Ukwaphuka we scaphoid: Izimpawu kanye Ukwelashwa

Ngokuvamile abantu baphuka izinqulu kubantu zenzeka kaningi ngokwanele. Ngokuvamile abalimala zomzimba. Ngokuvamile abantu baphuka izinqulu ezinjalo azilona usongo ekuphileni. Ezimweni eziningi, imithi yabo futhi okwalandela isikhathi zokutakula yimpumelelo.

Omunye lwezinhlobo ezivame kakhulu yokulimala kuyinto ukwa wethambo navicular. ICD wokubuyekeza 10 ababelwe lokhu S62.0 ikhodi umonakalo. I engavamile ngakho wukuthi lokhu kunzima kakhulu ukuhlonza ukwa. odokotela Abangenalwazi bajwayele ukuthatha umonakalo ngokulimaza ewubala nje, ngakho ukwelashwa unikezwa kahle. Esihlokweni lanamuhla sizochaza lokho izimpawu ahambisana ukwa wethambo navicular. Futhi, ukunaka kwakho izokwethulwa izindlela eyinhloko yokwelashwa.

inkomba yokwakheka

Navicular kubhekwa esinye sezici okubuhlungu kakhulu we esihlakaleni. Itholakala ohlangothini isithupha. Igama lakhe imfundo navicular liyadingeka ukwakha sifana isikebhe. Lasesihlakaleni emelelwa amathambo eziyisishiyagalombili ezincane, okuyinto yakha imigqa emibili. Ngamunye wabo phezu izakhi ezine. ithambo Navicular kungenziwa palpated bebodwa endaweni "snuffbox yokwakheka". Leli phuzu itholakala phakathi imisipha ye isithupha futhi nomthumbi imisipha.

Anatomy of the emalungeni namathambo we esihlakaleni ingenye ezinzima kakhulu umzimba wonke. Letakhi enze kube nokwenzeka ukuba enze ukunyakaza ezahlukene izindiza eziningana. Ngakolunye uhlangothi, nemisipha ukunikeza amandla amalunga omzimba. ithambo Navicular unesibopho ukudidiyela kanye ilungiselelo ezinye izakhiwo eziseduze. Ngakho-ke, umsebenzi wonke esihlakaleni sinqamukile ngesikhathi sayo.

Izimbangela izindlela umonakalo

Ukwa wethambo navicular avame kwenzeka ngenxa ekwindla isandla. Ngakho kukhona hyperextension e esihlakaleni. Ngakho-ke, kuyacaca ukuthi amaningi umthwalo uwela phezu scaphoid. Ezimweni ezingavamile ukulimala kuhlasimulise kuwumphumela ukuchayeka ngqo kulesi sakhiwo.

Iningi leziguli ukuthi nginesifo ukwa avaliwe ithambo navicular. Ukuba khona unokungaxhumani esikhumbeni kungadalwa izici ukuhlukumezeka. Ngokwesibonelo, lapho ehlela phezu kobuso enamadwala.

Ukulimala ithambo navicular ziyabonakala ngezindlela eziningana. Phakathi kwazo kunabafundi main kanje:

1. yokuhlukanisa transverse, okuyinto luhambisana nomthwalo kumiswa izingcezwana ezimbili ezifanayo ngosayizi.
2. Bone igebe ngasonqenqemeni.
3. Ukwa, ephelezelwa ukwakheka inqwaba izingcezwana bone ukufuduka. Uma kungenjalo, ibizwa ngokuthi comminuted.

Uma sikhuluma kwezimbangela eziyinhloko lezi ukulimala, ngokuvamile kwenzeka ngesikhathi kwezemidlalo noma ziwumphumela engozini yemoto.

emitholampilo isithombe

Ukwa wethambo navicular kunzima ngempela ukuxilonga. Lokhu kungenxa omnene isithombe emtholampilo. Ngakho kubalulekile ngokushesha ngemva ukulimala, funa usizo lukadokotela kanye kudlule luhlolo olunzulu. Lokhu kuzosiza ligweme izinkinga ezingase zivele esikhathini esizayo.

I ukubonakaliswa eyinhloko ukwa navicular zihlanganisa:

1. Ukubukeka ukuvuvukala endaweni ngayo. Ngokuhamba kwesikhathi, ungasabalalisa ezindaweni ngobubanzi.
2. Ukuba khona ubuhlungu phezu dorsum we esihlakaleni. Ukuqaleka yinto ngokuvamile nakakhulu lapho isandiso ngokuhlanganyela, noma ngokucindezela on endaweni ethintekile.
3. Ukwephula isandla usebenza ngokugcwele.
4. EBukhoneni hematoma kanye nokulimala ngenxa izitsha ukudabuka.

