Imisebenzi yokusekela nokuhamba kwejoyini le-ankle kunikezwa yi-distal epiphyses (imikhawulo) ye-fibula ne-tibia. Lokhu kuhlangana kubanga imithwalo eshaqisayo lapho uhamba, ugijima, ugxuma, kanye nezikhathi zamandla ezishubile zasemuva nezisontayo lapho ulinganisa ukugcina umzimba usesimweni esiqondile. Ngakho-ke, ukuphuka kweqakala kungenye yokulimala okuvame kakhulu kohlelo lwe-musculoskeletal, hhayi kuphela phakathi kwabasubathi, kodwa naphakathi kwabantu abavamile abangadlali imidlalo (kusuka ku-15 kuye ku-20% yenani).
Izizathu
Ukwephuka kweqakala okuhlukumezekile kwenzeka ngokushaywa ngamandla noma eminye imithelela yangaphandle eyeqile eqakaleni ngesikhathi semidlalo, ukuwa, noma izingozi zomgwaqo. Ukugingqa unyawo lwakho endaweni eshelelayo, engalingani noma egqoke izicathulo ezingakhululekile kuzovame ukudala lokhu kulimala. Ukuwa okungaphumeleli kungashukunyiswa yimisipha engathuthuki kahle kanye nokuhamba kahle kokunyakaza, ikakhulukazi ngesisindo eseqile. Ngenxa yokwephulwa kwenqubo ejwayelekile yokululama kwezicubu zamathambo, intsha, abesifazane abakhulelwe kanye nabantu abadala basengozini.
Izinguquko ezenzakalelayo noma ezitholakele zokugula, kanye nezifo ezahlukahlukene, njenge-arthritis, i-osteopathy, i-osteoporosis, isifo sofuba, ne-oncology, kwandisa amathuba okulimala. Ukudla okungenakulinganisela, ukungabi khona kwe-calcium nezinye izinto ezincane kunciphisa amandla amathambo nokuqina kwemisipha.
Iyini ingozi
Ngokwelashwa okufika ngesikhathi futhi okuqeqeshiwe, ngisho nokwaphuka okuyinkimbinkimbi, njengomthetho, kuphulukisa ngaphandle kwezinkinga nokusebenza kweqakala kubuyiselwe ngokuphelele. Ezimweni zokufuduka okunzima noma ukuhlukaniswa kwamathambo, izinkinga ezinzima zingenzeka futhi kube nokuvuselelwa okuyingxenye kuphela kokusebenza kwejoyini.
Uma kwenzeka isikhalazo sekwedlule isikhathi esikhungweni sezokwelapha noma ukuhlinzekwa okungafanele kosizo lokuqala, imiphumela emibi ingenzeka, kuze kufike ukuqala kokukhubazeka.
Ukuqhekeka okuvulekile nokuqhekeka okushiye amakhaya abo kuyingozi kakhulu, lapho izingcezu zethambo zingalimaza izicubu ezizungezile neziphetho zezinzwa, ezisongela ngokulahlekelwa ukuzwela nokuphazamiseka kwemisipha yonyawo. Ngakho-ke, kubalulekile ngomzuzu wokuqala ukuqinisekisa ukungasebenzi komzimba, ukungavumeli noma yimuphi umthwalo emlenzeni olimele, futhi ngokushesha okukhulu ukuletha isiguli egumbini lezimo eziphuthumayo.
Kwesinye isikhathi ukuphuka okuvaliwe kukhathazeka kuphela ngokuvuvukala okuhlangene, ubuhlungu obuncane, namandla okuhamba ahlala. Ngaphandle kwalokhu, futhi ezimweni ezinjalo, kuyadingeka ukuthi ubonane nodokotela ukuthola ukutholakala okunembile nokwelashwa okulungile.
Ukuqhekeka kweqakala langaphandle
Lokhu ukubhujiswa kwengxenye engezansi ye-fibula. Ikhodi ye-ICD-10 (ukuhlukaniswa kwezifo emhlabeni jikelele) - S82.6. Ukulimala okunjalo kubonakala ngezimpawu ezimnene - ukuvuvukala kwejoyinti leqakala, ubuhlungu obukhali ngesikhathi sokulimala nobuhlungu obubekezelelekayo noma ngabe uncike emlenzeni, ngoba umthwalo omkhulu uwela ku-tibia. Lokhu kuvame ukubangela ukubambezeleka kokuthintana nodokotela we-traumatologist, okungadala ukuhlangana kwamathambo okungalungile nokucekelwa phansi kwemisipha, imisipha kanye nemicu yezinzwa. Ngenxa yalokhu, ukuphuka okulula ukwelashwa kweqakala langaphandle kungaphenduka isifo esibi.
