I ruh tliak chu a dam dik lo em ni? Nge a la dam lo em ni? (Malunion leh Nonunion Fracture) chungchang hi han sawi ila!

Kan nunah vawi khat tal ruh, kut emaw, ke emaw tihchhiat hi thil awmze nei tak a ni. Chutiang a nih chuan doctor kan hmu vat a, plaster cast kan vuah a, a dam hun kan nghak thin. A tam zawkah chuan uluk taka enkawl a nih chuan heng ruh tliak te hi mawi takin a dam leh ang. Amaherawhchu, he damna kalphung hi a thleng dik loh chang a awm thin. Chu chu `(Malunion)` (misalignment) leh `(Nonunion)` (dam lohna tak tak) tih condition chungchang kan sawi a ngai a ni. Hengte hi a tithinur deuh thei a, chuvangin hengte hi hriat chian a pawimawh hle.

Heng `(Malunion)` leh `(Nonunion)` te hian eng nge a awmzia? A awlsam zawngin hrethiam ila, kan hrethiam ang em?

I kut emaw, i ke emaw ruh tliak ang maiin han mitthla teh. Doctor chuan a set tha a, plaster cast a dah bawk. Tunah chuan ruh tliak pahnih chu a inzawm leh tur a ni a, an awm dan ang chiah khan a inmil tur a ni.

• `(Malunion)` - Hriatthiam lohna:

A awlsam zawngin, `(Malunion)` tih awmzia chu ruh tliak pahnih chu an inzawm khawm a, mahse a dik lo tihna a ni . Chu chu ruh chu a inmil lo thei a, a inzawm lo deuh thei a, a nih loh leh a nih tur aia tawi a ni thei tihna a ni. Bêl chhe pahnih chu dik lo taka dah khawm leh ang mai a ni. Fused a ni a, mahse a dik chiah lo.

• `(Nonunion)` (Nonunion) - A remchan dan tur hloh:

``(Nonunion)`` tih hi a na deuh deuh a ni. Heta thil thleng chu ruh tliak pahnih chu a dam rei tawh hnuah pawh a inmil lo tak zet a ni . Chu chu thla tam tak hnuah pawh ruh pahnih inkarah hian inzawmna thar a awm lo tihna a ni. A dik tak chuan ruh hi a la chhe vek a ni.

Ruh a dam that loh chuan kan taksa ruh nghet leh chu ruhte hnathawh danah nghawng lian tak a nei thei a ni. I ke ruh pakhat chu a inmil lo a nih chuan i kal laiin i tlu thei a, i na thei ang tih han ngaihtuah teh, a dik em?

A tam zawkah chuan ruh tliak hi enkawl dan dik a nih chuan a dam tha hle. Hetiang thil a thlen loh chhan pahnih a awm thei. Pakhat chu `mechanical issue` a ni. Chumi awmzia chu a chhe lai pahnih chu tihdam laiin a inmil tawk lo tihna a ni. A dang chu `biological issue` a ni. Chumi awmzia chu i taksain i ruhte damna atana a mamawh ei tur tha leh thisen supply a nei lo tihna a ni. Doctor-te chuan heng natnate hi an enkawl hian heng thil pahnih hi an ngaihtuah vek a ni.

Nonunion fracture chi hrang hrangte chu engte nge ni?

Doctor-te chuan nonunion nei mi an enfiah hian type pakhatah an classified thin. Hei hian ruh chu a dam loh chhan leh eng thil nge a tihdam chhan tih hriatthiamna a pe a ni. A chi thum a awm a, chungte chu:

`(Hypertrophic nonunion)` tih hi eng nge ni?

Hetiang chiah hian ruh cell thar a lo awm tih hriat a ni. Chu chu taksain ruh tihdam a tum tihna a ni. Mahse, ruh tliak pahnih tawp lam chu a inzawm tha tawk lo. Chumi awmzia chu taksain biological resources a nei a, mahse a chhe pahnih chu a inzawm tha lo va, a dam chhungin a tla lo tihna a ni. Cement awm ang mai a ni a, mahse mortar chu a bond tha lo.

`(Atrophic nonunion)` tih hi eng nge ni?

