ʻEha ka pulima? He ʻano paha ia e paheʻe ai nā iwi ʻelua ma ka lima (Scapholunate Dissociation)!

Ke manaʻo nei ʻoe i kekahi manawa i kahi mea ʻē a ʻeha paha ma kou pulima? Malia paha ua hoʻomaka kēia ʻeha i kou hāʻule ʻana, hāpai i kahi mea kaumaha, a pāʻani paha i nā haʻuki. ʻO ka hapa nui o ka manawa, manaʻo mākou, "Auē, he ʻeha wale nō ia." Akā i kekahi manawa, hiki i kēia ke lilo i kūlana e pono ai ka nānā hou aku. ʻO ia ka mea a mākou e kamaʻilio ai i kēia lā, kahi kūlana e kū mai ana ma ka pulima e pono ai ka nānā hohonu iki.

He aha kēia dissociation o ka iwi pulima? (Scapholunate Dissociation)

I ka ʻōlelo maʻalahi, ʻo kēia `(Scapholunate Dissociation)` ʻo ia ka wā e neʻe iki ai nā iwi liʻiliʻi ʻelua i loko o ko kākou pulima, ka iwi `Scaphoid` a me ka iwi `Lunate`, mai kahi e pono ai, e hana ana i kahi hakahaka, a i ʻole `gap`, ma waena o lāua. I ka pololei, ua pili kēia mau iwi ʻelua kekahi i kekahi e kahi ligament ikaika loa, a mākou e kapa nei ʻo `Scapholunate Interosseous Ligament (SLIL). I kekahi ulia, ʻoiai ke wili ʻia ka lima a hāʻule, hiki i kēia `ligament` ke haehae. ʻO ia ka manawa e hemo ai ka pilina ma waena o nā iwi ʻelua, a hoʻomaka lākou e neʻe a puni. Ke hoʻohana ʻoe i kou pulima, neʻe kēia mau iwi ʻelua mai kekahi i kekahi, a i ʻole `dissociate`.

Ua like kēia me kahi puʻupuʻu i nakinaki ʻia e nā kaula ʻelua. Inā paʻa ka puʻupuʻu, e hui pū ana nā kaula ʻelua, akā i ka wā e wehe ʻia ai ke puʻupuʻu, e neʻe kaʻawale nā ​​kaula ʻelua.

ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o kēia maʻi?

ʻO kaʻoiaʻiʻo, hiki ke loaʻa kēia kūlana i kapa ʻia ʻo `(Scapholunate Dissociation)` i kekahi, me ka nānā ʻole i ke kāne, ka lāhui, a i ʻole ka hoʻomana. Eia nō naʻe, ʻo ka pilikia nui loa no ka poʻe e hāʻule ana ma ko lākou mau lima a me nā kuli . E noʻonoʻo, ke hele nei ʻoe ma ke alanui a paheʻe koke, a laila kau koke mākou i ko mākou mau lima ma ka honua e hoʻopakele iā mākou iho. ʻO ia ka manawa e hiki ai kēia ulia.

Pehea ka maʻamau o kēia ʻano?

E like me kā mākou e ʻike ai, ke nānā mākou i nā ʻeha pulima ʻē aʻe, hiki ke ʻike ʻia kēia kūlana `(Scapholunate Dissociation)` ma kahi o 5% (`5%`) o nā hihia . Eia kekahi, ʻo kekahi mau haki ma ka ʻāpana pulima, ʻoiai nā mea o ke ʻano a mākou e kapa nei he ``distal radius fractures``, ʻo ia hoʻi, i ka wā e haki ai ka iwi nui ma ka lima kokoke i ka pulima, hiki ke ʻike ʻia ma kahi o 40% (`40%`) o nā hihia me kēia kūlana `(SL dissociation)` . Aia kekahi mau haki kūikawā, e like me ``chauffeur fractures``, kahi i ʻike pinepine ʻia ai kēia.

No ke aha lā kēia e hana nei? He aha nā kumu?

