Kuyini ukuphuka kwe-metacarpal?

Isingeniso

I-metacarpal fracture ukulimala kwesandla okuvamile okuthinta amathambo amade esandleni. Ukuxilongwa okufanele kanye nokwelashwa kubalulekile ukuvimbela izinkinga zesikhathi eside ezifana nokunciphisa ukuhamba noma ubuhlungu obungapheli. Uma uzwa ubuhlungu besandla ngemva kokulimala, ukungenelela okufika ngesikhathi kubalulekile.

I-Biomechanics ye-Metacarpal Fractures

Ngokombono we-biomechanical, amathambo e-metacarpal angaphansi kokulayisha i-axial, amandla okugoba, nokucindezeleka okujikelezayo ngesikhathi sokusetshenziswa kwezandla nsuku zonke. Lapho amandla angaphandle edlula umkhawulo wokunwebeka wethambo, kwenzeka ukuphuka.

Kunezici ezimbalwa ezithonya iphethini yokuphuka:

• Isiqondiso nobukhulu bamandla

• Ukuma kwesandla kumthelela

• Ukuminyana kwamathambo nobudala

• Ukudonsa kwemisipha kusuka emisipha yesandla yangaphakathi nengaphandle

Isibonelo, ukuphuka kwentamo yesihlanu ye-metacarpal ngokuvamile kubonisa i-volar angulation ngenxa yokudonsa okungaphikiswa kwe-interossei nemisipha ye-lumbrical.

Amasistimu okulungisa ahlobene: I-Metacarpal Plate Fixation Systems - CZMEDITECH

Ukukhubazeka Okujikelezayo - Inkinga Ebucayi Kodwa Evame Ukuphuthelwa

Ngokungafani ne-angulation, ukukhubazeka kokujikeleza kungase kungabonakali ekucabangeni kwe-X-ray. Ngokomtholampilo, kutholakala kangcono ngokubheka ukuqondanisa kweminwe lapho isiguli senza isibhakela.

Ngisho namadigri ambalwa wokuzungezisa angaholela kokuthi:

• Ukugqagqana kweminwe

• Kwehliswe ukusebenza kahle kokubamba

• Ukukhubazeka kokusebenza kwesikhathi eside

Ngenxa yalesi sizathu, ukukhubazeka okujikelezayo kuthathwa njengenkomba eqinile yokulungiswa kokuhlinzwa, noma ngabe ukuphuka kubonakala kususwe indawo encane ngokwe-radiographically.

Le nuance yomtholampilo ihlukanisa kakhulu ukuhlolwa kwamathambo ochwepheshe ekulawuleni ukuphuka okuyisisekelo.

Izinkomba Zokungenela Ukuhlinzwa

Nakuba ama-metacarpal fractures amaningi angelashwa ngokucophelela, ukuhlinzwa kunconywa ngaphansi kwezimo ezilandelayo:

• I-angulation engamukelekile ngaphezu kokubekezelela ukusebenza

• Noma yiliphi izinga lokukhubazeka kokujikeleza

• Ama-metacarpal fractures amaningi

• Vula ama-fracture

• Ukubandakanyeka kwe-intra-articular

• Ukuhluleka kokunciphisa okuvaliwe

Umgomo oyinhloko wokuhlinzwa ukuqondanisa kwe-anatomical nokulungiswa okuzinzile, okuvumela ukuhlanganisa kusenesikhathi kuyilapho kunciphisa izinkinga.

Izindlela Zokulungisa Nokucatshangelwa Komtholampilo

Ukulungiswa Kwepuleti kanye Nesikulufu

Ihlinzeka ngokuzinza okuqinile nokuqondanisa okunembayo, okuwusizo ikakhulukazi kulokhu:

• Ukuphuka okuphindaphindiwe

• Ukuphuka kwe-Shaft

• Ukuphuka okuningi

Kodwa-ke, amapuleti adinga ukuphathwa ngokucophelela kwezicubu ezithambile ukugwema ukucasuka kwe-tendon.

I-Kirschner Wire (K-Wire) Ukulungiswa

Inketho encane evamise ukusetshenziselwa:

• Ukuphuka kwentamo

• Amacala ezingane

• Ukuzinza kwesikhashana

Ukulungiswa kwe-Intramedullary

Indlela ethandwa kakhulu elinganisa ukuzinza nokuphazamiseka okuncane kwezicubu ezithambile.

