{"id":192,"date":"2021-05-28T08:01:02","date_gmt":"2021-05-28T08:01:02","guid":{"rendered":"http:\/\/80.233.182.142\/?page_id=192"},"modified":"2021-11-15T13:10:54","modified_gmt":"2021-11-15T10:10:54","slug":"rokas-kirurgija","status":"publish","type":"page","link":"https:\/\/logina.lv\/index.php\/rokas-kirurgija\/","title":{"rendered":"Rokas \u0137irur\u0123ija"},"content":{"rendered":"\n<p>Rokas \u0137irur\u0123ija ir medic\u012bnas nozare, kuras speci\u0101listi veic \u0101rst\u0113\u0161anu da\u017e\u0101da veida aug\u0161\u0113jo ekstremit\u0101\u0161u probl\u0113mu un saslim\u0161anu gad\u012bjumos. T\u0101s ir <strong>gan traumas, gan sekas p\u0113c traum\u0101m un da\u017e\u0101da veida roku saslim\u0161anas, k\u0101 ar\u012b iedzimtas probl\u0113mas<\/strong>. Rokas \u0137irurgs veic \u0101rst\u0113\u0161anu ar\u012b rokas nervu pinuma boj\u0101jumu, tetrapl\u0113\u0123ijas un spasticit\u0101tes gad\u012bjumos. Rokas \u0137irurgi bie\u017ei tiek iesaist\u012bti ar\u012b citu \u0137erme\u0146a da\u013cu probl\u0113mu \u0101rst\u0113\u0161an\u0101, k\u0101 piem\u0113ram, apak\u0161\u0113jo ekstremit\u0101\u0161u saslim\u0161anu gad\u012bjumos.<\/p>\n\n\n\n<p><br><strong>Galvenais m\u0113r\u0137is ir iesp\u0113jami lab\u0101k atjaunot vai uzlabot rokas funkciju, t\u0101dej\u0101di paaugstinot cilv\u0113ka dz\u012bves kvalit\u0101ti.<\/strong><br><\/p>\n\n\n\n<p><strong>Rokas \u0137irurgam ir j\u0101b\u016bt zin\u0101\u0161an\u0101m:<\/strong><br>&#8211; Aug\u0161\u0113j\u0101s ekstremit\u0101tes anatomij\u0101.<br>&#8211; Musku\u013cu, c\u012bpslu, nervu, loc\u012btavu, asinsrites un kaulu metabolisma fiziolo\u0123ij\u0101.<br>&#8211; Da\u017e\u0101du rokas saslim\u0161anu un traumu konservat\u012bv\u0101 \u0101rst\u0113\u0161an\u0101.<br>&#8211; Da\u017e\u0101du rokas saslim\u0161anu un traumu \u0137irur\u0123isk\u0101 \u0101rst\u0113\u0161an\u0101, taj\u0101 skait\u0101 mikro\u0137irur\u0123ij\u0101.<br>&#8211; Rehabilit\u0101cij\u0101 un funkcion\u0101laj\u0101 ortoz\u0113\u0161an\u0101.<\/p>\n\n\n\n<p><strong>Rokas \u0137irurgs ir eksperts sekojo\u0161u probl\u0113mu gad\u012bjumos:<\/strong><br>&#8211; Rokas traumas \u2013 br\u016b\u010du kop\u0161ana, skeleta, asinsvadu, nervu un c\u012bpslu boj\u0101jumi.<br>&#8211; Rokas l\u016bzumi, \u0101rst\u0113\u0161ana l\u016bzumu dz\u012b\u0161anas (konsolid\u0101cijas) trauc\u0113jumu gad\u012bjumos.<br>&#8211; Rokas sai\u0161u boj\u0101jumi, loc\u012btavu nestabilit\u0101te.<br>&#8211; Rokas un plaukstas artroskopija.<br>&#8211; Rokas amput\u0101cija.<br>&#8211; Rokas apdegumi.<br>&#8211; Drag\u0101tu rokas boj\u0101jumu rekonstrukt\u012bv\u0101 \u0137irur\u0123ija.<br>&#8211; Rokas nervu boj\u0101jumu, rokas nerva pinuma boj\u0101jumu \u0101rst\u0113\u0161ana.<br>&#8211; Tetrapl\u0113\u0123ijas, insulta, b\u0113rnu cerebr\u0101l\u0101s triekas un smadze\u0146u boj\u0101jumu rad\u012bto rokas probl\u0113mu \u0101rst\u0113\u0161ana.<br>&#8211; C\u012bpslu transpoz\u012bcija;<br>&#8211; Rokas iedzimtu probl\u0113mu \u0101rst\u0113\u0161ana.<br>&#8211; Rokas loc\u012btavu artr\u012bti.<br>&#8211; Reimato\u012bd\u0101 un citu artr\u012btu, autoim\u016bnu saslim\u0161anu rad\u012btu rokas probl\u0113mu \u0101rst\u0113\u0161ana.<br>&#8211; Dipitr\u0113na kontrakt\u016bra.<br>&#8211; P\u0101rslodzes sindroms.<br>&#8211; Nervu kompresijas sindromi.<br>&#8211; Rokas infekcijas.<br>&#8211; Rokas asinsvadu saslim\u0161anas.<br>&#8211; Rokas audz\u0113ji.<\/p>\n\n\n\n<p><br>\u0160obr\u012bd Latvijas Republik\u0101 <strong>rokas \u0137irur\u0123ija ir \u0137irur\u0123ijas apak\u0161nozare. <\/strong>Par rokas \u0137irurgu var k\u013c\u016bt saist\u012bto nozaru profesion\u0101\u013ci, k\u0101 piem\u0113ram, plastikas \u0137irurgs vai traumatologs izejot speci\u0101lu apm\u0101c\u012bbu un noliekot sertifik\u0101cijas eks\u0101menu.<br>Katr\u0101 Eiropas dal\u012bbvalst\u012b ir sava asoci\u0101cija, kas apvieno rokas \u0137irur\u0123ijas speci\u0101listus, savuk\u0101rt Eiropas rokas \u0137irurgu asoci\u0101ciju feder\u0101cija (FESSH \u2013 Federation of European Societies for Surgery of the Hand) apvieno visu valstu asoci\u0101cijas. FESSH ir dibin\u0101ts 1966.gad\u0101 un taj\u0101 bija apvienotas 8 valstu asoci\u0101cijas biedru. \u0160obr\u012bd feder\u0101cij\u0101 ir apvienotas 26 dal\u012bbvalstu asoci\u0101cijas un v\u0113l 4 ir korespond\u0113jo\u0161o valstu asoci\u0101cijas. Feder\u0101cijas pamatdoma ir veidot vienotus kvalit\u0101tes standartus, att\u012bst\u012bt izgl\u012bto\u0161anu, zin\u0101tni un veicin\u0101t rokas \u0137irur\u0123ijas labas prakses standartus k\u0101 starp profesion\u0101\u013ciem, t\u0101 starp pacientiem. Latvijas rokas \u0137irurgu asoci\u0101cija 2010.gad\u0101 ir iest\u0101jusies FESSH.