Ingabe unenkinga encane eduze kwesihlakala sakho? Kungaba ukuphuka kwe-scaphoid!

Wake wawa washaya isandla sakho phansi, okwabangela ukulimala okukhulu esihlakaleni sakho? Noma mhlawumbe wajika isandla sakho ngendlela engafanele ngenkathi udlala, bese indawo yavuvukala wangabe usakwazi ukusishukumisa? Ngezinye izikhathi sicabanga ngalezi zinto ngokuthi "ukukhubeka nje," kodwa kungaba yinto engathi sína kakhulu. Yilokho okungenzeka uma kwenzeka into efana nale, ebizwa ngokuthi i-scaphoid fracture. Ake sixoxe ngalokhu ngokuningiliziwe namuhla, kulungile?

Kuyini ukuqhekeka kwe-Scaphoid?

Kalula nje, ukuphuka kwe-scaphoid kuwukuphuka kwethambo esihlakaleni sakho. Ithambo le-scaphoid litholakala phansi kozwane lwakho olukhulu, eduze kwesihlakala sakho. Isihlakala sakho sakhiwe ngamathambo amancane amaningana abizwa ngokuthi amathambo e-carpal. I-scaphoid ingenye yalawo mathambo e-carpal.

Lokhu kuvame ukwenzeka lapho siwa futhi selula isandla ukuze sibambe izandla zethu. Cabanga nje, ngokuzumayo uyashelela bese uyawa, bese ubeka izandla zakho phansi ngokushesha ukuze uzisindise, akunjalo? Yilapho-ke leli thambo lingase lonakale khona. Ngaphandle kwalokho, kungenzeka futhi ngenxa yezingozi zezimoto, imiphumela emibi ngenkathi udlala imidlalo, njll. Ngezinye izikhathi ukuhlinzwa kuyadingeka ukuze kulungiswe kahle leli thambo. Iningi labantu lithatha cishe izinyanga ezintathu ukuze lilulame ngokugcwele kulesi simo.

Izingxenye zethambo le-scaphoid kanye nalapho kwenzeka khona ukwaphuka

Leli thambo le-scaphoid linezingxenye ezintathu. Noma iyiphi yalezi zingxenye ingaphuka.

• I-Distal pole: Lesi yisiphetho sethambo le-scaphoid eliseduze nesandla sakho neminwe, okungukuthi, kude nengalo.
• Isinqe se-scaphoid: Lesi yisigaba esiphakathi kwethambo le-scaphoid. Isikhathi esiningi, okungukuthi, ukuphuka kwe-scaphoid okungaphezu kuka-70% kwenzeka kule ngxenye ephakathi.
• I-Proximal pole: Lesi yisiphetho sethambo le-scaphoid elibheke ebunzini lakho, ngaphakathi emzimbeni wakho.

La magama angase azwakale engajwayelekile kuwe. Kodwa odokotela bawasebenzisa ukuze babasize baqonde kahle ukuthi isihlakala sakho siphukile kanjani, ukuthi ithambo lakho le-scaphoid liphukile kuphi, nokuthi ithambo libekwe kanjani emzimbeni wakho njengamanje. Kodwa-ke, kungakhathaliseki ukuthi ulibiza ngokuthini, into ebaluleke kakhulu ukubona udokotela ngokushesha okukhulu bese uyahlolwa.

Kuvame kangakanani lokhu? Ubani okukuthola kaningi?

Ukuphuka kwe-scaphoid uhlobo oluvame kakhulu lokuphuka kwamathambo e-carpal esihlakaleni, okubangela cishe u-15% wabo bonke ukulimala kwesihlakala.

Eqinisweni, njengoba nje noma ubani engaphula ithambo, noma ubani angaphula ithambo le-scaphoid. Lokhu kungenxa yokuthi kuvame ukwenzeka ngenxa yokuwa noma ezinye izingozi. Kodwa-ke, kuvame kakhulu entsheni engaphansi kweminyaka engama-30 kanye nasebasha.Lokhu kuvame kakhulu. Uma uthambekele ekuweni, nawe usengozini enkulu. Futhi, abantu abanezifo ezincipha amathambo njenge-osteoporosis banamathuba amaningi okuphuka amathambo abo kalula kunabanye, ngakho-ke basengozini enkulu yokuphuka kwe-scaphoid.

Ziyini izimpawu?

