Nsateaa mu yaw? Ebetumi ayɛ tebea a nnompe abien a ɛwɔ nsa no mu twetwe (Scapholunate Dissociation)!

So ɛtɔ mmere bi a wote biribi a ɛyɛ nwonwa anaa ɛyɛ yaw nka wɔ wo nsateaa mu? Ebia ɛyaw yi fii ase bere a wohwee ase, maa biribi a emu yɛ duru so, anaa wodii agoru no. Mpɛn pii no, yesusuw sɛ, "Oh, ɛyɛ akisikuru kɛkɛ." Nanso ɛtɔ mmere bi a, eyi betumi ayɛ tebea a ɛhwehwɛ sɛ wɔde wɔn adwene si so kakra. Ɛno ne nea yɛbɛka ho asɛm nnɛ, tebea bi a ɛba wɔ nsateaa mu a ɛhwehwɛ sɛ wɔyɛ mu nhwehwɛmu kɔ akyiri kakra.

Dɛn ne saa nsateaa dompe a ɛpaapae yi? (Scapholunate a Wɔpaapae Mu) .

Sɛ yɛbɛka no tiawa a, saa `(Scapholunate Dissociation)` yi ne bere a nnompe nketewa abien a ɛwɔ yɛn nsateaa mu, `Scaphoid` dompe ne `Lunate` dompe no, tetew wɔn ho kakra fi baabi a ɛsɛ sɛ ɛwɔ no ho, na ɛma nsonsonoe, anaa `kwan`, ba wɔn ntam. Sɛ yɛbɛka no pɛpɛɛpɛ a, saa nnompe abien yi nam ntini bi a ɛyɛ den yiye so na ɛka bom, na yɛfrɛ no `Scapholunate Interosseous Ligament (SLIL). Wɔ akwanhyia bi mu, titiriw bere a nsa no twitwiw na ɛhwe ase no, saa `nhama` yi betumi atetew. Ɛno na nkitahodi a ɛda nnompe abien no ntam no mu yɛ mmerɛw, na efi ase di akɔneaba. Sɛ wode wo nsateaa di dwuma a, saa nnompe abien yi twe wɔn ho fi wɔn ho wɔn ho ho, anaasɛ `ɛtetew`.

Eyi te sɛ kɔndua a wɔde hama abien akyekyere no. Bere tenten a kɔndua no mu yɛ den no, nhama abien no bom, nanso bere a nhama no mu no, nhama abien no mu tetew.

Hena na ɛda adi sɛ obenya saa tebea yi?

Nokwarem no, saa tebea a wɔfrɛ no `(Scapholunate Dissociation)` yi betumi aba obiara mu, a ɔbarima anaa ɔbea, abusuakuw, anaa ɔsom mfa ho. Nanso asiane a ɛsen biara ne wɔn a wɔhwe ase wɔ wɔn nsa ne wɔn nkotodwe so no . Fa no sɛ, wonam abɔnten na mpofirim ara wohwe ase, na afei yɛde yɛn nsa to fam ara kwa de gye yɛn ho nkwa. Ɛno ne bere a ɛda adi kɛse sɛ akwanhyia yi bɛba.

Saa tebea yi abu so dɛn?

Sɛnea yebetumi ahu no, sɛ yɛhwɛ nsateaa mu akisikuru afoforo a, yebetumi ahu saa `(Scapholunate Dissociation)` tebea yi wɔ bɛyɛ 5% (`5%`) mu . Afei nso, wobetumi ahu akisikuru bi a ɛwɔ nsateaa no fã, titiriw nea yɛfrɛ no ``distal radius fractures``, kyerɛ sɛ, bere a dompe kɛse a ɛwɔ nsa no mu no bubu bɛn nsateaa no, wɔ bɛyɛ 40% (`40%`) mu wɔ nsɛm a ɛwɔ saa `(SL dissociation)` tebea yi mu Abubuo soronko bi wɔ hɔ, te sɛ ``chauffeur fractures``, a wɔtaa hu eyi.

Dɛn nti na eyi rekɔ so? Dɛn ne nea enti a ɛte saa?

