Muaj qhov nruab nrab thiab sab nraub qaum. Thawj suav nrog kev puas tsuaj ntawm lub taub hau thiab caj dab ntawm femur, qhov thib ob - intertrochanteric, transtrochanteric thiab cais pob txha ntawm trochanter. Raws li kev kho mob qhia, qhov tawg ntawm lub taub hau femoral tsis yog li ntawd.
Txheeb xyuas txoj kab ntawm pob txha pob txha, cov pob txha hauv qab no yog qhov txawv: subhead, transcervical, basal. Muab txoj hauj lwm ntawm lub limb thaum lub sij hawm raug mob rau lub caj dab femoral, lawv muab faib ua abduction thiab adduction fractures. Tom qab raug mob, nws yog ib qho tseem ceeb mus cuag ib tug traumatologist nyob rau hauv lub sij hawm. Qhov no yuav pab tiv thaiv kom tsis txhob muaj teeb meem kev noj qab haus huv loj. Hauv tsev, nws tsis tuaj yeem kuaj pom tus kab mob.
Vim li cas thiaj tshwm sim?
Kev tawg pob txha feem ntau tshwm sim thaum ib tus neeg poob rau ntawm lub duav ob txhais ceg vim qhov nce ntawm lub caj dab-diaphyseal lub kaum sab xis. Kev tawg yog hu ua valgus yog tias tus neeg mob tau poob rau ntawm txhais ceg adducted. Nyob rau hauv cov xwm txheej zoo li no, lub ncauj tsev menyuam-diaphyseal lub kaum sab xis txo qis. Varus pob txha yog ntau dua.
SymptomaticsPathology
Feem ntau, cov kws kho mob kuaj mob pob txha pob txha thiab pob txha pertrochanteric hauv cov neeg laus uas tau poob rau ntawm ib qho adducted lossis abducted ceg. Tom qab raug mob, qhov mob hnyav tshwm sim hauv pob qij txha. Nws nyuaj rau tsom rau ntawm ceg.
Txoj kev kuaj mob
Cov txheej txheem tseem ceeb ntawm kev kuaj mob suav nrog kev kuaj thiab kuaj lub cev. Thaum lub sij hawm tus txheej txheem, tus neeg mob nrog ib tug pertrochanteric puas muaj ib tug ntau zog pulsation nyob rau hauv lub cheeb tsam ntawm lub femoral sib koom. Tus neeg mob hnov mob hnyav. Tus neeg mob tsis tuaj yeem tsa ceg ntawm lub hauv caug.
lab thiab x-rays
Tus neeg mob yuav tsum tau kuaj ntshav dav dav thiab kuaj x-ray txhawm rau txiav txim siab qhov chaw puas thiab tus nqi ntawm lub caj dab-diaphyseal lub kaum sab xis. Los ntawm kev txheeb xyuas cov ntshav, koj tuaj yeem txheeb xyuas qhov muaj lwm yam pathologies thiab xaiv cov kev kho mob uas tsim nyog.
txheej txheem rov qab los ntawm tus neeg mob
Fracture ntawm lub caj dab femoral yuav tsum tau kho phais, tshwj tsis yog ntawm pob txha valgus thiab kev raug mob tawm tsam keeb kwm yav dhau los ntawm kev tsis pom zoo rau kev phais.
kev kho mob
Kev saib xyuas kev kho mob rau cov pob txha pertrochanteric hauv cov neeg mob hluas yog ua raws li kev siv Whitman plaster cam khwb cia, uas yuav tsum tau hnav rau ob peb lub hlis. Tom qab ntawd, nws raug tso cai taug kev ntawm cov ntoo khaub lig. Nws yog undesirable mus nqa tawmsiab rau ntawm qhov chaw raug mob. Tsuas yog rau lub hlis tom qab, cov kws kho mob tso cai rau lub nra. Kev ua neej puv thiab noj qab nyob zoo yog rov qab los tom qab 7 lub hlis. Cov kws tshaj lij tsis pom zoo kom siv cov ntaub qhwv lub duav rau cov neeg laus, vim tias muaj teeb meem tshwm sim. Feem ntau, tus kws kho mob yuav siv skeletal traction rau femoral condyles rau tus neeg mob rau 1-2 lub hlis. Cov ceg yuav tsum tau muab tshem tawm ntawm 25 degrees thiab tig sab hauv. Cov txheej txheem kho mob suav nrog kev kho lub cev.
