Ingaba unengxaki encinci kufutshane nesandla sakho? Isenokuba kukuqhekeka kwe-scaphoid!

Ngaba wakha wawa waza wabetha isandla sakho emhlabeni, nto leyo eyabangela ukwenzakala okukhulu esihlahleni sakho? Okanye mhlawumbi ujije isandla sakho ngendlela engafanelekanga ngelixa udlala, waza loo ndawo yavuvukala waza wangakwazi ukuyishukumisa? Ngamanye amaxesha sicinga ngezi zinto "njengokukruneka nje," kodwa zinokuba yinto enzulu ngakumbi. Yiloo nto enokwenzeka xa kwenzeka into efana nale, ebizwa ngokuba yi-scaphoid fracture. Makhe sithethe ngale nto ngokweenkcukacha namhlanje, kulungile?

Yintoni iScaphoid Fracture?

Ngamafutshane, ukwaphuka kwe-scaphoid kukuqhekeka kwethambo esihlahleni sakho. Ithambo le-scaphoid lifumaneka ezantsi kobhontsi wakho omkhulu, kufutshane nesandla sakho. Isandla sakho senziwe ngamathambo amancinci aliqela abizwa ngokuba ngamathambo e-carpal. I-scaphoid yenye yalawo mathambo e-carpal.

Oku kwenzeka rhoqo xa siwa size solule isandla ukuze sibambe izandla zethu. Khawuthelekelele, ngequbuliso utyibilika uze uwe, uze ngoko nangoko ubeke izandla zakho phantsi ukuze uzisindise, akunjalo? Kulapho ke eli thambo linokuthi lonakale khona. Ngaphandle koko, linokubangelwa ziingozi zeemoto, iimpembelelo ezinzima xa udlala imidlalo, njl. Ngamanye amaxesha kufuneka utyando ukuze kulungiswe kakuhle eli thambo. Uninzi lwabantu luthatha malunga neenyanga ezintathu ukuze luphile ngokupheleleyo kule meko.

Iindawo zethambo le-scaphoid kunye nalapho kwenzeka khona ukwaphuka

Eli thambo le-scaphoid linamacandelo amathathu. Naliphi na kula malungu linokwaphuka.

• Ipali ekude: Le yiphelo lethambo le-scaphoid elisezandleni zakho nakwiminwe yakho, oko kukuthi, kude nengalo.
• Isinqe se-scaphoid: Eli liphakathi kwethambo le-scaphoid. Uninzi lwexesha, oko kukuthi, ngaphezulu kwama-70% ee-scaphoid fractures zenzeka kweli candelo liphakathi.
• Ipali ekufutshane: Esi sisiphelo sethambo le-scaphoid elisebunzini lakho, ngaphakathi emzimbeni wakho.

La magama asenokuvakala engaqhelekanga kuwe. Kodwa oogqirha bawasebenzisa ukubanceda baqonde kakuhle indlela esihlunu sakho esaphukile ngayo, apho ithambo lakho le-scaphoid laphukile khona, kunye nendlela ithambo elibekwe ngayo emzimbeni wakho okwangoku. Nangona kunjalo, nokuba ubiza ntoni na, eyona nto ibalulekileyo kukubona ugqirha ngokukhawuleza kwaye uhlolwe.

Ixhaphake kangakanani le nto? Ngubani oyifumana rhoqo?

Ukuqhekeka kwe-scaphoid lolona hlobo luqhelekileyo lokuqhekeka kwamathambo e-carpal esihlahleni, oku kuthetha malunga ne-15% yazo zonke iingozi zehlahleni.

Enyanisweni, kanye njengokuba nabani na enokwaphula ithambo, nabani na unokwaphula ithambo le-scaphoid. Oku kungenxa yokuba kudla ngokubangelwa kukuwa okanye ezinye iingozi. Nangona kunjalo, kuxhaphake kakhulu kubantu abancinci abangaphantsi kweminyaka engama-30 ubudala nakubantu abakwishumi elivisayo.Oku kuqheleke ngakumbi. Ukuba uthambekele ekuweni, usengozini enkulu. Kwakhona, abantu abanezifo ezincipha amathambo ezifana ne-osteoporosis banamathuba amaninzi okuphuka amathambo abo kunabanye, ngoko ke basengozini enkulu yokuqhekeka kwe-scaphoid.

Zithini iimpawu?

