Fractures Open ndi gulu lawo. thandizo kwa fractures lotseguka

mafupa kuchokera wosweka si inshuwaransi ndi munthu aliyense, mosasamala kanthu za msinkhu, akazi kapena amuna kapena aliyense zina zenizeni. Mu fupa lothyoka amatanthauza kuwonongeka okwana kapena tsankho umphumphu fupa. Izi zingachititse kuti kugwa, mwadzidzidzi nkhonya amphamvu, zopangidwa kapena masoka achilengedwe chikhalidwe, galimoto ngozi.

mitundu ya fractures

Fractures anawagawa:

• kutsegula;
• chatsekedwa.

Nkhani zimene zimapezeka wovulala lotseguka

Open fractures - kuwononga mafupa, ali limodzi ndi kuswa umphumphu wa khungu ndipo chimapangitsa zofewa minofu, kumene wovulala ndi akulumikizana ndi chilengedwe kunja.

An wovulala lotseguka imatengedwa kuwononga zovuta, chifukwa kuvulala ngati azitaya matenda a mbali fupa la nyama tizilombo tating'onoting'ono. Ichi ndi chimene chimasiyanitsa womasuka ndi chatsekedwa wovulala malekezero. Khalidwe la fupa lothyoka ndi lotsegula ndi poyera fupa lomwe complicates mankhwala ndi n'kuukanda ndi detachment wa zimakhala zofewa m'dera la kuwonongeka, amene kumaonjezera ngozi ya matenda. Oopsa kwa moyo wa munthu pa fupa lothyoka lotseguka imatengedwa ngati magazi ndi mantha.

Zizindikiro za wovulala lotseguka

Zizindikiro poyera ndi kuvulala chatsekedwa zosiyana pang'ono, koma yoyamba, popereka zizindikiro ndi kakhumi wamphamvu. Choncho:

• zachilendo kwa sayenda ya nthambi ku malo kumene kulibe olowa;
• palpation wa zinkakhala m'dera pansi pa khungu lomveka crackle;
• pamaso pa bala, ndi ochepa, ndi yaikulu;
• venous magazi;
• chikhalidwe wovulalayo chatsika kwambiri,
• zizindikiro zosonyeza zoopsazo ndi hemorrhagic mantha.

Open wovulala: Gawo

fractures Open, malingana limagwirira chitukuko lagawidwa:

• poyamba-lotseguka, pamene kuwonongeka chifukwa kuti mafupa ndi zimakhala zofewa;
• lotseguka sekondale pamene khungu ndi zofewa minofu kuonongeka malekezero a zotsala fupa.

Popereka wovulala ndi kuopsa kwa moyo wa munthu maziko gulu zina. matenda ndiwo amaimira likulu makalata Russian, kutanthauza kuti:

• A - fractures ndi zazing'ono kuvulala minofu zofewa, amene viability lili kwathunthu kapena pang'ono chakhungu.
• B - Kuwononga ndi digiri pafupifupi yokoka, ndi minofu viability zofewa mu chotupa pang'ono kapena kwathunthu wosweka.
• Mu - wovulala kwambiri sizingasinthe kuwonongeka kwa minofu zofewa, omwe kuchotsa mosalephera kwa thanzi.

Gawo Kaplan-Markova likugwirizana matenda, kusonyeza mtundu wa mabala, kumene A - kubaya mabala; B - anatunduzidwa, lacerated mabala; B - tulo wosweka.
mawerengero achiroma mu matenda anasonyeza kukula bala:

• Ine - yaing'ono kukula kwa mpaka 1.5 masentimita.
• II - kukula kwa chilonda zimasiyanasiyana pakati 2-9 masentimita.
• III - chilonda masentimita oposa 10.

Gulu IV zikuphatikizapo fractures yaikulu kwambiri lolemera chikhalidwe. Pali matenda viability ya nthambi pamodzi ndi mavuto aakulu magazi ndi mantha. Nthawi zambiri, nthambi yonse.
Kutanthauzira kwa fractures lotseguka anatsimikiza ndi dzina la fupa kuonongeka. Zimakhala:

• phewa;
• chigongono;
• femoral;
• tibial ndi peroneal.

