Kev raug mob ntawm sab ceg qis yog qhov muaj ntau heev. Feem ntau, cov neeg muaj hnub nyoog, lovers ntawm heels thiab wedges, ncaws pob thiab cov menyuam yaus dhau heev lawm raug kev txom nyem los ntawm lawv. Tsis tas li ntawd, theem kev raug mob nce rau lub caij ntuj no, thiab nws paub tseeb tias yog vim li cas - txawm tias tus neeg ceev faj tshaj plaws tuaj yeem poob thaum dej khov.
mob pob taws yuav ua rau nws tus kheej
Yog tias koj tsis ntswj ob txhais ceg, ligaments puas lawm, pob txha tuaj yeem tawm ntawm pob qij txha. Nws tsuas yog tsis yooj yim sua kom tsis txhob hnov qab txog qhov teeb meem no, pob taws raug mob nrog mob, uas ua rau muaj zog ntau dua tom qab kev tawm dag zog. Thaum raug mob, ligaments yuav ncab los yog torn. Qhov mob yuav nce thiab ua tsis taus pa. Cov o tuaj tshwm yuav luag tam sim ntawd, tuaj yeem ua rau hemorrhages.
Thaum lub sijhawm txav mus los, koj tuaj yeem hnov tus yam ntxwv nyem, kev txav ntawm ko taw tsis zoo. Qee zaum qhov dislocation hnyav heev uas nws tuaj yeem pom txawm tias tsis muaj x-ray, ko taw tuaj yeem tig sab hauv. Qhov raug mob yog kub.
Kev tsis sib haum ntawm pob taws ntawm qhov sib txawv ntawm qhov hnyav
Kev raug mob raug faib raws li qhov hnyav. Nrog rau qib me me ntawm qhov hnyav, tsuas yog cov ligaments puas lawm, qhov kev hloov ntawm cov pob txha tsis tshwm sim. Tab sis tus kws kho mob yuav tsum tsis txhob txiav txim siab zaum kawg kom txog rau thaum pob qij txha yog X-ray thiab nws yuav tsis pom tseeb tias ligaments thiab pob txha nyob rau hauv.
Nrog rau qhov mob hnyav, cov ligaments raug torn, mob hnyav thiab o hnyav. Cov tawv nqaij kub nyob ib ncig ntawm cov pob qij txha raug mob. Nrog rau qib hnyav, cov ligaments tau tawg tag, cov pob txha tawm ntawm qhov sib koom ua ke, thiab nyem tau hnov. Nws yog tsis yooj yim sua rau kauj ruam ntawm txhais ceg vim mob hnyav, o hnyav thiab hematoma ntawm qhov chaw raug mob.
Nws yuav tsum tau coj mus rau hauv tus account tias qhov kev pheej hmoo ntawm kev rov ua kom rov muaj zog nce ntau zaus, vim tias cov ligaments tau ncab thiab poob elasticity. Cov kauj ruam yuav tsum tau ua kom tsis txhob raug mob rov qab: hnav khau nrog pob taws uas kho kom zoo, tsis txhob hnav khau siab heels, thiab ua ib qho kev tawm dag zog tas li txhawm rau ncab cov leeg ntawm ko taw thiab cov nyuj. Qhov kev tiv thaiv no tsis tuaj yeem muab qhov lees paub tseeb tias yuav tsis muaj kev cuam tshuam ntxiv, tab sis tseem nws zoo dua tsis muaj dab tsi. Nyob rau hauv cov ntaub ntawv ntawm dislocation, koj yuav tsum tau tso ob txhais ceg ntawm lub loads thiab immobilize nws.
Yog muaj pob txha
Thaum muaj pob txha tshwm sim thaum raug mob, kev ncaj ncees ntawm cov pob txha ntawm sab ceg yog tawg. Nyob rau hauv cov ntaub ntawv no, nws yog ib qhov tsim nyog yuav tau ua osteosynthesis - qhov no yog ib tug phais kev pab cuam nyob rau hauv thiaj li yuav rov qab tau qhov kev ncaj ncees. Feem ntau muaj pob txha tshwm sim yog tias tus ceg tawv ntawm sab hauv. Qhov no ntawm txhais ceg raug kev txom nyem feem ntau, vim hais tias nws bears lub ntsiab load thiab nws muaj ib tug tshwj xeeb anatomical qauv. Xws li kev raug mobtuaj yeem coj tus neeg mob mus rau qhov tsis taus, tshwj xeeb tshaj yog cov neeg mob hnub nyoog. Thaum osteosynthesis ntawm pob taws ua tiav, nws yog ib qho tsim nyog los kho cov kev ua haujlwm ntawm cov pob qij txha, cov ntshav ncig thiab cov hlab ntsha innervation, pob txha.