<\/p>\n\n\n\n<p class=\"has-vivid-green-cyan-color has-text-color has-medium-font-size\"><strong><span class=\"has-inline-color has-vivid-purple-color\">Karp\u0101lais kan\u0101ls jeb karp\u0101l\u0101 kan\u0101la sindroms<\/span><\/strong><\/p>\n\n\n\n<p><strong>Karp\u0101l\u0101 kan\u0101la sindroms ir viens no plaukstas nerva \u2013 medi\u0101n\u0101 nerva <\/strong>(lat\u012b\u0146u valod\u0101 &#8211; N.medianus ) <strong>kompresijas rezult\u0101t\u0101 radu\u0161\u0101s ju\u0161anas un musku\u013cu darb\u012bbas trauc\u0113jumi, kas var izpausties ar tirp\u0161anu, nej\u016bt\u012bgumu, \u201eadati\u0146u durst\u012b\u0161anas\u201d saj\u016btu \u012bk\u0161\u0137\u012b, r\u0101d\u012bt\u0101jpirkst\u0101 un vid\u0113j\u0101 pirkst\u0101, da\u013c\u0113ji zeltnes\u012b, k\u0101 ar\u012b ar v\u0101jumu, satverot priek\u0161metus, s\u0101p\u0113m plaukst\u0101 vai plaukstas loc\u012btav\u0101.<\/strong><br>Grie\u0137u valod\u0101 \u201ekarpos\u201d noz\u012bm\u0113 plauksta &#8211; t\u0101 radies Karp\u0101l\u0101 kan\u0101la sindroma nosaukums. Medi\u0101nais nervs (N.medianus) plaukstas loc\u012btavas l\u012bmen\u012b iet cauri m\u012bksto audu \u201etuneli\u201d, ko sauc par karp\u0101lo kan\u0101lu. Ja m\u0113s sav\u0101 priek\u0161\u0101 noliekam plaukstu ar nagiem uz leju, tad apak\u0161\u0113jo da\u013cu un s\u0101nu da\u013cas karp\u0101lam kan\u0101lam veido plaukstas loc\u012btavas kauli, bet aug\u0161\u0113jo da\u013cu veido sam\u0113r\u0101 cieta un neelast\u012bga saite, ko sauc par karp\u0101lo saiti.<br>Plaukstas loc\u012btavas rajon\u0101 ir v\u0113rojama l\u012bnija, kas skaidri iez\u012bm\u0113jas, plaukstu saliecot. Karp\u0101l\u0101 saite atrodas no \u0161\u012bs l\u012bnijas apm\u0113ram 3cm platum\u0101 uz pirkstu galu pusi un apm\u0113ram 2cm platum\u0101 uz elko\u0146a loc\u012btavas pusi. Karp\u0101l\u0101 kan\u0101l\u0101 iet medi\u0101nais nervs un 8 c\u012bpslas, kas saliec pirkstus &#8211; katram pirkstam, iz\u0146emot \u012bk\u0161\u0137i, ir divas saliec\u0113jc\u012bpslas.<br>Atk\u0101rtoti j\u0101uzsver, ka karp\u0101l\u0101 kan\u0101la sienas \u2013 plaukstas kauli un karp\u0101l\u0101 saite &#8211; nav elast\u012bgas strukt\u016bras. Karp\u0101l\u0101 kan\u0101la sindroms rodas gad\u012bjumos, kad k\u0101du iemeslu d\u0113\u013c c\u012bpslu izm\u0113ri vai ap c\u012bpsl\u0101m eso\u0161o nelielo muskul\u012b\u0161u un saistaudu izm\u0113ri palielin\u0101s (t\u016bska, iekaisums) un t\u0101 rezult\u0101t\u0101 tiek nospiests medi\u0101nais nervs. Spiediens p\u0101rtrauc nerva asinsriti. Ja spiediens ir ilgsto\u0161s un past\u0101v\u012bgs, tad nervs var l\u0113ni aiziet boj\u0101. <\/p>\n\n\n\n<p><strong>S\u016bdz\u012bbas<\/strong><br>Lai m\u0113s var\u0113tu just un kustin\u0101t pirkstus pa nervu aptuveni k\u0101 elektr\u012bba pa kabeli, no muguras smadzen\u0113m izplat\u0101s impulss. Nervs p\u0113c savas uzb\u016bves ir daudz m\u012bkst\u0101ks, maig\u0101ks, jut\u012bg\u0101ks uz apk\u0101rt\u0113jiem kairin\u0101jumiem par cit\u0101m strukt\u016br\u0101m &#8211; c\u012bpsl\u0101m, musku\u013ciem, sait\u0113m, kauliem un t\u0101p\u0113c pirm\u0101s s\u016bdz\u012bbas rodas par nerva darb\u012bbas trauc\u0113jumiem. Rodas ju\u0161anas trauc\u0113jumi pirkstos, par kuriem atbild medi\u0101nais nervs (\u012bk\u0161\u0137is, r\u0101d\u012bt\u0101jpirksts, vid\u0113jais pirksts, da\u013c\u0113ji zeltnesis) un plaukstas vidus da\u013ca, k\u0101 ar\u012b darb\u012bbas trauc\u0113jumi s\u012bkos plaukstas muskul\u012b\u0161os (visvair\u0101k \u012bk\u0161\u0137a saliec\u0113jmuskulis). Gad\u012bjum\u0101, ja karp\u0101l\u0101 kan\u0101la sindroma ra\u0161an\u0101s iemesls ir bijis c\u012bpslu iekaisums, tad v\u0113l\u0101k\u0101s stadij\u0101s var b\u016bt nov\u0113rojamas s\u016bdz\u012bbas, kas saist\u0101s ar c\u012bpslu darb\u012bbu &#8211; s\u0101pes pa c\u012bpslu gaitu, nesp\u0113ja piln\u0101 apjom\u0101 pakustin\u0101t pirkstus, sp\u0113c\u012bgas s\u0101pes plaukstas loc\u012btav\u0101, \u201ekrik\u0161\u0137\u0113\u0161ana\u201d (stenoz\u0113jo\u0161s ligament\u012bts).<br>Ja dienas laik\u0101 karp\u0101l\u0101 kan\u0101la sindroma pacienti s\u016bdz\u0113sies par ju\u0161anas trauc\u0113jumiem, tirp\u0161anu, s\u012bkiem kust\u012bbu trauc\u0113jumiem (piem., gr\u016bti iev\u0113rt adat\u0101 diegu, aizpog\u0101t pogu, saskait\u012bt naudas mon\u0113tas u.c.), tad nakt\u012bs bie\u017ei vien b\u016bs j\u0101mostas, lai roku izvingrin\u0101tu sp\u0113c\u012bgas tirp\u0161anas un plaukstas s\u0101pju d\u0113\u013c. Var b\u016bt saj\u016bta, ka no r\u012bta roka ir piet\u016bkusi. Var b\u016bt dedzino\u0161as s\u0101pes plaukst\u0101 un pirkstos, s\u0101pes var izstarot elko\u0146a virzien\u0101. Var b\u016bt izmain\u012bta plaukstas sv\u012b\u0161ana.