Thaum lub sijhawm ua haujlwm, nws yog qhov yuav tsum tau ua kom haum thiab ruaj khov kho qhov tawg. Qhov no tsuas yog ua tau nrog kev pab ntawm kev phais txoj kev kho mob. Muaj ntau ntau hom kev phais: qhib thiab kaw. Nyob rau hauv tus txheej txheem ntawm nqa tawm thawj txoj kev, ib tug arthrotomy ntawm lub duav pob qij txha yog ua. Tus kws kho mob pom cov khoom tawg. Ces punches tus pin. Thaum kawg ntawm tag nrho cov tsim nyog ua, tus kws phais sutures lub qhov txhab. Cov txheej txheem intra-articular tsis tshua siv los ntawm cov kws tshaj lij, txij li tom qab cov txheej txheem teeb meem no tshwm sim hauv daim ntawv ntawm coxarthrosis.
kev kho mob nrov
Raws li kev kho mob ntawm cov kws kho mob qhia, cov kws phais feem ntau siv cov txheej txheem kaw los yog ntxiv-articular ntawm kev phais. Tus neeg mob muab tso rau ntawm lub rooj zaum phais. Nrog rau kev siv tshuaj loog, cov khoom tawg yog repositioned los ntawm abducting li ntawm 20 degrees. Tom qab cov txheej txheem, nws yog ib qho tsim nyog yuav tsum tau x-ray.
Lub luag haujlwm tseem ceeb ntawm txhua hom kev phais mob yog kom phim cov pob txha tawg thiab kho lawv nrog tus pin tshwj xeeb, phaj, lossis bracket. Cov txheej txheem kho yog tsim los ntawm tus kws kho mob tshwj xeeb, nyob ntawm tus yam ntxwv ntawm tus neeg. Qhov tshwm sim x-ray yog lub hauv paus.
Tus neeg mob yuav rov qab sai npaum li cas?
Kev nrawm ntawm kev rov qab los nyob ntawm ntau yam. Ntawm cov no:
- zoo ntawm kev kho cov cuab yeej;
- yuav ua li cas kom raug cov khoom tawg;
- hom pob txha;
- muaj teeb meem;
- zoo pob txha qauv.
Yog tias tus neeg mob muaj cov kab mob ntawm cov kab mob musculoskeletal uas tsis yog trochanteric pob txha ntawm lub femur, ces yuav xav tau ntau yam haujlwm ntxiv.
Contraindications rau kev phais
Muaj ntau tus contraindications uas nws tsis pom zoo kom ua haujlwm. Namely:
- mob plawv hauv lub plawv;
- kab mob ntshav;
- thrombosis;
- kab mob endocrine;
- ntau purines hauv lub cev.
Feem ntau, cov kws kho mob siv lub kaum sab xis lossis lub hau ntswj dynamic los kho cov khoom tawg. Hauv qee qhov xwm txheej, nws yog qhov yuav tsum tau hloov lub mount thaum lub sijhawm. Feem ntau nyob rau hauv tus txheej txheem ntawm kev kho mob pob txha hauv cov neeg laus, tus kws kho mob siv tus pin. Qhov kev tsim no yog ntsia los ntawm tus kws kho mob tshwj xeeb los ntawm kev txiav me me. Tom qab kev phais, nws yog ib qho tseem ceeb uas yuav tau hnav ib daim ntaub qhwv tshwj xeeb.
txheej txheem rov ua dua
Thaum kev kho mob ntawm cov pob txha trochanteric tiav lawm, tus neeg mob lub cev yuav rov zoo li ob peb lub hlis. Thawj zaug koj yuav tsum siv cov cuab yeej. Tag nrho cov txheej txheem ntawm kev kho tus neeg mob yuav tsum nruj me ntsis tswj los ntawm tus kws kho mob tuaj koom. Koj yuav tsum paub hais tias nyob rau hauv cov neeg laus, lub sij hawm rov qab yuav qeeb, thiab cov teeb meem feem ntau yog unpredictable. Vim li no, koj yuav tsum mus ntsib kws kho mob tam sim yog tias koj qhov kev noj qab haus huv hnyav zuj zus.
kev kho mob ntxiv
kom ceev lub sijhawm rov qab ntawm tus qauv pob txha puas lawm, kws kho mob kws kho mob phwj phua lub cev ntawm kev kho mob rau tus neeg mob. Ua tsaug rau lawv qhov kev siv, koj tuaj yeem txhim kho cov ntshav ncig thiab kho cov leeg nqaij thiab pob txha. Nrog kev pab ntawm massage, laser stimulation, hydrotherapy, cua sov, electrophoresis, paraffin therapy thiab kho ce, koj muaj peev xwm sai sai kho tus neeg mob txoj kev noj qab haus huv tom qab ib tug trochanteric puas ntawm lub femur. Kev ua haujlwm ntawm cov pob txha puas lawm tau rov qab los tsuas yog tom qab rau lub hlis. Hauv qhov xwm txheej nyuaj, kev kho kom rov zoo tuaj yeem siv sijhawm ib xyoos.
Kev kho mob yuav ua li cas?
Yog tias koj mus ntsib kws kho mob raws sij hawm thiab ua tib zoo ua raws li tag nrho cov lus pom zoo, koj tuaj yeem rov ua lub cev sai sai. Qhov kev paub ntawm tus kws kho mob tuaj koom tsis muaj qhov tseem ceeb, yog li nws tsis pom zoo kom nrhiav kev pab los ntawm cov chaw kho mob dubious. Nrog rau qhov tawg pertrochanteric tawg, cov kws kho mob tsis tshua ua kev phais.