Uma une-scaphoid fracture, ungase ube nezimpawu ezifana nalezi:

• Ubuhlungu: Ikakhulukazi phansi kozwane olukhulu, khona kanye esihlakaleni.
• Ukuvuvukala: Indawo ethintekile yesandla ingase ivuvuke.
• Ubumnene: Indawo okukhulunywe ngayo ngenhla ibuhlungu uma ithintwa noma icindezelwa.
• Ukungakwazi ukuhambisa isihlakala: Ubunzima bokujika noma ukuphakamisa isandla.
• Ukuphuka noma ukushintsha kombala: Kungase kubonakale kuluhlaza okwesibhakabhaka noma kunsomi.
• Iqhubu noma ukukhubazeka okungajwayelekile: Isihlakala singase sizwakale noma sibukeke njengeqhubu elingajwayelekile.

Ukuphuka kwamathambo okuxoshwe kanye nokungaxoshiwe

Lawa amanye amagama amabili udokotela azowasebenzisa ukuchaza ukwaphuka kwakho. "Ukuphuka okuphukile" kusho ukuthi ngemva kokuphuka kwethambo, izingcezu ezimbili eziphukile zisuke zinyakaze kakhulu, zishiya isikhala esikhulu phakathi kwazo. "Ekuqhekekeni okungasuswanga"", ithambo lisaphukile, kodwa izingcezu ezimbili azikashukumi kakhulu, futhi zisaseduze nalapho zazikhona. "Ukuphuka okuphukile" kuvame ukudinga ukuhlinzwa ukuze kulungiswe.

Kungani lokhu kwenzeka?

Noma yikuphi ukushaya ngamandla esihlakaleni kungabangela ukuphuka kwethambo le-scaphoid. Izimbangela eziyinhloko yilezi:

• Ukuwa: Welulela izingalo zombili futhi welulela phansi.
• Izingozi zemidlalo: Njengalapho udlala ikhilikithi noma ibhola.
• Izingozi zezimoto.

Odokotela bakuthola kanjani lokhu?

Udokotela uzokuhlola ukuthi unesifo sokuphuka kwe-scaphoid ngokukuhlola nokwenza izivivinyo eziningana zezithombe.

Yiziphi izivivinyo ezenziwayo?

Ngemva kokuhlolwa, ungase ube nokuhlolwa okukodwa noma ngaphezulu kwalokhu okulandelayo:

• Ama-X-ray: I-X-ray ingabonisa ukuthi kukhona yini ukuphuka kwe-scaphoid noma elinye ithambo nokuthi kungakanani umonakalo owenziwe.
• Ukuthwebula izithombe ze-magnetic resonance (MRI): Ngezinye izikhathi udokotela wakho uzoyala ukuthi kwenziwe i-MRI scan. Lokhu kungasiza ekuhloleni ngokugcwele umonakalo emathanjeni nasemisipheni nasezicutshini ezizungezile.
• I-CT scan: Uma udinga ukuhlinzwa, udokotela wakho uzodinga isithombe esicacile somonakalo emathanjeni akho. I-CT scan ingabonisa amathambo nezicubu ezizungezile ngemininingwane eminingi kune-X-ray.

Ukuqhekeka kwe-scaphoid yemilingo

Ngezinye izikhathi ukuphuka kwe-scaphoid akubonakali ku-X-ray, futhi ngezinye izikhathi akubonakali nhlobo. Lokhu kubizwa ngokuthi ukuphuka kwe-scaphoid okungabonakali. Uma lokhu kwenzeka, udokotela wakho angase akucele i-MRI noma i-CT scan. Udokotela wakho uzokutshela ukuthi yiziphi izivivinyo ezengeziwe ongase uzidinge.

Okubalulekile: Tshela udokotela wakho ngqo ukuthi ubuhlungu kuphi nokuthi yini ebuhlungu uma ubucindezela. Uma ubuhlungu bakho busethanjeni le-scaphoid, futhi bungapheli ngemva kosuku olulodwa noma ezimbili, ungase ube nokuphuka okufihliwe. Lokhu kuphuka okufihliwe akudingi ukwelashwa okukhethekile, futhi akubeki zingozi ezikhethekile.

Yiziphi izindlela zokwelapha?

Ukwelashwa kokuphuka kwe-scaphoid yakho kuncike ekutheni kuyingozi kangakanani. Ithambo lakho eliphukile lidinga ukubuyiselwa ndawonye futhi lilashwe. Kuye ngokuthi lonakele kangakanani nokuthi liphukile kanjani, udokotela wakho angase asebenzise eyodwa noma ngaphezulu yalezi zindlela zokwelapha.

