Ukwaphuka kwesiseko se-Fifth Metatarsal

Unyango olungalunganga lwezaphuko zesiseko sesihlanu se-metatarsal lunokubangela ukwaphuka okungadibaniyo okanye ukulibaziseka kokudibana kwamalungu, kwaye iimeko ezinzima zinokubangela isifo samathambo, esinempembelelo enkulu kubomi bemihla ngemihla kunye nomsebenzi wabantu.

AyendaloSitrukture

I-metatarsal yesihlanu yinxalenye ebalulekileyo yekholamu esecaleni yonyawo, kwaye idlala indima ebalulekileyo ekuthwaleni ubunzima nasekuzinzeni konyawo. I-metatarsal yesine neyesihlanu kunye ne-cuboid zenza i-metatarsal cuboid joint.

Kukho imisipha emithathu enamathele kwisiseko se-metatarsal yesihlanu, i-peroneus brevis tendon inserts kwicala le-dorsolateral le-tuberosity kwisiseko se-metatarsal yesihlanu; imisipha yesithathu ye-peroneal, engaqinanga njenge-peroneus brevis tendon, ifakers kwi-diaphysis ekude ukuya kwi-metatarsal tuberosity yesihlanu; i-plantar fascia I-lateral fascicle inserts kwicala le-plantar le-basal tuberosity ye-metatarsal yesihlanu.

Ulwahlulo lwaphuka

Ukwaphuka kwesiseko se-metatarsal yesihlanu kwahlulwahlulwa nguDameron noLawrence,

Ukuqhekeka kweZone I kukuqhekeka kwe-avulsion ye-metatarsal tuberosity;

I-Zone II ifumaneka kunxibelelwano oluphakathi kwe-diaphysis kunye ne-proximal metaphysis, kuquka amalungu aphakathi kwamathambo e-metatarsal e-4 kunye ne-5;

Ukuqhekeka kweZone III kukwaphuka koxinzelelo lwe-proximal metatarsal diaphysis kude ne-4th/5th intermetatarsal joint.

Ngo-1902, uRobert Jones waqala ukuchaza uhlobo lokuqhekeka kwe-zone II kwisiseko se-metatarsal yesihlanu, ngoko ke ukwaphuka kwe-zone II kukwabizwa ngokuba yi-Jones fracture.

Ukuqhekeka kwe-avulsion ye-metatarsal tuberosity kwi-zone I lolona hlobo luqhelekileyo lokuqhekeka kwesiseko sesihlanu se-metatarsal, okubangela malunga ne-93% yazo zonke izaphuko, kwaye kubangelwa kukuguquguquka kwe-plantar kunye nobudlova be-varus.

Ukwaphuka kwethambo kwindawo yesi-2 kubangela malunga ne-4% yazo zonke iimfantu ezisezantsi kwe-metatarsal yesihlanu, kwaye zibangelwa kukujika kweenyawo kunye nokuxhatshazwa kwethambo. Ngenxa yokuba zifumaneka kwindawo apho igazi linikezelwa khona kwisiseko se-metatarsal yesihlanu, ukwaphuka kwethambo kule ndawo kunokubangela ukuba iimfantu zingabi namalungu okanye ukuba iimfantu ezibambezelekayo ziphinde ziphile.

Ukuqhekeka kweZone III kubangela malunga ne-3% yezaphuko zesihlanu zesiseko se-metatarsal.

Unyango olugcina indalo

Iimpawu eziphambili zonyango oluhlala ixesha elide ziquka ukushenxa kwamathambo angaphantsi kwe-2 mm okanye ukwaphuka okuzinzileyo. Unyango oluqhelekileyo lubandakanya ukungasebenzi ngeebhandishi ezithambileyo, izihlangu eziqinileyo, ukungasebenzi ngee-plaster casts, ii-cardboard compression pads, okanye izihlangu zokuhamba.

