Raws li kev txheeb xyuas kev puas tsuaj, txhais tes puas feem ntau. Qhov feem ntau sprain yog lub dab teg. Nws tshwm sim thaum lub caij tsaws thaum ntog ntawm ib sab caj npab nrog ntau flexion lossis overextension ntawm tes.
Feem ntau qhov tshwm sim no tshwm sim hauv kev sib cuag, lub zog lossis kev ua kis las hnyav - hockey, ncaws pob, ntaus pob, sib tw, nqa lub barbell, gymnastics, thiab lwm yam. Sprain ntawm sab xis pob qij txha tshwm sim ntau dua li sab laug, thiab piav qhia los ntawm qhov tseeb tias 85% ntawm cov neeg yog sab xis.
Qhov tseem ceeb ntawm kev raug mob
Ib pob txha yog kev puas tsuaj rau cov pob ntawm cov ntaub so ntswg uas muab kev sib txuas ntawm cov pob txha ntawm cov pob qij txha. Nws tshwm sim thaum lub load ntau dhau, thaum lub zog tensile ntawm ligament tshaj nws lub cev lub zog. Raws li ICD-10, dab teg sprain muaj code S63.
Cov ntaub so ntswg ntawm cov ligaments feem ntau tseem nyob ruaj khov, tab sis rau qee lub sijhawm lawv tsis tuaj yeem ua lawv txoj haujlwm. tau puas lawmnws puas tuaj yeem lossis ob peb pob khoom tib lub sijhawm.
me ntsis ntawm lub cev thiab lub cev
Cov ntaub so ntswg muaj collagen thiab elastin fibers uas tau teem rau tib lub sijhawm. Collagen yog lub luag haujlwm rau lawv lub zog, thiab elastin rau elasticity. Qhov dav ntawm ligament nyob rau hauv txoj kab uas hla, lub zog nws yog, thiab lub peev xwm los tiv thaiv deformation yog txiav txim los ntawm nws ntev. Nws hloov tawm tias qhov nqaim thiab luv ligaments ntawm tes tsuas yog qhov yooj yim tshaj plaws.
Sab dab teg pob txha tshwm sim ntau zaus hauv cov neeg sab laug, uas muaj li 15% ntawm cov pejxeem. Lub cev ntawm lub dab teg txawv ntawm lwm cov pob qij txha:
- Kev sib koom ua ke yog qhov nyuaj vim nws muaj ntau tshaj 2 qhov chaw.
- Muaj ib qho ntxiv cartilaginous daim duab peb sab hauv cov tshuaj ntsiav sib koom ua ke rau kev sib koom ua ke.
- Cov duab ntawm qhov sib koom ua ke yog elliptical (ib qho chaw yog concave, lwm qhov yog convex). Qhov no muab nws nrog 2 axes - kab rov tav thiab ntsug, nrog rau lub peev xwm tig.
Ntau tshaj li ib feem peb ntawm cov pob txha ntawm tes (8 tawm ntawm 27) yog concentrated hauv lub dab teg thiab txuas nrog ligaments. Cov ligaments ntawm lub dab teg muaj zog thiab elastic, tab sis qhov no tsis txiav txim siab lawv lub peev xwm los tiv thaiv cov loads tas li. Muaj 6 ligaments, lateral (collateral) ligaments raug mob ntau dua li lwm tus - radial thiab ulnar.
Cov qauv zoo li no muab kev hloov maj mam, tab sis tib yam xwm txheej ua rau muaj kev raug mob siab.
Kev puas tsuaj
Dab teg sprain raws li ICD-10 yog nyob rau hauv chav kawmS3-S63.6 - ruptures thiab sprains ntawm ligaments ntawm ntau qhov chaw ntawm tes. Qhov no suav nrog txhua qhov kev raug mob ntawm lub dab teg.
Qhov feem ntau ua rau lub dab teg sprains:
- tsaws ntawm caj npab thaum ntog lossis tsoo nyuaj;
- dab teg poob;
- dislocations;
- tawg;
- ntse txav;
- nqa qhov hnyav nrog snatch;
- nqa qhov hnyav nrog caj npab tawm;
- tuav lub cev hnyav nrog txhais tes yam tsis muaj kev txhawb nqa.
Tsis muaj leej twg tiv thaiv los ntawm cov xwm txheej zoo li no: tsis yog kis las lossis tib neeg.
Raws li ICD, kev sib tsoo ntawm lub dab teg tau muab tus lej S63.5. Cov kab lus no suav nrog cov kev raug mob hauv qab no - sprain thiab overstrain ntawm lub capsular-ligamentous apparatus nyob rau theem ntawm carpal, dab teg thiab ligaments.
