Ladder-a i thawh laiin rang takin i tlu a, i tlu emaw, car accident-ah emaw i awm ang tih han ngaihtuah teh. I ke ruh chu tuar theih loh khawpin i na a, i ke a hring nasa hle a, a pianphung lo takin a ben pawh a lang thei bawk. A na lutuk a, i ke pawh i dah thei lo, kal chu sawi loh. Hetiang dinhmunah hian ke ruh tliak mai mai ai pawhin a pawi zawk thei. Chu chu vawiinah hian fracture na tak kan sawi dawn a ni.
Pilon Fracture hi eng nge ni tak tak?
A awlsam zawngin, Pilon Fracture (Tibial Plafond Fracture) hi i ke ruh (tibia) hnuai lam, ke ruh inzawmna hmun dik takah a chhe nasa hle a ni. Kan keah hian ruh lian pahnih a awm a, a lian zawk chu `(tibia)` kan ti a, a te zawk chu `(fibula)` kan ti bawk. Pilon fracture-ah chuan heng ruh pahnih hi a chhe thei fo.
Hei hi chhan bik vangin `Pilon` an ti a. `Pilon` tih awmzia chu French tawngin `mole` tihna a ni. Mortar leh pestle-a thil i pound ang bawkin, he fracture hi chutiang chakna nasa tak nen a thleng thin. Ngaihtuah teh, i ke ruh (talus)-a ruh (talus nena inzawm ruh) chu chak takin a sang chho a, talus tawp chu a tikehsawm a ni. Chutiang process chu hetah hian a thleng thin.
Hei hi ke ruh tliak (sprained ankle fracture) pangngai a ni lo. Hei hi natna khirh tak a ni a, ke ruh (ankle joint) weight-bearing surface a tichhe a, a tam zawkah chuan comminuted fracture a awm thin. Chuvang chuan enkawl a buaithlak deuh.
Heng break chi hrang hrang hi a awm em?
Ni e, doctor-te chuan he ruh tliak nasat dan azirin classification engemaw zat an hmang thin. Kan hriatthiam awlsam ber leh hman tlanglawn ber chu `Ruedi-Allgower` classification hi a ni. A awlsam zawngin i hrethiam ang u.
- Type I: Hei hi ruh hian ruh a tihchhiat a, mahse ruh tliak te chu a che lo . An la awm reng a ni. Hei hi fracture chi khat na ber a ni.
- Type II: Hetah hian ruh chhe tawhte chu a inthlak danglam deuh a, chu chu ruh chu a inmil tawk lo tihna a ni. Amaherawhchu, a ruh chu a chhe tam lo.
- Type III: Hei hi a na ber a ni . Chutiang a nih chuan ruh chhe tawhte chu an sawn chhuak mai ni lovin, ruh chu a te tein an tikehsawm (comminution) . Tin, joint surface-ah pawh chhiatna nasa tak a awm bawk.
Enkawlna chi chu i ruh tliak chi hrang hrangah a innghat. Type III fracture a nih chuan operation a ngai ngei ang.
Hetiang thil hi i chungah thleng ta se eng symptoms nge i neih ang?
Pilon fracture hi a hrehawm hle. A symptoms a chiang hle.
| Symptom a ni | A awlsam zawngin sawifiah a ni |
|---|---|
| Tuar theih loh khawpa hrehawmna | Hei hi a symptom ber a ni. Ankle leh groin area-ah hian natna nasa tak, tuar theih loh a awm a. |
| A hring leh a hliam | Accident hnu rei vak lovah chuan ankle area chu nasa takin a lo hring tan dawn a ni. A vun chu a sen emaw, a sen emaw a lo ni thei. |
| Ke pianzia a inthlak danglam | Ruhte chu a inmil lo a nih chuan ke ruh chu a pianphung angin a inzawm lo va, a deformed bawk. |
| Thil rit phur thei lo | Chu ke hmanga leiah ke pen emaw, chu lam hawia rit dah emaw chu thil theih loh a lo ni ta a ni. |
| Skin blisters a awm thin | A nasat deuhah chuan hliam chhehvelah tuiin a khat blister a awm thei a, chu chuan a chhunga soft tissue te pawh a chhiat tawh tih a tilang a ni. |
Hetiang taka inthenna rapthlak tak hi engte nge ni?
Hetiang fracture hian high-impact force a mamawh tlangpui . A chhan tlangpui chu:
- Car accident: Hetiang hliam hi a thleng thei a, a bik takin car, motor, emaw three-wheeler accident-ah te hian a thleng thei a ni.
- Hmun sang tak atanga tlak: Thingkung, ladder, a nih loh leh building chhawng chunglam atanga tlak hi a chhan lian tak a ni.