Lub tsev nta
Cov qauv ntawm cov ceg qis yog qhov nyuaj, cov pob txha tuaj yeem tiv taus qhov hnyav ntawm tib neeg lub cev. Lub pob taws yog ib feem ntawm pob taws, nws muaj tibia thiab fibula, lawv ruaj ntseg kho cov talus ntawm txhua sab, uas ua ke ntau yam me me thiab ligaments. Ua tsaug rau nws, ib tug neeg tuaj yeem taug kev sai thiab nres sai sai. Nws yog qhov kev txhawb nqa tseem ceeb uas txuas cov pob qij txha thiab sab ceg. Qhov qis dua tso cai rau koj kom lub cev ncaj thiab txhawb nqa nws qhov hnyav. Lub pob qij txha, zoo li pob khawm, txuas tag nrho cov pob txha pob txha. Qhov tshwj xeeb ntu no txuas cov pob txha hauv qab rau hauv ko taw, ua tsaug rau qhov uas peb txav tau yooj yim. Peb tuaj yeem khoov ib leeg rau pem hauv ntej thiab rov qab thaum peb taug kev, thiab tsis poob rau hauv kev sib txawv, tiv taus cov khoom hnyav.
Kev puas tsuaj
Txawm tias peb cov pob txha zoo li nyias thiab tsis yooj yim, lawv tuaj yeem tiv taus qhov hnyav thiab cuam tshuam ntau. Tab sis nrog lub zog ncaj qha heev, txawm cov pob txha tawg. Kev sib tsoo tsheb lossis kev poob ntawm qhov siab tuaj yeem ua rau pob taws tawg. ICD 10 suav nrog qhov kev raug mob no hauv cov npe kab mob, thiab nws muaj nws tus kheej encoding. Kev faib tawm thoob ntiaj teb ntawm cov kab mob twb tau hloov kho 10 zaug, thiab hauv nws qhov tseeb version muaj kev qhia meej txog yuav tsim kev kuaj mob li cas. Yog ib qho tawg nrog lub qhov txhab qhibthiab nws tsis raug xaiv los yog qhib lossis kaw, ces nws yuav tsum raug cais raws li kaw.
Tib neeg muaj feem yuav kho tau cov ceg tawv, tsis tshua muaj pob txha. Yog hais tias qhov kev raug mob yog ncaj qha, ces qhov tawg yog feem ntau nrog los ntawm kev tsim ntawm ntau fragments. Kev tawg ntawm ligaments ntawm qhov sib txawv feem ntau tshwm sim los ntawm qhov tseeb tias ib tug neeg ntog rau hauv dej khov lossis hauv pem teb. Feem ntau raug mob thaum ua si sab nraum zoov: thaum caij skiing, rollerblading lossis skating. Feem ntau dawm ntawm cov kauj ruam lossis qhov chaw tsis sib xws.
Kev kho phais kho mob
Nyob rau hauv rooj plaub ntawm kev raug mob me, ob txhais ceg yog tsau nrog cov cam khwb cia lossis cov ntaub qhwv tshwj xeeb elastic. Nyob rau tib lub sijhawm, nws yuav tsum tsis txhob nruj heev, cov ntshav ncig yuav tsum tsis txhob cuam tshuam. pob taws pob taws hauv ICD-10 yog tus lej S82.6. Kev faib tawm thoob ntiaj teb tso cai rau cov lus hais kom hloov mus rau hauv cov lej, lawv tau yooj yim khaws thiab siv rau kev txheeb xyuas cov ntaub ntawv.
Yog tias koj tuaj yeem ua yam tsis muaj kev phais, ces cov kws kho mob ua haujlwm rov ua haujlwm. Yog tias tus kws phais pom o ntawm pob taws thiab daim duab tau lees paub tias muaj kev puas tsuaj, ces ib qho kev kho yuav tsis txaus. Muaj ntau qhov qhia txog kev ua haujlwm, qee qhov tau npaj tseg, lwm tus yuav tsum tau ua tam sim ntawd, thaum tus neeg mob nkag mus rau hauv tsev kho mob.
Osteosynthesis yog ua rau kev raug mob qhib thiab pob txha ob leeg. Tsis tas li ntawd nyob rau hauv cov ntaub ntawv uas muaj ib tug complex rupture ntawm ligamentous apparatus los yog ib tug rupture ntawm tibiofibular ib feem.