Tseem muaj qhov pheej hmoo rau qee ntu ntawm cov pej xeem:
- hypodynamia thiab hypokinesia;
- hnub nyoog laus, thaum ligament cov ntaub so ntswg tawg;
- leeg tsis sib haum xeeb los ntawm yug;
- mob caj dab thiab mob caj dab;
- cov leeg nqaij tsis zoo thiab tsis muaj kev cob qhia vim lub cev tsis muaj zog.
Qhov no ua rau qhov ncab ntawm ligaments, vim tias nyob rau hauv cov xwm txheej zoo li no lawv ua tsis zoo thiab nyias.
Dab teg sprain (ICD-10 code - S63) suav nrog cov pob txha saum toj no, overstrain ntawm ligamentous apparatus, dislocations ntawm tes thiab dab teg.
Kuj, ligaments tuaj yeem ncab thaum:
- kab mob ntawm pob qij txha;
- kev raug mob hnyav;
- thaum cov pob txha tawg tawg nyob hauvpob txha;
- dai ntawm kab kab rov tav yam tsis muaj kev txhawb nqa ko taw.
Symptomatic manifestations
Cov tsos mob ntawm pob qij txha thiab kev kho mob sib cuam tshuam. Nrog rau qhov mob hnyav heev, cov leeg raug torn, thiab lub suab nrov nrov tau hnov. Kev sib koom ua ke hauv cov xwm txheej zoo li no tsis txwv los ntawm txhua yam thiab ua dangling. Muaj qhov mob ntse ntse, liab ntawm daim tawv nqaij, bruise (hematoma) sai sai tshwm sim ntawm qhov chaw raug mob, o tuaj. Ua tiav immobility ntawm tes teev nyob rau hauv.
Raws li ICD-10, dab teg sprains kuj suav nrog code S63.3:
- mob rupture ntawm ligament ntawm lub dab teg thiab metacarpus;
- lateral ligament ntawm kev sib koom ua ke;
- palmar ligament.
Ib leeg raug mob mus txog 3 theem, tab sis qhov mob tshwm sim hauv txhua qhov.
- Thawj theem, yooj yim. Feem ntau tsis muaj cov tsos mob tshwm sim, tus neeg mob ua lub neej zoo li qub. Lub dab teg pob txha nyob rau theem 1 thiab 2 tuaj yeem lossis tsis muaj tsos mob. Qhov mob me me. Qhov chaw puas tsuaj tsawg tsawg.
- Second degree, nruab nrab. Kev tawg ntawm fibers yog ib feem. Qhov mob hnyav heev, muaj inflammatory edema. Kev txav mus los ntawm kev sib koom ua ke txo qis, tus neeg mus ntsib kws kho mob.
- Thib peb, hnyav. Cov tsos mob ntawm sprain ntawm lub dab teg yog pronounced sharply, brightly. Ntawm no yog ib tug rupture ntawm tag nrho ligament nrog ib tug yam ntxwv crunch. Qhov mob yog unbearable, bruising thiab o tam sim ntawd tshwm sim. Yog tias tsis muaj kev pab, cov ntshav ntws mus rau hauv lub hnab sib koom ua ke thiab tsim ib lub hygroma ntawm qhov sib koom ua ke. Nws tshwm sim tom qab 1-2 teevua npaws, uas qhia tau hais tias qhov pib ntawm cov tshuaj tiv thaiv inflammatory. Torn ligaments tsis tuav qhov sib koom ua ke, thiab nws dhau los ua mobile.
Lub dab teg pob txha yog qhov yooj yim heev kom paub qhov txawv ntawm qhov raug mob hnyav dua: nws tsis yog qhov raug rau nws kom protrude thiab deform articular thiab pob txha fragments raws li nyob rau hauv ib tug dislocation los yog puas. Thiab ib qho ntxiv: tsis zoo li cov pob txha ntawm tes, thaum ncab, kev txav mus los yog pom ntawm qhov chaw ntawm qhov txhab, nrog qhov muaj zog ntxiv.
Kev pab ib zaug
Algorithm of actions:
- tshem cov hniav nyiaj hniav kub ntawm txhuam, yog tias muaj, thiab tshem tawm lub tes tsho ntawm lub tsho;
- kom tiav cov ceg ceg;
- exclude any load;
- immobilize tes;
- pab tau khaub thuas;
- nyob rau hauv cov ntaub ntawv ntawm dislocation thiab rupture ntawm ligaments, thov ib tug splint;
- muab analgesic;
- thauj mus rau chav xwm txheej ceev.
