ʻO ka maʻi maʻi maʻi

ʻO ka maʻi ākea ākea kahi ʻano koʻikoʻi e pili ana i ka hoʻonui ʻana o kaomi i kahi keʻena muscle. Hiki iā ia ke alakaʻi i ka hōʻino ʻana i nā mākala a me nā aʻa a me nā pilikia me ke kahe o ke koko.

Pākuʻi mānoanoa o nā kinona, i kapa ʻia ʻo fascia, nā hui ʻokoʻa o nā mākala i nā lima a me nā wāwae kekahi i kekahi. Aia i loko o kēlā me kēia ʻāpana o ka fascia kahi wahi i hoʻopaʻa ʻia, i kapa ʻia he ʻāpana. Hoʻopili ka ʻāpana i nā mākala, nā aʻa, a me nā kīʻaha koko. Hoʻopuni ʻo Fascia i kēia mau hale, like me ke ʻano o ka uhi ʻana e uhi ai nā kaula.

ʻAʻole hoʻonui ʻo Fascia. ʻO kēlā me kēia ʻōhū i loko o kahi keʻena e alakaʻi i ka hoʻonui i ka kaomi ma kēlā wahi. Hoʻonui kēia kaomi, kaomi i nā mākala, nā kīʻaha koko, a me nā aʻalolo. Inā lawa ke kiʻekiʻe o kēia kaomi, e ālai ʻia ke kahe o ke koko i ka lumi. Hiki i kēia ke alakaʻi i ka hōʻeha mau loa i nā mākala a me nā aʻalolo. Inā kū lōʻihi ke kaomi, make paha nā mākala a ʻaʻole e hana hou ka lima a me ka wāwae. Hana ʻia ke kaha a i ʻole ke ʻoki ʻoki ʻana e hoʻoponopono i ka pilikia.

Hoʻokumu ʻia ka maʻi ākea ākea e:

• Trauma, e like me ka ʻeha a me ke ʻoki ʻana
• Iwi haʻi
• ʻĀʻī mākī loa
• ʻŪhā koʻikoʻi
• ʻO kahi mea hoʻolei a kaula paha i paʻa paʻa loa
• Loaʻa ka loaʻa ʻole o ke koko ma muli o ka hoʻohana ʻana i ka hoʻokūkū a i ʻole ke hoʻonohonoho ʻana i ka wā o ke ʻoki
  

Hiki ke hoʻokumu ʻia i ka maʻi wā lōʻihi (mau) e nā hana hou, e like me ka holo ʻana. Hoʻonui wale ke kaomi i kahi keʻena i ka wā o kēlā hana a iho i lalo ma hope o ka pau ʻana o ka hana. ʻO kēia ʻano maʻa mau ka palena ʻana o ka palena a ʻaʻole ia e alakaʻi i ka nalo o ka hana a me ka lālā. Eia nō naʻe, hiki i kaʻeha ke hōʻemi i ka hana a me ke ahonui.

ʻO ka maʻi maʻi maʻamau ka mea maʻamau i ka wāwae o lalo a me ka forearm. Hiki iā ia ke hana i ka lima, ka wāwae, ka ʻūhā, ka ʻūhā, a me ka lima luna.

ʻAʻole maʻalahi ke ʻike ʻia nā ʻōuli o ka compartment syndrome. Me kahi ʻeha hōʻeha, hiki i nā ʻōuli ke lilo i koʻikoʻi i loko o kekahi mau hola.

Pākuʻi ʻia paha nā ʻōuli:

• ʻOi aku ka ʻeha ma mua o ka mea i manaʻo ʻia me ka ʻeha
• ʻO ka ʻeha nui ʻaʻole e hele ma hope o ka lawe ʻana i ka lāʻau ʻeha a hāpai paha i ka wahi i hoʻopilikia ʻia
• Hoʻoemi i ka sensation, numbness, tingling, nawaliwali o ka wahi i hoʻopili ʻia
• ʻIli keʻokeʻo
• ʻO ka pehu a i ʻole hiki ʻole ke neʻe i ka ʻāpana i hoʻopili ʻia

E hana ka mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i nā ʻōuli, e kia ana i ka wahi i hoʻopilikia ʻia. E hōʻoia i ke kuhi, pono paha i ka mea hāʻawi ke ana i ka kaomi i ka lumi. Hana ʻia kēia me ka nila ʻana i waiho ʻia i loko o ke kino. Hoʻopili ka nila i ka mika kaomi. Hana ʻia ka hōʻoia ma ka wā a ma hope o kahi hana e hōʻeha ai i ka ʻeha.

