Bayan rauni, kashi da kyallen takarda sun lalace, kuma akwai ka'idodi na magani daban-daban da kuma hanyoyin da suka ji rauni. Kafin watsi da duk karaya, yana da muhimmanci don sanin girman raunin.
Raunin da ya ji taushi
I.classification
Rufe karaya
Raunin nama mai taushi nama mai taushi ana graded daga m zuwa mai tsanani, yawanci amfani da hanyar TSSSHER (Fig. 1)
Dama Haske: rauni rauni mai laushi
Rauni
Rauni: Rauni: Muhimmin Cinikin Murny ko Cinikin Fata na Ciniki ko Dukansu
Rauni
Hoto1: TSSSLE CRICICICICICICICICICICI
Bude rauni
Saboda karaya shine a cikin duniyar waje, mataki na lalacewar nama mai laushi yana da alaƙa da adadin makamashi da aka ƙware a lokacin rauni, ana amfani da rarrabuwa ta Gustilo (Hoto na 2)
Hoto na2: Gustiloclassification
Rubuta na: Tsabtace rauni mai tsabta <1 cm, karamin lalacewa tsoka, babu wani yanayin nama mai laushi, flap, babu rauni mai laushi, flap haifar
Type III: Rarrabawa ya haɗa da fata, tsoka, periosteteum, da ƙashi, tare da mafi yawan raunin bindiga da raunin gunshot
Type IIIIA: Wicksread da lalacewa da / ko kasancewar ƙwayoyin cuta mai laushi mai laushi, kyallen takarda tare da isasshen ɗaukar hoto na kashi da kuma tsarin neurovascular
Rubuta IIIB: Tare da lalacewa mai laushi mai laushi, mai jujjuyawar tsoka ko kayan masarufi yayin jiyya don samun ɗaukar hoto
Rubuta IIIC: Buɗe rauni tare da lalacewar jijiyoyin jini yana buƙatar daidaitawa da aka gyara Gustilo yana haifar da ci gaba da mummunan mummunan abu a lokacin gyara.
Gudanar da II.injy Gudanarwa
Rauni warkarwa yana buƙatar oxygenation, kunna hanyoyin sirular, tsarkake raunuka kyauta da ƙwayar cuta mara gurbata. Akwai manyan matakai huɗu na waraka: coagulation (minti); lokaci na kumburi (sa'o'i); mataki na nama (kwanaki kura); Lokacin samar da ƙwayar cuta (makonni).
Staging na jiyya
Lokaci mai rauni:ruwa ban ruwa, Debride, sake sake fasalin ƙashi, da kuma dawo da kewayon motsi
(1) Kimanta yawan rauni mai laushi da kuma raunin neurovascular
(2) Yi amfani da adadin kayan isotonic don ban ruwa a cikin ɗakin aiki don cire ƙwayar necrotic da jikinsu
(3) Ana aiwatar da dabide kowane 24 ~ 48 hours don cire dukkanin jikin kasashen waje da kyallen da ya gabata (4) an rufe rauni a kan rauni, kuma ana aiwatar da zurfin rauni, da kuma kimantawa mai zurfi da kuma doka.
(5) An sake komawa ƙarshen karfin zuciya na kyauta a cikin rauni; An cire ƙananan ƙwayoyin cuta na cortex don bincika kuma tsaftace rami na kashi
Sake gini:Yin ma'amala da Sequelae na rauni (jinkirin haɗin kai, nakasassu, kamuwa da cuta)
Tasitar:Psychognicy, zamantakewa, da kuma ci gaba mai haƙuri na mai haƙuri
Nau'in rauni na rauni da ɗaukar hoto
Rufewar rauni na farko ko ɗaukar hoto (3 ~ 5 kwana) na iya cimma nasarar sakamakon magani mai gamsarwa: (1) ƙulli na farko
(2) Raba gamsuwa
(3) ƙulli na sakandare
(4) Matsakaici-lokacin farin ciki flapplantation
(5) Flap na son rai (m na dijital divital)
(6) vascular pedicle flap (gursrocnemous flap)
(7) Flap kyauta (Fig. 3)
Hoto3: An bayar da jerin abubuwan da aka tsara na translants na kyauta
Lalacewar kashi
I.Cracture Direction
Transvere: lada na wani yanki mai rarrafe wanda tashin hankali ya haifar da tashin hankali
Overyly: Yanayin nauyi na matsin lamba saboda karaya na diagonal
Karkace: ɗaukar tsarin karaya saboda karkatacciyar karya
Ii.fratry
Classigfication bisa ga karaya, nau'in karaya, da sauransu (Fig. 4)
Abubuwan da aka yiwa cakulan iska suna da rauni tare da 3 ko fiye da ƙananan ƙananan kashi, yawanci sun haifar da rauni mai ƙarfi.
