Cov lus nug tseem ceeb rau cov neeg mob thaum hu rau tus kws kho mob traumatologist nrog pob txha pob txha metatarsal: Kuv yuav tau hnav lub cam ntev npaum li cas? Puas yog nws tsim nyog taug kev nrog cov ntoo khaub lig tom qab tawg? Yuav ua li cas rov qab koj txhais taw tom qab raug mob? Kab lus no yuav teb cov lus nug no thiab ntau lwm cov lus nug uas txaus siab.
Tus tib neeg ko taw yog cov qauv anatomically complex thiab muaj cov pob txha, cov leeg, ligaments thiab tendons, nrog rau cov nqaij mos. Nyob rau hauv tag nrho, tib neeg ko taw muaj 26 pob txha, uas tsuas yog tsib hu ua metatarsals. Lawv yog cov ntev tshaj nyob rau hauv ko taw. Dab tsi cuam tshuam rau pob txha pob txha ntawm 5th metatarsal? Xav paub ntau ntxiv tom qab.
Kev cuam tshuam ntawm qhov teeb meem
Raws li kev txheeb cais niaj hnub no, yog tias peb tham txog kev puas tsuaj ntawm cov pob txha metatarsal, qhov no yog tsib mus rau rau feem pua ntawm tag nrho cov pob txha ntawm cov pob txha ntawm tib neeg lub cev. Cov kev raug mob no tsis tshua muaj tshwm sim hauv cov txiv neej thiab poj niam. Cov pob txha feem ntau yog pob txha metatarsal 5, nrog rau 4 (qhov no cuam tshuam los ntawm lawv qhov chaw nyob hauvanatomically, tus thib peb metatarsal pob txha tawg tsis tshua muaj heev).
Cov pob txha uas ua rau tib neeg ko taw tsim ib txoj hauv kev yooj yim uas ua tau ntau yam haujlwm, xws li: lawv nqa tawm kev txav ntawm tus neeg, tiv taus qhov hnyav ntawm qhov sib txawv. Lawv muab kev poob siab thaum tib neeg taug kev.
Txhua tus pob txha ntawm ko taw hauv tib neeg, thiab lawv tus lej yog 26 daim, muaj feem cuam tshuam rau ib leeg. Yog hais tias ib tug ntawm lawv raug mob, puas los yog hloov chaw, ces qhov no yuav cuam tshuam ntxiv deformities thiab dysfunctions ntawm lwm tus.
Pab pawg cuam tshuam los ntawm kev pheej hmoo tawg:
- Cov neeg muaj hnub nyoog nees nkaum thiab plaub caug.
- Cov txiv neej koom nrog kev ua kis las.
- Ballerinas.
- ncaws pob.
Qhib lossis kaw pob txha ntawm 5th metatarsal yog ib qho ntawm cov pawg no.
Anatomical qauv ntawm tib neeg ko taw
- Cov pob txha metatarsal yog 5 cov pob txha tubular nyob nruab nrab ntawm phalanges ntawm cov ntiv tes thiab cov pob txha tarsal. Lawv lub luag haujlwm tseem ceeb yog ua kom muaj zog ntawm ko taw thiab ua lub luag haujlwm ntawm lub zog (khiav, taug kev thiab dhia).
- Cov pob txha luv tubular (phalanges) ntawm cov ntiv taw. Tus ntiv taw thib 1 muaj 2 phalanges, tag nrho cov seem ntawm 3. Tag nrho cov ntawm lawv ntawm txhua ceg yog 14. Ib pob txha ntawm cov pob txha metatarsal thib 5 tuaj yeem tshwm sim los ntawm kev sib tsoo.
- Peb cov pob txha cuneiform. Lawv lub npe hu li cas vim lawv lub ntsej muag.
- Cov pob txha cuboid nyob ntawm sabqhov chaw ntawm ko taw.
- Tus scaphoid nyob ntawm forefoot.
- Talus.
- pob txha pob txha.
Yog ib tug neeg muaj pob txha pob txha 5th metatarsal, ces nws yuav tsum hu rau tus kws kho mob orthopedic.
Nyob fractures
Kev tawg ntawm cov pob txha metatarsal yog to taub tias yog kev ua txhaum ntawm lawv txoj kev ncaj ncees vim raug mob.
Lawv raug cais raws li:
- Vim kev raug mob.
- Nyob los yog kev nyuaj siab.
Ntau kab tawg:
- Kev hloov pauv.
- Nyob zoo ib tsoom phooj ywg.
- T-shaped.
- Nyob zoo ib tsoom phooj ywg.
Fractures vim kev raug mob
Cia peb xav txog kev puas tsuaj los ntawm kev raug mob. Lawv tuaj yeem tsim los ntawm kev sib tsoo ntawm ko taw nrog cov khoom hnyav, nrog rau kev sib tsoo ntawm ko taw hauv cov txheej txheem taug kev lossis khiav.
