kalaai key asthishoth

kalaai key asthishoth yaantrik asaamaanyataon kaa ack samooh haye jisake parinamswarup jodon kaa vinash hotaa haye, joe kalaai mein hoe sakata haye. inn asaamaanyataon mein upaasthi kaa apakshay aur atee-taapiya huddy mein parivartan shamil hain, jisase dard, soojan aur kaary kii haani hoe sakati haye. kalaai kaa asthishoth haath key shalyachikitsakon dwara dekhi jaane vaali sabse aam sthitiyon mein seey ack haye.
kalaai kaa asthishoth idiopathic hoe sakata haye, lekin ise jyaadaatar post-traumatic sthiti key roop mein dekhaa jaataa haye. aghaat key baad key asthishoth key vibhinn prakaar hain. scafulonate unnat patan (slack) sabse aam roop haye, jisake baad scaffoid gair-sangh unnat patan (snack) haye. anya aghaat key baad key kaaran jaise kii doorasth trijya yaa alna key intra-articular fracture bhee kalaai key asthishoth kaa kaaran bunn sakate hain, lekin cumm aam hain.
prakaar.
slack aur snack kalaai key asthishoth key dou pattern hain, joe antarnihit chot key prakaar key aadhar parr anumaanit pattern kaa paalan karate hain. slack scaffolunate ligament tootane key kaaran hotaa haye, aur snack ack scaffoid fracture key kaaran hotaa haye joe gair-sangh koo thheek naheen kartaa haye. snack kii tulanaa mein slack adhik aam haye; kalaai key asthishoth key 55 pratishat rogiyon mein slack kalaai hoti haye.
slack.
scaffolunate unnat patan (slack) kalaai key asthishoth kaa ack anumaanit pattern haye joe lambe samay taka chaley gaye scaffolunate asthirta key upchaar key parinamswarup hotaa haye, joe badale mein scaffolunate ligament key tootane key liye gauna haye. iss tarah key galat sanrekhan kaa mukhya prakaar prishthiya antar-kaalit khand asthirta (dissy) haye jahan lunut haath key peechhe kii or konit hotaa haye.
snake.
scafied gair-sangh asthibhang scafied huddy key aakar koo badal detaa haye, jisase asamanya sanyukt gativigyaan hotaa haye. vikrit scafied seey sthirata kii kamee key kaaran, ack dissy vikasit kiya jaa sakata haye.
scafied gair-sangh unnat patan (snake) asthishoth kaa pattern haye joe antatah iss prakriya seey vikasit hotaa haye.
charan.
aghaat key baad key asthishoth koo chaar charanon mein vargeekrit kiya jaa sakata haye. yeye charan slack aur snack kalaai key beach samaan hain. pratyek charan kaa ack alag upchaar hotaa haye.
sanket aur lakshan.
kalaai key asthishoth kaa sabse aam praarambhik lakshan jodon kaa dard haye. dard gatividhi seey aataa haye aur aaraam karane key baad gatividhi honey parr badh jaataa haye. asthishoth seey prabhaavit kissy bhee jodd key saath anya sanketon aur lakshnon mein shamil hainh
inn lakshnon seey kaary mein kamee aaa cumm dainik gatividhi hoe sakati haye.
tantra.
aghaat key baad key kalaai key asthishoth key kaaran koo samajhane key liye kalaai kii shareer rachana koo jaanana aur samajhana mahatvapurna haye. haath koo teen bhaagon mein vibhajit kiya gayaa haih
kalaai mein aathh chhoti carple haddiyaan hoti hain. inn carple haddiyon mein seey pratyek kaa aakar aur aakar alag-alag hotaa haye. way kalaai kii sthirata mein yogdan karate hain aur dou panktiyon mein krambaddh hotey hain, jinamen seey pratyek mein chaar haddiyaan hoti hain.
sameepavarti pankti.
paarshv seey madhya taka aur jaba poorv seey dekhaa jaataa haye, tou nikatvarti pankti iss prakaar banati haih
doorasth pankti.
paarshv seey madhya taka aur jaba poorv seey dekhaa jaataa haye, tou doorasth pankti iss prakaar banati haih
nidan.
kalaai kaa asthi-gathiya mukhya roop seey ack naidaanik nidan haye, aur iss prakaar yeh mukhya roop seey rogi key chikitsa itihas, shaaririk pariksha aur kalaai key aiks-ray parr adharit haye.
chikitsa itihas.
rogi key chikitsa itihas mein umr, haath kaa prabhutva, vyavasaay aur haal key haath key aghaaton kaa sabse mahatvapurna mulyankan shamil honah chaahiye.
