Ðe wò ƒu gbã kpɔa? Mina míasrɔ̃ nu tso (Comminuted Fracture) ŋu le nya bɔbɔewo me!

Ɣeyiɣi aɖewo li le míaƒe agbe me si me wòle be míadze ŋgɔ afɔkuwo kple anyidzedze. Ɣeaɖewoɣi la, míate ŋu asi kple ƒoƒo sue aɖe, gake ɣebubuɣiwo la, míate ŋu agbã alɔ alo afɔ. Ne míegblɔ be ƒuwo gbãna la, ɖeko wo dometɔ aɖewo gbãna le teƒe ɖeka, gake gbagbã aɖewo li siwo me ƒua gbãna wòzua kakɛ geɖe, abe ɖe wogbãe ene. Emae nye nusi míeyɔna be `(Comminuted Fracture)` na ƒu ƒe gbagbã sesẽ sia tɔgbe. Eyata egbea míaƒo nu tso nɔnɔme sia si woyɔna be `(Comminuted Fracture)` ŋu tsitotsito vie , ale be nàte ŋu ase egɔme.

Nukae nye `(Comminuted Fracture)`?

Kpuie ko la, `(Comminuted Fracture)` nye ne wò ƒu ɖeka (i.e. ƒu) gbã ɖe akpa etɔ̃ alo esi wu nenema me . Bu eŋu ale: ne èda agba aɖe ɖe anyi la, egbãna ɖe eve ɣeaɖewoɣi, gake ɣeaɖewoɣi la, egbãna zua kakɛ suesuesuewo ƒe ƒuƒoƒo. Esia hã nye nu ɖeka ma ke. Le ƒu gbagbã bɔbɔe me la, ƒua ate ŋu agbã ɖe eve. Gake le `(Comminuted Fracture)` me la, ƒua gbãna zua kakɛwo, ɣeaɖewoɣi wòzua atikekui. Ele be nàse egɔme hã be esia nu sẽ vie wu aŋe si wogbã edziedzi . Elabena ne egbã zu kakɛwo ƒe ƒuƒoƒo la, esesẽna vie be woagatsɔ wo aƒo ƒu nyuie.

Nukatae ``Comminuted Fracture'' dzɔna? Nukawoe gbɔ wòtsona?

Hafi ƒu si le abe esia ene nagbã wòazu kakɛwo ƒe ƒuƒoƒo la, ele be wòanye nusi aƒoe sesĩe ŋutɔ, si agblẽ nu geɖe . Ƒã ŋutɔ be esia nadzɔ tso anyidzedze sue aɖe ko me. Nu aɖewo siwo ate ŋu ahe vɛ lae nye esi:

• Ʋufɔku sesẽwo: Esia ate ŋu atso ʋuwo abe ʋuwo kple dzokekewo ƒe gododo alo afɔku sesẽ bubuwo me.
• Tsitretsitsi tso kɔkɔƒe gã aɖe: Ne ège tso kɔkɔƒe gã aɖe, abe ati alo xɔ aɖe dzi ene.
• Kamedefefe me abi sesẽwo: Ate ŋu adzɔ le kamedefefe aɖewo siwo zɔna kabakaba, siwo kpɔa ŋusẽ ɖe ame dzi (e.g. rugby) me.
• Nuveviwɔame sesẽwo abe tudada ene: Le nɔnɔme siawo tɔgbe me la, ``Comminuted Fracture'' ateŋu adzɔ elabena wotsɔa ŋusẽ gã aɖe dea ƒua ŋu.

Gake, nu bubu aɖe hã li. Ne amewo le tsitsim la, woƒe ƒuwo gbɔdzɔna, si míeyɔna hã be `(Osteoporosis)`. Le amesi ƒe ƒuwo gbɔdzɔ alea gome la, mɔnukpɔkpɔ li be anyidzedze sue aɖe gɔ̃ hã, si magblẽ nu boo aɖeke na ame mamã dedie o, ate ŋu ana `(Comminuted Fracture)` nadze anyi. Gake nusi wokpɔna wue nye esiwo dzɔna le ŋusẽkpɔɖeamedzi gã siwo ŋu míeƒo nu tsoe va yi ta.

