Ukuphuka kwe-distal radius kungenye yezingozi ezivame kakhulu emalungeni emtholampilo, ezingahlukaniswa zibe zincane nezinzima. Kwama-fracture angasuswanga kahle, ukulungiswa okulula kanye nokuzivocavoca okufanele kungasetshenziswa ukuze kutholakale ukululama; noma kunjalo, kwa-fractures asuswe kakhulu, kufanele kusetshenziswe ukunciphisa ngesandla, i-splint noma i-plaster fixation; kwa-fractures enomonakalo osobala nomkhulu ebusweni be-articular, ukwelashwa ngokuhlinzwa kuyadingeka.
INGXENYE 01
Kungani i-distal radius ithambekele ekuqhekekeni?
Njengoba ingxenye ekude ye-radius iyindawo yokuguquka phakathi kwethambo elikhanseliwe nethambo eliqinile, iba buthaka kakhulu. Lapho isiguli siwa futhi sithinta umhlabathi, futhi amandla adluliselwa engalweni engenhla, ingxenye ekude ye-radius iba yindawo lapho ukucindezeleka kugxile khona kakhulu, okuholela ekuqhekekeni. Lolu hlobo lokuqhekeka lwenzeka kaningi ezinganeni, ngoba amathambo ezingane mancane futhi awanamandla ngokwanele.
Uma isihlakala silimele endaweni ende futhi intende yesandla ilimele futhi yaphuka, kubizwa ngokuthi i-extended distal radius fracture (Colles), futhi abangaphezu kuka-70% babo balolu hlobo. Uma isihlakala silimele endaweni egobile futhi ngemuva kwesandla kulimele, kubizwa ngokuthi i-flexed distal radius fracture (Smith). Ezinye izimo ezivamile zesihlakala zivame ukwenzeka ngemva kokuphuka kwe-distal radius, njengokukhubazeka kwe-"silver fork", ukukhubazeka kwe-"gun bayonet", njll.
INGXENYE 02
Kuphathwa kanjani ukuphuka kwe-distal radius?
1. Ukunciphisa ngobuqili + ukubopha ngeplasta + ukusetshenziswa kwamafutha emithi yendabuko yaseShayina yaseHonghui okuyingqayizivele
Ngeningi lamacala okuqhekeka kwe-distal radius, imiphumela eyanelisayo ingatholakala ngokunciphisa okunembile ngesandla + ukufakelwa kwe-plaster + ukusetshenziswa kwemithi yendabuko yaseShayina.
Odokotela abahlinzayo bamathambo badinga ukusebenzisa izikhundla ezahlukene zokuqinisa ngemuva kokunciphisa ngokwezinhlobo ezahlukene zokuphuka: Ngokuvamile, ukuphuka kweColles (uhlobo lokwandiswa kwe-distal radius fracture) kufanele kulungiswe ku-5°-15° yokugoba kwesundu kanye nokuphambuka okuphezulu kwe-ulnar; Smith Ukuphuka (ukuphuka kwe-flexion distal radius fracture) kwaqiniswa ekubambeni ingalo kanye nokugoba kwesandla. Ukuphuka kwe-dorsal Barton (ukuphuka kobuso obuhlangene be-distal radius ngokuphuma kwesandla) kwaqiniswa endaweni yokugoba kwesandla kanye nokuphinyiswa kwengalo, kanti ukugoba kwe-volar Barton fracture kwakusendaweni yokugoba kwesandla kanye nokugoba kwengalo. Buyekeza njalo i-DR ukuze uqonde indawo yokuphuka, futhi ulungise ukuqina kwezintambo ezincane ze-splint ngesikhathi ukuze ugcine ukulungiswa okusebenzayo kwe-splint encane.
2. Ukufakwa kwenaliti emhlane
Kwabanye iziguli ezingakwazi ukuzinza kahle, ukufakwa kweplasta okulula akukwazi ukugcina isikhundla sokuphuka kahle, futhi ukufakwa kwenaliti ye-percutaneous kuvame ukusetshenziswa. Lolu hlelo lokwelapha lungasetshenziswa njengendlela ehlukile yokufakwa kwangaphandle, futhi lungasetshenziswa kanye nama-plasta noma ama-bracket okufakwa kwangaphandle, okwandisa kakhulu ukuzinza kwengxenye ephukile uma kwenzeka ukulimala okulinganiselwe, futhi lunezici zokusebenza okulula, ukususwa okulula, kanye nomthelela omncane emsebenzini wesitho esithintekile sesiguli.
3. Ezinye izindlela zokwelapha, njengokunciphisa okuvulekile, ukulungiswa kwangaphakathi kwepuleti, njll.
Lolu hlobo lohlelo lungasetshenziswa ezigulini ezinezinhlobo eziyinkimbinkimbi zokuphuka kanye nezidingo eziphezulu zokusebenza. Izimiso zokwelapha ukunciphisa ukuphuka komzimba, ukusekela nokuqinisa izingcezu zamathambo ezisusiwe, ukufakelwa kwamathambo eziphazamiso zamathambo, kanye nosizo lokuqala. Imisebenzi yokusebenza yokubuyisela isimo sokusebenza ngaphambi kokulimala ngokushesha okukhulu.
Ngokuvamile, ngeningi lamacala okuqhekeka kwe-distal radius, isibhedlela sethu sisebenzisa izindlela zokwelapha ezilondolozayo njengokunciphisa ngesandla + ukubopha i-plaster + ukusetshenziswa kwe-plaster yemithi yesiShayina yendabuko yaseHonghui okuyingqayizivele, njll., okungaletha imiphumela emihle.
INGXENYE 03
Izinyathelo zokuphepha ngemva kokunciphisa ukuphuka kwe-distal radius:
A. Naka izinga lokuqina lapho ulungisa ukuphuka kwe-distal radius. Izinga lokuqina kufanele lifaneleke, kungabi lukhuni kakhulu noma lungakhululeki kakhulu. Uma kuqinile kakhulu, kuzothinta ukuhlinzekwa kwegazi emkhawulweni okude, okungaholela ekushayweni kwegazi okukhulu komphetho okude. Uma ukuqina kukhululekile kakhulu ukuba kunikeze ukuqina, ukushintsha kwamathambo kungase kwenzeke futhi.
B. Ngesikhathi sokulungiswa kokuphuka kwemisipha, akudingekile ukuyeka ngokuphelele imisebenzi, kodwa futhi kudingeka unake ukuzivocavoca okufanele. Ngemva kokuba ukuphuka kwemisipha sekuvinjelwe isikhathi esithile, kuzodingeka kufakwe ukunyakaza okuyisisekelo kwesihlakala. Iziguli kufanele zigcizelele ukuqeqeshwa nsuku zonke, ukuze kuqinisekiswe umphumela wokuzivocavoca. Ngaphezu kwalokho, ezigulini ezinezilungisi, ukuqina kwezilungisi kungalungiswa ngokuya ngamandla okuzivocavoca.
C. Ngemva kokuba ukuphuka kwe-distal radius sekulungisiwe, naka umuzwa wemilenze ekude kanye nombala wesikhumba. Uma imilenze ekude endaweni eqondile yesiguli iba bandayo futhi i-cyanotic, umuzwa uba mubi, futhi imisebenzi ilinganiselwe kakhulu, kubalulekile ukucabangela ukuthi ngabe kubangelwa yini ukuqina kakhulu, futhi kuyadingeka ukubuyela esibhedlela ukuze kulungiswe ngesikhathi.
Isikhathi sokuthunyelwe: Disemba 23-2022