Izimpawu esibonisa Waphuka scaphoid esihlakaleni, zihlukahlukene. Nge ukuxilongwa okufanele neluhlolo efanele ngokomzimba ukusola inkinga kulula.

zosizo lokuqala

Ngemva kokulimala isisulu esiphuthumayo ukunikeza usizo lokuqala. isandla Okokuqala kufanele azame kubathene. Isandiso imisipha reflex ukungezwani noma kuvusa displacement izinsalela. Nazo ngokufanayo, ungaqhubeka ona kwezicubu ezithambile. Kufanele sibe sesimweni khulula hang isandla isikhafu noma endwangwini. Ngokuzimela kuvikelwe nge ibhulashi futhi isondo asifanele amabhandeshi. Noma yimuphi zokwelapha ngaphandle kokukhuluma nodokotela is ngokuphelele contraindicated. Uma kungenjalo, kungamane nje kusilimaze isisulu, ngokwanele ukuba avuse ukuthuthukiswa sengozini yokuthola izifo.

Yini engenziwa okudambisa ubuhlungu?

• Namathisela ukugoqa ice endaweni ethintekile. Gcina ibhandishi ukupholisa akufanele kube sekudlule imizuzu engaphezu kwengu-15, ngakho abangele frostbite. Njengoba cindezela angasebenzisa ice cubes, ibhodlela abandayo noma iqatha lenyama eqandisiwe. Phakathi kwaso ebusweni isikhumba kuyadingeka ukubeka indwangu. Asikwazi ukuvumela ingress condensate ethintekile ukuze enenxeba elivulekile.
• Thatha tablet analgesic kwezidakamizwa. Ngakho kubalulekile ukuba ulandele imiyalo ebiyelwe futhi ukugwema overdosing. Kungenjalo, imithi kungabangela ubuthi.

Kokuthutha isisulu, njengoba umthetho, kwenziwe ngendlu. Ungashayela ithimba bezempilo, uma kunesidingo. Ngisho ngaphansi kwaziphi izimo lapho kufanele kube ukunyakaza labatimele imoto umuntu osola at ukwa wethambo navicular. ubuhlungu Namandla kubangela ukwehla emakamu.

ukuhlola Izici

Uma ubona into eyodwa noma ngaphezulu izimpawu lwesigemegeme esibuhlungu, abaye ezichazwe ngenhla nje, kufanele ngokushesha ukufuna usizo kumuntu ofanelekayo. Kungcono xhumana traumatologist noma udokotela ohlinzayo.

Isinyathelo sokuqala Kuhlolisisa anamnesis. Isiguli okufanele ukuchaza ukuthi kwandulelwe scaphoid obonakele. Kungenzeka falling, ezemidlalo olunzulu noma impi yasekhaya. Futhi, udokotela wakho kudingeka yazi ngezinguquko izifo ngaphambilini idluliselwe of uhlelo zemisipha, ukulimala we esihlakaleni.

Ngemva kwalokho, onguchwepheshe ngokuvamile ihamba behlolwa. Ekuqaleni kwawo-lwembula nokuvuvukala kwendawo ethintekile, ubuhlungu ukungakhululeki ngemva palpation. Ngezinye izikhathi isiguli ucele agobe ngokuhlanganyela esihlakaleni, kuyilapho sokunaka ukunyakaza ikakhulukazi endaweni.

Uma udokotela esolwa ukwaphuka we navicular ithambo izandla, isiguli ithunyelwa X-ray. Inqubo ngempela kwenziwe Ubukhulu ezintathu. Ukuswelakala kokusebenza ngokuhlanganyela kwezinso sobala esithombeni akusho ukuthi abekho ngokoqobo. Kulokhu, isiguli sisetshenziswa Gypsum, okuyinto ayikwazi ukususwa kungakapheli amasonto amabili.

Emva kwalesi sikhathi iyaphindwa esifubeni. Kwaphela izinsuku ezingu-14 ngesikhathi ithambo ukuya ngenqubo rarefaction, futhi igebe phakathi izingcezwana kuzokhulisa kubonakale. ophukayo okunjalo ingathiwa phezu radiograph. Ngesisekelo uphethwe udokotela uye eyenziwa angenza ukusazi ngokunembile isifo esikuphethe, ukuhlinzeka izincomo ukwelashwa.

ukwelashwa okulondoloza

Ukwelashwa nokuvikelwa ukwaphuka we navicular ithambo ibhulashi incike ngobucayi ukulimala kanye nezinga umsebenzi isisulu. Hhayi indima okungenani kule eyadlalwa isifiso nesineke ukuze siphinde sithole ngokushesha.