Nukae nye `(Comminuted Fracture)` ƒe dzesiwo? Aleke nèwɔ nya?

Àte ŋu akpɔ ale si gbegbe wòvea ame ne ƒu aɖe gbã wòzu kakɛ geɖe la le susu me. Dzesi vevi aɖewoe nye esi:

• Vevesese sesẽ: Nu vevitɔe nye vevesese sesẽ. Vevesesea ate ŋu asẽ ale gbegbe be màte ŋu aka asi eŋu gɔ̃ hã o.
• Vuvu kple abi kabakaba: Teƒe si abi la le adze vuvu gɔme kabakaba, eye ate ŋu adze blɔ/aɖabɛ gɔ̃ hã.
• Nuwɔametɔnyenye: Esia fia be ne alɔ alo afɔe la, eƒe nɔnɔme ate ŋu atrɔ eye wòadze abe ɖe wòkeke ene.
• Mate ŋu aʋuʋu abɔ kple afɔ o: Esia wɔnɛ be womete ŋu zãa alɔ alo afɔ si xɔ abi la alo ʋãnɛ o.
• Ɣeaɖewoɣi la, ƒu gbagbã aɖe ate ŋu ado to ŋutigbalẽa me: Esia nye afɔku vie. Míeyɔa esia hã be ``Open Comminuted Fracture``. Ne edzɔ alea la, mɔnukpɔkpɔ geɖe wu li be woaxɔ dɔlélea.
• Gbeɖiɖi "crackling" sese alo sese le afɔkua wɔɣi: (`(Crepitus)`) Ame aɖewo ateŋu ase alo ase ƒuwo ƒe ƒoƒo ƒe gbeɖiɖi.
• Ʋuʋu si mesɔ o ne woka asi teƒe si wògblẽ nu le ŋu: (`Ʋuʋu si mesɔ o`) Ate ŋu ase le eɖokui me abe alɔ/afɔ le bɔbɔm le teƒe si zi geɖe menye ƒunukpeƒe o ene.

Ne dzesi siawo dometɔ ɖeka alo esi wu nenema le ŋuwò la, ele vevie ŋutɔ be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo enumake.

Aleke ɖɔkta awɔ anya ``Comminuted Fracture'' nyuie?

Ne èyi kɔdzi kple abi si le abe esia ene la, ɖɔkta aɖe abia wò gbã be nukae dzɔ ɖe dziwò, ado teƒea kpɔ, eye emegbe wòawɔ dodokpɔ siwo gbɔna atsɔ anya nenye be gbagbãƒea nye ``nuveviwɔame si wogbã'' kple alesi gbegbe wòsesẽe:

• X-ray: Esiae nye dodokpɔ si bɔ wu. X-ray ate ŋu aɖe alesi ƒua gbãe, kakɛ nenie wogbãe, kple kakɛawo dometɔ nenie kaka ɖe teƒeteƒewo la afia kɔte.
• CT scan (Computed Tomography scan - CT scan): Ɣeaɖewoɣi, vevietɔ ne ƒunukpeƒea te ɖe ƒunukpeƒe aɖe ŋu (e.g. klo, abɔta), alo ne èdi be yeakpɔ nyatakaka bubuwo tso ƒu kakɛawo ŋu la, wò ɖɔkta ate ŋu adɔ be woawɔ CT scan. Esia ateŋu awɔ ƒuawo ƒe nɔnɔmetata si le akpa etɔ̃ (`3D`), si ateŋu akpeɖe ŋuwò be nàse nɔnɔmea gɔme nyuie wu.
• Magnetic Resonance Imaging (MRI): Ƒã hafi wozãa MRI tsɔ ɖoa ​​kpe gbagbãƒe si wogbã dzi. Gake ate ŋu ahiã be woawɔ MRI atsɔ akpɔe ɖa be nu gblẽ le lãmeka falɛfalɛawo (abe lãmekawo, lãkusiwo, lãmekawo, kple ʋukawo ene) siwo ƒo xlã gbagbãƒea ŋu hã.