Hetiang a nih chuan ruh thar siamna tur chhinchhiahna a awm lo. Tin, ruh hian thisen a nei tha lo bawk. Hei hian biological factors te hian ruh hi a dam thei lo tih a tilang a ni. A châng chuan ruhah natna hrik a awm thei a, chu chuan thisen kalna a tibuai thei a ni. Chutiang natna vei ``Nonunion`` chu ``Septic nonunion`` an ti bawk.

`(Oligotrophic nonunion)` tih hi eng nge ni?

Hetiang chiah hian ruh thar engemaw zat a lo piang a, mahse a kim lo. Ruh chi hnih chu hmun dik takah a awm lo. Ruh chu a set hmasak ber ṭum khan a set ṭha lo a ni mai thei, a nih loh leh a hnuah a tla thla a, a sawn a ni mai thei. Hetah hian stability factor leh biological factor pahnih hi a inrawlh thei a ni.

Engtin nge `(Malunion)` i nei tih i hriat theih ang? Eng nge a lan chhuah dan?

Ruh pakhat chu a inmil lo a nih chuan, ``malunion'' tia koh a nih chuan, hetiang thil hi i hmu thei a, i hre thei bawk:

• Pawn lam atanga hmuh theiha inthlak danglamna:
• I ruh chu a inzawm khawm emaw a hrual emaw a lang .
• Ruh chu a hrual ang maiin a lang , a nih loh leh a inher kual ang maiin a lang .
• Ruh chu a hma aia tawi zawkin a lang thei . Entirnan, ke pakhat chu a dang aiin a tawi deuh mai thei.

• Chu ruh hman huna harsatna lo awm thin:
• Ruh ah natna a awm.
• Chutah chuan swelling a awm.
• Kal laiin limping (ke a nih chuan).

Kan taksa ruh zawng zawng hi a inzawm khawm vek a ni. Chuvangin, ruh pakhat chu hmun khata a chak loh chuan ruh dangte chungah pressure extra a siam thei a ni. Chuvangin, ``malunion'' awmna hmunah chuan natna awm lo mahse, chu ruh chu hman a nih chuan taksa peng dangah natna a thlen thei a ni.

• Nerve nena inzawm harsatna: 1.1.

A châng chuan, a bula nerve chu ruh inzawm lote chuan a compress emaw, a pinch emaw thei bawk. Chutiang a nih chuan symptoms i nei thei a, chungte chu:

• Chu hmunah chuan rilru hahna emaw, tingling sensation (`(Paresthesia)`) emaw a awm.
• Muscle weakness , a nih loh leh a dik zawk chuan muscle atrophy.
• Nerve natna (Neuropathy) a awm.

`(Nonunion)` tih lanchhuahna chu engte nge ni?

Ruh pakhat a inmil lo a nih chuan, chu chu ``nonunion'' a awm a nih chuan, hetiang symptoms hi i hmu thei ang:

• Ruh tliakna hmunah hian natna thuk tak, rei tak daih thei a awm. Hetiang natna hi cast lakchhuah hnuah pawh a la awm chhunzawm zel thei.
• Chu ruh chu i hman hian chak lohna emaw, chetna tlem emaw i nei a ni .
• A visible change , entirnan, bump emaw gap emaw chu pawn lamah a lang thei a, ruh chu a rawn chhuak ang maiin a lang thei.

A châng chuan ruhah natna hrik a awm chuan heng chhinchhiahnate hi a rualin emaw, a hranin emaw a lo lang thei a ni:

• Vung
• Khawsik
• Khawsik hriat leh khawsik (chills) neih .

Engvangin nge fracture hi a dam tha lo va, ``malunion`` emaw ``nonunion`` emaw a awm? A chhante chu engte nge ni?

Ruh hi a dam tha lo mai thei. Ṭhenkhat chu kan thunun thei a, ṭhenkhat chu kan thunun thei lo. Chung zinga ṭhenkhat chu hetiang hi a ni:

• Fracture awm dan leh a nasat dan:

Fracture thenkhat chu tihdam harsa deuh deuh a awm bawk. Entirnan, spiral fractures (twisted taka chhe thin) emaw comminuted fractures (a chhe tam tak) , te hi a set tha lo hle. Tin, accident lian tak avanga ruh chhunga thisen kalna a tihbuai chuan chu chuan damna a nghawng thei bawk.

