Adọwa akwara nke ubu nkwonkwo: Mgbaàmà na Ọgwụgwọ

Ọ bụrụ na anyị na-arapara nchepụta nke na ọrụ na-mere si enwe nwoke, ihe mbụ a na ogologo na ike ụzọ bụ nke ubu nkwonkwo. Ọ bụ ya pụrụ iche Ọdịdị mere omume site na-apụtaghị ìhè na agba nke elu N'ịdị iji nweta ihe ndị ọzọ pụrụ iche na-enye nwa ara ọtọ atụmatụ.

N'aka, budata ịgbasa ya na ọrụ site na a mere support mgbe na-akpụ akpụ, aka ụmụ mmadụ na-otu n'ime ndị kasị mkpasasị uche akụkụ ahụ. Na nke a, ihe ọjọọ nke ubu-ọkiké, nke na-esokwa ndị adọwa akwara nke ubu nkwonkwo, emi odude ke ebe nke uche pụrụ iche na nke clinicians. Na ihe kpatara nke a - na o kwere omume na ọnwụ nke ike na-arụ ọrụ, na ihe na-aka njọ, a onye na nkwarụ n'ụzọ kwesịrị ekwesị ma ọ bụ na-adọ gwọrọ mebiri.

Brief anatomical akwụkwọ

The iche nke ubu nkwonkwo na-kwupụtara dị ka a ruru nke ya ezi articular ebupụta. Na guzobe nke ọkpụkpụ ọcha na-aka kpọmkwem ọkpụkpụ abụọ: agụba na humerus. The articular elu nke humerus na-anọchi anya * Tụkwasị isi. Banyere concave elu nke glenoid oghere oval agụba ebe ọ bụ banyere ugboro anọ nta karịa ebe n'akụkụ ndị obi ụtọ.

Ne si kọntaktị agụba na-dechapụ cartilage mgbanaka - oké connective Ọdịdị, a na-akpọ articular egbugbere ọnụ. Ọ bụ nke a fibrous mmewere, ọnụ na Capsule gbara ya gburugburu na nkwonkwo, na-enye ohere ya na-ke ziri ezi anatomical hà na n'otu oge ahụ na-arụ ịrịba nso nke ngagharị, nke bụ omume na na inyefe ngwaahịa nke ndị ọzọ niile na nkwonkwo.

Retaining nkwonkwo akwara na uru ahụ eme ije

Ọ na-enyere mkpa synovium nkwonkwo-ejigide ya anatomical Ọdịdị dị ike rostral-humeral ọgọdọ. Na ya na nkwonkwo inyịme ejigide mmezi-articular Capsule bloat biceps akaị (biceps) na subscapularis uru. Atọ ndị a connective eriri na-ata ahụhụ ma ọ bụrụ na e nwere a-agbawa nke akwara nke ubu nkwonkwo.

Subscapularis, deltoid, above- na podkostnaya, nnukwu na obere gburugburu, nakwa dị ka pectoralis isi na latissimus dorsi enye nkwonkwo a dịgasị iche iche nke mmegharị gburugburu niile atọ anyu. Biceps na ngagharị nke ubu nkwonkwo dịghị ekere òkè.

Unan na ubu na nkwonkwo na-akpata mmerụ

Otu n'ime ihe ndị kasị nkịtị unan nke ubu nkwonkwo ntọhapụ bruises. Ekwe Omume sprains nkwonkwo na a ele mmadụ anya n'ihu ma ọ bụ zuru ezu-agbawa ma ọ bụ na-enweghị ya. Na eze na nkwonkwo, intra ma ọ bụ mmezi-articular avulsion mgbaji ọkpụkpụ iberibe (na-ekekọta akwara) bụ n'etiti ndị kasị njọ unan.

