Kodi mukuvutika ndi kupweteka kwa dzanja? Kungakhale vuto lomwe mafupa awiri m'dzanja amatsetsereka (Scapholunate Dissociation)!

Kodi nthawi zina mumamva chinthu chachilendo kapena chopweteka m'dzanja lanu? Mwina ululuwu unayamba pamene munagwa, munanyamula chinthu cholemera, kapena munkachita masewera olimbitsa thupi. Nthawi zambiri, timaganiza kuti, "O, ndi kuvulala chabe." Koma nthawi zina, uwu ukhoza kukhala vuto lomwe limafuna chisamaliro chochulukirapo. Ndicho chimene tikambirane lero, vuto lomwe limapezeka m'dzanja lomwe limafuna kufufuzidwa mozama pang'ono.

Kodi kusokonekera kwa fupa la dzanja n'chiyani? (Kusokonezeka kwa Scapholunate)

Mwachidule, `(Scapholunate Dissociation)` iyi ndi pamene mafupa awiri ang'onoang'ono m'dzanja lathu, fupa la `Scaphoid' ndi fupa la `Lunate', amasuntha pang'ono kuchokera pomwe ayenera kukhala, ndikupanga mpata, kapena `mpata`, pakati pawo. Kunena zoona, mafupa awiriwa amalumikizidwa wina ndi mnzake ndi ligament yamphamvu kwambiri, yomwe timayitcha `Scapholunate Interosseous Ligament (SLIL). Pangozi ina, makamaka pamene dzanja lapindika ndikugwa, 'ligament' iyi imatha kung'ambika. Pamenepo ndi pomwe kulumikizana pakati pa mafupa awiriwa kumakhala komasuka, ndipo amayamba kuyendayenda. Mukagwiritsa ntchito dzanja lanu, mafupa awiriwa amachoka wina ndi mnzake, kapena 'kusiyana'.

Izi zili ngati mfundo yomwe yamangidwa pamodzi ndi zingwe ziwiri. Malinga ngati mfundoyo ndi yolimba, zingwe ziwirizo zimakhala pamodzi, koma mfundoyo ikamasuka, zingwe ziwirizo zimasuntha.

Ndani amene ali ndi mwayi waukulu wopeza vutoli?

Ndipotu, vutoli lotchedwa `(Scapholunate Dissociation)` lingachitike kwa aliyense, mosasamala kanthu za jenda, fuko, kapena chipembedzo. Komabe, chiopsezo chachikulu ndi cha iwo omwe amagwa ndi manja ndi mawondo awo . Tangoganizirani, mukuyenda mumsewu ndipo mwadzidzidzi mumatsetsereka, kenako timayika manja athu pansi kuti tidzipulumutse. Pamenepo ndiye ngoziyi ingachitike kwambiri.

Kodi vutoli ndi lofala bwanji?

Monga momwe tikuonera, tikayang'ana kuvulala kwina kwa dzanja, vuto la `(Scapholunate Dissociation)` limatha kuwoneka pa milandu pafupifupi 5% (`5%`) . Komanso, kusweka kwina m'dera la dzanja, makamaka komwe timatcha ``distal radius fractures``, kutanthauza kuti, fupa lalikulu m'dzanja likasweka pafupi ndi dzanja, limatha kuwoneka pa milandu pafupifupi 40% (`40%`) yokhala ndi vuto la `(SL dissociation)` ili . Pali kusweka kwina kwapadera, monga ``driver fractures``, komwe nthawi zambiri kumawoneka.

N’chifukwa chiyani izi zikuchitika? Kodi zifukwa zake ndi ziti?

Monga ndanenera kale, chifukwa chachikulu cha izi nthawi zambiri chimakhala "kugwa pa dzanja lotambasulidwa" . Kunena zoona, mukagwa ndikuyika dzanja lanu pansi ndikulilemera, kupanikizika kumatha kung'amba ``scapholunate interosseous ligament (SLIL)``.

Kupatula apo, pakhoza kukhala zifukwa zina zingapo:

• Kugwira chiwongolero mwamphamvu pa ngozi ya galimoto, monga galimoto: Minofu iyi imatha kuwonongeka ndi kugwedezeka kwa dzanja pa ngozi yadzidzidzi.
• Matenda ena obadwa nawo: Mwachitsanzo, matenda monga `Hereditary Spastic Paraparesis`.
• Kufooka kwa Minofu Yobadwa Nayo: Anthu ena amabadwa ndi mitsempha yosasunthika m'mafupa awo. Izi zimawachitikiranso mosavuta.
• Matenda a Nyamakazi: Uwu ndi matenda omwe amayambitsa kutupa kwa mafupa. Matendawa angayambitsenso kuti mitsempha yamagazi ifooke, zomwe zingayambitse vutoli.

