Ukuphuka Kwesisekelo Se-Metatarsal Yesihlanu

Ukwelashwa okungalungile kokuphuka kwesisekelo se-metatarsal kwesihlanu kungaholela ekuqhekekeni okungahlangani noma ekubambezelekeni kokuhlangana, futhi amacala amakhulu angabangela isifo samathambo, esinomthelela omkhulu empilweni yansuku zonke yabantu nasemsebenzini.

AngokwemveloSisakhiwoe

I-metatarsal yesihlanu iyisici esibalulekile sekholomu eseceleni yonyawo, futhi idlala indima ebalulekile ekuthwaleni isisindo nasekuzinzeni konyawo. I-metatarsal yesine neyesihlanu kanye ne-cuboid kwakha i-metatarsal cuboid joint.

Kunemisipha emithathu enamathele esisekelweni se-metatarsal yesihlanu, i-peroneus brevis tendon inserts ohlangothini lwe-dorsolateral lwe-tuberosity esisekelweni se-metatarsal yesihlanu; umsipha wesithathu we-peroneal, ongaqinile njenge-peroneus brevis tendon, inserts ku-diaphysis ekude kuya ku-metatarsal tuberosity yesihlanu; i-plantar fascia I-lateral fascicle inserts ohlangothini lwe-plantar lwe-basal tuberosity ye-metatarsal yesihlanu.

Ukuhlukaniswa kwamathambo

Ukuphuka kwesisekelo se-metatarsal yesihlanu kwahlukaniswa nguDameron noLawrence,

Ukuqhekeka kwe-Zone I kuwukuqhekeka kwe-avulsion kwe-tuberosity ye-metatarsal;

I-Zone II itholakala ekuxhumaneni phakathi kwe-diaphysis kanye ne-proximal metaphysis, kufaka phakathi amalunga aphakathi kwamathambo e-metatarsal e-4 ne-5;

Ukuqhekeka kwe-Zone III kuwukuqhekeka kokucindezeleka kwe-proximal metatarsal diaphysis ekude ne-4th/5th intermetatarsal joint.

Ngo-1902, uRobert Jones waqala ukuchaza uhlobo lokuphuka kwe-zone II kwesisekelo se-metatarsal yesihlanu, ngakho-ke ukuphuka kwe-zone II kubizwa nangokuthi ukuphuka kwe-Jones.

Ukuphuka kwe-avulsion kwe-metatarsal tuberosity ku-zone I uhlobo oluvame kakhulu lokuphuka kwesisekelo sesihlanu se-metatarsal, okubalwa cishe ku-93% wabo bonke ukuphuka, futhi kubangelwa ukugobeka kwe-plantar kanye nobudlova be-varus.

Ukuphuka kwethambo endaweni yesibili kubalelwa cishe ku-4% wabo bonke ukuphuka kwethambo phansi kwe-metatarsal yesihlanu, futhi kubangelwa ukugoba kwezinyawo kanye nobudlova bokudonswa kwegazi. Ngenxa yokuthi zitholakala endaweni yokugeleza kwegazi phansi kwe-metatarsal yesihlanu, ukuphuka kule ndawo kuthambekele ekungaxhumani noma ukuphuka okulibazisekile kuyaphola.

Ukuqhekeka kwe-Zone III kubalelwa cishe ku-3% wokuqhekeka kwesihlanu kwesisekelo se-metatarsal.

Ukwelashwa okulondolozayo

Izinkomba eziyinhloko zokwelapha ngendlela elondolozayo zifaka phakathi ukugudluka kwamanxeba okungaphansi kuka-2 mm noma ukuphuka okuzinzile. Izindlela zokwelapha ezivamile zifaka phakathi ukuvimba ukunyakaza ngamabhandeji anwebekayo, izicathulo ezinezithende eziqinile, ukuvimba ukunyakaza ngama-plaster casters, ama-cardboard compression pads, noma amabhuzu okuhamba.