Isi akpata mmebi nke ubu nkwonkwo bụ kpọmkwem ma ọ bụ anọ mmetụta ya n'ibu Ọdịdị. Nke a nwere ike ịbụ a kpọmkwem hit na-ada ada gbatịrị agbatị na ogwe aka na-atụ. Nkọ oké muscle erughị ala, akpali nkwonkwo, ma ọ bụ a na mberede ije nke nnukwu mpịakọta nwere ike ime ka dị ka a spren ma ọ bụ na eze nke nkwonkwo. Na-emekarị so ha adọwa akwara nke ubu nkwonkwo (picture egosi n'okpuru), ọ na-achọ ọ bụghị nanị na-emeso ndị kasị unan, ma weghachi ike n'ezi ihe nke ọgọdọ ngwa.

Ịrịba ama nke ọgọdọ agbawa

Injury nwere ike ime mgbe a na-a-ada na ndị kenyere akp na-atụ ma ọ bụ n'akụkụ ogwe aka. Ọ dịkwa ike ọgọdọ agbawa ruru ka a nkọ ije na kacha ime n'ókè ma ọ bụ kokwasịrị ma ọ bụ na ogwe aka, n'ihi na ihe atụ mgbe ama esịn si a elu.

Ịdọkapụta mebiri na-agbawa nke Capsule nke ubu nkwonkwo akwara njikọ mgbaàmà na-ji ụfụ n'oge ọjọọ, na nke ahụ bụ karịsịa ịrịba maka discontinuity, maka mmegharị ugboro usoro nke mmerụ. Ọzọkwa na-emepe emepe edema ebe nke mmebi na gbanwere elu nkwonkwo nhazi. Ke adianade edema, ọzịza ke kpụworo nwere ike isonye streamed si mebiri emebi ọbara arịa nso akwara, mọzụlụ ma ọ bụ ọbara.

Ọzọ ụzọ nke adabere na ogo nke mmerụ

Otu n'ime ihe ndị na-adakarị nnyocha ụzọ, ikwe ọkà n'ịgwọ ọnyá iji chọpụta ma e nwere a ele mmadụ anya n'ihu agbawa nke akwara nke ubu nkwonkwo ma ọ bụ ngụkọta mmebi, na-anọchi ultrasonic nchoputa na magnetik resonance Onyonyo. Ma ụzọ na-adịghị na-agba radial ibu, ma nwere nnọọ nnukwu mkpebi. Karịsịa, MRI na-enye ohere na kacha pụrụ ịdabere na-ekpebi nchoputa na oke nke ọgwụgwọ.

Radiography ma ọ bụ agbakọrọ tomography na-rụrụ iji zere ọkpụkpụ ọnya: fractures (gụnyere vouchers), dislocations, conjugated na a mgbaji ọkpụkpụ na na eze nke ubu nkwonkwo. Mgbe eji arthrocentesis. Arthroscopy rụrụ na-enyo enyo na degenerative mgbanwe nke connective anụ ahụ owuwu nke nkwonkwo ma ọ bụ breakage nke Capsule. Mgbe ụfọdụ, eji arthrography.

Ogo ogo mmerụ

The oge gboo nkewa nke dị mfe, na-agafeghị oke ka oké ihe ọjọọ, na etinyere megide adọwa akwara. Site a nta mmerụ nke ubu nkwonkwo, dịtụ ụdọ, na-agụnye ndinyanade mbịne na ele mmadụ anya n'ihu mmebi nke akwara nke emep uta eri, mgbe nọgide na-enwe ike n'ezi ihe nke ọbara arịa, irighiri akwara na uru. Ji a ele mmadụ anya n'ihu nkezi ogo eriri adọka nke akwara, uru ahụ gbara ya gburugburu na merụrụ ahụ òkè aka na usoro, nkwonkwo nwere ike mebiri emebi. The mbụ na-akọ na ogo spren, nke abụọ - stretchability ele mmadụ anya n'ihu discontinuity.

Oké mmebi esonyere a zuru iro akaị ike n'ezi ihe nke ihe owuwu (ọgọdọ) - discontinuity ubu nkwonkwo akwara njikọ obodo vaskụla mmebi, na akwara aka nke ntụpọ na nkwonkwo. Mgbe a na n'ókè o kwere mee na intraarticular avulsion fractures, nkwonkwo hemorrhage (hemarthrosis).

