Xav txog koj ua haujlwm ntawm ntaiv thiab mam li plam thiab poob, lossis koj raug xwm txheej tsheb sib tsoo. Koj hnov mob hnyav heev hauv koj pob luj taws, koj ceg o heev, thiab nws yuav zoo li khoov tsis zoo li qub. Nws mob heev uas koj tsis tuaj yeem tso koj ceg nqes, tsis hais txog kev taug kev. Hauv qhov xwm txheej zoo li no, nws tuaj yeem hnyav dua li ceg tawg yooj yim. Ntawd yog hom pob txha tawg loj uas peb yuav tham txog hnub no.
Qhov Pilon Fracture yog dab tsi tiag?
Hais yooj yim xwb, qhov Pilon Fracture (Tibial Plafond Fracture) yog qhov tawg loj heev hauv qab ntawm koj pob txha ceg (tibia), qhov chaw nws ntsib pob qij txha pob luj taws. Muaj ob lub pob txha tseem ceeb hauv peb ceg, qhov loj peb hu ua '(tibia)' thiab qhov me peb hu ua '(fibula)'. Hauv qhov Pilon fracture, ob lub pob txha no feem ntau tuaj yeem tawg.
Qhov no hu ua 'Pilon' rau ib qho laj thawj tshwj xeeb. 'Pilon' txhais tau tias 'mole' hauv Fab Kis. Ib yam li thaum koj ntaus ib yam dab tsi hauv lub mortar thiab pestle, qhov kev tawg no tshwm sim nrog lub zog loj heev. Xav txog, lub pob txha '(talus)' hauv koj lub pob qij txha (lub pob txha uas txuas rau talus) raug thawb nrog lub zog loj, tsoo qhov kawg ntawm talus. Ntawd yog hom txheej txheem uas tshwm sim ntawm no.
Qhov no tsis yog ib qho mob pob luj taws uas raug mob ib txwm muaj. Qhov no yog ib qho mob hnyav uas ua rau lub pob qij taws puas tsuaj, feem ntau ua rau pob txha tawg. Yog vim li ntawd nws thiaj nyuaj kho me ntsis.
Puas muaj tej hom kev so no?
Yog, cov kws kho mob siv ntau pawg nyob ntawm seb qhov pob txha tawg no hnyav npaum li cas. Qhov kev faib tawm yooj yim tshaj plaws thiab feem ntau siv rau peb kom nkag siab yog qhov kev faib tawm 'Ruedi-Allgower'. Cia peb nkag siab yooj yim.
- Hom I: Qhov no yog thaum pob txha tawg los ntawm qhov sib koom ua ke, tab sis cov pob txha tawg tsis tau txav mus . Lawv tseem nyob hauv qhov chaw. Qhov no yog hom pob txha tawg uas tsis hnyav heev.
- Hom II: Ntawm no, cov pob txha tawg me ntsis raug tshem tawm, txhais tau tias pob txha tsis sib dhos zoo. Txawm li cas los xij, pob txha tsis tawg ua ntau daim.
- Hom III: Qhov no yog qhov teeb meem hnyav tshaj plaws . Hauv qhov no, tsis yog tsuas yog cov pob txha tawg raug tshem tawm xwb, tab sis cov pob txha tau raug tsoo ua tej daim me me (comminution) . Kuj tseem muaj kev puas tsuaj loj heev rau qhov chaw ntawm cov pob qij txha.
Hom kev kho mob nyob ntawm seb koj pob txha tawg hom twg. Pob txha tawg hom III yuav tsum tau phais.
Yog tias muaj tej yam zoo li no tshwm sim rau koj, koj yuav muaj cov tsos mob li cas?
Kev tawg ntawm tus ncej yog ib qho mob heev. Cov tsos mob pom tseeb heev.
