Nukatae ƒuwo gbãna ɣeaɖewoɣi le nu suetɔ kekeake gɔ̃ hã me? (Pathologic Fracture) Na míasrɔ̃ nu tso eŋu.

Tsɔe be èle zɔzɔm le wò aƒea me eye wò afɔ ge ɖe modzakaɖebɔ alo afɔti sue aɖe ƒe dzogoe aɖe dzi. Alo míagblɔ be èƒo zikpui aɖe ƒe afɔ sesĩe vie. Zi geɖe la, ƒu gã aɖe si le míaƒe alɔnu alo afɔ me megbãna le nane si le abe ema ene ta o, alo? Ke hã, ame aɖewo ƒe ƒuwo gbɔdzɔna vie, eya ta nu sue aɖe si le abe ema ene gɔ̃ hã ate ŋu agbã wo. Emae nye nusi ŋu míele nu ƒom tsoe egbea (Pathologic Fracture).

Nukae nye esia (Pathologic Fracture)?

Kpuie ko la, Pathologic Fracture nye ƒu ƒe gbagbã . Gake menye ɖeko esia dzɔna o. Wò ƒuwo gbɔdzɔ le atikewɔwɔ ƒe nɔnɔme bubu aɖe si le wò ŋutilã me ta, si wɔe be woate ŋu agbã wu ƒu siwo sɔ. Ɣeaɖewoɣi la, ɖɔktawo yɔa esia hã be Pathologic Fracture.

Bu eŋu kpɔ ko, anyidzedze bɔbɔe, afɔku sue aɖe si dzɔ esime wòle kamedefefe wɔm, alo ŋusẽkpɔɖeamedzi sue aɖe si ŋutilãa ate ŋu anɔ te ɖo le dzɔdzɔme nu gɔ̃ hã ate ŋu ana ame aɖe si ƒe ƒuwo gbɔdzɔ la nagbã le dɔléle aɖe nu. Ele abe ati gbegblẽ aɖe si ate ŋu agbã ne wozi edzi vie gɔ̃ hã ene.

Ƒu ƒomevi kawo ŋue esia gblẽa nu le wu?

Nɔnɔme sia si woyɔna be dɔléle ƒe gbagbã ate ŋu adzɔ le ƒu ɖesiaɖe si le ŋutilãa me me ŋutɔŋutɔ. Gake wokpɔnɛ zi geɖe le ƒu siwo sesẽ ŋutɔ le dzɔdzɔme nu eye womegbãna bɔbɔe o me . Le kpɔɖeŋu me:

• Vertebrae : Esiawoe nye ƒu sue siwo wɔa míaƒe akɔta.
• Akɔta ƒe akɔta
• Humerus : Esia nye ƒu si le abɔta ƒe akpa si le etame tso abɔta va ɖo abɔta.
• Femur : Ƒu diditɔ kple sesẽtɔ kekeake le míaƒe ŋutilã me.
• Tibia : Afɔ ƒe ƒu ɣi si tso klo vaseɖe afɔkpodzi.
• Fibula : Ƒu tsɛ aɖe si zɔna sɔ kple afɔkpodzi.

Zi geɖe la, ne èɖiɖi vie ne èle aƒemedɔwo wɔm alo mèda asɔ o ne èle atrakpui aɖe dzi yim hã la, ƒã hafi ƒu gã siawo siwo le míaƒe abɔwo kple afɔwo me la gbãna. Gake ne atikewɔwɔ me dɔléle aɖe le ŋuwò si na wò ƒuwo gbɔdzɔ la, nudzɔdzɔ sue aɖe si le abe ema ene gɔ̃ hã ate ŋu ana wò ƒuwo nagbã le dɔléle ta .

Ɣeaɖewoɣi la, ahiã be woawɔ dɔ na ame be wòaɖɔ ƒu si gbã la ɖo. Alo, ate ŋu ahiã be woawɔ dɔ na ame be woaxe mɔ ɖe dɔléle ƒe gbagbã nu hafi wòadzɔ. Wò ɖɔkta aɖo aɖaŋu na wò hã be nàzã atike bubuwo na nɔnɔme si na wò ƒuwo le gbɔdzɔgbɔdzɔm. Ɣeyiɣi si wòxɔ hafi wòhaya la nɔ te ɖe ƒu si gbã kple nusi gbɔ wòtso dzi.

