- Khi nghi ngd HC C.E.K phai cho benh nhan vao vien de theo doi hang gid Bat dong nep tam thd
VET THUONG BAN TAY
1. DAI CUONG
Vet thtfdng ban tay hay gap, chiem khoang 40-50% tong so vet thtfdng do tai nan lao dong
C) ban tay co rat nhieu bo phan tinh te cua cd the: cd, gan, xtfdng, mach mau, than kinh, vi v^y tuy la mot vet thtfdng nho nhtfng rat kho khan trong xtf tri cap ctfu va rat phtfc tap trong dieu tri cac di chtfng ve sau (hinh 19.1).
• D a c diem vet th itdng ban tay
— Vet thtfdng ban tay d§ bi nhi§m khuan vi: + Khong co cd ldn va mang lien ket che phu + Chtfc nang ban tay la cam nam nen rat b ln
+ Cac bao hoat dich gan gap thong vdi nhau nen co the viem tay lan toa, ttf bao hoat dich cac ngon, co the lan rong tdi bao hoat dich quay hoac bao hoat dich tru.
Vi vay: "Tat ca cac vet thtfdng ban tay deu nhiem khuan" (Hainzl)
— Vet thtfdng ban tay de hoai tti gan, xtfdng: neu vet thtfdng ldn, mat da nhieu, gan, xtfdng khong dtfdc che phu va nuoi dtfdng nen bi hoai tti.
— Vet thtfdng ban tay de tan phe do:
+ Nhiem khuan ban tay, dac biet la nhi§m khuan bao hoat dich
+ Ton thtfdng gan gap, gan duoi va cac rong roc gay nen dinh gan ve sau, lam cho ban tay mat chtic nang.
+ Can lech xtfdng, ctfng khcip cac ngon tay lam cho ban tay khong gap duoi dtfdc. + Ton thtfdng than kinh: mat cam giac tinh te d dau ngon hoac liet van dong ngon.
• Yeu ca u d ieu tri
Yeu cau dieu tri vet thtfdng ban tay rat cao, ca ve giai phau va cd nang. Khi co vet thtfdng ban tay thi ly ttfdng nhat la tat ca cac ton thtfdng deu dtfdc xti ly ngay ttf dau va trong 1 lan p h iu thuat. Vdi mot vung p h iu thuat nho be, chat hep, cac p h iu thuat vien phai xti ly cac thtfdng ton hoan hao: ttf xtfdng, gan, mach mau, cung nhtf th in kinh, de benh nhan tap luyen phuc hoi chtic nang sdm.
Viec tap luyen phuc hoi chtic nang sau mo rat quan trong, gop mot phan ldn cho stf th&nh cong cua dieu tri.
Bo mach quay
i % —Bo mach, than kinh tai
Rong roc hinh nhlin
Rong roc hinh chtfthap
Bao hoat dich
Gan gap n6ng va gap s3u
Hinh 19.1. Giai p h iu ban tay