Ukuqhekeka kwe-distal radius yenye yezona zingozi zixhaphakileyo kwilungu lezonyango, ezinokwahlulwa zibe zincinci nezinzima. Kwiingozi ezingasuswanga kwindawo yazo, ukulungiswa okulula kunye nokuzilolonga okufanelekileyo kunokusetyenziswa ukuze kubuyiselwe impilo; nangona kunjalo, kwiingozi ezingasuswanga kwindawo yazo, kufuneka kusetyenziswe ukulungiswa ngesandla, ukufakelwa kwe-splint okanye i-plaster; kwiingozi ezinomonakalo ocacileyo nonzima kumphezulu we-articular, kufuneka unyango lotyando.
ICANDELO 01
Kutheni i-distal radius ithambekele ekuqhekekeni?
Ekubeni isiphelo esikude seradius yindawo yokutshintsha phakathi kwethambo elirhoxisiweyo kunye nethambo elincinci, libuthathaka. Xa isigulane siwa size sichukumise umhlaba, kwaye amandla adluliselwa engalweni engasentla, isiphelo esikude seradius siba yindawo apho uxinzelelo lugxininiswa khona, nto leyo ebangela ukwaphuka. Olu hlobo lokuqhekeka lwenzeka rhoqo ebantwaneni, kuba amathambo abantwana mancinci kwaye awanamandla ngokwaneleyo.
Xa isihlakala senzakele kwindawo ende kwaye intende yesandla yonakele kwaye yaphuka, ibizwa ngokuba yi-extended distal radius fracture (Colles), kwaye ngaphezulu kwama-70% abo balolu hlobo. Xa isihlakala senzakele kwindawo egobileyo kwaye umva wesandla wonakele, ibizwa ngokuba yi-flexed distal radius fracture (Smith). Ezinye ii-wrist deforms eziqhelekileyo zinokwenzeka emva kokuqhekeka kwe-distal radius, ezifana ne-"silver fork" deformity, "gun bayonet deformity", njl.
ICANDELO 02
Ziphathwa njani ii-distal radius fractures?
1. Ukunciphisa ngobuchule + ukufakelwa kweplasta + ukusetyenziswa kweoyile ekhethekileyo yamayeza esiTshayina aseHonghui
Kwinkoliso yezaphuko ze-distal radius, iziphumo ezanelisayo zinokufunyanwa ngokuncitshiswa ngokuchanekileyo ngesandla + ukulungiswa kweplasta + ukusetyenziswa kwamayeza emveli aseTshayina.
Oogqirha bamathambo kufuneka bathathe izikhundla ezahlukeneyo zokulungisa emva kokunciphisa ngokweentlobo ezahlukeneyo zokwaphuka: Ngokubanzi, ukwaphuka kweColles (uhlobo lolwandiso lwe-distal radius fracture) kufuneka kulungiswe kwi-5°-15° yokujika kwesundu kunye nokuphambuka okuphezulu kwe-ulnar; Smith Ukuqhekeka (ukuqhekeka kwe-flexion distal radius fracture) kwaqiniswa kwi-supination yengalo kunye ne-dorsiflexion yesandla. Ukuqhekeka kwe-dorsal Barton (ukuqhekeka komphezulu we-articular we-distal radius kunye nokuphuma kwesandla) kwaqiniswa kwindawo ye-dorsiflexion yelungu lesandla kunye ne-pronation yengalo, kwaye ukuqiniswa kokuqhekeka kwe-volar Barton kwakukwindawo ye-palmar flexion yelungu lesandla kunye ne-supination yengalo. Hlola rhoqo i-DR ukuze uqonde indawo yokwaphuka, kwaye ulungise ukuqina kweentambo ezincinci ze-splint ngexesha lokugcina ukulungiswa okusebenzayo kwe-slint encinci.