E like me kaʻu i ʻōlelo ai ma mua, ʻo ke kumu nui o kēia ka "hāʻule ʻana ma luna o ka lima i kīkoʻo ʻia" . I ka pololei, ke hāʻule ʻoe a kau i kou lima ma ka honua a kau i ke kaumaha ma luna, hiki i ke kaomi ke haehae i ka "ligament interosseous scapholunate (SLIL)".

Ma waho aʻe o kēia, aia paha kekahi mau kumu ʻē aʻe:

• Ke paʻa pono ʻana i ka huila hoʻokele i ka wā o kahi ulia kaʻa, e like me ke kaʻa: Hiki ke hōʻino ʻia kēia ligament e ka hopena ma ka lima i ka wā o kahi ulia koke.
• ʻO kekahi mau maʻi hoʻoilina: No ka laʻana, nā maʻi e like me ka 'Hereditary Spastic Paraparesis'.
• ʻO ka Laxity Ligament Congenital: Hānau ʻia kekahi poʻe me nā ligaments palupalu i ko lākou mau hono. ʻOi aku ka nui o kēia e hiki ke hana iā lākou.
• ʻO ka Rheumatoid Arthritis: He maʻi kēia e hoʻoulu ai i ka mumū o nā hono. Hiki i kēia maʻi ke hoʻonāwaliwali i nā ligaments, hiki ke alakaʻi i kēia maʻi.

He aha nā hōʻailona o kēia? Pehea kona manaʻo?

Inā loaʻa iā ʻoe kahi maʻi i kapa ʻia ʻo "Scapholunate Dissociation", e ʻike pinepine ʻoe i kēia mau mea:

• ʻEha ma ke kua o ka pulima, ʻoiai ke paʻa pono ʻana i kahi mea ('neʻe paʻa ikaika') : no ka laʻana, i ka wehe ʻana i kahi poʻi ʻōmole a i ʻole ka paʻa ʻana i kahi ʻūpā puka.
• Ka nāwaliwali i ka ikaika o ka paʻa ʻana: Ka hiki ʻole ke paʻa pono i nā mea e like me ma mua.
• Ka pehu a me ka ʻoluʻolu a puni ka pulima: Ua pehu ka ʻāpana a puni ka pulima a ʻeha ke hoʻopā.
• ʻEha i ka wā e hoʻolōʻihi ai i kou pulima: ʻEha ia ke hoʻohuli ʻoe i kou lima.
• I kekahi manawa lohe paha ʻoe i ke kani "kāomi" mai kou pulima mai.

E hoʻomanaʻo, ʻaʻole like kēia mau hōʻailona no kēlā me kēia kanaka. ʻOi aku ka nui o ka ʻeha o kekahi poʻe, ʻoi aku ka liʻiliʻi o kekahi. No laila, inā ʻike ʻoe i kahi mea ʻē ma kou pulima, ʻoi aku ka maikaʻi o ke ʻike ʻana i ke kauka.

Pehea e ʻike ai ke kauka i kēia?

Ke hele ʻoe e ʻike i ke kauka, e nīnau mua lākou iā ʻoe e pili ana i kāu mau hōʻailona. Pehea ka lōʻihi o kou ʻeha ʻana, pehea i hoʻomaka ai, a i ka manawa hea i ʻoi aku ka ʻino? A laila e nānā lākou i kou pulima lima e ʻike inā he ʻeha, pehu, a palupalu paha.

Eia kekahi, hiki i ke kauka ke hana i nā hoʻokolohua e like me:

