Ukuphuka kwentamo yehlombe: izimbangela, izimpawu, ukuxilongwa kanye nokwelashwa

I-humerus bone ivumela umuntu ukuba enze ukunyakaza okuningi, ukuphakama kwalo okungahluka. Noma yikuphi ukulimala kule ndawo kuphazamisa kabi umsebenzi wehlombe, okuvimbela ngokuphawulekayo isigqi sokuphila. Zingathinta izingxenye ezihlukene zesakhiwo esinesibindi. Ngokuvamile, odokotela bahlonza ukuphuka kwentamo yehlombe. Mayelana nezici kanye nezindlela eziyisisekelo zokwelapha inkulumo efanayo ye-traumas izongena ku-athikili yanamuhla.

Usizo lwe-Anatomic

I-humerus iyisakhiwo se-tubular eside. Iphakathi kwe-elbow nesifunda se-foreleg, kodwa iqukethe i-diaphysis ne-epiphyses emibili. I-Metaphyses iyindawo ehlukile yesikhashana phakathi kwalezi zingxenye. Ukuphela okuphezulu kwethambo kuboniswa yinhloko ye-articular, efana nebhola. Ngokushesha ngezansi yizintambo ezithintekayo zehlombe. Ukuhlukumeza okukhulu kule ndawo kuyinqaba kakhulu.

Ngaphansi kwetende lehlombe kukhona ama-tubercles amakhulu nezincane, lapho amathenda afakwe khona. Ngaphansi kwabo, "umngcele" uhlukanisa i-diaphysis yethambo kanye nokuphela kwayo. Leli gama libizwa ngokuthi "intamo yokugcoba ehlombe". Yile ndawo eyingozi kakhulu.

Ukuhlukaniswa kwezinto ezichazwe ngokwehlukana zibe yizigaba ezimbili kunalokho kunemibandela. Zibonakala ngesithombe esivamile somtholampilo. Ngakho-ke, odokotela banquma ukuwahlanganisela eqenjini elilodwa - ukuphuka kwentamo yokugaya ehlombe.

Izimbangela eziyinhloko zokulimala

Isizathu esiyinhloko sokwehlukana kwalolu hlobo kubhekwa njengomphumela ongaqondile wangempela. Isibonelo, uma uwela esihlakaleni noma ku-elbow. Kulesi simo, i-humerus igoba futhi ngesikhathi esifanayo ukucindezela kuyo kukhula eduze kwe-axis. Ezimweni ezingavamile, ukulimala kungumphumela wethonya lomzimba ngqo.

Ukwehlukana kwentamo yokugqoka ehlombe kujwayelekile ikakhulukazi kwabesifazane asebekhulile. Abesifazane abangaphezu kweminyaka engama-50 basengozini enkulu yokulimala ngenxa yezici eziningana:

• Isikhathi sokwemvelo futhi sithuthukise ukugula kwamathambo esizinda;
• Shintsha esakhiweni samathambo.

Imvelo yomonakalo inqunywa indawo yesikhumba ngokushesha ngesikhathi sokuwa. Ngenxa yalokhu, ukuphuka kwentamo yehlombe kukhishwa, kukhishwa kanye nokuthunjwa. Cabanga ukuthi yiziphi izinketho ezimele.

Ukuphulwa kwesikhashana

Phakathi kwazo zonke ukulimala okulimazayo lezi zinhlobo zingavamile kakhulu. Uma isandla sisendaweni engathathi hlangothi, kodwa kunomphumela womshini, ukuphazamiseka okuphambene okutholakala kuyatholakala. I-peripheral bone element ingena entanyeni ye-articular, yenza intamo ephukile ehlombe. Kuhlale kuvaliwe.

Ukwenyuka kokuncipha

Ukuhlukunyezwa okunjalo ngokuvamile kubangelwa ukuwela engalweni egobileyo. Umhlanganiso wesigqoko unesicindezelo esikhulu. Ngenxa yokuhamba kwezimbambo ezingezansi, ingxenye ye-shoulder distal yehlombe yenza ukunciphisa okukhulu. Bonke abanye abanakho ukuhamba okufanayo, ngakho-ke bakhonza njengehlobo lwe-fulcrum endaweni engaphezulu yehlombe. Ngakho, kuhlanganiswa i-lever, ephethe i-humerus. Ikhanda elihlangene lihlala endaweni yalo, ngoba idivayisi ye-ligament capsule ivimbela ukuhlukaniswa okufakelwayo. Ngenxa yalokho, kukhona ukwehluleka kokunciphisa kwentamo yehlombe.

