Kua pāngia tō pakihiwi e te taraiwa i a koe e takaro ana i te kirikiti? Kua paheke rānei koe, kua hinga rānei i a koe e eke pahikara ana, ā, kua pāngia tō pakihiwi ki te whenua? He mea noa te mamae o tō pakihiwi ina pā mai tēnā. Engari kua kite koe i ētahi wā, me taua mamae, he puku iti kei runga i tō pakihiwi? He tokomaha e mataku ana ina kite i tēnei. Ka whakaaro rātou, "Āe, mehemea ka puta mai taku wheua pakihiwi." I tēnei rā ka kōrero tātou mō tēnei āhuatanga. I roto i ngā kupu hauora, ka kiia tēnei he "Pikiwi Wehea."
He aha rawa te pakihiwi wehe?
He kupu ngāwari tēnei, he whara tēnei ki tētahi hononga i tō pakihiwi. Engari ehara i te pakihiwi kua motuhia, e ai ki te whakaaro o te tini tāngata. He rerekē rawa ngā mea e rua.
Whakaarohia, he pūnaha uaua o ngā wāhanga tō pakihiwi. I te wāhi e hono ai tō wheua kara (e kiia nei e tātou ko te "clavicle") ki te tihi o tō pakihiwi (te "acromion"), kei reira tētahi hononga iti. Ka kiia tēnei hononga ko te "hononga acromioclavicular" ko te hononga AC rānei.
He rite tēnei hononga ki tētahi piriti iti. Hei pupuri i te kaha o tēnei piriti, arā, hei pupuri i ngā wheua e rua kia piri tahi, he hononga kaha, he here rānei (`ligaments`). Hei tauira, i roto i tētahi aituā, ki te hinga koe ki runga i te pakihiwi, ka taea te totoro, te haehae rānei i ēnei hononga (`ligaments`). Ina pakaru, ina totoro rānei ēnei hononga, ka neke te wheua kara (clavicle) me te wheua pakihiwi (acromion) kia paku wehe tetahi i tetahi. Koinei te mea e kiia nei e tātou he Pakihiwi Wehe.
Kia maumahara, ehara tēnei i te nekehanga o te wāhanga nui o te pakihiwi, he rite ki te pōro. He āhuatanga motuhake tēnā. Ka pā tēnei ki te hononga e hono ana i te mata o te pakihiwi ki te wheua kaki.
He tino noa tēnei āhuatanga, ā, e ai ki ētahi rangahau e 40% o ngā whara pakihiwi e pā ana ki te hononga AC. He mea noa tēnei i waenga i te hunga e takaro ana i ngā hākinakina pā atu pērā i te whutupōro me te whutupaoro.
Me pēhea koe e mōhio ai mēnā kei a koe tēnei āhuatanga? (Ngā tohu)
Ka rerekē ngā tohu o te pakihiwi wehea i runga i te kaha o te whara. Tērā pea ka pāngia ētahi e te mamae ngawari noa iho, ko ētahi ia kāore e taea te neke i ō rātou pakihiwi nā te mamae nui. Me titiro tātou ki ngā tohu matua.
| Tohu | Whakaahuatanga |
|---|---|
| Te mamae i te taha o runga o te pakihiwi | Ka puta te mamae i te tihi o te pakihiwi, te pito o te wheua kaki. Tērā pea ka piki ake te mamae ina hiki ake tō ringa, ina hiki rānei i tētahi mea taumaha. |
| Puku puku i runga i te pakihiwi | Koinei te tohu e mataku ai te tini o te tangata. Ina pakaru te hononga, ka neke te mata o te pakihiwi ki raro i raro i te taumaha o te ringa. Kātahi ka puta te pito o te wheua kaki ki runga. |
| Te uaua ki te neke i te pakihiwi | Nā te mamae ka uaua ki te mahi i ngā mea pēnei i te hiki i tō ringa, te whakatakoto rānei i muri i tō tuara. |
| Te pupuhi me te mamae ina pēhia | Tērā pea ka pupuhi te hononga kua whara, ā, ki te pēhia e koe te wāhi ki tō maihao, tera pea ka tino mamae koe. |
| Te tae kikorangi (marumaru) | I ētahi wā ka kikorangi te kiri huri noa i te patunga. |
He aha tēnei e tupu nei? (Ngā take matua)
Ko te tino take o tēnei mate ko te hinganga tika ki runga i te pakihiwi. Ka taea e te pānga o taua hinganga te haehae i ngā hononga i kōrerotia e tātou.