Iingenelo zonyango oluhlala ixesha elide ziquka iindleko eziphantsi, ukungabikho kokwenzakala, kunye nokwamkelwa lula zizigulane; iingxaki ziquka ukwanda kokwaphuka okungadibaniyo okanye iingxaki zomanyano olulibazisekileyo, kunye nokuqina kwamalungu okulula.

UtyandoTukugcinwa kwezindlu

Iimpawu zonyango lotyando lwe-fifth metatarsal base fractures ziquka:

1. Ukufuduka kwaphuka okungaphezulu kwe-2 mm;

1. Ukubandakanyeka kwe > 30% yomphezulu we-articular we-cuboid distal ukuya kwi-metatarsal yesihlanu;

1. Ukuqhekeka okuqhekekileyo;

1. Ukwahlukana okanye ukungadibani kwamalungu emva konyango olungelulo utyando oluqhutywa ngokwahlukana;

1. Izigulane eziselula ezikhutheleyo okanye abadlali bezemidlalo.

Okwangoku, iindlela zotyando ezisetyenziswa kakhulu xa kutyunyuzwa isiseko se-metatarsal yesihlanu ziquka i-Kirschner wire tension band internal fixation, i-anchor suture fixation enentambo, i-screw internal fixation, kunye ne-hook plate internal fixation.

1. Ukulungiswa kwebhendi yoxinzelelo lwentambo kaKirschner

Ukufakelwa kwebhendi yoxinzelelo lwentambo kaKirschner yindlela yotyando eqhelekileyo. Iingenelo zale ndlela yonyango ziquka ukufikelela lula kwizinto zokubopha zangaphakathi, ixabiso eliphantsi, kunye nesiphumo esihle sokucinezelwa. Iingxaki ziquka ukurhawuzelelwa lusu kunye nomngcipheko wokukhululeka kwentambo kaKirschner.

2. Ukufakelwa kwe-suture ngee-ankile ezinemisonto

Ukufakelwa kwe-anchor suture ngentambo kufanelekile kwizigulane ezine-avulsion fractures kwisiseko se-metatarsal yesihlanu okanye ezineziqwenga ezincinci zaphuka. Iingenelo ziquka ukunqunyulwa okuncinci, utyando olulula, kwaye akukho mfuneko yokususwa okwesibini. Iingxaki ziquka umngcipheko wokuqhekeka kwe-anchor kwizigulane ezine-osteoporosis.

3. Ukufakwa kwezipikili ezingenanto

Isikrufu esingenanto lunyango olusebenzayo oluqatshelwa kwihlabathi liphela lokuqhekeka kwesiseko se-metatarsal yesihlanu, kwaye iingenelo zaso ziquka ukuqina okuqinileyo kunye nozinzo oluhle.

Ngokwezonyango, kwiingozi ezincinci ezisezantsi kwe-metatarsal yesihlanu, ukuba kusetyenziswa izikrufu ezimbini zokubopha, kukho umngcipheko wokuqhekeka. Xa kusetyenziswa isikrufu esinye sokubopha, amandla okulwa nokujikeleza ayancitshiswa, kwaye ukutshintshwa kwendawo kunokwenzeka.

4. Ipleyiti yehoko ilungisiwe

Ukufakwa kwepleyiti yehoko kuneempawu ezahlukeneyo, ingakumbi kwizigulana ezinee-avulsion fractures okanye i-osteoporotic fractures. Uyilo lwayo luhambelana nesiseko sethambo lesihlanu le-metatarsal, kwaye amandla okucinezelwa kokufakwa aphezulu. Iingxaki zokufakwa kwepleyiti ziquka iindleko eziphezulu kunye nokulimala okukhulu.

SuMama

Xa unyanga ukwaphuka kwamathambo ezantsi kwe-metatarsal yesihlanu, kuyimfuneko ukukhetha ngononophelo ngokwemeko yomntu ngamnye, amava akhe kunye nenqanaba lobuchwephesha, kwaye uqwalasele ngokupheleleyo iminqweno yesigulana.