Naomi Mitsemphayi wa olowa phewa: Zizindikiro ndi Chithandizo

Tikamapitiriza kukhala okhulupirika kwa chiphunzitso chakuti ntchito amapangidwa nyani munthu, chinthu choyamba mu njira iyi yaitali ndi yovuta wa olowa phewa. Zinali dongosolo lake lapadera kunatheka chifukwa cha zigawo zakuya za nthambi pamwamba kupeza mpumulo wa nyama zachilendo mbali zinchito.

Nayenso kwambiri kuwonjezera ntchito zake kuchokera thandizo chabe pamene ukuyenda, manja anthu akhala limodzi mwa madera ambiri maganizo a thupi. Pa nkhani imeneyi, zoipa za lamba phewa, zimene kawirikawiri zimathera pa Mitsemphayi chinang'ambika wa olowa phewa, m'dera mwapadera a clinicians. Ndipo chimayambitsa ichi - zotheka imfa ya kuchita ndi chimene chili choipa, munthu wolumala bwino kapena ayi yake anachiritsa kuwonongeka.

Mwachidule anatomical Buku

Wapadera olowa phewa chimaonetsera chiŵerengero wa pamalo ake enieni articular. Mu mapangidwe zinthu mafupa amagwira mafupa awiri: tsamba ndi humerus. The articular padziko humerus ikuyimiridwa ozungulira mutu. Pankhani pamwamba concave wa glenoid M'mimbamo chowulungika tsamba malo ndi za kanayi kakang'ono kuposa m'dera pafupi mpira.

Kusowa tsamba kukhudzana ndi kuchepetsa chichereŵechereŵe mphete - wandiweyani kapangidwe connective, wotchedwa articular mlomo. Ndi izi amafotokozera fibrous, pamodzi ndi kapisozi ozungulira olowa, ndipo walola kuti iye olondola anatomical Molingana ndi pa nthawi yomweyo kuchita osiyanasiyana zosaneneka za kayendedwe, zomwe n'zotheka katundu anagubuduza wa olowa ena onse.

Imadziwikabe ndi Mitsemphayi olowa ndi minofu kuwapangitsa kayendedwe

Amathandiza woonda synovium olowa kapisozi kusunga ake anatomical dongosolo wamphamvu rostral-humeral mitsempha. Pamodzi ndi mu olowa anakafika kusunga owonjezera articular kapisozi bloat kukongola tendon (kukongola) ndi minofu subscapularis. Atatu awa connective chingwe ndi zowawa ngati pali chotupa cha Mitsemphayi wa olowa phewa.

Subscapularis, deltoid, above- ndi podkostnaya, zazikulu ndi zazing'ono ozungulira, komanso pectoralis zazikulu latissimus dorsi kupereka olowa osiyanasiyana kayendedwe padziko nkhwangwa onse atatu. Kukongola m'magulu a olowa phewa sakhala nawo.

Kuvulala kwa olowa phewa ndi zimayambitsa kuvulala

Pakati pa kuvulala ambiri phewa olowa kumasulidwa mikwingwirima. N'zotheka sprains anzake anawononga tsankho kapena wathunthu kapena popanda izo. Dislocation limodzi kwapakati kapena owonjezera articular avulsion wovulala zidutswa (mu Mitsemphayi kuphatikana) ali pakati kuvulala ndi lalikulu kwambiri.

Zimayambitsa chachikulu cha kuwonongeka kwa olowa phewa ndi zotsatira mwachindunji kapena mozungulira pa matabwa ake makina. Izi zikhoza kukhala kugunda mwachindunji ndi kugwa ndikuyesetsa dzanja patsogolo. Lakuthwa kwambiri minofu mavuto, kusuntha olowa, kapena gulu mwadzidzidzi mabuku lalikulu zikhoza monga sprain kapena dislocation wa olowa. Kawirikawiri limodzi ndi Mitsemphayi awo chinang'ambika wa olowa phewa (chithunzi pansipa), pamafunika osati kuchitira kuvulala kwambiri, komanso kubwezeretsa umphumphu wa zida za mitsempha.

