Kev tawg ntawm lub hauv paus ntawm Fifth Metatarsal

Kev kho tsis zoo ntawm qhov tawg ntawm tsib lub metatarsal base tuaj yeem ua rau pob txha tawg tsis sib koom ua ke lossis sib koom ua ke qeeb, thiab cov mob hnyav tuaj yeem ua rau mob pob qij txha, uas muaj kev cuam tshuam loj heev rau tib neeg lub neej txhua hnub thiab kev ua haujlwm.

Alub cevSkev tsim khoe

Cov pob txha metatarsal thib tsib yog ib qho tseem ceeb ntawm cov pob txha sab nraud ntawm ko taw, thiab ua lub luag haujlwm tseem ceeb hauv kev tuav qhov hnyav thiab kev ruaj khov ntawm ko taw. Cov pob txha metatarsal thib plaub thiab thib tsib thiab cov pob txha cuboid tsim cov pob txha metatarsal cuboid.

Muaj peb txoj leeg txuas rau lub hauv paus ntawm tus ntiv tes thib tsib metatarsal, cov leeg peroneus brevis ntxig rau sab dorsolateral ntawm lub tuberosity ntawm lub hauv paus ntawm tus ntiv tes thib tsib metatarsal; cov leeg peroneal thib peb, uas tsis muaj zog npaum li cov leeg peroneus brevis, ntxig rau ntawm diaphysis distal rau tus ntiv tes thib tsib metatarsal tuberosity; lub plantar fascia Lub lateral fascicle ntxig rau sab plantar ntawm lub basal tuberosity ntawm tus ntiv tes thib tsib metatarsal.

Kev faib tawm ntawm pob txha tawg

Cov pob txha tawg ntawm lub hauv paus ntawm tsib metatarsal tau raug faib los ntawm Dameron thiab Lawrence,

Qhov tawg ntawm thaj tsam I yog qhov tawg ntawm cov pob txha metatarsal tuberosity;

Thaj tsam II nyob ntawm qhov sib txuas ntawm diaphysis thiab proximal metaphysis, suav nrog cov pob qij txha ntawm 4th thiab 5th metatarsal pob txha;

Cov pob txha tawg hauv cheeb tsam III yog cov pob txha tawg ntawm qhov proximal metatarsal diaphysis distal rau 4th/5th intermetatarsal sib koom ua ke.

Xyoo 1902, Robert Jones thawj zaug piav qhia txog hom pob txha tawg ntawm thaj tsam II ntawm lub hauv paus ntawm tsib metatarsal, yog li thaj tsam II pob txha tawg kuj hu ua Jones pob txha tawg.

Qhov avulsion fracture ntawm metatarsal tuberosity hauv thaj tsam I yog hom fifth metatarsal base fracture feem ntau, suav txog li 93% ntawm tag nrho cov pob txha tawg, thiab yog tshwm sim los ntawm plantar flexion thiab varus violence.

Cov pob txha tawg hauv thaj tsam II suav txog li 4% ntawm tag nrho cov pob txha tawg ntawm lub hauv paus ntawm tsib metatarsal, thiab yog tshwm sim los ntawm ko taw plantar flexion thiab adduction violence. Vim tias lawv nyob hauv thaj chaw watershed ntawm cov ntshav ntws ntawm lub hauv paus ntawm tsib metatarsal, cov pob txha tawg ntawm qhov chaw no feem ntau yuav tsis sib koom ua ke lossis qeeb qeeb kho pob txha tawg.

Qhov tawg ntawm thaj tsam III suav txog li 3% ntawm qhov tawg ntawm tsib lub metatarsal puag.

Kev kho mob kom zoo

Cov cim qhia tseem ceeb rau kev kho mob kom zoo suav nrog qhov tawg uas txav tsawg dua 2 hli lossis qhov tawg ruaj khov. Cov kev kho mob feem ntau suav nrog kev siv cov ntaub qhwv roj hmab los tiv thaiv kev txav mus los, khau tawv, kev siv cov plaster cam khwb cia, cov ntaub qhwv cardboard, lossis khau taug kev.

