Ukwa esandleni: Izimpawu, Sifo Nokuselapha

Akekho ogonyiwe ngenxa yokulimala, kuhlanganise sina. Ngakho izakhamuzi kungase kungasheleli ngaso sonke sithole ngobucayi umonakalo nomphumela, okuyinto ebalulekile ukwelashwa esifike ngesikhathi. Ukwa shayela akuyona ngaphandle, ngoba ngezinye izikhathi isisulu ingabe ukuthi ithambo siphukile. Ngenxa yalesi sizathu, kubalulekile ukuhlola ukhiye izimpawu ukuphumelela.

Ingqikithi inkinga

Ebusika noma lapho yokuphila asebenzayo ayikwazi ayifakiwe ukuwa oluqinile, ukugxila ibhulashi. It is yigalelo elinzima futhi singasetshenziswa kule ndawo kwesandla, isibonelo, ukwenziwa.

Kulezi izinhlobo nemiphumela ayikwazi wabusa ibhulashi ukwa.

Ukulimala yalolu hlobo ingase ibe izinhlobo ezintathu:

• Ngokuvamile abantu baphuka izinqulu lamathambo metacarpal;
• phalanges (okuvame kakhulu);
• isihlakala amathambo.

Asikwazi singalinaki iqiniso ukuthi ukwa ngezinye izikhathi kuhambisana shift, okuyinto igcwele yezinkinga ezengeziwe, ngakho uma kukhona imiphumela on the ibhulashi, okwabangela eziningi ubuhlungu, udinga ukubona udokotela.

Ukwahlukaniswa izifo

Mhlawumbe hhayi wonke umuntu uyazi ngakho, kodwa emkhakheni wezokwelapha kukhona ngezigaba international izifo. Kulesi simiso, idatha isifo ngasinye nezinhlobo zalo inikezwa ikhodi othize, okuboniswe izinombolo kanye namagama.

I-ICD isihlakala Waphuka ibekwe esigabeni S00-T98 (izihlokwana phezu 60 kuya 69 th), okuyinto izinikele ukulimala, ubuthi kanye nezinye imiphumela yethonya zangaphandle. Kule ngxenye ngezigaba international baloba yonke efanele izinhlobo waphuka, isihlakala kuhlasimulise futhi isandla (okokuqala, okwesibili ithambo metacarpal, isithupha, ezindaweni eziningi, njll).

Ngala idatha kungenzeka ukunquma ngokunembile uhlobo eqondile ukwa nifake abanekhono, ukusazi ngokunembile isifo esikuphethe.

izimpawu

Ukwa shayela Kunzima miss, kodwa namanje sikubiza izici ezithile ngeke bavunyelwe ukudida ke ngenxa yokulimala.

Okokuqala, ake ukuchaza izimpawu eziyinhloko:

• uma uzama ukuqondisa iminwe kukhona ubuhlungu obukhulu;
• ohlangothini emuva akha ukuvuvukala obonakalayo;
• Uma ukuhlukumezeka okukhulu zingase zibe zimbi isimo jikelele we isisulu itholiwe;
• e ibhulashi ukusonteka lubonakale.

Kulokhu, isikhumba kuba bluish, futhi ubuhlungu okungase kuthintwe hhayi kuphela e ukwelulwa iminwe, kodwa futhi phakathi ikhona, ngisho ezincane, ukunyakaza.

Navicular futhi metacarpals

Ngemva ukulimala kulezi zingxenye shayela ngemva kwesikhashana yabonakala edema ukwenza noma yikuphi ukunyakaza eziyinkinga. Uma inhloko babe Waphuka amathambo metacarpal, kanye ukusonteka ukuvuvukala uzovela ngemuva esandleni, ngokuqondile kwisayithi yokulimala.

Kodwa isihlakala ephukile ku scaphoid kungaholela yezinkinga ngaphezu nemiphumela esemqoka umbhalo wokulinyazwa. Ezimweni eziningi, nomonakalo onjalo is phetho ekwindla, ngesikhathi lapho wagcizelela onesandla esaphukileyo. Ngenxa yalokho, ngizwa ubuhlungu zenzeka ngasesinqeni se shayela kusukela ohlangothini isithupha. Kulokhu, ubuhlungu lingachazwa ngokuthi bezwe izinhlungu, njalo, Ivolumu ephansi. Deformation at ukulimala okunjalo akukhona, nokuvuvukala, nakuba kukhona kodwa okuncane. Lapha sithola umnyombo wale nkinga.