Zizindikiro za mitsempha chophukacho

Ngozi kumachitika pamene pali kugwa mu ndinapatsidwa anawonjezera patsogolo kapena mkono mbali. N'zothekanso mitsempha anawononga chifukwa kayendedwe lakuthwa mu pazipita chovomerezeka mmene kapena zapachikika kapena pa dzanja, mwachitsanzo pamene waponya kuchokera kumwamba ndi.

kuwonongeka motsatana ndi chophukacho wa kapisozi a zizindikiro phewa olowa Mitsemphayi yodziwika ndi kupweteka kwambiri pa nthawi ya choipa, ndi kuti ali kwambiri makamaka kwa discontinuity, pakuti kayendedwe kubwereza limagwirira kuvulazidwa. Komanso osauka edema m'dera kuwonongeka kuti kumasintha lakunja olowa kasinthidwe. Kuwonjezera edema, kutupa mu mapangidwe ndi kutenga nawo mbali akukhamukira ku Mitsempha zowonongeka pafupi tendons, minofu kapena magazi.

njira zina poona kukula kwa choipa

Mwa njira yachipatala kafukufuku, kulola traumatologist kuona ngati pali tsankho chophukacho wa Mitsemphayi wa olowa phewa kapena kuwonongeka okwana, akuyima akupanga matenda ndi chapamwamba kwambiri. njira onse suli zozungulira katundu, koma ndi lalikulu kwambiri kusamvana. Makamaka, Kujambula amalola kudalilika pazipita kudziwa matenda ndi kusankha chithandizo.

Radiography kapena yopangidwa tomography akutsatiridwa pofuna kupewa fupa zotupa: fractures (kuphatikizapo mavocha), dislocations, conjugated ndi wovulala ndi dislocation wa olowa phewa. Nthawi zambiri ntchito arthrocentesis. Arthroscopy anachita mu amaganiziridwa kusintha osachiritsika a nyumba connective minofu ya olowa kapena breakage wa kapisozi a. Nthawi zina, ntchito arthrography.

Mlingo wa kukula kwa choipa

Kulekana chakale la kumodzi, zolimbitsa kuti choipa kwambiri, ndi ntchito ndi Mitsemphayi ong'ambika. Ndi kuvulala pang'ono olowa phewa, ndi Mitsemphayi, monga anatambasula ndi kuwonongeka tsankho kwa Mitsemphayi wa ulusi, pokhalabe kukhulupirika kwa mitsempha, mitsempha. Yodziwika ndi digiri tsankho avareji CHIKWANGWANI kuichotsa wa tendons, ndi minofu ozungulira gawo anavulala nawo mbali, ndi kapisozi olowa akhoza kuonongeka. Choyamba chikukhudza mlingo sprain, wachiwiri - stretchability tsankho discontinuity.

kuwonongeka aakulu limodzi ndi wathunthu wakuswa tendon kukhulupirika kwa kapangidwe (mitsempha) - discontinuity phewa olowa Mitsemphayi mtima m'dera kuwonongeka, ndi kudzipeleka mitsempha ya zopindika mu kapisozi olowa. Pa mlingo zotheka ndi intraarticular avulsion izi fractures, olowa kukha mwazi (hemarthrosis).

Ndondomeko chithandizo

Malinga ndi mlingo wa kukula kwa kuwonongeka kwa phewa olowa mitsempha zida, mankhwala ndiwofatsa kapena kugwira ntchito angagwiritsidwe ntchito. Ngati pali chotupa tsankho la Mitsemphayi wa olowa phewa, chithandizocho okha njira ndiwofatsa. Ntchito analgesia ndi immobilization (immobilization). Mwina chimamangidwa bintovoy kapena pulasitala pulasitala, malingana ndi kuopsa kwa, chikhalidwe cha kuvulala ndi buku la nyumba bwanji. Bintovuyu kapena pulasitala immobilisation orthesis akhoza m'malo (magulu) wa phewa olowa kapena osasinthika fixation sing'anga.

A timapuma, makamaka ndi kuwonongeka kwa minofu ndi makapisozi limodzi ntchito opaleshoni. Wovulalayo ayenera hospitalization zoopsa mbiri ndiponso yaitali konzanso pambuyo kumaliseche m'chipatala.

Sikuyenda vuto kuchira kalozera

Mwamsanga malangizo kusiyana kwa phewa olowa Mitsemphayi ntchito idzagwira ntchito bwino mwayi apeze wonse ntchito olowa ndi kuchepetsa kuchuluka kwa mavuto choipa. Opaleshoni yokonza ndi mitsempha zowonongeka (tendon) minofu moyandikana ndi Kupha kuonongeka mtima chilema kapisozi kumachepetsa kuti crosslinking awo.

Pogonekedwa ndi mankhwala ambiri (narcosis) mwachindunji mwayi amapangidwa pa zowonongeka locus layerwise kung'ambika ndi kulekana kwa minofu. Zopindika anapeza sutured. bala chatsekedwa mu zigawo. Kumayambiriro nyengo postoperative ntchito pulasitala ndi kuponyedwa immobilization ndi zenera kwa suture postoperative.

Masiku pulasitala immobilization ndi chithandizo kuchipatala ofunitsitsa ndi buku la nyumba wathuyo. Chinthu chofunika chiwerengero cha bedi-masiku ndi zaka wodwala, chikhalidwe cha ntchito yake, co-morbidities.