| Cov tsos mob | Piav qhia yooj yim xwb |
|---|---|
| Qhov mob uas tsis muaj zog | Qhov no yog cov tsos mob tseem ceeb. Muaj mob hnyav heev, tsis tuaj yeem ua tau rau ntawm pob luj taws thiab qhov chaw ntawm lub puab tsaig. |
| Kev o thiab mob nqaij | Tom qab muaj xwm txheej tsis ntev, thaj tsam pob luj taws yuav pib o tuaj ntau heev. Daim tawv nqaij yuav hloov xiav lossis ntshav. |
| Kev hloov pauv ntawm cov duab ntawm ceg | Yog tias cov pob txha tsis sib dhos, lub pob luj taws yuav zoo li ncab thiab deformed tsis zoo li qub. |
| Tsis muaj peev xwm dais qhov hnyav | Nws ua tsis tau kom nqes mus rau hauv av nrog ceg ntawd lossis muab qhov hnyav rau sab ntawd. |
| Cov pob khaus ntawm daim tawv nqaij | Qee zaum mob hnyav heev, tej zaum yuav muaj cov hlwv dej puv nkaus rau ntawm daim tawv nqaij ib puag ncig qhov txhab, qhia tias cov nqaij mos sab hauv kuj tau raug puas tsuaj lawm. |
Ua cas ho muaj kev sib cais phem ua luaj li no?
Hom pob txha tawg no feem ntau xav tau lub zog loj heev . Cov ua rau feem ntau muaj xws li:
- Kev sib tsoo tsheb: Cov kev raug mob no tuaj yeem tshwm sim, tshwj xeeb tshaj yog hauv kev sib tsoo tsheb, maus taus, lossis peb lub log.
- Poob los ntawm qhov siab: Poob los ntawm qhov siab, xws li tsob ntoo, ntaiv, lossis pem teb sab saud ntawm lub tsev, yog ib qho ua rau loj.
- Kev sib tsoo kis las:Cov xwm txheej zoo li no kuj tuaj yeem tshwm sim hauv kev ua si ceev ceev xws li caij ski.
Txawm li cas los xij, qee zaum txawm tias pob txha tawg uas tsis tshua muaj zog kuj tuaj yeem tshwm sim. Qhov laj thawj rau qhov no yog cov kab mob uas ua rau cov pob txha tsis muaj zog .
Tshwj xeeb, ib tug neeg uas muaj kab mob xws li osteoporosis, uas ua rau cov pob txha nyias thiab tsis muaj zog, tuaj yeem raug mob pob txha tawg loj heev zoo li no txawm tias lawv plam thiab poob hauv tsev los xij.
Leej twg muaj kev pheej hmoo siab dua?
Txawm hais tias qhov kev phom sij no tuaj yeem tshwm sim rau txhua tus neeg, qee pawg neeg muaj kev pheej hmoo siab dua.
- Cov txiv neej hnub nyoog ntawm 25-50 xyoo: Tus mob no feem ntau tshwm sim rau cov txiv neej hauv pawg hnub nyoog no vim yog kev raug mob hnyav (xws li kev sib tsoo tsheb).
- Cov poj niam uas muaj pob txha tawg: Cov poj niam laus, tshwj xeeb tshaj yog, muaj feem yuav mob pob txha no ntau dua, txawm tias yog los ntawm kev poob me me los xij.
- Cov neeg ua haujlwm ntawm ntaiv thiab scaffolding: Cov neeg hauv kev lag luam kev tsim kho muaj feem yuav poob ntau.
- Cov neeg laus uas ntog ntau zaus: Cov neeg hnub nyoog tshaj 65 xyoo, uas tsis muaj kev sib npaug zoo, thiab cov uas ntog ntau zaus kuj muaj feem yuav muaj kev pheej hmoo ntau dua.
Tus kws kho mob kuaj mob li cas?
Thaum koj mus rau tsev kho mob, tshwj xeeb tshaj yog Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) nrog rau qhov raug mob zoo li no, tus kws phais pob txha yuav kuaj koj.
1. Kev kuaj lub cev: Tus kws kho mob yuav ua tib zoo kuaj koj ceg thiab pob luj taws, ua tib zoo saib seb puas o, mob nqaij, hloov pauv ntawm cov duab, thiab daim tawv nqaij.
2. X-ray: Qhov no yog qhov kev kuaj yooj yim thiab tseem ceeb tshaj plaws. X-ray tuaj yeem qhia meej meej tias pob txha puas tawg thiab qhov twg tawg.
3. Kev Tshuaj Xyuas CT: Feem ntau ntawm cov pob txha tawg ntawm tus ncej puab, yuav tsum tau siv kev tshuaj xyuas CT ntxiv rau kev siv X-ray. Qhov no yog vim tias kev tshuaj xyuas CT yog qhov tseem ceeb heev rau kev pom hauv peb qhov ntev (3D) seb pob txha tau tawg ntau npaum li cas, qhov kev puas tsuaj tau ua rau qhov sib koom ua ke, thiab seb cov pob txha tawg tau nyob li cas. Cov ntaub ntawv no yog qhov tseem ceeb rau kev npaj phais.