Cov dej khov qhwv hauv cov ntaub qhwv tuaj yeem ua qhov txias txias, nws lub sijhawm thov yog 30 feeb, tom qab ib nrab teev so koj tuaj yeem rov ua dua. Cov dej khov yuav txwv cov hlab ntsha, txo qhov mob thiab txo qhov o. Ntawm cov tshuaj loog, Paracetamol, Analgin, Ibuprofen tuaj yeem siv.
Cov ntaub qhwv nruj yog siv nrog cov ntaub qhwv elastic lossis cov ntaub qhwv tsis tu ncua. Immobilization ntawm txhais tes yuav zoo dua nqa tawm tsis nyob rau hauv qhov hnyav, tab sis nyob rau hauv ib tug tiaj tus.
Tsis tas li ntawd, txhawm rau txo qhov o thiab stagnation ntawm cov ntshav ntawm qhov chaw raug mob, nws yog qhov zoo dua los khaws ib txhais caj npab kom siab dua qib ntawm lub cev. Nws zoo duaua qhov no ntawm cov txaj tshwj xeeb hauv chav ua haujlwm raug mob. Ntxiv mus, kev kho mob sab nraud tsuas yog ua tau nrog 1 degree. Thaum cov ligaments raug torn, kho yog nqa tawm hauv tsev kho mob.
ntsuas ntsuas
X-ray, ultrasound thiab MRI yog siv rau kev kuaj mob. Nrog MRI, cov duab ntawm cov ntaub so ntswg raug coj los ntawm txheej, los ntawm cov ces kaum sib txawv. Txoj kev no tseem ceeb heev rau cov menyuam yaus.
Tus kws paub txog kev puas siab puas ntsws tuaj yeem kuaj xyuas tam sim ntawd, los ntawm kev kuaj xyuas, nug thiab palpation. Thiab tsuas yog yog tias xav tias pob txha tawg, yuav tsum muaj kev tshawb fawb ntsuas. Ultrasound feem ntau yog siv los ntsuas qhov mob ntawm ligaments ua ntej thiab tom qab kho.
X-ray tseem muaj npe nrov tshaj plaws thiab siv tau. Tus kws kho mob tuaj yeem ntseeg siab thiab tsis tos ntev los txiav txim seb hom kev raug mob - pob txha lossis pob txha ntawm daim duab.
Cov tsos mob ntawm kev raug mob ntawm x-ray:
- Thaum bruised lossis sprained, tsis muaj kev hloov pauv ntawm x-ray.
- Nyob rau hauv dislocations, articular nto tsis sib xws.
- Thaum muaj pob txha, kab tawg yog pom, tej zaum yuav muaj cov pob txha tawg.
Yuav muaj teeb meem ntawm pob txha
Sprain tuaj yeem nyuaj los ntawm cov kab mob hauv qab no:
- ntev tsis zoo vim tsis raug lossis tsis kho;
- hloov mus rau mob caj dab lossis mob caj dab;
- kev tsis ruaj khov thiab tsis muaj zog;
- stiffness;
- predisposition rau rov sprains;
- txo qis kev muaj peev xwm kis las hauv cheeb tsam uas txhais tes koom nrog.
Txoj Cai Kev Kho Mob
Kev kho mob pob tes taw tuaj yeem ua kom zoo, phais, tsis yog ib txwm muaj.
Txoj Kev Tiv Thaiv:
- tshuaj;
- tshuaj pleev ib ce;
- kho lub cev;
- massage;
- kev tawm dag zog.
Yuav tsum muaj lub sijhawm rov qab los rau kev kho mob.
Drug therapy
kho mob yog tsim nyog nyob rau txhua theem ntawm kev raug mob. Ua ntej tshaj plaws, NSAIDs (anti-inflammatory non-steroids) thiab analgesics raug sau tseg: Diclofenac, Indomethacin, Voltaren, Ketonal, Nise, Ortofen, thiab lwm yam. Lawv yog siv rau hauv cov ntsiav tshuaj thiab txhaj tshuaj.
Cov tshuaj pleev tshuaj tiv thaiv kab mob kuj tau sau tseg: "Fastum Gel", "Voltaren Gel", "Nise Gel", thiab lwm yam. Cov tshuaj pleev kom o thiab mob ntawm qhov chaw raug mob, pab kom sai tshaj plaws ntawm hematomas.
txhawm rau ntxiv dag zog rau kev sib koom tes, nws yog qhov zoo los noj cov tshuaj calcium thiab multivitamin complexes. Thawj 5 hnub tom qab raug mob, koj yuav tsum tau noj tshuaj tiv thaiv kab mob.