Kodi zizindikiro za izi ndi ziti? Kodi zimamveka bwanji?

Ngati muli ndi vuto lotchedwa "Scapholunate Dissociation", nthawi zambiri mudzakumana ndi zotsatirazi:

• Ululu kumbuyo kwa dzanja, makamaka mukagwira chinthu mwamphamvu ('kugwira mwamphamvu') : mwachitsanzo, mukatsegula chivundikiro cha botolo kapena mukagwira chogwirira chitseko.
• Kufooka pa mphamvu yogwirira: Kulephera kugwira zinthu mwamphamvu monga kale.
• Kutupa ndi kupweteka kozungulira dzanja: Malo ozungulira dzanja amatupa ndipo amapweteka kukhudza.
• Ululu mukatambasula dzanja lanu: Zimapweteka mukatembenuza dzanja lanu.
• Nthawi zina mungamve phokoso la "kudina" kuchokera m'dzanja lanu.

Kumbukirani, zizindikiro izi sizimachitika mofanana kwa aliyense. Anthu ena amamva ululu wochulukirapo, ena ochepa. Choncho, ngati mukumva china chake chachilendo m'dzanja lanu, ndi bwino kupita kwa dokotala.

Kodi dokotala amazindikira bwanji izi?

Mukapita kukaonana ndi dokotala, choyamba adzakufunsani za zizindikiro zanu. Kodi mwakhala ndi ululu kwa nthawi yayitali bwanji, unayamba bwanji, ndipo umakula liti? Kenako adzayang'ana dzanja lanu kuti awone ngati pali ululu uliwonse, kutupa, kapena kufewa.

Komanso, dokotala akhoza kuchita mayeso monga:

• Mayeso Okhudza Kusintha kwa Scaphoid: Mu mayesowa, dokotala amaika dzanja lake pamwamba pa fupa lanu la scaphoid ndikusuntha dzanja lanu. Mayesowa amawunika kukhazikika kwa fupa la scaphoid.
• X-ray: Izi zitha kusonyeza kukula kwa mpata pakati pa mafupa a scaphoid ndi lunate (mpata wa scapholunate). Kawirikawiri, mpata uwu ndi 2 mm kapena kuchepera. Komabe, pankhani ya kugawanika kwa SL, mpata uwu ukhoza kukhala 5 mm kapena kuposerapo. Nthawi zina, mutha kuwona china chake chotchedwa "chizindikiro cha mphete" pa X-ray. Uku ndi kusalingana bwino kwa fupa la scaphoid.
• Mayeso a MRI (Maginito Owonetsa Kugwirizana kwa Maginito):MRI imatha kuwonetsa bwino ngati scapholunate interosseous ligament (SLIL) yang'ambika. Imatha kupeza chithunzi chabwino cha minofu yofewa yozungulira fupa.
• Arthroscopy: Izi zimaphatikizapo kupanga kachidutswa kakang'ono kwambiri ndikuyika kamera (scope) kudzera pamenepo kuti muyang'ane mkati mwa cholumikizira. Izi zimakupatsani mwayi wowona kuwonongeka kwa mitsempha mwachindunji. Nthawi zina, chithandizo chingachitike nthawi yomweyo ndi arthroscopy.

Kodi izi zimachiritsidwa bwanji? (Chithandizo)

Pochiza matenda otchedwa `Scapholunate Dissociation`, choyamba muyenera kuchita ndi:

• Mankhwala ochepetsa ululu: Mankhwala amaperekedwa kuti achepetse ululu.
• Kupindika kwa dzanja: Chingwe chapadera chopindika chimagwiritsidwa ntchito kuletsa dzanja ndi chala chachikulu kuyenda. Izi zimathandiza kuti mitsempha yowonongeka ipole.

Kenako, dokotala wanu angakutumizireni kwa katswiri wa zamanja. Vutoli nthawi zambiri limafuna opaleshoni ya zamanja mkati mwa milungu isanu ndi umodzi kuchokera pamene mwavulala.

Pa opaleshoni, mudzapatsidwa mankhwala oletsa ululu (kutanthauza kuti mudzakhala mutulo tofa nato), kapena mudzapatsidwa mankhwala oletsa ululu (kutanthauza kuti mudzangokhala chete). Pa opaleshoni, dokotala adza:

• Kudula pang'ono kumapangidwa kumbuyo kwa dzanja.
• Minofu yoonongekayo imachotsedwa ndikutsukidwa.
• Kenako, kuti mutseke mpata pakati pa mafupa a scaphoid ndi lunate, kutanthauza kuti, kuti mubwezeretse mafupa awiriwa pamodzi, mumagwiritsa ntchito chinthu chonga mtsempha wotengedwa kwina m'thupi lanu, chokokera, kapena screw yachitsulo.
• Pomaliza, kudulako kumasokedwanso pamodzi.