Lapho isisulu ngemva kokuwa engazizwa nezinhlungu ezinzima kanti akukho izibonakaliso ukusonteka uhlangothi, namanje kude ukugcwaliseka ukuthi ukwa iphutha. Ngenxa yalokho, yonke into zingancishiswa self-ukuxilongwa futhi ngaphandle usizo lochwepheshe lodokotela oqeqeshiwe. Kwezinye izimo, isisulu enquma ukuya kudokotela ngemuva kwezinyanga ezimbalwa kusukela esikhathini lapho esihlakaleni eziphukile etholwe. Ukulimala namanye amathambo, ngaphezu scaphoid futhi metacarpal, eqoshiwe kakhulu kuyaqabukela.

Kuwufanele nazi ukuthi zona lezo waphuka nemihuzuko Uyi izimpawu ezimbalwa ezivamile: ukuvuvukala futhi abukhali noma ezidabukile ubuhlungu. Ngakho-ke, emva kokuwa noma ezinye amandla kwangaphandle kuyadingeka noma kunjalo ukuvakashela esibhedlela.

Uma ukwa zase zihleliwe ibhulashi offset, kungenzeka adinga kokungenela op, okungukuthi nenkanuko edlulele kanye ekuhleleni kabusha. Leli qiniso waphinda kugcizelela isidingo sokuzibophezela uphethwe ngesikhathi esifanele.

Izici waphuka zezingane

Ekuqaleni, kufanele sinake kakhulu iqiniso lokuthi le organic compounds emathanjeni yezingane siphezulu kunamanye ukuthi abantu abadala. Ngenxa yalokho, igobolondo evikela ithambo (periosteum), Ubuye ubulukhuni kangcono futhi kuyaqina. Lezi zici ukuvumela izingane ukuba baphathe isandla eziphukile ngendlela ehlukile.

Lezi umehluko ezilandelayo kusuka kokulimala e abadala:

1. Iziguli abasebasha abangontanga ngemva ukulimala kungaba ekutilungisa emaphutsa ukuchema kuzo asalile. Lokhu kuchazwe ikhono ukusebenza ezifana asebenzayo imisipha kanye nokukhula ngokushesha of amathambo izicubu.

2. Izindwangu izakhiwo ezilimele ezinganeni uyalulama ngokushesha kakhulu futhi kulula kuka abantu oseqinile ngenxa ukubukeka esasizosheshisa ka calluses futhi ezingeni lelisetulu kwegazi periosteal.

Ngokuvamile abantu baphuka izinqulu 3. Wezingane zihlukaniswa yokuthi ukulimala Kunjengokulinda eguqa noma ukwa ithambo. Ngenxa yalesi sizathu, ukuhamba kancane izingcezwana amathambo izinsalela.

Lapho enhlekeleleni enjalo ingane kuyakuba khona ukukhala uhlale ujabule kubonakale. Ezinye izindaba zika- isandla ngemuva ukwa ezinganeni ushintsho efanayo e abadala (ukuvuvukala, ukulahlekelwa ukuhamba, deformity, ubuhlungu, ukuvuvukala, njll).

Kusobala ukuthi umzimba wengane ukuze silulame ukulimala kalula, kodwa akusho ukuthi ungakwazi aphathe kancane umbuzo yokwelashwa. Ukubamba iqhaza lodokotela kuleli cala, ngempela, futhi ngokushesha ngangokunokwenzeka.

zosizo lokuqala

Uma emva ukulimala izibonakaliso sici ukwa, kumelwe ukulungele ukwenza izinyathelo ezimbalwa ezilula, kodwa obalulekile.

Okokuqala kubalulekile ukuthi isisulu thatha amaphilisi ezinhlungu, ngemva kwalokho-ke kuyodingeka silungise ibhulashi. Lezo uzomvikela endaweni elimele ekulimaleni eyengeziwe ngenxa ukunyakaza ngaphandle kokubonisana nomkayo. Uma kwenzeka siba ukubhekana ukwa evulekile komsebenzi wokuqala kwenziwe - ukuyeka ukopha, futhi ngokushesha.

Esinye isinyathelo esibalulekile - ukususwa ibhulashi ezilimele noma iyiphi ngemihlobiso. Izinyathelo ezinjalo zingenzeka ngenxa ukuphazamiseka mechanical kunyatheliswa emasongweni ingcindezi noma iziphandla. Ngaphezu kwalokho, lapho uzobe zokuzikhukhumeza, ukususa imihlobiso kuyoba nzima kakhulu.

Uma kukhona ukwa of a ngomunwe ibhulashi, kufanele usetshenziswe endaweni ezilimele abandayo futhi ngaleyo ndlela ukubambezela ukubukeka edema. Lesi senzo futhi ukunciphisa lokujabulela ubuhlungu.

ukuhlola

Ukuze sithole izici ukulimala kudingeka ekuqaleni ngiphendukele udokotela ohlinzayo ukuhlukumezeka owazi nesineke ngenxa yokulimala, zizodingida isandla nangemva palpation ukuqondisa kuhlolisiswa radiographic.