Sɛnea madi kan aka no, nea ɛde eyi ba titiriw ne ``nsa a wɔateɛ so a wobɛhwe ase`` . Sɛ yɛbɛka no pɛpɛɛpɛ a, sɛ wohwe ase na wode wo nsa to fam na wode mu duru to so a, nhyɛso no betumi atetew ``scapholunate interosseous ligament (SLIL)`` no mu.

Sɛ ɛno da nkyɛn a, ebia ntease afoforo pii wɔ hɔ:

• Steering wheel a wobɛkura mu denneennen bere a kar akwanhyia te sɛ kar: Saa ntini yi betumi asɛe denam nsa no a ɛbɛbɔ bere a ɛrebɔ mpofirim no so.
• Awosu mu tebea horow bi: Sɛ nhwɛso no, tebea horow te sɛ `Hereditary Spastic Paraparesis`.
• Congenital Ligament Laxity: Wɔwo nnipa binom a ntini a ɛyɛ mmerɛw wɔ wɔn nkwaa mu. Eyi nso betumi ato wɔn kɛse.
• Rheumatoid Arthritis: Eyi yɛ yare a ɛma nkwaa no ho yɛ hyew. Saa yare yi nso tumi ma ntini a ɛwɔ nipadua no mu no yɛ mmerɛw, na ɛno betumi de tebea yi aba.

Dɛn ne eyi ho sɛnkyerɛnne? Ɛte nka dɛn?

Sɛ wowɔ tebea bi a wɔfrɛ no ``Scapholunate Dissociation'' a, mpɛn pii no wubenya nea edidi so yi:

• Ɛyaw a ɛba nsateaa akyi, titiriw bere a wokura biribi denneennen (`strong gripping motion`) : sɛ nhwɛso no, bere a wobue toa ano anaasɛ worekura ɔpon ano.
• Mmerewa a ɛwɔ ahoɔden a wɔde kura nneɛma mu: Sɛ obi ntumi nkura nneɛma mu denneennen te sɛ kan no.
• Nsateaa a ɛho ahonhon na ɛyɛ mmerɛw: Beae a atwa nsateaa no ho ahyia no ho ahonhon na sɛ wode wo nsa bɛka a, ɛyɛ yaw.
• Ɛyaw bere a woretrɛw wo nsateaa mu: Ɛyɛ yaw bere a wodan wo nsa no.
• Ɛtɔ da bi a wobɛte "clicking" nnyigyei bi a efi wo nsateaa mu reba.

Kae sɛ, saa sɛnkyerɛnne ahorow yi mma obiara. Nnipa binom te ɛyaw pii, ebinom nso sua. Enti, sɛ wote nka sɛ biribi a ɛyɛ soronko wɔ wo nsateaa mu a, ɛbɛyɛ papa sɛ wobɛkɔ oduruyɛfo nkyɛn.

Ɔkwan bɛn so na oduruyɛfo hu eyi?

Sɛ wokɔ oduruyɛfo nkyɛn a, wobedi kan abisa wo yare no ho sɛnkyerɛnne. Bere tenten ahe na woanya ɛyaw no, ɛyɛɛ dɛn na efii ase, na bere bɛn na emu yɛ den? Afei wɔbɛhwehwɛ wo nsateaa mu ahwɛ sɛ ɛyaw, ɛho wosow, anaa ɛyɛ mmerɛw bi wɔ hɔ anaa.

Nea ɛka ho no, oduruyɛfo betumi ayɛ nhwehwɛmu te sɛ:

