Kwiimbaleki nakubasebenzi bezandla, okuphambili kunikwa:

• Ukulungiswa okuzinzileyo

• Ukubuyela kwangoko kumsebenzi

• Ukuqina kwexesha elide

Imida yotyando inokuba sezantsi kwaba bantu ngenxa yeemfuno eziphezulu zokusebenza.

Ziziphi izinto ezichaphazela kakhulu i-prognosis yokusebenza kwexesha elide?

Imiba ephambili yengqikelelo ibandakanya:

• Ukuchaneka kokunciphisa ukuphuka

• Ukuzinza kokulungiswa

• Ukubuyisela kwisimo sangaphambili

• Ukungabikho kokukhubazeka okujikelezayo

Xa ezi zinto ziphuculwe, uninzi lwezigulana lufumana umsebenzi okufutshane-oqhelekileyo wesandla.