Ukukhethwa kokulungiswa kuncike kuphethini yokuphuka, okuthandwa ngudokotela ohlinzayo, kanye nezinga lomsebenzi wesiguli.

Ukuphathwa Kwangemva Kokuhlinzwa kanye Nokwelashwa Kwezandla

Imiphumela yokuhlinzwa eyimpumelelo incike kakhulu ekuvuselelweni kwangemva kokuhlinzwa. Ukunyakaza okulawulwayo kusenesikhathi kusiza ukuvimbela ukuqina nokunamathela kwe-tendon.

Iphrothokholi ehlelekile yokubuyisela ngokuvamile ihlanganisa:

• Ukulawulwa kwe-edema

• Ukuzivocavoca okuhamba kancane kancane

• Ukuqiniswa okuqhubekayo

• Ukuqeqeshwa kabusha okusebenzayo

Ukuxhumana phakathi kukadokotela ohlinzayo kanye nomelaphi wezandla kubalulekile ukuze umuntu alulame.

Ukucatshangelwa Okukhethekile Emaqenjini Eziguli Ahlukene

Abasubathi

Abasubathi bavame ukudinga:

• Buyela ngokushesha uzodlala

• Ukulungiswa okuzinzile okuvumela ukunyakaza kwangaphambi kwesikhathi

• Ukuhlukaniswa okuvikelekile ngesikhathi sokuphumula

 Abasebenzi Ngezandla

Kubasebenzi abathembele emandleni okubambelela, ukwelashwa kuqala kuqala:

• Ukuzinza kwemishini

• Ukuqina kwesikhathi eside

• Ukuvimbela ubuhlungu obungapheli

Iziguli Ezikhulile

Ikhwalithi yamathambo kanye ne-comorbidities kuthonya kokubili ukukhetha ukwelashwa kanye nomugqa wesikhathi wokuphulukisa.

Imiphumela Yesikhathi Eside kanye Nesibikezelo

Ngokuphathwa okufanele:

• Iningi leziguli liphinde libuyele ekusebenzeni kwesandla okujwayelekile

• Amandla okubamba ngokuvamile abuyela ku->90% wesisekelo

• Ukukhubazeka isikhathi eside akuvamile

Imiphumela engemihle ivame ukuhlotshaniswa nokuxilongwa ukubambezeleka, ukukhubazeka kokujikeleza okungalashwa, noma ukuvuselelwa okunganele.

Kungani Ukuphathwa Kwe-Metacarpal Fracture Kudinga Ubungcweti Abakhethekile

Nakuba i-metacarpal fracture ivamile, ukuphathwa kwayo kudinga ukuqonda okunembile kwe-anatomical kanye nokwahlulela kokusebenza. Amaphutha amancane ekuqondaneni angaba nemiphumela emikhulu ekusebenzeni kwesandla.

Yingakho ukunakekelwa kwe-trauma yesimanje kugcizelela:

• Ukuhlola okunembile

• Ukulungiswa okusekelwe ebufakazini

• Ukugqugquzela kusenesikhathi

Isigaba se-FAQ

Yiziphi izici zokuphuka ezibonisa kakhulu ukulungiswa kokuhlinzwa?

Ukulungiswa kokuhlinzwa kuboniswa ngokuyinhloko ngokukhubazeka okujikelezayo, i-angulation engazinzile, ukubandakanyeka okuningi kwe-metacarpal, ukuphuka okuvulekile, isandiso se-intra-articular, noma ukwehluleka kokunciphisa okuvaliwe. Phakathi kwalokhu, ukungahambi kahle kokujikeleza kuthathwa njengokubaluleke kakhulu ekusebenzeni.

Ingakanani i-angulation eyamukelekayo ekusebenzeni kokuphuka kwe-metacarpal?

I-angulation eyamukelekayo iyahlukahluka ngedijithi. Ngokuvamile, i-angulation enkulu ibekezelelwa kuma-metacarpals ase-ulnar kunakuma-metacarpals angama-radial. Kodwa-ke, noma yiliphi izinga lokukhubazeka kokujikeleza akwamukelekile, kungakhathaliseki ukubekezelela i-angulation.

Kungani ukukhubazeka okujikelezayo kuthathwa njengokubaluleke kakhulu kunokwehliswa?