Ukuba une-scaphoid fracture, unokufumana iimpawu ezifana nezi:

• Intlungu: Ingakumbi ezantsi kobhontsi omkhulu, kanye esihlahleni.
• Ukudumba: Indawo echaphazelekayo yesandla ingadumba.
• Ukuthamba: Indawo ekhankanyiweyo apha ngasentla ibuhlungu xa ichukunyiswa okanye icinezelwe.
• Ukungakwazi ukuhambisa isandla: Ubunzima bokujika okanye ukuphakamisa isandla.
• Ukugruzuka okanye ukutshintsha kombala: Isenokubonakala iluhlaza okwesibhakabhaka okanye imfusa.
• Iqhuma okanye ukukhubazeka okungaqhelekanga: Isandla singavakala okanye sibonakale njengeqhuma elingaqhelekanga.

Ukuqhekeka kwamathambo agxothiweyo nalawo angagxothwanga

La ngamanye amagama amabini aza kusetyenziswa ngugqirha ukuchaza ukwaphuka kwakho. "Ukuqhekeka okushiyekileyo" kuthetha ukuba emva kokuba ithambo liphuke, iziqwenga ezibini eziphukileyo ziye zashukuma kakhulu, zishiya umsantsa omkhulu phakathi kwazo. Kwi "ukuqhekeka okungasuswanga" , ithambo lisaphuke, kodwa iziqwenga ezibini azishukumanga kakhulu, kwaye zisekufutshane nendawo ebezikuyo. "Ukuqhekeka okushiyekileyo" kudla ngokufuna utyando ukuze kulungiswe.

Kutheni oku kusenzeka?

Naluphi na ukubetha ngamandla esihlahleni kunokubangela ukwaphuka kwethambo le-scaphoid. Ezona zizathu ziphambili zezi:

• Ukuwa: Wolulelwe phezulu iingalo zombini zoluliwe waza wolulelwa phantsi.
• Iingozi zemidlalo: Njengaxa udlala ikhilikithi okanye ibhola ekhatywayo.
• Iingozi zezithuthi.

Oogqirha bayibona njani le nto?

Ugqirha uza kuxilonga ukuba ngaba une-scaphoid fracture ngokukuxilonga nokwenza iimvavanyo ezininzi zokuthatha imifanekiso.

Zeziphi iimvavanyo ezenziwayo?

Emva kokuba uhlolwe, ungenza olunye okanye ngaphezulu kwezi vavanyo zilandelayo zomfanekiso:

• Ii-X-reyi: I-X-reyi inokubonisa ukuba kukho ukwaphuka kwi-scaphoid okanye kwelinye ithambo kunye nokuba monakalo mkhulu kangakanani owenziweyo.
• I-Magnetic resonance imaging (MRI): Ngamanye amaxesha ugqirha wakho uya kuyalela i-MRI scan. Oku kunokunceda ukuvavanya ngokupheleleyo umonakalo owenzeka emathanjeni nakwimisipha kunye nezicubu ezijikelezileyo.
• I-CT scan: Ukuba kufuneka utyando, ugqirha wakho uya kufuna umfanekiso ocacileyo womonakalo owenzekileyo emathanjeni akho. I-CT scan ingabonisa amathambo kunye nezicwili ezingqongileyo ngokweenkcukacha ezingaphezulu kune-X-ray.

Ukuqhekeka kwe-scaphoid ye-occult

Ngamanye amaxesha ukwaphuka kwe-scaphoid akubonakali kwi-X-ray, kwaye ngamanye amaxesha akubonakali konke konke. Oku kubizwa ngokuba yi-occult scaphoid fracture. Ukuba oku kuyenzeka, ugqirha wakho unokuyalela i-MRI okanye i-CT scan. Ugqirha wakho uya kukuxelela ukuba loluphi uvavanyo olongezelelweyo onokulufuna.

Kubalulekile: Xelela ugqirha wakho ngqo apho uziva ubuhlungu khona kunye nokuba yintoni ebuhlungu xa uyicinezela. Ukuba intlungu yakho ikwithambo le-scaphoid, kwaye ayipheli emva kosuku okanye ezimbini, usenokuba nokwaphuka okufihlakeleyo. Ezi zaphuka ezifihlakeleyo azifuni naluphi na unyango olukhethekileyo, kwaye azibeki mngcipheko ukhethekileyo.

Zithini iindlela zonyango?

Unyango lokwaphuka kwe-scaphoid yakho luxhomekeke ekubeni inzulu kangakanani na. Ithambo lakho elaphukileyo kufuneka libuyiselwe ndawonye lize lipholiswe. Ngokuxhomekeke ekubeni lonakele kangakanani kwaye laphukile njani, ugqirha wakho angasebenzisa olunye okanye ngaphezulu kwezi ndlela zonyango.