shaaririk jaanch.
jaanch aksar radioscafied jodd (jaba sparsh yaa radioscafied jodd koo sthanantarit karate samay), prishthiya radial soojan aur kalaai key jodd kii asthirta mein komalata dikhaayegi. dhyaan dein kii loga kaha sakate hain kii unhein kursi seey uthane mein pareshani hoe rahee haye jaba haathon parr haath kii rail key khilaf dhakka dekar dabaav daala jaataa haye. yuva loga haath dard key kaaran push-upp naheen curr paane kii shikayat curr sakate hain.
kaee pareekshan aur kaary hain joe taba kiye jaa sakate hain jaba kissy rogi koo slack yaa snake key kaaran austeoarthritis honey kaa sandeh hoe.
slaikah
pareekshanah
snaakah
aiks-ray.
trijya huddy aur carple key beach asthishoth 2 mimi seey cumm key "radiocarple sanyukt sthaan" dwara ingit kiya jaataa haye.
slack
kyonki slack scaffolunate ligament tootane key parinamswarup hotaa haye, isaliye donon haddiyon key beach ack badaa sthaan hotaa haye, jise terry thomas saain key roop mein bhee jaanaa jaataa haye. asthishoth aur 3 mimi seey badaa sthaan sandigdh haye aur 5 mimi seey badaa sthaan ack siddh slack pathology haye. ligament tootane key kaaran scafied asthirta sthir yaa gatishil hoe sakati haye. jaba aiks-ray naidaanik hotaa haye aur ack vishvasaniya terry thomas sanket hotaa haye tou yeh ack sthir scaffoid asthirta hoti haye. jaba rogi dwara yaa tou jaanch karane vaale chikitsak dwara herfer karke scafied koo asthir banaa diyaa jaataa haye tou yeh ack gatishil asthirta haye.
snack
snack kalaai kaa nidan karane key liye aapako ack pee. aeye. vyu aiks-ray aur ack paarshv drishya aiks-ray kii aavashyakta hoti haye. slack kii tarah, paarshv drishya aiks-ray yeh dekhane key liye kiya jaataa haye kii kyaa koee dissy haye.
sanganit tomography (ct) yaa chumbakiya anunaad imaging (mri) kaa upayog shayed hii kabhi snack yaa slack kalaai austeoarthritis kaa nidan karane key liye kiya jaataa haye kyonki iska koee atirikt moolya naheen haye. saath hii, yeye takneeken maanak aiks-ray kii tulanaa mein bahut adhik mahangi hain. yadi kissy anya antarnihit vikriti yaa bimari key liye koee majboot sandeh haye tou ct yaa mri kaa upayog kiya jaa sakata haye.
upchaar.
aghaat key baad kii kalaai key asthishoth kaa ilaaj roodhivaadi roop seey yaa shalya chikitsa key saath kiya jaa sakata haye. kaee rogiyon mein, ack roodhivaadi (gair-shalya chikitsa) drishtikon paryaapt haye. kyonki asthishoth pragatisheel haye aur lakshan badatar hoe sakate hain, isaliye kissy bhee charan mein shalya chikitsa upchaar kii salah dee jaati haye.
charan I.
charan I key liye, aam taur parr, gair-shalya chikitsa upchaar paryaapt haye. iss prakaar kii chikitsa mein splint yaa cast immobilisation kaa upayog, jodon mein dard paida karane vaale corticosteroid key injection aur dard koo cumm karane aur prabhaavit jodd key karyatmak upayog mein sudhaar key liye ack pranaaleegat gair-steroidal anty-inflammatory dawa kaa upayog shamil haye. haalaanki, gair-shalya chikitsa chikitsa dwara dabaaye jaane vaale dard kii matra seemit haye aur kalaai key asthishoth key shalya chikitsa upchaar kii pragati key saath apariharya haye.
charan I shalya chikitsa upchaar mein aksar pashch antar-tantrika kii mootra-vichhedan hoti haye aur aksar anya prakriyaon key saath sanyukt hoti haye. ack slack key mamle mein, scaffolunate ligament koo ack radial styloedectomy key saath sanyojan mein punarnirmit kiya jaa sakata haye, jisamen radial styloid koo shalya chikitsa dwara doorasth trijya seey hataa diyaa jaataa haye. snyaak key mamle mein, scaffoid kii sthirata koo badhaane key liye scraffoid koo pench key saath thheek karke yaa huddy key graft (mait-russ prakriya) koo rakhkar scaffoid kaa punarnirmaan kiya jaa sakata haye.
