Izinyathelo Zokwelapha Ukuphuka Kwamathambo Ezilwaneni
Ukuphuka kwamathambo ezilwaneni—kungakhathaliseki ukuthi izilwane ezifuywayo ezifana namakati nezinja, noma imfuyo—kuyizimo ezibucayi ezidinga ukwelashwa okusheshayo, okunembile, nokuhleliwe. Ukuphuka kwamathambo kungenzeka ngenxa yezingozi zomgwaqo, ukuwa kusuka phezulu, ukulimala ngesikhathi sokulwa, ukuchotshozwa izinto ezisindayo, noma ngenxa yamathambo aqhekekile abangelwa izifo ezithile. Uma kungelashwa kahle, ukuphuka kwamathambo kungabangela ubuhlungu obuhlala isikhathi eside, ukukhubazeka okungapheli, ukukhubazeka kokuhamba, ukutheleleka, ngisho nokufa ezimweni ezimbi kakhulu. Lokhu okulandelayo yizinyathelo ezivamile zokwelapha ukuphuka kwamathambo ezilwaneni emtholampilo wezilwane, kusukela kosizo lokuqala kuya ekuvuseleleni.
1. Ukubona Izimpawu Zokuphuka Kwamanxeba
Isinyathelo sokuqala sokwelashwa siqala ngokubona izimpawu. Izimpawu ezivamile zokuphuka kwezicubu ezilwaneni zifaka phakathi ukuxhuga noma ukungakwazi ukuhamba, ukuvuvukala endaweni elimele, ukuzwela ukuthinta, izinguquko ezingavamile endaweni yezitho zomzimba, kanye "nomsindo wokugaya" njengoba ithambo lishintsha. Ekuqhekekeni okuvulekile, ithambo lingase libonakale liphuma esikhumbeni kanye nokopha. Izilwane zingase futhi zibonise izimpawu zomzimba njengobuthakathaka, ukuphefumula okusheshayo, izinsini eziphaphathekile (uphawu lokushaqeka), noma ukwenqaba ukudla ngenxa yobuhlungu.
Kubalulekile ukukhumbula ukuthi izilwane zivame ukufihla ubuhlungu bazo. Amakati, isibonelo, angase abonakale ethule futhi acashe. Ngakho-ke, noma yiluphi ushintsho olungazelelwe ekuziphatheni ngemva kokulimala kufanele luphakamise izinsolo zokulimala okukhulu, okuhlanganisa nokuphuka.
2. Usizo Lokuqala: Zinzisa Futhi Unciphise Ingozi Yokulimala Okuqhubekayo
Uma sekusolwa ukuthi kukhona ukuphuka, umgomo wosizo lokuqala ukuvimbela ukunyakaza ngokweqile kwethambo eliphukile, ukunciphisa ubuhlungu, nokugwema izinkinga. Izilwane ezibuhlungu zingase zilume noma ziklwebhe, ngakho-ke ukuphepha kwabahlengikazi nakho kubalulekile. Sebenzisa indwangu, ingubo yokulala, noma umlomo lapho kuphephile ukuvimbela ukulunywa, ikakhulukazi ezinjeni.
Ezinye izimiso zosizo lokuqala:
– Nciphisa ukunyakaza: beka isilwane endaweni encane noma ekhejini lokuthutha.
– Ukuvimba okwesikhashana: Uma kungenzeka, sebenzisa i-splint elula eyenziwe ngekhadibhodi elijiyile, ukhuni oluncane, noma omagazini abasongiwe abasongwe ngendwangu. Kodwa-ke, uma ungaqiniseki, kungcono ukugxila ekuvimbeleni ukunyakaza nokubona udokotela wezilwane ngokushesha kunokusebenzisa i-splint ngendlela engafanele.
– Uma kuqhekeka ithambo: mboza inxeba ngendwangu ehlanzekile noma i-gauze ehlanzekile ukuze unciphise ukungcola. Ungazami ukufaka ithambo kabusha.
– Yisa ngokushesha esikhungweni sezokwelapha: ukwelashwa okuqondile kudinga ukuhlolwa okukhethekile kanye nemishini.
Unganiki imithi yabantu efana ne-ibuprofen noma i-paracetamol ngaphandle kweseluleko sikadokotela wezilwane ngoba ingaba yingozi, ikakhulukazi emakatini.
3. Ukuhlolwa Kwezokwelapha kanye Nokuhlolwa Kwesimo Esijwayelekile
Lapho efika emtholampilo, udokotela wezilwane uzokwenza ukuhlolwa okuphelele. Ukwelashwa kokuphuka kwethambo akugxili nje kuphela emathanjeni kodwa futhi nasesimweni somzimba. Ukulimala okukhulu kungabangela ukushaqeka, ukopha kwangaphakathi, noma ukulimala kwezinye izitho zomzimba. Udokotela wezilwane ngokuvamile uzosebenzisa indlela "yokuzinzisa kuqala, bese kuba yindlela yokuqinisa amathambo".