Ukungasebenzi kahle kwesandla/isihlakala

Uma ukwaphuka kwakho kungekukhulu kakhulu, okusho ukuthi ithambo le-scaphoid alikasuki kude kakhulu nalapho lalikhona (`elingasuswanga`), kungadingeka ukuthi ufake i-splint noma i-plaster ye-Paris cast kuphela. I-splint ivame ukuhlala cishe amasonto amathathu kuya kwamahlanu. I-cast ihlala isikhathi eside, ngokuvamile amasonto ayisithupha kuya kwayisishiyagalombili. Kuzo zombili izimo, kuzodingeka wenze enye i-X-ray ukuqinisekisa ukuthi ithambo lakho liyaphola kahle.

Ukunciphisa amathambo ngaphandle kokuhlinzwa (Ukunciphisa okuvaliwe)

Uma kwenzeka ukwaphuka okukhulu, kwenziwa inqubo ebizwa ngokuthi i-closed reduction ukuze kulungiswe ithambo le-scaphoid. Lokhu akusikho ukuhlinzwa. Udokotela uzocindezela futhi adonse ingaphandle lomzimba wakho ukuze alungise ithambo eliphukile ngaphakathi. Ngesikhathi enza lokhu, uzokwenza okunye kwalokhu okulandelayo ukuze akusize uzizwe ubuhlungu obuncane:

• Kufakwa umuthi wokubulala izinzwa wendawo ukuze kuncishiswe indawo ezungeze ithambo eliphukile.
• Kunikezwa imithi yokudambisa umzimba wonke.
• Umzimba wakho wonke uzolaliswa (`i-anesthesia ejwayelekile`).

Ngemva kokwenza lokhu ``(Ukunciphisa okuvaliwe)``, udokotela uzokufaka i-splint noma i-plaster.

Ukuhlinzwa kokuphuka kwe-Scaphoid

Amanxeba amaningi anzima adinga ukuhlinzwa. Udokotela ohlinzayo uzolungisa ithambo lakho le-scaphoid futhi alilungise endaweni yalo, ukuze libuye lihlangane futhi liphole. Ngokuvamile, bazokwenza into ebizwa ngokuthi "i-Internal fixation." Lokhu kusho ukuthi udokotela ohlinzayo uzofaka izingcezu zensimbi ngaphakathi kwethambo lakho ukuze alibambe endaweni yalo lize liphole. Lezi zindlela "i-Internal fixation" yilezi:

• Amapuleti nezikulufo: Amapuleti ensimbi nezikulufo ezifakwa ethanjeni ukuze zibambe izingcezu zamathambo ndawonye.
• Izikhonkwane nezintambo:Izikhonkwane nezintambo zisetshenziselwa ukubamba izingcezu ezincane zamathambo ndawonye kunezinye izinto zokubopha. Lokhu kuvame ukusetshenziswa kanye namapuleti noma ezinye izinto ezifana nezinduku.

Abanye abantu bagcina lezi zingcezu zensimbi emizimbeni yabo. Abanye abantu kufanele baphinde bahlinzwe ukuze zisuswe.

Ukufakelwa kwamathambo

Uma ukuphuka kwe-scaphoid yakho "kususiwe" kakhulu, okusho ukuthi izingcezu ziqhelelene kakhulu, noma uma ithambo lakho lingapholi kahle, kungadingeka ukuthi ube nenqubo ebizwa ngokuthi "ukufakelwa kwamathambo." Udokotela ohlinzayo uzofaka izicubu zethambo ezengeziwe ukusiza ithambo lakho eliphukile ukuthi libuye ndawonye. Ngemuva kwalokho, bavame ukwenza "ukulungiswa kwangaphakathi," bebamba izingcezu ndawonye kuze kube yilapho ithambo liphola. Kunezindawo eziningana lapho ithambo lingathathwa khona ukuze kufakwe lezi zingcezu zamathambo:

• Ukusuka kwenye indawo emzimbeni wakho - ngokuvamile phezulu kwethambo lakho lesinqe.
• Kusuka komunye umuntu (umnikeli wangaphandle).
• Ingcezu eyenziwe ngobuciko.

Ukuhlinzwa kokuphuka kwe-scaphoid kuvame ukwenziwa njengezinqubo zokulaliswa esibhedlela.

Ngemva kokuhlinzwa kwakho, isihlakala sakho kuzodingeka sivalwe. Kungase kudingeke ugqoke i-splint noma i-cast ngaphambi kokuthi uphinde usebenzise isandla sakho njengoba wawenza ngaphambi kokuba siphuke.