Njira ya imfa fupa ndi mtundu wa kuwonongeka pa x-ray wovulala ogaŵikana:

• oblique;
• mtanda;
• fractures bampala zimene zimachitika pa nkhani ya galimoto kugunda;
• helical;
• Big / melkooskolchatye;
• awiri (osamukira wovulala makombo fupa ndipo popanda).

Kupeza Vuto

fractures Open savuta matenda. Kudziwa zonse kuwonongeka wovulala ayenera palpated. Pamakhala X-ray kuchita, zimene zimathandiza inu kudziwa nthawi yeniyeni walakwitsa, mtundu wa wovulala, chikhalidwe cha kusamutsidwa, kuchuluka kwa zidutswa fupa. Open nthambi fractures, fractures a mafupa yaitali ndi msana amafuna osachepera awiri zithunzi X-ray, zinabala mu ndege ziwiri zosiyana perpendicular. Nthawi zina, ziyenera a chikhalidwe zofewa tija ungabwere Kujambula. Ndi fupa lothyoka lotseguka pali chiopsezo cha kuwonongeka kwa mitsempha ndi mtima wosagawanika. Ngati aliyense, kapena ndi kukaikira, muyenera kukaonana ndi neurosurgeon ndi mtima opaleshoni.

thandizo ndi fupa lothyoka lotseguka

thandizo kwa kuvulala kwa mtundu umenewu uli chakuti:

1. Lekani magazi, kuchitira m'mbali mwa chilonda antiseptic.
2. Ikani ndi kuvala wosabala mwachindunji chilonda ndi fupa lothyoka malo.
3. Perekani mankhwala ochititsa ngati Analgin, Pentalgin.
4. kugwetsa nthambi pa malo amene anapezeka kuwononga.
5. Transport wozunzidwayo yapafupi siteshoni mwadzidzidzi.
Thandizo fractures lotseguka Mulimonsemo Sayenera akuyesetsa kuti muyike pena lofalitsidwa kunja fupa, kuchotsa ziwalo wopindidwa, mayikidwe a mafupa kuonongeka. Wenewu kukulitsa vuto la m'mimba.

Panja m'chiuno wovulala chingachitike chifukwa cha kugwa kapena galimoto kugunda. Izi kawirikawiri limodzi ndi anthu anasintha wa zinyalala, kumuchititsa munthu mkhalidwe ululu mantha.

Chinthu choyamba kuchita - ndi anesthetize. Ndiye onetsetsani kuti splint mwendo. Kuti tichite zimenezi, mukhoza kugwiritsa ntchito chinthu chilichonse yaitali: bolodi, chitoliro, ndodo. Splinting zachitika pamodzi thupi lonse kuyambira ku mapazi kwa armpit kwambiri. Koma simungathe kuponyedwa ku mbali kumene mafupa othyoka kuwoneka.

Open wovulala dzanja - ichi ndi mtundu ambiri kuvulazidwa. Nthawi zambiri kumachitika chifukwa mmene amphamvu kapena kugwa. Kuwonjezera magazi manja lotseguka wovulala akhozanso kukopeka ndi chotupa amphamvu a nthambi, olowa chilema. Mpata wa mtundu uwu kuwonongeka ndi kuthekera sankatha magazi mwambo chotupa cha mtsempha wamagazi mwazi ndi kusiya. Thandizo Choyamba ndi zoika loko-basi chifukwa kulephera kuyenda. Ndipo ayenera kuchitapo kanthu mfundo osachepera awiri m'dera wovulala. Mwachindunji ntchito pa zovala za. Chingwe chabwazi kapena zolimba bandeji pamwamba m'dera kuonongeka kwa pothandiza kuletsa kutaika kwa magazi.

Zikukhudza chala palibe anthu ambiri kuwonongeka, chifukwa mwachindunji zoopsa ngati chinthu cholemera kugwa, zimakhudza, psinjika, tucking mapazi ake. thandizo kwa kuvulala kwa mtundu umenewu ndi osavuta. Zimakhala munthu aliyense amene ali pafupi, kapena wovulalayo. Chinthu chachikulu mu nkhani iyi - kugwetsa phazi. Nsapato ayenera kuchotsedwa pa nthawi yomweyo. Chala kuonongeka ayenera kumangirira kwa chinthu chilichonse olimba kapena chala wapafupi. Zikukhudza chala zingakhale:

• kutsegula;
• chatsekedwa;
• wovulala ndi kusamutsidwa;
• comminuted;
• malire wovulala.