Izinzuzo zokwelashwa okulondolozayo zifaka phakathi izindleko eziphansi, ukungabi nakulimala, kanye nokwamukelwa kalula yiziguli; izinkinga zifaka phakathi ukwanda kokuphuka kokungaxhumani noma izinkinga zokuhlangana okulibazisekile, kanye nokuqina kwamalunga okulula.

UkuhlinzwaTukubuyiselwa kwempahla

Izinkomba zokwelashwa ngokuhlinzwa kwe-fifth metatarsal base fractures zifaka:

1. Ukufuduka kokuqhekeka okungaphezu kuka-2 mm;

1. Ukubandakanyeka kwe-> 30% yobuso obuhlanganisiwe be-cuboid distal kuya ku-metatarsal yesihlanu;

1. Ukuphuka okuqhekekile;

1. Ukuhlangana kwamathambo okulibazisekile noma ukungahlangani ngemva kokwelashwa okungadingi ukuhlinzwa;

1. Iziguli ezisencane ezikhuthele noma abadlali bezemidlalo.

Njengamanje, izindlela zokuhlinzwa ezisetshenziswa kakhulu zokuphuka kwesisekelo se-metatarsal yesihlanu zifaka phakathi i-Kirschner wire tension band internal fixation, i-anchor suture fixation ngentambo, i-screw internal fixation, kanye ne-hook plate internal fixation.

1. Ukulungiswa kwebhendi yokucindezela ucingo lweKirschner

Ukufakwa kwebhande lokucindezela ucingo lweKirschner kuyindlela yokuhlinzwa evamile. Izinzuzo zale ndlela yokwelapha zifaka phakathi ukufinyelela kalula ezintweni zokubopha zangaphakathi, izindleko eziphansi, kanye nomphumela omuhle wokucindezela. Okubi kufaka phakathi ukucasuka kwesikhumba kanye nengozi yokukhululeka kwentambo yeKirschner.

2. Ukufakwa kwe-suture ngezikhonkwane ezinentambo

Ukufakwa kwe-anchor suture ngentambo kufaneleka ezigulini eziphukile e-avulsion phansi kwe-metatarsal yesihlanu noma ezinezingcezu ezincane eziphukile. Izinzuzo zifaka phakathi ukusikwa okuncane, ukusebenza okulula, kanye nokungadingeki kokususwa kwesibili. Okubi kuhlanganisa ingozi yokuwa kwe-anchor ezigulini ezine-osteoporosis.

3. Ukufakwa kwezinzipho ezingenalutho

Isikulufu esingenalutho siyindlela yokwelapha ephumelelayo eyaziwayo emhlabeni wonke yokuphuka kwesisekelo se-metatarsal yesihlanu, futhi izinzuzo zayo zifaka phakathi ukuqina okuqinile kanye nokuqina okuhle.

Ngokwezokwelapha, uma kuqhekeka okuncane phansi kwe-metatarsal yesihlanu, uma kusetshenziswa izikulufo ezimbili ukuze kuqiniswe, kunengozi yokuqhekeka. Uma kusetshenziswa isikulufo esisodwa ukuze kuqiniswe, amandla okulwa nokujikeleza ayancishiswa, futhi kungenzeka ukuthi kuphinde kufakwe endaweni yaso.

4. Ipuleti le-hook lilungisiwe

Ukufakwa kwe-hook plate kunezinkomba eziningi, ikakhulukazi ezigulini ezinamathambo aphukile noma amathambo aphukile. Isakhiwo saso sokwakheka sifana nesisekelo sethambo lesihlanu le-metatarsal, futhi amandla okucindezela ukuhlanganiswa aphezulu kakhulu. Okubi kokufakwa kwe-plate kufaka phakathi izindleko eziphezulu kanye nokulimala okukhulu.

Si-ummary

Uma welapha ukwaphuka kwamathambo phansi kwe-metatarsal yesihlanu, kubalulekile ukukhetha ngokucophelela ngokwesimo somuntu ngamunye, ulwazi lomuntu siqu lukadokotela kanye nezinga lobuchwepheshe, futhi ucabangele ngokugcwele izifiso zomuntu siqu zesiguli.