Distal radius fracture ndi imodzi mwazovulala zomwe zimafala kwambiri m'machitidwe azachipatala, omwe amatha kugawidwa kukhala ofatsa komanso ovuta.Kwa fractures yosasunthika pang'ono, kukonza kosavuta ndi masewera olimbitsa thupi oyenera kungagwiritsidwe ntchito pochira;komabe, chifukwa cha ming'alu yotayika kwambiri, kuchepetsa pamanja, kupukuta kapena pulasitala iyenera kugwiritsidwa ntchito;kwa fractures ndi zowonongeka zoonekeratu komanso zowonongeka pamwamba pa articular, chithandizo cha opaleshoni chimafunika.
CHIGAWO 01
Chifukwa chiyani distal radius imakonda kusweka?
Popeza malekezero akutali a radius ndi malo osinthira pakati pa fupa la cancellous ndi compact fupa, ndi lofooka.Wodwalayo akagwa ndikukhudza pansi, ndipo mphamvu imaperekedwa kumtunda kwa mkono, mapeto akutali a radius amakhala pamene kupsyinjika kumakhala kovuta kwambiri, zomwe zimapangitsa kuti pakhale kupasuka.Kusweka kwamtunduwu kumachitika kawirikawiri kwa ana, chifukwa mafupa a ana ndi ochepa komanso osalimba mokwanira.
Dzanja likavulala pamalo otalikirapo ndipo chikhatho cha dzanja chikuvulala ndikusweka, chimatchedwa fracture ya distal radius fracture (Colles), ndipo oposa 70% aiwo ndi amtunduwu.Pamene dzanja lavulazidwa pamalo osinthika ndipo kumbuyo kwa dzanja kuvulala, amatchedwa flexed distal radius fracture (Smith).Kupunduka kwina kwa dzanja kumatha kuchitika pambuyo pakedistal radius fractures, monga "silver fork" deformity, "gun bayonet" deformity, etc.
CHIGAWO 02
Kodi distal radius fractures amathandizidwa bwanji?
1. Kuchepetsa mwachinyengo + pulasitala kukonza + wapadera Honghui chikhalidwe Chinese mankhwala mafuta ntchito
Pazophulika zambiri za distal radius, zotsatira zokhutiritsa zitha kupezeka kudzera mukuchepetsa bwino kwamanja + pulasitala + kugwiritsa ntchito mankhwala achi China.
Madokotala ochita opaleshoni a mafupa amafunika kukhala ndi maudindo osiyanasiyana kuti athetsedwe pambuyo pochepetsera malinga ndi mitundu yosiyanasiyana ya fractures: Kawirikawiri, Colles (mtundu wowonjezera distal radius fracture) fractures iyenera kukhazikitsidwa pa 5 ° -15 ° ya palmar flexion ndi kupatuka kwakukulu kwa ulnar;Smith The fracture (flexion distal radius fracture) inakhazikika pamphuno ndi dorsiflexion ya mkono.The dorsal Barton fracture (kuphulika kwa articular pamwamba pa distal radius ndi kusuntha kwa dzanja) kunakhazikitsidwa pa malo a dorsiflexion wamgwirizano wa dzanjandi kutchulidwa kwa mkono, ndi kukonza kwa volar Barton fracture inali pamalo a palmar flexion of the wrist joint ndi supination of forearm.Nthawi ndi nthawi yang'anani DR kuti mumvetsetse malo ophwanyika, ndipo sinthani kulimba kwa zingwe zazing'ono panthawi kuti mupitirize kukonza bwino kachidutswa kakang'ono.
2. Percutaneous singano kukonza
Kwa odwala ena omwe ali ndi vuto losakhazikika, kukonza pulasitala kosavuta sikungathe kusunga bwino malo ophwanyika, ndipo kukonza singano kwa percutaneous nthawi zambiri kumagwiritsidwa ntchito.Dongosolo la mankhwalawa litha kugwiritsidwa ntchito ngati njira yosinthira kunja, ndipo ingagwiritsidwe ntchito limodzi ndi pulasitala kapenakukonza kwakunjamabatani , zomwe zimawonjezera kwambiri kukhazikika kwa mapeto osweka pa vuto la kuvulala kochepa, ndipo zimakhala ndi zizindikiro za ntchito yosavuta, kuchotsa mosavuta, komanso kuchepa kwa ntchito ya wodwalayo.
3. Njira zina zothandizira, monga kuchepetsa kutseguka, kukonza mkati mwa mbale, ndi zina zotero.
Dongosolo lamtunduwu lingagwiritsidwe ntchito kwa odwala omwe ali ndi mitundu yovuta ya fracture komanso zofunikira zazikulu zogwirira ntchito.Mfundo zochizira ndi kuchepetsa kuthyoka kwa mafupa, kuthandizira ndi kukonza zidutswa za fupa zomwe zachotsedwa, kulumikiza mafupa opunduka mafupa, ndi chithandizo mwamsanga.Zochita zogwirira ntchito kuti mubwezeretse ntchitoyo musanavulale mwamsanga.
Ambiri, kwa ambiri distal fractures utali wozungulira, chipatala chathu utenga njira ndiwofatsa mankhwala monga kuchepetsa pamanja + pulasitala fixation + wapadera Honghui chikhalidwe Chinese mankhwala pulasitala ntchito, etc., amene angathe kupeza zotsatira zabwino.
CHIGAWO 03
Njira zodzitetezera mutatha kuchepetsa kuphulika kwa distal radius:
A. Samalirani kuchuluka kwa kuthina pokonza ma distal radius fractures.Mlingo wa kukonza uyenera kukhala woyenera, osati wothina kwambiri kapena womasuka kwambiri.Ngati itakonzedwa mwamphamvu kwambiri, idzakhudza kuperekedwa kwa magazi kumtunda wa distal, zomwe zingayambitse ischemia yoopsa kwambiri.Ngati kukhazikikako kuli kotayirira kwambiri kuti apereke kukonza, kusuntha kwa mafupa kungabwerenso.
B. Pa nthawi ya fracture fixation, sikoyenera kusiya ntchito kwathunthu, komanso kuyenera kumvetsera masewera olimbitsa thupi.Pambuyo pa kuthyokako kwakhala kosasunthika kwa nthawi ndithu, kayendetsedwe ka dzanja kadzafunika kuwonjezeredwa.Odwala ayenera kulimbikira maphunziro tsiku lililonse, kuti awonetsetse zotsatira zolimbitsa thupi.Kuonjezera apo, kwa odwala omwe ali ndi zowonongeka, zomangira zowonongeka zimatha kusinthidwa molingana ndi masewero olimbitsa thupi.
C. Pambuyo pakutha kwa distal radius fracture, tcherani khutu kukumverera kwa miyendo ya distal ndi mtundu wa khungu.Ngati ziwalo za distal m'dera lokhazikika la wodwalayo zimakhala zozizira komanso za cyanotic, kumverera kumasokonekera, ndipo ntchitozo zimakhala zochepa kwambiri, m'pofunika kuganizira ngati zimayamba chifukwa chokhazikika kwambiri, ndipo m'pofunika kubwerera kuchipatala. kuti musinthe nthawi.
Yoyo
Malingaliro a kampani Sichuan Chenanhui Technology Co., Ltd
Tel/WhatsApp: +8615682071283
Email: liuyaoyao@medtechcah.com
Nthawi yotumiza: Jan-06-2023
