Sɔntɛnde, yu an kin jɔs at, nɔto so? I tan lɛk se i dɔn swɛt. Bɔrku pipul kin tink se na smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl. Bɔt sɔmtɛm, sɔm kayn tin de wae kin mek pɔrsin gɛt dis pen. Kienböck in sik na wan sik wae nɔr kin bɔrku bɔt impɔtant fɔ no bɔt. Dis nem kin bi nyu tin to yu, bɔt i impɔtant fɔ no bɔt am.
Fɔ tɔk am simpul wan, wetin na Kienböck in sik?
Okay, mek wi ɛksplen dis rili simpul wan. yu an na sכm sכm bon dεm, dat na 8 bon dεm we jכyn togeda. Wi kin kɔl dɛn tin ya `(Carpal bones)` . Pan dɛn et bon ya, wan smɔl bon de we shep lɛk kres mun, rayt na di midul. Dis na wetin dɔktɔ dɛn kin kɔl `(Lunate)` bon. dis `(Lunate)` bon de εp bכku fכ bεnd εn rכt wi an fayn fayn wan.
Kienböck in sik na wan sik we di blɔd we de go na di lunate bon kin go dɔŋ smɔl smɔl ɛn leta i kin stɔp. Jɔs lɛk aw tik kin day we i nɔ gɛt wata, na so dis bon kin day smɔl smɔl we i nɔ gɛt blɔd. Insay mɛrɛsin, dɛn kin kɔl dis ɔstiɔnɛkrɔsis . Dis nɔ kin apin wantɛm wantɛm, bɔt i kin wɔs smɔl smɔl as tɛm de go. Sɔmtɛm, dis kin ivin mek yu gɛt tin dɛn lɛk at at sik na yu an.
Udat dɛn kin gɛt dis sik mɔ? Wetin na di tin dɛn we kin mek i apin?
Pan ɔl we dis sik kin apin pan ɛni ej, i kin bɔku pan man dɛn we ol bitwin 20 ɛn 40. Bɔt dis nɔ min se uman dɛn nɔ kin ebul fɔ gɛt am.
i nכ sכri yet 100% wetin de mek di bכdi saplai to di lunate de dכn. Bɔt sɔm tin dɛn de we dɛn tink se kin mek dis apin:
- di prכblεm dεm wit di bכdi we de gi bכdi to di bon: sכm pipul dεn kin bכn wit abnכmal tin dεm na di we aw di bכdi we de gi bכdi to di ``Lunate`` bon de posishכn. Insay dɛn kayn tin ya, chans de fɔ mek di blɔd nɔ bɔku. Masta sabi bukman dɛn biliv se na dis na di men tin we kin mek i apin.
- Trauma to di wrist: Yu kin dɔn fɔdɔm, yu gɛt motoka aksidɛnt, ɔ yu gɛt bad bad injuri na yu an we yu de ple spɔt. dis kin apin we di lunate bon dεm dכn pwεl εn dεn kכt di bכdi fכ fכlכ, we kin mek dis kכndyushכn.
- difrεns insay di lεngth fכ di bon dεm na di an: Tu men bon dεm de na di lכw pat na wi an, di rayus εn di ulna . Na sɔm pipul dɛn, dɛn tu bon ya nɔ kin lɔng di sem. Wan shɔt smɔl pas di ɔda wan. we dis apin, dεn de put abnכmal prεshכn pan di lunate bon we di an de muv. As tɛm de go, dis prɛshɔn kin pwɛl di bon ɛn i kin mek di blɔd nɔ flɔ fayn.
- Ɔda sik dɛn we pɔsin kin gɛt:Pipul wae gɛt sik dɛm wae gɛt fɔ du wit blɔd lɛk ``Sickle cell anemia'' ɛn ``Lupus'', ɛn di wan dɛm wae gɛt sɔm nyurolɔjik sik dɛm lɛk ``Cerebral palsy'' kin gɛt di sik we dɛn kɔl Kienböck.
Wetin na di sayn dɛm fɔ dis sik?
Bɔrku tɛm, nɔr big sayn nɔr kin de na di fɔs stej fɔ dis sik. Sɔm pipul dɛn nɔ kin gɛt ɛni sayn atɔl. Bɔt sɔm kɔmɔn sayn dɛn de we dɛn kin si. Lɛ wi si wetin dɛn bi.
