Ukuqhekeka kwesisekelo se-metatarsal yesihlanu

Ukwelashwa okungafanele kokuqhekeka kwesisekelo sesihlanu kweMetatarsal Base Fractures kungaholela ekuqhekekeni okungapheli noma inyunyana ukubambezeleka, futhi amacala abuhlungu angadala umthelela omkhulu empilweni nasemsebenzini wabantu nsuku zonke.

AunzomicalSI-Tructure

I-metatarsal yesihlanu iyingxenye ebalulekile yekholomu yamuva yonyawo, futhi idlala indima ebalulekile ekungeneni kwesisindo nokuqina konyawo. Ama-metatarsals wesine nelesihlanu kanye ne-Cu-id yakheka iMetatarsal Culoid Joint.

Kunamathamo amathathu anamathiselwe esisekelweni se-metatarsal yesihlanu, i-peroneus brevis tenson ifaka ohlangothini lwe-durolatal of the turoluty ezansi kwesisekelo se-metatarsal yesihlanu; Imisipha yesithathu ye-perineal, engaqinile njenge-peroneus brevis tendon, ifaka kwidayidi le-diaphlesis liye kwi-forth metatarval Truberoluty; I-plaplar fascia i-aarelial ifaka i-fascles esohlangothini lwesitshalo se-basal tuberoty ye-matatarsal yesihlanu.

Ukuhlukaniswa kwe-Fracture

Ama-fractures esisekelo se-metatarsal yesihlanu ahlukaniswa yi-Dameron kanye noLawrence,

I-Zone I Fractiseres yi-auvulsion fractures ye-metatarsal tukeloty;

I-Zone II itholakala ekuxhumekeni phakathi kwedayiso kanye ne-proximal metaphysis, kufaka phakathi amalunga phakathi kwamathambo we-4 nelesi-5;

I-Zone III Fractures iyingcindezi yokuphazamiseka kwe-proximal metatarsal diaphysis distrimal distep

Ngo-1902, uRobert Jones wachaza kuqala uchaze uhlobo lwe-Zone II Fracture yesisekelo se-metatarsal yesihlanu, ngakho-ke i-Zone II Fracture ibizwa nangokubizwa ngokuthi uJones Fracture.

Ukuqhekeka kwe-Avilsion kwe-MetatarSal Tuberoluty E-Zone I kuyinto evame kakhulu yohlobo lwe-Fifth Metatarsal Base Fracture, accounting cishe ama-93% awo wonke ama-fractures, futhi kubangelwa udlame lwe-plantar kanye nodlame lwe-varsus.

I-Fractures in Zone II cishe cishe ama-4% awo wonke ama-fractures esisekelweni se-metatarsal yesihlanu, futhi kubangelwa unyawo lwe-plantar nodlame lokungenisa. Ngoba zitholakala endaweni enamanzi yokuhlinzekwa kwegazi ezansi kwe-metatarsal yesihlanu, ukuqhekeka kule ndawo kuthambekele ekungatheni noma ukubambezeleka kokuphulukisa.

I-Zone III Fractures account cishe cishe ama-3% we-Fifth Metatarsal Base Fractures.

Ukwelashwa okulondoloziwe

Izinkomba eziyinhloko zokwelashwa ezilondoloziwe zifaka ukufuduka kokukhishwa okungaphansi kuka-2 mm noma ama-fleble fractures. Ukwelashwa okujwayelekile kufaka phakathi ukungasebenzi kahle kwamabhandethi anwebekile, izicathulo ezisebenza kanzima, ukungasebenzi kahle nge-plaster casts, amaphakethe wokucindezela amakhadibhodi, noma amabhuzu wokuhamba.

Izinzuzo zokwelashwa ezilondolozayo zifaka izindleko eziphansi, akukho thambekela, nokwamukelwa okulula yiziguli; Okubi kubandakanya ukuncishiswa okuphezulu kwe-fracture nonunion noma ukubambezeleka kwezinkinga zezinyunyana, kanye nokuqina okuhlanganyelwe okulula.

-OkuhlinzaTphendutha

Izinkomba zokuthola ukwelashwa kokuhlinzwa kwe-metatarsal base base fractures zifaka:

1. Ukuhanjiswa kwe-fracture okungaphezu kuka-2 mm;

1. Ukubandakanyeka kwe> 30% yobuso be-articular ye-ciboid distal ku-metatarsal yesihlanu;

1. Ukwaphuka okuhlanganisiwe;

1. I-Fracture ibambezele inyunyana noma i-nonunion ngemuva kokwelashwa okungaphuzi;

1. Iziguli ezincane ezisebenzayo noma abasubathi bezemidlalo.

Njengamanje, izindlela ezivame ukusetshenziswa zokuhlinzwa kwezisekelo ze-metatarsal yesihlanu zifaka i-kirschner wire tension band fixeration, i-anchor suture fixeration ngentambo, i-hook plate fixeration yangaphakathi.

1

Ukulungiswa kwe-Kirschner Wire Tension Fensication kuyindlela yokuhlinzwa yendabuko. Izinzuzo zale ndlela yokwelashwa zifaka ukufinyelela okulula kwezinto zokulungiswa kwangaphakathi, izindleko eziphansi, kanye nomphumela omuhle wokucindezela. Okubi kubandakanya ukucasuka kwesikhumba kanye nengozi ye-kirschner wire soning.

2. Ukulungiswa kokusungula ngamahange ane-threaded

Ukulungiswa kwe-anchor supure ngentambo kulungele iziguli ezinama-auvingsion fractures esisekelweni se-metatarsal yesihlanu noma ngezicucu ezincane ze-fracture. Izinzuzo zifaka ukuvela okuncane, ukusebenza okulula, futhi asikho isidingo sokususwa kwesibili. Okubi kubandakanya ubungozi bokuvela kwe-anchor ezigulini nge-osteoporosis. .

3. Ukulungiswa kwezipikili eziyize

I-Holeil Screw iyindlela efinyelelekayo yezwe lonke yokuqhekeka kwezisekelo zesisekelo se-metatarsal yesihlanu, futhi izinzuzo zawo zifaka ukulungiswa okuqinile nokuqina okuhle.

Ngokwenyama, kuma-fractures amancane ngaphansi kwe-metatarsal yesihlanu, uma kusetshenziselwa izikulufo ezimbili ukuze zilungiswe, kukhona ubungozi bokubuya. Lapho isikulufa esisodwa sisetshenziselwa ukulungiswa, amandla alwa nokujikeleza abuthakathaka, futhi abuye abuyele emuva.

4. Iplate ye-Hook ilungisiwe

Ukulungiswa kwepuleti ye-Hook kunezinkomba eziningi ezahlukahlukene, ikakhulukazi iziguli ezinama-avilsion fractures noma ama-osteoporotic fractures. Isakhiwo saso sokuklama sifana nesisekelo sethambo lesihlanu le-metatarsal, futhi amandla okucindezela okulungiswa aphezulu aphezulu. Okubi kokulungiswa kwepuleti kufaka phakathi izindleko eziphakeme kanye nosizi olukhulu kakhulu.

Sumzemari

Lapho ukwelapha ama-fractures esisekelweni se-metatarsal yesihlanu, kuyadingeka ukukhetha ngokucophelela ngokwesimo esithile somuntu ngamunye, isipiliyoni somuntu siqu sodokotela kanye nezinga lobuchwepheshe kanye nezinga lesiguli.