Nukae nye Pathologic Fracture ƒe dzesiwo?

Dzesi siwo dzena le Pathologic Fracture ŋu sɔ kple esiwo dzena le gbagbã si sɔ me ŋutɔ. Woawoe nye:

• Vevesese : Vevesese sesẽ si womate ŋu ado dzi atsɔ o ate ŋu adzɔ.
• Vuvu : Teƒe si ƒua gbã la avuvu.
• Vevesese: Wosea veve ne woka asi eŋu alo te ɖe eŋu.
• Inability to move normally : Womate ŋu aʋuʋu ŋutilã ƒe akpa si ŋu dɔlélea le alo azãe le mɔ si sɔ nu o.
• Abi alo ŋutigbalẽ ƒe amadede ƒe tɔtrɔ : Ɣeaɖewoɣi la, ate ŋu adze blɔ/aɖabɛ.
• Nuwɔametɔ alo ƒunukpeƒetetedɔ : Woate ŋu akpɔ nɔnɔme alo ƒunukpeƒetetedɔ si mebɔ o le afisi wògbã le.

Nu vevitɔe nye be ne dzesi siawo le ŋuwò hã la, ele be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo godoo be nànya nenye be Pathologic Fracture ye alo menyee o, kple nusi gbɔ wòtso.

Nukatae esia dzɔna ɖo? (Pathologic Fracture) Nusiwo Wòtsona

Nusi koŋ gbɔ Pathologic Fracture tsonae nye, ne mènya gɔ̃ hã o, atikewɔwɔ ƒe nɔnɔme aɖe si nana wò ƒuwo gbɔdzɔna le mɔ si mele dzɔdzɔme nu o nu le wò ŋutilã me . Nu vevi eve siwo gbɔ esia tsonae nye ƒumeŋuɖui kple ƒumeŋuɖui.

Le ƒumeŋuɖui ta

Ƒumeŋuɖui nye dɔléle si me ƒuwo va nɔa ʋuʋum vivivi eye wogbãna . Ðeko wòle abe ɖe woɖe do ɖe wo me tso eme teti koe nye ema ene. Esia wɔnɛ be ƒuawo megasẽna o eye wòte ŋu gbãna bɔbɔe. Ne ame geɖe gbã ƒu vɔ ko hafi wova nya be ƒumeŋuɖui le yewo ŋu. Esia le alea elabena ɖewohĩ dɔlélea ƒe dzesi aɖeke madze ƒã le gɔmedzedzea me o .

Nyɔnuwo kple amesiwo xɔ wu ƒe 65 koŋue le afɔku me be woaxɔ ƒumeŋuɖui. Ðewohĩ èse be mía tɔgbuiwo kple mamawo agbã alɔ alo afɔ ne wodze anyi vie gɔ̃ hã. Susu vevi siwo tae wòle nenema ɖo dometɔ ɖekae nye ƒumeŋuɖui.

Le ƒu ƒe dɔdzẽ alo abi ta

Dɔdzẽ nye lãmenugbagbevi siwo mesɔ o ƒe ƒuƒoƒo sesẽ aɖe si dzɔna le míaƒe ŋutilã ƒe akpa sia akpa. Esiawo dometɔ aɖewo ate ŋu anye kansa (dɔlékui vɔ̃ɖi), gake bubuwo ate ŋu anye esiwo menye kansa o (siwo me dɔlékui mele o). Ƒu ƒe abi menye dɔdzẽ sesẽwo o, ke boŋ lãmenugbagbevi siwo mesɔ o siwo nana ƒua gbɔdzɔnae.

A (Pathologic Fracture) ate ŋu adzɔ ne dɔdzẽ alo abi aɖe do le ƒu aɖe me, alo ne ekaka ɖe ƒua me tso teƒe bubu. Emegbe ƒua ƒe dzɔdzɔmenɔnɔme kple eƒe ŋusẽ gbɔdzɔna.