Ukungakwazi ukuhamba kwesandla/isandla

Ukuba ukwaphuka kwakho akukukhulu kakhulu, oko kuthetha ukuba ithambo le-scaphoid alikahambi kakhulu apho lalikhona (`elingasuswanga`), ungadinga kuphela ukunxiba i-splint okanye i-plaster ye-Paris cast. I-splint idla ngokuhlala malunga neeveki ezintathu ukuya kwezintlanu. I-cast ihlala ixesha elide kancinci, idla ngokuhlala iiveki ezintandathu ukuya kwezisibhozo. Kuzo zombini iimeko, kuya kufuneka uphinde wenze i-X-ray ukuqinisekisa ukuba ithambo lakho liyaphola ngokufanelekileyo.

Ukunciphisa amathambo ngaphandle kotyando (Ukunciphisa okuvaliweyo)

Kwabo baqhekeke kakhulu, kwenziwa inkqubo ebizwa ngokuba yi-closed reduction ukuze kulungiswe ithambo le-scaphoid. Olu asilotyando. Ugqirha uza kucinezela aze atsale ngaphandle komzimba wakho ukuze kulungiswe ithambo eliphukileyo ngaphakathi. Ngelixa esenza oku, uza kwenza enye yezi zinto zilandelayo ukukunceda uzive ungeva ntlungu ingako:

• I-anesthetic yendawo ifakwa ukuze ivale indawo ejikeleze ithambo eliphukileyo.
• Kunikwa amayeza okuthomalalisa umzimba wonke.
• Umzimba wakho wonke uza kufakwa i-anesthesia kwaye uza kulaliswa (`i-anesthesia eqhelekileyo`).

Emva kokwenza le ``(Closed reduction)``, ugqirha uza kukufaka i-splint okanye i-plaster.

Utyando lokuqhekeka kwe-Scaphoid

Uninzi lwaphuka olunzima lufuna utyando. Ugqirha uza kulungisa ithambo lakho le-scaphoid aze alilungise endaweni yalo, ukuze libuye liphinde liphile. Amaxesha amaninzi, baya kwenza into ebizwa ngokuba yi-"Internal fixation." Oku kuthetha ukuba ugqirha uza kufaka iziqwenga zesinyithi ngaphakathi kwethambo lakho ukuze alibambe lide liphole. Ezi ndlela ze-"Internal fixation" zezi:

• Iipleyiti kunye nezikrufu: Iipleyiti zesinyithi kunye nezikrufu ezifakwa ethanjeni ukuze zibambe iziqwenga zamathambo ndawonye.
• Izikhonkwane kunye neengcingo:Izikhonkwane kunye neengcingo zisetyenziselwa ukubamba iziqwenga ezincinci zamathambo kunye kunezinye izixhobo zokuncamathisela. Ezi zihlala zisetyenziswa kunye neepleyiti okanye ezinye izixhobo ezifana neentonga.

Abanye abantu bagcina ezi ziqwenga zesinyithi emizimbeni yabo ngonaphakade. Abanye abantu kufuneka baphinde batyandwe ukuze zisuswe.

Ukufakelwa kwamathambo

Ukuba ukwaphuka kwe-scaphoid yakho "kususiwe kakhulu," oko kuthetha ukuba iziqwenga zikude kakhulu, okanye ukuba ithambo lakho alipholi kakuhle, kunokufuneka wenze inkqubo ebizwa ngokuba yi-"bone grafting." Ugqirha uza kufaka ezinye izicwili zethambo ukunceda ithambo lakho elaphukileyo libuyele ndawonye. Emva koko, baya kwenza "i-internal fixation", bebambe iziqwenga ndawonye de ithambo liphole. Kukho iindawo ezininzi apho ithambo lingathathwa khona kwezi grafting zethambo:

• Ukusuka kwenye indawo emzimbeni wakho – rhoqo ngaphezulu kwethambo lesinqe sakho.
• Kusuka komnye umntu (umnikeli wangaphandle).
• Isiqwenga esenziwe ngobuchule.

Utyando lokwaphuka kwe-scaphoid ludla ngokwenziwa njengeenkqubo zokulaliswa ngaphandle.

Emva kotyando lwakho, isihlakala sakho kuya kufuneka singasebenzi. Kusenokufuneka unxibe i-splint okanye i-cast ngaphambi kokuba uphinde usebenzise isandla sakho njengoko ubusenza ngaphambi kokuba siphuke.

Ngawaphi amayeza asetyenziswayo xa kuqhekeka i-scaphoid?

