Khosi phewa wovulala: zimayambitsa, zizindikiro, matenda ndi mankhwala

Humerus zimathandiza munthu kuti apange kwambiri kuyenda, matalikidwe amene zingasiyane. kuwonongeka kwa malowa kungasokoneze pa ntchito za pamapewa yamphamvu kabwerebwere kayendedwe ka moyo. Iwo zingakhudze mbali zosiyanasiyana za chotero dongosolo wosalimba. Nthawi zambiri, madokotala anandipeza wovulala khosi la paphewa. Za mbali ndi njira yaikulu ya chithandizo cha kuvulala yoteroyo m'nkhani lero.

Buku anatomical

Humerus - ndi yaitali dongosolo tubular. Iwo inali pakati pa chigongono ndi paphewa lamba dera, ndipo tichipeza awiri diaphysis ndi epiphysis. mtundu wa mabacteria kusintha mbali nawa metaphyses. Mapeto chapamwamba fupa ukufanizidwa ndi mutu limodzi limene akufanana mpira. Malowa ali pamtunda basi pansipa phewa anatomical khosi. fractures kwambiri am'derali osowa.

Basi pansipa khosi phewa ali yaikuluikulu tokhala, amene anaphatikiza tendon lapansi. Pansi akuthamanga ndi "malire" umene umawalekanitsa diaphysis mafupa ndi kutha chapamwamba. Last mwinamwake wotchedwa "khosi opaleshoni ya paphewa." Ndi malo kawirikawiri poyera kuti choipa.

Kupatukana anafotokoza fractures m'magulu awiri tentatively kwambiri. Iwo yodziwika ndi wonse chithunzi matenda. Choncho, madokotala anaganiza kuphatikiza iwo mu gulu limodzi - opaleshoni khosi wovulala paphewa.

Zimayambitsa chachikulu cha kuvulala

Chinthu chachikulu chomwe fractures a chikhalidwe ichi imatengedwa kuti yozungulira makina kanthu. Mwachitsanzo, pamene kugwa pa dzanja kapena mkono. Choncho pali flexion wa humerus ndi kuwonjezeka munthawi yomweyo mu chipsyinjo pa izo axially. Nthawi zina, kuwonongeka ndi chifukwa zimakhudza mwachindunji thupi.

Wovulala khosi opaleshoni ya phewa makamaka zofala akazi okalamba. Madona zaka zoposa 50 ali pa chiopsezo zoopsa chifukwa zinthu zingapo:

• kusintha kwa thupi ndi osauka pa maziko a fupa kufooka kwa mafupa;
• kusintha mu dongosolo fupa.

Khalidwe nthambi kuwonongeka anatsimikiza ndi malo panthawi kugwa. Poganizira zimenezi, khosi phewa wovulala ndi inagunda, adduktsionnym ndi atigwira. Taonani kuti amaimira aliyense embodiments lapansi.

inagunda wovulala

Mwa kuvulala onse zoopsa wa mtundu uwu ndi zochepa wamba onse. Pamene dzanja ili zinakambirana, koma ichi limodzi ndi kanthu makina, matenda yopingasa wovulala. Zotumphukira fupa mchitidwe alowa mutu olowa, kupanga kale inagunda wovulala khosi la paphewa. Iye nthawizonse kutsekedwa.

Adduktsionny wovulala

kuvulala Izi kawirikawiri chifukwa cha kugwa pa mkono wopindidwa. Pa nthawi yomweyo pa chigongono kwambiri mathithi kuthamanga. Chifukwa cha kuyenda kwa m'mbali m'munsi mwa humerus wapotalikira zimapangitsa kuchepetsa pazipita. Ena alibe kuyenda zofanana, choncho ndi achilendo fulcrum m'dera chapamwamba phewa. Choncho aumbike adzakoka chokhethemulira amene katundu wolemera humerus. Articular mutu amakhalabe malo chifukwa cha mitsempha-kapisozi chipangizo chindiletsa dislocation wa yokumba lapansi. Motero, pali wovulala ndi adduktsionny khosi phewa.

Mu nkhani ya choipa cha chikhalidwe ichi chapakati fupa mpukutu ndi ankatembenukira patsogolo, ndi zotumphukira - kunja ndi mphambu. njingayo anapanga therebetween yomwe imatithandiza kumveketsa mkati.

atigwira wovulala

kuwononga zinthu zimenezi ndi kugwa mu dzanja yoikidwayo. Mphamvu ya kuthamanga ikukula mbali ziwiri nthawi imodzi. Zotumphukira fupa mchitidwe ukusunthira mkati. m'mphepete ake akunja akapsa zitasintha chapakati mpukutu mu galimoto malo. Ndi pang'ono otsiriza anapanduka pansi, kutsogolo. Chifukwa ndi makona kutsegula kunja.

chithunzi matenda

Pa chiphaso cha wovulala ayenera yomweyo funsani mungayambe ndi kuwononga dipatimenti ya chipatala yapafupi. Pa khosi zoipa phewa, kawirikawiri limasonyeza makamaka matenda chithunzi. Wozunzidwayo woyamba amavutika m'dera wovulala. Izo sizingakhoze agonjetsedwa ndi analgesics ochiritsira. Izi zimafunika chithandizo cha mankhwala othetsa ululu zimene angathe kupeza yekha m'chipatala.

