Kuputsika kweBase yeFifth Metatarsal

Kurapwa kwakashata kwechishanu metatarsal base fractures kunogona kukonzera kutyoka kusiri mubatanidzwa kana kunonoka kubatana, uye zviitiko zvakakomba zvinogona kukonzera arthritis, iyo ine simba guru pahupenyu hwezuva nezuva hwevanhu nebasa.

AnatomicalStructure

Yechishanu metatarsal chikamu chakakosha che lateral column yetsoka, uye inoita basa rinokosha mukuremera uye kugadzikana kwetsoka.Yechina neyechishanu metatarsals uye cuboid zvinoumba metatarsal cuboid joint.

Kune matendon matatu akasungirirwa kunheyo yechishanu metatarsal, iyo peroneus brevis tendon inoisa pane dorsolateral side ye tuberosity pachigadziko chechishanu metatarsal;chechitatu cheperoneal muscle, iyo isina kusimba seperoneus brevis tendon, inoisa pa diaphysis distal kusvika kune yechishanu metatarsal tuberosity;the plantar fascia Iyo lateral fascicle inopinza padivi peplantar ye basal tuberosity yechishanu metatarsal.

Kupatsanurwa kwechikamu

Kutsemuka kwechigadziko chechishanu metatarsal kwakarongwa naDameron naLawrence,

Zone I fractures ndeye avulsion fractures ye metatarsal tuberosity;

Zone II inowanikwa pakubatana pakati pe diaphysis uye proximal metaphysis, kusanganisira majoini pakati pe4th uye 5th metatarsal mapfupa;

Zone III fractures is stress fractures ye proximal metatarsal diaphysis distal kusvika kune 4th / 5th intermetatarsal joint.

Muna 1902, Robert Jones akatanga kutsanangura rudzi rwezone II kuputsika kwenheyo yechishanu metatarsal, saka iyo zone II fracture inonziwo Jones fracture.

Kutsemuka kwekutsemuka kwemetatarsal tuberosity munharaunda I ndiyo yakajairika mhando yechishanu metatarsal base fracture, inoverengera inosvika 93% yekutyoka kwese, uye inokonzerwa neplantar flexion uye varus mhirizhonga.

Kuputsika munharaunda II kunoda kusvika 4% yezvose zvakaputsika pasi pechishanu metatarsal, uye zvinokonzerwa netsoka plantar flexion uye adduction mhirizhonga.Nekuda kwekuti ivo vari munzvimbo yemvura yekuyerera kweropa pazasi pechishanu metatarsal, kuputsika panzvimbo iyi kunowanzoitika kune kusiri mubatanidzwa kana kunonoka kuputsika kunopora.

Zone III fractures account inosvika 3% yechishanu metatarsal base fractures.

Conservative kurapwa

Chiratidzo chikuru chekurapa kwekuchengetedza zvinosanganisira kutsemuka kusingasviki 2 mm kana kutsemuka kwakagadzikana.Mishonga yakajairika inosanganisira kusamira nemabhandeji anorarika, bhutsu dzakaomeswa, kusamira nepurasita, mapedhi ekumanikidza makadhibhodi, kana bhutsu dzekufamba.

Zvakanakira kurapwa kwechinyakare zvinosanganisira mutengo wakaderera, pasina kukuvara, uye kugamuchirwa nyore nevarwere;izvo zvisina kunaka zvinosanganisira kuwanda kwechiitiko chekutyoka kusiri kwechipiri kana kunonoka kubatanidzwa kwemubatanidzwa, uye nyore kuoma kwemajoini.

KuvhiyaTreatment

Zviratidzo zvekuvhiya kurapwa kwechishanu metatarsal base fractures zvinosanganisira:

1. Kuputsika kusimuka kweanopfuura 2 mm;

1. Kubatanidzwa kwe> 30% ye articular surface ye cuboid distal kusvika kune yechishanu metatarsal;

1. Comminuted fracture;

1. Kutyoka kunonoka kubatana kana kusabatana mushure mekusavhiya kurapwa;

1. Varwere vechidiki vanoshingaira kana vatambi vemitambo.

Parizvino, nzira dzinowanzo shandiswa dzekuvhiya dzekutyoka kwechigadziko chechishanu metatarsal dzinosanganisira Kirschner waya tension band yemukati fixation, anchor suture fixation neshinda, screw mukati mekugadzirisa, uye hook plate mukati mekugadzirisa.

1. Kirschner wire tension band kugadzirisa

Kirschner wire tension band fixation inzira yechinyakare yekuvhiya.Zvakanakira nzira iyi yekurapa zvinosanganisira kuwana nyore kune mukati mekugadzirisa zvinhu, yakaderera mutengo, uye yakanaka compression maitiro.Zvakaipa zvinosanganisira kushatirwa kweganda uye njodzi yeKirschner kusunungura waya.

2. Suture fixation ine threaded anchors

Anchor suture fixation neshinda inokodzera varwere vane avulsion fractures pazasi pechishanu metatarsal kana nediki diki zvidimbu.Zvakanakira zvinosanganisira diki incision, nyore kushanda, uye hapana chikonzero chechipiri kubviswa.Kukanganisa kunosanganisira njodzi yeanchor prolapse muvarwere vane osteoporosis..

3. Hollow mbambo kugadzirisa

Hollow screw chirongwa chinozivikanwa pasi rose chinoshanda chekutyoka kwepasi pechishanu metatarsal, uye zvakanakira zvinosanganisira kusimba kwakasimba uye kugadzikana kwakanaka.

Kliniki, kune madiki madiki pazasi pechishanu metatarsal, kana maviri screws akashandiswa kugadzirisa, kune njodzi yekuparara.Kana imwe screw ichishandiswa kugadzirisa, iyo anti-kutenderera simba inopera simba, uye kuchinjisa kunogoneka.

4. Hook ndiro yakagadziriswa

Hook plate fixation ine huwandu hwakawanda hwezviratidzo, kunyanya kune varwere vane avulsion fractures kana osteoporotic fractures.Chimiro chayo chekugadzira chinoenderana nehwaro hwechishanu metatarsal bone, uye iyo yekusimbisa yekumanikidza simba yakakwira.Kuipa kwekugadziriswa kweplate kunosanganisira kudhura kwakanyanya uye kushungurudzika kukuru.

Summary

Paunenge uchirapa kuputsika pasi pechishanu metatarsal, zvinodikanwa kuti usarudze zvakanyatsoenderana nemamiriro emunhu ega ega, ruzivo rwechiremba wega uye tekinoroji nhanho, uye funga zvizere zvishuwo zvemurwere.