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Jersey Finger (Avulsion ng Flexor Tendon)

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The deep flexor tendon avulses off the fingertip — why it is time-critical, and the surgery to reattach it.

Illustrasyon ng jersey finger — ang malalim na flexor tendon ay naputol mula sa buto ng dulo ng daliri.
Jersey finger: ang malalim na flexor tendon ay napuputol sa dulo ng daliri, kaya hindi na makakalikot ang pinakadulo ng daliri. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ang nararamdaman mo

Ang Jersey finger ay karaniwang nangyayari sa isang sandali na malinaw mong naaalala, kadalasan habang humahawak o humihila sa isang bagay sa panahon ng palakasan. Ang isang klasikong halimbawa ay ang paghawak sa isang buhol ng jersey ng kalaban sa rugby o football habang lumalayo sila, mula rito nagmula ang pangalan. Mayroong biglaang matulis na sakit sa dulo ng daliri, at pagkatapos ay pamamaga at maaaring magkakaroon ng pamumula o pamumula na may asul na kulay (bruise).

Ang nakikilalang senyales ay ang hindi mo makapagbaluktot ng dulo ng daliri. Ang kasukasuan sa dulo ng daliri (ang maliit na kasukasuan na pinakamalapit sa kuko, tinatawag na DIP joint) ay hindi aaluktot papunta sa palad mo kapag sinubukan mong gumawa ng kamay na nakasiksik, kahit na gumagalaw ang ibang bahagi ng daliri. Ang ring finger (daliring pang-apat) ang pinakakaraniwang apektado. May ilang tao rin ang nakakakita ng masakit na buntong hangin o pamamaga na mas malayo pa sa ibabang bahagi ng daliri o kahit sa palad: ang buntong hangin na iyon ay ang dulo ng tendon, na nahiwalay sa buto at bumalik pabalik tulad ng isang inilayang elastic band.

Ano ang nangyayari talaga

Isang matibay na tendon na tinatawag na flexor digitorum profundus (FDP) ang tumatakbo sa palad na bahagi ng bawat daliri at dumudugtong sa maliit na buto sa dulo ng daliri. Ang tungkulin nito ay yumuko sa huling kasukasuan. Sa jersey finger, pinipilit na tuwidin ang daliri sa eksaktong oras na mahigpit na kumukunot ang kalamnan, at napuputol ang tendon sa kung saan ito nakadugtong sa buto ng dulo ng daliri, minsan ay kasama ang maliit na piraso ng buto.

Mahalaga kung gaano kalayo bumalik ang maluwag na dulo ng tendon, at ginugupit ng mga doktor ang mga sugatang ito base sa eksaktong pagbabalik na iyon (ang Leddy–Packer classification). Kapag bumalik lamang ng kaunti ang tendon at nananatili sa daliri, karaniwang nananatili ang bahagi ng suplay ng dugo nito at maaaring maghintay nang kaunti. Kapag bumalik ito nang buo papunta sa palad, nawawalan ito ng suplay ng dugo at ang daan kung saan ito karaniwang dumudulas (ang pulley system) ay nagsisimulang mag-scar at sarado. Ito ang dahilan kung bakit time-critical ang ganap na retracted na jersey finger: habang higit na matagal itong iniwan, higit na mahirap itong ibabalik at idugtong muli. Ang sugat kung saan may nananatiling piraso ng buto na nakadugtong ay madalas na nananatili sa sarili nitong posisyon at minsan ay maaaring gawin nang kaunti nang huli.

Mga maitutulong namin dito

Ang Jersey finger ay halos laging ginagamutan sa pamamagitan ng operasyon upang isama ang tendon sa buto. May ilang paraan upang gawin ito, depende sa kung ano ang nangyari sa tendon:

  • Kung ang tendon ay nahilayo nang buo mula sa buto, ito ay isasama gamit ang isang maliit na anchor na ilalagay sa buto, o sa pamamagitan ng mga tahi na dadaan sa dulo ng daliri at ihihiwalay sa ibabaw ng isang pindutan (isang "pull-out" na pagkukumpuni).
  • Kung kasama nito ang isang piraso ng buto, ang pirasong iyon ay ibabalik at hahawakan sa tamang posisyon, karaniwan ay gamit ang isang maliit na turnilyo, wire, o maliit na plate.