Phewa olowa Malo dzanja ovulalawo wotaya magwiridwe ake, koma flexion kuyenda pa chigongono zina amaumirira. Wozunzidwayo zambiri nayo wodwala nthambi mkono. Nthawi iliyonse ndimayesetsa kuti gulu linalake, iye akuyamba kubva wosaneneka.

Olowa maonekedwe sasintha. Pamene atigwira wovulala akhoza kupezeka "Anabweza," monga pa dislocation phewa. zifukwa mofulumira kwambiri amawonjezereka. Patapita nthawi, pali hematoma, omwe amakwaniritsa kukula zina miyeso ndithu.

Kovuta akuthamanga khosi phewa wovulala ndi kusamutsidwa. Pankhaniyi, m'mphepete mwa fupa mwina compress ozungulira minofu ndi mtima mitolo, kuchititsa zizindikiro zotsatirazi:

• anasonyeza kumalekezero edema;
• ziwalo;
• chitukuko cha aneurysm ndi;
• gwero lachisokonezo zofewa minofu.

Pankhani ya inagunda wovulala chithunzi matenda zambiri afewetsedwa, ndipo palibe ululu. Motero, angavutike, pasanathe masiku ochepa sankatikayikira kuli choipa osati kuchipatala.

njira matenda

Ngati mukukayikira wovulala lankhulani ndi a mungayambe ndi kuwononga dipatimenti ya chipatala yapafupi. Poyamba, dokotala zomuyenereza woberedwa, kulongosolerana madandaulo alipo ndi mavuto a choipa. Pambuyo kuti akapatsidwa angapo mayesero zina ndi matenda zolondola.

Kwambiri nkhani amakhala ndi X-ray wa lamba phewa. Zithunzi kwenikweni kumachitidwa zolosera ziwiri: ofananira ndi molunjika. Mu nkhani ya zotsatira zokayikitsa Komanso kungafune CT. Ngati mukukayikira wovulala wa kwapakati woikidwa ultrasound.

thandizo

Cholinga cha thandizo kwa wozunzidwayo - mpumulo ululu. M'pofunikanso kuyesera kugwetsa nthambi wovulala. Mbali yoyamba, simungakhoze kuchita popanda thandizo la analgesics. Vuto nduna mankhwala kunyumba ndi "Keterol", "Analgin" ndi "Nimesulide". Mankhwala mlingo ayenera kusintha malinga ndi malangizo Ufumuyo medicament lapansi.

Ngati simungathe kupanga surcharge, ndi X-ray kuonetsetsa kuopsa kwa zoipa, asanapite kuchipatala Ndi bwino kugwetsa nthambi. Chifukwa chaichi kuchokera ku zipangizo zidutswa angathe kupanga kosynochuyu bandeji. Kwa iye zigwirizane minofu kapena mpango, chidutswa cha zovala. Mu mawonekedwe ayenera amafanana ndi makona isosceles. Triangular bandeji ayenera chokhwima m'njira kuti muzilowa mkono pa chigongono.

mankhwala Features

Kodi kukhala matenda "wovulala khosi phewa" chithandizo, dokotala mukuganiza. Mu nkhani iyi, ayenera kuganizira zaka wodwalayo, chikhalidwe cha kuvulala wake ndi kukhalapo kwa zidutswa fupa kusamutsidwa. Choncho, mankhwala akhoza kukhala ndiwofatsa kapena opaleshoni lathu. Odwala ena akulangizidwa chigoba samatha. Chithandizo cha wovulala odwala achikulire osiyana pang'ono. Funso limeneli n'kofunika kuganizira payokha.

wovulala chithandizo popanda zizindikiro kukondera

Mu wopepuka wovulala analimbikitsa outpatient chithandizo. Choyamba, m'malo hematoma, adokotala amaika ndi mankhwala ochititsa, ndi kupitirira kwa imposition a pulasitala splint kwa Turner. Woyenera immobilization wa miyendo wosweka kumathandiza chitukuko cha contractures. Kuvala splint izo akulimbikitsidwa masabata 4.

Siteji yotsatira mankhwala kumafuna ka mankhwala ndi UHF. Mwezi woyamba mtima wa bwino anapereka kwa ntchito za mtundu malo amodzi. Kwa zimakhudza mwachindunji pa fupa lothyoka la ntchito phonophoresis ndi electrophoresis ndi mankhwala.

