I ruh i tihchhiat hnuah a set tha lo em ni? (Malunion & Nonunion Fractures) te hi a tha hle a ni.

Aw, ruh tliak hi ngaihtuah pawh i duh lo a ni lawm ni? Mahse accident-ah te, hmun sang atanga tlu emaw, car accident-ah te pawh a thleng thei. A tam zawkah chuan doctor-te enkawlna, bandage leh plaster hnawih ang chi hmang hian ruh chhe tawhte chu mawi takin an dah khawm leh thei a ni. Mahse, a chang chuan, heng thilte hi i ngaihtuah angin a thleng awlsam lo. An inrem tawk lo a nih chuan, a nih loh leh an in fit lo tak tak a nih chuan eng nge thleng ang? Vawiin hian chutiang condition pahnih kan sawi dawn a ni: Malunion leh Nonunion .

Malunion leh Nonunion chu eng nge ni?

A awlsam zawngin, hei hian ruh a tliak hnua a dam tha lo tihna a ni.

• Malunion chu ruh tliakte chu inzawm khawm a, mahse kawng dik lo, hmun dik lo taka awm a ni . Plate chhe pahnih chu dik lo taka glue khawm ang maiin. Ruhte chu hrual theih, ben emaw, tawi emaw theih a ni.
• Nonunion chu ruh tliakte chu a dam lo tak tak a, rei tak hnuah pawh a dam lo tihna a ni. Thingpui chhe pahnih, a inmil lo mai mai ang mai a ni.

Chutiang chuan ruh pakhat chu a inrem lo a nih chuan, a nih loh leh a inrem lo vek a nih chuan kan taksa ruhro nghet leh hnathawhnaah nghawng lian tak a nei thei a ni. Ke ruh pakhat chu a inmil lo a nih chuan kal a harsat ang tih han ngaihtuah teh.

A tam zawkah chuan ruh tliak hi enkawl dan dik a nih chuan a dam tha hle. An tih loh chuan a chhan a awm ngei ang. Mechanical problem a ni thei - chu chu a chhe lai chu a dam laiin a in fit tha lo tihna a ni. A nih loh leh biological problem a ni thei bawk - chu chu i taksa hian ruh pakhat tihdam theihna tur resources a nei tlem tihna a ni. Doctor-te chuan heng natnate hi an enkawl hian heng zawng zawng hi an ngaihtuah vek a ni.

Nonunion chi hrang hrangte chu engte nge ni?

I doctor chuan i nonunion chu ``Hypertrophic'', ``Atrophic'', emaw ``Oligotrophic'' tiin a classified thei. He classification hi ruh dam lohna chhan finfiahna atanga siam a ni.

• Hypertrophic nonunion: Hei hi ruh thar a lo pian lai a ni a, mahse ruh tliak tawp lam chu a inzawm tha lo. Phên dangin sawi ila, i ruh hian damna atana mamawh biological components (e.g., thisen supply, cells) zawng zawng a nei vek a, mahse a dam lai hian ruh chi hrang hrangte chu a inzawm tha tawk lo. In sakna atana hmanraw mamawh zawng zawng nei mah la, a bangte chu a nghet lo hle tih han ngaihtuah teh.
• Atrophic nonunion-ah chuan:Hetiang a nih chuan ruh thar hmuh theih a awm lo va, ruh hian thisen supply tha tak a dawng lo. Hei hian ruh hi biological reasons vangin a dam lo tih a tilang. Tui leh ei leh in nei lovin thlai a lo hring ang maiin. A chang chuan ruh chhungah natna hrik (septic nonunion) a awm chuan thisen supply pawh a tibuai thei bawk.
• Oligotrophic nonunion: Hetiang a nih chuan ruh thar engemaw zat a lo piang a, mahse a kim lo. Ruh hnah te hi a awmna tur dik takah a awm lo. Ruh chi hrang hrangte chu a tir lamah chuan a set dik lo a ni mai thei, a nih loh leh a hnuah an inzawm khawm a ni mai thei. Ruh chi hrang hrangte dinhmun nghet leh biological factors-ah harsatna a awm thei.

Malunion natna lanchhuahna chu engte nge ni?

Ruh pakhat chu a inmil lo (malunion) chuan hetiang hi i hmu mai thei:

• I ruhte chu a inzawm emaw, a ben emaw angin a lang.
• Ruh chu a hrual ang maiin a lang .
• Ruh chu a hma aiin a tawi zawkin a lang.

Hetianga ruh inmil lo i hman hian a hnuaia symptoms te hi i nei thei ang:

• Ruh awmna hmunah a na a.
• A hring (swelling) a awm .
• Kal laiin limping (ke a nih chuan).