• Scaphoid Shift Test: Wɔ sɔhwɛ yi mu no, oduruyɛfo no de ne nsa to wo scaphoid dompe no atifi na ɔde wo nsateaa no tu. Saa sɔhwɛ yi hwɛ sɛnea scaphoid dompe no gyina pintinn.
• X-ray: Eyi betumi akyerɛ sɛnea nsonsonoe a ɛda scaphoid ne lunate nnompe (scapholunate gap) ntam no yɛ kɛse. Mpɛn pii no, saa kwan yi yɛ milimita 2 (mm 2) anaa nea ennu saa. Nanso, wɔ SL mpaapaemu fam no, saa nsonsonoe yi betumi ayɛ milimita 5 (mm 5) anaa nea ɛboro saa. Ɛtɔ da bi a, wobɛtumi ahunu biribi a wɔfrɛ no "ring sign" wɔ X-ray so. Eyi yɛ scaphoid dompe no a ɛnhyia.
• MRI (Magnetic Resonance Imaging) sɔhwɛ:MRI betumi akyerɛ pefee sɛ ebia scapholunate interosseous ligament (SLIL) no mu atetew anaa. Ebetumi anya ntini a ɛyɛ mmerɛw a atwa dompe no ho ahyia no ho mfonini pa.
• Arthroscopy: Eyi hwehwɛ sɛ wɔyɛ ntwitwiridii ketewaa bi na wɔde mfoninitwa afiri (scope) fa mu hwɛ nkwaa no mu. Eyi ma wuhu sɛnea ntini ahorow no asɛe no tẽẽ. Ɛtɔ mmere bi a, wobetumi ayɛ ayaresa bere koro no ara a wɔde yɛ ntini mu nhwehwɛmu no.

Ɔkwan bɛn so na wɔsa eyi? (Ayaresa)

Sɛ woresa tebea bi a wɔfrɛ no `Scapholunate Dissociation` a, nneɛma a edi kan a ɛsɛ sɛ woyɛ ne:

• Nnuru a wɔde kum ɛyaw: Wɔde nnuru ma de tew ɛyaw so.
• Splinting: Wɔde splint soronko bi di dwuma de ma nsateaa ne nsateaa no ntumi nkɔ baabiara. Eyi boa ma ntini a asɛe no sa yare.

Afei, ɛda adi sɛ wo duruyɛfo de wo bɛkɔ nsa ho ɔbenfo nkyɛn. Mpɛn pii no, tebea yi hwehwɛ sɛ wɔyɛ wɔn nsa oprehyɛn wɔ adapɛn asia akyi wɔ opira no akyi.

Bere a wɔreyɛ oprehyɛn no, wɔbɛma wo aduru a wɔde kum nipadua no nyinaa (a ɛkyerɛ sɛ wobɛda koraa), anaasɛ wɔbɛma wo aduru a wɔde kum wo wɔ ɔmantam mu (a ɛkyerɛ sɛ wo ho bɛtɔ wo nkutoo). Bere a wɔreyɛ oprehyɛn no, oduruyɛfo no bɛyɛ:

• Wɔtwa ketewaa bi wɔ nsateaa no akyi.
• Woyi ntini a asɛe no na wɔtew ho.
• Afei, sɛnea ɛbɛyɛ a wobɛto ɔkwan a ɛda scaphoid ne lunate nnompe ntam no mu, kyerɛ sɛ, wode biribi te sɛ ntini a wɔafa afi w’ankasa nipadua mu baabi foforo, nhama a wɔde pam, anaa dade skru di dwuma.
• Awiei koraa no, wɔsan pam nea wɔatwa no bom.

Dɛn na metumi ayɛ de atew asiane yi so?

Sɛnea ɛbɛyɛ a asiane a ɛwɔ `(Scapholunate Dissociation)` mu no so bɛtew no, adeɛ a ɛho hia paa ne sɛ wobɛtu anammɔn de abɔ wo ho ban afiri asehweɛ ho. Wubetumi ayɛ nneɛma te sɛ:

• Apɔw-mu-teɛteɛ a ɛma kari pɛ, nhyehyɛe, ne ahoɔden tu mpɔn mu a wode wo ho bɛhyɛ.
• Akwantu mu asiane ahorow a wobeyi afi hɔ wɔ fie. Sɛ nhwɛso no, hwɛ sɛ nhama a ɛho ayɛ hare, kanea a enni mu, ne ntama a wɔde hyɛ mu anaa.
• Sɛ ɛho hia a, fa afiri a ɛboa te sɛ poma anaa nea wɔde nantew di dwuma.
• Ɔhyɛ mpaboa a ɛyɛ tratraa, ɛyɛ den, na eye a ɛtwetwe.

Sɛ mewɔ saa tebea yi a, dɛn na metumi ahwɛ kwan? (Nsɛnnennen a ɛba) .