Iipilisi zokubulala iintlungu ezibizwa ngokuba yi-"NSAIDs", ezifana ne-aspirin okanye i-ibuprofen, zinokubangela ukopha kunye nezinye iingxaki emva kotyando. Ngoko ke, ugqirha wakho uza kuthetha nawe ngamayeza onokuwasebenzisa ukunciphisa iintlungu emva kotyando.

Iziphumo ebezingalindelekanga ezinokubakho ze-NSAIDs:

• Ukopha.
• Izilonda zesisu.
• Intlungu yesisu.
• Iingxaki zamathumbu.

Ngaba ukwaphuka kwe-scaphoid kuya kuziphilisa ngokwako?

Ungaze uzityeshele iimpawu ezifana nentlungu, ukudumba, okanye ukuthamba. Nokuba iimpawu zakho azikho mbi kakhulu, usadinga unyango. Ukuba awufumani unyango lokuphuka kwe-scaphoid, ungagqibela uneengxaki ezinkulu kamva, ezinje:

• I-Acute compartment syndrome (ACS): Uxinzelelo ngaphakathi kwezihlunu luyanda, ukuhamba kwegazi kwiithishu kuyanqanyulwa, kwaye umonakalo osisigxina wezihlunu kunye nemithambo-luvo unokwenzeka.
• `(Malunion)`: Xa amathambo akho aphukileyo engahambelani kakuhle xa ephola.
• Ukungadibani: Amathambo akho awadibani ngokupheleleyo okanye ngokuyinxenye.
• I-Avascular necrosis (i-osteonecrosis): Esi sisifo esibuhlungu samathambo esiba mandundu ngokuhamba kwexesha. Sinokuchaphazela amandla akho okushukuma. Kwenzeka xa igazi liphuma ethanjeni.
• I-arthritis yesandla: Iimeko ezibizwa ngokuba yi-"Nonunion" kunye ne-"Avascular necrosis" zinokubangela i-arthritis esandleni nasesihlahleni. I-arthritis yesandla inokubangela iintlungu, ukudumba, ukuqina, kunye nokukhubazeka.

Ndiza kuziva ngcono ngokukhawuleza kangakanani emva konyango?

Kungathatha iiveki ezininzi ukuba iimpawu zakho ziphele. Ngokuxhomekeke kuhlobo lotyando olwenzekileyo ukulungisa ukwaphuka kwe-scaphoid yakho, unokukwazi ukuhambisa ingalo yakho kwakhona kwiiveki ezimbalwa.

Nangona kunjalo, ukuba unentlungu enganyamezelekiyo engapheziyo, bonana nogqirha ngokukhawuleza.

Ingancitshiswa njani le ngozi?

Landela la macebiso okhuseleko ukuze unciphise umngcipheko wokwenzakala:

• Soloko unxibe ibhanti yakho xa ukhwela imoto.
• Nxiba izixhobo zokhuseleko ezifanelekileyo kuyo yonke imisebenzi nemidlalo.
• Gcina ikhaya lakho nendawo yakho yokusebenza icocekile ngokususa izinto ezinokubangela ukuba wena okanye omnye umntu atyibilike aze awe.
• Xa uthatha nantoni na evela phezulu, soloko usebenzisa izixhobo okanye izixhobo ezifanelekileyo. Ungaze ukhwele ezitulweni okanye etafileni.
• Landela indlela yokutya kunye nesicwangciso sokuzilolonga esinceda ukugcina amathambo akho esempilweni.
• Ukuba uneminyaka engaphezu kwama-50 ubudala, okanye ukuba kukho umntu kusapho lwakho onesifo sokudumba kwamathambo, thetha nogqirha wakho malunga nokufumana uvavanyo lokuqina kwamathambo.
• Ukuba usebenzisa induku okanye isixhobo sokuhamba xa uhamba, soloko usisebenzisa, kwaye lumka kwiindawo ezingalinganiyo.

Ndingakuthintela ukwaphuka kwe-scaphoid?

Ukuqhekeka kwe-scaphoid kudla ngokubangelwa kukuwa okanye ezinye iingozi, ngoko ke akukho nto ingako inokwenziwa ukuthintela oku, ngaphandle kokuqaphela xa uhamba (usebenzisa i-crane/walker ukuba unayo) kunye nokuqaphela kwiindawo ezingalinganiyo.

Ndingalindela ntoni ukuba ndine-scaphoid fracture?

Ukuba uphuke i-scaphoid, ungalindela ukuba uphile ngokupheleleyo.

Uza kufuna unyango lomzimba ukuze ufumane amandla kunye nomgama wokunyakaza esihlahleni sakho.

Kuthatha ixesha elingakanani ukuba ukwaphuka kwe-scaphoid kuphole?