Kan taksa ruh zawng zawng hi a inzawm khawm vek a ni. Chuvangin ruh hmun khata a chak loh chuan ruh dangte chungah rit leh pressure a siam belh thei a ni. Chuvangin ruh hliam i hman hian taksa peng dangah natna i nei thei a ni.

Ngaihtuah teh, i bula nerve chu ruh chi hrang hrang inmil lo avanga pinch emaw, pulled emaw a nih chuan, hengte hi nerve nena inzawm symptoms i neih theihte chu a ni:

• Tingling, rulhut tlan kual vel ang maia hriatna (paresthesia).
• Hliam na hmuna ruh te chu a chak lo va, atrophy a ni .
• Nerve na (neuropathy) a awm a.

Nonunion hian eng symptoms nge a neih?

Ruh pakhat a inzawm khawm loh (nonunion) chuan hetiang hian symptoms i hmu thei ang:

• A chhe laiah chuan natna thuk tak, awm reng a awm .
• Chumi kawngah chuan chak lohna a la awm a, chu chu che thei lo anga inhriatna a ni .
• Pawn lam atang chuan danglamna i hmu thei , knot emaw gap emaw ang mai pawh a ni thei.

A châng chuan ruhah natna a awm chuan heng natna lan chhuahnate hi a awm thei a, a awm lo thei bawk:

• Vung
• Khawsik
• Ka vawt deuh deuh a.

Engvangin nge heng malunion leh nonunion te hi a lo awm?

Ruh a tliak chuan a dam tha lo emaw, a dam lo emaw pawh ni thei chhan tam tak a awm. A bulpui ber thenkhat han thlir ila:

• Engtin nge a chhe, eng ang taka chhe nge:Entirnan, ruh hrual (spiral fractures) emaw, chi hrang hranga inthen (comminuted fractures) emaw chuan a dam tha lo hle. Tin, ruh chhunga thisen kalna tichhe thei hliam na tak (traumatic injuries) i neih chuan damna a nghawng dawn a ni. A chhan chu ruh nung leh dam nan thisen supply a pawimawh em em a ni.
• Engtiang chiahin nge i enkawl rang a, engtiang chiahin nge i enkawl that: Ruh i tihchhiat ruala doctor i hmuh loh chuan a dam lo tan thei a ni. A châng chuan ruh chi hrang hrangte chu uluk taka set pawh ni se, a la chhuak thei tho. Hei hi enkawlna a tlai emaw, enkawlna a tling tawk lo emaw a nih chuan a thleng tam zawk.
• Dam laia chawlh hahdam leh invenna: Ruh pakhat chu a dam lai hian a hmunah leh a awmna tur dik takah dah reng a pawimawh hle. Mi thenkhat chuan ruh a dam theih nan a hma aia rei an hmang thin. 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 dam theihna: Ruh chu a dam zauh zauh chuan malunion emaw nonunion emaw a nih a rinawm zawk. Mi tar , ei leh in lama harsatna (a bik takin calcium leh vitamin D), emaw, metabolic natna, zunthlum leh thyroid natna te chuan ruh damna a tikhawtlai thei a, a tikhawlo thei bawk. Tin, zuk leh hmuam leh nicotine hman hian ruh a tichak lo thei a, damna a tikhawtlai thei bawk tih hriat reng a pawimawh bawk.

Engtin nge doctor-te hian heng natnate hi an hriat chhuah?

Hetiang dinhmun i hriatchhuah hian doctor chuan hliam i neih dan leh i damdawi lam thil dang i neih theih dan tur a zawt hmasa ang che. Tichuan, i ke taksa chu a enfiah ang. Pawn lam atanga i hmuh theih danglamna leh i sawn chhuah chuan engtin nge a awm tih ang chi thilte chu a en ang. Fracture awmna hmun azirin i kal dan emaw, i ke sei zawng teh emaw an duh mai thei.

Tichuan, a nihna takah chuan ruh thlalak (`imaging`) an la thin. Hei hian X-ray , CT scan , emaw MRI ang chi test te a hmang thei a ni.

Doctor chuan ruh chu taksa tana hmun pangngai lo, dik lo takah a dam tawh em tih a enfiah ang. Chutiang a nih chuan malunion a ni tih a rel ang.

Ruh chu rei tak a dam loh chuan emaw, a dam kim loh chuan `delayed union` emaw nonunion emaw an ti a. Ruh a dam hun chhung hi a hliam chi hrang hrang, ruh tliak chi leh i hriselna zawng zawng a zirin a danglam thei. A tlangpuiin ruh pakhat chu a dam lova a dam theih nan thla ruk, thla kua, thla sawm leh pahnih a ngai thei.

Heng malunion leh nonunion te hi siam theih a ni em?