Yuav kho li cas? Puas tsim nyog phais?
Kev kho mob rau qhov tawg ntawm tus pilon nyob ntawm ntau yam, suav nrog hom pob txha tawg, qhov ntau npaum li cas ntawm cov pob txha uas raug tshem tawm, kev puas tsuaj rau daim tawv nqaij thiab cov leeg, thiab koj txoj kev noj qab haus huv tag nrho.
Cov xwm txheej uas tsis tas yuav phais (Kev Kho Mob Tsis Phais)
Qhov no tsis tshua muaj. Tsis tas yuav phais tshwj tsis yog tias qhov pob txha tawg me me xwb, uas txhais tau tias cov pob txha tawg tsis txawm tias ploj me ntsis (tsis ploj) . Hauv qhov no, koj tus kws kho mob yuav pom zoo kom ua cov kev kho mob hauv qab no:
- So:Lawv hais kom koj so koj txhais ceg thiab tsa nws kom siab li siab tau.
- Siv ib daim cam khwb cia los yog khau looj plab hlaub: Yuav kom ceg tsis txav tau thiab kom nws ruaj khov kom txog thaum pob txha zoo, koj yuav tsum siv ib daim cam khwb cia, ib daim splint, los yog khau looj plab hlaub tshwj xeeb.
- Siv cov pas nrig: Nws tsis zoo rau muab qhov hnyav rau ntawm ceg kom txog thaum nws zoo, yog li koj yuav tsum siv cov pas nrig.
- Tshuaj: Qee zaum cov tshuaj ua kom cov ntshav nyias (anticoagulants) yuav raug muab rau kom tiv thaiv cov ntshav txhaws hauv cov leeg ntawm ob txhais ceg.
- Kev Kho Mob Lub Cev: Tom qab pob txha kho tau zoo lawm, kev kho mob lub cev yog qhov tseem ceeb kom rov qab muaj zog thiab txav tau hauv ceg thiab pob luj taws.
Kev Kho Mob Phais
Feem ntau ntawm Pilon pob txha tawg , kev phais mob yog qhov tsim nyog , vim tias feem ntau, cov pob txha tawg tau plam tawm ntawm qhov chaw thiab txav mus los.
Qhov tseem ceeb tshaj plaws yog tias tej zaum yuav tsis tau phais tam sim ntawd tom qab muaj xwm txheej. Vim tias qhov o ntawm ceg siab heev, nws yuav siv sijhawm ob peb hnub lossis ib lossis ob lub lis piam kom qhov o ploj mus. Yog tias phais thaum qhov o tseem siab, qhov muaj feem yuav kis kab mob thiab qhov txhab zoo yuav txo qis.
Muaj ob hom kev phais mob tseem ceeb.
1. Qhib Kev Txo thiab Kev Kho Sab Hauv (ORIF):
Qhov no yog qhov kev phais mob uas siv ntau tshaj plaws. Hais yooj yim xwb, qhov koj ua yog, tus kws phais yuav txiav daim tawv nqaij, mus rau qhov chaw tawg, thiab kho tag nrho cov pob txha uas raug tshem tawm rov qab mus rau lawv qhov chaw qub (kev txo qis) . Tom qab ntawd, cov phaj hlau tshwj xeeb thiab cov ntsia hlau raug siv los kho cov pob txha kom lawv tsis txhob txav mus dua (kev kho sab hauv) . Cov phaj thiab cov ntsia hlau no feem ntau yuav nyob hauv lub cev mus tas li.
2. Kev Kho Sab Nraud:
Qhov no yog ib qho txheej txheem txawv me ntsis. Yog tias qhov o ntawm ceg hnyav heev, lossis yog tias muaj cov tawv nqaij mob hnyav, kev phais ORIF tsis tuaj yeem ua tau tam sim ntawd. Hauv cov xwm txheej zoo li no, cov txheej txheem no yog siv los ua kom ceg ruaj khov ib ntus. Ntawm no, tus kws phais mob tho ntau tus pas hlau rau hauv cov pob txha thiab txuas cov pas no rau ntawm lub thav duab sab nraum lub cev . Lub thav duab no ua rau cov pob txha ruaj khov yam tsis txav. Thaum qhov o tau ploj mus thiab daim tawv nqaij tau zoo dua, lub thav duab raug tshem tawm thiab kev phais ORIF piav qhia saum toj no raug ua.