charan II.
stage II kalaai austeoarthritis key upchaar mein, dou upchaar vikalp hain joe sabse safal saabit hue hain.
pahala upchaar vikalp proximal row carpectomy haye. iss shalya chikitsa key dauran carple haddiyon kii sameepavarti pankti (scafied, lunut, triquetrum, pisiform) koo hataa diyaa jaataa haye. yeh mahatvapurna haye kii radioscafocapitate ligament koo akshunna chhod diyaa jaae, kyonki yadi ligament koo sanrakshit naheen kiya jaataa haye tou capitate huddy kalaai key alner paksh mein badal jaayegi aur doorasth trijya seey door chully jaayegi. door key trijya key capitate aur lunut fosa key beach nayaa banaa jodd poorv scaffoid-lunet-radius jodd key roop mein sarvangsam naheen haye, halanki proximal row carpectomy key parinam aam taur parr utkrisht hotey hain. 40 varsh seey adhik umr key rogiyon mein proximal row carpectomy koo prathamikta dee jaati haye kyonki inn rogiyon koo apane shesh jeevan key dauran nae baney capitate-radial jodd mein austeoarthritis vikasit honey kii ack chhoti see sambhavana hoti haye.
40 varsh seey cumm ayu key rogiyon koo radiocapitate jodd mein asthishoth vikasit honey kaa ack badaa mauka hotaa haye. inn rogiyon koo adhik samay taka jeevit rehna hotaa haye, isaliye jodon kii visangati lambe samay taka bunny rahegi. iss prakaar, iss rogi kii aabaadi mein chaar-koney vaale gathiya pahali pasand kaa upchaar haye. capitate, lunut, hammett aur triquetrum iss prakriya mein ack saath bandhe hotey hain aur scafied koo baahar nikala jaataa haye. arthrodesis key nishpaadit honey seey pahale, lunut koo dissy sthiti seey baahar curr diyaa jaanaa chaahiye. kyonki radiolunate jodd aamtaur parr charan II slack aur snake kalaai mein sanrakshit hotaa haye, yeh jodd sameepavarti kalaai kaa ekmatra shesh jodd hoe sakata haye.
donon prakriyaon koo aksar kalaai key ooshmaa key saath jodaa jaataa haye, jaisa kii upchaar charan I key paath mein varnit haye.
charan III.
stage III kalaai austeoarthritis key liye ekmatra upchaar vikalp chaar-koney vaale arthrodesis haye, jaisa kii stage II mein oopar varnit haye. proximal row carpectomy ack vikalp naheen haye, kyonki charan III mein capitate pahale seey hii austeoarthritis seey prabhaavit hotaa haye. isaliye, yeh prakriya kewal ack nae dardanaak jodd kii or leey jaayegi.
charan IV.
iss charan mein dou shalya chikitsa upchaar vikalp hain-kull kalaai kii arthroplasty aur kull kalaai kii arthrodesis.
kull kalaai gathiya charan IV kalaai asthishoth key rogiyon key liye maanak shalya chikitsa upchaar bunn gayaa haye. iss prakriya key dauran carple haddiyon koo ack saath jodaa jaataa haye aur phir door key trijya mein baandh diyaa jaataa haye. joe rogi abhee bhee bhaari shram karna chaahte hain, way iss shalya chikitsa drishtikon kaa sabse adhik laabh uthaate hain, kyonki shalya chikitsa aur thheek honey key baad bhee yeh sambhav haye. haalaanki, iss prakaar kii shalya chikitsa seey gati kaa chaap behad cumm hoe jaataa haye.
joe loga gati-bachaav prakriya chaahte hain, unake liye sabse achchha vikalp kull kalaai kii arthroplasty haye. halanki, prabhaav bhaar seey bachana chaahiye, 4.5 kilogram seey adhik bhaari vastu koo naheen uthaaya jaanaa chaahiye. isaliye, iss shalya chikitsa drishtikon mein shalya chikitsa key baad kii gatividhi pratibandh hain. phir bhee, ack taraf kull kalaai gathiya aur doosari taraf kull kalaai gathiya vaale rogi, kull kalaai gathiya koo pasand karate hain. prakriya kuchh tatvon kii maujood haye. sabse pahale, sameepavarti pankti koo hataa diyaa jaataa haye aur doorasth pankti koo metacarples seey jodaa jaataa haye. phir, arthroplasty key ack taraf koo doorasth pankti parr aur doosari taraf doorasth trijya parr rakhaa jaataa haye. isake alawa, alna kaa sir hataa diyaa jaataa haye.

