Zosankha Za Chithandizo cha Broken Shin Bone
Tibia ndi fupa lalikulu lomwe lili pakati pa bondo ndi bondo. Chiwalo ichi cha thupi chimatchedwa (mwachipatala) mwendo, ndipo pamodzi ndi phazi ndi ntchafu, zimapanga kumapeto kwenikweni (mwendo ndiye kwenikweni gawo pakati pa bondo ndi minofu, ngakhale kuti anthu ambiri amatchula kumapeto kwenikweni monga 'mwendo'). Pali mafupa awiri a mwendo, tibia ndi fibula.
Tibia ndi fupa lalikulu lomwe anthu amawatcha kuti fupa. Ambiri a thupi lawo amathandizidwa ndi tibia. Chifuwa ndi fupa laling'ono lomwe lili kunja kwa mwendo, ndipo sichimathandiza thupi, komabe limagwira ntchito zofunikira pambali ndi mawondo a minofu ndipo zimagwirizana ndi minofu ndi mitsempha.
Mitambo ya Tibia
Zomwe zimapangitsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda zimakhala zovulaza kwambiri zomwe zimakhalapo zikagwa, ngozi za galimoto, kuvulaza masewera, ndi zina zamphamvu. Chimake cha tibia ndi gawo lalikulu la fupa, osati fupa la fupa lomwe lili pansi pa bondo kapena pamwamba pa bondo. Dzina lachipatala la pamtanda wa tibia ndilojambulira mafupa. Mthunzi wa tibia ndi chubu, ngakhale kuti uli ndi katangidwe kakang'ono kamodzi kokha ndi tibia pachimake pokhala chigwa chowonekera kutsogolo kwa shin. Pamwamba pa tibia amatchedwa mtengo wa tibial , ndipo pansi pa fupa amatchedwa tibial cefond .
Pakatikati mwa dzenje la fupa ndi mchere wa mafupa. Mbali yakunja ya fupa ndi yowuma ndi yolimba; izi zimatchedwa kaloti ya fupa ndipo zimapereka mphamvu ya tibia. Monga tafotokozera, gawo ili la tibia ndilo kuvulazidwa kwakukulu komwe kumachitika kokha pambuyo pa zochitika zazikulu .
Nthawi zina mafupa amatha kufooka mosavuta, ndipo mafupa amatha kuwonongeka. Izi zimatchedwa fractures pathologic , ndipo zimachitika pamene fupa lafooka ndi osteoporosis, chotupa, matenda, kapena zina.
Zizindikiro za Tibial Shaft Fractures
Tibial shaft fractures nthawi zambiri zimachitika ndi kuvulala koopsa. Zizindikiro zomwe zimachitika paziphuphuzi ndi izi:
- Kupweteka pazomwezo
- Kupunduka kwa mwendo
- Kutupa ndi kuvulaza kuzungulira
- Kulephera kuyika kulemera kwa mwendo
Tibial shaft fractures iyenera kuyesedwa mu chipinda chodzidzimutsa. Ngakhale kuti kuvulala kungawoneke bwino, ndikofunika kuyesa kumapeto kwake kuti musamangoganizira za tibia, komanso chifukwa chovulala mpaka kumapeto. Anthu omwe amapitiriza kuvulalawa ayenera kukhala ndi kuwonetsetsa kwathunthu kwa thupi, monga pangakhale kuvulala kwina kumene kumachitika komwe sikungakhale koonekera chifukwa cha ululu mwendo.
Matenda ambiri a tibia akhoza kuthandizidwa bwinobwino ndi mayesero a X-ray. Kugwedezeka kwa mafupa sikungathe kuwonetsa x-ray, ndipo kuvulala kumeneku kungakhale koonekeratu pa mayesero monga MRI kapena scan. Komabe, njira yachizolowezi yowunika ndi x-ray kuyamba.
Njira Zothandizira Tibial Shaft Fractures
Mphuno ya tibial yophulika ikhoza kuchitidwa ndi njira zingapo malinga ndi mtundu wa kupasuka ndi kugwirizana kwa fupa.