Ixesha eliza kuthatha ukuze uphile lixhomekeke kubukhulu bokwaphuka kwakho kunye nonyango olufunekayo. Uninzi lwabantu luthatha malunga neenyanga ezintathu ukuphiliswa kukwaphuka kwe-scaphoid.

Zininzi nezinye izinto ezinokuchaphazela ixesha elithathwa ngumzimba wakho ukuba uphile. Thetha nogqirha wakho okanye ugqirha wakho malunga nexesha elifanelekileyo kwimeko yakho.

Ngaba andizukukwazi ukuya emsebenzini okanye esikolweni?

Ukuba usenokwenza umsebenzi wakho okanye umsebenzi wesikolo nokuba ingalo yakho ayishukumi, awuyi kukwazi ukuya emsebenzini okanye esikolweni.

Ngelixa uphola, thetha nogqirha wakho okanye ugqirha wakho ngaphambi kokuba uqalise ukwenza umthambo.

Imbono yokuqhekeka kwe-scaphoid

Ithemba lokuba izaphuko ze-scaphoid zilungile. Nokuba utyando, kufuneka uphile ngokupheleleyo, kuba izaphuko zakho azinakuba nemiphumo emihle ixesha elide.

Kufuneka uye nini esibhedlele ngokukhawuleza?

Ukuba ucinga ukuba uphuke i-scaphoid – okanye naluphi na olunye uphuke ithambo – kufuneka ubone ugqirha ngokukhawuleza. Yiya kwigumbi longxamiseko ngokukhawuleza ukuba unenye yezi mpawu:

• Intlungu enzima enganyamezelekiyo.
• Ukuba awukwazi ukushukumisa inxalenye yomzimba wakho, unokushukumisa ngokuqhelekileyo.
• Ukuba inxalenye yomzimba wakho ibonakala yahlukile kunesiqhelo, ukuba ibonakala ngathi itsibile endaweni yayo.
• Ukuba ithambo lakho libonakala ngesikhumba sakho.
• Ukudumba.
• Ukuba kuvela imivumbo emitsha kunye nezinye iimpawu.

Ukuba ukhe waba nengozi enkulu (ukwenzakala), yiya kwigumbi likaxakeka ngokukhawuleza.

Yeyiphi imibuzo omele uyibuze ugqirha?

• Ingaba ndine-scaphoid fracture, okanye olunye uhlobo lwe-fracture?
• Yeyiphi inxalenye yethambo lam le-scaphoid ephukileyo?
• Ngaba ndiza kufuna utyando?
• Kuza kuthatha ixesha elingakanani ukuphiliswa?
• Ndingawuqala nini kwakhona umsebenzi womzimba?

Ukuphuka kwethambo kusoloko kuyoyikisa, ingakumbi ukuba kwenzeka ngequbuliso, njengaxa utyibilika uze uwe. Ukuqhekeka kwe-scaphoid kusabela kakuhle kunyango, kwaye kukho iindlela ezininzi zokunceda amathambo akho nomzimba wakho uphile kakuhle. Thetha nogqirha wakho ngeendlela zokugcina amathambo akho omelele kwaye esempilweni, kwaye ufumane uvavanyo loxinano lwamathambo rhoqo ukuba ungaphezulu kweminyaka engama-50 okanye ukuba kukho umntu kusapho lwakho one-osteoporosis.

Okokugqibela, izinto ekufuneka uzikhumbule

Ngoko ke, uyabona, nokuba unengxaki encinci esihlahleni sakho, ayilocebo lilungileyo ukungayinaki nje. Ukwaphuka kwe-scaphoid yinto enokunyangeka ngokupheleleyo ukuba inyangwa ngokufanelekileyo.

Eyona nto ibalulekileyo kukubona ugqirha ngokukhawuleza ukuba uneempawu. Ngale ndlela, banokufumanisa ukuba kwenzeka ntoni kanye kanye baze baqalise unyango olufunekayo.

Khumbula, kubaluleke kakhulu ukukhathalela impilo yamathambo akho. Ukutya okunesondlo, ukuzilolonga ngokufanelekileyo, kunye nokuthatha amanyathelo okuzikhusela kwiingozi kunokunceda ekuthinteleni ezi meko ukuya kuthi ga kwinqanaba elithile. Ukuba unemibuzo, ungathandabuzi ukubuza ugqirha wakho. Emva koko unokuqiniseka.

Ukuqhekeka kwe - scaphoid, ukuqhekeka kwesandla, iintlungu zesandla, ukuqhekeka kwethambo, i-X-ray, i-MRI, utyando lwethambo