Yimiphi imithi esetshenziswayo yokuphuka kwe-scaphoid?

Ama-painkiller abizwa ngokuthi "ama-NSAID", njenge-aspirin noma i-ibuprofen, angabangela ukopha kanye nezinye izinkinga ngemva kokuhlinzwa. Ngakho-ke, udokotela wakho ohlinzayo uzokhuluma nawe ngemithi ongayithatha ukunciphisa ubuhlungu ngemva kokuhlinzwa.

Imiphumela emibi engaba khona ye-NSAID:

• Ukopha.
• Izilonda zesisu.
• Ubuhlungu besisu.
• Izinkinga zamathumbu.

Ingabe ukuphuka kwe-scaphoid kuzophola ngokwako?

Ungalokothi uzishaye indiva izimpawu ezifana nobuhlungu, ukuvuvukala, noma ukuthamba. Ngisho noma izimpawu zakho zingembi kakhulu, usadinga ukwelashwa. Uma ungatholi ukwelashwa kokuphuka kwe-scaphoid, ungagcina unezinkinga ezinkulu kamuva, njenge:

• I-Acute compartment syndrome (ACS): Ingcindezi ngaphakathi kwemisipha iyanda, ukugeleza kwegazi kuya ezicutshini kuyanqamuka, futhi kungenzeka umonakalo ohlala njalo wemisipha kanye nemizwa.
• `(Malunion)`: Uma amathambo akho aphukile engahlangani kahle lapho ephola.
• Ukuhlangana: Amathambo akho awahlangene ngokuphelele noma ngokwengxenye.
• I-Avascular necrosis (i-osteonecrosis): Lesi yisifo samathambo esibuhlungu esiba sibi kakhulu ngokuhamba kwesikhathi. Singathinta ikhono lakho lokunyakaza. Kwenzeka lapho ukugeleza kwegazi ethanjeni kunqamuka.
• I-arthritis yesandla: Izimo ezibizwa ngokuthi "i-Nonunion" kanye ne-"Avascular necrosis" zingabangela i-arthritis esandleni nasesihlakaleni. I-arthritis yesandla ingabangela ubuhlungu, ukuvuvukala, ukuqina, kanye nokukhubazeka.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Kungathatha amasonto ambalwa ukuthi izimpawu zakho ziphele. Kuye ngohlobo lokuhlinzwa okwadingeka ulungise ukuphuka kwe-scaphoid yakho, ungase ukwazi ukuhambisa ingalo yakho futhi phakathi namasonto ambalwa.

Kodwa-ke, uma ubuhlungu obungabekezeleleki obungapheli, bona udokotela ngokushesha.

Ingancishiswa kanjani le ngozi?

Landela lawa macebiso okuphepha ukuze unciphise ingozi yokulimala:

• Gqoka ibhande lakho lesihlalo njalo uma ugibele imoto.
• Gqoka imishini yokuphepha efanele kuyo yonke imisebenzi nemidlalo.
• Gcina ikhaya lakho nendawo yakho yokusebenza icocekile ngokususa izinto ezingabangela ukuthi wena noma omunye umuntu ashelele futhi awe.
• Uma uthatha noma yini endlini, sebenzisa amathuluzi noma imishini efanele ngaso sonke isikhathi. Ungalokothi ukhwele ezihlalweni noma ematafuleni.
• Landela uhlelo lokudla nokuzivocavoca olusiza ekugcineni amathambo akho ephilile.
• Uma uneminyaka engaphezu kwengu-50 ubudala, noma uma othile emndenini wakho ene-osteoporosis, khuluma nodokotela wakho mayelana nokuhlolwa kokuqina kwamathambo.
• Uma usebenzisa induku noma i-walker ukuhamba, yisebenzise njalo, futhi uqaphele ezindaweni ezingalingani.

Ngingakuvimbela yini ukuphuka kwe-scaphoid?

Ukuphuka kwe-scaphoid kuvame ukubangelwa ukuwa noma ezinye izingozi, ngakho-ke akukho okuningi okungenziwa ukuvimbela lokhu, ngaphandle kokuqaphela lapho uhamba (usebenzisa induku/i-walker uma unayo) nokuqaphela ezindaweni ezingalingani.

Yini engingayilindela uma nginokukhubazeka kwe-scaphoid?

Uma unesifo sokuphuka kwe-scaphoid, ungalindela ukululama okuphelele.

Uzodinga ukwelashwa ngokomzimba ukuze uthole amandla nobubanzi bokunyakaza esihlakaleni sakho.

