ʻO ka Scaphoid Fracture: He aha kāu e ʻike ai e pili ana i kahi lima i haki

Anter

• He aha ka scaphoid?
• He aha ka hana i ka haʻi scaphoid?
• He aha ke kumu o ka haʻi scaphoid?
• Pehea e ʻike ʻia ai ka haʻi scaphoid?
• He aha ka lāʻau no ka haʻi scaphoid?
• Hoʻolei
• ʻOki kino
• Hoʻoulu ulu iwi
• He aha ke kuanaʻike no ka poʻe i loaʻa ka haʻi scaphoid?

He aha ka scaphoid?

ʻO ka iwi scaphoid kekahi o nā iwi karpal liʻiliʻi he ʻewalu i kou lima. Aia ia ma ka ʻaoʻao manamana nui o kou pulimaʻu ma lalo pono o ka radius, kekahi o nā iwi nui ʻelua i kou lima. Pili ia i ka neʻe a hoʻokūpaʻa i kou lima. ʻO ka inoa kahiko nona ka iwi navicular.

Hiki iā ʻoe ke loaʻa i kou iwi scaphoid ma ke kau ʻana i kou manamana nui i luna ke nānā aku ʻoe i ka hope o kou lima. ʻO ka indentation triangular i hoʻokumu ʻia e nā lou o kou manamana nui ua kapa ʻia ʻo "snombox anatomic." Aia kāu scaphoid ma lalo o kēia huinakolu.

He aha ka hana i ka haʻi scaphoid?

ʻO ke kūlana o ka scaphoid ma ka ʻaoʻao o kou lima a me ka nui nui e maʻalahi ai i ka ʻeha a me ka haki. ʻO ka ʻoiaʻiʻo, ʻo ia ka iwi carpal pinepine haki, e helu ana e pili ana i nā haki carpal.

ʻEkolu ʻāpana o ka scaphoid:

• kia pili: ka hopena kokoke loa i kou manamana nui
• pūhaka: ka piko waena o ka iwi e waiho ana ma lalo o ka snuffbox anatomic
• kia distal: ka hopena kokoke loa i kou forearm

Ma kahi o 80 pākēneka o nā haki scaphoid e hana ana ma ka pūhaka, 20 pākēneka ma ka poli kokoke, a he 10 pākēneka ma ka kia mamao.

Hoʻopili ke kahua o ka haki pehea e ola ai. ʻO ka haki i ka pou mamao a me ka pūhaka e hoʻōla wikiwiki no ka mea he lako koko maikaʻi ko lākou.

ʻO ka hapa nui o ka pou proximal he lako koko maikaʻi ʻole e ʻoki maʻalahi ʻia i ka haki. Me ka ʻole o ke koko, make ka iwi, ka mea i kapa ʻia ʻo ka neural avros. ʻO nā haki i ka poli kokoke ʻaʻole e hoʻōla maikaʻi a wikiwiki paha.

He aha ke kumu o ka haʻi scaphoid?

Kū ʻo FOOSH no ka "hāʻule ma luna o kahi lima kīkoʻo aku." ʻO ia ka mīkini ma hope o ka haki o nā lālā luna.

Ke ʻike ʻoe e hāʻule ana ʻoe, hana ʻiʻo ʻoe i ke kuʻi ʻana i kou lima a hoʻolōʻihi i kou lima e hoʻāʻo e haki i ka hāʻule me kou lima.

Pale kēia i kou alo, poʻo, a hoʻi i hope o ka ʻeha, akā ʻo ia hoʻi kou lima a me kou lima e lawe i ka ikaika piha o ka hopena. Ke kumu o ka piʻo ʻana o kou pūlima ma mua o ka mea e hele ai, e haki paha.

ʻO ke kihi o kou pūlima ke kuʻi ia i ka honua e pili ana i kahi e haki ai. ʻO ka lōʻihi o ke kūlou o kou lima, ʻo ka nui o ka haki o kou iwi iwi. Ke hoʻemi iki ʻia kou lima, lawe ka iwi radius i ka ikaika o ka hopena e hopena ai i ka haʻi radius distal (Colles 'or Smith haki).