He maha ngā āhuatanga ka puta ai tēnei:
- Ngā aituā hākinakina: Te tukinga, te hinga rānei i ngā hākinakina pēnei i te whutupōro, te whutupaoro, me te hoki. I tō tātou whenua, ka pā mai ngā whara pēnei ina hinga te kaitākaro i a ia e takaro ana i te pōro i a ia e tākaro kirikiti ana.
- Te hinganga: Ki te whara tō pakihiwi, pērā i te paheke me te hinga i roto i te wharepaku, te hinga rānei i ngā arawhata.
- Ngā aituā motuka: Ina koa i ngā aituā motopaika, ina pā te pakihiwi ki te whenua.
Me pēhea te tātaritanga a te tākuta i tēnei?
Ina haere koe ki te tākuta mō te mamae o tō pakihiwi, ka pātai tuatahi ia ki a koe mō te aituā me ō tohumate. Kātahi ka tirotirohia tō pakihiwi.
- Whakamātautau tinana:Ka pā te tākuta ki tō pakihiwi, ka tirohia mēnā he mamae, he pupuhi, he wero wheua rānei. I ētahi wā ka tono atu rātou kia hiki ake tō ringa me te taumaha iti. Ki te kite koe i ngā wero wheua e piri mai ana, ka taea e koe te mārama ki te whara.
- Ngā Whakamātautau Whakaahua: Hei whakatau i te kaha tuturu o te whara, ka tukuna pea koe e tō tākuta mō ētahi whakamātautau.
- X-ray pakihiwi: Ka taea e tēnei te whakaatu mārama i te tawhiti o ngā wheua e rua.
- Matawai ultrasound: Ka āwhina tēnei ki te tirotiro mēnā he kino ki ngā hononga.
- Matawai MRI (Whakaahua Āhua Aukume): Kāore e hiahiatia tēnei i te nuinga o ngā wā. Heoi, ki te uaua te whara, ka tonoa pea he MRI kia mārama ake ai te kite i te kino o ngā hononga me ngā kiko ngohengohe e karapoti ana.
I muri i ēnei whakamātautau, i runga i te āhua o tō whara, ka tukuna pea koe e tō tākuta ki tētahi taote pokanga wheua . Māna e whakatau te maimoatanga i runga i te kaha o te whara.
Te whakarōpūtanga o te kaha o te whara
E ono ngā wāhanga matua e whakarōpūhia ana e ngā tākuta mō ngā whara pakihiwi wehea i runga i te kaha o te whara. Ko te whakarōpūtanga e whakamahia whānuitia ana ko te whakarōpūtanga Rockwood. Mā tēnei whakarōpūtanga ka whakatauhia mēnā e hiahiatia ana he pokanga me te roa o te wā e ora ai.
| Momo whara | Whakaahuatanga (māmā) |
|---|---|
| Momo I | He paku totoro noa te hononga o te hononga AC. Kāore anō kia wehea ngā wheua e rua. Tērā pea ka mamae, ka pupuhi hoki. Ka ora ake i roto i ētahi wiki. |
| Momo II | Kua pakaru katoa te hononga AC, engari ko ngā hononga kaha ake i raro iho (ngā hononga coracoclavicular, CC rānei) he iti noa te totoro. Kua ara ake te wheua kara, ā, e kitea ana. |
| Momo III | Kua pakaru katoa ngā hononga AC me CC. E kitea mārama ana te wheua kaki hei puku. He tino mamae me te pupuhi. |
| Momo IV | Kua haehae te hononga, ā, kua panaia te wheua kaki ki muri. He mate kino tēnei. He maha ngā wā e hiahiatia ana he pokanga. |
| Momo V | He kino rawa atu tēnei i te momo III. Kua haehae ngā hononga, kua panaia rawatia te wheua kaki ki runga, ā, ka whara pea ngā uaua o te pakihiwi. Me tino hiahiatia he pokanga. |
| Momo VI | He tino onge tēnei mate, ā, he tino kino hoki. Ka pakaru te hononga, ka pēhia te wheua kaki ki raro, ka mau ki raro i te pakihiwi. Me tino pokanga. |
He aha te rongoā mō tēnei?