Ukuphuka kweqakala langaphakathi
Lokhu ukubhujiswa kokuphela okuphansi kwe-fibula (ngokusho kwe-ICD-10 - S82.5.). Ezimweni ezinjalo, ukuqhekeka kwe-oblique noma okuqondile (ukubizwa) kwe-medle malleolus kuyenzeka, okuvame ukuba nzima ngama-sprains, futhi kungahle kuhambisane nobuhlungu obukhulu, ukulahleka komsebenzi wokusekela womlenze, ukuvuvukala okukhulu nokulimala endaweni ehlanganisiwe.
Ukwephuka kwendawo
Lawa amacala ayingozi kakhulu futhi ayinkimbinkimbi okulimala eqakaleni, okuveze izimpawu: ubuhlungu obubekezelelekayo obubekezelekayo, ukuvuvukala okukhulu, ukopha kakhulu kwendawo kanye nokuqaqamba kwesici lapho imisipha yomlenze ongezansi icindezelekile noma unyawo lunyakaziswa. Kwesinye isikhathi ucezu lwethambo lubulala izicubu ezizungezile bese luphuma, lubangele ukopha nobungozi bokutheleleka enxebeni. Lokhu kuvame ukwenzeka ngokuqhekeka kwe-apical (ukuphuka kwe-tibia noma i-fibula eduze kwe-distal pineal gland). Ezimweni ezinzima kakhulu, womabili amaqakala alimala ngokuhlukaniswa nokuqhekeka kwemisipha.
Ukwephuka ngaphandle kokuhamba
Ukulimala okunjalo kubonakala ngokucekelwa phansi kwengxenye yomlenze ngaphandle kobuhlungu obunzima kanye ne-edema ebucayi. Kukhona ukungakhululeki okuncane kuphela lapho ugoba unyawo futhi uhamba.
Ukuphuka kweqakala ngaphandle kokuhamba kungadideka ngomgogodla, ngakho-ke kungcono ukuhlola ukuxilongwa nodokotela wezokwelapha.
Ukuxilongwa
Indawo ngqo kanye nobukhulu bomonakalo busungulwa kusetshenziswa ukuhlolwa kwe-X-ray. Izithombe eziningana zihlala zithathwa ngezindiza ezahlukahlukene (kusuka kwamabili noma ngaphezulu, kuya ngobunzima bokulimala). Ukuhlola isimo sezicubu ezithambile nemisipha, kanye nokukhipha ubukhona be-hematomas yangaphakathi, ukubekwa kwe-magnetic resonance imaging noma i-computed tomography kunqunyiwe.
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Izici zokwelashwa
Indlela esemqoka yokubuyisa ubuqotho bethambo ukuqina ngokuphelele kokuhlangana kweqakala. Ngokuya ngohlobo lokulimala, indawo efanelekile yezingcezu iqinisekiswa ngokuncishiswa okuvaliwe noma okuvulekile. Ngemuva kokuhlinzwa, kwenziwa izinqubo ezidingekayo zokuphulukisa isilonda.
Ukwelashwa okulondolozayo
Izindlela ezinjalo zisetshenziswa ezimweni zokuqhekeka okuvaliwe ngaphandle kokuhamba noma kungasuswa ngokunciphisa okuvaliwe, futhi amathuluzi we-ligamentous anomonakalo omncane. Ngaphezu kokungasebenzi, imithi isetshenziselwa ukudambisa izinhlungu, i-edema nokuqeda izinqubo zokuvuvukala.
Isimo esingagculisi sempilo yesiguli kungaba yisizathu sokwenqaba ukuhlinzwa kanye nokusetshenziswa kwemithi yokulondoloza.