<\/p>\n\n\n\n<p><strong>Prec\u012bzi karp\u0101l\u0101 kan\u0101la sindroma att\u012bst\u012b\u0161an\u0101s meh\u0101nismi un c\u0113lo\u0146i ne vienm\u0113r ir atrodami, bet noz\u012bme ir:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>bie\u017e\u0101m, ilgsto\u0161\u0101m pirkstu saliek\u0161anas un atliek\u0161anas kust\u012bb\u0101m (druk\u0101\u0161ana, \u0161\u016b\u0161ana, rokdarbi u.c.);<\/li><li>statiskam, ilgsto\u0161am, vienveid\u012bgam plaukstas un pirkstu sasprindzin\u0101jumam (piem., darbs ar datorpeli);<\/li><li>p\u0101rslodzes sindromam (ilgsto\u0161s, smags darbs bez atp\u016btas periodiem);<\/li><li>traumai, piem\u0113ram plaukstas kaulu vai apak\u0161delma kaulu l\u016bzumi vai s\u012bk\u0101m atk\u0101rtot\u0101m traum\u0101m k\u0101 sasitumi, pame\u017e\u0123\u012bjumi;<\/li><li>endokr\u012bn\u0101m slim\u012bb\u0101m un audu vielmai\u0146as trauc\u0113jumiem (piem., cukura diab\u0113ts, pazemin\u0101ta vairogdziedzera darb\u012bba);<\/li><li>saistaudu sist\u0113mas slim\u012bb\u0101m;<\/li><li>audz\u0113jiem, higrom\u0101m.<br>\u013boti svar\u012bga ir agr\u012bna karp\u0101l\u0101 kan\u0101la sindroma diagnozes noteik\u0161ana. Sarun\u0101 ar rokas speci\u0101listu b\u016btu svar\u012bgi izv\u0113rt\u0113t iesp\u0113jamos medi\u0101n\u0101 nerva nospieduma c\u0113lo\u0146us. Ir \u013coti daudz jaut\u0101jumu, kurus \u0101rstam b\u016btu svar\u012bgi zin\u0101t &#8211; k\u0101du darbu cilv\u0113ks dara, k\u0101 darbs konkr\u0113ti tiek dar\u012bts, vai nav k\u0101das blakus saslim\u0161anas, k\u0101di ir br\u012bv\u0101 laika pavad\u012b\u0161anas paradumi (ad\u012b\u0161ana, sports u.c.) utml.<\/li><\/ul>\n\n\n\n<p><strong>\u0100rst\u0113\u0161anas iesp\u0113jas:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>aktivit\u0101\u0161u veik\u0161anas modifik\u0101ciju,<\/li><li>orto\u017eu lieto\u0161anu,<\/li><li>pirkstu stiepjo\u0161os vingrin\u0101jumus,<\/li><li>pretiekaisuma l\u012bdzek\u013cus,<\/li><li>stero\u012bdu injekcijas<\/li><li>\u0137irur\u0123isku saites p\u0101rdal\u012b\u0161anu.<\/li><\/ul>\n\n\n\n<p>S\u0101kotn\u0113j\u0101s karp\u0101l\u0101 kan\u0101la sindroma stadij\u0101s var\u0113tu pal\u012bdz\u0113t <strong>speci\u0101li stiepjo\u0161ie vingrin\u0101jumi,<\/strong> ortozes, pretiekaisuma medikamenti, vitam\u012bni.<br>B\u016btiska noz\u012bme ir <strong>plaukstas orto\u017eu lieto\u0161anai<\/strong>. Karp\u0101l\u0101 kan\u0101la sindromam ir \u012bpa\u0161as ortozes, kuras var lietot gan dien\u0101, gan nakt\u012b. Pirms ieg\u0101d\u0101ties un uzs\u0101kt orto\u017eu lieto\u0161anu ieteicama rokas \u0137irurga, ergoterapeita konsult\u0101cijas, lai izv\u0113l\u0113tos vispiem\u0113rot\u0101ko un lab\u0101ko ortozi katr\u0101 konkr\u0113t\u0101 gad\u012bjum\u0101, k\u0101 ar\u012b apg\u016btu t\u0101s pareizu lieto\u0161anu.<br><strong>Stero\u012bdu injekciju veik\u0161ana <\/strong>ir diskutabla un da\u017e\u0101dos literat\u016bras avotos efektivit\u0101te tiek v\u0113rt\u0113ta at\u0161\u0137ir\u012bgi. Oblig\u0101ti b\u016btu j\u0101zina, ka \u0161\u0101du injekciju var veikt tikai t\u0101ds speci\u0101lists, kuram ir labas zin\u0101\u0161anas rokas saslim\u0161an\u0101s. Nepareiza injekcijas veik\u0161ana var izrais\u012bt nopietnas komplik\u0101cijas.<br><strong>\u0136irur\u0123iska \u0101rst\u0113\u0161ana noz\u012bm\u0113<\/strong>, ka oper\u0101cijas laik\u0101 caur griezienu plaukst\u0101 tiks p\u0101rdal\u012bta ciet\u0101 saite un t\u0101d\u0101 veid\u0101 no saspie\u0161anas atbr\u012bvots medin\u0101nais nervs. Oper\u0101cija ieteicama situ\u0101cij\u0101s, kad karp\u0101l\u0101 kan\u0101la simptomi biju\u0161i ilgsto\u0161i vai s\u016bdz\u012bbas ir \u013coti sp\u0113c\u012bgas, ne\u0137irur\u0123iska \u0101rst\u0113\u0161ana nedod rezult\u0101tus, \u0101rsts konstat\u0113 izteiktus ju\u0161anas trauc\u0113jumus un plaukstas musku\u013cu izdilumu.<\/p>\n\n\n\n<p><strong>Oper\u0101ciju var veikt lok\u0101l\u0101 anest\u0113zij\u0101.<\/strong> P\u0113coper\u0101cijas period\u0101 nepiecie\u0161ams atrasties rokas \u0137irurga un ergoterapeita uzraudz\u012bb\u0101, lai nodro\u0161in\u0101tu iesp\u0113jami \u0101tru un efekt\u012bv\u0101ku rokas pilna apjoma funkcijas atg\u016b\u0161anu. Ja nerva nospiedums ir ilgsto\u0161s un ir jau nov\u0113rojams \u012bk\u0161\u0137a muskul\u012b\u0161a izteikts izdilums, tad ar\u012b p\u0113c \u0137irur\u0123iskas saites p\u0101rdal\u012b\u0161anas un nerva atbr\u012bvo\u0161anas uzlabo\u0161an\u0101s var notikt \u013coti l\u0113ni (6-12m\u0113ne\u0161u laik\u0101), bet pilnv\u0113rt\u012bga plaukstas funkcija var ar\u012b neatjaunoties.<br>Pirm\u0101s p\u0113coper\u0101cijas dien\u0101s kust\u012bbu apjoms j\u0101ierobe\u017eo, lai mazin\u0101tu t\u016bsku un nerastos s\u0101pes. \u0160uves parasti no\u0146em 10.-12.p\u0113coper\u0101cijas dien\u0101. P\u0113c \u0161uvju no\u0146em\u0161anas nepiecie\u0161ams uzs\u0101kt pilnu kust\u012bbu izstr\u0101di, r\u0113taudu mobiliz\u0101ciju, bet fiziskas aktivit\u0101tes neiesaka uzs\u0101kt \u0101tr\u0101k k\u0101 3.