Waimarie, ko te nuinga o ngā whara pakihiwi kua wehea (ina koa ko ngā momo I, II, me ētahi momo III) ka taea te rongoā me te kore pokanga. Ko te tikanga rongoā ka whakawhirinaki ki te kaha o te whara.Maimoatanga Kore-Pokanga
- Okiokinga me te ārai i te nekehanga: He mea nui kia okioki tō ringa i ngā rā tōmua kia memeha ra ano te mamae. Tērā pea ka tūtohu tō tākuta kia whakamahia he taura hei ārai i te nekehanga o tō ringa. Mā tēnei ka āwhina i te ārai i te nekehanga koretake o te pakihiwi, ā, ka āwhina hoki i te whakaora i ngā hononga.
- Hukapapa: I ngā rā tuatahi 48-72, mā te paninga hukapapa ki te wāhi whara mō te 15-20 meneti i ia 2-3 hāora ka tino whakaiti i te mamae me te pupuhi.
- Ngā rongoā whakamamae mamae: Hei whakahaere i te mamae, ka tohua pea e tō tākuta ngā rongoā whakamamae mamae whānui pērā i te paracetamol, ngā rongoā anti-inflammatory kore-steroidal (NSAID) rānei (pērā i te ibuprofen me te naproxen).
- Whakaora Tinana: Kia mutu te mamae, he mea nui ngā mahi whakaora tinana hei āwhina i te whakahoki mai i te nekehanga o te pakihiwi me te whakapakari i ngā uaua huri noa i te pakihiwi. Engari kia maumahara, me tīmata noa ēnei mahi i muri i te whiwhi whakaaetanga mai i te tohunga wheua.
- Te karo i te hiki taumaha: Me karo rawa koe i te hiki i ngā taumaha kia ora rā anō te patunga, mō te 8-12 wiki te roa.
Te Maimoatanga Pokanga
Tērā pea e hiahiatia he pokanga mō ngā whara kino ake (momo IV, V, VI), ngā whara momo III rānei kāore e pai ki te maimoatanga kore-pokanga. Mēnā ka puta he whara momo III, inā koa i roto i te tangata taitamariki, kaha, hākinakina rānei, he nui ake te tūponotanga ka tūtohu tō tākuta i te pokanga. Ko ngā mahi o te pokanga ko:
- Whakatika, whakakaha rānei i ngā hononga pakaru.
- Te whakamahi i ngā taputapu motuhake (pēnei i ngā pine, ngā waea, ngā pereti rānei) hei nuku i te wheua kaki me te pakihiwi ki te tūranga tika, hei whakau hoki i a rātou.
- I ētahi wā, mēnā kua roa te whara, me hanga anō te hononga mā te whakamahi i te kiko i tangohia mai i tētahi atu wāhanga o te tinana (te kiko tāpiri).
Kia pēhea te roa e ora ai?
Ko te roa o te whakaoranga e whakawhirinaki ana ki te kaha o te whara me te maimoatanga i whakawhiwhia ki a koe.
I te nuinga o te wā, ko te whara iti (momo I, II) kāore e hiahiatia he pokanga ka ora i roto i te 2-6 wiki. Tērā pea ka taea e koe te hoki ki te nuinga o ngā mahi o ia rā i roto i te 3 marama pea.
Ki te pokanga koe, ka roa ake te wā whakaora. Kāore e taea e koe te whakamahi i tō pakihiwi mō te ono wiki i muri i te pokanga. Ki te rongoā tinana, ka ono marama pea te roa ka tino ora ai.