Kusetshenziswa ukugqoka okungenamandla
Uma kwenzeka ukuqhekeka okulula ngaphandle kokuhamba nokuqhekeka kwemisipha, ngemuva kokuxilongwa nokuqedwa kwe-edema, kusetshenziswa ibhandeshi eliyindilinga elenziwe ngo-U noma elilingana nobude elenziwe ngopulasitela, ibhandishi lokwenziwa noma ipulasitiki esezingeni eliphansi. Ukumboza ingxenye yonyawo nengxenye engezansi yomlenze ongezansi, kufanele kunikeze ukulungiswa okucacile kwejoyinti futhi kungaphazamisi ukujikeleza kwegazi okujwayelekile emlenzeni. Endabeni yokungasebenzi, ngemuva kokuncishiswa okuvaliwe, i-X-ray yokulawula iyadingeka ukuze kuqinisekiswe ukuthi ukuma kwalezi zingcezwana kulungile.
Ngaphezu kwamabhandeshi, izinhlobo ezahlukahlukene zepulasitiki namabhandeshi ahlanganisiwe namazinyo asetshenziswayo. Imishini enjalo ilungiswa kalula ngosayizi wesitho. Ngemvume kadokotela wakho, ungazisusa bese uzibeka kuwe.
Ngokuya ngobulukhuni bokuqhekeka, noma yimuphi umthwalo oselungu lomzimba ongenawo amandla ukhishwa isikhathi esithile. Isikhathi sokugqoka okokulungisa noma ibhandeshi naso sincike kulokhu (kusuka emavikini angu-4-6 kuye ezinyangeni ezimbili noma ngaphezulu).
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Ukunciphisa ukunciphisa okwenziwe ngesandla
Le nqubo yenziwa ngaphansi kwe-anesthesia yendawo. Udokotela ohlinzayo uzizwa edokhumeni nasekuqondisweni kwamathambo asuswe emakhaya futhi aqinisekise ukuma kwawo okulungile kokwakheka komlenze ohlangene naphansi.
Isikhathi nekhwalithi yokubuyiselwa kokusebenza kwesitho kuncike ebangeni lesikhathi nokunemba kokuqaliswa kwayo.
Ukwelashwa kokuhlinzwa
Ukuhlinzwa kuyadingeka:
- Ngokuqhekeka okuvulekile.
- Lapho ukulimala kuyinkimbinkimbi ngokuphuka okuphelele kwemisipha noma kunezingcezu eziningi.
- Ngokuqhekeka kwemalleolar okubili noma okuthathu.
Kulezi zimo, ngaphansi kwe-anesthesia ejwayelekile, ilunga liyavulwa futhi amathambo nezicucu zibekwe obala, kanye nokulungiswa kwazo ngosizo lwezipikili ezikhethekile zezokwelapha, izikulufo nezikhonkwane (i-osteosynthesis). Ngasikhathi sinye, imisipha eyonakele, imisipha nemiphetho yezinzwa iyabuyiselwa. Ngemuva kwalokho kufakwa ukhonkolo, ongafaki indawo yokuhlinzwa futhi uvumele ukwelashwa nokulawulwa kwenqubo yokupholisa amanxeba.
Izinkinga ezingenzeka
Ngokuvakashelwa udokotela sekwedlule isikhathi, ukuzelapha noma ukwephula imithetho nemibandela yokugqoka okokulungiselela, amathambo kanye nezicucu zawo kungakhula ndawonye endaweni engeyona eyemvelo, okuzophazamisa ukusebenza okujwayelekile kwejoyinti futhi kuvuse ukuhlukaniswa kanye nokwakhiwa kwezinyawo ezicabalele.
Ikholi eyakhiwe ngokungafanele ingancinza imicu yezinzwa futhi ivimbele noma ivimbele ukugcinwa kwemisipha yonyawo nokuzwela kwesikhumba. Ukwelashwa okungazelelwe kwesilonda sangemva kokuhlinzwa kungadala inqubo yokuvuvukala noma isifo esithathelwanayo sezicubu zemisipha, amathambo nemithambo yegazi.
Kungakanani ukuhamba ukhonkolo ophuke iqakala
Kunoma ikuphi, isamente noma enye into yokulungisa isuswa kuphela ngemuva kwe-X-ray yokulawula, eqinisekisa ukuhlangana okuphelele nokulungile kwamathambo nezicucu, kanye nesimo esijwayelekile semisipha nemisipha.
Isikhathi sokugqoka
Okokuqala, isikhathi sokugqoka idivayisi yokulungisa sincike ku:
- Isikhathi kanye nokunemba kosizo lokuqala.
- Uhlobo nobunzima bokuphuka.
- Izici zomuntu ngamunye zomzimba wesiguli.
Ukudla okunomsoco nokunamathela ezincomweni zikadokotela obekhona kuyalekelela ekusheshiseni ukululama.