-4. p\u0113coper\u0101cijas ned\u0113\u013c\u0101. Pilnv\u0113rt\u012bga rokas funkcija parasti atgrie\u017eas l\u012bdz 12. p\u0113coper\u0101cijas ned\u0113\u013cai.<\/p>\n\n\n\n<p><strong>Oper\u0101cijai ir iesp\u0113jamas komplik\u0101cijas:<\/strong><br>Nerva boj\u0101jums \u2013 oper\u0101cijas laik\u0101 var ievainot nervu un tas var rad\u012bt izteiktas s\u0101pes, ju\u0161anas trauc\u0113jumus vai I.p. musku\u013ca darb\u012bbas trauc\u0113jumu. Ja oper\u0101ciju veic rokas \u0137irur\u0123ij\u0101 specializ\u0113jies \u0101rsts un izmanto m\u016bsdienas tehnolo\u0123ijas, piem\u0113ram, optisko palielin\u0101jumu, \u0161\u0101das komplik\u0101cijas risks ir pavisam neliels. Literat\u016br\u0101 min\u0113tais \u0161\u012bs komplik\u0101cijas risks ir 2-4%. Ja nervs boj\u0101ts, visbie\u017e\u0101k nepiecie\u0161ama \u0137irur\u0123iska \u0101rst\u0113\u0161ana \u2013 nerva sa\u0161\u016b\u0161ana.<br>Recid\u012bvs \u2013 p\u0113c oper\u0101cijas pacientam atk\u0101rtojas s\u016bdz\u012bbas par tirp\u0161anu un ju\u0161anas trauc\u0113jumiem. Ja s\u016bdz\u012bbas ir t\u016bl\u012bt p\u0113c oper\u0101cijas, tad tas var\u0113tu liecin\u0101t par nepiln\u012bgu karp\u0101l\u0101s saites \u0161\u0137el\u0161anu. Ja s\u016bdz\u012bbas par\u0101d\u0101s pak\u0101peniski ilg\u0101k\u0101 laik\u0101 p\u0113c oper\u0101cijas, k\u0101 ar\u012b pacientam nov\u0113ro izteiktus r\u0113taudus oper\u0101cijas rajon\u0101, tas var b\u016bt saist\u012bts ar r\u0113taudu probl\u0113mu. P\u0113c literat\u016bras datiem \u0161\u012bs komplik\u0101cijas risks ir neliels \u2013 2-4%. Ja izveidojas recid\u012bvs, nepiecie\u0161ama atk\u0101rtota oper\u0101cija.<br>Infekcija \u2013 iesp\u0113jama br\u016bces infekcija, t\u0101pat k\u0101 veicot jebkuru oper\u0101ciju. Nepiecie\u0161ama savlaic\u012bga antibakteri\u0101la terapija.<br>Izteikti r\u0113taudi \u2013 var veidoties \u013coti izteikti r\u0113taudi oper\u0101cijas br\u016bces rajon\u0101 un tas var rad\u012bt s\u0101pes, hiperj\u016bt\u012bgumu, ju\u0161anas trauc\u0113jumus oper\u0101cijas r\u0113tas rajon\u0101 ilg\u0101ku laiku. S\u016bdz\u012bb\u0101m vajadz\u0113tu mazin\u0101ties 6-8 ned\u0113\u013cu laik\u0101 kop\u0161 oper\u0101cijas. Lai mazin\u0101tu s\u016bdz\u012bbas, rekomend\u0113 rehabilit\u0101ciju, kas sev\u012b ietver r\u0113taudu mobiliz\u0113\u0161anu, mas\u0101\u017eas ar m\u012bkstino\u0161iem un mitrino\u0161iem kr\u0113miem, pretr\u0113tu kr\u0113mi.<br>St\u012bvums (algodistrofija) \u2013 diezgan lielai pacientu da\u013cai, aptuveni 5-7%, kas ir 1 no 20, p\u0113c plaukstas oper\u0101cijas var att\u012bst\u012bties izteikta t\u016bska, s\u0101pes un st\u012bvums pirkstos. \u0160o komplik\u0101ciju nav iesp\u0113jams pirms oper\u0101cijas paredz\u0113t un to var kori\u0123\u0113t tikai ar rehabilit\u0101ciju un fizioproced\u016br\u0101m, prets\u0101pju terapiju un cit\u0101m konservat\u012bv\u0101m \u0101rst\u0113\u0161anas metod\u0113m. T\u016bska un st\u012bvums pak\u0101peniski mazin\u0101s un kust\u012bbu apjoms, sp\u0113ks atjaunojas.<\/p>\n\n\n\n<p class=\"has-text-color has-medium-font-size\" style=\"color:#5181e1\"><strong><span class=\"has-inline-color has-vivid-purple-color\">Dipitr\u0113na slim\u012bba jeb kontrakt\u016bra<\/span><\/strong><\/p>\n\n\n\n<p><strong>Dipitr\u0113na slim\u012bba jeb kontrakt\u016bra ir plaukstas saistaudu slim\u012bba, kas nosaukta \u0137irurga v\u0101rd\u0101<\/strong>, kas pirmo reizi aprakst\u012bja \u0161o slim\u012bbu un oper\u0101cijas b\u016bt\u012bbu &#8211; baron Guillaume Dupuytren.<br>Jebkuram cilv\u0113kam plaukst\u0101 zem \u0101das atrodas saistaudu sl\u0101n\u012btis jeb fascija, kas \u0161\u0137ir \u0101das audus no dzi\u013c\u0101kiem audiem \u2013 asinsvadiem, nerviem, c\u012bpsl\u0101m. <strong>Dipitr\u0113na slim\u012bbas gad\u012bjum\u0101 zem \u0101das eso\u0161ais saistaudu sl\u0101n\u012btis sabiez\u0113, veidojot cietus mezgli\u0146us un, sev\u012b ievelkot dzi\u013c\u0101k\u0101s strukt\u016bras<\/strong>. T\u0101 pirksti pak\u0101peniski savelkas saliekt\u0101 st\u0101vokl\u012b. Cilv\u0113ks vairs nesp\u0113j piln\u0101 apjom\u0101 atliekt pirkstus, reiz\u0113m var b\u016bt s\u0101pes mezgli\u0146u viet\u0101. Pie smag\u0101k\u0101m stadij\u0101m rodas izmai\u0146as ar\u012b loc\u012btav\u0101s, kaulos, pirkstu deform\u0101cijas. Mezgli\u0146i var b\u016bt gan plaukst\u0101, gan pirkstos. Visbie\u017e\u0101k mezgli\u0146i veidojas zeltnesim un mazajam pirkstam. V\u012brie\u0161i parasti slimo bie\u017e\u0101k nek\u0101 sievietes. Noz\u012bme ir iedzimt\u012bbai. Dipitr\u0113na slim\u012bba nav audz\u0113js un mezgli nepaliek \u013caundab\u012bgi. Var tikt iesaist\u012bta viena vai abas rokas.<\/p>\n\n\n\n<p><strong>Riska faktori:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Skandin\u0101vu izcelsme ( \u201eVikingu slim\u012bba\u201d), bie\u017e\u0101k Zieme\u013ceirop\u0101.