Distal radius fracture yog ib qho ntawm cov kev raug mob feem ntau hauv kev kho mob, uas tuaj yeem muab faib ua me me thiab hnyav.Rau cov pob txha me me uas tsis yog txav chaw, kev kho yooj yim thiab kev tawm dag zog tsim nyog tuaj yeem siv rau kev rov qab los;Txawm li cas los xij, rau kev puas tsuaj loj heev, kev txo qis, kev sib tsoo lossis plaster fixation yuav tsum tau siv;rau cov pob txha uas pom tseeb thiab puas tsuaj loj rau cov pob qij txha, kev phais yuav tsum tau kho.
PART 01
Vim li cas lub vojvoog distal thiaj li ua rau tawg?
Txij li thaum lub distal kawg ntawm lub vojvoog yog qhov hloov pauv ntawm cov pob txha pob txha thiab cov pob txha pob txha, nws kuj tsis muaj zog.Thaum tus neeg mob ntog thiab kov hauv av, thiab lub zog xa mus rau sab caj npab, qhov kawg ntawm lub vojvoog dhau los ua qhov chaw uas qhov kev ntxhov siab ntau tshaj plaws, uas ua rau tawg.Hom pob txha no tshwm sim ntau zaus hauv cov menyuam yaus, vim cov menyuam cov pob txha kuj me me thiab tsis muaj zog txaus.
Thaum lub dab teg raug mob nyob rau hauv txoj hauj lwm txuas ntxiv thiab lub xib teg ntawm tes raug mob thiab pob txha, nws yog hu ua qhov txuas ntxiv qhov hluav taws xob tawg (Colles), thiab ntau dua 70% ntawm lawv yog hom no.Thaum lub dab teg raug mob nyob rau hauv txoj hauj lwm flexed thiab sab nraub qaum ntawm tes raug mob, nws yog hu ua flexed distal radius fracture (Smith).Qee lub dab teg raug deformities yuav tshwm sim tom qabdistal radius tawg, xws li "silver fork" deformity, "phom bayonet" deformity, thiab lwm yam.
PART 02
Yuav kho cov pob qij txha ntawm qhov distal li cas?
1. Manipulative txo + plaster fixation + cim Honghui tshuaj suav tshuaj pleev daim ntawv thov
Rau feem ntau ntawm cov kab hluav taws xob distal tawg, cov txiaj ntsig zoo tuaj yeem tau txais los ntawm cov lus qhia meej txo + plaster fixation + daim ntawv thov tshuaj suav tshuaj.
Cov kws kho mob orthopedic yuav tsum tau txais cov haujlwm sib txawv rau kev kho tom qab txo qis raws li ntau hom pob txha: Feem ntau hais lus, Colles (extension type distal radius fracture) fractures yuav tsum tau kho ntawm 5 ° -15 ° ntawm palmar flexion thiab siab tshaj ulnar deviation;Smith Qhov tawg (flexion distal radius fracture) tau kho nyob rau hauv supination ntawm lub forearm thiab dorsiflexion ntawm lub dab teg.Lub dorsal Barton tawg (pob txha ntawm articular nto ntawm lub distal radius nrog dislocation ntawm lub dab teg) yog tsau nyob rau hauv txoj hauj lwm ntawm dorsiflexion.dab tegthiab pronation ntawm lub forearm, thiab fixation ntawm lub volar Barton tawg yog nyob rau hauv txoj hauj lwm ntawm palmar flexion ntawm lub dab teg thiab supination ntawm lub forearm.Ib ntus tshuaj xyuas DR kom nkag siab txog qhov chaw tawg, thiab kho qhov nruj ntawm cov hlua me me hauv lub sijhawm kom tswj tau qhov kev txhim kho zoo ntawm qhov me me.
