Ðe wò ƒu meɖo nyuie le eƒe gbagbã vɔ megbe oa? (Malunion & Nonunion ƒe Gbagbãƒewo) .

Oo, ƒu gbagbã nye nusi ŋu màdi be yeabu gɔ̃ hã o, alo? Gake ate ŋu adzɔ le afɔku, gege tso kɔkɔƒe, alo ʋufɔku gɔ̃ hã me. Zi geɖe la, ne wozã atike si ɖɔktawo nana, abe aŋesisi kple ɖewohĩ aŋɔsisi ene la, woate ŋu agbugbɔ ƒu gbagbãawo aƒo ƒu nyuie. Gake ɣeaɖewoɣi la, nusiawo medzɔna bɔbɔe abe alesi nèsusui ene o. Nukae dzɔna ne womewɔ ɖeka nyuie o, alo ne womewɔ ɖeka kura o? Egbea, míaƒo nu tso nɔnɔme eve siawo tɔgbe ŋu: Malunion kple Nonunion .

Nukae nye Malunion kple Nonunion?

Kpuie ko la, esia fia nɔnɔme siwo me ƒu mehayana nyuie le ƒu gbagbã megbe o.

• Malunion nye ne wotsɔ ƒu gbagbãwo tsaka ɖekae, gake le mɔ gbegblẽ nu, le nɔnɔme si mesɔ o me . Abe agbalẽ gbadzɛ eve siwo wotsɔ glue bla ɖe wo nɔewo ŋu madzemadzee ene. Woate ŋu ahe ƒuawo, abɔbɔ wo, alo awɔ wo kpuie.
• Ðekawɔwɔmanɔmanɔ nye ne ƒu gbagbãwo mehaya kura o, le ɣeyiɣi didi aɖe megbe gɔ̃ hã . Ele abe ati gbagbã eve siwo mawɔ ɖeka o ko ene.

To mɔ sia dzi la, ne ƒu aɖe mesɔ o, alo ne mesɔ kura o la, ate ŋu akpɔ ŋusẽ gã aɖe ɖe míaƒe ŋutilã ƒe ƒunukpeƒe ƒe liƒo kple dɔwɔwɔ dzi. Bu alesi azɔlizɔzɔ asesẽe ne ƒu aɖe si le afɔ aɖe me mesɔ o ŋu kpɔ.

Zi geɖe la, gbagbãƒewo hayana nyuie ne wowɔ atike na wo nyuie. Ne womewɔe o la, ke ele be susu aɖe nanɔ anyi. Ate ŋu anye mɔ̃ɖaŋununya ƒe kuxi - si fia be, kakɛ siwo gbã la mewɔ ɖeka nyuie le dɔyɔɣi o. Alo ate ŋu anye nugbagbewo ƒe kuxi - si fia be nunɔamesiwo mesɔ gbɔ le wò ŋutilã si be wòada ƒu aɖe o. Ðɔktawo bua nu siawo katã ŋu ne wole nɔnɔme siawo dam.

Nukawoe nye ɖekamawɔmawɔ ƒomevi veviwo?

Wò ɖɔkta ateŋu atsɔ wò nonunion ade hatsotso me be ``Hypertrophic'', ``Atrophic'', alo ``Oligotrophic''. Wotu vovototodedeameme sia ɖe nusiwo na ƒua mele hayahayam o ƒe kpeɖodziwo dzi.