Thaum muaj qhov tsis sib xws, ib qho splint yog siv thiab hnav tsawg kawg yog ob lub lis piam. Nrog rau theem nrab ntawm kev raug mob, tom qab 2 lub lis piam, cov txheej txheem ntawm kev rov ua haujlwm ntawm cov leeg mob pib. Niaj hnub no, lawv tsiv mus rau kev ua yeeb yam tshwj xeeb. Qhov no ua kom cov txheej txheem rov qab los ntawm lub dab teg. Nws yog ib qho tseem ceeb uas cuam tshuam ligamentstxhob strain.
Physiotherapy
Cov txheej txheem hauv qab no feem ntau tau sau tseg:
- phono thiab electrophoresis;
- kev kho paraffin thiab ozokerite;
- UHF kev kho mob;
- laser thiab magnetotherapy;
- balneotherapy.
Physiotherapy tshem tawm cov tsos mob ntawm ncab, rov ua kom lub cev muaj zog ntawm tes. Nyob rau tib lub sijhawm, cov ntshav ntws normalizes sai dua, spasms ntawm cov leeg ntawm lub dab teg sib koom ploj mus, cov ntaub so ntswg zoo dua nrog cov pa oxygen, thiab cov metabolism rov qab los.
Rehabilitation exercises
Kev tawm dag zog yuav rov ua kom cov ntiv tes txav mus. Ntawm lawv:
- piano ntiv tes txav;
- voj voog tig nrog txhuam;
- tes txav mus rau sab;
- txhawm rau txhim kho kev txawj tsav tsheb zoo, khaws cov khoom me me los ntawm qhov chaw (cov khoom sib tw, hlaws, nyees khawm) yog qhia;
- dov lub pob ntawm lub rooj nrog koj xib teg.
Lub nra nce zuj zus. Nws yog qhov zoo dua rau kev tawm dag zog raws li kev saib xyuas ntawm tus kws tshaj lij.
Koj tuaj yeem muab kev kho mob qoj ib ce nrog zaws. Nws tseem zoo dua los rub cov tshuaj pleev kom zoo thaum lub sijhawm zaws kom txhim kho cov nyhuv kho.
Massage yuav pab txhawb kom rov kho tau sai tshaj plaws. Nrog rau txoj hauv kev zoo, kev sib koom tes sib koom ua ke tau rov qab ua tiav.
kho mob phais
Nws yog ua tiav nrog kev tawg tag ntawm ligaments. Thaum lub sij hawm ua hauj lwm, cov ntaub so ntswg puas yog sutured, thiab nws functionality yog tag nrho rov qab. Tom qab ntawd ib lub seam yog thov, thiab caj npab yog tsau nrog plaster. Tom qab tshem tawm kujsau ntawv kho mob hauv zos nrog tshuaj pleev thiab kho lub cev.
Yog tias muaj kev hem thawj ntawm kev kis tus kabmob thib ob, kev kho tshuaj tua kab mob tau muab tshuaj ntev txog 10 hnub.
Dab tsi yog qhov kev kwv yees
Nrog rau kev pabcuam raws sijhawm, kev kho mob txaus thiab ua raws li cov ntawv kho mob, lub sijhawm kho tau txo qis, thiab kev ua haujlwm ntawm tes tuaj yeem rov qab los. Yuav tsis muaj teeb meem rau qhov no.
Thaum twg kuv tuaj yeem muab kuv txhais caj npab puv puv?
Loads tau tsuas yog thaum txhais tes kho tau tag nrho. Txwv tsis pub, qhov xwm txheej tsuas yog hnyav dua.
Yog li, kev thauj khoom tuaj yeem ua tau yog:
- yog tias tsis muaj mob ntawm caj npab thaum so thiab nrog me ntsis load;
- kev xav ntawm lub zog ntawm tes raug mob tsis txawv ntawm cov neeg noj qab haus huv;
- muaj kev tso cai los ntawm tus kws kho mob tuaj koom ua haujlwm siv txhuam.
Kev Tiv Thaiv
Tau kawg, tsis muaj leej twg tiv thaiv los ntawm kev poob qis, thiab nws tsis tuaj yeem tiv thaiv caj npab. 85% ntawm sprains tshwm sim hauv lub neej txhua hnub. Tab sis tseem muaj peev xwm ua tau qee yam kev ceev faj. Cov no suav nrog kev ceev faj thiab ceev faj tuav tes raug mob rau 6 lub hlis tom ntej tom qab raug mob, kev siv cov braces, bandages, taping los tiv thaiv lub dab teg thaum lub sij hawm kev cob qhia kev ua kis las, thiab kev ua kom cov leeg ntawm lub dab teg nrog kev tawm dag zog.
Ua ntej txhua qhov kev tawm dag zog lub cev, ligaments thiab cov leeg ntawm tes yuav tsum tau kneaded thiab sov so nrog sov so. Koj yuav tsum zam qhov hnyav nce thiab noj kom raug.