Osamukira wovulala analandira ndi kutsutsa mphamvu chala fupa, zikubweretsa pakutchulidwa kuvulazidwa. Mwina limodzi ndi siudzalandilidwa ngathi lamulo la misempha pafupi, mitsempha ya magazi, minofu. Limodzi ndi kuwonongeka ndi ululu, kutupa, osati kuonongeka chala, koma phazi lonse, magazi pansi khungu, misomaliyo, kuphwanya nthambi ntchito.

chithandizo zina

Pambuyo popereka thandizo ayenera m'chipatala mu dipatimenti "Vutoli". Moscow ali zinthu zambiri zapaderazi, ntchito usana ndi usiku, kumene wodwalayo ndi thandizo zonse zofunikira. Powapatsa katswiri thandizo madokotala kudziwa kukula kwa kuwonongeka angayamikire hemodynamic, kukachititsa matenda yaikulu ya wovulala monga anayendera, namkulunga, chithandizo, kudziwika zizindikiro matenda zoipa, ndi X-ray. Wodwala adzapatsidwa procaine anatseka misewu ndi jakisoni ndi kafumbata, kusankha nthumwi, yotakata-sipekitiramu mankhwala kuteteza matenda.

Kenako, wodwala kunditumiza ku chipinda cha opareshoni, kumene chilonda ndi kutsukidwa kwa matupi ena ndi dothi atagona payokha zidutswa fupa chikutha lowonongeka, minofu nonviable issekutsya, chilonda zidzatsekedwa ndi n'kukhala wovulala chatsekedwa. Chakudya m'mbali mwa chilonda kuyenera kuchitidwa popanda nkhawa, ngati izi sizingatheke, ndiye mwambo dermepenthesis.

Khwelero chithandizo chachikulu opaleshoni n'kofunika kwambiri chifukwa neutralizes nyengo chitukuko cha tizilombo tizilombo zomera ndi amalenga yabwino kwa machiritso chilonda. Komanso, excision za "osauka khalidwe" minofu ndi zabwino kwachilengedwenso chinthu, chifukwa moyo wathanzi minofu bwino kulimbana ndi matenda ndi kuchiritsa.

Ndi bwino ngati chisamaliro chachikulu opaleshoni adzapatsidwa choyamba maola 8 zoipa. Pa nthawi imeneyi, tizilombo sadzakhala ndi nthawi kudutsa mwakuya mu bala kuti zimakhala ndi, kufalitsa thupi lonse la magazi ndi lymph.

PECVD kungakhale: Kumayambiriro unachitikira woyamba mawola 24 choipa; anachedwa kwa maola 48; Patapita. The zifukwa pochedwetsa ukhalebe zoopsa mantha, akutaya mwazi wambiri, alowererepo ntchito amagwirizana ndi kuwonongeka kwa ziwalo zofunika kwambiri.

Njira yaikulu ya immobilization makombo fupa

Kugwetsa kuwononga n'kofunika Mulimonsemo. Kutero, chifukwa umboni, kusankha:

• ndi pulasitala;
• chigoba samatha;
• chachikulu, anachedwa mkati nyumba osteosynthesis zitsulo;
• Kunja fixation chipangizo kwa fixation kunja.

Osewera ali wabwino hygroscopic, oyenera chikukonzekera zikutanthauza kuti otsutsa odwala kudwala sikutanthauza luso luso kupereka Mumakonda mwapang'onopang'ono kumalekezero anavulala. Komabe, gypsum immobilizes mfundo moyandikana ndi akhoza compress nthambi mu gulaye ndi.

Chigoba samatha zimathandiza kusunga nthambi ndi kupanga Mavalidwe. Ngati muli ndi fupa lothyoka momasuka ndi kusamutsidwa, ndi kutambasuka kwa amalola kusuntha reponirovat zidutswa. Koma njira imeneyi immobilization amafuna bedi zina, mupumule nthambi amaperekedwa si wathunthu, pamafunika polojekiti ndi kusintha.
Osteosynthesis anapanga ndi oblique, helical, comminuted fractures zovuta kukhalabe, komanso awiri kapena angapo.