• Hypertrophic nonunion: Esia nye ɣeyiɣi si me ƒu yeyewo le wɔwɔm, gake ƒu kakɛ siwo gbã ƒe nugbɔwo meƒo ƒu nyuie o. Ne míagblɔe bubui la, nugbagbevi siwo katã hiã (e.g., ʋu ƒe sisi, lãmenugbagbeviwo) le wò ƒu me be wòada gbe le wo ŋu, gake ƒu ƒe kakɛawo melé ɖe wo nɔewo ŋu nyuie le dɔyɔɣi o. Tsɔe be xɔtunu siwo katã hiã be woatsɔ atu xɔ la le asiwò, gake womebla gliawo nyuie o.
• Atrophic nonunion: .Le go sia me la, ƒu yeye aɖeke medzena o, eye ƒua mexɔa ʋu nyui o. Esia fia be ƒua mele dɔyɔyɔm le nugbagbewo ƒe susuwo ta o. Abe alesi numiemie yrɔna tsi kple nunyiame manɔmee ene. Ɣeaɖewoɣi la, ne dɔlékui aɖe le ƒua me (septic nonunion) la, ʋua hã ate ŋu agblẽ.
• Oligotrophic nonunion: Le go sia me la, ƒu yeye aɖewo dzɔna, gake mede blibo o. Ƒu kakɛawo mele teƒe nyuitɔ o. Ðewohĩ womeɖo ƒu kakɛawo nyuie le gɔmedzedzea me o, alo wova tsaka emegbe. Kuxiwo ate ŋu anɔ ƒu kakɛawo ƒe liƒo kple nugbagbevi siwo le wo me ŋu.

Nukawoe nye dɔmawɔmawɔ nyuie ƒe dzesiwo?

Ne ƒu aɖe mesɔ o (malunion) la, àte ŋu akpɔ nu siawo tɔgbe:

• Wò ƒuwo dzena abe ɖe wokeke alo wobɔbɔ ene.
• Edze abe ƒua tro ene .
• Ƒua dzena kpuie wu alesi wònɔ tsã.

Ne èle ƒu si mesɔ o zãm le mɔ sia nu la, àte ŋu akpɔ dzesi siwo gbɔna:

• Evea ame le afisi ƒua le.
• Ʋuʋudedi le afima .
• Afɔkpodzi ne èle zɔzɔm (ne afɔe).

Ƒu siwo katã le míaƒe ŋutilã me la do ƒome kple wo nɔewo. Eyata ne ƒu aɖe gbɔdzɔ le teƒe ɖeka la, ate ŋu ana kpekpeme kple nyaƒoɖeamenu geɖe wu nasu ƒu bubuwo dzi. Eyata ne èzã ƒu si xɔ abi la, àte ŋu ase veve le ŋutilã ƒe akpa bubuwo.

Bu eŋu kpɔ, ne lãmeka aɖe si te ɖe ŋuwò la ƒo alo hee le ƒu kakɛ siwo mesɔ o ta la, esiawoe nye dzesi siwo do ƒome kple lãmeka si nàte ŋu akpɔ:

• Tingling, seselelãme abe anyidiwo le du dzi le tsatsam ene (paresthesia).
• Lãmetsi siwo le teƒe si woxɔ abi la gbɔdzɔna eye woƒe lãme ƒuna.
• Lãmetsiŋusẽ ƒe vevesese (ahɔhɔ̃mekawo ƒe dɔléle) le dzɔdzɔm.

Nukawoe nye ɖekawɔwɔ manɔsenu ƒe dzesiwo?

Ne ƒu meƒo ƒu o (nonunion) la, àte ŋu akpɔ dzesiwo abe:

• Vevesese deto aɖe si nɔa anyi ɖaa le teƒe si wogbã la.
• Gbɔdzɔgbɔdzɔ aɖe gakpɔtɔ le nuto ma me, si nye seselelãme be yemete ŋu le ʋuʋum nyuie o .
• Àte ŋu akpɔ vovototo aɖe tso gota , ɖewohĩ abe ƒoƒoe alo dometsotso ene.

Ɣeaɖewoɣi la, ne dɔlékui aɖe le ƒua me la, dzesi siawo ate ŋu akpe ɖe eŋu alo manɔ eŋu o:

• Tete
• Asrã
• Vuvɔ le wɔwɔm nam.

Nukatae ɖekawɔwɔ masɔmasɔ kple ɖekamawɔmawɔ siawo dzɔna?

