Kupwanyika kweiyo base yeChishanu Metatarsal

Kubata zvisina kufanira kweChishanu Metatarsal Base Fractures kunogona kutungamira kuunganidzira kusanzwisisika kana kunonoka kubatana, uye nyaya dzakakomba dzinogona kukonzera kurira kwerthritis, iyo ine chekuita nehupenyu hwezuva nezuva uye kushanda kwezuva nezuva uye basa.

ANatomicalSTructure

Metatarsal yeChishanu chikamu chakakosha chekiraji refu yetsoka, uye anoita basa rakakosha mukurema-kurema uye kugadzikana kwetsoka. Yechina neyechishanu metatarsal uye ye cuboid fomu iyo metatarsal cuboid Joint.

Kune matatu ma tendon akasungirirwa pachigadziko chechishanu metatarsal, iyo peroneus brevis tendon inoisa pane dreshisteral rutivi pachigadziko chemita yechishanu; Iyo yechitatu yechipatara yemusuru, iyo isina kusimba seye peroneus brevis Tendon, inoisa pane diaphysis distal kusvika kune yechishanu metatarsal tuborts; Iyo plantar fascia iyo yakazotevera fascicle inoisa pane iyo plantar side yeiyo basal tabuni rezvishanu metatarsal.

Kuputsika kuiswa

Fractures yeiyo base yeyechishanu metatarsal yaive yakatarwa neDimerer uye Lawrence,

Zone i rractures izere mafurati eiyo metatarsal tubority;

Zone II iri pane kubatana pakati pe diaphysis uye iyo proximal metaphysis, kusanganisira majoini pakati pegumi nemana uye 5th metatarsa ​​mafupa;

Zone III Fractures ndeyekumanikidza mafungidziro eiyo proximal metatarsal diaphysis distal kusvika kune 4th / 5th intermetatarsal Joint.

Muna 1902, Robert Jones akatanga arondedzera mhando yeiyo zone II kupwanya cheshanu metatarsal, saka nzvimbo II kupwanya kunonzi Jones kupwanyika.

Iyo Avulsion inokatyamadza yeiyo metatarsal tumbenity muZone Ini ndiyo yeChishanu metatarsal base, accounting 93% yezvakapetwa, uye zvinokonzerwa nePlinesar Flexion uye chisimba chevarus.

Fractures muZone II account yeanenge 4% yezvakapwanyika zvese pazasi pechishanu metatarsal, uye inokonzerwa netsoka zvekushandisa uye kutevedzera chisimba. Nekuti ivo vari mundima yakawa mvura yeropa pachigadziko chechishanu metatarsal, fractures panzvimbo ino vanonzwisisika kana kunonoka kupora.

Zone III Fractures Akaunti yeanenge 3% yeChishanu Metatarsal Base Fracts.

Conservative Kurapa

Iyo huru inoratidza kurapa kwekuchengetedza inosanganisira kutapudzwa kwekutyaira pasi pe2 mm kana kugadzikana zvikanganiso. Kurapa kwakawanda kunosanganisira kusvibiswa neElastic Bandges, shangu dzakaomeswa-dzakashata, kusarudzika nePlaster cast, Cardboard compression mapepa, kana bhutsu dzinofamba.

Zvakanakira kurwisa kwekuchengetedza kunosanganisira mutengo wakaderera, hapana kushungurudzika, uye kugamuchirwa kuri nyore nevarwere; Zvinokanganisika zvinosanganisira zvakakwirira zviitiko zvekupwanya nonunion kana kunonoka Union matambudziko, uye zviri nyore kubatana.

KuvhiyaTkutenderwa

Zviratidzo zvekurapa kwekuvhiya kweChishanu Metatarsal Base Fractures zvinosanganisira:

1. Kupwanya kutama kweanopfuura 2 mm;

1. Kubatanidzwa kwe> 30% yeiyo articular pamusoro pe cubod distal kusvika kune yechishanu metatarsal;

1. Craytute yakafambiswa;

1. Kupwanya kunonoka kubatana kana kusaziva mushure mekurapwa kusiri kwekuvhiya;

1. Vanoshandisa varwere vechidiki kana vatambi vemitambo.

Parizvino, iyo inowanzoshandiswa nzira dzekuvhiya dzezvikamu zvechishanu metatarnal inosanganisira Kirschner wire tension band yemukati, screw yemukati yekugadzirisa, uye hove plate yekugadziriswa kwemukati.

1. Kirschner Wire Tension Band Fixation

Kirschner Wire Tension Band Kugadziriswa ndeyechinyakare mishonga yekuvhiya maitiro. Zvakanakisa zveiyi nzira yekurapa inosanganisira mukana uri nyore kune zvemukati zvigadzirwa zvekugadzirisa, mutengo wakaderera, uye kudzikisira kwakanaka. Zvinokanganisika zvinosanganisira kushatirisa kweganda uye njodzi yeKirivan Wire kusunungura.

2. Kugadziriswa kwehuremu nematanho akatsvuka

Anchor Suture Fixation ine tambo yakakodzera kune varwere vane madhiri ezvikamu zvechishanu kana nezvimedu zvidiki zvidiki. Izvo zvakanakira zvinosanganisira zvidiki zvinosanganisira, kushanda kwakareruka, uye hapana chikonzero chekubviswa kwechipiri kubviswa. Zvinokanganisika zvinosanganisira njodzi yeAnchor prarapse muvarwere vane osteoporosis. .

3. Hollow chipikiri

Hollow screw inozivikanwa pasi rese kurapwa kwemukati yekukona kwesigo yeChishanu metatarsal, uye zvakanakira zvinosanganisira kugadziriswa kwakasimba uye kugadzikana kwakanaka.

Clinically, kune zvidiki zvidiki pazasi pechishanu metatarsal, kana maviri screcs anoshandiswa kuti gadziriswe, kune njodzi yekudzokorora. Kana screw imwe ishandiswe nekuda kwekugadziriswa, simba rekutenderera rinotenderera rinorasika, uye kudzokorora kunogoneka.

4. Hook plate yakatarwa

Hook Plate Fixation ine huwandu hwakawanda hwezviratidzo, kunyanya kune varwere vane madhiri emafuru kana esteoporotic fractures. Chimiro charo chechimiro chinoenderana neshamba yeChishanu Metatarsal pfupa, uye gadziriso yekuenzanisa simba rakakwirira. Zvakaipa zvekugadziriswa kweplate zvinosanganisira yakakwira mutengo uye yakakura trauma.

SUmmary

Kana kurapa mapundu pazasi pechishanu metatarsal, zvakafanira kusarudza nokungwarira zvinoenderana nemamiriro ezvinhu emumwe neumwe, chiremba wechiremba uye hunyanzvi hwehunyanzvi, uye fungisisa zvido zvemurwere.