Ngengozi yalolu hlobo, i-fragment ephakathi yethambo iqhubekela phambili, futhi i-peripheral eyodwa - ngaphandle nangaphezulu. I-angle yenziwa phakathi kwabo, evula ngaphakathi.

Ukuqothulwa kwephutha

Umonakalo onjalo ungenzeka uma uwela esandleni sokuhoxiswa. Kulesi simo, amandla okucindezela akhula ngesikhathi esisodwa. I-peripheral bone element ishintshwe ngaphakathi. Ingqimba yalo yangaphandle yenza ukuthi ukuphenduka kwegceke eliphakathi libe yindawo yokunciphisa. Futhi lo mkhuba uhamba kancane uye phambili. Ngenxa yalokho, i-angle evulekile yenziwa.

Isithombe somtholampilo

Ngemuva kokuthola ukuphuka, kufanele uhambe ngokushesha emnyangweni wezokuthungathaza esibhedlela esiseduze. Njengomthetho, isithombe somtholampilo esifanayo sibonisa ukulimala entanyeni yehlombe. Okokuqala, isisulu sizwa ubuhlungu obukhulu endaweni yokuhlukana. Ayikwazi ukunqotshwa ngama-analgesics avamile. Kudinga usizo lwamaphilisi aqinile, angatholakala kuphela esibhedlela.

Ezindaweni ezihlangene zehlombe, isandla esilimele silahlekelwa ukusebenza kwayo, kepha ukuhamba kwe-flexion ku-elbow ngezinye izikhathi kugcinwa. Isihluthulelo ngokuvamile sithatha isilonda esigulayo ngesandulela. Ngemizamo yokuhamba, uqala ukuzwa ubuhlungu obunzima.

Ukubonakala kokujoyina akuguquki. Ngokuqothulwa kwephutha, kungase kube "i-wiggling", njengokususwa kwehlombe. Indawo yokulimala ikhula ngokushesha kakhulu. Ngemva kwesikhashana, kukhona i-hematoma, ubukhulu bezinye izikhathi obufinyelela usayizi omkhulu.

Kakhulu kunzima ukuphuka kwentamo yehlombe nokuhamba. Kulesi simo, izingxenyeni zethambo zingakwazi ukucindezela izicubu ezizungezile kanye nezinqwaba zemithambo yegazi, okubangela izimpawu ezilandelayo:

• Kubonakala ukuvuvukala kwesilungu;
• Ukukhubazeka;
• Ukuthuthukiswa kwe-aneurysm;
• I-Neurosis yezicubu ezithambile.

Uma kwenzeka ukuphuka okuphazamisekile, isithombe somtholampilo ngokuvamile sivuthiwe, futhi ayikho isifo sobuhlungu. Ngenxa yalokho, isisulu singase singasolisi izinsuku eziningana ukuba khona kokulimala futhi singafuni usizo lwezokwelapha.

Izindlela zokuxilongwa

Uma kukhona ukusola kokuphuka, kufanele uxhumane nomnyango wesifo sofuba esibhedlela esiseduze. Ekuqaleni, udokotela kufanele ahlole isisulu, achaze izikhalazo ezikhona kanye nezimo zomonakalo. Emva kwalokhu, kunezibalo eziningi ezengeziwe zokuhlolwa eziqokwe ukuze zithole ukutholakala okunembile.

Okufundiswa kakhulu yi-radiography yebhande lehlombe. Izithombe kufanele zenziwe ngezilinganiso ezimbili: axial futhi ngqo. Uma kwenzeka imiphumela engabaza, i-CT ingadingeka. Uma kukhona ukusola kwe-intra-articular fracture, ukuhlolwa kwe-ultrasound kunqunywe.

