Wovulala scaphoid kuti: Zizindikiro ndi Chithandizo

Fractures anthu nthawi zambiri zokwanira. Kawirikawiri anavulala nthambi. fractures amenewa kuopseza moyo. Nthawi zambiri, mankhwala ndi nthawi kuchira wotsatira ali bwino.

Za mtundu wina ambiri kuvulala ndi wovulala fupa navicular. ICD 10 younikanso anatumizidwa izi kuwonongeka malamulo S62.0. The peculiarity wa ndi kuti zovuta kudziwa wovulala. madokotala wosadziwa zambiri kutenga kuwonongeka wovulalayu zazing'ono, kotero chithandizo wapatsidwa bwino. M'nkhani lero tidzalankhula kufotokoza zimene zizindikiro ali limodzi ndi wovulala fupa navicular. Komanso, ganizira Adzaperekedwa ku njira waukulu wa mankhwala.

Buku anatomical

Navicular ndi chimodzi mwa zinthu zambiri zoopsa za polumikizira. Malowa ali pamtunda pa mbali chala. dzina maphunziro ake navicular chofunika kupanga chokhala bwato. Dzanja umaimiridwa ndi mafupa eyiti laling'ono, limene kupanga mizere iwiri. Aliyense ali pa mbali zinayi. Navicular fupa akhoza palpated paokha m'dera la "anatomical snuffbox". Mfundo isanafalikire pakati pa tendons ya chala chachikulu ndi abductor minofu.

Matenda a zimfundo ndi mafupa a dzanja ndi imodzi mwa zovuta kwambiri m'thupi lonse. nyumba izi n'zotheka kuchita izikhala mu ndege angapo. Komano, Mitsemphayi amapereka mphamvu mafupa. Navicular fupa ndi udindo kwa mugwirizano ndi dongosolo la nyumba ina yapafupi. Choncho, ntchito ya dzanja lonse wosweka nayenso ake.

Zimayambitsa ndi njira kuwononga

Wovulala fupa navicular zambiri kumachitika chifukwa kugwa mu dzanja. Choncho pali hyperextension mu polumikizira. Choncho, zambiri za katundu imagwera pa scaphoid lapansi. Nthawi zina zoipa zoopsa chifukwa cha kukhudzana mwachindunji dongosolo lino.

Ambiri odwala matenda ndi chatsekedwa wovulala fupa navicular. Pamaso pa mipata pakhungu bwino zimayamba ndi zinthu zoopsa. Mwachitsanzo, pamene kugwa padziko miyala.

Kuwonongeka kwa fupa navicular ali m'njira zingapo. Ena mwa iwo ndi yaikulu motere:

1. Yopingasa yogawikana, amene kumatanthauza mapangidwe zidutswa ziwiri zofanana ndi kukula.
2. Bone kusiyana pa mphepete.
3. Wovulala, limodzi ndi mapangidwe ambiri zidutswa ndi fupa kusamutsidwa. Apo ayi, amatchedwa comminuted.

Ngati ife kulankhula za mavuto akuluakulu amene amayambitsa kuvulala izi, iwo amayambira pa masewera kapena chifukwa cha ngozi.

chithunzi matenda

Wovulala fupa navicular ndi kovuta matenda. Ichi ndi chifukwa chithunzi wofatsa matenda. Kotero ndikofunika yomweyo pambuyo choipa, kupempha thandizo kwa dokotala ndipo pochitika tinafotokoza mwatsatanetsatane. Izi zingathandize kupewa mavuto m'tsogolo.

Mawonetseredwe waukulu wovulala navicular monga:

1. Maonekedwe a kutupa m'dera ankachitira. Pa nthawi, ingafalire ku madera onse.
2. Pamaso pa ululu pa dorsum wa polumikizira. The kusapeza zambiri poipa pamene olowa kutambasuka, kapena kukanikiza pa zinkakhala m'dera.
3. Kulakwila ntchito dzanja zonse.
4. Kukhalapo kwa hematoma ndi kufinya chifukwa ziwiya chophukacho.