• Engtiang chiahin nge enkawlna chu an dawn rang leh tha em:

Ruh a tliak hnua enkawl vat a nih loh chuan a dam lo tan thei a ni. Tin, ruh chu uluk taka set a nih hnuah leh cast an hnawih hnuah pawh a hmun atang chuan a la kal chhuak thei tho bawk. Hei hi enkawlna tihkhawtlai emaw, hman dan (e.g., cast chakna) a tawk lo emaw a nih chuan a thleng tam zawk.

• I dam chhoh chhung khan i chawlh hahdam tha em tih leh i inveng em tih:

Damna kawngah hian ruh tliak chu immobilized a, a awmna tur dik takah fix a pawimawh hle. A châng chuan, a dam theih nân a hma aia rei a daih thei bawk. Chutiang hunah chuan doctor-in cast a lakchhuah hma lutuk emaw, ruh i hman hma lutuk emaw chuan harsatna a awm thei.

• I hriselna zawng zawng leh i taksa chakna i mamawh chu:

Damna a slow chuan malunion emaw nonunion emaw a awm theihna a sang zawk. Kum upa lam , ei leh in lama harsatna (a bik takin calcium leh vitamin D), leh metabolic condition, zunthlum leh thyroid natna nei te tan chuan ruh dam hi a tlai emaw, a famkim lo emaw a ni thei. Zuk leh hmuam leh nicotine hman hi ruh tichak lotu leh damna tikhawtlaitu lian ber a ni bawk.

Engtin nge doctor-te hian heng `(Malunion)` leh `(Nonunion)` dinhmunte hi dik taka an hriat theih?

Hetiang harsatna i nei nia i hriat chuan doctor-in accident chungchang leh i damdawi lam harsatna dang i neihte chu a zawt hmasa ang che. Tichuan, ruh chu taksa enfiahna (physical examination) an nei ang . Pawn lam atanga hmuh theih tur danglamna eng pawh an zawng ang a, ruh sawn avanga i rilru put hmang an zawt ang che. Kea kal turin an ti mai thei che a, a nih loh leh ruh sei zawng an teh thei bawk.

Chumi hnuah chuan ruh hi imaging test an ti tlangpui. Chûng zîngah chuan:

• `(X-rays)` (X-ray): Hei hi i en hmasak ber a ni fo.
• `(CT scan)` (CT scan): Ruh chiang zawk, cross-sectional image a hmu thei.
• `(MRI)` (MRI scan): Hei hian ruh chhehvela tissue nem tak tak, nerve ang chi te chu a tichhia em tih hriat nan a pui a ni.

Doctor chuan ruh chu non-anatomical position-ah a dam tawh tih a hriat chuan ``malunion'' a ni tih a thutlukna siam ang.`` Ruh chu a dam tan loh emaw, dam hun remchang tak hnua a dam kim loh emaw chuan ``delayed union`` emaw ``nonunion emaw tia hriat a ni.`` Dam hun chhung chu hliam awm dan, ruh inrawlh leh i hriselna a zirin a danglam thei. A tlangpuiin thla ruk, thla kua, thla sawm leh pahnih hnua a dam loh chuan ``nonunion`` an ti thin.

Heng `(Malunion)` leh `(Nonunion)` dinhmunte hi tihdam theih a ni em? Enkawlnate chu engte nge ni?

Thu lawmawm tak chu malunion emaw nonunion emaw zawng zawng hi "fixed" vek a ngai lo. Ruh inrawlh, i hman zat leh i nitin nun a nghawng danah a innghat a ni. Mahse, nonunion ṭhenkhat chuan i chetna a tikhawtlai thei a, natna a thlen thei a, harsatna dang a thlen thei bawk. Chutiang hunah chuan buaina siam\hat nan operation neih a ngai mai thei. Doctor-te chuan nonsurgical treatment an enchhin hmasa ang a, a hlawhtlin loh chuan surgery an hmang leh ang.

`(Malunion)` (Ruh dik lo) enkawl dan .