Ngā mea ka taea e koe te mahi māu ake i te wā e ora ana koe
Kia whakaaetia koe e tō tākuta, he maha ngā mahi whakakori tinana māmā ka taea e koe te mahi i te kāinga hei whakapakari i tō pakihiwi me te whakanui ake i te ngāwari.
1. Ngā mahi whakakori tinana
Ka taea te tīmata i ēnei i muri i te memeha haere o te mamae.
- Te totoro o te pendulum:
- Tū tata ki tētahi mea pērā i te tēpu, whakatakotoria tō ringa pai ki runga i te tēpu, ka piko mārire ki mua.
- Tukua te ringa kua whara kia iri noa ki raro.
- Whakangāwarihia ngā uaua o tō pakihiwi, ka nekehia tō ringa ki mua, ki muri hoki, ki taha ki taha, me te porowhita hoki.
- Me mahi i te tuatahi, kaua e whakamahia he taumaha. I muri i ētahi rā, ki te kore he mamae, ka taea e koe te mahi me te pupuri i tētahi taumaha iti, pērā i te pounamu wai.
- Te piki pakitara:
- Tū atu ki te pakitara.
- Whakatakotoria ngā pito o te ringa kua whara ki te pakitara.
- Nā, pērā i te pūngāwerewere, ngokingoki mārire atu i te pakitara ki ō maihao. Piki ki te teitei rawa e taea e koe, pupuri mō te 30 hēkona, kātahi ka ngokingoki mārire atu ki raro.
2. Ngā mahi whakapakari uaua
Ka taea e koe te tīmata i ēnei ina kua ora ake koe.
- Ngā pēhitanga o te hope:
- Takoto ki runga i te papa, pikohia ō turi, me te pupuri i ō waewae ki runga i te papa.
- Kia tika tonu ngā ringa e rua ki ō taha.
- Nā, kōpeketia ō pakihiwi me te mea kei te kukume koe i a rātou ki tō tuaiwi.
- Puritia mō te 5 hēkona, kātahi ka whakangā. Me mahi i tēnei kia 20 ngā wā.
Ko te mea nui: Kaua e akiaki i tētahi mahi whakakori tinana mā te mamae. Mēnā ka whakanui ake tētahi mahi whakakori tinana i tō mamae, kati ka kōrero ki tō tākuta, ki tō kaiwhakaora tinana rānei.
Āhea koe me toro atu ki te tākuta?
Mena kei a koe tētahi o ngā tohu e whai ake nei i muri i te whara o tō pakihiwi, me toro atu koe ki te tākuta tonu. Mena e tika ana, haere ki te Tari Ohotata (ETU) o te hōhipera tata.
- Mena he mamae nui .
- Mena he puku, he āhua rerekē rānei e kitea mārama ana i runga i te pakihiwi.
- Mena he ngoikore, he kore rānei e rongo i ō ringaringa, i ō maihao rānei.
- Mena kei te mātao , kei te kōmā rānei ōu maihao .
- Ki te mea kua kore e ora tō ringa.
- Mena he uaua ki te neke i te ringa i te tikanga noa.
Karere Tangohia ki te Kāinga
- Ko te pakihiwi kua wehea he pakaru i te hononga e hono ana i te mata o te pakihiwi ki te wheua kaki. He rerekē tēnei āhua i te pakihiwi kua motu.
- Ko ngā tohu matua ko te mamae i te pakihiwi o runga me te āhua o te wheua kaki e pupū ake ana.
- I te nuinga o te wā, ka taea te rongoā i tēnei mate me te kore pokanga mā te okiokinga, te hukapapa, ngā rongoā whakamamae mamae, me te whakaora tinana.
- Tērā pea e tika ana te pokanga mēnā he kino rawa te whara (momo IV, V, VI), mēnā rānei kāore e angitu ētahi atu maimoatanga.
- Mena he whara tō pakihiwi, he mamae nui, he āhua hē, he ngoikore rānei tō ringa, rapua tonutia he tohutohu hauora.
- Kaua e tīmata i tētahi mahi whakakori tinana me te kore he whakaaetanga a tō tākuta.
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