Le dodokpɔ siawo megbe hafi ɖɔktaa tsoa nya me le nusi tututu gblẽ le ŋuwò kple atikewɔwɔ si ƒomevi wòhiã ŋu.

Aleke nèwɔa atike na `(Comminuted Fracture)`? Ɣeyiɣi didi kae wòxɔna hafi wòhayana?

Míegblɔ xoxo be ``Comminuted Fracture'' nye gbagbã si sesẽ vie. Ne ƒua gbã zu kakɛ geɖe la, ehiã be woagbugbɔ kakɛawo aƒo ƒu ahaɖɔ wo ɖo le mɔ si ana womaʋuʋu o nu. Ne menye nenema o la, ƒua madze nyuie o.

Eyata zi geɖe la, ``Comminuted Fracture'' hiã amekoko.

Amekoko bia be woagbugbɔ ƒu kakɛ siwo gbã la ayi woƒe nɔƒe gbãtɔ alesi woate ŋui eye emegbe woagatsɔ wo aƒo ƒui. Mɔnu vovovowo li na esia:

• Open Reduction and Internal Fixation (ORIF): Esiae nye amekokomɔnu si wozãna wu.
• `Open Reduction` gɔmee nye: Ðɔkta lãa ŋutigbalẽa, yia ƒu si gbã la gbɔ, eye emegbe wòtsɔa asi trɔa asi le ƒu kakɛawo ŋu.
• `Ememe Kpekpeɖeŋu` gɔmee nye: Alesi wotsɔa ƒu kakɛ siwo wodzra ɖo la ɖoa wo nɔewo ŋu to ga gbadzɛ tɔxɛwo, gavi, atikplɔ alo ɖawo dede eme tso eme. Wotsɔa ga tɔxɛ siwo wowɔ be woasɔ ɖe ŋutilãa nu la wɔa esiawoe.
• External Fixation: Le comminuted gbadzɛ aɖewo siwo nu sẽ ŋutɔ me, vevietɔ ne abi si le ʋuʋu ɖi alo ne abi la vuvu ŋutɔ la, ɖewohĩ manya wɔ be woawɔ ORIF dɔ na ame enumake o. Le nɔnɔme mawo me la, wozãa mɔ̃ aɖe si woyɔna be external fixator.
• Esia bia be woatsɔ gaƒoɖokui geɖe (`pins` alo `screws`) ato ŋutigbalẽ si le teƒe si wògbã la tame kple ete me ayi ƒua me, eye woatsɔ wo abla ɖe xɔtunu (`frame`) si le ŋutilãa godo ŋu. Esia kpena ɖe ame ŋu be ƒu kakɛawo nɔa wo nɔƒe evɔ womeʋãna o. Ne abi la haya vie eye abi la nu fa ko la, woate ŋu awɔ dɔ na `(ORIF)` emegbe. Ɣeaɖewoɣi la, woateŋu azã `(External Fixator)` sia vaseɖe esime ƒua nahaya.

Atikewɔwɔ amekoko manɔmee:

Ƒã ŋutɔ be woada `(Comminuted Fracture)` amekoko manɔmee. Esi ƒu kakɛawo kaka ɖe teƒe geɖe ta la, womasɔ nyuie kple `(Plaster Cast)` alo `Splint` ko o. Gake ƒã ŋutɔ , ne ƒu kakɛawo medidi boo tso wo nɔewo gbɔ o la, ɖɔkta ate ŋu adze agbagba be yeada gbe le wo ŋu amekoko manɔmee to aŋɔ si wotsɔ ƒoa ƒui la sisi me. Ke hã, esia mekpɔa dzidzedze boo o.