<\/li><li>V\u012brietis.<\/li><li>Vecums p\u0113c 40 gadiem.<\/li><li>Slim\u012bba sastopama k\u0101dam no radiniekiem.<\/li><li>Bie\u017e\u0101k v\u0113rojama cilv\u0113kiem ar aknu cirozi, diab\u0113tu, epilepsiju, alkoholismu.<\/li><\/ul>\n\n\n\n<p>\u0160o slim\u012bbu noteikt var \u0101rsts, kas p\u0101rzina plaukstas saslim\u0161anas, apskatot, iztaustot un nov\u0113rt\u0113jot pacienta rokas. \u0100rst\u0113\u0161anai s\u0101kuma stadij\u0101s var lietot mas\u0101\u017eu, staip\u012b\u0161anu, sild\u012b\u0161anu, \u0101das barojo\u0161us un mitrino\u0161us l\u012bdzek\u013cus, proced\u016bras. Lai pareizi veiktu vingrin\u0101jumus un sild\u012b\u0161anu, rekomend\u0113 speci\u0101lista konsult\u0101ciju. P\u0101r\u0101k agres\u012bva vai nepareiza vingrin\u0101\u0161ana un mas\u0101\u017ea var pasliktin\u0101t st\u0101vokli.<\/p>\n\n\n\n<p><strong>Operat\u012bva \u0101rst\u0113\u0161ana \u2013 sabiez\u0113to audu iz\u0146em\u0161ana, atbr\u012bvojot dzi\u013c\u0101k\u0101s strukt\u016bras (nervus, asinsvadus), nepiecie\u0161ama p\u0101rsvar\u0101 sekojo\u0161os gad\u012bjumos:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Ir s\u0101pes mezgli\u0146u rajon\u0101, kas trauc\u0113 str\u0101d\u0101jot, aktivit\u0101t\u0113s;<\/li><li>Ir b\u016btiski saliekti pirksti un tos nav iesp\u0113jams pas\u012bvi atliekt l\u012bdz galam \u2013 tas noz\u012bm\u0113, ka ar laiku loc\u012btavas \u201eiest\u0101v\u0113sies\u201d un var rasties izmai\u0146as loc\u012btav\u0101, c\u012bpsl\u0101s. Jo vair\u0101k un ilg\u0101ku laiku pirksti ir saliekt\u0101 st\u0101vokl\u012b, jo sare\u017e\u0123\u012bt\u0101k \u0101rstam veikt oper\u0101ciju un pacientam gr\u016bt\u0101ks p\u0113coper\u0101cijas periods un slikt\u0101ks p\u0113coper\u0101cijas rezult\u0101ts.<\/li><li>Kosm\u0113tiski iemesli.<\/li><\/ul>\n\n\n\n<p>Oper\u0101ciju ieteicams veikt \u0137irurgam, kas ir zino\u0161s rokas \u0137irur\u0123ij\u0101.<br>P\u0113c oper\u0101cijas pacientam parasti nepiecie\u0161ams rehabilit\u0101cijas kurss, kas sev\u012b ietver r\u016bpes par \u0101das st\u0101vokli, r\u0113taudu m\u012bkstin\u0101\u0161ana (vingrin\u0101jumi, mas\u0101\u017ea), kust\u012bbu izstr\u0101de, k\u0101 ar\u012b var b\u016bt nepiecie\u0161amas speci\u0101las stiepjo\u0161as ortozes, lai pirksti atkal neatgrieztos saliekt\u0101 st\u0101vokl\u012b. P\u0113coper\u0101cijas procesu ieteicams veikt \u0137irurga un ergoterapeita uzraudz\u012bb\u0101, lai izv\u0113l\u0113tos piem\u0113rot\u0101ko katr\u0101 konkr\u0113taj\u0101 gad\u012bjum\u0101, k\u0101 ar\u012b apm\u0101c\u012btu pareizi veikt rehabilit\u0101ciju.<\/p>\n\n\n\n<p>Svar\u012bgi jau laikus doties pie \u0101rsta, jo \u0101rst\u0113\u0161anas rezult\u0101ti atkar\u012bgi no slim\u012bbas stadijas, k\u0101 ar\u012b no rokas terapijas p\u0113c oper\u0101cijas.<\/p>\n\n\n\n<p class=\"has-vivid-purple-color has-text-color has-medium-font-size\"><strong>Stenoz\u0113jo\u0161s ligament\u012bts<\/strong><\/p>\n\n\n\n<p>\u0160is j\u0113dziens apz\u012bm\u0113 <strong>c\u012bpslu saslim\u0161anas<\/strong>, atkar\u012bb\u0101 no to lokaliz\u0101cijas vietas rok\u0101. Pirkstos un plaukst\u0101 saliec\u0113jc\u012bpslas aptver saites, kas nodro\u0161ina to, ka c\u012bpsla pirksta garum\u0101 un plaukst\u0101 kust\u0101s pa vienu noteiktu ce\u013cu. \u0160\u0101das saites vienam pirkstam ir vair\u0101kas un pa c\u012bpslas gaitu veido t\u0101du k\u0101 \u201etuneli\u201d. J\u0101atz\u012bm\u0113, ka saites diezgan cie\u0161i aptver c\u012bpslu un t\u0101s nav \u012bpa\u0161i elast\u012bgas. <\/p>\n\n\n\n<p>Gad\u012bjumos, kad <strong>rodas neatbilst\u012bba starp c\u012bpslas izm\u0113riem un \u201etuneli\u201d, ko veido saites, c\u012bpsla vairs nevar br\u012bvi kust\u0113ties un tas rada s\u016bdz\u012bbas<\/strong>. Parasti \u0161\u0101da situ\u0101cija att\u012bst\u0101s l\u012bmen\u012b, kur pirksti p\u0101riet plaukst\u0101. \u0160\u0101da neatbilst\u012bba var rasties no t\u016bskas, iekaisuma, r\u0113to\u0161an\u0101s. Var b\u016bt gr\u016btniec\u012bbas laik\u0101 vai sastopams pie t\u0101d\u0101m saslim\u0161an\u0101m k\u0101 reimato\u012bdais artr\u012bts vai cukura diab\u0113ts. S\u0101kotn\u0113j\u0101 stadij\u0101 <strong>visbie\u017e\u0101k\u0101s s\u016bdz\u012bbas ir s\u0101pes pa c\u012bpslas gaitu, nesp\u0113ja saliekt vai atliekt pirkstu. St\u0101voklim att\u012bstoties t\u0101l\u0101k, uz c\u012bpslas var izveidoties paresnin\u0101jums, \u201emezgli\u0146\u0161\u201d un cilv\u0113kam rodas saj\u016bta, ka pirksta saliek\u0161anu vai atliek\u0161anu pavada \u201eklik\u0161\u0137is\u201d.<\/strong> \u0160\u0137ietamais klik\u0161\u0137is rodas br\u012bd\u012b, kad mezgli\u0146\u0161 tiek izvilkts cauri saitei.