Kuwonongeka kwa Mitsemphayi wa chigongono

N'kovuta kwambiri zinthu banja, kuvulala ndi kawirikawiri wa Akatswiri, pamene ntchito yogwira ndi lakuthwa yoweyula dzanja, anawerama pa chigongono. Chiopsezo gulu zikuphatikizapo, poyamba pa zonse, osewera tennis, golfers, mpira, baseball, ndi Polo madzi.

Nthawi zambiri anavulala annular mitsempha ya utali wozungulira, ulna ina mitsempha, kapena zozungulira. Ndi chizindikiro cha kuwonongeka kwa ululu, kuwonjezeka pa gulu. Yodziwika ndi edema, kukha mwazi mu minofu ozungulira. Chance wa hemarthrosis. Ngati pali anawononga kwathunthu kwa Mitsemphayi, akhoza pang'ono kuchepetsa mafupa mkono mu olowa.

Radiography amalola kusiyanitsa ndi wovulala dislocation. Kujambula ndidzakuwonetsa kumene isanafalikire chotupa cha Mitsemphayi wa chigongono. Chithandizo cha chotupa tsankho ndi chosakwanira wa ndiwofatsa a. Likukhudza immobilization kwa masabata angapo. A timapuma unapangidwa pulasitiki Mitsemphayi opaleshoni kuonongeka.

Mwachidule thunthu ya dzanja olowa

Lovuta dongosolo inapanga articular chichereŵechereŵe padziko mbale cheza ndi ulna ndi mkono ndi scaphoid, lunate ndi triangular mbali burashi. Pisiform fupa lili mkati mwa tendon ndi nawo mwachindunji mu mapangidwe olowa salandira.

Limbikitsani olowa Mitsemphayi asanu. The kanjedza ndi chigongono ndi dzanja mitsempha padziko kumbuyo - kumbuyo kwa gulu la burashi. Pa mbali ndi lateral palmar (kumbali ya chala chachikulu) ndi ulnar (chala mbali pang'ono) Mitsemphayi.

Kuwonongeka kwa Mitsemphayi wa dzanja ndi n'kukhala kwambiri kuposa Mitsemphayi chinang'ambika wa olowa phewa. Koma koposa Mitsemphayi chigongono.

Kuswa dzanja Mitsemphayi

Limagwirira wa zosayembekezereka kuvulala kugwirizana ndi kugwa mu patsogolo poyera dzanja kapena nkhonya kwa iye akufunitsitsa kapena anaweramuka burashi. Udindo wa dzanja pa nthawi ya avulala mwachindunji zogwirizana kudziwa za mitsempha mwina imawonongeka. Koposa zonse anavulala connective mosiyana ndi dongosolo khola la burashi lapansi.

Top mbali ya kuwonongeka mitsempha: ululu, edema, mkhutu ntchito olowa ndi minofu zofewa hematoma. Ngati pali ululu pa kayendedwe mu zala kapena dzanja izo kumawonjezera zikuchepa kumayambiriro mu olowa, angathe amaganiziridwa Mitsemphayi chinang'ambika wa dzanja olowa. Zizindikiro ndi lowonjezera ndi kafukufuku matenda a hardware: X-ray - kuti achotse fractures fupa, ultrasound ndi / kapena Kujambula. N'zofunika kudziwa chikhalidwe cha kuwonongeka kwa Mitsemphayi ndipo zimakhala zina zofewa ozungulira olowa.

Monga mmene zinalili ina, ngati pali kusiyana Mitsemphayi wa dzanja limodzi chithandizo kudzadalira choopsa zoipa. Mu wofatsa ndi zolimbitsa kusalekerera likukhudza ndiwofatsa pansi zolemera - ntchito strategy.

Kaya wotani kuwonongeka chinachitika, chimene chikhalidwe cha kuswa umphumphu wa nyumba limodzi olowa ndi kuvulazidwa, dzanja, m'zigongono, kapena pali tsankho kapena wathunthu chophukacho wa Mitsemphayi wa olowa phewa, mankhwala ayenera nthawi zonse kuperekedwa ndi katswiri. Kuvomerezedwa upo mu mbiri chipinda (fupa lothyoka chipatala ndi zoopsa ku chipatala kapena mu dipatimenti kulandiridwa ndi traumatological kuchipatala). Izi ndi zowona makamaka ndi zoopsa mwana, monga odwala wamng'ono, pali zinthu zingapo zochititsa obwera ndi ukalamba kuti akhoza chinthu ndi kuvulala kwambiri. Ndipo anachedwa kufunafuna kuchipatala woyenera angakhale ndi zotsatira zoipa yaitali.