• Dɔdzẽ vɔ̃ɖiwo: Ne ƒumekansa (sarcoma) le ŋuwò la, ate ŋu atsi le ƒua ŋutɔ me. Gake ebɔ wu be kansa nakaka ɖe ƒuwo me tso ŋutilã ƒe akpa bubu (e.g., no, lãkusi, ʋuka) (ƒu ƒe kaka).
• Ƒumeŋuɖui siwo me dɔlékui aɖeke mele o: Esiawo nye ƒumeŋuɖui siwo me kansa lãmenugbagbeviwo mele o, gake wotsina le ƒuwo me. Wole ƒomevi vovovowo. Ƒomevi siawo dometɔ ɖesiaɖe ate ŋu ana ƒua nagbɔdzɔ (pathologic fracture).

Aleke nàwɔ anya dɔléle sia nyuie?

Ðɔkta aɖe akpɔe be Pathologic Fracture le ŋuwò.Wowɔa ŋutilãmedɔdada kple nɔnɔmetatawo dodokpɔ vovovowo .

Woawɔ nɔnɔmetatawo dodokpɔ siawo dometɔ ɖeka ya teti atsɔ ado wò ƒu si xɔ abi la kple nuto siwo ƒo xlãe kpɔ:

• X-ray : Esiawo ate ŋu aɖe ƒu ƒe gbagbã afia kɔte.
• MRI Scan (MRI - Magnetic Resonance Imaging) : Esia wɔnɛ be menye ƒuwo koe nèkpɔna o, ke boŋ lãmeka falɛfalɛ siwo ƒo xlãe kple nusiwo le abe dɔdzẽ ene hã.
• CT scan (Computed Tomography scan) : Esia ate ŋu awɔ ƒuwo kple lãkusi siwo ƒo xlãe ƒe nɔnɔmetata tsitotsito hã.

Le nusi gbɔ gbagbãƒea tso nu la, ahiã be nàgawɔ dodokpɔ bubuwo na wò. Le kpɔɖeŋu me:

• Ʋudodokpɔ hena kansa : Kpɔ kansa ƒe dzesiwo ɖa.
• Biopsy : Lãmetsi alo lãkusi sue aɖe ɖeɖe kple edodokpɔ le nusuekpɔmɔ̃ me.
• Ƒu ƒe kpekpeme dodokpɔ (DXA scan) : Esia le vevie ŋutɔ be woatsɔ akpɔe ɖa be ƒumeŋuɖui hã le lãme na ame hã.

Aleke nèdaa (Pathologic Fracture) ƒe dɔléle aɖee?

Dɔléle ƒe Gbagbãdɔ ƒe atikewɔwɔ nɔ te ɖe ƒu si wogbã kple nusi gbɔ wòtso dzi . Abe alesi wòle le gbagbãƒe bubuwo katã gome ene la, wozãa atike siwo gbɔna na Pathologic Fractures:

• Mɔxexeɖedɔléle nu: Ðewohĩ ahiã be nàdo aŋetu alo aŋenu si wotsɔ blaa nu. Ɣeyiɣi didi si wòahiã be nàdo ɖeka anɔ te ɖe ƒu si gbã ƒomevi dzi. Ahiã be ame akpa gãtɔ nado aŋekotoku kwasiɖa geɖe. Ðewohĩ ahiã hã be nàwɔ X-ray be nàkpɔe ɖa be ƒua le hayahayam nyuie hã.
• Amekoko: Dɔléle ƒe gbagbã aɖewo hiã be woawɔ dɔ na wo. Amekola la `ɖoa` ƒu gbagbã la eye wòɖɔnɛ ɖo vaseɖe esime wòhaya eye wògatrɔ va ɖekae. Mɔnu si bɔ wue nye `ememe fixation`. Esia fia be amekolaa tsɔa ga gbadzɛwo, gaviwo, alo gaviwo dea ƒua me. Ɣeaɖewoɣi la, nusiawo ate ŋu anɔ wo nɔƒe le woƒe agbemeŋkekewo katã me. Ðewohĩ ahiã be woawɔ dɔ na ame aɖewo ake be woaɖe wo ɖa emegbe.
• Kekelidɔdamɔnu: Ne ɖɔktaa te ŋu ke ɖe dɔdzẽ alo abi aɖe ŋu hafi ƒua gbã la, woate ŋu awɔ keklẽŋusẽdɔdamɔnu atsɔ atsrɔ̃e. Kekeli sia gblẽa tsitsi si mesɔ o le ƒua me eye wònana ƒumelãmenugbagbevi siwo le lãmesẽ me gatsina ake. Woate ŋu awɔ keklẽŋusẽdɔdamɔnu hã le amekoko vɔ megbe le dɔléle ƒe gbagbã si ƒumeŋuɖui hena vɛ ta.
• Dɔléle si gbɔ wòtso la dada: Esia le vevie ŋutɔ.Ðewohĩ ahiã be woawɔ atike bubuwo hã atsɔ ada nɔnɔme alo dɔdzẽ si gbɔ wòtso si na wògbã la. Le kpɔɖeŋu me, ne kansa le ŋuwò la, ahiã be nàwɔ dɔ kple kansadɔdala. Wò ɖɔkta aɖe nusi nàkpɔ mɔ na kple atikewɔwɔ si ƒomevi nàhiã la me na wò.