• Surgery ni lo enkawlna: 1.1.
• Bracing: I hman hunah ruh chu a hmun tha zawka awm reng tura pui turin brace vuah turin an ti mai thei che.
• Orthotics: Ke pakhat a tawi zawk chuan kekawr insert bik hmangin a danglamna chu i khum thei ang.
• Physical therapy: Hei hian exercise bik a huam a, chu chuan taksa ruh inzawmte a tichak thei a, ruh chunga pressure a tihziaawm thei bawk.
• Natna tidamtu: NSAIDs (non-steroidal anti-inflammatory drugs) te hi a chang chuan a nuam lo tihziaawmna tur a niPainkiller pangngai ang chi te pawh i hmang thei bawk.

• Surgery hmanga enkawl dan:
• Osteotomy: Surgeon chuan ruh a tikehsawm thei a, a awmna hmun a siamrem thei bawk .
• Limb lengthening surgery: Kut emaw ke emaw chu na taka tih tawi a nih chuan, hmanraw bik hmangin a sei theih nan operation tih theih a ni.

`(Nonunion)` (ruh inzawm lo) enkawl dan .

• Surgery ni lo enkawlna: 1.1.
• Medical therapy: Taksa pum huap natna (e.g. zunthlum), natna hrik emaw, ei leh in tha lo emaw a awm chuan chu chu enkawl hmasak tur a ni.
• Orthoses: Brace, splint emaw cast emaw hmangin ruh a dam theih nan leh a tlak chhuah loh nan an hmang thin.
• Bone stimulator: Hengte hi ruh tihdamna atana ultrasonic wave emaw electromagnetic wave emaw hmanga ruh tihdamna atana hmanraw bik an ni.
• Biological injection: Stem cell emaw platelet tamna plasma emaw chu ruh chhungah inject theih a ni a, chu chuan damna leh thanlenna a tichak a ni.

• Surgery hmanga enkawl dan:
• Debridement: Surgeon chuan ruh atanga tissue thi, dam lo a la chhuak thin.
• Vascular surgery: Thisen supply a buai a nih chuan vascular surgery hmanga siam that leh theih a ni.
• Bone grafting: Surgeon chuan i taksa peng dang (i hip bone ang chi) emaw, donor ruh atanga ruh chi khat a la a, a bo laiah a dah lut a ni. Hei hian ruh thar thanna bul tanna tha tak a pe a ni.
• Open reduction leh internal fixation: Surgeon chuan ruh chi hrang hrangte chu a hmun dangah a dah leh a, surgical screw, plate emaw nail emaw hmangin a inzawm khawm thin.

Enkawl hnua dam lehna chu engtin nge a awm?

Non-surgical leh surgical treatment pahnih hian malunion leh nonunion enkawlna kawngah hlawhtlinna rate sang tak an nei a ni . Chu chu chanchin lawmawm tak a ni. Mahse, a dam kim theih nan leh a pangngaia a awm leh theih nan hun engemaw chen a la ngai thei (rehabilitation). I dam leh hma loh chuan kea kal tur chuan tiang emaw, kea kalna emaw i hman a ngai mai thei. Physics therapy pawh i mamawh thei bawk.

A châng chuan enkawlna a hlawhchham thei bawk. Hei hi ruh chu a awmna tur dik takah a vawn theih loh chuan emaw, doctor-te’n kan sawi tawh biological factors (thisen supply leh nutrition ang chi) te an control theih loh chuan a thleng thei a ni.

Kan hriat reng tur pawimawh ber berte (Take-Home Message) .

Ruh tliak hi tu chungah pawh a thleng thei. A chang chuan ruh kan tliak tih pawh kan hre nghal lo. Mahse, rinhlelhna tlemte pawh i neih chuan doctor pan nghal a, i enfiah nghal a tha ber.

• Fracture te hi a hma, quality care an dawn chuan an dam tha zawk thin .
• I doctor chuan i hliam chu a enfiah ang a, damna tikhawtlai thei thil eng pawh a hmuchhuak ang.
• `(Malunion)` emaw `(Nonunion) emaw laka invenna tur kawng tha ber an hrilh ang che. Chu thupekte chu uluk taka zawm a pawimawh hle.

Chuvangin, he thu hi i tan a tangkai ngei ka beisei. Ruh tliak i neih chuan hlauthawng suh la, damdawi lam thurawn dik tak zawm pawh theihnghilh suh. Hei hian hetiang harsatna lo thleng tur hi a veng thei fo.

` Fracture, malunion, nonunion, malunion, ruh enkawlna, ruh zai