Indlela yokugcina, ngasendleleni, kubaluleke kakhulu, ngoba ivumela ukuhlukanisa a dislocation ukwa shayela noma ukulimala engaba. Iphuzu eliyinhloko ukuthi kumugqa ophezulu amathambo carpal ixhunywe ngokuhlanganyela uvumelanise, uma umonakalo okuyinto anganikeza ubuhlungu isihlakala.

Esimweni esinjalo, ukukhomba endaweni ethintekile ngaphandle-X-ray kuyoba yinkinga kakhulu. ungenza siphetfo lesicacile ngesisekelo lolu lwazi: ukuphathwa ngayo ekhaya ngemva kwanoma iyiphi ukulimala isandla kanye ibhulashi ngaphezulu - iphutha elingathí sina.

ukwelashwa

Ezimweni eziningi, ukuhlinzwa wokulinyazwa isandla ayidingekile. Ukuze yokutakula ikhiqize kakhudlwana okusheshayo abalimele izinsalela awashintsheki yi-band, eyehlela kaningi bafike endololwaneni.

ngemva nenkanuko edlulele ezifana izinsuku ezingu-7 kwenziwa ibhulashi-X ray. Lokhu kwenza kube nokwenzeka ukunquma indlela ezilimele endaweni aphulukise. Ibhandishi isuswe ezimweni eziningi emasontweni 4-5.

Uma lwaphuka umunwe (ndlela yokuhlasela yokuhlanganisa izihlangu eyodwa) ngaphandle kokuthatha ihlangothi, ukunqunywa imilenze izosetshenziswa njengoba izinyathelo zokulungisa.

Esimeni lapho sisebenzelana ophukayo wethambo lokuqala metacarpal, wenza kabusha udoti, futhi izinsuku ezimbili emva ukulimala. Ingasetshenziselwa zokuthola usimende, izikhonkwane kanye izinaliti. Ukuze ukulimala ngaphandle ukufuduka nezinye amathambo metacarpal ngemva ukunciphisa kuyoba usimende kwanele.

Ngokuqondene ukwa wethambo navicular, impatho salo siyisinqumo esinzima kunazo zonke. Ezimweni eziningi, ukulungisa kahle usimende, kodwa ngaso sonke isikhathi. Kuyaphawuleka ukuthi ukuba aphathe lesi ukulimala kuba nzima nakakhulu uma umugqa ukwa sidlula amathambo emzimbeni. Kulokhu, yokutakula zingase zephuze izinyanga.

Uma kufanele aphathe umunwe wakho, i-ukulungisa kuphela ndlela yokuhlasela yokuhlanganisa izihlangu ezilimele, le nkulumo ubuncane. Isikhundla umunwe uzimisele.

Ngezinye izikhathi kufanele aphathe ukwa kakhulu. Offset ibhulashi, sibonelo, singasetjentiswa kakhulu izinkinga inqubo yokutakula. Indlela ephumelela kunazo zonke ukuchayeka kulokhu kwamathambo noma avaliwe. Esinye isici nezinkinga ungase ube ukwa evulekile, okuyiwona ukwelashwa usebenzisa kokungenela kuhlinzwa, noma kunalokho, isikhumba ngokuxhunyelelwa.

yokutakula

Iziguli eziningi ufuna ukwazi ukuthi ukugcina ukusebenza walo ibhulashi ngemva ukwa nokululama kwayo. Umphumela ngezindlela eziningi umuntfu kweyeme etinyatselweni letitsatfwa izisulu ngokwabo. Ukuze Dice usuphinde njengoba mobile njengakuqala ukulimala, badinga njalo ukuthuthukisa. Kodwa ukuqala umsebenzi onjalo kunengqondo kuphela ngemva kwadokotela kwatholakala ukuthi amathambo welapha.

Ukuqala inqubo nge yokutakula umzimba ukukhanya kangcono (flexion-isandiso, Ukujikeleza Palm et al.). kuvevezela ngenkathi contraindicated. Udinga ukuzibandakanya emasontweni ambalwa azayo. Kwezinye izimo, umuntu alulame ngokugcwele kuzodingeka basebenze kanzima phezu isimo ibhulashi phakathi nezinyanga eziyisithupha.

Lokhu kufanele agweme noma iziphi isinyathelo - zonke izivivinyo futhi ufake umfutho owengeziwe yabo kanye nesikhathi okumele wavumelana udokotela ukuba khona.

Imiphumela

Ukwa esihlakaleni - lena ukulimala ezimbi kakhulu, okuyinto kakhulu nzima imisebenzi ebalulekile lohlaselwayo. Kodwa le nkinga lunganqotshwa uma unelungelo lokukhalaza odokotela kanye wakufanelekela ukuqala ukwelashwa.