Hoʻohui hou ʻana i nā helu
ʻO ka hoʻopili hou ʻana i nā huahelu ke kahakaha e hoʻopili hou i nā manamana a i ʻole nā manamana wāwae i ʻoki ʻia (ʻoki ʻia).
Hana ʻia ke kaha ma ke ʻano aʻe:
- Hāʻawi ʻia ka anesthesia laulā. ʻO kēia ka mea e hiamoe ke kanaka a hiki ʻole ke ʻeha. A e hāʻawi ʻia i ka anesthesia āpana (spinal and epidural) e hoʻopōpō ai i ka lima a i ʻole ka wāwae.
- Hōʻalo ke kaukoki i nāʻiʻo i hōʻino ʻia.
- ʻOki ʻia nā wēlau o nā iwi.
- Hoʻonoho ke kaukōkō i ka manamana lima a i ʻole ka manamana wāwae (i kapa ʻia ka helu) ma kahi. Hoʻohui hou ʻia nā iwi me nā kaula a i ʻole ka pā a me nā ʻāpana.
- Hoʻoponopono i nā Tendons, ukali ʻia e nā aʻalolo a me nā kīʻaha koko. ʻO ka hoʻomaikaʻi ʻana i ke aʻalolo a me nā kīʻaha koko ka mea nui i ka kūleʻa o ke kaʻina hana. Inā pono, hoʻohana ʻia nā mākia me nā aʻalolo a me nā kīʻaha koko mai kekahi ʻāpana o ke kino.
- Hoʻopili ʻia ka ʻeha me nā humuhumu a hoʻopaʻa ʻia.
Hana ʻia ke kīʻaha ke hoʻopau ʻia nā manamana lima a me nā manamana wāwae a aia nō i kahi ʻano e ʻae ai i ke ola hou ʻana.
Nā pōpilikia no ka anesthesia a me ke kahakaha ma nā ʻano āpau:
- Nā hopena i nā lāʻau, nā pilikia hanu
- Kahe ʻana o ke kahe, ke koko, maʻi
ʻO nā pōʻino o kēia ʻoki ʻana:
- Ka make ʻana o ke kinō i kanu hou ʻia
- Hoemi i ka hana nerve a i ʻole neʻe i ka huahelu i kuhi ʻia
- Ka nalowale ʻana o ka naʻau i ke kiko i hoʻoulu hou ʻia
- ʻOʻoleʻa o nā helu
- ʻEha e mau ana ma hope o ke kaha
- Koi hou ʻia nā ʻoki ʻana no ka huahelu i kanu hou ʻia
Mālama nui ʻia ʻoiai ʻoe ma ka haukapila e hōʻoia i ke kahe pono o ke koko i ka ʻaoʻao i hoʻopili hou ʻia. E hāpai ʻia ka lima a i ʻole ka wāwae. Hoʻomaʻamaʻa paha i ka lumi e hōʻoia i ke kahe o ke koko kūpono. E nānā pinepine ʻia ka ʻāpana pili hou e ʻike pono he kahe maikaʻi ke kahe.
Ma hope o kou hoʻokuʻu ʻia ʻana mai ka haukapila, pono paha ʻoe e komo i kahi mea hoʻolei e pale ai i ka manamana lima a i ʻole ka manamana wāwae. Kauoha paha ke kauka lāʻau hōʻoki koko e pale aku i ke koko.
ʻO ka mālama kūpono o ka ʻāpana i ʻoki ʻia a i ʻole nā ʻāpana he mea nui ia i ka replantation kūleʻa. Ma lalo o nā kūlana kūpono, aia kahi manawa kūpono e hiki ai i ke kīpoki ke hoʻihoʻi i ka hoʻohana ʻana o ka manamana lima a i ʻole ka manamana wāwae. Pono ʻoe i nā kipa ukali me kāu kauka olakino, nāna e hoʻomau i ka nānā ʻana i ke kahe o ke koko ma kahi o ka ʻoki kino.
ʻOi aku ka moho o nā keiki no ke ʻoki hou ʻana ma muli o ko lākou hiki ke hoʻōla a me ka hoʻoulu hou ʻana i nā mea.
Hana maikaʻi ʻia ka hoʻoulu ʻana o kahi ʻāpana ʻoki ʻia i loko o 6 mau hola ma hope o ka ʻeha. Akā hiki ke kūleʻa ka replantation inā anuanu ʻia ka ʻoki i ʻoki ʻia a hiki i 24 mau hola ma hope o ka ʻeha.
ʻAʻole loaʻa iā ʻoe ka maʻalahi like ma ka manamana lima a me ka manamana wāwae ma hope o ke kahakaha ʻana. Hiki ke hoʻomau i nā loli ʻeha a me ka naʻau.
Revascularization o nā hua helu i ʻoki ʻia; Hoʻohui hou o nā manamana lima
- Manamana komo lima
- Hoʻohui hou ʻia ʻana o nā helu - moʻo
ʻO Higgins JP. Mea kanu hou. 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 42.
Klausmeyer MA, Jupiter JB. Mea kanu hou. I: Browner BD, Jupiter JB, Krettek C, Anderson PA, hua. Trauma skeletal: ʻepekema kumu, ka hoʻokele, a me ke kūkulu hou ʻana. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2020: chap 51.
ʻO Rose E. Hoʻokele o nā ʻoki. I: Roberts JR, Custalow CB, Thomsen TW, eds. ʻO Roberts a me Hedges 'Nā Kauka Lapaʻau i ka Medicine Emergency a me ka Care Acute. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 47.