A Maisonneuve kuputsana inzira yakasiyana-siyana yepakumbo kuputsika kunoitika apo chikwama chinoshandiswa zvine simba kunze (kunze kwekuzungunuka). Iko kuputsika kunokosha nokuti kurapwa kunoda nguva dzose kunoda kuvhiyiwa, uye pasina kunyatsoongorora bhechi (nemabvi), zvinokwanisika kupotsa iyi purogiramu yekukuvara.
Kutanga
The Maisonneuve yakaputsika yakatumidzwa zita rechiremba wechiremba wechiFrance ainzi Jules Germain Maisonneuve.
Dr. Maisonneuve (akadaro MAY-mwanakomana-OU-ve) akatsanangura iyi yekukuvara purogiramu uye kushamwaridzana kwayo nekukuvadza kunokonzera kushanduka kwakasimba kwekunze kwechikwama chechikwama. Dr. Maisonneuve akanga ari chibvumirano chaDkt Dupuytren, mumwe chiremba wechiremba wechiFrench aiva nechirwere chemajoka chakakosha nokuda kwechiitiko chaakatsanangura.
Nhasi, zita raDkt Maisonneuve richiri kushandiswa kurondedzera iyi purogiramu yekukuvara. Nepo ichi chiri chimiro chisina kujairika chepakumbo kuputsika , zvinokosha nekuti pasina kutarisisa, izvi zvingaita sekukuvara kwakanyanya. Kana zvisina kunyatsoongororwa, zvinogona kuva nematambudziko kwenguva refu emakumbo emakumbo, kusanganisira mavanga epakutanga .
Zviratidzo
Pane zviratidzo zvakasiyana-siyana zvinotarisirwa kutarisa izvo zvingaratidza kukuvadzwa kwepakumbo kunogona kuva Maisonneuve kuputsika. Chokutanga, ndechokunzwisisa nzira yekukuvara sevarwere vanotsigira kupera kweCneneuve kazhinji vaine simba rakaoma rekunze kwechechi.
Izvi zvingangova kukuvadzwa kwemitambo kana kuitika kubva pakuwa kuita mabasa akadai. Zvimwe zviratidzo zvekukuvara uku zvinosanganisira:
- Uturu uye kuzviputika kumativi echomukati memakumbo (kumativi ose emukati malleolus )
- Unhu hwakakomberedzwa nechokunze kwebvi (iyo inotyisa fibula )
- Kunzwa kurwadziwa mumhuru nemukomana ( kukuvara kwe syndesmosis )
Varwere vachange vane x-rays kuti vaone maitiro ekukuvadza, uye kana pane kunetseka kuti kukuvadza kwacho kwave kuparadzwa kwe Maisonneuve, ipapo ma-ray emabvi anofanira kuwanikwa zvakare. Mune vamwe varwere, kune chirwere chakanyanya kufema-chema chinogona kukonzera kurapwa. Ganda rinofanira kuongororwa nekuda kwezvimedu zvinoputika uye zvimwe zviratidzo zvekukuvara kwakanyanya.
Kurapa
Kurapa kwekuvhipisa ndiko kunyoreswa kwakakwana kweCneneuve kuputsika, kunyange mune vamwe varwere vasina mhedzisiro yekuputika kana gumbo remakumbo, kana mune varombo vanovhiyiwa vakwegura (varwere vakwegura kana vanorwara), kurapwa kwemashure kunogona kuonekwa. Zvisinei, chiitiko chekuparara kweCneneuve ndechekuvhiya kuti idzorere kugadzikana kumakumbo echikwata.
Apo kugadziriswa kweCheneneuve kachiputsika kuputika, rutivi rwemukati (rwomukati) rutivi rwakagadzirwa, uye syndesmosis inogadziriswa. Zvisinei, iyo moto inoputika pamabvi haifaniri kuongororwa. Chimiro chakakosha chinofanira kuitirwa munzvimbo ndeye syndesmosis (iyo ligament inobatanidza mapfupa emapfupa). I syndesmosis inogadziriswa nemapapiro kana zvakanyanya suture material, masendimita mashoma pamusoro pekubatana kwechikwama.
Rehab Kubva Kuvhiya
Rehab mushure meKeneneuve kuputsika ndedzimwe mwedzi wedzimwechete uye zvichienderana nekuoma kwekukuvara, uye mirayiridzo yechiremba wako.
Nyanzvi dzakawanda dzechiremba dzichagadzirisa chidzitiro kwevhiki 4-6 mushure mekuvhiyiwa, uye kudzivirira kuyerwa kunotakura kumucheto kwevhiki dze12 kusvika kwekutsvaga pakuvhiyiwa. Mukuwedzera, vamwe vanachiremba vanokurudzira kuvhiya kwechipiri kuti vabvise hardware inoshandiswa kugadzirisa syndesmosis vasati vatendera kubata-kutakura kuti vadzoke zvakare. Izvi zvinokakavadzana uye zvinogona kukurukurwa nechiremba wako.
Sources:
Michelson JD "Ankle Fractures Inoguma Kubva Kukuvadza KwemaRotational" J Am Acad Orthop Surg November / December 2003; 11: 403-412.