Usizo lokuqala kumuntu ohlukunyeziwe

Inhloso eyinhloko yokuhlinzeka usizo lokuqala kumuntu ohlukunyezwe ukubhekana nesifo sobuhlungu. Futhi kuyadingeka ukuzama ukuvimbela imilenze eyalimala. Esikhathini sokuqala, asikwazi ukwenza ngaphandle kosizo lwe-analgesics. Cishe yonke ikhabhinethi yemithi yekhaya ine "Keterol", "Analgin" noma "Nimesulid." Isilinganiso semithi kufanele sikhethwe ngokuhambisana nemiyalelo ehlanganiswe nemithi.

Uma kungekho ndlela yokwenza i-X-ray ekhokhelwe futhi uqiniseke ukuthi ubuhlungu bokulimala, ngaphambi kokuya esibhedlela, kunconywa ukuthi ungasilondolozi isitho. Ukuze wenze lokhu, ungenza ibhande le-bandage kusuka ezintweni ezifakiwe. Kuye, noma yisiphi isambatho noma i-shawl, ingubo yokugqoka. Ngefomu, kufanele ifane nexantathu ye-isosceles. Ibhande le-bandage kufanele lisetshenziswe ngendlela yokuthi lisekela ingalo elugqeni.

Izici zokwelapha

Kufanele kube yimithi yokwelapha "ukuphuka kwentamo yehlombe" ukwelashwa, udokotela unquma. Kulesi simo, kumele acabangele ubudala benduli, uhlobo lokulimala kwakhe kanye nokutholakala kweziqephu zokuhamba. Ngakho-ke, ukwelapha kungaba yindlela yokuzimela noma yokuhlinzwa. Ezinye iziguli zinconywa ukulandelwa kwezidumbu. Ukwelashwa kokuphuka kweziguli asebekhulile kuhlukile kakhulu. Lo magazini kufanele ucatshangelwe ngokwehlukana.

Ukwelashwa kwephutha ngaphandle kwempawu zokuhamba

Ngokwehluleka okungaqondakali, ukwelashwa okwelashwa kunconywa. Okokuqala, udokotela wethula isifo sokubulala umzimba endaweni ye-hematoma, bese eqala ukusebenzisa i-gypsum loom ku-Turner. Ukuphoqeleka okunamandla kwesigungu esiphukile kuvimbela ukuthuthukiswa kwezivumelwano. Ukugqoka ama-longots kunconywa amaviki angu-4.

Isigaba esilandelayo sokwelashwa kuhilela ukuqokwa kwamaphilisi kanye ne-UHF. Ngenyanga yokuqala, isiguli sinconywa isethi yokuzivocavoca okuyi-static. Ukuze kutholakale ngokuqondile endaweni yokuqhekeka, i-phonophoresis ne-electrophoresis nemithi isetshenziswa.

Ngemuva kwamasonto amane okungaqedi, baqala ukuvuselela okusebenzayo. Ngale njongo kungenzeka ukubhekana nanoma yisiphi isikhungo sokunakekelwa okuvuselelayo lapho ochwepheshe bangathatha khona uhlelo lwezenzo ngabanye. Ngokuvamile, ukuphulwa okungahambi kahle, izinqubo ezilandelayo zinconywa:

• Ukubhuka;
• Ukwelashwa kwe-Laser;
• Izicelo ngeparafini;
• Ukuvivinya umzimba;
• UV irradiation;
• I-Balneotherapy;
• DDT.

Ukukhubazeka emva kokulimala okunjalo kubuyiselwa emuva kwezinyanga ezimbili.

Ukwelashwa kokuphulwa nokuhamba

Umonakalo onjalo udinga ukwelashwa esibhedlela. Ezimweni eziningi, kusetshenziselwa izindlela ezizenzekelayo. Udokotela osebenzisa i-anesthhesia yendawo noma ejwayelekile wenza kuqala ukuphindaphinda kwe-manual. Kuqhutshwa ngephambano ehlukile ukusuka endleleni yokulimala. Kulesi simo, i-peripheral bone element iqhathaniswa ne-central fragment.

Inqubo ngokwayo iyenziwa endaweni ejwayelekile. Udokotela ohlinzayo kancane kancane wenza konke okusebenzayo futhi uqondisa izenzo zabasizi. Ngemva kokuqedela, i-bandage noma i-gypsum lingeta isetshenziselwa isilonda esilimele.