• Hoʻāʻo Hoʻololi Scaphoid: Ma kēia hoʻāʻo, kau ke kauka i kona lima ma luna o kou iwi scaphoid a hoʻoneʻe i kou pulima lima. Nānā kēia hoʻāʻo i ke kūpaʻa o ka iwi scaphoid.
• X-ray: Hiki i kēia ke hōʻike i ka nui o ka hakahaka ma waena o nā iwi scaphoid a me nā iwi lunate (scapholunate gap). ʻO ka maʻamau, ʻo kēia hakahaka he 2 millimeters (2 mm) a emi mai paha. Eia nō naʻe, i ke ʻano o ka dissociation SL, hiki i kēia hakahaka ke 5 millimeters (5 mm) a ʻoi aku paha. I kekahi manawa, hiki iā ʻoe ke ʻike i kahi mea i kapa ʻia he "ring sign" ma kahi X-ray. He kuhi hewa kēia o ka iwi scaphoid.
• Hoʻāʻo MRI (Magnetic Resonance Imaging):Hiki i kahi MRI ke hōʻike maopopo inā ua haehae ʻia ka ligament scapholunate interosseous (SLIL). Hiki iā ia ke kiʻi i kahi kiʻi maikaʻi o nā ʻiʻo palupalu a puni ka iwi.
• ʻO Arthroscopy: Pili kēia i ka hana ʻana i kahi ʻoki liʻiliʻi loa a me ke komo ʻana i kahi kāmela (scope) ma o ia mea e nānā i loko o ke hono. Hiki iā ʻoe ke ʻike pololei i ka pōʻino o nā ligaments. I kekahi manawa, hiki ke hana ʻia ka lāʻau lapaʻau i ka manawa like me ka arthroscopy.

Pehea e mālama ʻia ai kēia? (Lāʻau lapaʻau)

I ka mālama ʻana i kahi maʻi i kapa ʻia ʻo 'Scapholunate Dissociation', ʻo nā mea mua e hana ai:

• Analgesics: Hāʻawi ʻia nā lāʻau lapaʻau e hōʻemi i ka ʻeha.
• ʻO ka ʻoki ʻana: Hoʻohana ʻia kahi ʻoki kūikawā e hoʻopaʻa i ka pulima a me ka manamana nui. Kōkua kēia i ka ho'ōla ʻana o nā ligaments i hōʻino ʻia.

A laila, e kuhikuhi paha kāu kauka iā ʻoe i kahi loea lima. Pono pinepine kēia ʻano i ke ʻoki lima i loko o ʻeono pule o ka ʻeha.

I ka wā o ke ʻoki ʻana, e hāʻawi ʻia ʻoe i ka anesthesia laulā (ʻo ia hoʻi, e hiamoe loa ʻoe), a i ʻole e hāʻawi ʻia ʻoe i ka anesthesia kūloko (ʻo ia hoʻi, e mae wale ʻoe). I ka wā o ke ʻoki ʻana, e hana ke kauka:

• Hana ʻia kahi ʻoki liʻiliʻi ma ke kua o ka pulima.
• Wehe ʻia a hoʻomaʻemaʻe ʻia ke kino i hōʻino ʻia.
• A laila, no ka pani ʻana i ka hakahaka ma waena o nā iwi scaphoid a me nā iwi lunate, ʻo ia hoʻi, e hoʻihoʻi mai i nā iwi ʻelua, hoʻohana ʻoe i kahi mea e like me ke aʻalolo i lawe ʻia mai kahi ʻē aʻe o kou kino ponoʻī, kahi humuhumu, a i ʻole kahi wili hao.
• ʻO ka hope, ua humuhumu hou ʻia ka ʻoki.

He aha kaʻu e hana ai e hōʻemi i kēia pilikia?

No ka hōʻemi ʻana i ka pilikia o ka `(Scapholunate Dissociation)`, ʻo ka mea nui loa, ʻo ia ke hana i nā hana e pale aku ai iā ʻoe iho mai ka hāʻule ʻana. Hiki iā ʻoe ke hana i nā mea e like me:

• Ke komo ʻana i nā hoʻomaʻamaʻa e hoʻomaikaʻi ai i ke kaulike, ka hoʻonohonoho ʻana, a me ka ikaika.
• Ke wehe ʻana i nā pōpilikia kuʻia i loko o ka home. Eia kekahi laʻana, e nānā i nā kaula palupalu, nā kukui maikaʻi ʻole, a me nā moena.
• Inā pono, e hoʻohana i kahi mea kōkua e like me ke koʻokoʻo a i ʻole ka mea hele wāwae.
• Ke komo ʻana i nā kāmaʻa pālahalaha, paʻa, a me ke kaomi maikaʻi.