ʻO ka pahuhopu o ka mālama ʻana e pale i ka pohō mau. No ka maʻi hōʻino koʻikoʻi, pono koke ke kauka. ʻO ka hoʻopaneʻe ʻana i ka ʻoki kino hiki ke alakaʻi i kahi pōʻino mau loa. Kāhea ʻia ke ʻokiʻoki fasciotomy a pili i ka ʻoki ʻana i ka fascia e hoʻomaha ai i ke kaomi.

No ka maʻi maʻi maʻi maʻamau:

• Inā paʻa paʻa ka hoʻolei a i ʻole ke kaula, pono e ʻoki a hoʻokuʻu ʻia paha e hoʻomaha ai i ke kaomi
• Ke kū nei i ka hana hou a hana paha, a i ʻole ke hoʻololi ʻana i ke ala o kāna hana
• Ke hāpai nei i ka wahi i pā ma luna o ka pae o ka puʻuwai e hoʻoliʻiliʻi i ka pehu

Me ka hōʻoia koke a me ka mālama ʻana, maikaʻi loa ka nānā aku a ola nā mākala a me nā aʻa i loko o ka lumi. Eia nō naʻe, ua hoʻoholo ʻia ka nānā holoʻokoʻa e ka ʻeha i alakaʻi ʻia i ka maʻi.

Inā lohi ka ʻike, hiki i ka ʻeha mau loa a me ka nalo ʻana o ka hana maʻa i ka hopena. ʻOi aku ka maʻamau kēia ke ʻike ʻole ka mea ʻeha a i ʻole sedated nui a ʻaʻole hiki ke hoʻopiʻi i ka ʻeha. Hiki ke hana ʻia kahi ʻeha nerve paʻa ma hope o ka liʻiliʻi ma mua o 12 a 24 mau hola o ke kaomi. ʻOi aku ka wikiwiki o ka hōʻeha ʻana i nā mākala.

Hoʻopili nā pilikia me ka hōʻeha mau i nā aʻalolo a me nā mākala e hiki ke hōʻino loa i ka hana. Kapa ʻia kēia ʻo Volkmann ischemic contracture inā kū i ka forearm.

I nā hihia ʻoi loa, koi ʻia paha ka ʻokiʻoki.

Kāhea koke aku i kāu mea hāʻawi inā loaʻa ʻoe i kahi ʻeha a loaʻa i ka pehu nui a i ʻole ʻeha e hoʻomaikaʻi ʻole me nā lāʻau ʻeha.

ʻAʻohe paha ala e pale ai i kēia ʻano. ʻO ka hōʻoia mua a me ka mālama ʻana e kōkua i ka pale ʻana i nā pilikia he nui. I kekahi manawa, hana ʻia nā fasciotomies ma mua e hōʻalo i ka maʻi maʻi maʻi maʻi i loaʻa i ka hihia o ka ʻehaʻeha nui.

Inā komo ʻoe i kahi mea hoʻolei, ʻike i kāu mea lawelawe a i ʻole hele i ka lumi pilikia inā piʻi ka ʻeha ma lalo o ka cast, ʻoiai ma hope o kou lawe ʻana i nā lāʻau ʻeha a hānai i kahi.

Uha - maʻi maʻi maʻi; ʻOki kino - compart Syndrome; Trauma - maʻi maʻi maʻi; ʻEha mākala - maʻi maʻi maʻi; Fasciotomy - maʻi maʻi maʻi

• Hoʻokiʻoki wāwae - hoʻokuʻu
• ʻO ka ʻoki wāwae a me ka wāwae paha - hoʻololi i ka lole

• Anatomia lima

ʻO Jobe MT. ʻO Comprehensive Syndrome a me Volkmann ʻaelike. I: Azar FM, Beaty JH, Canale ST, hua. ʻO Campbell's Operative Orthopedics. 13th ed. Piladelapia, PA: Elsevier; 2017: chap 74.

ʻO Modrall JG. ʻO ka Syndrome Syndrome a me kāna hoʻokele. I: Sidawy AN, Perler BA, hua. ʻO Rutherford's Vascular and Endovascular Surgery. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 102.

Stevanovic MV, Sharpe F. Comprehensive maʻi a me Volkmann ischemic ʻaelike. I: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS, hua. ʻO keʻoki lima lima ʻōmaʻomaʻo o Green. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 51.