Yog vim li cas rau kev phais
Tshwj tsis tsim nyog, tus kws kho mob yuav tsis ua kev phaispob taws osteosynthesis. Tab sis feem ntau cov txheej txheem no yog tsim nyog los kho cov pob txha zoo rau tus neeg mob. Kev ua haujlwm yog ua kom tsis txhob los ntshav los yog txhawm rau ua kom qhib qhov chaw ntawm cov khoom tawg lossis osteosynthesis. Qee zaum daim duab puv nkaus tsuas pom tau thaum ua haujlwm thiab cov pob txha pom tias nws yog dab tsi.
Txhawm rau rov ua kom tag nrho cov haujlwm ntawm pob qij txha, nws yog qhov yuav tsum tau ua haujlwm, tab sis txawm tias tom qab tag nrho cov kev tsim nyog, tus kws kho mob tsis tuaj yeem lav tias tus neeg mob yuav taug kev yam tsis muaj kev txaj muag. Qee cov txheej txheem tom qab tawg tuaj yeem hloov tsis tau, vim tias cov hlab ntsha thiab cov hlab ntsha kuj raug cuam tshuam thaum raug mob. Cov chaw tawg tuaj yeem tsim cov kab mob pob txha ntev ntev.
Kev kuaj mob ua ntej
Kev kuaj mob ua ntej yog qhov yuav tsum tau ua. Cov tsos mob ntawm pob txha:
- mob hnyav ntawm palpation,
- pob taws o,
- txav tau txwv lossis ua tsis tau vim qhov mob thiab ko taw misalignment.
Txog kom txo qhov mob, tus neeg raug tsim txom raug txhaj tshuaj loog hauv zos. Tom qab txhaj tshuaj, tus ceg ceg yog immobilized, tsis tas yuav tsum tau tso cai kom cov pob txha tawg tsis ua mob rau cov hlab ntsha thiab cov ntaub so ntswg. Tus kws kho mob siv X-ray thiab, yog tias tsim nyog, dopplerography. Nyob rau theem kawg, X-ray raug coj mus rau qhov kev xav tau.
Kuv puas tuaj yeem zam kev phais? Muaj Teeb Meem
Yog tias txoj haujlwm no tuaj yeem zam tau, tus kws kho mob yuav tsis pom zoo. Tom qab tag nrho, ib qho kev ua haujlwm yog txuam nrog kev pheej hmoo, tom qab ntawd qhov yuav tshwm sim ntawm pulmonary embolism thiab tob thrombosis nce. Lub qhov txhab tom qab kev phais yuav tsis zoo vim yog kev loj hlob ntawm cov nqaij mos thiab daim tawv nqaij necrosis.
Yog tias tus neeg mob tsis ua raws li tag nrho cov lus pom zoo thiab tsis tau so tag, ces qhov kev cog hniav yuav xoob thiab qhov sib koom ua ke tsis tseeb yuav tsim. Lub hom phiaj tseem ceeb ntawm kev ua haujlwm yog txhawm rau txhim kho cov pob txha pob txha kom raug raws li qhov ua tau, thiab osteosynthesis tso cai rau qhov no ua tiav. Yog tias tsis muaj kev ua haujlwm, nws tsis tuaj yeem rov qab kho cov pob txha ncaj ncees, txawm tias thaum ua haujlwm, nws tsis tuaj yeem ua tiav qhov txiaj ntsig zoo. Tab sis yog tias tsis muaj dab tsi ua tiav, ces cov ntaub so ntswg necrosis yuav pib, thiab yav tom ntej ib feem ntawm ceg yuav tsum tau txiav.
Kev npaj rau kev ua haujlwm kom rov zoo ntawm cov pob txha
Txog li 15% ntawm pob txha pob txha tshwm sim ntawm pob taws. Tib lub sijhawm, cov pob txha nyob ze, pob txha mos thiab cov leeg feem ntau raug kev txom nyem. Feem ntau nws yog ib qho tsim nyog yuav tau ua osteosynthesis ntawm pob taws nrog lub phaj vim qhov kev hloov ntawm cov pob txha, txawm hais tias nws tau kho nrog plaster. Cov kws kho mob tseem ua haujlwm rau kev raug mob ntev thiab cov pob txha tsis raug.