Kodi kuchiritsa fractures lotseguka

Bone wovulala machiritso chikuchitika mu magawo angapo. Woyamba siteji kukonzekera angatchedwe. Apa pali Manga lymph ndi magazi clotting, magazi kuundana anapanga malekezero a makombo, ndi seramu anamasulidwa aumirira akulowa minofu zofewa.

Mu gawo lachiwiri amayamba chachikulu connective minofu callus. Iwo ali kapangidwe wandiweyani, ngakhale kuti palibe mu mchere wa manyumwa kapena fupa. chimanga ili salola mafupa ulere kusamukira ku malo zowonongeka. Pakuti nthawi ya ndondomeko izi zikhoza kukhala zosiyana. A ambiri minofu chofuna, pamaso pa minofu zofewa pakati pa mafupa umatha, matenda, yafupika luso maselo tsinde ku fupa minofu kuchuluka mwina m'mbuyo ndondomekoyi.

Gawo lachitatu akuyamba pafupifupi 2-3 masabata pambuyo wovulala lapansi. Iwo amakhala ndi ossification. Connective minofu callus ting'onoting'ono basi. Komabe, kunyamula katundu malo amodzi kapena zazikulu si koma angathe Choncho, immobilization odalirika akadali zogwirizana. Nthawi imeneyi, anakweza mlingo wa kashiamu mu seramu magazi.

Pa gawo lachinayi kukonzanso yomaliza ya callus ku fupa wathunthu. Patapita miyezi ingapo kuchokera pa wovulala fupa latsopano akhoza kulimbana kulemera kwa thupi. Callus zambiri yokulirapo kuposa mafupa leni wosweka. Zochuluka kwambiri chinali kuwonongeka kwa fupa ndi minofu ozungulira, zochuluka kwambiri adzakhala kukula kwa chimanga. Kenako, yafupika ndi kusindikizidwa kwa zimakhala ndi resorption zigawo akale fupa. Wongolerani zinchito katundu adzakhala imathandizira pa kukonzanso wa callus lapansi.

Anachedwa mapangidwe callus amakhala ndi fupa lothyoka lotseguka. Kuchiza ndi machiritso a zoopsa angakhale ndi ndondomeko yaitali, ngati:

• pa fupa lothyoka malo opangidwa osakwanira kuchuluka kwa magazi kuundana ndi zolimbikitsa mapangidwe callus chachikulu fupa;
• ndi njira pachimake yotupa, kusintha zowononga zokhudza maonekedwe a callus pamaziko a matenda;
• ndondomeko ya lifotabe makombo fupa;
• mu minofu connective callus anapanga fibrocartilage.

Mlingo wa mapangidwe callus mwachuluka amadalira bwanji ndi pamene mothandizana ndi fupa lothyoka malo, m'badwo wodwalayo ndi zinthu zina.
Mofulumira ndondomeko ya mapangidwe callus akhoza kugwiritsa ntchito antireticular cytotoxic seramu Bogomolets, fupa chakudya, ufa, eggshell, phosphorous mafuta nsomba.

zotsatira za fractures

Mu fractures lotseguka ndi zoopsa zochepa chabe. Nthawi si amamasulira thandizo oyenerera - koyamba maola 6-8 pambuyo zifukwa - angakhale ndi zotsatira sizingasinthe. Patapita nthawi ino, mukhoza kuyamba sepsis, matenda magazi.

Pamene jekeseni bala lapansi angathe kafumbata. Pambuyo kukhudzana ndi wovulalayo mu traumatology issekutsya zakhudzana malo, koma pa mbali ndithu mtunda minofu kapena tendons, kupulumutsa moyo wa munthu, pali Mwina mkulu kuti wodwalayo wolemala.

Kuyambira takambiranazi mapeto kuti machiritso opindulitsa n'zotheka ndi chithandizo chokwanira woyamba ndi woyamba kuchipatala thandizo operekedwa ndi traumatology lapansi. Moscow, kukhala mzinda waukulu amapereka onse zipangizo kupereka thandizo lofunika.