Ekuqaleni kwawo-amasu ukuchayeka olandelanayo asetshenziswa ngaphandle ukufuduka. Ukuze ukwelashwa ku- joint isihlakala kanye umunwe lokuqala sisetshenziswa usimende. Ngebhandeshi ezigqokwayo cishe izinyanga ezimbili kuze ukwa akuyona srastetsya ngokuphelele. Ezinye iziguli aphikelele ngokuthi ukuhlinzwa ukunciphisa isikhathi immobilization bese alulame ngokushesha ukuxubha. Le ndlela yokwelashwa namanje kuyindaba yokukhathalelwa impikiswano phakathi odokotela abahlinzayo.

Ukwa yesithathu engezansi scaphoid ithambo aphulukise emasontweni 4-6. Le ngxenye ibhulashi libhekene ukuphakelwa kahle kwegazi, ngakho izinkinga nokubuyiselwa cishe ayenzeki.

Ukwa wesithathu maphakathi noma isigxobo proximal kudinga ukuphathwa eside. Lezi izindawo scaphoid ompofu liningi igazi. Coalescence isikhathi ixhomeke yobudala lesiguli, umzimba. Ngezikhathi, udinga ukuvakashela kudokotela. Ngo ikakhulukazi ezimweni ezibucayi kungadinga-esiteji-X-ray nakuma-CT scan ukuhlola ukuziphatha zokululama ebudlelwaneni.

Kungakhathaliseki endaweni eqondile Gypsum ukuhlukumezeka ukwa wethambo navicular sisetshenziswa zonke iziguli. Nakuba egqoke amabhandeshi, odokotela batusa:

• ukhawule ukuhamba esihlakaleni;
• ukulahla lo mdlalo;
• udle ukudla ukulinganisela;
• ulandele umbuso yomsebenzi kanye nokuphumula.

ого быстрее. Ngokweyame ezinhlinzekweni izincomo ngenhla inqubo ephulukisa ngizoya th isheshe.

kokungenela kuhlinzwa

Ngo ukufuduka okuphawulekayo izinsalela noma ingozi eliphezulu avascular necrosis iziguli Kunconywa ukuhlinzwa. Umgomo wayo lomkhulu - ekulinganiseni esitho ethintekile. Le ndlela kusiza sokubuyiselwa ekuseni kokuphakelwa kwegazi endaweni ethintekile, ukwa ukuphulukiswa.

Ukuhlinzwa is kuvame ukwenziwa esigulini esingalalisiwe esibhedlela nokusetshenziswa izinzwa zesifunda noma zendawo. Phakathi ukusebenza, udokotela kususa displacement izinsalela elungisa isikulufa yabo (nolwelwesi). Ukuze ukuhlola umphumela etholwe usebenzisa-X-ray umumo womsebenzi.

Sika senziwa ngemuva noma entendeni ohlangothini esihlakaleni. Ubukhulu bayo futhi kwasendaweni ethize kuxhomeke kulokho ingxenye ithambo navicular yabekwa ukuhlukumezeka. Offset iqedwe sasivumela kalula. Fresh Waphuka scaphoid thambo esihlakaleni ngokuvamile omiswe screw ngokusebenzisa imbobo ye-3-5 mm.

Uma umonakalo sroslos indlela engalungile idinga ukuba bucayi. Udokotela ohlinzayo lokuqala enza imbobo enkulu, okuvumela ukuba afeze osteotomy. Ngemva kwalokho, wabe kabusha anatomy kulungile bese elungisa ngezikulufo ithambo.

Lapho kukhona ukulimala amaningi, phakathi nokuhlinzwa, a xhumelela ekhethekile. Kuyinto inguqulo zokwenziwa ithambo izicubu. It ibekwe emhlabeni lesion. I milisa isetshenziselwa ukugqugquzela izicubu ukuphulukiswa inqubo.

isikhathi ekululameni

Lapho sitholakele "waphuka scaphoid ibhulashi" imigomo zokwelapha incike nokuvuselelwa uhlelwe kahle. izinqubo yokutakula ziqale Yiqiniso umzimba yokwelapha. Zonke umzimba ukukhethela uchwepheshe. Umgomo wabo oyinhloko - ukuqeda ukuqina kanye contracture. Ukuvuselelwa isikhathi kungenziwa ihlukaniswe izigaba ezintathu okunemibandela.

