A châng chuan i kutphah a na mai mai ṭhin a ni lawm ni? Sprain ang mai a ni. Mi tam zawk chuan ni engemaw zat hnuah a reh mai thei, hliam tenau tak niin an ngai. Mahse a chang chuan he natna hi a chhan lian zawk a awm thin. Kienböck natna hi a tlem hle a, mahse hriat tur pawimawh tak a ni. He hming hi i tan chuan thil thar a ni mai thei, mahse i hriat chian a pawimawh.
A awlsam zawngin, Kienböck natna hi eng nge ni?
Okay, hei hi awlsam takin han sawifiah ila. I kutphah hi ruh te tak te atanga siam a ni a, chu chu ruh 8 inzawmkhawm a ni. Hengte hi `(Carpal bones)` kan ti a. Heng ruh pariat zingah hian ruh te tak te, thlasik (crescent moon) ang maia siam, a lai takah a awm a ni. Hei hi Doctor ten `(Lunate)` ruh an tih chu a ni. He `(Lunate)` ruh hian kan kut ben leh rotate tha takah a pui nasa hle.
Kienböck natna hi lunate bone-a thisen kalna chu a tlahniam zauh zauh a, a tawpah chuan a tawp ta a ni. Thingkung tui tel lova a thi ang bawkin he ruh hi thisen tel lovin a thi zauh zauh a ni. Damdawi lamah chuan hei hi osteonecrosis an ti a. Hei hi a thleng thut lo va, hun kal zelah a na zual sauh sauh a ni. A châng chuan, hei hian kutphah-a arthritis ang chi dinhmun pawh a thlen thei bawk.
Hetiang hi tuin nge nei tam zawk? A chhante chu engte nge ni?
He natna hi kum eng pawha awm thei mah se, a tlangpuiin mipa kum 20 leh 40 inkarah a tam ber a, mahse, hmeichhiain an vei thei lo tihna erawh a ni lo.
Lunate-a thisen supply tlahniam chhan hi 100% a la chiang lo. Mahse, chutianga ti thei nia ngaih thil engemaw zat a awm a:
- Ruh-a thisen petu thisen kalna kawngte harsatna: Mi thenkhat chu ``Lunate`` ruh-a thisen petu thisen kalna kawngte dinhmun dik lo neiin an piang a. Chutiang hunah chuan thisen pek tlem theihna chance a sang zawk. Mithiamte chuan hei hi a chhan ber niin an ngai.
- Trauma to the wrist: I tlu emaw, car accident emaw, infiamna i khelh laiin i kutphah hliam na tak i tuar emaw pawh a ni thei. Hei hi lunate ruh a chhiat a, thisen kal a tihtawp chuan a thleng thei a, chu chuan he natna hi a thlen thei a ni.
- Kut ruh sei zawng inang lo: Kan kut hnuai lamah hian ruh lian pahnih a awm a, chungte chu radius leh ulna te an ni. Mi thenkhatah chuan heng ruh pahnih hi a sei zawng a inang lo. Pakhat chu a dang aiin a tawi deuh. Chutiang a nih chuan kut zungtang a che laiin lunate bone-ah pressure pangngai lo tak a awm thin. Hun a kal zel a, he pressure hian ruh a tichhe thei a, thisen kal pawh a tichhe thei bawk.
- Damdawi lam harsatna dangte:Thisen kaihhnawih natna ``Sickle cell anemia'' leh ``Lupus'' nei te, leh thluak lam natna thenkhat ``Cerebral palsy'' nei te chu Kienböck natna vei an hlauhawm hle.
He natna lan chhuah dan engte nge ni?
A tam zawkah chuan he natna hi a bul tan tirh lamah hian symptom lian tham a awm lo. Mi thenkhat chuan symptom engmah an nei lo mai thei. Mahse symptoms tlanglawn thenkhat hmuh tur a awm. Eng nge an nih i en ang u.