Cov kab mob hauv qab no tau muab cais tawm:
- Fracture ntawm 5th metatarsal pob txha nrog kev hloov pauv - raws li kev puas tsuaj, cov pob txha tawg tau hloov chaw.
- pob txha tawg tsis txav.
- Qhib pob txha.
- Kaw pob txha ntawm 5 lub metatarsal.
Yog tias ib tus neeg tau txais kev raug mob zoo li no yam tsis muaj kev hloov pauv, cov ntsiab lus ntawm cov pob txha puas yuav nyob hauv tib txoj haujlwm. Qhov qhib pob txha yog nrog los ntawm kev ua txhaum ntawm kev ncaj ncees ntawm daim tawv nqaij, qhov twg cov pob txha tuaj yeem pom ntawm qhov txhab.
Qhov qhib pob txha yog qhov txaus ntshai rau ib tus neeg, txij li feem pua ntawm cov kab mob thiab qhov tshwm sim ntawm cov teeb meem yav tom ntej, xws li phlegmon, osteomyelitis, sepsis,gangrene thiab tetanus, siab heev. Nws siv sijhawm ntev npaum li cas rau qhov 5th metatarsal puas los kho? Xav paub ntau ntxiv hauv qab no.
Cov cim qhia tseem ceeb
- Mob ntawm qhov chaw ntawm pob txha pob txha tshwm sim tam sim tom qab raug mob lossis tom qab qee lub sijhawm.
- pob txha raug mob thaum lub sijhawm raug mob nrog lub crunch uas tus neeg mob hnov.
- Pab tau metatarsal sib txawv rau sab.
- Tus neeg mob muaj tus ntiv taw luv qhov muag.
- Pab tau o hnub tom qab pob txha lossis tib hnub.
Jones pob txha
Ib yam ntawm cov kev raug mob no yog Jones pob txha. Qhov no yog pob txha pob txha ntawm 5 lub metatarsal pob txha nrog kev hloov pauv, uas cov tawg maj mam loj hlob ua ke. Tom qab ntawd, hauv qee tus neeg mob, cov pob txha yeej tsis loj hlob ua ke.
Ntau zaus, cov neeg mob tuaj yeem kuaj tsis raug. Raws li qhov tshwm sim, kev kho mob ko taw tau raug sau tseg.
Nyob fractures
Cov no yog kev raug mob uas tshwm sim los ntawm cov kab nrib pleb uas tsis tshua pom pom ntawm x-rays.
Yog vim li cas rau qhov tshwm sim:
- Kev tawm dag zog hnyav ntawm ko taw.
- Tshwj xeeb, pom ntawm cov neeg ncaws pob uas, nyob rau hauv tus txheej txheem ntawm kev khiav, nrawm nrawm nrawm nrawm hauv marathons.
- Cov qauv thiab cov duab ntawm cov pob txha metatarsal nrog kev sib txawv.
- Hloov cov duab ntawm ko taw.
- cuam tshuam cov khau nruj thaum hnav.
- Ntau zaus kuaj pom cov neeg koom nrog hauv kev ua yeeb yam ballroomqib.
- Osteoporosis.
Cov hom pob txha saum toj no yuav tsum tau kho thiab kho raws sijhawm. Tus cwj pwm tsis saib xyuas rau qhov kev raug mob no tuaj yeem cuam tshuam rau tus mob ntawm ko taw yav tom ntej.
Yuav kuaj mob li cas?
- Tus neeg mob mob ko taw tom qab kev tawm dag zog (kev taug kev ntev lossis khiav).
- Mob ploj mus tom qab so luv luv thiab tom qab ntawd rov mob dua yog tias tus neeg pib taug kev ncig chav lossis sawv hauv ib qho chaw ntev.
- Thaum soj ntsuam ko taw, tus neeg mob qhia qhov mob taw tes ntawm qhov chaw tawg.
- Tseem pom sab nrauv ntawm pob txha yog o ntawm ko taw, tab sis tsis muaj qhov nqaij tawv.
Cov tsos mob saum toj no qhia tias koj yuav tsum mus ntsib kws kho mob. Cov cim zoo sib xws tau pom nrog pob txha ntawm cov pob txha metatarsal thiab pob txha. Kev ntseeg yog suav tias yog yuam kev: yog tias tus neeg mob taug kev, ces nws tsis xav tau kev kho mob. Kev kuaj mob ntawm pob txha pob txha ntawm lub hauv paus ntawm 5 lub pob txha metatarsal ntawm ko taw, ua tsis tau raws sijhawm, thiab kev kho tsis tsim nyog ntawm cov pob txha, suav nrog cov qaug zog, ua rau muaj qhov tshwm sim loj.
Yuav ua li cas yog qhov teeb meem?