Ngesikhathi besanda kuqala LFK ephishekela imisebenzi elandelayo:

• ukuphumula imisipha endaweni ethintekile;
• ukuqedwa ubuhlungu;
• ukuqedwa ukopha;
• normalizing nokusakazwa uketshezi lymph;
• nokubuyiselwa izinqubo umzimba.

Lezi imigomo zikuvumela ukukhetha izivivinyo ephumelela kunazo. Njengomthetho, wasebenzisa umunwe flexion nokwelulwa, isiyingi futhi pendulum ibhulashi ukunyakaza. Lesi sigaba yokutakula sihlala 14 izinsuku.

Kusukela ngesonto lesithathu umsebenzi eziningana ukushintshwa. Manje yokuzijwayeza kuhloswe obusebenzayo yokutakula esitho zebanga ahlangene motion. Kuze kube yimanje, ke Kunconywa izakhiwo ahlukahlukene nge ibhola Gymnastic kanye emshinini.

Esigabeni sesithathu yezinhloso umsebenzi yokwelapha kukhona ukukhulisa ithoni wonke umzimba, ukuthuthukisa isimo abathintekayo. Iziguli avunyelwe umzimba kuyinkimbinkimbi: push-ups, donsa-ups, njalo njalo.

Ngemva ukwa ithambo scaphoid nokususa ukhonkolo Physiotherapy compulsorily esimisiwe (UHF, ukubhucungwa, upharafini zokugezela). A izindlela ekhethwe kahle ukuvuselelwa ungakwazi ukubuyisa ngokugcwele ukuhamba kanye nokwethulwa ngokuyiko kwezinhlelo esitho abalimala.

imiphumela kungenzeka

okuyikona wokulinyazwa kubaluleke kakhulu ngoba kukuvumela ukuthi uvimbele ukuthuthukiswa imiphumela engemihle. Ngaphezu kwalokho, abakwazi ukushiya ngaphandle kokwelashwa ukwa wethambo navicular. Ukwelapha eyenziwa ngasekupheleni, esongela ukubukeka ukuxakeka. Phakathi kwazo kunezinye njengabayingozi kakhulu yilezi:

1. Osteoarthritis we ngokuhlanganyela esihlakaleni. Lokhu zokugula kuhambisana olunzima ubuhlungu futhi ukuhamba elinganiselwe ezingalweni nasemilenzeni. Ezimweni sina ngokukhethekile, kuholela ukukhubazeka.
2. Okungafanele bone ukuphulukiswa. Ezimweni ezingavamile, izingcezwana ezilimele tho engela kancane. Isiguli e ngako kulendzaba kusho kwati eqinile ubuhlungu nokuhlukumezeka. Inkinga efanayo zingaxazululwa kuphela ngosizo operation entsha. Phakathi ukuhlinzwa kwenziwe kabusha scrapping ithambo ukuqondanisa tonkhe tincenye. Ngemva kwalokho, uqhubekele kabusha ithambo.
3. Necrosis. Against isizinda abampofu kwegazi ithambo kancane kancane ziyophela. Ngenxa yalokho asathuthuka ukuvuvukala, futhi ezimweni eziphambili ezingavela esibhibhayo. Ukuqeda ezinalesisifo zijwayele kudinga ukunqunywa okuphelele esandleni. Aseptic ifomu necrosis eba kancane kancane. Ezigabeni zokuqala akunakwenzeka ukubona, ngisho radiograph. ngemuva kwezinyanga 2-3 ukulimala wabonisa izimpawu evelele izifo. Isikhathi esining impela, londoloza ithambo akuseyona kungenzeka.

Kufinyeta

Ngokwezibalo, ukwa we scaphoid ngokuvamile kuba impela engabonwa. Ngakho-ke, lesi sifo ukuvela esingokwemvelo yezinkinga ezihlukahlukene. Imiphumela yaloku kuhlola okungenhla Esifike Ngesikhathi nokwelashwa abanekhono osemqoka kakhulu nokululama kwakhe ngokuphumelelayo. Kulokhu, ngokusebenzisa inqubo elungile ukuvuselelwa ayikwazi ukubuyisela ngokuphelele ukusebenza esitho.

Odokotela baxwayisa ukuthi ukwa wethambo navicular (ICD-10 - S62.0) kuyisifo esingathí sina esingase kakhulu. Bambalala futhi uzibe zako akufanele kube. Ukulimala nelilodwa ithambo ezincane kuholela ukuphazamiseka lonke esihlakaleni.