Izinyathelo zomtholampilo zifaka:
– ukuhlolwa kwezimpawu ezibalulekile (ukushaya kwenhliziyo, izinga lokuphefumula, izinga lokushisa, umbala wezinsini);
– ukuhlolwa kobuhlungu nendawo yokulimala;
– ukuhlolwa kwamanxeba avulekile, ukopha, noma izinkinga zemizwa;
– ukunikezwa koketshezi ngemithambo uma kwenzeka ukuphelelwa amanzi emzimbeni noma ukushaqeka;
– ukunikezwa kwemithi yokunciphisa ubuhlungu (imithi yobuhlungu) kanye nokuqeda ubuhlungu uma kudingeka.
4. Ukuxilongwa: I-X-ray kanye nokuhlolwa okusekelayo
Izinga elijwayelekile lokuxilonga ukuphuka yi-X-ray yendawo elimele, ngokuvamile okungenani ezindaweni ezimbili (isb., ohlangothini kanye ne-ventrodorsal) ukuze kubonakale ngokucacile umugqa wokuphuka. Ama-X-ray asiza ekunqumeni uhlobo lokuphuka: ukuphuka okulula, ukuphuka okuhlanganisiwe (ukuqhekeka kube yizicucu eziningana), ukuphuka kwe-greenstick (okuvamile ezilwaneni ezincane), ukuphuka kwangaphakathi kwe-articular (okubandakanya ilunga), kanye nokuhlukana okuhambisana nakho.
Ezimweni ezithile, udokotela wakho angase asikisele:
– I-CT-scan ukuze kutholakale ukwaphuka okuyinkimbinkimbi (isib. amathambo obuso noma e-pelvic);
– I-ultrasound yesifuba/i-X-ray ukuhlola ukulimala okwengeziwe;
– ukuhlolwa kwegazi ukuhlola isimo esijwayelekile kanye nokulungela ukubulala izinzwa.
5. Indlela Yokunquma Ukwelashwa: Okugcinayo vs. Okusebenza
Ukukhetha indlela kuncike endaweni lapho inxeba liphukile khona, ubukhulu balo, ubudala besilwane, usayizi womzimba, kanye nesimo saso esijwayelekile. Ngokubanzi, kunezindlela ezimbili: ezigcina ukuqina (okungahlinzwa) kanye nezokuhlinzwa (ukuhlinzwa kwamathambo).
A. Ukwelashwa Okungaguquguquki (I-Cast noma i-Splint)
Le ndlela ifanelekela ukuphuka okuzinzile, okuphansi kokufuduka, ngokuvamile emathanjeni athile aphansi (i-radius, i-ulna, noma i-tibia), kanye nasezilwaneni ezincane. Udokotela uzofaka:
– i-bant yokubamba isikhundla,
– noma iplasta/ithusi ukuze kuqiniswe ukuqina.
Isihluthulelo sokwelashwa okuphumelelayo okulondolozayo ukuhlolwa njalo. I-cast eqine kakhulu ingavimbela ukuhamba kwegazi futhi ibangele ukuvuvukala, izilonda zokucindezeleka, noma i-necrosis. Abanikazi kufanele baqaphe uzwane ukuze babone ukuvuvukala nokubanda, iphunga, kanye nezinguquko zokuziphatha ezibonisa ubuhlungu.
B. Ukwelashwa Kokuhlinzwa (Ukulungiswa Kwangaphakathi/Kwangaphandle)
Ukuhlinzwa kuvame ukudingeka uma ukwaphuka:
– ukushintshashintsha/ukungazinzi,
- okunqunyelwe,
- okubandakanya amalunga,
– kwenzeka emathanjeni amakhulu (i-femur, i-humerus),
– noma ezilwaneni ezisebenzayo/ezinkulu.
Izindlela zokusebenza zifaka:
– Izikhonkwane nezintambo: ezisetshenziselwa ukuphuka okuthile, ikakhulukazi amalunga noma izilwane ezincane.
– Ipuleti nesikulufu: kunikeza ukuqina okuphezulu, okuvame ukukhethwa uma kuphuka amathambo isikhathi eside.
– Iphini le-intramedullary (ipeni le-intramedullary): iphini lifakwa emgodini womnkantsha ukuze libambe ingxenye.
– I-fixator yangaphandle: uhlaka olungaphandle komzimba oluxhunywe ethanjeni ngezikhonkwane; luvame ukusetshenziselwa ukuphuka okuvulekile ngoba luvumela ukunakekelwa kwenxeba kube lula.
Udokotela wezilwane uzocabangela izingozi zokubulala izinzwa, amathuba okutheleleka, kanye nezindleko kanye nesikhathi sokululama.
6. Ukuphathwa Kobuhlungu, Ukutheleleka, Nokunakekelwa Kwenxeba
Ngemva kwenqubo, ukuphathwa kobuhlungu kuyinto eza kuqala. Isilwane esikhululekile sizolulama ngokushesha futhi sizodla. Imithi yokwelapha ubuhlungu evamile esetshenziswa emtholampilo wezilwane ihlanganisa ama-NSAID aqondene nezilwane (ngemithamo ephephile), ama-opioid athile, noma inhlanganisela njengoba kudingeka.