The ọgwụgwọ usoro

Dabere na larịị nke ogo mmebi nke ubu nkwonkwo ọgọdọ ngwa, mgbanwe ma ọ bụ ịkpa agwọ ọrịa nwere ike ji mee. Ọ bụrụ na e a ele mmadụ anya n'ihu agbawa nke akwara nke ubu nkwonkwo, ọgwụgwọ na-ejedebeghị na mgbanwe ụzọ. Applied analgesia na Immobilization (Immobilization). Ikekwe nnukwu bintovoy ma ọ bụ ihe nkedo, dabere na ogo, ọdịdị nke ihe ọjọọ na olu nke na-emetụta akụkụ. Bintovuyu ma ọ bụ plaster immobilisation orthesis ike dochie (ìgwè) nke ubu nkwonkwo ma ọ bụ a isiike fixation ọkara.

A zuru ezu ezumike, karịsịa na mmebi nke uru ahụ na nkwonkwo capsules, eji n'ịwa ahụ. The aja kwesịrị ụlọ ọgwụ trauma profaịlụ na n'ihu ogologo oge ghara ịgbanwe mgbe orùrù si n'ụlọ ọgwụ.

Arụmọrụ kpatara mgbake ndu

The mee elu mee mgbazi ọdịiche nke ubu nkwonkwo akwara njikọ ọrụ ga-etinyere, mma Ohere maka a zuru mgbake nke nkwonkwo ọrụ ma belata pasent nke mmerụ nsogbu. Ịwa mmezi nke a mebiri emebi ọgọdọ (akaị) n'akụkụ muscle, na mkpochapu mebiri emebi vaskụla nkwarụ Capsule ebelata ka ha crosslinking.

N'okpuru general ná Nkụnwụ (narcosis) kpọmkwem ohere ka n'elu mebiri emebi locus layerwise dissection na nkewa nke anụ ahụ. Ntụpọ hu sutured. The ọnya a na-emechi na n'ígwé. Ná mmalite postoperative oge iji a plaster igba Immobilization na a window maka postoperative agịga.

AFỌ plaster Immobilization na ọgwụgwọ n'ụlọ ọgwụ na-ekpebisi ike site na olu nke na-emetụta akụkụ. Ihe dị mkpa maka ọnụ ọgụgụ nke bed-ụbọchị bụ afọ nke onye ọrịa, ọdịdị nke ọrụ ya, na ngalaba-morbidities.

Mmebi nke akwara nke n'ikpere aka

Ọ bụ nnọọ obere na ezinụlọ ọnọdụ, ihe ọjọọ bụ ihe na-ahụkarị nke ọkachamara na-eme egwuregwu, mgbe eji nọ n'ọrụ na-egbusi-efegharị efegharị aka, kpebisiri na n'ikpere aka. Egwu na-agụnye, nke mbụ niile, tennis Player, golfers, bọl, baseball, na mmiri na Polo.

Ọtụtụ mgbe merụrụ ahụ annular ọgọdọ nke okirikiri, ulna nnochianya ọgọdọ, ma ọ bụ radial. Ọ bụ ihe ịrịba ama nke mmebi nke ihe mgbu, na-amụba n'oge ije. Ji edema, hemorrhage n'ime gburugburu anụ ahụ. Chance nke hemarthrosis. Ọ bụrụ na e a zuru-agbawa nke akwara nwere ike ubé dechapụ aka ọkpụkpụ na nkwonkwo.

Radiography-enye ohere ka ọdịiche dị na mgbaji ọkpụkpụ nke na eze. MRI ga-egosi ebe metụtara nanị akụkụ ụfọdụ agbawa nke akwara nke n'ikpere aka. Ọgwụgwọ nke ele mmadụ anya n'ihu na-ezughị ezu agbawa nke a mgbanwe. Emetụta Immobilization ruo ọtụtụ izu. A zuru ezu ezumike ka nke plastic ịwa ahụ mebiri emebi akwara.