Thaum tus neeg mob tau mus rau hauv tsev kho mob hauv qhov mob hnyav thiab muaj kev raug mob uas tsis yog pob txha, kev ua haujlwm tsis tau ua tam sim ntawd. Thaum xub thawj, tus neeg raug tsim txom yuav tsum tau ruaj khov, uas yuav siv sij hawm ob peb hnub, thiab tsuas yog tom qab ntawd thiaj li ua tiav osteosynthesis ntawm pob taws. Tsis tas li ntawd, ib qho contraindication rau kev phais yog qhov tsis zoo ntawm cov ntaub so ntswg thiab daim tawv nqaij nyob rau hauv qhov chaw no, qhov ua rau tej zaum yuav kis tau tus kab mob tsis ntev los no.kab mob. Ua ntej kev ua haujlwm, tus neeg yuav tsum tau noj 12-teev kev tshaib kev nqhis, kev kho los tiv thaiv edematous yog nqa tawm. Tom qab kev npaj ua ntej, tus neeg mob raug xa mus rau chav ua haujlwm.
Kev ua haujlwm
Tus neeg mob tau muab tshuaj noj ua ntej. Osteosynthesis ntawm pob taws yog ua raws li kev siv tshuaj loog lossis hauv zos. Tus neeg mob yog nyob rau hauv lub supine txoj hauj lwm, lub hauv caug pob qij txha ntawm cov ceg ua hauj lwm yog me ntsis khoov. Ib qho hemostatic tourniquet yog siv rau tus ncej puab. Tag nrho cov ceg tawv yog kho thiab qhov chaw phais yog them nrog cov nplaum los yog cov ntaub so ntswg, feem ntau yog siv cov ntaub so ntswg pov tseg. Kev ua haujlwm tuaj yeem siv sijhawm li ib nrab teev mus rau ob teev.
Hauv kev ua haujlwm, tus kws phais ua haujlwm osteosynthesis ntawm pob taws nrog screws, siv lub phaj nrog lub voj nro, yog tias tsim nyog, siv Kirschner xov hlau. Tag nrho cov ntaub ntawv yuav tsum tsis muaj menyuam, lawv raug xaiv raws li qhov raug mob. Tom qab ua haujlwm nkag mus, xaiv txoj kev ua haujlwm, feem ntau nws yog osteosynthesis ntawm fibula nrog screws thiab phaj. Tom qab ua haujlwm, tus neeg mob mus txog lub sijhawm rov zoo.
Siv lub cuab yeej Ilizarov
Cov cuab yeej no tau siv dav hauv kev kho mob, nrog rau nws txoj kev pab kho qhov curvature ntawm ob txhais ceg, lawv cov proportions. Nws yog siv rau cov pob txha ntawm cov ceg, nws tsis tso cai rau cov seem txav mus, txhim kho cov pob qij txha cuav thiab cov pob txha tsis sib haum, thiab tsis tas yuav tsum tau ntxiv immobilization ntawm lub limb. Ilizarov apparatus zoo li ib tug txawv txawv tsim nyob rau hauv daim duab, tab sis nws yog siv txawm nyob rau hauv cov ntaub ntawv uas cov neeg siv tsuas xav kom lengthen cov ceg.
Txhua qhov chaw ntawm lub cuab yeej yog tsim los ntawm cov khoom zoo, tab sis koj yuav tsum tau ceev faj thaum sib dhos. Nyob rau hnub ntawm kev teeb tsa, nws yog sterilized nrog rau lwm cov twj paj nruag. Ilizarov apparatus nyob rau hauv daim duab twb tau sib sau ua ke, tab sis nws muaj ib tug nyias muaj nyias qhov chaw, thiab ua hauj lwm nrog nws yuav tsum tau ceev faj. Txhawm rau ntxig cov xov hlau rau hauv cov pob txha, tus kws kho mob kuj xyaum cov ntaub so ntswg. Nyob rau hauv tsis muaj cov ntaub ntawv yuav tsum tau tso cai rau hlawv kom tsis txhob provoke purulent txheej txheem, yog li ntawd, thaum drilling, nquag nres yuav tsum tau ua. Thaum lub sij hawm qhia, cov koob yuav tsum tsis txhob kov cov ntaub so ntswg, txwv tsis pub muaj menyuam yuav raug ua txhaum cai.
Tom qab ua haujlwm, tus neeg mob kuj mus txog lub sijhawm kho thiab rov zoo.
Nyob rau hauv lub neej yav tom ntej, tus neeg mob yuav tsum tau ua lwm yam haujlwm kom tshem tawm cov phiaj thiab cov xov hlau ntawm cov pob txha thiab tshem tawm cov cuab yeej Ilizarov, yog tias nws tau teeb tsa.