Karya na patolicy sifar karaya rami na ruwa yana faruwa ne a fannin lalata cuta na cutar ta baya, ciki har da: kumburin kashi, osteoporosis, da sauransu
Rashin cikawa ba su ragu cikin guda na kashi daban ba
Kashi na yanki tare da distal, tsakiya, da kuma gutsuttsura gutsutsuren. Endatearshen sashi yana tasiri ne ta hanyar wadatar jini, yawanci sakamakon rauni mai ƙarfi, tare da fitarwa ta nama mai laushi daga kashi, yana haifar da matsaloli tare da warkarwa na kashi.
Karji tare da lahani na kashi, bude baki tare da gutsuttsuran ƙashi, ko rauni-da ba a buƙatar fashewar rauni, ko rauni mai rauni wanda ke haifar da lahani na kashi.
Karji tare da ƙananan ƙwayar ƙashin ƙwai suna kama da karaya na kashi a cikin cewa ba su ƙunshi duk giciye-kashi na kasusuwa ba kuma yawanci sakamakon tashin hankali ne.
Ruwa na damuwa yana haifar da maimaita kaya kuma sau da yawa suna faruwa a cikin diddige da Tiba.
Avulsion karar karaya yana haifar da rauni na kayan kasusuwa lokacin da jijiyoyin ko jijama ta miƙa.
Karatun tsintsrusrvorizai shine karaya wanda aka matse shi da kashi-kashi na kashi, yawanci ta hanyar lodi.
Hoto na 4: Classigfication na karaya
Iii.factors tasiri karfin warkarwa
Masana'antu: Age, Cutar Kudi na Merabolor, Matsayi na Aiki, Matsayi na Tsaro, Matsakaicin Kudi, Tsarin Kayayyaki, Tsarin Kayayyaki, Tsarin Kulla, Tsarin Kayayyaki matakin rauni na makamashi, mataki na lahani.
IV. Abubuwan da ke tattare da jiyya
An nuna magani da ba na tiyata ga marasa lafiya da raunin da ya samu ko kuma waɗanda ke ba da izini saboda abubuwan da ke tattare da juna.
Rage: Train tare da dogon tsinkaye na dogon lokaci, rabuwa.
Gyara katakon takalmin katakon karaya da yawa: gyarawa da rage kashi ta hanyar gyarawa ta waje, gami da dabarar gyara uku.
Kashin tubular ci gaba da gyara dabarar dabarar matsawa: wata hanya, gami da harkar fata, ƙirar ƙashi.
Jiyya na Jiyya
(1) Gyara ta waje ta dace da fashewar fashewa, rufewa tare da rauni mai laushi mai laushi, da karaya tare da kamuwa da cuta (Fig. 5)
Hoto na 5: Tsarin gyara na waje
(2) gyaran ciki ya dace da wasu nau'ikan fashewar kuma ya bi ka'idodin AO (Table 1)
Tebur 1: Juyin Juyin Juyin Ao cikin Karaya
Tsararren gutsuttsuran na buƙatar daidaitawa da tsararru, ciki har da matsawa mai tsauri
(4) Rage kai tsaye:
Ana aiwatar da fasahar dillali a cikin yankin da aka kwantar da ita don rage rauni ta hanyar tashin hankali ta taushi, kuma gyaran waje, ao ya sami damar yin amfani da na'urar ko kuma budurwar AO da aka samu.