Note to patient
Thaum ib qho ntawm cov tsos mob ntawm pob txha tshwm, nws yog ib qho tseem ceeb mus ntsib kws kho mob raws sij hawm. Ua ntej ntawm tag nrho cov, traumatologist visuallytshuaj xyuas tus neeg mob thiab palpate qhov chaw puas. Tus kws kho mob tshwj xeeb tso qhov kev kuaj mob raws li qhov tshwm sim ntawm tus neeg mob qhov kev kuaj mob. Nws yog ib qho tseem ceeb kom ua tiav tomography, kuaj ntshav thiab zis. Kev noj tshuaj rau tus kheej yog txwv tsis pub, vim qhov no tuaj yeem ua rau muaj teeb meem loj. Txawm hais tias qhov kaw pertrochanteric pob txha pob txha tsis ua rau muaj kev phom sij rau lub neej, nws yog ib qho tseem ceeb kom pib kho tam sim ntawd.
hom pob txha loj
Transtrochanteric thiab intertrochanteric puas tuaj yeem tshwm sim tib yam. Txawm li cas los xij, lawv tau muab faib ua ntau hom. Ntawm cov hom kev puas tsuaj loj hauv cheeb tsam no ntawm tib neeg lub cev pob txha yog:
- Strochanteric pob txha ntawm lub diaphysis nrog kev hloov chaw.
- Intertrochanteric nrog rauj (tsis muaj offset).
- Intertrochanteric yam tsis muaj hammering (tuaj yeem kuaj pom).
- Los ntawm trochanteric (tsis muaj gouging lossis txav chaw).
- Kiab.
- Kaw pertrochanteric pob txha ntawm femur.
Hom pob txha tshwj xeeb tuaj yeem txheeb xyuas tau tom qab kev kuaj mob zoo.
Yuav noj li cas thaum lub sijhawm rov zoo?
Feem ntau, pob txha yuav tsum tau kho mus sij hawm ntev, thaum lub sij hawm nws yog ib qho tseem ceeb kom ua raws li kev noj haus kom zoo. Tom qab raug mob, ib cheeb tsam ntawm lub siab yog tsim, raws li ib tug tshwm sim ntawm cov cell tuag, qhov twg cov txheej txheem metabolic yog qhib. Vim li no, lub cev xav tau qee cov ntsiab lus tseem ceeb thiab cov vitamins.
Nrog pob txha, koj yuav tsum noj zaub mov kom zoo. Cov zaub mov yuav tsum suav nrogtxaus cov protein, rog thiab carbohydrates. Nws yog ib qho tsim nyog yuav tsum tsom rau cov khoom noj uas muaj protein ntau. Cov zaub mov uas yooj yim digestible yuav tsum tau noj. Txhawm rau kom tsis txhob cuam tshuam kev ua haujlwm ntawm lub plab zom mov, nws raug nquahu kom noj zaub mov me me.
Ua tsaug rau qhov no, cov txheej txheem ntawm cov pob txha rov tsim dua tshiab yuav nrawm dua thiab cov txheej txheem ntawm kev nqus cov ntsiab lus tseem ceeb rau hauv cov hnyuv yuav normalizes. Nrog kev pab ntawm ascorbic acid thiab tocopherol, kev noj qab haus huv ntawm tus neeg mob tuaj yeem txhim kho, vim lawv muaj peev xwm txo qis kev ua haujlwm ntawm lipid peroxidation. Noj ntau cov zaub mov uas muaj calcium (cov khoom noj mis nyuj thiab ntses).
noj qab nyob zoo yuav saturate lub cev nrog cov vitamins thiab txhim kho kev noj qab haus huv ntawm tus neeg mob. Nws yuav ua kom cov txheej txheem kho kom zoo thiab saj zoo ntawm cov zaub mov, uas plays lub luag haujlwm tseem ceeb sib npaug. Txij li thaum tus neeg mob nyiam zom, tag nrho lub cev rov tsim dua thiab tus neeg mob rov zoo nyob rau lub sijhawm luv tshaj plaws.
Nws yog ib qho tseem ceeb kom tsis txhob overload lub plab zom mov nrog cov khoom xyaw nyuaj zom. Cov khoom noj uas pom zoo muaj xws li: qaib ntxhw, nqaij nyuj, cod, trout, cereals, khoom noj siv mis, zaub, txiv hmab txiv ntoo, taum, peas, broccoli, currants, turnips, txiv ntseej, radishes. Nws yog ib qho tsim nyog los sib tham hauv kev nthuav dav cov ntawv qhia zaub mov tom qab ua haujlwm. Cov pob txha trochanteric yog ib yam kab mob uas yuav tsum tau kho kom tiav raws li kev saib xyuas nruj ntawm tus kws kho mob.