Yuav siv sijhawm ntev npaum li cas thiaj kho tau?
Qhov no yog ib qho teeb meem uas ntau tus neeg muaj. Kev tawg ntawm tus ncej puab yuav siv sijhawm ntev heev los kho. Qhov no yog ib yam dab tsi uas yuav tsum tau ua siab ntev thiab mob siab rau.
- Kev kho pob txha: Feem ntau nws yuav siv sijhawm 3 txog 6 lub hlis rau pob txha kom kho tag nrho tom qab phais.
- Kev rov zoo tag nrho: Txawm li cas los xij, txoj haujlwm tsis tau xaus thaum pob txha kho. Nws tuaj yeem siv sijhawm ib xyoos lossis ntau dua kom rov qab muaj zog, txav mus los, thiab ua haujlwm li qub hauv ceg.Tej zaum yuav siv sijhawm me ntsis.
Kev kho mob lub cev yog qhov tseem ceeb heev rau txoj kev kho mob no. Nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li tus kws kho mob thiab tus kws kho mob lub cev cov lus qhia kom zoo sai.
Thaum twg koj yuav tsum mus ntsib kws kho mob?
Yog tias koj muaj ib qho tsos mob uas tau hais hauv tsab xov xwm no, tshwj xeeb tshaj yog tom qab muaj xwm txheej loj, mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd, tsis txhob ncua sijhawm. Yog tias koj mus tsis tau ib leeg, hu rau 1990 lub tsheb thauj neeg mob.
Yog tias koj muaj cov tsos mob no thaum koj nyob hauv tsev tom qab phais, nws yuav yog ib qho cim qhia txog kev kis kab mob. Yog tias yog, koj yuav tsum mus rau tsev kho mob tam sim ntawd :
- Yog tias koj hnov liab, o, lossis sov so nyob ib puag ncig qhov txhab phais.
- Yog tias muaj kua dej zoo li kua qaub tawm ntawm qhov txhab.
- Yog koj kub taub hau .
Cov teeb meem mus sij hawm ntev ntawm tus mob no yog dab tsi?
Kev tawg ntawm cov pob qij txha yog ib qho mob uas nyuaj kho vim nws ua rau lub pob qij txha puas tsuaj. Yog li ntawd, txawm tias kho tau zoo tshaj plaws los xij, qee qhov teeb meem mus sij hawm ntev kuj tseem tuaj yeem tshwm sim tau.
- Mob Ntev: Qee tus neeg yuav mob pob luj taws txawm tias tom qab zoo lawm los xij.
- Kev Nyuaj Siab ntawm Cov Pob Qij Txha: Lub peev xwm los khoov thiab ncab cov pob qij txha pob qij txha yuav raug txo qis.
- Mob pob qij txha tom qab raug mob: Qhov no yog qhov teeb meem feem ntau. Qhov kev raug mob tuaj yeem ua rau cov pob txha mos ntawm qhov chaw ntawm pob qij txha puas tsuaj, uas tuaj yeem ua rau mob pob qij txha dhau sijhawm. Qhov no ua rau mob thiab o.
Yuav kom tiv thaiv lossis tswj tau tej yam no, nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li tus kws kho mob cov lus qhia thiab kev kho lub cev kom raws nraim.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Qhov tawg ntawm Pilon tsis yog qhov tawg ceg ib txwm muaj, tab sis yog ib qho mob hnyav uas ua rau lub pob qij txha pob qij txha puas tsuaj loj heev.
- Qhov no feem ntau tshwm sim vim muaj cov xwm txheej cuam tshuam loj xws li kev sib tsoo tsheb thiab kev poob ntawm qhov siab.
- Cov tsos mob tseem ceeb yog mob tsis taus, o, thiab hloov pauv ntawm cov duab ntawm ceg. Yog tias qhov no tshwm sim, mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd.
- Feem ntau, yuav tsum tau phais mob nyuaj rau kev kho mob.
- Cov txheej txheem kho kom rov zoo no siv sijhawm ntev heev. Nws yuav siv sijhawm ib xyoos lossis ntau dua los kho kom zoo tag nrho. Kev kho lub cev yog qhov yuav tsum tau ua.
- Muaj kev pheej hmoo ntawm kev mob xws li mob pob qij txha thiab mob pob qij txha hauv lub sijhawm ntev, yog li nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li cov lus qhia kho mob.
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