<br>V\u0113l joproj\u0101m nav piln\u012bb\u0101 skaidrs \u0161\u012b st\u0101vok\u013ca att\u012bst\u012b\u0161an\u0101s iemesls, bet <strong>var\u0113tu b\u016bt noz\u012bme: <\/strong>ilgsto\u0161\u0101m, atk\u0101rtot\u0101m pirkstu kust\u012bb\u0101m vai ilgsto\u0161\u0101m sasprindzin\u0101jumam saliek\u0161anas st\u0101vokl\u012b. Var\u0113tu b\u016bt noz\u012bme traumai. Noz\u012bme ir visiem st\u0101vok\u013ciem, kas palielina \u0161\u0137idruma uzkr\u0101\u0161anos audos, radot t\u016bsku. Visbie\u017e\u0101k skarts \u2013 zeltnesis, vid\u0113jais pirksts, mazais pirksts.<\/p>\n\n\n\n<p><strong>\u0100rst\u0113\u0161anu iedala tr\u012bs veidos:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Konservat\u012bva \u0101rst\u0113\u0161ana<\/strong> \u2013 fizioterapija, speci\u0101li vingrin\u0101jumi, nepiecie\u0161am\u012bbas gad\u012bjum\u0101 ortozes (ir gan speci\u0101li dienai, gan naktij). Rekomend\u0101cijas var sniegt \u0101rsts, kas orient\u0113jas rokas saslim\u0161an\u0101s vai ergoterapeits, rehabilitologs. Nepareizi vingrin\u0101jumi un fizioproced\u016bras st\u0101vokli var tikai pasliktin\u0101t.<\/li><li><strong>Medikamentoza \u0101rst\u0113\u0161ana<\/strong> \u2013 var lietot pretiekaisuma l\u012bdzek\u013cus, kas no\u0146ems s\u0101pes un mazin\u0101s t\u016bsku. C\u012bpslas t\u016bskain\u0101 rajon\u0101 var ievad\u012bt sp\u0113c\u012bgas pretiekaisuma z\u0101les (kortikostero\u012bdi). Injekcijas var veikt ne vair\u0101k k\u0101 divas-tr\u012bs reizes. Reti, bet iesp\u0113jama komplik\u0101cija \u2013 c\u012bpslas p\u0101rtr\u016bk\u0161ana. Injekcijas var sniegt palieko\u0161u rezult\u0101tu, bet var ar\u012b nedot rezult\u0101tu.<\/li><li><strong>Operat\u012bva \u0101rst\u0113\u0161ana <\/strong>\u2013 tiek izdar\u012bts neliels grieziens \u0101d\u0101, atrasta saite, kas ierobe\u017eo br\u012bvas c\u012bpslas kust\u012bbas un t\u0101 tiek ie\u0161\u0137elta, c\u012bpslu atbr\u012bvojot. Oper\u0101cijas gad\u012bjum\u0101 situ\u0101cija tiek piln\u012bb\u0101 atrisin\u0101ta. Tom\u0113r p\u0113c oper\u0101cijas var b\u016bt nepiecie\u0161ams laiks, lai c\u012bpsla piln\u012bb\u0101 \u201enomierin\u0101tos\u201d un ergoterapeita pal\u012bdz\u012bba, lai nepie\u013cautu p\u0101r\u0101k lielu r\u0113taudu veido\u0161anos, pal\u012bdz\u0113tu pak\u0101peniski atjaunot pilnu kust\u012bbu apjomu, par\u0101d\u012btu pirkstu vingrin\u0101jumus, kas pal\u012bdz\u0113tu izvair\u012bties no \u0161\u0101das situ\u0101cijas att\u012bst\u012bbas citiem pirkstiem.<\/li><\/ul>\n\n\n\n<p><strong><span class=\"has-inline-color has-vivid-purple-color\">De Kerv\u0113na sindroms<\/span><\/strong> (De Quervaine)<\/p>\n\n\n\n<p>L\u012bdz\u012bga situ\u0101cija \u2013 <strong>c\u012bpslas neatbilst\u012bba sai\u0161u \u201etunelim\u201d var rasties pa \u012bk\u0161\u0137a jeb pirm\u0101 pirksta atliec\u0113jc\u012bpslu gaitu pie plaukstas pamatnes.<\/strong> \u0160aj\u0101 gad\u012bjum\u0101 cauri vienam \u201etunelim\u201d iet vair\u0101kas c\u012bpslas.<\/p>\n\n\n\n<p>\u0160aj\u0101 lokaliz\u0101cij\u0101 situ\u0101cija visbie\u017e\u0101k rodas, ja cilv\u0113ks veic t\u0101das aktivit\u0101tes (ve\u013cas mazg\u0101\u0161ana, darbs ar rot\u0113jo\u0161iem meh\u0101nismiem u.c.), kuru veik\u0161an\u0101 nepiecie\u0161ama bie\u017ea \u012bk\u0161\u0137a atliek\u0161ana un vienlaic\u012bga plaukstas pamatnes loc\u012btavas atliek\u0161ana uz maz\u0101 pirksti\u0146a pusi. \u0160is past\u0101v\u012bgais c\u012bpslu nospriegojums rada berzi sai\u0161u &#8220;tunel\u012b&#8221;, kam seko t\u016bska un &#8220;kan\u0101la&#8221; sa\u0161aurin\u0101\u0161an\u0101s. \u0160\u012b probl\u0113ma <strong>bie\u017ei nov\u0113rojama jaunaj\u0101m m\u0101mi\u0146\u0101m<\/strong>, kad mazuli bie\u017ei un ilgsto\u0161i aukl\u0113 \u2013 b\u0113rnu ce\u013cot aiz padus\u0113m visi pirksti, ar\u012b \u012bk\u0161\u0137is ir iztaisnots un ar maksim\u0101lu slodzi.<\/p>\n\n\n\n<p>\u0100rst\u0113\u0161ana agr\u012bn\u0101s stadij\u0101s ar vingrin\u0101jumiem, fizioproced\u016br\u0101m, var lietot medikamentus, blok\u0101des un v\u0113l\u0101k\u0101s stadij\u0101s \u2013 oper\u0101cija. \u0100rst\u0113\u0161ana tiek veikta p\u0113c t\u0101diem pa\u0161iem principiem, k\u0101 iepriek\u0161 min\u0113ts.<\/p>\n\n\n\n<p class=\"has-luminous-vivid-orange-color has-text-color has-medium-font-size\"><strong><span class=\"has-inline-color has-vivid-purple-color\">C\u012bpslu iekaisums<\/span><\/strong><\/p>\n\n\n\n<p>C\u012bpslu iekaisums rok\u0101 un pirkstos visbie\u017e\u0101k rodas no p\u0101rslodzes, traum\u0101m, infekcijas vai blakus saslim\u0161an\u0101m (podagra, cukura diab\u0113ts). <\/p>\n\n\n\n<p><strong>Parasti c\u012bpslu iekaisums izpau\u017eas k\u0101:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>s\u0101pes vai diskomforts,<\/li><li>t\u016bska,<\/li><li>aps\u0101rtums, karstuma saj\u016bta,<\/li><li>ierobe\u017eotas kust\u012bbas.