I-Offset
Kulesi simo, isinqumo esinqumayo ukulungiswa kwangaphambi kokujoyina ngesikhathi sokuhlinzekwa kosizo lokuqala kanye nokulethwa okusheshayo kwesisulu egumbini labezimo eziphuthumayo. Ngaphandle kwalokho, ukufuduka kungaba nzima ukulungisa ngokunciphisa okuvaliwe futhi ukungenelela kokuhlinzwa kuyadingeka.
Akukho offset
Ezimweni eziningi zokuphuka okunjalo, ukukhubazeka kuthatha inyanga eyodwa kuya kwezimbili. Isikhathi sokululama ngokugcwele sincike ekuqineni kwezinyathelo zokuvuselela kanye nezimpawu zomuntu ngamunye zesiguli.
Uma ingxenye yangaphandle ilimele
Ukwephuka okunjalo kuyelashwa ngokuhlinzwa, ngakho-ke kuzothatha izinyanga ezimbili noma ngaphezulu ukufaka ibhandeshi lokulungisa. Ngemuva kwanoma yikuphi ukuhlinzwa, kulokhu, isikhathi sokululama sinqunywa nezinga lokuphola kwesilonda sangemva kokuhlinzwa.
Ngokuqhekeka kwe-malleolus ye-lateral ngaphandle kokuhamba
Leli yicala elilula kakhulu lokucekelwa phansi kobuqotho beqakala, futhi ukulungiswa kwejoyini kuyadingeka isikhathi esingangenyanga eyodwa nengxenye. Kakade ngemuva kwesonto, umthwalo ojwayelekile owenziwe emlenzeni uvunyelwe.
Izigaba ze-Fusion
Ngesikhathi sokuqhekeka, ukopha kwendawo kwenzeka, futhi izinsuku zokuqala ezinhlanu, eziyisikhombisa kunenqubo yokuvuvukala ngokwakhiwa kophawu oluthambile oluvela kwizicubu ezinemicu (ukubuyisela kabusha). Ngemuva kwalokho kuqala ukwenziwa kwemicu yokuxhuma ye-collagen (ukubuyiselwa emuva) kusuka kumaseli akhethekile - ama-osteoclast kanye nama-osteoblasts. Ngemuva kwalokho, ngenxa yokwakheka kwamaminerali eseli, kwakhiwa ikholi phakathi kwezingcezu kungakapheli inyanga. Emasontweni amathathu kuya kwamane alandelayo, ukwenziwa kwesakhiwo kwenzeka, ngenxa yokugcwala kwayo nge-calcium.
Ukubuyiselwa okuphelele kwethambo elonakele nemvelo yalo, eqinisekisa ukusebenza okugcwele kwejoyinti leqakala, kungenzeka ngemuva kwezinyanga ezingu-4-6 zokuvuselelwa.
Isikhathi sokuvuselelwa
Isikhathi sokuvuselelwa singahlala kusuka ezinyangeni ezine kuya kweziyisithupha noma ngaphezulu. Kuya ngobunzima bokuqhekeka, izindlela zokwelashwa ezisetshenzisiwe nezimpawu zomuntu ngamunye - ubudala, impilo, indlela yokuphila kanye nokuba khona kwemikhuba emibi. Ukusheshisa kwezinqubo zokululama kwenziwa lula yi:
- Ukuqala kokuqala komthwalo okhishiwe emlenzeni olimele nokwenza izivivinyo ze-gymnastics yezokwelapha.
- Ukubhucungwa kwendawo kanye nokwelashwa okuhlukahlukene kwe-physiotherapy.
- Ukudla okunomsoco, okuqinisekisa ukugcwala komzimba ngezinto ezidingekayo namaminerali (ikakhulukazi i-calcium).
- Isikhundla sokuphila esisebenzayo kungukuqaliswa kwazo zonke izinqubo ezinqunyiwe, ukwelashwa okuvivinya umzimba njalo (ukuzivocavoca umzimba) kanye nokuthuthukiswa kokuhamba ngokuhlanganyela, ngaphandle kobuhlungu obuvumelekile nobuthakathaka bemisipha ethambile.
Ukuzivocavoca umzimba kokuqala kokuvivinya iqakala kufanele kuqalwe ngokushesha ngemuva kokuba i-pain syndrome isiqediwe esincomweni noma ngaphansi kweso likadokotela.