Patatha milungu inayi ya immobilization chitani konzanso yogwira. Chifukwa chaichi, mungathe kupita kulikonse pakati konzanso chithandizo kumene akatswiri akhoza kusankha ntchito pulogalamu payekha. Childs, njira zotsatirazi akulimbikitsidwa wopepuka wovulala:

• kutikita;
• laser mankhwala;
• ntchito ndi paraffin;
• mankhwala thupi;
• UV walitsa;
• balneotherapy;
• DDT.

Luso ntchito pambuyo kuwonongeka amenewa amabwezeretsedwa miyezi 2.

Chithandizo cha wovulala ndi kusamutsidwa

Pamene kuwonongeka ngati amafuna chithandizo chilengedwe chipatala. Nthawi zambiri, iwo anagwiritsanso mwa njira ndiwofatsa. Doctor ntchito wamba kapena ambiri ochititsa dzanzi Achiritsa woyamba chatsekedwa pamanja muyike pena. Iwo ikuchitika malangizo n'zosiyana ku limagwirira zoipa. Pankhaniyi mchitidwe zotumphukira amagwirizana ndi makombo fupa chapakati.

Ndondomeko palokha imagwiridwa mu malo supine. Dokotalayo anachita mbali zonse za mpheto ndipo amatsogolera zochita za othandizira. Nditamaliza nthambi bandeji zowonongeka kapena pulasitala splint.

Nthawi wovulala immobilization kuchepetsa pafupifupi miyezi 2. dokotala ayenera kuwunika ntchito njira kuchira. Kuti tichite zimenezi, wodwala ayenera nthawi umodzi akatemera. Analipira X-ray limakupatsani zotsatira n'kamodzi. The ufulu kuchipatala mabungwe chithunzi akhoza anatola tsiku lotsatira. Employability zambiri akubwerera mwakale pambuyo masabata 10.

Features ya chithandizo cha fractures okalamba

Nthawi zambiri, kuchotsa wovulala khosi phewa odwala okalamba ntchito njira ndiwofatsa. Pamene choipa adduktsionnoy limasonyeza fixation oyambirira miyendo kwa masabata 4. Pamene koyamba atigwira kuwonongeka zochita samatha, kenako chitani immobilization lapansi. Nthawi zina, pamafunika opaleshoni.

Monga mpumulo ululu wa zinkakhala m'dera palinso zina zoletsa ntchito. Mwachitsanzo, mlingo wa mankhwala ochititsa ayenera kusankha otsika. Apo ayi, kuchuluka imabwera zochita osafunika mbali monga hypotension kapena chizungulire. Chithandizo kumaphatikizapo poika odwala onse popanda yekha, nambala ya mankhwala. Choyamba, ndi kukonzekera kashiamu ndi mankhwala kusintha magazi. Ubwino wa iwo kumaonekeranso pamene iwo amayamba coalesce wovulala khosi la paphewa.

Anthu achikulire ndi nthawi kuchira pambuyo kuvulala wopepuka mlandu za 2-3 miyezi. Kutalika kwa nthawi konzanso makamaka anatsimikiza ndi mkhalidwe wonse wa wodwalayo, zokwanira zolimbitsa thupi. Mawu amenewa kwambiri kuchuluka ngati wovulalayo pali matenda aakulu. Pakati pa pathologies ambiri aakulu ngozi kwambiri ndi matenda a shuga.

Opaleshoni alowererepo sikawirikawiri anatumizidwa odwala achikulire amene wovulala khosi mapewa wapezeka. Konzanso ndipo mu nkhani iyi ndi chokwanira yaitali. Monga ulamuliro, ndi nthawi ya miyezi itatu. Pamene mtundu wa alowererepo kwambiri kumaonjezera ngozi ya mavuto opatsirana. Nthawi ya thromboembolism mu m'badwo uno zambiri zimabweretsa imfa.

Wovulala khosi phewa ndi zotsatira zake

Matenda kuvulala wa mtundu uwu - ndi chodabwitsa sizachilendo. Iwo akhoza kukhala ndi zotsatira za mankhwala kuchepa (cholakwika accrete wovulala, pseudarthrosis). Nthawi zina mavuto a zoopsa chifukwa cha kukhudzana m'dera phewa. Mwachitsanzo, mu fractures zambiri kuonongeka Mitsemphayi ndi tendons, minofu ndi misempha. Motero, pali magazi, matenda zinchito kapena ubongo mu nthambi akhudzidwa.

Kuthetsa Mwina mkulu wa mavuto awa, m'pofunika milandu kuvulazidwa amaganiziridwa yomweyo kupempha thandizo dokotala. Atayendetsa kumupima, adokotala akhoza mankhwala chithandizo chokwanira, ngati pakufunika kutero. chidwi ziperekedwe kwa ndondomeko konzanso. Mu fractures zovuta ndi bwino kuti atembenukire ku malo apadera chithandizo konzanso, zomwe akatswiri adzatha kusankha pulogalamu yothandiza kwambiri kwa normalization manja.