Pana na puupuu wawae.

No a pau na nā palapū kūlana 'he nui ke ano o ka lala ino. Muli o kona kulana, he pono ole fracture o ke kuʻekuʻe wāwae.

Na puupuu wawae - kaʻina i lilo 'i ke kuʻekuʻe wāwae ami. Kēia ami he o nā puʻupuʻu wāwae: kīloi paʻewa (aia ma luna o ka pā ili o ka tibia) a me ka medial (aia ma kaʻaoʻao ma loko). Wahi a ka 'ikepili helu, he iwakalua pakeneka o nā nā palapū o ka musculoskeletal'ōnaehana mea pono kekahi lahuikanaka i mokumokuia na puupuu wawae.

Ka pilikia nui o ka trauma a me ka fracture hooleiiaʻi mawaho mawaho (kīloi paʻewa) na puupuu wawae (ma kahi o kanawalu pakeneka o na hihia), a wale umikumamalima - he iwakalua hapahaneri no i hana ino iki mai medial.

He nui na ano o ka fractures , ke kaumaha ma muli o nā 'ano o nā mechanics: supinatsionno-e alakai, pronation-hookuuia a me ka hoʻokaʻa. Eia hou kekahi, hoʻokaʻawale pūʻulu o kaʻawale fracture waho a me loko na puupuu wawae, e like me ka pono me hamama a me ka paʻa fractures, fracture offset.

Symptoms o ka puupuu wawae fracture - eha, hoʻokano, loli ma ka contours o ka hoʻopōʻino hui a me ka ho'āʻo. E hoʻokūpaʻa i ka fracture, e like me ka hookupaa i kona mechanics, a ua lawe mai i ke koho ano o ka lapaʻau X-Ray o ke kuʻekuʻe wāwae ami.

Lapaʻau o fracture na puupuu wawae paʻakikī loa. Keia mea kuhikuhi no i ka mea i ke kuʻekuʻe wāwae ami 'ole ka loa huikau, iwi ke aupuni' superficially koko i loko o ke akamai o kona kulana maʻalahi hoʻonawaiwali. Ua hiki aku i ka pakeneka kiʻekiʻe o ka heluna kanaka o ke kīnā o ke kino e like me ka hopena o ka puupuu wawae fracture (umi pakeneka).

Fracture o ke kuʻekuʻe wāwae, a i ole, ua malamaia lakou nei,, hele aku ai i ka hoʻohuikau 'o ka articular mau surfaces (ami congruence). O kŰia ke kumu mauʻeha, a Hoʻoweliweli 'o ia i ke kahua o ka ino arthrosis. Ka maʻi hiki aku i ka 'aʻe' ana o statics a meʻano o ka hui, a pinepine welau a me ke kino kīnā.

ua hoemi ia mau walaʻauʻana i kūpono na puupuu wawae fracture lapaau: makeʻe kulana, aʻoki lāʻau lapaʻau lapaʻau. Makeʻe kulana lapaʻau nā:

- Hoopaa iho la hana lima reposition, puna immobilization;

- paa hou mai la ka ho'ēmiʻana ka hoʻohana 'ana i ka repositioned i loko o ka manaʻo, me ka nou ana la o;

- reposition traction? Ee a laila. Ka loa he ākea Manual paa hou mai la ka ho'ēmiʻana me ka kau ana o ka nou ana la o. Ma keia hihia, he superposition o ke kiola ana i ke kee na hapakolu o ka "kīpaku" type tibia.

Drawbacks o ka makeʻe kulana ano o ka lapaʻau.

• impossibility o ka piha anatomic ka ho'ēmiʻana.

• I ka nou ana la o ka mea, he pilikia kiʻekiʻe o nā haumāna pohupani hale ma hope o ka ho'ēmiʻana o ka edema.

• hiki ho okumu ana o relapses tibiofibular diastasis a me subluxation o ka wāwae.

Me ka mahuahua ma ka olelo nani he mea he manawa kūpono o ka ho okumu ana o ka puna ka hikina o ka epidermal blistering. Eia hou kekahi, he pilikia kiʻekiʻe o postimmobilizatsionnyh hui contractures, hoʻopulapula ma i hiki ke lawe i ka ewalu - malama he umi kumamalua.

Ka pahu hopu oʻoki lāʻau lapaʻau lapaʻau i pololei hoʻohālike o ka hakina, hoihoi ligaments, ana o ke koena o cartilaginous'aʻaʻa, e like me ke ana o ka hale lio osteosynthesis.

Surgically lapaau ana na puupuu wawae fracture ka hoʻohana 'ana i na (kaiapuni) a mawaho fixation. Ua nui kona pomaikai ma ua loaʻa ka wā osteosynthesis nā kui nao, mahope mai, e like me nā huila, i kēiaʻano hana i ka wa pono osteosynthesis mau'ālike o nā iwi koena ai. Eia naʻe, no ka pono o ka osteosynthesis me nā kui nao mea i hiki ia lakou ke ku imua o ka pono koa ma luna o ka iwi, no laila hoi e pono i hou ka hoʻokō 'ana o ka nou ana la o.

Fracture o ka puupuu wawae, i hanaʻia hooloihi ae i immobilization e alakai i ka mea complications.