Vevesese dzi ɖuɖu:

Esi wònye be esia vea ame ŋutɔŋutɔ ta la, ɖɔktaa ana vevesesenutsitike siwo sɔ wò .

Ɣeyiɣi si woatsɔ ada gbe le ame ŋu:

Ɣeyiɣi si wòxɔna hafi ``Comminuted Fracture'' haya la toa vovo tso ame ɖeka gbɔ yi bubu gbɔ eye wònɔa te ɖe gbagbãƒea ƒe nɔnɔme nu. Exɔa ɣeyiɣi didi wu alesi wògbãna le mɔ si sɔ nu.

• Ate ŋu axɔ ɣleti geɖe (zi geɖe la, ɣleti 3-6 alo esi wu nenema) hafi ƒu kakɛawo naƒo ƒu ɖekae eye wosẽna ɖe edzi.
• Le ema megbe gɔ̃ hã la, ne èdi be yeagazã alɔ/afɔ si ŋu dɔlélea le la ake la, ahiã godoo be nàwɔ atike aɖe si woyɔna be kamedede . Esia hã ate ŋu axɔ ɣleti geɖe.

Eyata, ate ŋu axɔ ƒe ɖeka hafi wòahaya keŋkeŋ. Eyata ele vevie be nàgbɔ dzi ɖi ahawɔ atike nɛ.

Nukae nye kuxi siwo ate ŋu ado tso ``Comminuted Fracture'' me?

Abe abi ɖesiaɖe ene la, ``Comminuted Fracture'' ateŋu ahe kuxi aɖewo vɛ. Enyo be nànya nusiawo hã:

• Dɔdzedze:Vevietɔ le ``Open Fracture`` (ne woto ŋutigbalẽa me eye ƒua ɖe go) alo le amekoko megbe la, dɔlékuiwo ateŋu age ɖe abi la me eye woahe dɔlékui vɛ.
• Lãmetsi alo ʋukawo ƒe gbegblẽ: Ne ƒu aɖe gbã la, ƒu kakɛ ɖaɖɛawo ate ŋu agblẽ nu le lãmeka alo ʋuka siwo te ɖe eŋu ŋu.
• Compartment Syndrome: Esia nye dɔléle sesẽ aɖe. Lãmetsi siwo ƒo xlã abi la ƒe vuvu ate ŋu ana nyaƒoɖeamenu si le xɔa me nadzi ɖe edzi, si ana ʋu natso. Esia nye nɔnɔme si hiã be woawɔ atike na ame kpata. Dzesiawo dometɔ aɖewoe nye vevesese sesẽ, abi, kple abɔ/afɔwo ƒe ʋuʋu.
• Malunion alo Nonunion: Ɣeaɖewoɣi la, ƒu kakɛawo ate ŋu aƒo ƒu madzemadzee (abe ƒumeŋuɖui ene). Alo woate ŋu anɔ anyi ɖekae ɣeyiɣi didi aɖe. Ne edzɔ alea la, ɖewohĩ ahiã be woagawɔ dɔ na wò ake.
• Le ɣeyiɣi aɖe megbe la, ƒunukpeƒeveame (Arthritis): Vevietɔ ne ƒunukpeƒetetedɔ aɖe si gbã la, le ɣeyiɣi aɖe megbe la, ƒunukpeƒe ma ate ŋu axɔ ƒunukpeƒetetedɔ, si fia be ƒunukpeƒeveame.
• Vevesese atraɖii: Ame aɖewo ate ŋu ayi edzi anɔ veve sem ne abi la haya gɔ̃ hã.
• Abɔ/afɔ ƒe sesẽ kple dɔmawɔmawɔ nyuie: Abɔ/afɔ si xɔ abi ate ŋu asẽ eye mate ŋu abɔbɔ alo aɖɔ ɖo abe tsã ene o. Afi siae kamedede va nɔa vevie ŋutɔ le.