- Cov pob txha ntawm tib neeg ko taw hloov pauv, ua rau muaj kev txwv txav thiab ua rau nws nyuaj rau khau.
- Muaj peev xwm txhim kho arthrosis ntawm qhov chaw raug mob.
- Kev sib haum xeeb ntawm cov pob txha hloov chaw yog qhov tseem ceeb, txwv tsis pub angular deformation yuav tshwm sim.
- Tus neeg mobmob ko taw mob.
- Tus neeg mob sai sai nkees ntawm ob txhais ceg, thiab tshwj xeeb tshaj yog thaum nws taug kev lossis sawv ntsug.
- Yog pob txha tsis kho, ces phais yog qhov tsim nyog.
Diagnosis
Tom qab kev puas tsuaj ntawm lub hauv paus ntawm pob txha metatarsal thib 5, kev kuaj mob tuaj yeem ua tau los ntawm qhov muaj kev raug mob, cov neeg mob tsis txaus siab, kuaj pom ntawm ko taw, nrog rau siv cov khoom siv xoo hluav taws xob.
Kev kho mob
Niaj hnub nimno hom kev kho mob hauv traumatology:
- Kev ua haujlwm ntawm plaster cam khwb cia. Nws yog siv nyob rau hauv rooj plaub thaum muaj pob txha ntawm 5 lub pob txha metatarsal ntawm ko taw yam tsis muaj kev txav ntawm cov khoom tawg.
- A cam khwb cia yog siv los tiv thaiv qhov chaw ntawm kev raug mob los ntawm ntau hom kev cuam tshuam ntawm cov pob txha tawg, ua kom qhov tseeb ntawm cov pob txha tawg hauv cov phiaj xwm anatomical thiab qhov tsis tuaj yeem ntawm ko taw, uas yog qhov tsim nyog rau kev kho sai.
- Kev phais mob. Kev hloov pauv ntawm cov pob txha tawg vim qhov tshwm sim ntawm cov pob txha metatarsal yuav tsum muaj kev phais, nrog rau kev siv cov pob txha me me rau lawv kho thiab sib piv.
- Tus neeg mob yuav tsum siv lub cuab yeej thaum taug kev rau tag nrho lub sijhawm, tsis hais hom kev kho mob twg (kev phais lossis kev saib xyuas). Crutches pab daws kev ntxhov siab ntawm ko taw.
- Thaum tus neeg mob tau tso cai tshem tawm cov ntaub qhwv, ib qho kev kho kom rov zoo tuaj tos nws rov qab mus rau lub neej nquag thiab rov ua haujlwm ko taw.
Cov tshuaj niaj hnub muab txoj kev kho tshiab, hu ua osteosynthesis,uas tus kws kho mob muaj peev xwm sib piv cov pob txha tawg thiab muab lawv txoj hauj lwm raug. Nrog kev pab los ntawm ib tug tshwj xeeb pas nrig, fixation yog nqa tawm nyob rau hauv lub pob txha. Cov txheej txheem no ua rau nws ua tau nyob rau theem pib siv lub nra ntawm ko taw thiab ua kom muaj zog ntxiv nrog cov ntiv taw.
Yuav tsum tau immobilization
Yuav kom txo qis qhov tshwm sim ntawm qhov raug mob metatarsal, so thiab xav tau qee qhov kev txav mus los, uas, dhau los, yuav pab tshem tawm qhov kev hloov pauv thib ob thiab tsim txhua yam kev mob zoo rau kev kho dua tshiab.
Yog tus neeg raug tsim txom tsis muaj qhov tawg ntawm qhov tawg, ces qhov cam khwb cia ntawm qhov tawg ntawm 5 lub pob txha metatarsal hloov mus rau qhov tshwj xeeb orthosis.
Nws tso cai rau koj ua lub cev qoj ib ce, tsis ua rau mob thiab o ntawm cov nqaij mos ntawm ko taw.
Ua ke nrog kev tsis sib haum xeeb ntawm pob txha, tshuaj tua kab mob, kho lub cev, kev npaj cov hlab ntsha thiab cov tshuaj pleev decongestant tuaj yeem sau tau. Qhov kev poob qis hauv qhov tshwm sim no qhia tias tsib mus rau xya hnub tom qab tawg ntawm 5 cov pob txha metatarsal, nws muaj peev xwm ua kom muaj kev tswj xyuas hluav taws xob.
Yog li, kev ua kom lub cev muaj zog ntawm ko taw ua rau pob txha pob txha ntawm tsib metatarsal pob txha. Cov neeg mob yws txog qhov mob thaum lawv tawm dag zog tsis tu ncua. Thaum xub thawj, nws ua rau nws tus kheej hnov txog thaum qoj ib ce, tom qab ntawd cov tsos mob tshwm sim ntau dua, vim li ntawd, cov duab kho mob ntawm "cov pob txha tshiab" tsim.