| Di sayn we de sho se di sik de | Aw dat kin fil? |
|---|---|
| Pen na yu an | I tan lɛk di pen we pɔsin kin gɛt we i swɛt in an. E kin bi wan smɔl pen wae kin kam ɛn go sɔmtɛm, ɔr kin bi wae yu de fil ɔltɛm, wae de shap. |
| Swel ɛn stif | Mi an luk lɛk se i dɔn swel. We a wek na mɔnin, i kin fil lɛk se i stif ɛn i nɔ kin izi fɔ bɛn. |
| I nɔ izi fɔ ol (wik grip) . | Mi an dɛn kin wik we a de du tin dɛn lɛk fɔ opin wata bɔtul kap ɔ tɔn domɔt knob. Mi an dɛn kin at we a es sɔntin we ebi. |
| Ristrikshɔn fɔ muv | Yu nɔ go ebul fɔ bɛn yu an ɔp ɛn dɔŋ ɔ sayd to sayd izi wan lɛk aw yu bin de du trade. |
| Krepitashɔn | we yu muv yu an, i de mek sawnd we ‘krak krak’, lεk se di bon dεm de grind frכm insay. |
| Pen na wan patikyula ples | a fil pen we a pres mi finga na di tap pan mi an, rayt na di midul (we di lunate bon de). |
De tin wae impɔtant pas ɔl na, wae yu gɛt pen lɛk dis, nɔr ignore am, tink se, "Na jɔs wan sprain." Ɛspɛshali if di pen nɔ stɔp afta wan ɔ tu wik, yu fɔ rili go to dɔktɔ.
Aw dɔktɔ kin no bɔt dis sik?
We yu go to dɔktɔ, i go aks yu bɔt di pen, aw lɔng i dɔn de, ɛn ustɛm i go wɔs. Dɔn i go chɛk yu an. I go nid fɔ du bɔku tɛst dɛn fɔ no if i gɛt di sik.
- X-ray ɛgzamin: Di fɔs tin we yu fɔ du na fɔ tek ɛkstrem rayt. Bɔt we di sik bigin, di ɛkstrem rayt nɔ kin sho bɔku difrɛns.
- MRI Scan: Dis na di bɛst we fɔ no dis sik. MRI skan kin no di fכs stej if di ``Lunate`` bon de bכn כ nכ de bכn, εn if di bon dכn stat fכ day.
- CT skan: CT skan kin ɛp fɔ si klia wan if di bon brok ɔ skata.
- Bon Skan: Dis kin luk aw di bon dεm na di bכdi de wok.
Di 4 stej dɛm fɔ Kienböck in sik
Afta dɛn tɛst ya, di dɔktɔ go tɛl yu us stej yu sik de insay 4 men stej dɛn de.
| Stej | Wetin kin apin na dis stej? |
|---|---|
| Stej 1. Di wan we mek | Dis na di fɔs tɛm. Di pen kin fil lɛk se yu an dɔn swɛt. No difrɛns nɔ de pan di ɛkstrem rayt. bכt if yu luk am wit MRI, yu kin si se di bכdi we de gi di `(Lunate)` bon dכn dכn. |
| Stej 2. Di wan we mek | Bikɔs blɔd nɔ de, di bon kin bigin fɔ at lɛk rɔk. dis dεn kכl am ``sklεrosis'' . We dɛn tek ɛkstrem rayt, di bon kin wayt pas di ɔda wan dɛn. Di pen kin bɔku smɔl. |
| Stej 3. Di wan we mek | Di bon we dɔn at dɔn brok naw ɛn bigin fɔ brok. Dis kin mek di ɔda bon dɛn na di an muf smɔl frɔm usay dɛn bin de bifo. Di pen kin bɔku, di trɛnk we de na di an kin stɔp, ɛn i kin at fɔ bɛn di an. |
| Stej 4. Di wan we mek | Dis na di tin we bad pas ɔl. Di lunate bon dɔn lɛf smɔl fɔ brok ɛn brok. Nɔto dat nɔmɔ, bɔt di ɔda bon dɛn we de rawnd am sɛf kin bigin fɔ west. Di wrist joyn insɛf kin pwɛl, ɛn at at sik kin apin. |
I kin tek sɔm pipul dɛn sɔm mɔnt fɔ go frɔm stej 1 to 4. Fɔ ɔda pipul dɛn, i kin tek sɔm ia.
Wetin na di tritmɛnt dɛm fɔ dis?
Pan ɔl we nɔrbɔdi nɔr de fɔ mɛn dis sik, di tritmɛnt dɛm wae de naw kin ɛp fɔ ridyus pen, fɔ mek yu an wok fayn, ɛn fɔ stɔp di sik fɔ wɔs. Di tritmɛnt kin dipen pan bɔku tin, lɛk di stej we yu sik, yu ej, ɛn di wok we yu de du.
Tritmɛnt dɛn we dɛn nɔ gɛt ɔpreshɔn
Dɛn kin du dɛn tin ya kwik kwik wan na di sik.