Zizindikiro amakhala zikukhudza scaphoid dzanja, zosiyanasiyana. Ndi matenda enieni ndiponso moyenera thupi muone akuganiza vuto n'kosavuta.

choyamba-chithandizo

Pambuyo kuvulazidwa kwa wozunzidwayo kukufunikira kupereka thandizo. dzanja Choyamba ayesetse kugwetsa. Extension reflex minofu mavuto kapena imautsa kusamutsidwa makombo fupa. Nawonso, akhoza zina sizingavulaze zimakhala zofewa. Ziyenera kukhala mu malo ufulu popachika dzanja pa mpango kapena chidutswa cha nsalu. Paokha wotetezedwa kudzera burashi ndi tayala si oyenera nsalu. chithandizo chilichonse popanda kufunsa dokotala mwamtheradi contraindicated. Apo ayi, inu mukhoza kuvulaza ochitiridwayo, zokwanira imautsa chitukuko cha mavuto aakulu.

Kodi tingatani kuti kupweteka?

• Angagwirizanitse Manga ayezi kwa zinkakhala m'dera. Kusunga bandeji yozizira sayenera kuposa mphindi 15, kuti chifukwa frostbite. Monga compress akhoza kugwiritsa ntchito ayezi cubes, botolo madzi ozizira kapena chidutswa cha nyama mazira. Pakati pa izo ndi Pamwamba pa khungu m'pofunika kuyala nsalu. Tisalole ingress wa zakhudzana condensate kuti pachilonda.
• Tengani piritsi chomwa mankhwalawa analgesic. Choncho m'pofunika kutsatira malangizo unazunguliridwa ndi kupewa overdosing. Apo ayi, mankhwala zingachititse poizoni.

Yonyamula ochitiridwayo, monga ulamuliro, ikuchitika nyumba. Mungathe kuitana gulu la zachipatala, ngati n'koyenera. Mulimonse mmene payenera kukhala gulu palokha pa galimoto munthu amene akuganiza pa wovulala fupa navicular. ululu amphamvu zimayambitsa kuchepa ndende.

diagnostics Features

Pamene inu muwona zizindikiro chimodzi kapena zingapo zoopsazo, amene yatchedwa pamwamba basi, muyenera yomweyo kupempha thandizo oyenerera. Ndi bwino kufunsa munthu traumatologist kapena dokotala.

Chinthu choyamba matenda ndi anamnesis. Wodwala ayenera kufotokoza zimene unachitika zowonongeka scaphoid. Kungakhale kugwa, tamaliza masewera kapena nkhondo zoweta. Komanso, dokotala wanu ayenera kudziwa za matenda kale anasamutsa a dongosolo minofu ndi mafupa, kuvulala kwa polumikizira.

Kenako, katswiri zambiri chimatsatira kuona thupi. Kumayambiriro anaulula kutupa mu zinkakhala m'dera, ululu kusapeza pambuyo palpation. Nthawi zina wodwala anafunsa kukhotetsa dzanja limodzi pamene powasamalira kayendedwe makamaka m'deralo.

Ngati dotolo amaganiziridwa wovulala ndi navicular manja fupa, mtima uli anatumiza kwa X-ray. Ndondomeko kwenikweni ikuchitika miyeso itatu. Chosowa kuvutika apeza chithunzi sikutanthauza kuti kulibe kwenikweni. Pankhaniyi, wodwalayo umagwiritsidwa gypsum, amene sakhoza kuchotsedwa mu masabata awiri.

Itatha nthawi iyi akubwerezedwa pachifuwa. Kwa masiku 14 nthawi fupa ipyole pa ndondomeko ya rarefaction, ndipo kusiyana pakati pa makombo zingawonjezere chimaonekadi. Chotero wovulala ndi zikhoza kuganiziridwa pa radiograph lapansi. Pamaziko a matenda dokotala wakhala akugwira akhoza kupanga matenda zolondola, kupereka malangizo chithandizo.

mankhwala ndiwofatsa

Chithandizo cha fupa lothyoka la navicular burashi fupa zimadalira kusalekerera kuvulazidwa ndi mlingo wa ntchito za wovulalayo. Osati ntchito osachepera mu izi ankaimba ndi chilakolako cha wodwala kuchira msanga.