Malunion emaw nonunion emaw zawng zawng hi siamthat a ngai lo. Eng ruh nge tihchhiat, ruh i hman zat leh chu natnain nitin nun a nghawng danah a innghat a ni. Mahse a chang chuan, ruh a dam tha lo chuan ke a ti harsa thei a, a ti na thei a, harsatna dang a thlen thei bawk. Chutiang a nih chuan, siam ṭhat nân operation neih a ngai mai thei. I doctor chuan nonsurgical treatment a enchhin hmasa ang a, a hlawhtlin loh chuan surgery neih a rawt ang.

Malunion enkawl dan tur

Surgery ni lo enkawlna: 1.1.

• Bracing: A chang chuan ruh chu a hmun tha zawka awm reng turin brace bik hman theih a ni.
• Orthotics: A bik taka siam shoe insert hian ke sei zawng inthlauhna chu a khum thei a ni.
• Physical therapy: Exercise bik hian ruh natna a tichak a, ruh chunga phurrit a tihziaawm thei bawk.
• Natna tihdamna: A chang chuan natna tihdamna damdawi hman tlanglawn tak, NSAID ang chi te pawh i hmang thei.

Surgery hmanga enkawl dan:

• Osteotomy: Hetah hian ruh surgeon chuan ruh inmil lo chu a tan a, a hmunah a dah leh thin.
• Limb lengthening surgery: Kut emaw ke emaw tih tawi a nih chuan surgeon chuan hmanraw bik hmangin a sei thei a ni.

Nonunion enkawl dan tur

Surgery ni lo enkawlna: 1.1.

• Medical therapy: Thil dang (e.g. zunthlum), natna hrik emaw, ei leh in lama harsatna emaw avanga enkawl i ngai mai thei.
• Orthoses: Brace, splint emaw cast emaw hian ruh chu a che thei lo va, a dam theih nan a pui thei bawk.
• Bone stimulator: Hengte hian ultrasonic emaw electromagnetic wave emaw hmangin ruh damna a tichak a ni.
• Biologic injection: Stem cell emaw platelet tamna plasma emaw injection hian ruh dam leh thanna a tichak thei a ni.

Surgery hmanga enkawl dan:

• Debridement: Hetah hian orthopaedic surgeon chuan ruh atanga tissue thi a la chhuak thin.
• Vascular surgery: Vascular surgeon chuan i thisen kalna kawngte chu a ti thei a, chu chuan i thinlungah thisen a kal leh thei a ni.
• Ruh grafting: 1.1.Hetah hian orthopaedic surgeon chuan i taksa peng dang atang emaw, donor ruh atang emaw ruh thenkhat a la a, a bo laiah a dah lut thin. He ruh thlak hian ruh thar thanna tur bul tanna tha tak a pe a ni.
• Open reduction leh internal fixation: Hetah hian orthopedic surgeon chuan ruh chi hrang hrangte chu a siam tha leh a, surgical screw leh plate emaw nail emaw hmangin a fix khawm thin.

Enkawl hnuah eng dinhmun nge a awm?

Non-surgical leh surgical treatment pahnih hian malunion leh nonunions enkawlna kawngah hlawhtlinna rate sang tak an nei a ni. Mahse, dam lehna leh insiamthatna tur hian hun a duh a ni. I dam hma chuan cane emaw walker emaw i hman a ngai mai thei. Hun engemaw chen chu physical therapy i tih a ngai mai thei bawk. A châng chuan ruhte chu a inmil thei lo a nih chuan, emaw, doctor-in a hnuaia biological factors a thunun theih loh chuan enkawlna chu a hlawhchham thei a ni.

Ruh tliak hi tu chungah pawh a thleng thei. Ruh tliak i neih leh neih loh chu a chiang ngai lo. Mahse i nei mai thei nia i ngaih chuan a rang thei ang bera Doctor pan a tha ber. A chhan chu fracture te hi rang tak leh uluk taka enkawl a nih chuan a dam tha zawk thin. I doctor chuan i hliam chu a enfiah ang a, a dam lohna tur daltu awm thei chu a hre chhuak ang. Chumi hnuah chuan malunion emaw nonunion emaw thlen ai chuan, a dam ṭhat theih nâna i tih theihte chu a fuih ang che.

Hriat reng tur pawimawh ber ber (Take-Home Message) .

Ruh i tihchhiat chuan hlauthawng suh. Mahse, awlsam takin la bawk suh. Doctor hmu nghal la, inenkawlna mumal tak la rawh. Doctor thupek dik takin zawm rawh. Cast pek i nih chuan phelh tura a tih che hma loh chuan ha reng ang che. Exercise turin a ti che a nih chuan dik takin ti rawh. Ei leh in inthlau tak ei la, a bik takin calcium leh vitamin D tamna ei tur ei rawh. A chhan chu nun hrisel nei tur chuan ruh hrisel hi a pawimawh em em a ni!

` Ruh tliak, malunion, nonunion, ruh tihdam, ruh surgery, ruh enkawlna, ruh tliak