Ne ƒu aɖe gbã la, susu geɖe li siwo tae mate ŋu ada gbe le eŋu nyuie o alo mahaya kura o. Na míalé ŋku ɖe wo dometɔ vevi aɖewo ŋu:

• Alesi wògbãe, aleke gbegbe wògblẽe nye si:Le kpɔɖeŋu me, ƒu siwo wotro (spiral fractures) alo wogbã wo kakɛ geɖe (comminuted fractures) mehayana nyuie o. Azɔ hã, ne abi sesẽwo (nuveviwɔame) le ŋuwò si gblẽa nu le ʋu si yia ƒua me ŋu la, akpɔ ŋusẽ ɖe eƒe dɔyɔyɔ dzi. Elabena ʋu ƒe sisi le vevie hafi ƒua nanɔ agbe ahahaya.
• Alesi wowɔa atike na wò kabakaba kple alesi wònyoe: Ne mèyi ɖɔkta gbɔ ne ènya gbã ƒu ko o la, ate ŋu adze hayahaya gɔme masɔmasɔ. Ɣeaɖewoɣi la, ne woɖo ƒu kakɛawo nyuie gɔ̃ hã la, woate ŋu avuvu kokoko. Esia ate ŋu adzɔ wu ne atikewɔwɔa tsi megbe alo ne atikewɔwɔa mesɔ gbɔ o.
• Gbɔɖeme kple ɖokuiwò takpɔkpɔ le dɔyɔyɔ me: Ele vevie ŋutɔ be nàna ƒu nanɔ teƒe nyuitɔ eye wòanɔ teƒe nyuitɔ esime wòle dɔyɔyɔm. Ame aɖewo xɔa ɣeyiɣi didi wu alesi wònɔna hafi ƒu aɖe hayana. Le nɔnɔme mawo me la, kuxiwo ate ŋu ado mo ɖa ne ɖɔktaa ɖe ƒua ɖa kaba akpa alo ne èdze ƒua zazã gɔme kaba akpa.
• Wò lãmesẽ bliboa kple ŋutete si le asiwò be nàda dɔ: Ne ƒu aɖe haya vivivi la, anɔ eme be wòazu malunion alo nonunion. Ame siwo tsi , nunyiame ƒe veve (vevietɔ calcium kple vitamin D), alo lãmenugbagbeviwo ƒe dɔwɔwɔ abe suklidɔ kple lãkusidɔ ene ate ŋu ana ƒu ƒe dɔyɔyɔ nagbɔdzɔ alo axe mɔ nɛ gɔ̃ hã. Ele vevie hã be míaɖo ŋku edzi be atama kple nicotine zazã hã ate ŋu ana ƒuwo nagbɔdzɔ eye wòahe dɔyɔyɔ ɖe megbe.

Aleke ɖɔktawo wɔa dea dzesi nɔnɔme siawoe?

Ne ɖɔktaa le dɔléle sia tɔgbe kpɔm la, abia wò gbã tso alesi abi la dzɔe kple atikewɔwɔ me nɔnɔme bubu ɖesiaɖe si ate ŋu anɔ ŋuwò ŋu. Emegbe, awɔ wò afɔ ŋuti ŋutilãmedɔdada. Alé ŋku ɖe nuwo abe tɔtrɔ siwo nàte ŋu akpɔ le gota kple alesi wòsena le eɖokui me ne èʋuʋui ene ŋu. Le afisi afɔa ƒe gbagbã le nu la, woate ŋu adi be yewoalé ŋku ɖe alesi nèzɔnae ŋu alo adzidze afɔa ƒe didime.

Emegbe, le nyateƒe me la, woɖea ƒua ƒe fotowo (`nɔnɔmetata`). Esia ate ŋu azã dodokpɔwo abe X-ray , CT scan , alo MRI ene .

Ðɔktaa alé ŋku ɖe eŋu be ƒua haya le nɔnɔme si mesɔ o, si mesɔ na ŋutilãa o hã. Ne nenemae la, atso nya me be ɖekawɔwɔ gbegblẽe.