Kumayambiriro ndiwofatsa njira kukhudzana ndi ntchito popanda kusamutsidwa. Chithandizo pa za dzanja olowa ndi chala choyamba umagwiritsidwa pulasitala. Bandeji amupatse pafupi miyezi iwiri mpaka fupa lothyoka si srastetsya kwathunthu. Odwala ena amaumirira ndi opaleshoni kuchepetsa immobilization nthawi ndi achire mwamsanga bwezerani. Njira imeneyi mankhwala akadali ndi nkhani ya kusamvetsetsana pakati pa madokotala.

Wovulala wachitatu m'munsi mwa scaphoid amachiritsa fupa masabata 4-6. Mbali imeneyi ya burashi ndi amakhala ndi wabwino kotunga mwazi, mavuto ndi kubwezeretsedwa pafupifupi zimachokeradi.

Wovulala wachitatu pakati kapena mzati proximal amafuna mankhwala yaitali. Mbali zimenezi za scaphoid ali ndi osauka magazi okwanira. Coalescence nthawi kwakukulukulu zimadalira m'badwo wodwala, ndi kupukusa chakudya. Nthawi muyenera kukaonana ndi adokotala kuti akuoneni. Mu makamaka nkhani yaikulu kungafune gawo X-ray ndi CT mapanga sikani kuti aone khalidwe la ayambe mphamvu.

Kaya yofunika gypsum zoopsa wovulala fupa navicular umagwiritsidwa odwala onse. Atavala nsalu, madokotala amalangiza:

• asagwiritse sayenda wa polumikizira;
• kusiya masewera;
• kudya chakudya chamagulu;
• kutsatira ulamuliro wa ntchito ndi zina.

ого быстрее. Mutu kuti malangizo pamwamba kuchiritsa ndondomeko adzapita mofulumira kwambiri TH.

alowererepo opaleshoni

Mu Amowabu kusamutsidwa makombo fupa kapena chiopsezo avascular necrosis odwala akulimbikitsidwa opaleshoni. cholinga Aika - ziziyenda nthambi akhudzidwa. Njira imeneyi facilitates kubwezeretsa oyambirira a kapezedwe magazi kwa zinkakhala m'dera, fupa lothyoka machiritso.

Opaleshoni nthawi anachita pa outpatient maziko ntchito mankhwala ochititsa dzanzi dera kapena m'deralo. Pa ntchito, adokotala amachotsa kusamutsidwa makombo fupa atakhazikitsa wononga awo (analili). Kuonanso bwino chifukwa analandira ntchito X-ray mapindidwe akuwala.

Dulani pa tsiku kumbuyo kapena mbali kanjedza a polumikizira. kukula kwake ndi kutanthauzira yeniyeni zimadalira gawo la fupa navicular chinaperekedwa ku zoopsa. Kuchepetsa inathetsedwa mwachilungamo mosavuta. Mwatsopano zikukhudza scaphoid fupa la polumikizira zambiri mulibe wononga ndi kudzera ang'ambe thupilo pafupifupi 3-5 mm.

Ngati kuwonongeka sroslos njira yolakwika amafuna yaikulu kwambiri. The dokotala woyamba akupanga ang'ambe thupilo lalikulu, amene amalola kuti akachite zinthu osteotomy. Kenako, akupitiriza angakwanitse thunthu olondola, ndipo kenako atakhazikitsa ndi zomangira fupa.

Pamene wavulala, pa opaleshoni, ndi kumezanitsa wapadera. Ndi Baibulo kupanga minofu fupa. Izo aikidwa padziko chotupa cha. kumezanitsa ntchito yotithandiza minofu machiritso ndondomeko.

nthawi kuchira

Pamene matenda a "zikukhudza scaphoid burashi" mawu a chithandizo kwakukulukulu amadalira mwadongosolo konzanso. njira kuchira kuyamba ndi kuyamba kuchita zinthu zolimbitsa thupi mankhwala. Zochita zonse amasankha katswiri. cholinga chawo chachikulu - kuthetsa stiffness ndi contracture. nthawi konzanso akhoza kugawidwa mu magawo atatu makonzedwe.