| Symptom a ni | Chu chu engtin nge a ngaih? |
|---|---|
| Kut na a na | Kut zungtang hliam na ang mai a ni. Natna na lo tak, a chang chuan lo thleng leh bo thin a ni thei a, a nih loh leh natna khirh tak, na tak tak a ni thei bawk. |
| A hring leh a nghet lo | Ka kutphah chu a hring vek niin a lang. Zing ka harh chuan a khauh a, ben harsa ka ti hle. |
| Hman harsa (weak grip) . | Tui bottle khuhna hawn emaw, kawngkhar khar emaw tih ang chi thil ka tih hian ka kut chu a chak lo hle. Thil rit tak ka chawi chuan ka kut a na. |
| Inkalpawhna khap | I kutphah chu a hma leh a hnuai emaw, a sir lehlamah awlsam takin i ben thei lo. |
| Crepitation (Crepitation) a ni | I kutphah i sawn chuan ‘cracking’ ri a siam a, ruhte chu a chhung atanga a rawn hrual ang maiin a awm. |
| Hmun bik pakhata natna | Ka kutphah chunglam, a lai takah (lunate bone awmna hmunah) ka kut zungtang ka hmet hian natna ka nei thin. |
A pawimawh ber chu, hetiang natna i tawn hian ngaihthah suh, "A hliam mai mai a ni" tih ngaihtuah suh. A bik takin kar khat emaw kar hnih emaw hnuah a natna a reh loh chuan doctor pan ngei ngei tur a ni.
He natna hi engtin nge doctor hian a hriat theih ang?
Doctor i pan hunah chuan a natna chungchang te, eng chen nge a awm tawh tih te, engtikah nge a na zual zel tih te a zawt ang che. Tichuan i kutphah chu a enfiah ang. Diagnosis finfiah nan test eng emaw zat a tih a ngai dawn a ni.
- X-ray examination: A hmasa ber chu X-ray a ni. Amaherawhchu, natna a tan tirh lamah chuan X-ray-ah hian danglamna lian tham a lang lo mai thei.
- MRI Scan: Hei hi he natna hi hriat chian dan tha ber a ni. MRI scan hian a tir lamah ``Lunate`` ruh chu thisen a chhuak leh chhuak lo tih a hriat theih a, ruh chu a thi tan tawh em tih pawh a hriat theih bawk.
- CT scan: CT scan hian ruh chu a chhe emaw, a chhe emaw tih chiang taka hriat theih nan a pui thei a ni.
- Bone Scan: Hei hian taksa chhunga ruh awmte hnathawh dan a en thei a.
Kienböck natna stage pali te
Heng test neih zawh hian doctor chuan i natna chu eng stage-ah nge a awm tih a hrilh ang che, main stage 4 a awm.
| Dawhsan | Hetiang dinhmunah hian eng nge thleng? |
|---|---|
| Stage 1-na a ni | Hei hi a vawi khatna a ni. A na chu kutphah hliam ang maiin a awm. X-ray-ah hian danglamna a awm lo. Mahse MRI hmanga i en chuan `(Lunate)` ruh a thisen supply a tlahniam tih i hmu thei. |
| Stage 2-na a ni | Thisen tlakchham vangin ruh chu lungpui ang maiin a khauh tan thin. Hei hi ``sclerosis'' an ti a. X-ray-ah chuan ruh chu a dang zawng aiin a var zawkin a lang. A na chu a zual deuh deuh a. |
| Stage 3-na a ni | Tunah chuan ruh khauh tawh chu a chhe tawh a, a chhe tan ta a ni. Hei hian kutphah ruh dangte chu an awmna hmun a\angin tlem a ti che thei a ni. A na a zual a, kut chakna a tlahniam a, kut ben pawh a harsa ta hle. |
| Stage 4-na a ni | Hei hi a pawi ber a ni. Lunate ruh chu a chhe vek tawh mai a, a chhe vek tawh bawk. Chu mai ni lovin a chhehvel ruh dangte pawh a chhe tan ta a ni. Wrist joint ngei pawh a chhia a, arthritis a awm bawk. |
Mi thenkhat chu stage 1 atanga 4 thlenga kal tur chuan thla engemaw zat a ngai thei a, thenkhat tan chuan kum tam tak a ngai thei bawk.
Hei hi eng enkawlna nge ni?
He natna hi damdawi pakhat mah awm lo mah se, tuna enkawlna hian natna tihziaawmna kawngah a pui thei a, kutphah hnathawh a tichak thei a, natna a zual zel tur chu a titawp thei bawk. Enkawlna chu thil tam takah a innghat a, chung zingah chuan i natna dinhmun, i kum leh i hnathawhna te pawh a tel.