2. Percutaneous koob fixation
Rau qee cov neeg mob uas muaj kev ruaj ntseg tsis zoo, kev txhim kho plaster yooj yim tsis tuaj yeem tswj tau txoj haujlwm tawg, thiab percutaneous koob fixation feem ntau yog siv.Txoj kev npaj kho mob no tuaj yeem siv los ua ib qho kev kho sab nraud, thiab tuaj yeem siv ua ke nrog plaster lossissab nrauv fixationbrackets, uas ua rau kom muaj kev ruaj ntseg ntawm qhov kawg ntawm qhov tawg thaum muaj kev raug mob tsawg, thiab muaj cov yam ntxwv ntawm kev ua haujlwm yooj yim, tshem tawm tau yooj yim, thiab tsis tshua muaj kev cuam tshuam rau kev ua haujlwm ntawm tus neeg mob lub cev cuam tshuam.
3. Lwm txoj kev kho mob, xws li qhib txo, phaj sab hauv fixation, thiab lwm yam.
Hom kev npaj no tuaj yeem siv rau cov neeg mob uas muaj kev puas tsuaj ntau yam thiab kev ua haujlwm siab.Cov qauv kev kho mob yog anatomical txo cov pob txha, kev txhawb nqa thiab kho cov pob txha tawg, pob txha grafting ntawm pob txha tsis xws luag, thiab kev pab thaum ntxov.Cov dej num ua haujlwm kom rov ua haujlwm zoo ua ntej raug mob sai li sai tau.
Feem ntau, rau feem ntau ntawm cov kab hluav taws xob tawg, peb lub tsev kho mob tau txais kev kho mob xws li kev txo qis + plaster fixation + cim Honghui tsoos suav tshuaj plaster daim ntawv thov, thiab lwm yam, uas tuaj yeem ua tiav cov txiaj ntsig zoo.
PART 03
Kev ceev faj tom qab txo qhov tawg ntawm qhov tawg ntawm qhov distal:
A. Ua tib zoo saib xyuas qhov ntsuas nruj thaum kho qhov tawg ntawm qhov tawg.Lub degree ntawm fixation yuav tsum tsim nyog, tsis nruj heev los yog xoob heev.Yog tias kho nruj dhau, nws yuav cuam tshuam rau cov ntshav mus rau qhov kawg ntawm qhov kawg, uas tuaj yeem ua rau mob ischemia ntawm qhov kawg ntawm qhov kawg.Yog hais tias lub fixation yog xoob heev los muab fixation, pob txha hloov yuav tshwm sim dua.
B. Thaum lub sij hawm ntawm kev txhim kho pob txha, nws tsis tas yuav tsum tau nres kev ua ub ua no, tab sis kuj yuav tsum tau ua tib zoo saib xyuas kev tawm dag zog kom raug.Tom qab qhov tawg tau raug immobilized rau ib lub sijhawm, qee qhov kev txav ntawm dab teg yuav tsum tau ntxiv.Cov neeg mob yuav tsum hais kom muaj kev cob qhia txhua hnub, txhawm rau ua kom lub cev muaj zog.Tsis tas li ntawd, rau cov neeg mob nrog fixers, qhov nruj ntawm fixers tuaj yeem hloov kho raws li kev siv zog.
C. Tom qab qhov tawg ntawm qhov distal tawg yog tsau, ua tib zoo saib xyuas qhov kev xav ntawm qhov distal ceg thiab xim ntawm daim tawv nqaij.Yog hais tias lub distal ceg nyob rau hauv lub taag cheeb tsam ntawm tus neeg mob yuav txias thiab cyanotic, qhov kev xav deteriorates, thiab cov kev ua ub no yog heev txwv, nws yog tsim nyog los txiav txim seb nws yog tshwm sim los ntawm nruj heev fixation, thiab yuav tsum tau rov qab mus rau lub tsev kho mob. rau kev hloov kho hauv lub sijhawm.
Yog
Sichuan Chenanhui Technology Co., Ltd
Tel/WhatsApp: +8615682071283
Email: liuyaoyao@medtechcah.com
Post lub sij hawm: Jan-06-2023