Mankhwala omwe amafala kwambiri ndi awa:
- Kutayira: Kuponyedwa kuli koyenera kuti tibial shaft fractures omwe sali othawa kwathunthu ndipo akugwirizana bwino. Odwala amafunika kukhala mu chingwe chomwe chimadutsa pamwamba pa bondo ndi pansi pa bondo (kutalika kwa mwendo). Ubwino wa kuponyera ndikuti ziphuphuzi zimakonda kuchiza bwino ndi kuponyera zimapewa kuopsa kwa opaleshoni monga matenda. Odwala omwe ali ndi matendawa ayenera kuyang'aniridwa kuti athetse machiritso oyenera a tibia ndi kuonetsetsa kuti mafupa apitirize kulumikizana.
- Intrameduallary (IM) Rodding: Intrameduallary rodding ndi ndondomeko yoyika ndodo yomwe ili pakati pa tibia kuti agwirizane. Tibial rodding ndi njira yopaleshoni yomwe imatha pafupifupi ola limodzi ndi theka ndipo nthawi zambiri imakhala ikuchitidwa ndi anesthesia. Odwala adzakhala ndi chowombera pambali pa mawondo, ndi zocheperako pansi pa bondo ndi pamwamba pa bondo. Kuphatikizanso apo, zina zowonongeka zingapangitse kuthamanga pafupi ndi kupweteka kuti thupi likhale lokhazikika. Mitengo ya IM imatetezedwa mkati mwa fupa ndi zikopa zonse pamwambapa ndi pansipa. Zilonda zachitsulo ndi ndodo zikhoza kuchotsedwa ngati zimayambitsa mavuto, koma zingakhalenso m'malo mwa moyo. Tibial rodding imapangitsa kuti mafupa azigwirizana. Kawirikawiri chiopsezo chachikulu cha opaleshoni ndi kupweteka kwa maondo, ndipo zambiri zokhudza vutoli ndi matenda. Kugonjetsedwa kwa ndodo kungatenge kuchotsedwa kwa ndodo kuti kuchiza matenda.
- Mipata ndi Maso: Mipata ndi mipiritsi sizogwiritsidwa ntchito mocheperapo, koma zimathandiza pazinthu zina zomwe zimathyoka, makamaka zomwe zimakhala pafupi ndi mawondo kapena mitsempha (onani zolemba pa tibial plateau ndi tibial plafond fractures). Ochita opaleshoni ambiri amasankha IM imodo ya tibial shaft fractures pokhapokha kuti fracture ili pafupi kwambiri ndi mgwirizano kuti mulole kuti IM imangidwe. Muziphuphu zimenezi pafupi ndi chophatikizira pamwamba, mbale ndi zikuluzikulu zingakhale njira yabwino yokonzekera.
- Fixator yakunja: Wowonetsera kunja angakhale othandizira pa mitundu inayake ya kupasuka. Okonzekera kunja amayamba kugwiritsidwa ntchito pa ziphuphu zoopsa kwambiri, zowonjezereka zowonongeka zomwe zimagwirizanitsidwa ndi mazira ndi zovulaza. Pazochitikazi, kuyika kwa IM mabala kapena mbale sizingatheke chifukwa cha kuvulala kofewa. Pakakhala kuvulala kwakukulu, chowongolera kunja chingapereke chitsimikizo chabwino pokhapokha ngati kulola kuyang'anira ndi chithandizo cha mavitamini ozungulirawa.
Mawu Ochokera
Kuwonongeka kwa Tibia kumapweteka kwambiri. Tibia ndi fupa lalikulu, lamphamvu lomwe limathandiza thupi lathu lonse. Nthawi zambiri kuvulala kumeneku ndi chifukwa cha vuto lalikulu. Pachifukwachi, tibia fractures ingafune mankhwala osadziwika kuti atsimikizire kuti mafupa amatha kubwerera. Popanda chithandizo choyenera, pali zotheka nthawi yaitali zomwe zingathe kuchepetsa ntchito yachibadwa ya mapeto. Anthu omwe ali ndi mavuto a nthawi yayitali pambuyo poti firimu la tibia likuphwanyika akhoza kukhala ndi zovuta kuyenda moyenera.
> Zotsatira:
> Melvin JS, Dombroski DG, Torbert JT, Kovach SJ, Esterhai JL, Mehta S. "Kuwombera mthunzi womasuka: I. Kufufuza ndi kasamalidwe koyamba" J Am Acad Orthop Surg. 2010 Jan; 18 (1): 10-9.
> Mashru RP, Herman MJ, Pizzutillo PD. "Tibial shaft imafalikira ana ndi achinyamata" J Am Acad Orthop Surg. 2005 Sep; 13 (5): 345-52.