Ki te kore e tika te maimoatanga o ngā whati o te turanga tuarima o te metatarsal, ka hua ake te kore hononga o te wheua, te roa rānei o te hononga o te wheua, ā, i ngā wā kino rawa atu, ka puta ake te mate rumatiki, ka nui te pānga ki te oranga me te mahi o te tangata i ia rā.
Aā-taiaoShangangae
He wāhanga nui te tuarima o ngā wheua metatarsal o te pou taha o te waewae, ā, he mahi nui tāna ki te amo i te taumaha me te pumau o te waewae. Ko te tuawhā me te tuarima o ngā wheua metatarsal me te porowhita te hononga porowhita o te metatarsal.
E toru ngā uaua e piri ana ki te turanga o te tuarima o ngā metatarsal, ka whakaurua te uaua peroneus brevis ki te taha dorsolateral o te ngongo i te turanga o te tuarima o ngā metatarsal; ko te uaua peroneal tuatoru, kāore i te kaha pērā i te uaua peroneus brevis, ka whakaurua ki te diaphysis distal ki te tuarima o ngā metatarsal tuberosity; ko te plantar fascia ka whakaurua te uaua lateral ki te taha plantar o te basal tuberosity o te tuarima o ngā metatarsal.
Te whakarōpūtanga o te whati
I whakarōpūtia ngā whati o te turanga o te tuarima o ngā metatarsal e Dameron rāua ko Lawrence,
Ko ngā whati Rohe I he whati avulsion o te ngongo metatarsal;
Kei te hononga i waenga i te diaphysis me te proximal metaphysis ngā Rohe II, tae atu ki ngā hononga i waenga i ngā wheua metatarsal tuawhā me te tuarima;
Ko ngā whati Rohe III he whati ahotea o te diaphysis metatarsal proximal kei tawhiti atu i te hononga intermetatarsal 4/5.
I te tau 1902, i whakaahua tuatahitia e Robert Jones te momo whati rohe II o te turanga o te tuarima o ngā metatarsal, nō reira ka kiia hoki te whati rohe II ko te whati Jones.
Ko te whati avulsion o te ngongo metatarsal i te rohe I te momo whati turanga metatarsal tuarima e tino kitea ana, e 93% pea o ngā whati katoa, ā, ka puta mai i te piko plantar me te tutu varus.
E 4% pea o ngā whati katoa i te turanga o te tuarima o ngā metatarsal e puta mai ana i ngā whati i te rohe II, ā, nā te piko o te waewae me te kaha o te tāpiritanga o te waewae i puta ai. Nā te mea kei roto i te rohe e rere ai te toto i te turanga o te tuarima o ngā metatarsal, ka ngāwari ngā whati i tēnei wāhi ki te kore e honoa, ki te kore rānei e ora ngā whati.
Ko ngā whati o te turanga metatarsal tuarima e pā ana ki te 3% o ngā whati o te Rohe III.
Te maimoatanga tiaki
Ko ngā tohu matua mō te maimoatanga pūmau ko te nekehanga o te whati i raro i te 2 mm, ngā whati pumau rānei. Ko ngā maimoatanga noa ko te whakaū i te nekehanga mā te whakamahi i ngā takai rapa, ngā hu pakari, te whakaū i te nekehanga mā te whakamahi i ngā whakarewa raima, ngā papa kōpeketanga kāri, ngā pūtu hikoi rānei.
Ko ngā painga o te maimoatanga pūmau ko te iti o te utu, te kore whara, me te ngāwari o te whakaaetia e ngā tūroro; ko ngā ngoikoretanga ko te nui o ngā raruraru o te kore-uniona whati, o te kore-uniona rānei, me te ngāwari o te pakari o ngā hononga.
PokangaTte tiaki
Ko ngā tohu mō te maimoatanga pokanga mō ngā whati o te turanga metatarsal tuarima ko:
- Nekehanga whati neke atu i te 2 mm;
- Te pānga o te > 30% o te mata hononga o te wheua tapawhā ki te pito tawhiti o te tuarima o ngā metatarsal;
- Whati pakaru;
- Te whati i whakaroa te hononga, te kore rānei e hono i muri i te maimoatanga kore-pokanga;
- Ngā tūroro taitamariki hohe, ngā kaitākaro hākinakina rānei.
I tēnei wā, ko ngā tikanga pokanga e whakamahia whānuitia ana mō ngā whati o te turanga o te tuarima o ngā metatarsal ko te whakapiri ā-roto o te whitiki kume waea Kirschner, te whakapiri tuitui punga ki te miro, te whakapiri ā-roto o ngā tīwiri, me te whakapiri ā-roto o te pereti matau.
1. Te whakau i te whitiki kume waea a Kirschner
He tikanga pokanga tuku iho te whakau i te taura kume waea Kirschner. Ko ngā painga o tēnei tikanga maimoatanga ko te ngāwari o te uru atu ki ngā rauemi whakau ā-roto, te iti o te utu, me te pai o te pānga pēhi. Ko ngā ngoikoretanga ko te mumura o te kiri me te mōrearea o te wetekina o te waea Kirschner.
2. Te whakapiri tuitui me ngā punga miro
He pai te whakau tuitui punga ki te miro mō ngā tūroro he whati pakaru i te turanga o te tuarima o ngā metatarsal, he iti rānei ngā kongakonga whati. Ko ngā painga ko te tapahi iti, te mahi ngāwari, me te kore e hiahiatia he tango tuarua. Ko ngā ngoikoretanga ko te mōrearea o te heke o te punga i roto i ngā tūroro he osteoporosis.
3. Te whakapiri i ngā whao tuwhera
He maimoatanga whai hua e mōhiotia ana i te ao katoa te tīwiri tuwhera mō ngā whati o te turanga o te tuarima o ngā metatarsal, ā, ko ōna painga ko te pumau me te pumau pai.
I roto i te haumanu, mō ngā whati iti i te turanga o te tuarima o ngā metatarsal, ki te whakamahia ngā tīwiri e rua hei whakapiri, ka tūpono te whati whakamuri. Ina whakamahia te tīwiri kotahi hei whakapiri, ka ngoikore te kaha ārai-hurihuri, ā, ka taea te neke anō.
4. Kua whakaukia te pereti matau
He whānuitia ngā tohu mō te whakapiri pereti matau, inā koa mō ngā tūroro he whati avulsion, he whati osteoporosis rānei. He rite te hanganga hoahoa ki te turanga o te tuarima o ngā wheua metatarsal, ā, he teitei te kaha o te pēhi whakapiri. Ko ngā ngoikoretanga o te whakapiri pereti ko te utu nui me te whara nui.
Summary
I te wā e rongoatia ana ngā whati i te turanga o te tuarima o ngā metatarsal, me āta whiriwhiri kia rite ki te āhuatanga motuhake o ia tangata, ki ngā wheako whaiaro me te taumata hangarau o te tākuta, ā, me whai whakaaro nui ki ngā hiahia whaiaro o te tūroro.
Wā tuku: Pipiri-21-2023