Kuxi bubu siwo ate ŋu ado mo ɖa le Pathologic Fracture ta

Dɔléle ƒe gbagbã, abe gbagbã bubuwo ene, ate ŋu ahe kuxi aɖewo vɛ. Wo dometɔ aɖewoe nye:

• Acute Compartment Syndrome (ACS): Esia nye ne nyaƒoɖeamenu si le lãmeka aɖe me dzi ɖe edzi eye ʋu ƒe sisi yi lãmekaa me nu tso. Esia ate ŋu ana lãmekawo kple lãmekawo nagblẽ tegbee.
• Malunion: Ne ƒu gbagbãwo meva ƒo ƒu nyuie le dɔyɔɣi o.
• Nonunion: Ƒu si megava ƒo ƒu bliboe alo eƒe akpa aɖe o.

Ɣeyiɣi didi kae wòxɔna hafi (Pathologic Fracture) hayana?

Ɣeyiɣi si wòxɔna hafi Pathologic Fracture nahaya nɔ te ɖe nu geɖe dzi:

• Ƒu kae wogbã?
• Nukae nana ƒuwo gbãna?
• Atikewɔwɔ ka ƒomevie nèhiã?
• Ðe abi bubu aɖewo hã le ŋuwòa?

Zi geɖe la, exɔa ɣleti geɖe hafi ƒu si gbã la haya. Ƒo nu kple wò ɖɔkta alo amekola tso ɣeyiɣi si sɔ na wò nɔnɔme tɔxɛa ŋu. Ɣeyiɣi si nàhaya hã anɔ te ɖe nɔnɔme si gbɔ wòtso si na wògbã la dzi. Ne ƒu gbagbãa haya gɔ̃ hã la, nɔnɔmewo abe ƒumeŋuɖui, ƒumeŋuɖui si me dɔlékui aɖeke mele o, alo kansa ene ate ŋu abia ɣeyiɣi bubu hafi woate ŋu ada wo.

Ðe woate ŋu axe mɔ ɖe gbagbãƒe siawo ƒomevi nua?

Ẽ, woate ŋu axe mɔ ɖe enu vaseɖe afi aɖe. Ne wò ɖɔkta ate ŋu akpɔ ƒunukpeƒetetedɔ, abi, alo ƒumeŋuɖui ƒe dzesiwo hafi ƒu aɖe gbã la, mɔnukpɔkpɔ nyui aɖe li be woate ŋu axe mɔ ɖe dɔléle ƒe gbagbã nu. Ɣeaɖewoɣi la, dɔdzẽ kple nɔnɔme siwo nana ƒuwo gbɔdzɔna ate ŋu ana ame nase veve hafi ƒu aɖe nagbã. Woyɔa esia be "dɔléle ƒe gbagbã si gbɔna," si gɔmee nye "ƒu ƒe gbagbã si ate ŋu adzɔ kpuie." Ne èse ƒu ƒe vevesese yeye aɖe , yi ɖɔkta gbɔ enumake.

