Ukuphuka kwesifazane kubhekwa njengokulimala kanzima ohlelweni lwe-musculoskeletal futhi kudinga ukwelashwa okuyinkimbinkimbi. Ngokuya ngendawo yokwephulwa kobuqotho, kunezinhlobo ezahlukahlukene zokulimala. Kuzoba nobuhlungu obukhulu, ukwehla kokuhamba, ukusonteka nokunciphisa isitho, ukulahleka kwegazi okukhulu (ngokuqhekeka okuvulekile). Ukuxilongwa kucaciswa kusetshenziswa i-radiography. Uma kunesidingo, ukuhlolwa kwe-joint kunqunyelwe i-MRI. Ukwelashwa kuhilela ukulungisa izingcezu ukuze kuqhutshekwe futhi kuhlanganiswe kahle
Ulwazi oluvamile
Ukwephuka kwesifazane kwenzeka ngokuvela ngqo noma ukuwa emlenzeni. Ukulimala okunjalo kunezinkinga eziningi. Ukulimala kwenzeka kunoma yiliphi izinga locezu, ngakho-ke, kwezokwelapha, bahlukaniswa njengokwephuka:
- intamo ye-trochanteric neyesifazane (ithambo eliphezulu);
- diaphyseal (umzimba wethambo);
- distal (ingxenye engezansi).
Lokhu kulimala kwehlukile ngendlela yokwenza, izimpawu, ukwelashwa, nokubikezela ukululama.
Insiza yezimo eziphuthumayo
Ukwephuka kwethambo elikhulu kangaka kungabulala, ngakho-ke ukwelashwa okuphuthumayo kufanele kunikezwe ngokushesha. Uma imikhumbi ilimele ngokuphuka okuvulekile, kufanele kufakwe i-tourniquet ngenhla kwesilonda ukunqanda ukopha. Kubalulekile ukukhumbula ukuthi lokhu kufanele kwenziwe ngamahora ama-2 kuphela, ngaphandle kwalokho izicubu ze-necrosis zizovela. Inothi elibonisa isikhathi lifakwa ngaphansi kwezingubo. Uma kungekho phepha, bhala esikhunjeni sesisulu. Kungcono ukungashiyi imininingwane ezingutsheni, esibhedlela bangazikhipha.
Umlenze ophukile kufanele ungahambi, lokhu kuzovimbela ukufuduka kwezicucu, ukwanda kwegazi. I-splint noma ibhodi eqondile ifakwa kuwo wonke umlenze kusuka emhlane ongezansi kuye enyaweni kusuka ngaphandle nangaphakathi kwesitho esingezansi. Ngasikhathi sinye, unyawo akumele ulenge. Isisulu sibekwa ohlakeni bese siyiswa esibhedlela. Ukudambisa izinhlungu kunikezwa umuthi wokubulala izinzwa (Ibuprofen, Nurofen, Analgin, Paracetamol).
Ukuphuka kwentamo yeTrochanteric neyesifazane
Ithambo lethanga liyisigaxa. Engxenyeni yalo ephezulu kunekhanda, elingena emgodini wamathambo okhalo, lakha ilunga le-hip. Ngezansi kwekhanda kune-septum ezacile - intamo. Ixhuma emzimbeni nge-engeli. Kulezi zindawo kukhona ama-protrusions - amathe amancane namakhulu. Ukulimala komthelela kuvame ukwenzeka kulezi zindawo.
Izimbangela zokwephuka
Ukulimala okuphezulu kwabesifazane kuvame ukubonwa ekugugeni. Lokhu kwenziwa lula ngamathambo nemisipha ephansi. Emzimbeni wesifazane, igebe eliphakathi kwentamo nomzimba wethambo libukhali kunamadoda, kuthi nentamo uqobo lincane. Ngalesi sizathu, ukulimala kuvame kakhulu.
Ukwephuka kweTrochanteric kwenzeka ngenxa yokulimala ezingozini, ukuwa, izimo eziphuthumayo, ngesikhathi semidlalo. Ngokukhula, ukulimala kwe-hip kungenzeka ngisho nokukhubeka, ukudlulisa okubukhali kwesisindo somzimba emlenzeni owodwa.