Kodi ndingatani kuti ndichepetse chiopsezochi?

Kuti muchepetse chiopsezo cha `(Scapholunate Dissociation)`, chinthu chofunikira kwambiri ndikuchitapo kanthu kuti mudziteteze ku kugwa. Mutha kuchita zinthu monga:

• Kuchita masewera olimbitsa thupi omwe amathandiza kuti thupi likhale logwirizana, logwirizana, komanso lolimba.
• Kuchotsa zoopsa m'nyumba. Mwachitsanzo, yang'anani ngati zingwe zotayirira, magetsi oipa, ndi makapeti sizili bwino.
• Ngati kuli kofunikira, gwiritsani ntchito chipangizo chothandizira monga ndodo kapena choyendera.
• Kuvala nsapato zosalala, zolimba, komanso zogwira bwino.

Kodi ndingayembekezere chiyani ngati ndili ndi vutoli? (Zovuta)

Ngati simulandira chithandizo cha kusokonezeka kwa SL mwachangu, mavuto ngati awa angachitike:

• Ululu wosatha: Mungakhale ndi ululu wopitirira m'dzanja.
• Matenda a nyamakazi otupa: Matenda a nyamakazi amatha kuyamba chifukwa cha kutupa kwa malo olumikizirana mafupa.
• Kusakhazikika kwa mafupa: Dzanja la mkono lingamveke ngati likuyenda mosalamulirika.
• Kuchepa kwa mphamvu yogwirira: Mwina simungathe kugwira zinthu bwino.
• Akakolo a Scapholunate Advanced Collapse (SLAC): Uwu ndi matenda a nyamakazi omwe amachititsa kuti chibwano chiziwonongeka. Izi zitha kukhala zopweteka kwambiri.

Kodi zinditengera nthawi yayitali bwanji kuti ndichire ngati ndili ndi (Scapholunate Dissociation)? (Outlook)

Ngati mwachitidwa opaleshoni ya SL dissociation, muyenera kuvala pulasitala kwa milungu ingapo pambuyo pake. Dokotala akachotsa, physiotherapy ingathandize dzanja lanu kuti likhalenso ndi mphamvu. Ndi chithandizo choyenera komanso physiotherapy, muyenera kubwerera ku zochita zanu zachizolowezi mkati mwa miyezi ingapo.

Kodi ndingadzisamalire bwanji ndi Scapholunate Dissociation?

Mukalandira chithandizo cha matenda a SL dissociation, lankhulani ndi dokotala wanu za mitundu ya zochita ndi masewera olimbitsa thupi omwe mungachite mosamala. Pali mapulogalamu enaake olimbitsa thupi omwe angakuthandizeni kupezanso mphamvu ndi kuyenda bwino m'dzanja lanu. Musapitirire zomwe dokotala wanu wakuuzani kuti muchite ndipo chitani zinthu zovuta kwambiri padzanja lanu.

Uthenga Wopita Nawo Kunyumba

Chabwino, kotero `Scapholunate Dissociation` yomwe tidakambirana ndi pamene mafupa awiri ang'onoang'ono m'dzanja, `Scaphoid` ndi `Lunate`, amachoka pamalo awo, zomwe zimapangitsa kuti pakhale mpata pakati pawo. Chifukwa chachikulu cha izi ndi kuwonongeka kwa `Ligament` yomwe imalumikiza mafupa awiriwa. Izi nthawi zambiri zimachitika mukagwa ndi dzanja lanu litatambasula.

Zizindikiro zazikulu ndi kupweteka kwa dzanja, kutupa, kufewa, komanso kuchepa kwa mphamvu yogwirira. Dokotala amagwiritsa ntchito mayeso monga scaphoid shift test, X-ray, MRIs, ndi arthroscopy kuti adziwe izi.

Opaleshoni nthawi zambiri ndiyo njira yabwino kwambiri yothandizira. Ndi chithandizo choyenera komanso chithandizo cha thupi, anthu ambiri amatha kubwerera ku zochita zawo zachizolowezi mkati mwa miyezi ingapo. Chifukwa chake, ngati muli ndi ululu kapena kusapeza bwino m'dzanja lanu, ndikofunikira kuonana ndi dokotala ndikupeza upangiri m'malo mongoganiza kuti ndi kuvulala chabe.

Dzanja , Kupweteka kwa Dzanja, Mafupa a M'manja, Mitsempha, Kupatukana kwa Scapholunate, Kusweka, Opaleshoni