Kuphulika kwa Base of The Fifth Metatarsal

Kuchiza kolakwika kwa magawo asanu a metatarsal base fractures kungayambitse kusweka kosagwirizana kapena kuchedwetsa mgwirizano, ndipo milandu yoopsa ingayambitse nyamakazi, yomwe imakhudza kwambiri moyo wa tsiku ndi tsiku wa anthu ndi ntchito.

Awa natomicalStructure

Metatarsal yachisanu ndi gawo lofunika kwambiri la phazi la phazi, ndipo limagwira ntchito yofunikira pakulemera ndi kukhazikika kwa phazi.Metatarsal yachinayi ndi yachisanu ndi cuboid amapanga metatarsal cuboid joint.

Pali ma tendon atatu omwe amamangiriridwa kumunsi kwa metatarsal yachisanu, peroneus brevis tendon imayika pa dorsolateral mbali ya tuberosity pansi pa metatarsal yachisanu;minofu yachitatu ya peroneal, yomwe siili yolimba ngati peroneus brevis tendon, imayika pa diaphysis distal mpaka yachisanu ya metatarsal tuberosity;The lateral fascicle imalowetsa kumbali ya plantar ya basal tuberosity yachisanu metatarsal.

Gulu la fracture

Kuphulika kwa maziko a metatarsal yachisanu adasankhidwa ndi Dameron ndi Lawrence,

Zone I fractures ndi avulsion fractures ya metatarsal tuberosity;

Zone II ili pa kugwirizana pakati pa diaphysis ndi proximal metaphysis, kuphatikizapo mafupa pakati pa 4th ndi 5th metatarsal mafupa;

Zone III fractures ndi kupsinjika maganizo kwa proximal metatarsal diaphysis distal mpaka 4th / 5th intermetatarsal joint.

Mu 1902, Robert Jones poyamba anafotokoza mtundu wa zone II fracture m'munsi mwa metatarsal wachisanu, choncho zone II fracture amatchedwanso Jones fracture.

Kuphulika kwa metatarsal tuberosity mu zone I ndi mtundu wachisanu wa fracture wa metatarsal base fracture, womwe umakhala pafupifupi 93% ya fractures zonse, ndipo amayamba chifukwa cha kuphulika kwa zomera ndi chiwawa cha varus.

Mafractures mu zone II amakhala pafupifupi 4% ya zosweka zonse pamunsi pa metatarsal yachisanu, ndipo amayamba chifukwa cha kupindika kwa phazi ndi chiwawa chowonjezera.Chifukwa iwo ali m'dera la madzi okhetsa magazi m'munsi mwa metatarsal yachisanu, fractures pamalo ano zimakhala zosavuta kapena zochedwa fractures kuchira.

Zone III fractures imakhala pafupifupi 3% yachisanu chachisanu cha metatarsal fractures.

Chithandizo chodziletsa

Zizindikiro zazikulu za chithandizo chodziletsa ndi monga kusamuka kwa fracture zosakwana 2 mm kapena fractures yokhazikika.Thandizo lodziwika bwino limaphatikizapo kutsekeka ndi mabandeji zotanuka, nsapato zolimba, kusasunthika ndi pulasitala, zomangira za makatoni, kapena nsapato zoyenda.

Ubwino wa chithandizo chokhazikika umaphatikizapo mtengo wotsika, osapwetekedwa mtima, komanso kuvomerezedwa mosavuta ndi odwala;kuipa kwake kumaphatikizapo kuchuluka kwa kuthyoka kwa mgwirizano kapena kuchedwa kwa mgwirizano, komanso kuuma kwamagulu kosavuta.

OpaleshoniTkubwezeretsa

Zizindikiro za chithandizo chamankhwala chachisanu cha metatarsal base fractures ndi monga:

1. fracture kusamutsidwa kuposa 2 mm;

1. Kuphatikizidwa kwa> 30% ya pamwamba pa cuboid distal mpaka metatarsal yachisanu;

1. Kuphwanyidwa kosalekeza;

1. Kusweka kuchedwa mgwirizano kapena kusagwirizana pambuyo pa chithandizo chosachita opaleshoni;

1. Odwala achinyamata ochita masewera kapena othamanga.

Pakalipano, njira zopangira opaleshoni zomwe zimagwiritsidwa ntchito pothyoka tsinde la metatarsal yachisanu ndi monga Kirschner wire tension band internal fixation, anchor suture fixation ndi ulusi, screw internal fixation, ndi hook plate internal fixation.

1. Kirschner waya tension band fixation

Kirschner wire tension band fixation ndi njira yachikhalidwe yopangira opaleshoni.Ubwino wa njira yochizirayi umaphatikizapo kupeza kosavuta kwa zida zokonzera mkati, zotsika mtengo, komanso zotsatira zabwino za psinjika.Zoyipa zimaphatikizapo kuyabwa pakhungu komanso chiopsezo cha kumasula waya wa Kirschner.

2. Suture fixation ndi nangula wa ulusi

Anchor suture fixation ndi ulusi ndi yoyenera kwa odwala omwe ali ndi fractures ya avulsion pamunsi pa metatarsal yachisanu kapena ndi tizidutswa tating'ono tating'ono.Ubwino wake umaphatikizapo kudula pang'ono, ntchito yosavuta, ndipo palibe chifukwa chochotsa chachiwiri.Zoyipa zimaphatikizapo chiopsezo cha nangula prolapse odwala osteoporosis..

3. Kukhazikika kwa misomali yopanda kanthu

Hollow screw ndi njira yothandiza yodziwika bwino padziko lonse lapansi ya mathyoka a m'munsi mwa metatarsal yachisanu, ndipo ubwino wake ndi kukhazikika kolimba ndi kukhazikika kwabwino.

Zachipatala, chifukwa cha ming'alu yaying'ono m'munsi mwa metatarsal yachisanu, ngati zomangira ziwiri zimagwiritsidwa ntchito pokonza, pali chiopsezo cha refracture.Pamene screw imodzi imagwiritsidwa ntchito kukonza, mphamvu yotsutsa-kuzungulira imafooka, ndipo kusuntha kumatheka.

4. Hook mbale yokhazikika

Kukonzekera mbale ya mbedza kumakhala ndi zizindikiro zambiri, makamaka kwa odwala omwe ali ndi fractures kapena osteoporotic fractures.Mapangidwe ake amafanana ndi maziko a fupa lachisanu la metatarsal, ndipo mphamvu yopondereza yokhazikika ndiyokwera kwambiri.Kuipa kwa kukonza mbale kumaphatikizapo kukwera mtengo komanso kuvulala kwakukulu.

Summary

Pochiza fractures m'munsi mwa metatarsal wachisanu, m'pofunika kusankha mosamala malinga ndi mkhalidwe wa munthu aliyense, zinachitikira dokotala ndi luso mlingo, ndi bwino kuganizira zofuna za wodwalayo.