Nu siawo tɔgbe medzɔna ɖe amesiame dzi o, gake ele vevie be nànya be woate ŋu adzɔ eye nàwɔ ɖe ɖɔkta ƒe mɔfiamewo dzi nyuie.

Nukae wòle be nàwɔ be nàhaya kaba le `(Comminuted Fracture)` megbe?

Ne ``Comminuted Fracture'' le ŋuwò eye nèle atike wɔm la, lé be na nu siawo be wòakpe ɖe ŋuwò nàhaya kaba:

• Wɔ ɖe ɖɔkta ƒe mɔfiamewo dzi pɛpɛpɛ: Emae nye nu vevitɔ kekeake. Wɔ nusianu pɛpɛpɛ, abe alesi nàno wò atike ene, alesi nàlé be na wò abi, gbɔɖeme agbɔsɔsɔme si nèhiã, kple ɣeyiɣi si wòle be nàgadze azɔlizɔzɔ gɔme ake.
• No atike siwo woŋlɔ na wò ɖe game dzi: No atike siwo woŋlɔ na wò, abe vevesesenutsitikewo kple ɖewohĩ dɔlékuiwutikewo ene (be nàxe mɔ ɖe dɔlékuiwo xɔxɔ nu), abe alesi wogblɔe ene.
• Gbɔɖeme le vevie: Ele vevie ŋutɔ be nàgbɔ ɖe eme alɔ/afɔ si ŋu dɔlélea le vaseɖe esime ƒua nahaya. Mègawɔ nu kpekpe aɖeke kɔklɔ, duƒuƒu alo titri o vaseɖe esime wò ɖɔkta nagblɔ na wò be nàwɔe.
• Do teƒe si dɔlélea le la ɖe dzi be wòaɖe abi dzi akpɔtɔ: Ne alɔ/afɔe la, etsɔtsɔ kɔe kple akɔtaɖonu ate ŋu akpe ɖe ŋuwò nàɖe abi dzi akpɔtɔ.
• Kpɔ egbɔ be yewɔ ŋutilãmedɔdada: Ne wò ɖɔkta kafui la, de kamedede ƒe ɣeyiɣiwo edziedzi. Wɔ kamededeawo le aƒeme hã. Esia akpe ɖe ŋuwò be ŋusẽ nagaɖo wò alɔ/afɔ ŋu eye wòate ŋu atrɔ ɖe nɔnɔmewo ŋu ake.
• Ƒo nuɖuɖu nyui siwo me nunyiame le:Ƒo nuɖuɖu siwo me calcium kple vitamin D sɔ gbɔ ɖo (abe notsi, yogurt, cheese, amagbe damawo, kple tɔmelã) geɖe wu, siwo kpena ɖe ƒuwo ƒe dɔyɔyɔ ŋu. Nuɖuɖu siwo me protein sɔ gbɔ ɖo hã le vevie.
• Ne ènoa atama la, dzudzɔ: Atamanono hea ƒuwo ƒe dɔyɔyɔ ɖe megbe ŋutɔ. Eyata ne atamanolae nènye la, edzudzɔ fifia nye kpekpeɖeŋu gã aɖe na wò.
• Mègadzo le atikewɔwɔ me dodokpɔwo dzi o: Yi ɖɔkta gbɔ le ŋkeke siwo dzi wòagblɔ na wò be nàtrɔ ava kpɔ wò nɔnɔmea ɖa.

Ðe woate ŋu axe mɔ ɖe ``Comminuted Fracture'' nua?

Afɔkuwo nye nusiwo dzɔna le ɣeyiɣi si me míele mɔ kpɔm na wo kura o. Gake dedienɔnɔ ƒe ɖoɖo aɖewo dzi wɔwɔ ate ŋu aɖe abi gã xɔxɔ ƒe afɔkua dzi akpɔtɔ.