Tus kws kho mob yuav tsum tau kuaj xyuas. Nws yuav tsum tau tshuaj xyuas ob pob qij txha, scaphoid, thiab lub hauv paus ntawm 5th metatarsal. Kev kuaj mob yog ua los ntawm cov khoom siv X-ray. Rau ib qho kev puas tsuaj, thiab tshwj xeeb tshaj yog cov pob txha metatarsal 5, x-ray ntawm ko taw yog ua nyob rau hauv 3 qhov projections: lateral, anteroposterior thiab oblique. Hauv qhov xwm txheej hnyav, lwm yam kev ntsuas yuav raug siv: MRI lossis kev ua haujlwm zoo.
pab thawj rau tus neeg raug tsim txom
Prehospital first aid muaj xws li:
- Tsim kom muaj qhov so rau ko taw.
- Nws yog ib qho tsim nyog yuav tsum tau siv txias rau thaj tsam ntawm tsib metatarsal. Ib pob dej khov pab ntau heev. Nws yog siv los txo qhov o ntawm cov nqaij mos thiab txo qhov mob ntawm ko taw. Nyob rau hauv tsev, ib tug zoo tib yam phuam yog haum, nyob rau hauv uas cov dej khov yog qhwv. Muaj qee lub sij hawm uas qhov txias tuaj yeem siv tau. Nws yog ib qho tsim nyog ua qhov txheej txheem no li nees nkaum feeb txhua teev.
- Elastic bandage yog haum rau kho ko taw kom tom qab tso cov compression stocking ntawm ceg. Nws siv yuav tsum tau hnav khaub ncaws hnav txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm
- Tus mob ko taw yuav tsum muab tso rau ntawm lub platform tsa. Tus neeg mob tso ko taw saum lub duav.
- Pab tau ko taw splint.
- Nrhiav chav xwm txheej ceev uas ze tshaj plaws rau kev kho mob.
5 metatarsal tawg: rov kho dua
Ntxhais nkauj mos ab tau hnav ib hlis thiab ib nrab.
Tus kws kho mob (traumatologist) tuaj yeemtso cai rau tus neeg mob mus rau theem ntawm cov ceg tawg nkaus xwb yog tias qhov fused metatarsal tawg yog pom ntawm x-ray. Lub plaster splint yuav tsum tau muab tshem tawm tsuas yog nrog kev tso cai los ntawm tus kws kho mob. Ua qhov no yog ntxov ntxov thiab txwv tsis pub. Kev ua si lub cev thaum lub sijhawm rov zoo yog qhov tseem ceeb rau kev txhaj tshuaj. Thawj qhov uas tus neeg mob yuav tsum ua yog txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhaws). Tus kws kho mob tau sau ntawv kho lub cev, uas pab txhawb kev rov ua haujlwm sai thiab pab rov qab tus neeg mob nrog pob txha kom ua neej nyob. Thaum muaj mob thaum lub sij hawm kawm lub cev, yuav tsum tau ncua kev kawm ntawv.
Kev ua luam dej, zaws thiab kho lub cev muaj txiaj ntsig zoo. Kev tawm dag zog dej nrog me me loads zoo rov qab ua haujlwm ntawm ko taw. Yog tias qhov o ntawm txhais ceg tau nce, koj tuaj yeem siv Lyoton 1000 lossis Troxevasin tshuaj pleev.
Cov khau tshwj xeeb orthopedic thiab insoles uas kws kho mob tau sau tseg ua rau cov txheej txheem kho kom zoo dua qub. Nws kuj raug pom zoo kom ua "kev tawm dag zog hauv tsev".
Kev tawm dag zog
"kev tawm dag zog hauv tsev" rau ko taw yog raws li hauv qab no:
- Flex thiab nthuav cov ntiv taw.
- Zaum saum lub rooj zaum, koj yuav tsum "nce" ntawm koj cov ntiv taw thiab pob taws.
- rub ko taw ntawm koj (10 txog kaum tsib zaug).
- rub ko taw tawm ntawm koj (txog rau kaum tsib zaug).
- Tig ko taw mus rau sab laug (kaum zaug).
- Tig ko taw mus rau sab xis (kaum zaug).
Ko taw ua haujlwm feem ntau rov qab los li qub 1 hlis tom qabtshem tawm plaster. Txhawm rau ntxiv dag zog rau cov pob txha, tus neeg mob yuav tsum noj zaub mov muaj calcium thiab vitamins txhua hnub.
Kev tawg tuaj yeem tshwm sim rau txhua tus, tshwj xeeb tshaj yog tias tus neeg ua lub neej nquag. Koj yuav tsum tau ceev faj, sim ua kom tsis txhob raug mob lub sijhawm, hnav khau zoo thiab sim noj cov zaub mov uas muaj calcium txaus hauv lawv.