2. Ukufakelwa kwenaliti ejikeleze i-percutaneous
Kwabanye abaguli abangazinzi kakuhle, ukulungiswa kweplasta okulula akukwazi ukugcina indawo yokuqhekeka, kwaye ukulungiswa kwenaliti ye-percutaneous kudla ngokusetyenziswa. Olu cwangciso lonyango lungasetyenziswa njengendlela eyahlukileyo yokulungiswa kwangaphandle, kwaye lungasetyenziswa kunye neebrackets zeplasta okanye zokulungiswa kwangaphandle, okwandisa kakhulu ukuzinza kwesiphelo esiqhekekileyo kwimeko yokwenzakala okuncinci, kwaye luneempawu zokusebenza okulula, ukususwa lula, kunye nempembelelo encinci kumsebenzi welungu elichaphazelekayo lesigulana.
3. Ezinye iindlela zonyango, ezinje ngokunciphisa okuvulekileyo, ukulungiswa kwangaphakathi kweplate, njl.
Olu hlobo lwesicwangciso lungasetyenziswa kwizigulana ezineentlobo ezintsonkothileyo zokwaphuka kunye neemfuno eziphezulu zokusebenza. Imigaqo yonyango kukunciphisa ukwaphuka komzimba, ukuxhasa nokuqinisa iziqwenga zamathambo ezisusiweyo, ukufakelwa kwamathambo kwiziphene zamathambo, kunye noncedo lwangethuba. Imisebenzi yokusebenza ukubuyisela imeko yokusebenza ngaphambi kokwenzakala ngokukhawuleza.
Ngokubanzi, uninzi lwezaphuko zeradiyo ekude, isibhedlele sethu sisebenzisa iindlela zonyango ezilondolozayo ezifana nokunciphisa ngesandla + ukufakelwa kweplasta + ukusetyenziswa kweplasta ekhethekileyo yamayeza esiTshayina aseHonghui, njl.njl., enokufumana iziphumo ezilungileyo.
ICANDELO 03
Amanyathelo okuzikhusela emva kokunciphisa ukwaphuka kwe-distal radius:
A. Nika ingqalelo kwinqanaba lokuqina xa ulungisa ukwaphuka kwe-distal radius. Inqanaba lokuqina kufuneka libe lifanelekileyo, kungabi ngqongqo kakhulu okanye kungabi khululekile kakhulu. Ukuba iqinile kakhulu, iya kuchaphazela ukuhanjiswa kwegazi ukuya kwi-distal end, nto leyo enokukhokelela kwi-ischemia enzima ye-distal end. Ukuba ukuqina kukhululeka kakhulu ukuba kungabi nokukwazi ukuqinisa, ukutshintsha kwamathambo kunokuphinda kwenzeke.
B. Ngexesha lokulungiswa kwezaphuko, akufuneki uyeke ngokupheleleyo imisebenzi, kodwa kufuneka unikele ingqalelo ekuzilolongeni ngokufanelekileyo. Emva kokuba izaphuko zingasebenzi ixesha elithile, kuya kufuneka kongezwe intshukumo esisiseko yesandla. Izigulane kufuneka zigxininise ekuqeqeshweni yonke imihla, ukuze kuqinisekiswe ukuba umthambo usebenza kakuhle. Ukongeza, kwizigulane ezinee-fixers, ukuqina kwee-fixers kunokulungiswa ngokomlinganiselo womthambo.
C. Emva kokuba ukwaphuka kwe-distal radius kulungisiwe, qaphela indlela amalungu angaphandle aziva ngayo kunye nombala wolusu. Ukuba amalungu angaphandle kwindawo emiselweyo yesigulana abanda kwaye abe ne-cyanotic, imvakalelo iyawohloka, kwaye imisebenzi inciphile kakhulu, kuyimfuneko ukuqwalasela ukuba ingaba ibangelwa kukuqina kakhulu, kwaye kuyimfuneko ukubuyela esibhedlele ukuze kulungiswe ngexesha.
Ixesha lokuthumela: Disemba-23-2022