• Dedienɔnɔ ƒe ɖoɖowo dzi wɔwɔ:
• Do zikpuimeka ɣesiaɣi ne èle ʋuwo me.
• Do gakuku si sɔ ne èle dzokeke alo gasɔ dom.
• Wɔ ɖe dɔwɔnu kple ɖoɖo siwo le dedie dzi le dɔwɔƒe, vevietɔ le teƒe siwo afɔku le abe xɔtutu ene.
• Ne èle kamedefefewo wɔm la, zã dedienɔnɔ ƒe dɔwɔnuwo (e.g., dzɔlawo, nutsyɔnu) siwo sɔ na kamedefefea.
• Mɔxexe ɖe anyidzedze nu (vevietɔ na ame tsitsiwo):
• Nya nu tso afɔku siwo ate ŋu ado tso wò aƒe me le wò aƒeme be nàdze anyi ahadze anyi (e.g., tsileƒewo, atrakpuiwo). Ne ehiã la, de asiléƒe kple abadzivɔ siwo meʋuʋuna o la eme.
• Kpɔ egbɔ be akaɖi nyuiwo le afima le zã me.
• Ne azɔlizɔzɔ sesẽ na wò la, zã atizɔti alo azɔlizɔnu abe alesi wò ɖɔkta gblɔe ene.
• Ƒuwo me léle ɖe asi sesĩe:
• Ƒo nuɖuɖu si da sɔ si me calcium kple vitamin D sɔ gbɔ ɖo.
• Kamedede edziedzi (kamedede si tsɔa kpekpeme doa ŋusẽ ƒuwo).
• Ne dɔléle aɖe abe ƒumeŋuɖui ene le ŋuwò la, na woawɔ atike nɛ nyuie.

Nu siawo ŋu bubu akpe ɖe mía ŋu vaseɖe afi aɖe be míakpɔ mía ɖokui ta tso abi gãwo abe `(Comminuted Fracture)` ene me.

Nu vevitɔ kekeake siwo wòle be wòanɔ susu me na wò (Take-Home Message) .

Enyo, eyata míeƒo nu geɖe tso `(Comminuted Fracture)` ŋu egbea. Nu vevi siwo dzi wòle be nàɖo ŋkui lae nye esi:

• ``Comminuted Fracture`` nye nɔnɔme sesẽ aɖe si me ƒu gbãna zua kakɛ geɖe.
• Zi geɖe la, ŋusẽkpɔɖeamedzi sesẽ aɖe ŋutɔ gbɔe esia tsona (abe afɔku gã aɖe, anyidzedze tso kɔkɔƒe ene).
• Ne èxɔ abi abe esia ene la , ele vevie be nàyi atikewɔƒe enumake.
• Zi geɖe la, nɔnɔme sia bia be woawɔ dɔ na ame be wòaɖɔ ƒu kakɛawo ɖo nyuie.
• Exɔa ɣeyiɣi hafi wòdaa gbe, eye kamedede nye dɔyɔyɔ ƒe akpa vevi aɖe ŋutɔ.
• Ne èwɔ ɖe ɖɔkta ƒe mɔfiamewo dzi pɛpɛpɛ eye nètsɔ dzigbɔɖi da dɔ na ɖokuiwò la, àte ŋu ahaya nyuie.

Mègavɔ̃ o, ke boŋ lé be na wò dedienɔnɔ ɣesiaɣi. Elabena abe alesi wogblɔnɛ ene la, "Afɔɖeɖe nyo wu atikewɔwɔ." Mele mɔ kpɔm be nyatakaka sia aɖe vi na wò!

` Comminuted Fracture, ƒu gbagbã, ƒu si wogbã, amekoko, ƒu ƒe dɔyɔyɔ, kamedede, afɔkuwo, ƒu ƒe atikewɔwɔ