Ukukhubazeka okujikelezayo kuholela ekwedluleni kweminwe ngesikhathi sokuguquguquka, okuphazamisa kakhulu izinsimbi zokubamba kanye nokusebenza kwezandla. Ngisho nokuphenduka okuncane kungabangela ukukhubazeka kokusebenza okungalingani futhi kunxeshezelwa kabi ngamajoyinti aseduze.

Yiziphi izinzuzo ezibalulekile zokulungiswa kwamapuleti ekwephukeni kwe-metacarpal?

Ukunikezwa kokulungiswa kwamapuleti:

• Ukuzinza okuqinile

• Ukuqondanisa kwe-anatomical okunembile

• Ukugqugquzela kusenesikhathi

• Ingcuphe yengozi yokufuduka kwesibili

Kuwusizo ikakhulukazi ekuqhekekeni kwe-shaft, amaphethini ahlanganisiwe, nokulimala okuningi kwe-metacarpal, nakuba ukuphathwa ngokucophelela kwezicubu ezithambile kuyadingeka ukuze kuncishiswe ukucasuka kwe-tendon.

Kukuziphi izimo lapho izintambo ze-Kirschner zikhethwa kuzo?

Ukulungiswa kwe-K-wire kuvame ukusetshenziselwa:

• Ukuphuka kwentamo ye-Metacarpal

• Amaphethini okuphuka anzima kancane

• Ukuzinza kwesikhashana

• Amacala ezingane noma anesidingo esiphansi

Ngenkathi zihlasela kancane, izintambo ze-K ngokuvamile zidinga ukumiswa kwesikhathi eside uma kuqhathaniswa nokulungiswa kwamapuleti.

Iyiphi indima edlalwa ukulungiswa kwe-intramedullary ekwelashweni kwesimanje kwe-metacarpal fracture?

Ukulungiswa kwe-Intramedullary kunikeza ibhalansi phakathi kokuzinza nokuphazamiseka okuncane kwezicubu ezithambile. Ivumela ukunyakaza kwangaphambili kunokuphina nge-percutaneous ngenkathi igwema ezinye izinkinga ezihlobene nepuleti, iyenze ifanelekele ukukhetha ukuphuka kwe-shaft nentamo.

Ukuhlanganisa kusenesikhathi kuyithinta kanjani imiphumela yesikhathi eside?

Ukuhlanganisa okulawulwa kusenesikhathi kunciphisa:

• Ukuqina kwamalunga

• Ukunamathela kwe-tendon

• I-muscle atrophy

Ukulungiswa okuzinzile okuvumela ukunyakaza kusenesikhathi kuyisici esibalulekile sokululama kokusebenza, ikakhulukazi ezigulini ezidingeka kakhulu.

Yiziphi izinkinga zangemva kokuhlinzwa odokotela abahlinzayo okufanele baziqaphe ngokucophelela?

Izinkinga ezijwayelekile zihlanganisa:

• I-Malunion noma i-nonunion

• Ukucasuka kwezingxenyekazi zekhompyutha

• Ukunamathela kwe-tendon

• Amandla okubamba ancishisiwe

• Ukutheleleka ezindaweni ezivulekile

Iningi lezinkinga zokusebenza zesikhathi eside zihlotshaniswa nokungalungi okwanele noma ukubuyisela ukulibaziseka.

Ahluke kanjani amasu okwelapha kubasubathi nabasebenza ngezandla?

Kubasubathi kanye nabasebenzi bezandla, kuqalwa kuqala:

• Ukulungiswa okuzinzile

• Ukubuyela kwangaphambi kwesikhathi emsebenzini

• Ukuqina kwesikhathi eside

Imikhawulo yokuhlinzwa ingase ibe phansi kulezi zibalo ngenxa yezidingo eziphezulu zokusebenza.

Yiziphi izici ezithonya kakhulu ukubikezelwa kokusebenza kwesikhathi eside?

Izici ezibalulekile zokubikezela zihlanganisa:

• Ukunemba kokunciphisa ukuphuka

• Ukuzinza kokulungiswa

• Ukuvuselelwa kwangaphambi kwesikhathi

• Ukungabi bikho kokukhubazeka kokujikeleza

Uma lezi zici zithuthukisiwe, iziguli eziningi zithola ukusebenza kwesandla esiseduze nokwejwayelekile.