- Infiamna lama chetsualna: 1.1.Hetiang accident hi skiing ang chi infiamna chak takah pawh a thleng thei bawk.
Mahse, a chang chuan low-impact fracture pawh a awm thei. Hei hi a chhan chu ruh tichak lo thei natna vang a ni .
A bik takin ruh natna ang chi natna nei, ruh hring leh chak lohna nei chuan in lama tlu leh tlu pawh ni se, hetiang hian ruh tliak na tak a tuar thei a ni.
Tute nge risk sang zawk?
Hetiang hlauhawmna hi tu chungah pawh thleng thei mah se, pawl thenkhat chu an hlauhawm zawk a ni.
- Mipa kum 25-50 inkar: Hetiang dinhmun hi he kum lama mipaah hian a tam zawk a, hei hi high-force injury (car accident ang chi) vang a ni.
- Hmeichhia ruh natna vei: A bik takin hmeichhe kum upa zawkte chu he ruh tliak hi an vei tam zawk a, tlu tlemte atang pawhin.
- Ladder, scaffolding, etc.-a hnathawkte: In sakna lama thawkte chu tlu hlauhawmna sang tak an nei a.
- Tar tlu fo: Kum 65 chunglam, balance tha lo, tlu fo te pawh an hlauhawm zawk.
Engtin nge doctor hian hei hi a hriat chian?
Hetiang hliam neia damdawi ina i kal hunah, a bik takin Emergency Department (ETU)-ah hian orthopaedic surgeon-in a enfiah ang che.
1. Taksa endikna: Doctor chuan i ke leh kekawrte uluk takin a enfiah ang a, a hring, a hliam, a pianzia inthlak danglam leh vun dinhmun a ngaihven ang.
2. X-ray: Hei hi test bulpui leh pawimawh ber a ni. X-ray hmangin ruh a tliak em tih leh a tliakna hmun chu chiang takin a lang thei a ni.
3. CT Scan: Pilon fracture tam takah chuan X-ray bakah CT scan a ngai thin. Hei hi a chhan chu CT scan hi ruh engzat nge a tliak tih te, ruh chunglam engzat nge tihchhiat a nih tih te, a chhe tawhte chu engtin nge an awm tih te chu three dimension (3D)-a hmuh theihna atan a pawimawh hle a ni. He information hi surgery ruahmanna atan a pawimawh hle.
Engtin nge enkawl a nih? Surgery neih a ngai em?
Pilon ruh tliak enkawlna hi thil engemaw zatah a innghat a, chung zingah chuan ruh tliak chi hrang hrang, ruh tliak a inthlak zat, vun leh thau chhiatna, leh i hriselna zawng zawng te pawh a tel.
Surgery neih ngai loh case (Nonsurgical Treatment) 1.1.
Hei hi a tlem hle. A ruh tliak hi a tenau lutuk a nih loh chuan operation a ngai lo va, chu chu ruh tliak te chu tlemte pawh a inthlak (non-displaced) tihna a ni. Chutiang a nih chuan i doctor chuan a hnuaia enkawlnate hi a rawt thei ang:
- Hahchawl:I ke chu chawlh tir la, a rei thei ang bera chawi sang turin an ti che a ni.
- Cast emaw boot emaw hman: Ke chu a che thei lo tur leh ruh a dam hma loh chuan a nghet theih nan cast, splint emaw, special boot emaw i hnawih a ngai mai thei.
- Crutch hman dan: Ke a dam hma loh chuan rit dah hi a tha lo a, chuvangin crutches i hman a ngai dawn a ni.
- Damdawi: A chang chuan ke ruh chhunga thisen zam a awm loh nan thisen tithianghlimtu (anticoagulants) pek theih a ni.
- Physical Therapy: Ruh a dam hnuah chuan ke leh ke ruh chakna leh chetna neih leh theih nan physical therapy hi a pawimawh hle.
Surgery hmanga enkawl a ni
In most cases of Pilon fracture , surgery is definitely necessary , a chhan chu a tam zawkah chuan ruh tliak te chu a hmun atanga chhuakin a inher kual thin a ni.
A pawimawh ber chu, accident hnu lawkah surgery hi tih a ni lo mai thei. Kea a hring hi a sang em em a, chuvang chuan a natna chu a tlahniam theih nan ni engemaw zat emaw, kar khat emaw kar hnih emaw pawh a ngai thei. Swelling a la sang laia surgery tih a nih chuan natna kai leh hliam dam theihna chance a tlahniam a ni.
Surgery hi chi hnih a awm a.