Ang pinakamahalagang salik ay ang oras. Ang isang tendon na umuwi pabalik sa palad ay karaniwang kailangang kumpunihin sa loob ng humigit-kumulang 7 hanggang 10 araw, bago ito mawalan ng masyadong haba at dugo. Ang isang sugat na hawak ng isang piraso ng buto ay madalas ay maaaring ayusin nang kaunti nang huli. Ito ang dahilan kung bakit ang mabilis na pagsusuri ay tunay na nagbabago sa mga posibleng pagpipilian.

Kung ang sugat ay hindi napansin o napansin lamang sa loob ng ilang linggo o buwan, ang isang simpleng pagkakasama ay maaaring hindi na posible. Sa sitwasyong iyon, ang mga pagpipilian ay mas malalaking operasyon: pagbuo muli ng tendon gamit ang graft, o, kung ang joint ng dulo ng daliri ang problema, pagsasama ng maliit na joint na iyon upang makapagbigay ng matatag at walang sakit na daliri. Pagkatapos ng anumang pagkukumpuni, ang maingat na isinasagawa na programa ng hand therapy ay mahalaga upang makapagpagalaw ng tendon nang ligtas nang hindi ito nahihila papalabas habang ito ay gumagaling.

Ano ang inaasahan

Kapag naipagaling nang maaga at maayos ang jersey finger, maganda ang prognosis at karamihan sa mga tao ay nakakabalik sa malakas at kapaki-pakinabang na galaw ng dulo ng daliri. Gayunpaman, hindi mabilis ang paggaling. Dahil mahina ang naipagaling na flexor tendon sa unang ilang linggo, magdudulot ka ng protektibong splint at susundin ang programa ng hand therapist na unti-unting ligtas na ipinapakilala ang paggalaw, at ang pagmadali sa prosesong ito ang pangunahing dahilan ng pagkabigo ng paggaling. Karaniwang tumatagal ng ilang buwan bago makabalik sa buong hawak at mas mabibigat na gawain, at ang iyong therapist at surgeon ang magbibigay-direksyon sa timing ng iyong pagbabalik sa sports o manual na trabaho.

Mahalagang malaman na kahit ang isang magandang paggaling ay maaaring mag-iwan ng dulo ng daliri na medyo mas matigas kaysa sa kabilang panig. Ang mga sugat na naipagaling nang huli, o kung saan kinakailangan ng graft o joint fusion, ay karaniwang may mas limitadong galaw ng dulo ng daliri, na eksaktong dahilan kung bakit napakahalaga ang maagang paggamot.

Kailan pumunta sa doktor

  • Hindi mo makapagbukol ng dulo ng daliri pagkatapos ng pinsala sa pagkapit. Ito ang pangunahing senyales ng jersey finger at dapat itong suriin agad: huwag hintayin na baka magbawi ito. Maaaring hiwalay ang tendon mula sa buto kahit mukhang "naka-jam" o naka-sprain ang daliri, at ang pinakamagandang resulta ay nakukuha sa maagang pag-aayos.
  • May masakit na bula sa daliri o palad pagkatapos ng ganitong uri ng pinsala, lalo na kung may pagkawala ng kakayahang yumuko ang dulo ng daliri.
  • Malakas na sakit, pamamaga, o pagkadugo sa daliri pagkatapos ng pinsala sa sports o pagkapit na hindi nawawala.
  • Anumang pinsala sa daliri kung saan tila mali ang galaw, pakiramdam, o itsura ng daliri: kapag may pagdududa, ipa-assess ito, dahil maikli ang oras para sa pinakamagandang resulta.

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