Dislocation ntawm tus taw - Cov tsos mob, kev kho mob

Nyob rau hauv nqa tawm dislocations zaus cov kev tshawb fawb nws pom hais tias dislocation ntawm ko taw nyob rau hauv nws cov ntshiab daim ntawv no yog tsawg tsawg thiab yog kwv yees li 14-15 1 ntawm tag nrho cov xov tooj ntawm cov dislocations. Feem ntau cov feem ntau nws yog ua ke nrog rau lwm cov ceg raug mob tej zaum yuav ntxiv puas los yog dislocation ntawm lub pob luj taws, cov kev kho mob nyob rau hauv cov ntaub ntawv no yog ntau npaum li cas complicated.

Tej zaum subtalar dislocation ntawm ko taw, thiab ib tug dislocated nyob rau hauv ib tug transverse sib koom tes, dislocation ntawm ib tug ntiv tes. Raws li feem ntau tshwm sim dislocated talus thiab navicular pob txha priplyusny, hos lwm yam pob txha sprains yog tsis tshua muaj heev. Tag nrho cov dislocations yog tsis tshua muaj, yeej muaj ntau ntau yam subluxations nyob rau hauv lub sib koom tes ntawm lub ko taw.

Yuav ua li cas los kho ib tus dislocated ko taw.

Tag nrho yog yus muaj dislocations anamnesis nyob rau hauv raug lead lom rau pawg, lub ntsiab hom ntawm kev kho mob yog cov ua kom tiav thiab lasting fixation tom qab nyob rau hauv tshuaj loog ua dislocation yog tshem tawm. Tom qab ua kom tiav rau thaum kawg ntawm kev kho mob rau tus neeg mob yuav tsum tau tseem ntev txaus los cuam tshuam tus mob uas tej zaum yuav tsum tau nrog los ntawm o thiab txawm lameness. Tag nrho cov kws txawj pom zoo hais tias cov neeg uas tau raug kev txom nyem ib dislocation ntawm ko taw, thaum lub sij hawm tab-siv orthopedic instep.

Subtalar dislocation ntawm ko taw tshwm sim tsis tshua. Thaum zoo li no hom ntawm kev raug mob, nws talus tsis txav, thiab cov xaav ntawm lub calcaneus thiab cov navicular thiab cuboid pob txha ntawm tus tarsus. Tej dislocations tshwm sim vim ib tug lub caij nplooj zeeg ntawm ib qhov siab, thaum muaj kev vam khom rau lub tais pawg. Feem ntau cov feem ntau lawv yog sab hauv thiab posteromedial, feem ntau nrog los ntawm tawg ntawm lub taub hau ntawm lub talus thiab cov navicular pob txha.

Cov tsos mob ntawm kev raug mob yog teev edema hindfoot thiab ceev ceev tshwm sim hematoma. Yog hais tias muaj yog ib tug nrog dislocation, tus taw yog me ntsis txav inward. Tej zog tom qab xws li kev raug mob yog heev mob mob heev thiab xwb, yuav luag nkaus tsis tuaj kawm ntawv cov nyiaj them yug muaj nuj nqi ntawm lub cov ko taw. Nyob rau hauv lub rooj plaub uas ib tug qis pob txha tau ua ke nrog xaav ntawm ko taw, ces tsis pom kev tau pom ib tug tseem ceeb nce nyob rau hauv lub pob taws. Nyob rau hauv thiaj li yuav tsim kom muaj ib tug tseem mob yog tsim nyog los siv ob projections X-ray.

Kev kho mob ntawm no hom ntawm dislocation heev lub sij hawm-siv thiab yuav tsum tau tam sim ntawd reposition, uas yog nqa tawm nyob rau hauv kev tshuaj loog. Quickness tshem tawm dislocation yog tsim nyog vim hais tias muaj yog hemorrhage, thiab lub resulting o yuav es yuav txo tau. Tom qab daws qhov teeb meem yuam ntiab tawm ntawm lub toes thiab fixation ntawm lub hauv caug sib koom tes, uas yog khoov duav rau ntawm ib lub kaum sab xis ntawm 150 °. Tom qab ntawd, cov kev tswj yog nqa tawm X-ray xeem. Tom qab 3-4 lub lim piam ntawm fixation yog muab tshem tawm thiab tau yuav tsum tau siv ntawm lub cev txoj kev kho thiab zaws rau ib tug tag nrho rov qab los ntawm qhov raug mob extremity kev kawm. Nws kuj pom zoo rau hnav instep deposit li 6 lub hlis. Serviceability pib rov qab tsis muaj ntxov tshaj 2 lub hlis.

Dislocation nyob rau hauv transverse tarsal sib koom tes ntawm lub ko taw tshwm sim vim direct txhua yam kev raug mob. Qhov no raug mob feem ntau tshwm sim nyob rau hauv motorcyclists uas tshwm sim forcible flexion ntawm lub forefoot. Xws li ib tug dislocation yog feem ntau nrog los ntawm tawg ntawm ko taw los yog cuboid navicular cov pob txha.

Cov tsos mob ntawm no hom ntawm daim tawv nqaij poob plig yog nro thoob plaws lub dorsum ntawm ko taw, nws deformation, raws li zoo raws li edema thiab mob heev. Thaum probing kom meej meej qhia tau hais tias lub xaav ntawm lub navicular pob txha. Rau ib tseeb mob no kuj tsim nyog rau kev X-ray nyob rau hauv ob qhov.

Dua li ua ntej los mus tshem tawm no dislocation, lub zoo dua. Yog hais tias muaj yog tsis muaj contraindications, lub lag luam yog ua nyob rau hauv kev tshuaj loog. Yog hais tias ib tug neeg yog txhob tshuaj loog, txoj kev ua no yog nqa tawm siv lub intraosseous loog.

Tom qab tshem tawm ntawm dislocation ntawm ko taw tsau, thiab cov plaster yog muab tshem tawm nyob rau hauv 1,5-2 lub hlis. Yuav kom restore functionality siv physiotherapy.