- Wrist immobilization: Dɛn kin mek di an nɔ muv insay wan kɔst fɔ sɔm mɔnt. Dis rɛst kin ɛp di bon sɔm tɛm fɔ mek di blɔd go bak.
- Di tin dɛn we de mek pɔsin fil pen: Yu dɔktɔ kin tɛl yu fɔ tek mɛrɛsin dɛn we de mek yu nɔ fil pen lɛk ibuprofen fɔ mek yu nɔ gɛt pen ɛn fɔ mek yu nɔ swel. Bɔt mɛmba se dɛn mɛrɛsin ya nɔ fayn fɔ pipul dɛn we gɛt asma, bɛlɛ ɔlsa, ay blɔd prɛshɔn, kidni ɔ at sik. So , nɔ ɛva tek dɛn mɛrɛsin ya we yu nɔ go to dɔktɔ.
- Ɔkupeshɔn tɛrapi: Wan ɔkupeshɔn tɛrapist go tich yu aw fɔ du di wok dɛn we yu de du ɛvride di we we go mek yu nɔ gɛt pen na yu an.
Tritmɛnt tru ɔpreshɔn
If di sik bad, ɔ if ɔda tritmɛnt nɔ ɛp, di dɔktɔ kin tɛl yu fɔ du ɔpreshɔn. Di kayn ɔpreshɔn we dɛn go du go difrɛn difrɛn wan bay di stej we di sik de.
| Nem fɔ di ɔpreshɔn | Simply put, dis na wetin de hapun... |
|---|---|
| Jɔyn Lɛvɛl | if di lεngth fכ di tu bon dεm na di fכs an, ``Radius'' εn ``Ulna'', difrεn, dεn de du כpεrayshכn fכ ikwal dεn lεngth. Dɛn kin graft smɔl bon pan di shɔt bon fɔ mek i lɔng, ɔ dɛn kin kɔt smɔl bon frɔm di lɔng bon fɔ mek i shɔt. dis de ridyus di prεshכn pan di ``Lunate'' bon. |
| Rivaskulayzeshɔn | Dis involv fɔ mek di blɔd go bak to di lunate bon. sכm sכm bon wit bכdi vεsεl dεn de tek am frכm כda pat na di bכdi (e.g., di tכŋ) εn transplant am insay di lunate bon we de day. Dis kin bi na di fɔs tu stej dɛm fɔ di sik. |
| Fusion we dɛn kɔl | We di sik bad, dɛn kin put sɔm bon dɛn na di an togɛda fɔ mek di pen nɔ bɔku. Sɔntɛnde, if dɛn put di bon dɛn na di wan ol an togɛda, dɛn nɔ kin ebul fɔ bɛn di an, bɔt dɛn kin rɔta di an. |
| Prɔksimal Row Kapɛktomi (PRC) . | if di lunate bon brok kכmplit, dεn kin pul di bon εn sεvεra bon dεm we de nia am. Dis kin mek yu nɔ fil pen, bɔt i kin mek yu nɔ muv sɔm an. |
| Implant Arthroplasty we dɛn kin du | insay dis, dεn de pul di ``Lunate`` bon we dεn pwεl εn riples am wit wan atifishal bon (``prosthetic``). |
Ustɛm yu fɔ rili go to dɔktɔ?
Di kwik we dɛn no dis sik, na di mɔ di tritmɛnt ɛn rizulyt go bɛtɛ. So, nɔ wet te yu si di sayn dɛm we de dɔŋ ya ɛn go to dɔktɔ.
- If i nɔ izi fɔ yu fɔ muv yu an, yu an, ɔ yu finga dɛn.
- If na unusual redness de rawnd di wrist.
- If di swɛlin de wɔs.
- If pen de we pɔsin nɔ go ebul fɔ bia .
Yu dɔktɔ go sɛn yu to spɛshal dɔktɔ we de du dis, we na ɔtpidist .
Mɛsej we dɛn kin kɛr go na os
- Kienböck sik na wan sik we nɔ kin apin so ɔltɛm we di blɔd we de go na di smɔl bon we de na yu an we dɛn kɔl lunate kin kɔt, ɛn dis kin mek i day smɔl smɔl.
- Di fɔs sayn kin jɔs bi pen we yu fil lɛk se yu an dɔn swɛt. So if yu gɛt pen we nɔ de dɔn lɛk dis, nɔ ignore am.
- Dis sik kin wɔs smɔl smɔl as tɛm de go. If dɛn nɔ trit am, di pen kin bɔku ɛn di an nɔ kin ebul fɔ muv atɔl.
- Yu rizulyt go dipen mɔ pan aw yu kin no di sik kwik kwik wan ɛn bigin fɔ trit am.
- Tɔk to yu dɔktɔ fɔ disayd us tritmɛnt we go fayn fɔ yu.
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