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Izimpawu zokulimala
Ukuqhekeka kwesifazane kuhlale kuhambisana nobuhlungu obunzima, obungaqedwa kuphela yizidakamizwa. Ukulimala entanyeni nakuma-protuberances we-trochanteric kubonakala ngezindlela ezihlukile.
Ukulimala entanyeni yesifazane kuhambisana nobuhlungu obulinganiselwe ezindaweni zangasese nezomgogodla. Lapho uhamba, ubunzima bokungaphatheki kahle bukhula kakhulu. Ukuzwa ukuthi indawo ephukile ayibangeli ukungakhululeki okuningi, kuzwakala ubuhlungu obungathandeki. Kukhona ukuvuvukala kwezicubu, kepha akukho ukulimala.
Ukwephuka kwe-trochanteric kubonakala ngokuhamba kancane kwezitho zomzimba. Ubuhlungu bubukhali, abubekezeleleki lapho buzwakala, ukopha kuyabonakala endaweni yokulimala, ukuvuvukala kuyabonakala kakhulu.
Uma kwenzeka umonakalo engxenyeni engenhla ye-femur, kukhona ukujika komlenze othintekayo kuya ngaphandle, ukufinyeza kanye ne- "sticking heel syndrome" - ukungakwazi ukuphakama endaweni ephezulu.
Amaqhinga okwelashwa
Intamo yesifazane ayimboziwe yi-periosteum, ngakho-ke ikhula ndawonye ngokungafanele. Ukunikezwa kwegazi kuyaphazamiseka, izingcezu zimbozwe izicubu ezihlanganisiwe ngokuhamba kwesikhathi. Ukuphakama komonakalo kungukuthi, ukubhebhetheka kwe-fusion kuzoba kubi kakhulu. Ukukhubazeka ngokuvamile kungumphumela wokwelashwa ngaphandle kokuhlinzwa.
Ama-protuberances we-trochanteric ahlinzekwa kahle ngegazi, namafomu we-callus ngokushesha ekuhlukumezeni. Ukulimala kule ngxenye kuphulukisa ngaphandle kokuhlinzwa ngokwelashwa okuhle. Izinkinga zingenzeka ngezingcezu eziningi ezisuswe emakhaya.
Amasu okwelashwa akhethwa yi-traumatologist, ngokuya ngezinga lokulimala nobudala besiguli. Ngokuqhekeka kwe-intra-articular, ukuhlinzwa kuyadingeka. Ukungahambisani nale ndlela izifo ezingapheli nokuguga. Ukuphumula kombhede isikhathi eside kungaholela ezinkingeni ngesimo se-bedsores, i-pneumonia, i-thromboembolism. Ngalesi sizathu, kuyadingeka ukuthi unikeze isiguli ukuhamba okuhambisana nokukhubazeka kwethambo elimele. Ukulungiswa kwamathambo ngesipikili se-trilobate noma i-autoplasty yethambo kuyenziwa.
Okwephuka kwe-trochanteric, ukuncipha kwamathambo kunconywa izinyanga ezimbili. Okulandelayo, kufakwa ukhonkolo. Kuzokwazi ukunyathela isitho esilimele ezinyangeni ezine. Ukuhlinzwa kokulimala okunjalo kunganciphisa isikhathi sokwelashwa. Ngesikhathi sokuhlinzwa, i-fixation yenziwa ngezipikili ezintathu, ngezikulufo kanye namapuleti. Ngemuva kwamasonto ayisithupha, umthwalo ogcwele emlenzeni uvunyelwe.
Ukuphuka kwe-diaphyseal
Ukulimala komzimba we-femur kuhambisana nokulahleka kwegazi okukhulu nokushaqeka okubuhlungu.
Izimbangela zokulimala
Ukulimala kwamathambo kwenzeka ngenxa yomthelela, ukuwa, ukugoba, ukusonteka. Abantu abaneminyaka emincane naphakathi nendawo bathinteka kakhulu. Izicucu ezahlukahlukene ziyavela, ezidonsa imisipha enamathele kuzo kuzo zonke izinhlangothi. Lokhu kubangela ukufuduka okuningi.
Izimpawu zokulimala
Izikhalazo eziyinhloko zezisulu zokuphuka kwesifazane:
- ubuhlungu obungabekezeleleki endaweni yokulimala;
- i-edema;
- umlenze ukusonteka;
- ukuhamba okungavamile;
- ukulahleka kwegazi;
- ukunciphisa isitho;
- ukushaqeka okuhlukumezayo.