Sɛ woannya SL dissociation ayaresa ntɛm a, nsɛnnennen te sɛ eyinom betumi aba:

• Ɛyaw a enni sabea: Ebia wo nsateaa mu yaw kɔ so.
• Ntini mu yare a ɛma obi ho hyehye no: Ntini mu yare betumi aba bere a nkwaa no ayɛ hyew no.
• Nkwaa a entumi nnyina: Ebia nsateaa no bɛte nka te sɛ nea ɛretu a wontumi nni so.
• Ahoɔden a wɔde kura nneɛma mu a ɛso tew: Ebia wuntumi nkura nneɛma mu yiye.
• Scapholunate Advanced Collapse (SLAC) Ankle: Eyi yɛ ntini mu yare a ɛyɛ mmerɛw a ɛma nsateaa nkwaa no sɛe. Eyi betumi ayɛ yaw paa.

Bere tenten ahe na ebegye ansa na me ho atɔ me sɛ mewɔ (Scapholunate Dissociation) a? (Nsusuwii) .

Sɛ wɔyɛ wo oprehyɛn ma SL dissociation a, ɛho behia sɛ wohyɛ cast adapɛn kakraa bi wɔ ɛno akyi. Sɛ oduruyɛfo no yi fi hɔ wie a, nipadua mu ayaresa bɛboa ma wo nsateaa asan anya ahoɔden. Sɛ wosa wo yare yiye na wosa wo nipadua mu a, ɛsɛ sɛ wutumi san kɔ wo dwumadi ahorow a woyɛ daa no so wɔ asram kakraa bi mu.

Mɛyɛ dɛn ahwɛ me ho wɔ Scapholunate Dissociation ho?

Sɛ wosa SL dissociation yare wie a, wo ne wo duruyɛfo nkasa mfa dwumadi ne apɔw-mu-teɛteɛ ahorow a wubetumi ayɛ dwoodwoo ho. Apɔw-mu-teɛteɛ nhyehyɛe pɔtee bi wɔ hɔ a ebetumi aboa wo ma woasan anya ahoɔden ne baabi a wubetumi akɔ baabiara wɔ wo nsateaa mu. Mma ntra nea wo duruyɛfo ka kyerɛ wo sɛ yɛ no da na yɛ nneɛma a ɛyɛ den dodo wɔ wo nsateaa so.

Nkrasɛm a Wɔde Kɔ Fie

Okay, enti `Scapholunate Dissociation` a yɛkaa ho asɛm no ne bere a nnompe nketewa abien a ɛwɔ nsateaa no mu, `Scaphoid` ne `Lunate`, tu fi baabi, na ɛma nsonsonoe ba wɔn ntam. Nea ɛde eyi ba titiriw ne `Ligament` a ɛka nnompe abien yi bom no sɛe. Eyi taa ba bere a woateɛ wo nsa mu ahwe ase no.

Nsɛnkyerɛnne titiriw ne nsateaa mu yaw, ɛho ahonhon, ɛyɛ mmerɛw, ne ahoɔden a wɔde kura mu a ɛso tew. Oduruyɛfo de nhwehwɛmu ahorow te sɛ scaphoid shift test, X-ray, MRI, ne arthroscopy di dwuma de hu eyi.

Mpɛn pii no, oprehyɛn ne ayaresa a eye sen biara. Sɛ wɔde ayaresa a ɛfata ne nipadua mu ayaresa di dwuma a, nnipa dodow no ara tumi san kɔ wɔn dwumadi ahorow a wɔtaa yɛ no mu wɔ asram kakraa bi mu. Enti, sɛ wo nsateaa yɛ wo yaw anaasɛ wo ho nyɛ wo dɛ bere nyinaa a, ɛho hia sɛ wokɔ oduruyɛfo nkyɛn na wunya afotu sen sɛ wubesusuw sɛ ɛyɛ wo nsateaa a ɛyɛ mmerɛw ara kwa.

` Nsateaa, Nsateaa mu Ɛyaw, Nsa Nnompe, Ntini, Scapholunate Dissociation, Abubu, Oprehyɛn