Hoʻopili pinepine kahi ʻeha FOOSH i ka scaphoid no ka mea ʻo ia ka pilina nui ma waena o kou lima a me ka forearm. Ke hāʻule ʻoe i kou lima, nā ikaika āpau i hana ʻia ke kuʻi kou lima i ka honua e hele i kou forearm ma o ka scaphoid. Hoʻokau ka ikaika i ka nui o ke koʻikoʻi ma luna o kēia iwi liʻiliʻi, hiki ke hana i ka haki.

Loaʻa nā ʻeha FOOSH i nā haʻuki he nui, ʻo ia hoʻi nā mea e like me ka skiing, skating, a me ka snowboarding. ʻO ke kau ʻana i kahi pale lima lima he ala maʻalahi ia e pale ai i kēia mau ʻeha.

Ke komo nei i nā haʻuki e hoʻokūkū pinepine nei i kou iwi iwi, e like me ka pana pana ʻana a i ʻole nā ​​gymnastics, hiki ke hana i ka haʻi scaphoid. ʻO nā kumu ʻē aʻe e hoʻopili pololei i kāu palima a me nā kaʻa kaʻa kaʻa.

Pehea e ʻike ʻia ai ka haʻi scaphoid?

ʻAʻole maopopo pinepine nā haʻi Scaphoid a hiki i ka paʻakikī ke kuhi.

ʻO ka hōʻailona maʻamau ka ʻeha a me ke aloha ma luna o ka snuffbox anatomic. Mālie pinepine kaʻeha. E māhuahua paha ia me ka ʻūlū ʻana a me ka hopu ʻana.

ʻAʻohe pinepine ʻike ʻia ka deformity a i ʻole ka pehu ʻana, no laila ʻaʻole ia e nānā haki. E hoʻomaikaʻi paha ka ʻeha i nā lā a me nā pule ma hope o ka haki. No kēia mau kumu, manaʻo ka poʻe he nui wale ka pulinaʻi sprained a hoʻopaneʻe i ka loaʻa ʻana o ka lāʻau kūpono.

Ke mālama ʻole ʻia me ka immobilization koke, hiki ʻole i ka haʻi ke hoʻōla. Kapa ʻia kēia nonunion, a hiki ke kumu i nā pilikia lōʻihi lōʻihi. No nā ʻāpana scaphoid nonunion. Hiki i nā necrosis ākea ke kumu i ka nonunion.

ʻO nā kukuna X ka mea hana diagnostical mua. Eia nō naʻe, ʻaʻole i ʻike ʻia nā haki scaphoid ma kahi X-ray ma hope pono o ka ʻeha.

Inā ʻike ʻole ʻia kahi haki, akā manaʻo mau kāu kauka he hoʻokahi kāu, e hoʻoneʻe ʻia kou pūlima lima me ka manamana lima a hiki i ka hana hou ʻana o nā lālani X 10 a 14 mau lā ma hope. I kēlā manawa, ua hoʻomaka kahi haʻihaʻi e hoʻōla a ʻike nui ʻia.

Inā ʻike kāu kauka i ka haki akā ʻaʻole hiki ke haʻi inā pololei pololei nā iwi a pono paha i ka ʻike hou aku, hiki i kahi CT scan a i ʻole MRI ke kōkua i kāu kauka e hoʻoholo i ka lapaʻau kūpono. Hiki ke hoʻohana ʻia kahi scan iwi akā ʻaʻole ia e loaʻa ākea e like me nā hoʻokolohua ʻē aʻe.

He aha ka lāʻau no ka haʻi scaphoid?

Pili ka lāʻau āu e loaʻa ai:

• kaulike o nā iwi haʻi: inā ua neʻe ka iwi i waho o ke kūlana (haki i haʻalele ʻia) a i ʻole kaulike ʻia (nondisplaced bali)
• manawa ma waena o ka ʻeha a me ka mālama ʻana: ʻo ka lōʻihi o ka manawa, ʻo ka nonunion ka nui
• wahi nahae: ʻoi aku ka pinepine o ka nonunion me nā haʻihaʻi o ke kia kokoke

Hoʻolei

ʻO ka haki nondisplaced i ka pūhaka a i ʻole ka pou distal o kāu scaphoid e mālama koke ʻia ma hope o ka hōʻeha ʻana e hiki ke mālama ʻia e ka immobilizing ʻana i kou pulima me ka mea hoʻolei no ʻeono a 12 mau pule. I ka manawa e hōʻike ai kahi X-ray i ka haʻi ua hoʻōla ʻia, hiki ke hoʻoneʻe ʻia ka mea hoʻolei.