V.Taging na magani
Dangane da tsarin ilmin biochemical na karar fata, an kasu kashi hudu (Tebur 2). A lokaci guda, haɗe tare da tsarin biochemical, lura da karaya zuwa matakai uku, wanda ke inganta kammala aikin biochemical da warkaswar karaya (Hig. 6).
Tebur 2: Hanyar rayuwa na warkar da karaya
Hoto na 6: Matsakaicin zane na ƙwayar cuta da warkarwa a cikin mice
Zamani mai kumburi
Temorrhage daga wurin karaya da kuma kewaye kyallen takarda yana kafa hematoma, siffofin nama na nama a ƙarshen fashewa, da osteoblasts da fibrrrrims fara yaye.
Downtime
Amsar Kira na ainihi na faruwa a cikin makonni 2, tare da samuwar wani yanki na kashin baya ta hanyar warkar da karaya ta gaba, da kuma duk takamaiman kayan warkarwa suna da alaƙa da yanayin jiyya.
Hani
A lokacin aiwatar da gyara, an maye gurbinsu da kashi na Brided kashi, kuma an karye koguwar medullary don alamar kammala gyaran rauni.
Wahala
Jinkiri na kungiyar ne ya nuna shi ne ta hanyar rashin ƙarfi ba waraka a cikin tsarin lokacin da ake tsammani, amma har yanzu yana da wasu ayyukan nazarin halittu, kuma dalilan jinkirta da suka shafi karfin warkarwa.
Nassion an bayyana azaman rauni ba tare da shaidar cutar asibiti ko radiological, da manyan abubuwan da suka faru sune:
(1) Batun atrophic saboda rashin halaye na ilimin halitta don warkewa, yawanci ana nuna alamar ƙarshen kasusuwa (graft ko siyar da kashi na kashi na gida).
(2) Rashin Hawan Hypertrtroon yana da Vascular na Cverculozation da ikon ilimin halittar jiki, wanda yawanci ana bayyana shi kamar yadda aka karye shi da ingantaccen kwanciyar hankali (farantin ƙwai da kuma gyaran ciki).
(3) Nassarancin Dystrophic yana da isasshen wadatar jini, amma kusan babu buƙatar haɓakar kira, da rage ragi ana buƙatar sake yin shi saboda rashin isasshen ƙaura da rage ƙarshen tashin hankali.
(4) Don haduwa da kamuwa da cuta tare da kamuwa da cuta, jiyya ya fara cire kamuwa da cuta, sannan ya inganta warkar da karaya. Kurarrun kasusuwa cuta cuta cuta ce ta kashi da kamuwa da cuta, wanda zai iya zama kamuwa da cutar kai tsaye da cututtukan fata da cututtukan cututtukan jini da kuma wajibi ne a gano ƙwayoyin cuta.
Cikakken yanayin zafi na yanki yana sananniya da jin zafi, ƙididdigar rashin jin daɗi, ƙwayoyin cuta, da edema, ciki har da ƙauyuka na tsarin juyayi mai juyayi. Yawancin lokaci yakan faru ne bayan rauni da tiyata, kuma an gano su kuma kula da wuri, tare da juyayi na jijiya idan ya cancanta.
• Heterotopics heterotopic (ho) ya zama gama gari bayan rauni ko tiyata, kuma ya zama ruwan dare a cikin gwiwar hannu na iya haifar da ma'adinai na kashi bayan ta hanyar farko.
• Matsin lamba a cikin ɗakin periophysal yana ƙaruwa zuwa wani matakin, yana lalata turare na ciki.
• Raunin neurovascastular yana da dalilai daban-daban na rauni na neurovascular saboda wurare daban-daban.
• Necrosis navasisis na faruwa a wuraren ba da isasshen jini, musamman, duba raunin da yanayin yanayin da ba za a iya ba da shi.
Lokacin Post: Dec-31-2024