Kuthatha isikhathi esingakanani ukuthi ukuphuka kwe-scaphoid kuphole?

Isikhathi esizokuthatha ukuze ululame sizoncika ebunzimeni bokuphuka kwakho kanye nokwelashwa okudingayo. Iningi labantu lithatha cishe izinyanga ezintathu ukuphulukiswa ekuqhekekeni kwe-scaphoid.

Kunezinye izinto eziningi ezingathinta ukuthi kuthatha isikhathi esingakanani ukuthi umzimba wakho ululame. Khuluma nodokotela wakho noma udokotela ohlinzayo mayelana nesikhathi esifanele isimo sakho.

Ingabe ngeke ngikwazi ukuya emsebenzini noma esikoleni?

Uma usakwazi ukwenza umsebenzi wakho noma umsebenzi wesikole ngaphandle kokunyakaza isihlakala sakho, ngeke ukwazi ukuya emsebenzini noma esikoleni.

Ngesikhathi usalulama, khuluma nodokotela wakho ohlinzayo noma udokotela ngaphambi kokuba uqale kabusha umsebenzi womzimba.

Umbono wokuphuka kwe-scaphoid

Umbono wokuphuka kwe-scaphoid muhle. Ngisho noma uhlinzwa, kufanele ululame ngokuphelele, njengoba ukuphuka kwakho cishe kungeke kube nemiphumela yesikhathi eside.

Kunini lapho kudingeka uye esibhedlela ngokushesha?

Uma ucabanga ukuthi unesifo sokuphuka kwe-scaphoid – noma esinye isifo sokuphuka kwethambo – kufanele ubonane nodokotela ngokushesha okukhulu. Yiya egumbini lezimo eziphuthumayo ngokushesha uma unezinye zalezi zimpawu:

• Ubuhlungu obukhulu obungabekezeleleki.
• Uma ungakwazi ukuhambisa ingxenye yomzimba wakho, ungayihambisa ngokujwayelekile.
• Uma ingxenye yomzimba wakho ibukeka ihlukile kunejwayelekile, uma ibonakala sengathi igxume endaweni yayo.
• Uma ithambo lakho libonakala ngesikhumba sakho.
• Ukuvuvukala.
• Uma kuvela imivimbo emisha kanye nalezi ezinye izimpawu.

Uma uke waba nengozi enkulu (ukulimala), hamba uye egumbini lezimo eziphuthumayo ngokushesha.

Yimiphi imibuzo okufanele uyibuze udokotela?

• Ingabe nginokuphuka kwe-scaphoid, noma olunye uhlobo lokuphuka?
• Iyiphi ingxenye yethambo lami le-scaphoid ephukile?
• Ingabe ngizodinga ukuhlinzwa?
• Kuzothatha isikhathi esingakanani ukuphulukiswa?
• Ngingaqala nini futhi umsebenzi womzimba?

Ukuphuka kwethambo kuhlale kuyesabisa, ikakhulukazi uma kwenzeka ngokuzumayo, njengalapho ushelela futhi uwe. Ukuphuka kwe-scaphoid kusabela kahle ekwelashweni, futhi kunezindlela eziningi zokusiza amathambo akho nomzimba wakho ukuthi uphulukiswe kahle. Khuluma nodokotela wakho ngezindlela zokugcina amathambo akho eqinile futhi enempilo, futhi uthole ukuhlolwa kokuqina kwamathambo njalo uma uneminyaka engaphezu kwengu-50 noma uma othile emndenini wakho ene-osteoporosis.

Okokugcina, izinto okufanele uzikhumbule

Ngakho-ke, uyabona, noma ngabe unenkinga encane ngesihlakala sakho, akuwona umqondo omuhle ukumane ungayinaki. Ukuphuka kwe-scaphoid kuyinto engelapheka ngokuphelele uma yelashwa kahle.

Into ebaluleke kakhulu ukubonana nodokotela ngokushesha okukhulu uma unezimpawu. Ngaleyo ndlela, bangathola ukuthi kwenzekani bese beqala ukwelashwa okudingekayo.

Khumbula, kubaluleke kakhulu ukunakekela impilo yamathambo akho. Ukudla okunempilo, ukuvivinya umzimba okufanele, kanye nokuthatha izinyathelo zokuphepha ukuze uzivikele ezingozini kungasiza ekuvimbeleni lezi zimo ngezinga elithile. Uma unemibuzo, ungangabazi ukubuza udokotela wakho. Khona-ke ungaqiniseka.

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