Ɣeaɖewoɣi la, woate ŋu awɔ amekoko (si woyɔna be prophylactic fixation) atsɔ aɖe dɔdzẽ alo abi aɖe ɖa hafi ƒua nagbã. Ne ƒumeŋuɖui alo dɔléle bubu aɖe si gblẽa nu le ƒu ƒe kpekpeme ŋu le ŋuwò la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàzã atikewo kple atike bubuwo atsɔ ado ŋusẽ wò ƒuwo eye wòaɖe wò ƒuwo ƒe gbagbã ƒe afɔkua dzi akpɔtɔ.

Ele vevie be woado wò kpɔ zi ɖeka le ƒea me (alo zi alesi wò ɖɔkta kafui).Azɔ hã, ne dzesi yeye aɖewo dze ŋuwò, abe vevesese si ƒo xlã ƒu alo vevesese ne èzi edzi ene la, gblɔe na wò ɖɔkta enumake. Ne èsusu be yeɖo afɔku me la, bia wò ɖɔkta tso domenyiŋusẽfianu dodokpɔ hena kansa alo ƒu ƒe kpekpeme dodokpɔ, si ate ŋu ade dzesi ƒumeŋuɖui kaba ŋu.

Ɣekaɣie wòle be nàyi kɔdzi enumake? (Ne nɔnɔme kpata aɖe dzɔ)

Ne èsusu be ƒu gbã, vevietɔ ne dzesi siawo le ŋuwò la, yi xɔ si me wokpɔa dɔnɔwo gbɔ kpata le enumake :

• Vevesese sesẽ ŋutɔ.
• Ne màte ŋu aʋuʋu wò ŋutilã ƒe akpa aɖeke o.
• Ne ŋutilã ƒe akpa aɖe dze nu wɔnuku aɖe, alo edze abe ɖe mele teƒe aɖeke o ene.
• Ne ƒua dzena to ŋutigbalẽa me.
• Ne vuvu le eŋu.
• Ne abi yeyewo do kpe ɖe dzesi siawo ŋu.

Nya siwo wòle be nàbia wò ɖɔkta

Àte ŋu abia wò ɖɔkta nya siawo abe esiawo ene:

• Ƒu kae wogbã?
• Ðe esia nye Pathologic Fracture alo fracture ƒomevi bubua?
• Ðe mahiã be woawɔ atike na ma?
• Atikewɔwɔ ƒe nɔnɔme kae na wògbã alea?
• Ðe kansa le ŋunyea?

Ƒu gbagbã doa vɔvɔ̃ na ame ɣesiaɣi. Ate ŋu ado vɔvɔ̃ na ame wu ne edzɔ le atikewɔwɔ ƒe nɔnɔme aɖe si ŋu mènya nu tsoe o ta. Wò ɖɔkta aɖe nusi na ƒu gbã, alesi nàte ŋu akpe ɖe wò ŋutilã ŋu wòahaya, kple atikewɔwɔ siwo hiã be woatsɔ aɖu nusi gbɔ wòtso dzi me.

Mègavɔ̃ gbeɖe be yeabia nya o. Zi alesi nèse wò lãmesẽnyawo gɔme nyuie la, zi nenemae kakaɖedzi anɔ asiwò be nàdze ŋgɔ nusi le ŋgɔ na wò.

Mlɔeba (Take-Home Message) .

Pathologic Fracture nye dɔléle sesẽ aɖe. Gake woate ŋu akpɔ egbɔ ne wokpɔ dɔlélea nyuie eye wodae nyuie . Nu vevitɔe nye be nàlé be na wò ƒuwo ƒe lãmesẽ eye nàdi atikewɔla ne èkpɔ dzesi aɖewo siwo mebɔ o. Gblɔ wò ɖɔkta na wò faa, bia wò nyawo, eye nàwɔ ɖe wò atikewɔwɔ ƒe ɖoɖoa dzi. Àte ŋu anɔ te ɖe nɔnɔme sia nu dzidzedzetɔe.

` Pathologic Fracture, Ƒu ƒe gbagbã, Ƒu siwo gbɔdzɔ, Ƒumeŋuɖui, Ƒumeŋuɖui, Ƒume Kansa, Ƒu ƒe Lãmesẽ