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Izinkomba eziyinhloko zokwelashwa
Ukuvimbela ukuthuthuka okuhlukumezayo, isisulu sinqunyelwe ukudambisa izinhlungu nezidakamizwa. Ukuze ululame ekulahlekelweni kwegazi, kwenziwa ukumpontshelwa igazi. Ngokuya ngokulimala, kuyadingeka ukuxhuma izingxenye zethambo bese ususa izingcezu ezikhona. Ngenxa yalokhu, izindlela zokulungiswa kwangaphandle, i-hardware traction, nokuhlinzwa kuyasetshenziswa.
Uma kunezifo ezinzima ezingapheli, ukutheleleka kwesilonda esivulekile, impilo ebuthakathaka yesiguli, khona-ke esikhundleni sokuhlinzwa, ukunqotshwa kwamathambo kunqunyelwe amasonto ayisithupha kuya kwayisithupha. Ngemuva kwalokho kufakwa ukhonkolo izinyanga ezi-4. Kulokhu, amalunga we-hip kanye namadolo ahlala enganyakazi isikhathi eside, okuthinta kabi isimo sawo. Ukuhlinzwa kukuvumela ukuthi ukhulise ukuhamba kwesiguli ngokushesha futhi ugweme izinkinga ngenxa yokungakwazi ukuhamba isikhathi eside. Ukungenelela kokuhlinzwa kwenziwa lapho kungekho ukuphikisana, isimo sempilo esivamile sesiguli. Lokhu kusebenzisa izinduku, amapuleti, izikhonkwane.
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Ukuphuka okude
I-femur engezansi inokwandiswa futhi yakha izindlela ezimbili - zangaphakathi, zangaphandle. Indawo yabo ixhumana ne-tibia, i-kneecap, yakha idolo elihlangene.
Ukuqhekeka kwe-Condylar kwenzeka ngenxa yokuwa noma umthelela ekuhlanganyeleni kwamadolo, kwesinye isikhathi kuhambisane nokususwa kwezicucu. Abantu asebekhulile bahlupheka kakhulu. Kukhona amathuba okulimala kweyodwa noma kuzo zombili izindlela. Ukushintshwa kwezingcezu kuye phezulu naseceleni kuyisici. Imvamisa, igazi lithelwa esikhwameni se-articular ngesikhathi sokulimala.
Izimpawu zokuhlukumezeka
Izimpawu ezijwayelekile zokulimala kwe-femur engezansi:
- ubuhlungu obukhulu bamadolo;
- ukulinganiselwa kokuhamba emlenzeni;
- ukuvuvukala kokuhlangana kwamadolo;
- ukuphambuka komlenze ongezansi ngaphandle (ngokuqhekeka kwe-condyle yangaphandle) noma ngaphakathi (ngomonakalo ku-condyle yangaphakathi).
Izici zokwelashwa kokulimala okude
Ngemuva kwe-anesthesia, ukubhoboza ilunga elonakele kwenziwa. Igazi elibanjiwe liyakhishwa, umuthi uyajova. Uma bekungekho ukufuduka, khona-ke kufakwa ukhonkolo kusuka emaqakaleni kuya endaweni yokububula izinyanga eziyi-1-2, ngokuya ngobukhulu bokulimala. Uma kunezicucu, ziyaqhathaniswa, kuphela lapho zilungiswa ngosimende. Lapho kungenakwenzeka ukugoqa izingxenye zethambo kahle, kwenziwa ukuhlinzwa, izingcezu zilungiswa ngezikulufo. Ukudonswa kwamathambo kusetshenziswa uma kunesidingo.
Ngemuva kokwelashwa, kwenziwa inkambo yokutakula. I-Physiotherapy, i-massage yezokwelapha, ukudla okunomsoco, izivivinyo ezikhethekile zisiza ukubuyisela ngokushesha ukuhamba kwethambo eligulayo.
Ukuphuka inqulu ukulimala kanzima, ikakhulukazi lapho usugugile. Udokotela ukhetha izindlela zokwelashwa ngokuya ngempilo yesiguli nezinga lomonakalo. Ukuvuselelwa kuzoba isikhathi eside, udinga ukukuqala esibhedlela bese uqhubeka ekhaya.