Pa siteji koyamba LFK akuthamangitsa ntchito zotsatirazi:

• yosangalala a minofu zinkakhala m'dera;
• Kupha kuwawa;
• Kupha kukha mwazi;
• normalizing kufalitsa madzi lymphatic;
• kukonzanso njira kagayidwe kachakudya.

zolinga izi amakulolani kunyamula Zochita yabwino kwambiri. Monga ulamuliro, ntchito chala flexion ndipo powunikiridwa m'chiphiphiritso, zozungulira ndipo pendulum burashi kuyenda. imeneyi kuchira kumatenga 14 masiku.

Kuyambira Msabata lachitatu la masewera olimbitsa thupi angapo kusinthidwa. Tsopano olimbitsa umalimbana zinchito nthambi achire komanso osiyanasiyana anzake a apaulendo. Kuti zimenezi zitheke, yovomereza maofesi osiyanasiyana ndi gymnastic mpira ndipo pa makina.

Mu gawo lachitatu la zolinga zolimbitsa mankhwala ayenera kulera kamvekedwe ka lake lonse, kusintha maganizo anakhudzidwa. Odwala saloledwa Zochita zovuta: Kankhani akuluakulu, kukokera akuluakulu, ndi zina zotero.

Pambuyo fupa lothyoka la scaphoid fupa ndi kuchotsa osewera mokakamiza yoikidwiratu physiotherapy (UHF, zofikisa, paraffin osambira). A njira loyenera la konzanso ingathandize kubwezeretsa kuyenda kwambiri ndi dzuwa la nthambi anavulala.

zotsatira zotheka

Olondola matenda a choipa n'kofunika kwambiri chifukwa zimathandiza kupewa chitukuko cha kukumana ndi mavuto. Komanso, sangachoke popanda mankhwala wovulala fupa navicular. Mankhwalawa ikuchitika mochedwa, kuopseza maonekedwe matendawo. Mwa iwo amaonedwa owopsa ndi:

1. Nyamakazi ya dzanja olowa. kudwala Izi limodzi ndi woopsa ululu ndi kusuntha pang'ono mu nthambi. Nthawi makamaka lalikulu, tidzapeza chilema.
2. Kusagwiritsa fupa machiritso. Nthawi zina, makombo kuonongeka zinaphatikizidwa pa ngodya pang'ono. Wodwala Pankhaniyi akukumana amphamvu ululu nkhawa. A nayenso angathe kuthetsedwa popanda thandizo la ntchito watsopano. Pa opaleshoni anachita kukonzanso scrapping fupa mayikidwe zinthu zonse. Pambuyo pake, chitani ndikasendeza fupa.
3. Necrosis. Against maziko a kapezedwe osauka magazi kwa fupa ndi pang'onopang'ono. Chifukwa cha kukhala ndi ndondomeko yotupa, ndipo nthawi zapamwamba pangabuke chilonda. Kuthetsa matenda kawirikawiri umafuna amputation wathunthu manja. Aseptic necrosis mawonekedwe akufotokozera pang'onopang'ono. Mu masiteji koyamba sikutheka onani, ngakhale pa radiograph a. miyezi 2-3 pambuyo choipa anasonyeza zizindikiro kutchulidwa matenda. Nthawi zambiri, koma fupa ndi zosatheka.

kuti adzimvera

Malinga ndi kafukufuku, wovulala scaphoid zambiri amaona ndithu. Choncho, matenda ndi chibadidwe maonekedwe a mavuto osiyanasiyana. Panthawi yake matenda ndi mankhwala woyenera ndi kiyi kuchira bwino. Pankhaniyi, ntchito ndondomeko yolondola ya konzanso sangathe kwathunthu kubwezeretsa magwiridwe a nthambi.

Madokotala kuchenjeza kuti wovulala fupa navicular (ICD-10 - S62.0) ndi nthenda yoopsa kwambiri. Amanyalanyaza ndi kunyalanyaza mawonetseredwe ake sayenera. Kuwonongeka kwa fupa wochepa zambiri zimabweretsa kusokoneza dzanja lonse.