Brief mmewere nke nkwojiaka nkwonkwo

Mgbagwoju ke Ọdịdị kpụrụ nkwonkwo articular cartilage elu nke radieshon efere na ulna site aka na scaphoid, lunate na zita n'akụkụ ahịhịa. Pisiform ọkpụkpụ na-emi odude ke ime nke akaị na kpọmkwem na-ekere òkè n'usoro nke nkwonkwo anaghị anabata.

Ike nkwonkwo ise akwara. The palm bụ n'ikpere aka na nkwojiaka ọgọdọ si azụ elu - azụ nke a ụyọkọ ahịhịa. On n'akụkụ bụ mpụta palmar (n'akụkụ nke isi mkpịsị aka) na ulnar (Mkpịsị aka nta akuku) akwara.

Mmebi nke akwara nke nkwojiaka bụ ọtụtụ efu karịa adọwa akwara nke ubu nkwonkwo. Ma nke ka n'ikpere aka akwara.

Ịhapụ nkwojiaka akwara njikọ

The usoro nke omume nke unan metụtara na a ọdịda na-atụ gụrụ ogwe aka ma ọ bụ a igbu ka kpebisiri ma ọ bụ ịgbatị ahịhịa. Ọnọdụ nke aka n'oge nke mmerụ bụ ozugbo mkpa iji chọpụta nke nke ọgọdọ nwere ike mebiri emebi. Na nke ka nke merụrụ ahụ connective ncherita-n'ogige Ọdịdị nke ahụ ahịhịa.

Top atụmatụ nke ọgọdọ mmebi: mgbu, edema, mkpọchị nkwonkwo ọrụ na adụ anụ ahụ hematoma. Ọ bụrụ na e mgbu na ije na mkpịsị aka ma ọ bụ n'aka ya enwekwu sharply na uzo na nkwonkwo, ọ nwere ike na-enyo enyo na-adọwa akwara nke nkwojiaka nkwonkwo. Mgbaàmà na-complemented nchọpụta na nchoputa nke ngwaike: X-ray - ewepu ọkpụkpụ fractures, ultrasound na / ma ọ bụ MRI. Ha na-mkpa iji chọpụta ọdịdị nke mmebi nke akwara na ndị ọzọ na-adụ anụ ahụ gbara ya gburugburu na nkwonkwo.

Dị ka ọ bụla ọzọ, ma ọ bụrụ na e nwere a ọdịiche akwara nke nkwojiaka nkwonkwo, na ọgwụgwọ ga-adabere na ogo nke ihe ọjọọ. Na nro na-agafeghị oke ogo emetụta mgbanwe n'okpuru oké - arụmọrụ atụmatụ.

N'agbanyeghị ụdị mmebi mere, ihe ọdịdị nke emebi ike n'ezi ihe nke nkwonkwo akụkụ, a na nkwonkwo na-merụrụ ahụ, nkwojiaka, n'ikpere aka, ma ọ bụ na e nwere a ele mmadụ anya n'ihu ma ọ bụ zuru ezu-agbawa nke akwara nke ubu nkwonkwo, ọgwụgwọ mgbe niile kwesịrị ga-ndinọ site a ọkachamara. Amanyere bụ iwu alo na profaịlụ ogige (mgbaji ọkpụkpụ ọgwụ nwere trauma n'ụlọ ọgwụ ma ọ bụ na ndibọbọ ngalaba nke ụlọ ọgwụ traumatological). Nke a bụ eziokwu karịsịa nke nwata trauma, dị ka ọ tọrọ ọrịa, e nwere ọtụtụ afọ metụtara atụmatụ na ike igbanwe a ezigbo ahụ. Na-egbu oge na-achọ eru enyemaka ahụ ike pụrụ iduga ọjọọ ogologo oge pụta.