<\/li><\/ul>\n\n\n\n<p>C\u012bpslu iekaisums var rad\u012bt s\u0101pes, kas izstaro gan uz aug\u0161u, gan uz leju no iekaisu\u0161\u0101s vietas. Viena pirksta c\u012bpslas iekaisums var rad\u012bt s\u016bdz\u012bbas vis\u0101 rok\u0101. Pav\u0113rojot un izanaliz\u0113jot s\u0101pju raksturu, nereti var secin\u0101t, ka s\u0101pes provoc\u0113 k\u0101da noteikta kust\u012bba vai darb\u012bba. Var b\u016bt rakstur\u012bga krik\u0161\u0137\u0113\u0161ana vai gurkst\u0113\u0161ana pa c\u012bpslas gaitu.<br>Svar\u012bgi ir izv\u0113rt\u0113t iesp\u0113jamos c\u0113lo\u0146us c\u012bpslas iekaisumam. Gad\u012bjum\u0101, ja rodas aizdomas par c\u012bpslas iekaisumu, visbie\u017e\u0101k s\u0101kotn\u0113ji nepiecie\u0161ams roku atp\u016btin\u0101t, veikt relaks\u0113jo\u0161us, stiepjo\u0161us vingrin\u0101jumus (rekomend\u0113jams v\u0113rsties pie ergoterapeita, rokas \u0137irurga vai cita speci\u0101lista, kur\u0161 p\u0101rzin rokas terapiju. Nepareizi vingrin\u0101jumi st\u0101vokli var pasliktin\u0101t!), lietot pretiekaisuma un prets\u0101pju l\u012bdzek\u013cus. Ja st\u0101voklis neuzlabojas, tad noteikti nepiecie\u0161ama speci\u0101lista konsult\u0101cija. Ja c\u012bpslas iekaisums ir ilgsto\u0161i, tad to ir gr\u016bt\u0101k \u0101rst\u0113t. <\/p>\n\n\n\n<p><strong>\u0100rst\u0113\u0161anu veic:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>konservat\u012bvi (vingrin\u0101jumi, miers, medikamenti u.c.),<\/li><li>medikamentozi (injekcijas u.c.),<\/li><li>\u0137irur\u0123iski.<br>Vislab\u0101k, ja c\u012bpslu iekaisumus s\u0101k \u0101rst\u0113t agr\u012bni, jo tad sagaid\u0101mi lab\u0101ki un \u0101tr\u0101ki rezult\u0101ti. C\u012bpslu iekaisumi visbie\u017e\u0101k rodas no p\u0101r\u0101k lielas vai nepareizas slodzes, ta\u010du var b\u016bt pirmais v\u0113stnesis k\u0101dai nopietn\u0101kai rokas vai visa organisma saslim\u0161anai, t\u0101p\u0113c prec\u012bzas diagnozes noteik\u0161anai var b\u016bt nepiecie\u0161ams veikt papildus izmekl\u0113jumus.<\/li><\/ul>\n\n\n\n<p class=\"has-vivid-green-cyan-color has-text-color has-medium-font-size\"><strong><span class=\"has-inline-color has-vivid-purple-color\">L\u016bzumi rok\u0101<\/span><\/strong><\/p>\n\n\n\n<p>Bie\u017e\u0101kie iemesli: <strong>kritieni, traumas, sporta traumas, ce\u013cu satiksmes negad\u012bjumi, tie\u0161a trauma (sitiens). <\/strong><\/p>\n\n\n\n<p>L\u016bzumi rodas, ja \u0101r\u0113j\u0101 sp\u0113ka iedarb\u012bba ir sp\u0113c\u012bg\u0101ka par kaula iztur\u012bbu. L\u016bzuma veids ir atkar\u012bgs no traumas meh\u0101nisk\u0101s iedarb\u012bbas. L\u016bzums var lokaliz\u0113ties jebkur\u0101 rokas kaul\u0101.<br><\/p>\n\n\n\n<p><strong>L\u016bzuma paz\u012bmes:<\/strong><br>a) kaula berz\u0113\u0161an\u0101s, m\u0113\u0123inot kustin\u0101t ekstremit\u0101ti;<br>b) ekstremit\u0101tes garuma, formas un lieluma izmai\u0146as, kust\u012bbu trauc\u0113jumi;<br>c) t\u016bska un aps\u0101rtums l\u016bzuma rajon\u0101;<br>d) ju\u0161anas trauc\u0113jumi;<br>e) rokas tirp\u0161ana;<br>f) musku\u013cu sasprindzin\u0101jums, spazmas.<br><\/p>\n\n\n\n<p><strong>Ja ir aizdomas par rokas l\u016bzumu, tad l\u012bdz neatliekam\u0101s pal\u012bdz\u012bbas iera\u0161an\u0101s br\u012bdim ieteicams:<\/strong><br>a) no\u0146emt rotaslietas un gredzenus;<br>b) ja ir br\u016bce \u2013 uzlikt t\u012bru p\u0101rs\u0113ju, lai taj\u0101 neiek\u013c\u016btu mikrobi;<br>c) stabiliz\u0113t loc\u012btavu virs un zem loc\u012btavas l\u012bme\u0146a;<br>d) atst\u0101t roku t\u0101d\u0101 poz\u012bcij\u0101, k\u0101da t\u0101 ir (m\u0113\u0123in\u0101jums iztaisnot saliektu roku, var veicin\u0101t nerva un c\u012bpslu boj\u0101jumu).<br><\/p>\n\n\n\n<p><strong>\u0100rst\u0113\u0161ana<\/strong><br>Ja ir aizdomas par kaulu l\u016bzumu, nepiecie\u0161ams veikt<strong> rentgena izmekl\u0113jumu. <\/strong>\u0100rsts, apskatot rentgenu, konstat\u0113s l\u016bzuma apm\u0113ru un izv\u0113rt\u0113s nepiecie\u0161amo \u0101rst\u0113\u0161anu, taj\u0101 skait\u0101 &#8211; oper\u0101cijas nepiecie\u0161am\u012bbu. Reiz\u0113m prec\u012bzai st\u0101vok\u013ca izv\u0113rt\u0113\u0161anai var b\u016bt nepiecie\u0161ami ar\u012b s\u012bk\u0101ki izmekl\u0113jumi \u2013 piem\u0113ram, <strong>kompj\u016btera tomogr\u0101fija <\/strong>(CT).<br>Vienk\u0101r\u0161us l\u016bzumus parasti \u0101rst\u0113 <strong>konservat\u012bvi \u2013 uzliekot \u0123ip\u0161a longeti.<\/strong> Ja kauls neatrodas pareizi, nob\u012bd\u012bjies, k\u0101 ar\u012b prognoz\u0113jams, ka nenotiks laba un pareiza kaula sadz\u012b\u0161ana var b\u016bt nepiecie\u0161ama <strong>oper\u0101cija<\/strong>. Ja kauls nav b\u016btiski nob\u012bd\u012bjies, reiz\u0113m traum\u0113t\u0101 vieta tiek ats\u0101pin\u0101ta (anest\u0113zija) un kaulu ar speci\u0101l\u0101m kust\u012bb\u0101m \u0101rsts var novietot pareiz\u0101 st\u0101vokl\u012b \u2013 veic <strong>repoz\u012bciju<\/strong>. Oper\u0101cijas laik\u0101 \u0101rsts kaulu novieto iesp\u0113jami lab\u0101 st\u0101vokl\u012b un <strong>fiks\u0113 ar speci\u0101l\u0101m konstrukcij\u0101m<\/strong> \u2013 stiepl\u0113m, skr\u016bv\u0113m, pl\u0101ksn\u0113m.