Surgery tel lova enkawlna te
Hengte hi natna a hmaa tih thin a ni tlangpui.
- Wrist immobilization: Kut hi thla engemaw zat chhung chu cast-ah immobilization a ni. He chawlhna hian a chang chuan ruh chu thisen a kal leh theih nan a pui thei a ni.
- Painkillers: I doctor chuan natna leh hliam tihziaawmna atan ibuprofen ang chi anti-inflammatory damdawi a rawn rawt thei ang. Mahse hre reng ang che, heng damdawi te hi Asthma, pum ulcer, thisen sang, kal emaw thinlung natna nei tan chuan a tha lo. So , doctor rawn hmasa lovin heng damdawi te hi ei ngai suh.
- Occupational therapy: Occupational therapist chuan nitin hna thawh dan tur a zirtir ang che, chu chuan kut natna tihziaawmna tur a siam ang.
Surgery hmanga enkawl
Natna a nasat chuan, a nih loh leh enkawlna dangin a puih loh chuan doctor chuan zai a rawt thei a ni. Surgery chi hrang hrang tih tur chu natna stage a zirin a inang lo ang.
| Surgery neihna hmun hming | A awlsam zawngin, hei hi a thleng thin... |
|---|---|
| Joint Leveling tih a ni | Forearm-a ruh pahnih, ``Radius'' leh ``Ulna'' te sei zawng a danglam chuan an sei zawng inang tlang turin operation an ti thin. Ruh tawi takah chuan ruh te tak te chu a sei theih nan an grafted a, a nih loh leh ruh sei tak atang chuan a tawi nan te te an tan bawk. Hei hian ``Lunate'' ruh chunga pressure a tihziaawm a ni. |
| Revascularization tihchhuah a ni | Hei hian lunate bone-a thisen supply siam that leh a huam a ni. Ruh te tak te, thisen kalna kawng nei chu taksa peng dang (e.g., thigh) atanga lak chhuah a ni a, thi tur lunate bone-ah dah a ni. Hei hi natna hmasa pahnihah chauh tih theih a ni. |
| Fusion a ni | Natna a nasat chuan kutphah ruh engemaw zat dah khawm a, natna tihziaawmna turin. A châng chuan kutphah pum ruhte chu dah khawm a nih chuan kutphah chu a ben thei lo va, kut chu a inher thei a ni. |
| Proximal Row Carpectomy (PRC) hmanga tihchhuah a ni. | Lunate ruh chu a chhe vek a nih chuan ruh leh a bula ruh engemaw zat chu lakchhuah a ni. Hei hian natna a tiziaawm a, mahse kut zungtang chetna thenkhat erawh a tikhawtlai thung. |
| Implant Arthroplasty tih a ni | Hei hian ``Lunate`` ruh chhia chu lakchhuah a ni a, ruh siam (``prosthetic``) hmanga thlak a ni. |
Engtikah nge doctor i hmuh ngei ang?
He natna hi hriatchhuah thuai a nih chuan a enkawl dan leh a rah chhuah a tha zawk ang. Chuvangin, a hnuaia symptoms te hi i tawn hma leh doctor i hmuh hma chu nghak suh.
- I kutphah, kut emaw, kut zungtang emaw tihchet harsatna i neih chuan.
- A kutphah vel a sen danglam bik a awm chuan.
- A hring a na zual zel a nih chuan.
- Natna tuar theih loh a awm chuan .
I doctor chuan he mi chungchânga specialist, orthopaedist -ah a refer ang che .
Take-Home Thuchah a ni
- Kienböck natna hi thil awm lo tak a ni a, i kut ruh te tak te, lunate an tih, thisen kalna chu a titawp a, zawi zawiin a thi ta a ni.
- A lan chhuah hmasak ber chu kut zungtang hliam ang maia natna a ni mai thei. Chuvangin hetiang hian persistent pain i neih chuan ngaihthah suh.
- He natna hi hun kal zelah a zual zauh zauh a. Enkawl loh chuan a na a zual thei a, kut chu a che thei lo vek thei bawk.
- I result chu natna i hriat chhuah thuai leh enkawl tan danah a innghat nasa hle ang.
- I doctor nen inbia la, eng enkawlna kawng nge i tan a tha ber tih rel rawh.
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