ʻOki kino

Nā ʻāpana i loko o ka pou proximal o ka scaphoid, hoʻoneʻe ʻia, a mālama ʻole ʻia ma hope koke iho o ka ʻeha e koi ai i ka hoʻoponopono. ʻO ka pahuhopu e hoʻihoʻi i nā iwi i ke kaulike a hoʻokūpaʻa iā lākou i hiki iā lākou ke hoʻōla pono.

Ma hope o ke kahakaha ʻana, ma loko o ka poʻe hana maʻamau ʻoe no ʻewalu a 12 mau pule. Lawe ʻia ka hoʻolei ke hōʻike koke kahi X-ray i ka haʻi ua hoʻōla ʻia.

No nā haʻihaʻi nonunion, koi ʻia ke ʻōpala me ka hoʻopili ʻana i ka iwi ma kahi kahi manawa lōʻihi ma waena o ka haki a me ka nonunion, ʻaʻole pili pono nā iwi iwi naha, a ʻilihune paha ke koko.

Ke pōkole ka manawa ma waena o ka haki a me ka nonunion, kokoke pū ka iwi iwi haʻi, a maikaʻi ke kahe o ke koko, hoʻohana ʻia paha kahi stimulator iwi.

Hoʻoulu ulu iwi

Hiki i ka hoʻoulu ʻana i ka iwi ka hoʻopili ʻana o ka lāʻau. Hiki i nā hāmeʻa lole ke hoʻoulu i ka ulu a me ka hoʻōla ʻana ma o ka noi ʻana i kekahi ultrasound a i ʻole ka pae haʻahaʻa o ka uila i ka iwi ʻeha. I nā kūlana kūpono, kōkua paha kēia mau koho.

Inā pono ʻoe i kahi ʻoki a ʻaʻole paha, pono paha ʻoe i ka lāʻau a me ka hana ʻoihana no ʻelua a ʻekolu paha mau mahina ma hope o ka hemo ʻana o ka mea hoʻolei e loaʻa hou ka ikaika a me ka neʻe i kou pulima a me nā mākala a puni ia.

He aha ke kuanaʻike no ka poʻe i loaʻa ka haʻi scaphoid?

Ke mālama koke ʻole ʻia ka haʻi scaphoid, ʻaʻole ia e hoʻōla pono. ʻO nā pilikia i hiki ke hoʻopili ʻia:

• lohi ke uniona: ʻaʻole i hoʻōla loa ka haki ma hope o nā malama ʻehā
• nonunion: aole hoola iki ka naha

Hiki i kēia ke alakaʻi i ka instability o ka hui pūlima. I nā makahiki ma hope aku, hoʻomohala ka hui i ka osteoarthritis.

ʻO nā pilikia kūpono ʻē aʻe e pili pū me:

• nalo o ka hoʻoneʻe lima
• nalo o ka hana, e like me ka hōʻemi ʻana i ka ikaika paʻa
• avrosic necrosis, a hiki i ka 50 pākēneka o nā haki i ke kia kokoke
• osteoarthritis, keu hoʻi inā nonunion a i ʻole avrosia necrosis i hana ʻia

Maikaʻi loa ka hopena inā ʻike ʻoe i kāu kauka ma hope koke o ka haki, no laila ke neʻe ʻole ʻia kou lima. ʻAneʻane e ʻike ka poʻe āpau i ka ʻoʻoleʻa o ka lima ma hope o ka haʻi o ka scaphoid, akā e hoʻi hou ka hapa nui o ka poʻe i ka neʻe a me ka ikaika i loaʻa i ko lākou pulima lima ma mua o ka haki.