1. Open Reduction leh Internal Fixation (ORIF) hmanga tihchhuah a ni.
Hei hi surgery neih tam ber a ni. A awlsam zawngin, i tih tur chu, surgeon chuan vun chu a tikehsawm a, a ruh tliakna hmunah a kal a, ruh chi hrang hrang displaced zawng zawng chu an awmna hmasa berah a siamrem leh vek a (reduction) Tichuan, special metal plate leh screw hmangin a ruhte chu a che leh tawh loh nan ruh chhungah an fix thin (internal fixation) . Heng plate leh screw te hi taksaah dam chhung atan dah a ni tlangpui.
2. Pawn lam atanga Fixation: 1.1.
Hei hi kalphung danglam deuh a ni. Ke ruh a na hle a nih chuan, a nih loh leh vun natna na tak a awm chuan ORIF surgery hi tih nghal theih a ni lo. Chutiang hunah chuan he procedure hi ke chu hun eng emaw chen atana tihngheh nan hman a ni. Hetah hian surgeon chuan ruh chhungah hian thir zungbun engemaw zat a drill a, heng tiangte hi taksa pawn lama frame-ah a dah a ni . He frame hian ruhte chu a che thei lo. A hring a reh a, vun dinhmun a ṭhat chuan frame chu lakchhuah a ni a, a chunga kan sawi tawh ang khan ORIF surgery chu tih a ni.
Eng chen nge tihdam a ngaih?
Hei hi mi tam takin harsatna an neih a ni. Pilon fracture hi a dam theih nan hun rei tak a ngai a ni. Hei hi dawhtheihna leh inpekna mamawh tak a ni.
- Ruh damna: A tlangpuiin ruh hi operation hnua a dam kim theih nan thla 3 atanga thla 6 vel a ngai thin.
- Dam leh vek: Mahse, ruh chu vawi khat a dam chuan hna chu a tawp lo. Kea chakna, chetna leh hnathawh dan pangngai neih leh theih nan kum khat emaw a aia rei emaw a ngai thei.Hun a la ngai mai thei.
He damna kawngah hian physiotherapy hi a pawimawh hle. Dam chakna tur chuan doctor leh physiotherapist-te thupek dik tak zawm a pawimawh hle.
Engtikah nge doctor i hmuh ang?
He thuziaka kan sawi tak symptoms te hi i neih chuan, a bik takin accident na tak i tawh hnuah, damdawi in Emergency Department (ETU) ah kal nghal la, tihkhawtlai lohvin. Mahni chauh i kal thei lo a nih chuan 1990 ambulance service call rawh.
Operation hnua in lama i awm laiin heng symptoms zinga pakhat tal i neih chuan infection chhinchhiahna a ni thei. Chutiang a nih chuan damdawi inah i kal nghal tur a ni :
- Surgery hliam chhehvel chu a sen, a hring emaw, a lum emaw i hriat chuan.
- Hliam atang hian pus ang chi tui a luang chhuak a nih chuan.
- Khawsik i neih chuan .
Hetiang dinhmun hian hun rei tak chhunga nghawng a neihte chu engte nge ni?
Pilon fracture hi enkawl harsa tak a ni a, a chhan chu joint surface ngei pawh a tichhia a ni. Chuvangin, enkawlna tha ber pawh nise, hun rei tak chhunga harsatna engemaw zat a awm thei a ni.
- Chronic Pain: Mi thenkhat chuan an dam hnuah pawh a chang chuan ke ruh na an nei thei.
- Joint Stiffness: Ankle joint fully flex leh extend theihna a tlahniam thei.
- Post-traumatic arthritis: Hei hi harsatna awm tam ber a ni. Hliam hian ruh chunglama cartilage a tichhe thei a, hun kal zelah arthritis a thlen thei a ni. Hei hian natna a thlen a, a ti na bawk.
Heng thilte hi ven emaw, thunun emaw tur chuan Doctor thupek leh physical therapy dik taka zawm a pawimawh hle.
Take-Home Thuchah a ni
- Pilon Fracture hi ke ruh tliak pangngai a ni lo va, natna khirh tak, ke ruh ruh (ankle joint) ngei pawh nasa taka tichhe thei a ni.
- Hei hi high-impact events, car accident leh hmun sang atanga tlak vang a ni tlangpui.
- A lan chhuah dan ber chu tuar theih loh khawpa na, a hring, leh ke pianzia inthlak danglam te hi a ni. Hetiang a nih chuan damdawi in pakhat Emergency Department (ETU) ah kal nghal tur a ni.
- Vawi tam tak chu enkawlna atan hian complex surgery a ngai thin.
- Recovery process hi a rei hle. A dam kim theih nan kum khat emaw a aia rei emaw a ngai thei. Physical therapy hi tih ngei ngei tur a ni.
- Hun rei tak chhung chu ruh natna leh ruh natna ang chi natna a awm theihna a awm a, chuvangin damdawi lam thurawn zawm a pawimawh hle.
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