Kodi n'zotheka kutsimikiza ndi fractures

Wovulala ndi choipa makina, kutsimikiza imene palibe. Komabe, Kafukufuku amasonyeza kuti ena kuvulala akhoza kupewedwa ngati fupa anali ndi dongosolo kwambiri wandiweyani. Kumene, kuchokera kuvulala bwinobwino mwambo kugwa kuchokera kumwamba, ngozi zapamsewu, achiwawa nkhonya izo sizidzakupulumutsani, koma aliyense kugwa kapena podvertyvanie mapazi kudzathera wosweka. Choncho cholinga chachikulu cha kupewa - ndi kulimbitsa mafupa ndi kuteteza kufooka kwa mafupa.

Chinthu choyamba muyenera tcheru - ichi ndi chakudya. Mapuloteni chakudya, pamodzi ndi ambiri khofi ndi zakumwa zofanana, amachepetsa chiwerengero cha kashiamu mu thupi. Kuthetsa vuto ndi kupereka mayamwidwe wabwino kashiamu adzathandiza sipinachi, Beets, udzu winawake, ndiwo zamasamba, mtedza, tiyi, koko ndi nthaka munali mankhwala.

Ndizoonekeratu pamenepa ndi kutsatira wovulala kupewa muyeso - kukhalabe kulemera wathanzi. Kufooka kwa mafupa angathe osati pamaso pa kulemera muyeso, amene kumawonjezera katundu pa mafupa, koma kuchepa thupi kwambiri sizidzakhala mpumulo kwa iye. M'pofunika kudziwa pamene kusiya.

Thandizo kulemera wathanzi akhoza kukhala masewera. Ndi kusewera masewera sakhala timva latsopano kapena madzulo ndi usiku anakhala mu ochitira masewera a. Koma yapadera kwa theka la ola kapena ola katatu pa mlungu pansi pa mphamvu ya pafupifupi aliyense. Mwachibadwa, maofesi maphunziro ayenera payekha payekha, kutenga nkhani m'badwo, ukupeza, mwayi. Ndi zingathandize mabogi mu masewero olimbitsa thupi kapena dokotala. Samalani ndi masewera olimbitsa kwambiri ayenera kukhala amuna ndi akazi.

Mafupa m'mavuto ndi zizolowezi zoipa: kumwa ndi kusuta. Ndipo ngati ntchito choyamba asungike ku Mlingo osachepera, m'pofunika kusiya kusuta kwathunthu. Mu osuta fractures kuchiritsa osati cholimba, komanso Mwina ndi maphatikizidwe pachithunzichi. Atamwa mowa ndi kuphwanya njira kagayidwe kachakudya za thupi. Uchidakwa akuphwanya mayamwidwe kashiamu ndi thupi, amene impairs kachulukidwe fupa la nkhaniyi.

Chinanso chofunika pa thanzi la thupi lathu, ndi vitamini D, amene wambiri chofunika akhoza akamagwira dzuwa tsiku lililonse osachepera kwa mphindi 15. vitamini Zimenezi zimathandiza mayamwidwe wa calcium. Kugwiritsa ntchito sunbathing, ndithudi, izo si zofunika kwa aliyense, makamaka kwa anthu ndi khungu tcheru. Koma phindu la kukongola makampani zamakono amapereka kusankha osiyanasiyana zipangizo kuteteza khungu, zomwe sitiyenera kunyalanyaza.

bwino kwambiri analekerera fractures a anthu achikulire. A choipa munthu kungachititse kuti ngakhale banal kugwa mu nyumba yekha, nyumba yake. Choncho, mu nkhani iyi ayenera yowalanga pazipita kuti Njirazi. Kodi zikutanthauza chiyani? Iwo ayenera kuchotsa zonse lotayirira atapachikidwa mawaya m'dera pansi. Makalipeti ndi makalapeti ayenera kugona mosabisa, musati kusochera. Ngati pali bafa mmenemo, muyenera kukhazikitsa handrails ndi mphasa sanali Pepala anaika. nsapato Home ayenera kukhala omasuka, ndi chokhacho okhwima, ndipo ayenera kugwa ndi mapazi anu poyenda.

fractures Open mafupa - ndi choipa zosasangalatsa kwambiri ndi nthawi yaitali ndinachira. Konzani woyamba chisanadze mankhwala ndi mankhwala thandizo amathandiza kuti kubwezeretsa kwa nthambi yachibadwa.