Ne ƒua mehaya ɣeyiɣi didi o, alo ne mehaya keŋkeŋ o la, woyɔnɛ be `delayed union` alo nonunion. Ɣeyiɣi si wòxɔna hafi ƒu nahaya ate ŋu ato vovo le abi si nèxɔ, ƒu si ƒomevi wògbã, kple wò lãmesẽ bliboa nu. Zi geɖe la, ate ŋu axɔ ɣleti ade, enyi, alo wuieve hafi ƒu nahaya evɔ mehaya o.

Ðe woate ŋu awɔ ɖekawɔwɔ masɔmasɔ kple ɖekawɔwɔ manɔsenu siawo?

Menye malunion alo nonunion ɖesiaɖee wòle be woadzra ɖo o. Enɔ te ɖe ƒu si gbã, alesi gbegbe nèzãa ƒua, kple alesi gbegbe nɔnɔmea kpɔa ŋusẽ ɖe wò gbesiagbegbenɔnɔ dzii dzi. Gake ɣeaɖewoɣi la, ƒu si mehaya nyuie o ate ŋu ana azɔlizɔzɔ nasesẽ, ana wòase veve, alo ahe kuxi bubuwo vɛ. Ne edzɔ alea la, ate ŋu ahiã be woawɔ dɔ nɛ atsɔ aɖɔe ɖo. Wò ɖɔkta ate atike siwo menye amekoko o la kpɔ gbã eye emegbe wòaɖo aɖaŋu be nàwɔ dɔ na wò ne womewɔ dɔ o.

Malunion ƒe atikewɔwɔ

Atikewɔwɔ siwo menye amekoko o:

• Kpekpeɖeŋunana: Ɣeaɖewoɣi la, woate ŋu azã akɔtaɖonu tɔxɛ aɖe atsɔ akpe ɖe ƒua ŋu wòanɔ nɔnɔme nyuitɔ me.
• Atsyɔ̃ɖoɖo: Afɔkpa si wowɔ etɔxɛe ate ŋu akpe ɖe ame ŋu wòaxe afɔ ƒe didime ƒe vovototo.
• Lãmesẽfefewɔwɔ: Kamedede tɔxɛwo ate ŋu ado ŋusẽ lãmeka siwo ŋu dɔlélea le eye wòaɖe agba si le ƒuwo dzi dzi akpɔtɔ.
• Vevesesenutsitikewo: Ne èle veve sem ɣeaɖewoɣi la, àte ŋu azã vevesesenutsitike siwo bɔ abe NSAID ene.

Atikewɔwɔ to amekoko me:

• Ƒumeŋuɖui: Le esia me la, ƒumeŋutinunyala aɖe lãa ƒu si mesɔ o la eye wògaɖonɛ ɖe teƒe si wòle.
• Amekoko na abɔ alo afɔ didi: Ne wotso abɔ alo afɔ kpuie la, amekola ate ŋu azã mɔ̃ tɔxɛ aɖe atsɔ adidie.

Atikewɔwɔ na Nonunion

Atikewɔwɔ siwo menye amekoko o:

• Atikewɔwɔ: Ðewohĩ ahiã be woawɔ atike na wò ɖe nɔnɔme bubu aɖe (e.g. suklidɔ), dɔlékui aɖe, alo nunyiame ƒe veve ta.
• Orthoses: Akɔtaɖonu, aŋe, alo aŋe si wotsɔ ƒoa ƒu ate ŋu akpe ɖe ƒua ŋu wòagaʋã o eye wòakpe ɖe eŋu wòahaya.
• Ƒu ƒe ʋuʋu: Esiawo zãa ultrasonic alo electromagnetic ƒutsotsoewo tsɔ doa ŋusẽ ƒu ƒe dɔyɔyɔ.
• Dɔlékuiwo dodo: Dodo na lãmenugbagbeviwo alo ʋumenugbagbeviɣidɔ si me ʋumenugbagbevi dzĩwo sɔ gbɔ ɖo ate ŋu ana ƒuwo nahaya ahatsi.