Cov txiaj ntsig ntawm kev kho mob kom zoo suav nrog tus nqi qis, tsis muaj kev raug mob, thiab yooj yim lees txais los ntawm cov neeg mob; qhov tsis zoo suav nrog qhov muaj ntau ntawm kev tawg tsis sib koom ua ke lossis kev cuam tshuam qeeb ntawm kev sib koom ua ke, thiab yooj yim rau cov pob qij txha.

Kev phaisTkev kho mob

Cov cim qhia rau kev phais mob ntawm qhov tawg ntawm tsib lub metatarsal base suav nrog:

1. Kev tawg ntawm qhov tawg ntau dua 2 hli;

1. Kev koom tes ntawm > 30% ntawm qhov chaw sib koom ua ke ntawm lub cuboid distal mus rau qhov thib tsib metatarsal;

1. Kev tawg ua tej daim me me;

1. Pob txha tawg qeeb lossis tsis sib koom tom qab kev kho mob uas tsis yog phais;

1. Cov neeg mob hluas lossis cov neeg ncaws pob uas nquag ua si.

Tam sim no, cov txheej txheem phais mob uas siv ntau rau kev tawg ntawm lub hauv paus ntawm tsib metatarsal suav nrog Kirschner hlau nruj band sab hauv fixation, anchor suture fixation nrog xov, ntsia hlau sab hauv fixation, thiab hook phaj sab hauv fixation.

1. Kev kho cov hlua khi Kirschner

Kev kho cov hlau Kirschner yog ib txoj kev phais mob ib txwm muaj. Qhov zoo ntawm txoj kev kho mob no suav nrog kev nkag mus rau cov khoom siv kho sab hauv yooj yim, tus nqi qis, thiab kev nias zoo. Qhov tsis zoo suav nrog kev khaus tawv nqaij thiab kev pheej hmoo ntawm Kirschner hlau xoob.

2. Kev kho cov xov nrog cov anchors threaded

Kev kho cov pob txha txuas nrog xov yog qhov tsim nyog rau cov neeg mob uas muaj pob txha tawg ntawm lub hauv paus ntawm tsib metatarsal lossis muaj cov pob txha tawg me me. Qhov zoo suav nrog kev phais me me, kev ua haujlwm yooj yim, thiab tsis tas yuav tshem tawm zaum ob. Qhov tsis zoo suav nrog kev pheej hmoo ntawm pob txha tawg hauv cov neeg mob uas muaj pob txha tawg.

3. Kho cov ntsia hlau khoob

Hollow screw yog ib qho kev kho mob zoo uas tau lees paub thoob ntiaj teb rau kev tawg ntawm lub hauv paus ntawm tsib metatarsal, thiab nws cov txiaj ntsig suav nrog kev ruaj khov thiab kev ruaj khov zoo.

Hauv kev kho mob, rau cov pob txha tawg me me ntawm lub hauv paus ntawm tsib metatarsal, yog tias siv ob lub ntsia hlau rau kev kho, muaj kev pheej hmoo ntawm kev tawg. Thaum siv ib lub ntsia hlau rau kev kho, lub zog tiv thaiv kev tig yuav tsis muaj zog, thiab rov hloov chaw tau.

4. Lub phaj nuv tau kho lawm

Kev kho lub phaj nuv muaj ntau yam cim qhia, tshwj xeeb tshaj yog rau cov neeg mob uas muaj pob txha tawg lossis pob txha tawg. Nws cov qauv tsim phim lub hauv paus ntawm pob txha metatarsal thib tsib, thiab lub zog nias kho yog qhov siab heev. Qhov tsis zoo ntawm kev kho lub phaj suav nrog tus nqi siab thiab kev raug mob loj heev.

Slub tebchaws

Thaum kho cov pob txha tawg ntawm lub hauv paus ntawm tsib metatarsal, nws yog ib qho tsim nyog yuav tsum xaiv kom zoo raws li txhua tus neeg qhov xwm txheej tshwj xeeb, tus kws kho mob tus kheej kev paub thiab qib kev txawj ntse, thiab xav txog tus neeg mob lub siab nyiam.