Isikhathi sokungasebenzi kahle kwe-fracture ene-displacement cishe izinyanga ezimbili. Udokotela kumele aqaphele inqubo yokutakula. Ngenxa yalokhu, isiguli kufanele ngaso sonke isikhathi sithathe izithombe zehlombe. I-X eyayikhokhelwayo ikuvumela ukuba uthole imiphumela esheshayo. Ezikhungweni zezokwelapha zamahhala, isithombe singathathwa ngosuku olulandelayo. Ukukhathazeka ngokuvamile kuvame ukubuyela evamile emavikini ayishumi.

Izici zokwelapha iziphuzo kubantu asebekhulile

Ezimweni eziningi izindlela zokuzivikela ezisetshenziselwa ukuqeda ukwephulwa kwentamo ehlombe ezigulini asebekhulile. Ngomonakalo wokukhushulwa, ukulungiswa kwangaphambili kwesigungu samasonto amane kuboniswa. Uma kwenzeka umonakalo ongavamile, izinyathelo zokudoba ziqala kuqala, bese ziqala ukungasebenzi. Kwezinye izimo, ukungenelela kokuhlinzwa kuyadingeka.

Ngokuphathelene ne-anesthesia yendawo ethintekile, kukhona neminye imikhawulo. Isibonelo, umthamo we-anesthetic kufanele ukhethwe okungenani. Uma kungenjalo, amathuba okuthuthukisa ukusabela okungafuneki okungafuneki ngendlela ye-hypotension noma isizungu seyanda. Ukwelapha futhi kusho ukuqokwa kwazo zonke iziguli ngaphandle kokungafani nemithi eminingi. Okokuqala, lezi zithako ze-calcium nemithi yokuthuthukisa ukujikeleza kwegazi. Umphumela omuhle ovela kubo ubonakala uma ukuphuka kwentamo yehlombe kuqala ukukhula ndawonye.

Kulaba asebekhulile, isikhathi sokuphumula emva kokulimala okunzima cishe cishe izinyanga ezingu-2-3. Ubude benkathi yokuvuselela ngokuyinhloko kunqunywa isimo jikelele sesiguli, umsebenzi owanele wezimoto. Lesi sikhathi sanda kakhulu uma isisulu sinenkinga enkulu yezempilo. Phakathi kwenani elikhulu lama-pathologies angelapheki, ingozi enkulu kakhulu yisifo sikashukela.

Ukungenelela kokuhlinzwa akuvamile ukuthi iziguli ezisebekhulile zinezintambo ezisehlathini. Ukuvuselelwa, futhi kulokhu, kude kakhulu. Njengomthetho, isikhathi salo cishe izinyanga ezintathu. Ngokungenelela okunjalo, ingozi yokuthola izinkinga ezithathelwanayo iyanda kakhulu. Ukuqala kwe-thromboembolism kule minyaka ngokuvamile kuholela ekufeni.

Ukuphuka komlomo wesibeletho nemiphumela yayo

Izinkinga emva kokulimala kwalolu hlobo zivame kakhulu. Zingakhonza njengomphumela wokwelashwa okungenele (ukuphulwa okungalungile okufakiwe, i-pseudoarthrosis). Ngezinye izikhathi imiphumela emibi yokuhlukunyezwa ingenxa yempembelelo endaweni ehlombe. Isibonelo, i-fractures ivame ukulimaza izigulane namathenda, imisipha kanye nokuphela kwezinzwa. Ngenxa yalokho, ukuphuma kwegazi kwenzeka, ukuphazamiseka okusebenzayo noma kwezinzwa emlenzeni olimele.

Ukukhipha amathuba aphezulu kulezi zinkinga, kuyadingeka ukuba ufune usizo lwezokwelapha ngokushesha uma usola ukuhlukunyezwa. Ngemva kokudlula ukuhlolwa, udokotela uzokwazi ukunikeza ukwelashwa okwanele, uma kudingeka. Ukugxila okumele kubhekelwe kwinqubo yokuvuselela. Uma kwenzeka izinkinga eziyinkimbinkimbi, kungcono ukuxhumana nesikhungo esikhethekile sokunakekelwa kokuvuselelwa, ochwepheshe bazo bazokwazi ukukhetha uhlelo oluphumelelayo kunazo zonke ukulungiswa komsebenzi wesandla.