Uma kuqhekeka noma kuhlinzwa, udokotela angase anikeze:
– ama-antibiotic okuvimbela/ukwelapha izifo,
– ukunakekelwa njalo kwezilonda (ukuhlanza, ukushintsha amabhandeji),
– lawula ukuvuvukala ngokucindezela okubandayo ekuqaleni kokulimala (njengokweseluleko sikadokotela).
Abanikazi kufanele balandele isimiso semithi kanye nomthamo. Ukuyekisa ama-antibiotic ngokushesha kakhulu kungandisa ingozi yokutheleleka okunzima ukwelapha.
7. Imikhawulo Yemisebenzi Nokuvuselelwa
Iphutha elivame kakhulu ngemva kokuphuka ukuvumela isilwane ukuba sisebenze kakhulu ngaphambi kokuba amathambo aphulukiswe ngokugcwele. Ngisho noma amathambo ebonakala sengathi ayathuthuka, angase abe buthakathaka ezigabeni zokuqala zokuphulukiswa. Odokotela bavame ukuncoma:
– ukuphumula ekhejini amasonto amaningana,
– ukuhamba okufushane ngentambo (yezinja) ngesikhathi esibekiwe,
– vimbela izilwane ukuthi zingagxumi (okubalulekile kumakati), isibonelo ngokunciphisa ukufinyelela ezindaweni eziphakeme.
Ukuvuselelwa kungathatha uhlobo lwe-physiotherapy olula ukuvimbela ukuqina kwamalunga kanye nokulahlekelwa yimisipha. Kwezinye izimo, i-hydrotherapy (ukuzivocavoca ngamanzi) kusiza ukuqinisa imisipha ngaphandle kokulayisha amathambo ngokweqile, kodwa kufanele kwenziwe ngaphansi kwesiqondiso sochwepheshe.
8. Ukulawulwa Okuvamile Nokuhlolwa Kokwelapha
Ukwelashwa kokuphuka kwethambo kuvame ukuthatha amasonto amaningana kuya ezinyangeni, kuye ngokuthi ithambo liqhekeke kuphi, ubudala balo, kanye nendlela elilungiswe ngayo. Ukuhlolwa njalo kuyadingeka ukuze:
- hlola indawo yethambo,
– qinisekisa ukuthi akukho ukutheleleka noma ukwehluleka kokufakelwa,
– nquma ukuthi i-cast isuswa nini noma ukuthi umsebenzi ungandiswa nini.
Ama-X-ray aphindaphindwayo avame ukwenziwa ukuhlola ukwakheka kwe-"callus" (izicubu ezintsha zethambo) kanye nokuqina kokuhlangana.
9. Izinkinga Okufanele Uziqaphele
Ngisho noma kwelashwa, ukuphuka kwezicubu kungabangela izinkinga ezifana nalezi:
– ukutheleleka kwamathambo (i-osteomyelitis), ikakhulukazi lapho kuqhekeka khona amathambo avulekile;
– ukungahlangani (amathambo awahlangani) noma i-malunion (ihlanganiswe kodwa isendaweni engafanele);
– ukulimala kwemithambo yegazi noma kwemizwa;
– ukuqina kwamalunga ngemva kokwethuka;
– izilonda zokucindezeleka ezibangelwa yi-plaster casts.
Uma isilwane siphinde siqhuga kakhulu ngokuzumayo, sivuvukala kakhulu, siphuma ubomvu, sishiswe umkhuhlane, noma senqaba ukudla, xhumana nodokotela ngokushesha.
10. Ukuvimbela: Nciphisa Ingozi Yokuqhekeka Kwamathambo
Ukuvimbela kungcono njalo kunokwelapha. Abanikazi banganciphisa ingozi yokuphuka kwesikhumba ngokwenza okulandelayo:
– gcina izilwane endlini/egcekeni elivaliwe ukuze zingashayiswa yizimoto;
– sebenzisa intambo uma uhamba ezindaweni ezinabantu abaningi;
– qaphela ukudla okunomsoco, ikakhulukazi i-calcium ne-vitamin D (ngokwezincomo zikadokotela);
– vimbela ukukhuluphala okungabeka umthwalo emathanjeni nasemalungeni;
– yenza ukuhlolwa okuvamile kwezilwane ezindala ezisengozini yokuba nesifo sokuwohloka kwamathambo noma isifo sokugaya ukudla.
I-Penutup
Ukwelapha ukuphuka kwamathambo ezilwaneni kuyinqubo enezinyathelo eziningi edinga ukuxilongwa okunembile, ukukhethwa kwezindlela ezifanele zokuzinzisa, ukulawula ubuhlungu, kanye nokunakekelwa okuqondisiwe ngemva kokuhlinzwa. Ngosizo lokuqala olufanele, ukunakekelwa kwezilwane okufanele, kanye nokuhambisana nomnikazi nokulawula imisebenzi kanye nemikhawulo, amathuba esilwane okululama athuthuka kakhulu. Uma kwenzeka ukulimala futhi kusolwa ukuthi kukhona ukuphuka, kungcono ukuyisa isilwane kudokotela wezilwane ngokushesha ukuze sithole ukwelashwa kochwepheshe nokuvimbela izinkinga zesikhathi eside.