Atikewɔwɔ to amekoko me:

• Debridement: Le esia me la, ƒumeŋutinunyala ɖea lãkusi kukua ɖa le ƒua ŋu.
• Ʋukawo ƒe dɔwɔwɔ: Ʋukawo ƒe amekola ate ŋu awɔ dɔ na wò ʋukawo be ʋu nagaɖo wò dzi me.
• Ƒu ƒe dodo:Le esia me la, ƒumeŋutinunyala la xɔa ƒu aɖe tso wò ŋutilã ƒe akpa bubu, alo tso ƒu si wotsɔ na wò me, eye wòdoa ƒu ɖe akpa si bu la me. Ƒu sia si wodo na ame la naa ƒu yeyewo ƒe tsitsi dzea egɔme nyuie.
• Ðeɖekpɔkpɔ le gaglãgbe kple ememe nuléle ɖe te: Le esia me la, ƒumeŋutinunyala la gbugbɔa ƒu kakɛawo ɖoa wo nɔewo ŋu eye wòtsɔa amekoko ƒe gaviwo kple agbawo alo ɖawo ɖɔa wo ɖo ɖekae.

Aleke nɔnɔmea le le atikewɔwɔ vɔ megbe?

Dɔdamɔnu siwo menye amekoko o kple esiwo womewɔna o siaa kpɔa dzidzedze gã aɖe le dɔdamɔnu siwo mewɔ ɖeka kple dɔmawɔmawɔ nyuie o kple esiwo mewɔ ɖeka kple wo nɔewo o dada me. Gake hayahaya kple gbugbɔgaɖoanyi xɔa ɣeyiɣi. Ðewohĩ ahiã be nàzã atizɔti alo afɔdzideƒe vaseɖe esime nàhaya. Ðewohĩ ahiã hã be woawɔ kamedede na wò hena ɣeyiɣi aɖe. Ɣeaɖewoɣi la, ne womate ŋu aɖo ƒuawo ɖe ɖoɖo nu nyuie o, alo ne ɖɔktaa mete ŋu ɖu nugbagbevi siwo le wo me dzi o la, atikewɔwɔa ate ŋu ado kpo nu.

Ƒu gbagbã ate ŋu adzɔ ɖe ame sia ame dzi. Menye ɣesiaɣie wòdzena ƒã ne ƒu gbã alo megbã o. Gake ne èsusu be ɖewohĩ ɖe le ye ŋu la, anyo wu be nàkpɔ ɖɔkta kaba ale si nàte ŋui. Elabena lã gbagbãwo hayana nyuie wu ne woda wo kaba eye woda wo nyuie. Wò ɖɔkta alé ŋku ɖe wò abi la ŋu ahakpɔ nusi ate ŋu anɔ mɔ xem nɛ be wòagahaya o. Emegbe aɖo aɖaŋu na wò le nusi nàte ŋu awɔ atsɔ akpe ɖe eŋu wòada gbe le eŋu nyuie ŋu, tsɔ wu be wòahe ɖekawɔwɔ masɔmasɔ alo ɖekamawɔmawɔ vɛ.

Nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Mègatsi dzodzodzoe ne ègbã ƒu o. Gake mègabu eŋu nu tsɛe hã o. Kpɔ ɖɔkta enumake eye nàwɔ atike na wò nyuie. Wɔ ɖe ɖɔkta ƒe mɔfiamewo dzi pɛpɛpɛ. Ne wona cast wò la, ke yi edzi vaseɖe esime wòagblɔ na wò be nàɖee. Ne egblɔ na wò be nàde kame la, wɔe nyuie. Ðu nuɖuɖu si da sɔ, vevietɔ nuɖuɖu siwo me calcium kple vitamin D sɔ gbɔ ɖo. Ne atamanolae nènye la, edzudzɔ atamanono kpena ɖe ame ŋu ŋutɔ le dɔyɔyɔ me. Elabena ƒu siwo le lãmesẽ me le vevie na agbe nyui nɔnɔ!

` Ƒu ƒe gbagbã, malunion, nonunion, ƒu ƒe dɔyɔyɔ, ƒu ƒe dɔwɔwɔ, ƒu ƒe atikewɔwɔ, ƒu gbagbã