<br>\u0100rsts izv\u0113l\u0113sies konkr\u0113tai situ\u0101cijai un ar\u012b visp\u0101r\u0113jam vesel\u012bbas st\u0101voklim atbilsto\u0161\u0101ko \u0101rst\u0113\u0161anas metodi. \u0100rst\u0113\u0161ana paraksti ir vienk\u0101r\u0161\u0101ka un rezult\u0101ts ir veiksm\u012bg\u0101ks, ja l\u016bzums nav sk\u0101ris loc\u012btavas, c\u012bpslas vai nervus, k\u0101 ar\u012b liela noz\u012bme ir savlaic\u012bgi uzs\u0101ktai rehabilit\u0101cijai. Atsevi\u0161\u0137as kust\u012bbas oper\u0113taj\u0101 rok\u0101 var uzs\u0101kt jau pirmaj\u0101s dien\u0101s p\u0113c oper\u0101cijas, bet l\u016bzums piln\u012bb\u0101 sadz\u012bst aptuveni 6 \u2013 8 ned\u0113\u013cu laik\u0101. Konkr\u0113tas rekomend\u0101cijas par kust\u012bb\u0101m sniedz \u0101rsts. P\u0113c oper\u0101cijas vai \u0123ip\u0161a longetes no\u0146em\u0161anas roka savu sp\u0113ku atg\u016bst 3 \u2013 4 m\u0113ne\u0161u laik\u0101, jo s\u0101kum\u0101 var b\u016bt iev\u0113rojams kust\u012bbu apjoma ierobe\u017eojums un st\u012bvums.<br>Ja l\u016bzums ir sk\u0101ris loc\u012btavas virsmu, tad ilgtermi\u0146\u0101 past\u0101v loc\u012btavas deform\u0101cijas (artrozes) att\u012bst\u012b\u0161an\u0101s risks, l\u012bdz ar to ir nepiecie\u0161ama regul\u0101ra rokas st\u0101vok\u013ca nov\u0113rt\u0113\u0161ana un kontrole.<\/p>\n\n\n\n<p class=\"has-vivid-cyan-blue-color has-text-color has-medium-font-size\"><strong><span class=\"has-inline-color has-vivid-purple-color\">\u201eKr\u012bto\u0161ais\u201d pirksts<\/span><\/strong><\/p>\n\n\n\n<p>Ar \u0161o nosaukumu apz\u012bm\u0113 <strong>nesp\u0113ju ar savu musku\u013cu sp\u0113ku notur\u0113t taisnu jeb atliektu pirksta galu.<\/strong> \u0160\u0101da situ\u0101cija parasti rodas traumu gad\u012bjum\u0101, kad noticis <strong>atliec\u0113jc\u012bpslas atr\u0101vums no t\u0101s piestiprin\u0101\u0161an\u0101s vietas pirksta gal\u0101 ar vai bez kaula fragmenta.<\/strong><br>Traumu izraisa atsitiens attiec\u012bb\u0101 pret taisnu vai saliektu pirkstu. Bie\u017ei trauma ir pavisam neliela un sadz\u012bviska \u2013 kl\u0101jot dr\u0113bes, gatavojot \u0113st, veicot kop\u0161anas un t\u012br\u012b\u0161anas darbus. Bie\u017ei sastopama trauma sport\u0101 &#8211; volejbols, basketbols.<br>Galven\u0101 \u201ekr\u012bto\u0161\u0101\u201d pirksta paz\u012bme \u2013 <strong>nav iesp\u0113jams akt\u012bvi veikt pirksta gala atliek\u0161anu!<\/strong><\/p>\n\n\n\n<p><strong>\u0100rst\u0113\u0161ana<\/strong><br>B\u016btu ieteicams veikt rentgenu, lai p\u0101rliecin\u0101tos, vai c\u012bpslas boj\u0101jums ir ar vai bez kaula fragmenta un vai nav citi kaula boj\u0101jumi. Izmekl\u0113juma rezult\u0101ts ietekm\u0113s t\u0101l\u0101ko \u0101rsta ieteikto \u0101rst\u0113\u0161anu un iesp\u0113jamo rezult\u0101tu un prognozi.<br>Ja l\u016bzuma nav, tad parasti \u0101rst\u0113 bez oper\u0101cijas &#8211; ar piel\u0101gojamas vai individu\u0101li izgatavotas ortozes pal\u012bdz\u012bbu, kas j\u0101lieto 24stundas diennakt\u012b vismaz 4-6ned\u0113\u013cas.<br>Ortozes m\u0113r\u0137is ir notur\u0113t pirksta galu taisnu un pat nedaudz atliektu un nepie\u013caut pirksta gala saliek\u0161anu, tie\u0161i t\u0101p\u0113c ortoze ir j\u0101n\u0113s\u0101 nep\u0101rtraukti (k\u0101 to ir nor\u0101d\u012bjis \u0101rsts).<br>Ja tiek konstat\u0113ts l\u016bzums, tad var b\u016bt nepiecie\u0161ama oper\u0101cija, lai kaula atl\u016bzu\u0161o da\u013cu novietotu pareiz\u0101 st\u0101vokl\u012b. Ar\u012b p\u0113c tam parasti lieto fiksatoru.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Rokas \u0137irur\u0123ija ir medic\u012bnas nozare, kuras speci\u0101listi veic \u0101rst\u0113\u0161anu da\u017e\u0101da veida aug\u0161\u0113jo ekstremit\u0101\u0161u probl\u0113mu un saslim\u0161anu gad\u012bjumos. T\u0101s ir gan traumas, gan sekas p\u0113c traum\u0101m&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_mi_skip_tracking":false,"footnotes":""},"class_list":["post-192","page","type-page","status-publish","hentry"],"aioseo_notices":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Rokas \u0137irur\u0123ija - Loginas Mikro\u0137irur\u0123ijas un Rehabilit\u0101cijas centrs<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/logina.lv\/index.php\/rokas-kirurgija\/\" \/>\n<meta property=\"og:locale\" content=\"lv_LV\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Rokas \u0137irur\u0123ija - Loginas Mikro\u0137irur\u0123ijas un Rehabilit\u0101cijas centrs\" \/>\n<meta property=\"og:description\" content=\"Rokas \u0137irur\u0123ija ir medic\u012bnas nozare, kuras speci\u0101listi veic \u0101rst\u0113\u0161anu da\u017e\u0101da veida aug\u0161\u0113jo ekstremit\u0101\u0161u probl\u0113mu un saslim\u0161anu gad\u012bjumos. 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