He aha kaʻu e manaʻo ai inā loaʻa iaʻu kēia maʻi? (Nā pilikia)

Inā ʻaʻole ʻoe e loaʻa koke i ka lāʻau no ka dissociation SL, hiki ke loaʻa nā pilikia e like me kēia:

• ʻEha mau loa: Loaʻa paha iā ʻoe ka ʻeha pulima e hoʻomau nei.
• ʻO ka maʻi ʻeha: Hiki i ka maʻi ʻeha ke ulu me ka mumū o ka hui.
• Ka paʻa ʻole o ka hui: Hiki i ka lima ke manaʻo me he mea lā e neʻe ana me ka hoʻomanawanui ʻole.
• Ka ikaika o ka paʻa ʻana i hoʻemi ʻia: ʻAʻole paha ʻoe e hiki ke paʻa pono i nā mea.
• ʻO ka Scapholunate Advanced Collapse (SLAC) Ankle: He ʻano maʻi arthritis degenerative kēia e hoʻopau ai i ka hui pulima. Hiki ke ʻeha loa kēia.

Pehea ka lōʻihi o koʻu ho'ōla ʻana inā loaʻa iaʻu (Scapholunate Dissociation)? (Outlook)

Inā loaʻa iā ʻoe ke ʻoki kino no ka dissociation SL, pono ʻoe e komo i kahi cast no kekahi mau pule ma hope. Ma hope o ka wehe ʻana o ke kauka, e kōkua ka lāʻau lapaʻau kino i kou pulima e hoʻihoʻi i ka ikaika. Me ka mālama kūpono a me ka lāʻau lapaʻau kino, pono ʻoe e hoʻi i kāu mau hana maʻamau i loko o kekahi mau mahina.

Pehea e mālama ai iaʻu iho me ka Scapholunate Dissociation?

Ma hope o ka mālama ʻana no ka dissociation SL, e kamaʻilio me kāu kauka e pili ana i nā ʻano hana a me nā hoʻomaʻamaʻa hiki iā ʻoe ke hana palekana. Aia nā papahana hoʻoikaika kino kikoʻī e hiki ke kōkua iā ʻoe e hoʻihoʻi i ka ikaika a me ka laulā o ka neʻe ʻana i kou pulima. Mai hele ma mua o ka mea a kāu kauka e haʻi aku ai iā ʻoe e hana a hana i nā mea paʻakikī loa ma kou pulima.

Leka Lawe-Home

ʻAe, ʻo ka `Scapholunate Dissociation` a mākou i kamaʻilio ai, ʻo ia ka wā e neʻe ai nā iwi liʻiliʻi ʻelua ma ka pulima, ʻo `Scaphoid` a me `Lunate`, ma waho o ko lākou wahi, e hana ana i kahi hakahaka ma waena o lākou. ʻO ke kumu nui o kēia, ʻo ia ka hōʻino ʻana i ka `Ligament` e hoʻopili ana i kēia mau iwi ʻelua. Hana pinepine kēia i ka wā e hāʻule ai ʻoe me kou lima i kīkoʻo ʻia.

ʻO nā hōʻailona nui ka ʻeha o ka pulima, ka pehu ʻana, ka palupalu, a me ka emi ʻana o ka ikaika o ka paʻa ʻana. Hoʻohana ke kauka i nā hoʻokolohua e like me ka hoʻāʻo hoʻololi scaphoid, nā X-ray, MRI, a me ka arthroscopy e ʻike ai i kēia.

ʻO ke ʻoki ʻana ka lāʻau lapaʻau maikaʻi loa. Me ka mālama kūpono a me ka hoʻōla kino, hiki i ka hapa nui o ka poʻe ke hoʻi i kā lākou hana maʻamau i loko o kekahi mau mahina. No laila, inā loaʻa iā ʻoe ka ʻeha mau a i ʻole ka ʻoluʻolu ʻole ma kou pulima lima, he mea nui e ʻike i ke kauka a loaʻa ka ʻōlelo aʻoaʻo ma mua o ka manaʻo he ʻeha wale nō ia.

Pūlima lima , ʻEha pūlima lima, Iwi lima, Ligaments, Scapholunate Dissociation, Fracture, ʻoki kino