Ma phalanges ndi mafupa ang'onoang'ono aatali omwe amaphatikizana kupanga zala ndi zala, zomwe zimapangitsa kuti mafupawo akhale mafupa. Mafupa ang'onoang'ono a tubular awa ndi atatu mwa chiwerengero cha zala zomwe zimatchedwa zala zazitali, ndi ziwiri za chala chachikulu ndi chala chachikulu. Etymologically, mawu awa amachokera ku Greek "phalagx » kutanthauzamatabwa a cylindrical, ndodo". Phalanx yoyamba ya chala nthawi zonse imalankhula ndi metacarpal ya dzanja kapena metatarsal phazi. Ponena za phalanges ena, amafotokozedwa pakati pawo. Choncho phalanx ndi gawo la fupa lomwe limagwirizanitsidwa ndi ma phalanges ena pamtunda wa interphalangeal joints: ndi izi zomwe zimapatsa zala kuyenda kwawo ndi mphamvu. Nthawi zambiri pathologies wa phalanges ndi fractures, mankhwala amene nthawi zambiri mafupa, mwachitsanzo mwa splint, ndipo nthawi zina opaleshoni, makamaka pamene zotupa za mitsempha kapena tendons anawonjezera kuti fracture.

Phalanx ndi gawo la fupa lodziwika bwino: limapanga mafupa a chala kapena chala, ndipo minofu yosiyana imayikidwa pazigawo za fupa. Kuyika molunjika, pa chala chilichonse, pamwamba pa mzake, phalanges amasiyanitsidwa kukhala woyamba kapena metacarpals, masekondi kapena pakati, ndi wachitatu kapena ungual.

Choncho phalanges amapanga mafupa akutali kwambiri a dzanja, kapena phazi. Zala zazitali chilichonse chili ndi phalanges zitatu pa chala chilichonse, kumbali ina chala chachikulu, chomwe chimatchedwanso kuti pollux, kapena chala chachikulu, chomwe chimatchedwanso hallux, chimakhala ndi ziwiri zokha. The distal phalanx ndi yomwe imanyamula msomali, proximal phalanx ndi yomwe ili pamizu ya chala. Pazonse, pali phalanges khumi ndi anayi pa dzanja lililonse, ndipo ochuluka pa phazi lililonse, kupanga okwana makumi asanu ndi zisanu ndi chimodzi phalanges.

Malumikizidwe omwe amalumikiza phalanges wina ndi mnzake amatchedwa ma interphalangeal joints. Phalanx yomwe ili pafupi kwambiri ndi metacarpus imatchedwanso proximal phalanx, phalanx yapakati imatchedwa phalangina, ndi phalanx yomwe ili kumapeto kwa chala, yomwe imatchedwanso distal phalanx, nthawi zina imatchedwanso phalangette.

Ntchito ya phalanges ndikupatsa zala mphamvu zawo, kuyenda kwawo mwapadera komanso kofunikira kwambiri ku chiwalo chapadera ichi chomwe ndi dzanja. Pachifukwa ichi, malekezero a phalanges amazunguliridwa pamtunda wa kuyankhulana ndi mafupa ena, kumene nangula wa phalangeal ligaments ali. M'malo mwake, ma phalanges oyandikira a zala zonse amalumikizana ndi mafupa a metacarpal ndi phalanges wapakatikati amalankhula bwino ndi distal phalanges. Ndipo ma phalanges awa amalankhula, ndendende, ndi phalanges ena, pamlingo wamagulu a interphalangeal.

Kuvulala kwa zala, pamlingo wa phalanges, kungakhale koyambitsa zoopsa, komanso rheumatological, neurologic kapena congenital. Koma kwenikweni, ma pathologies omwe amapezeka pafupipafupi a phalanges amakhala fractures. "Kuphulika kwa manja kungakhale kovuta ndi kupunduka ngati sikunatsatidwe, kuuma ndi kuwonjezereka, komanso kupunduka ndi kuuma ndi kusamalidwa bwino.", Anachenjeza wasayansi waku America dzina lake Swanson.

Chifukwa chake, fractures za pasterns ndi phalanges ndizowopsa kwambiri mpaka kumapeto, ndipo 70% yaiwo imachitika pakati pa zaka 11 ndi 45. Kuthyoka kwa phalanges nthawi zambiri kumachitika chifukwa cha kuvulala ndi kugwa, kapena kuphwanya. Nthawi zambiri, zimachitika pambuyo pa kugwedezeka pang'ono kapena popanda kuvulala kwa fupa la pathological (lofooka ndi chotupa cha fupa). Chotupa chofala kwambiri mwa zotupazi ndi chondroma, chomwe ndi chotupa chomwe chimafooketsa fupa m’kupita kwa zaka.

Kumayambiriro kwa makumi awiri^e m'zaka za zana lino, phalanx fractures onse anachiritsidwa popanda opaleshoni, ndipo ambiri a iwo akupitirizabe kuchiritsidwa bwino lero popanda opaleshoni. Kusankhidwa kwa chithandizo choyenera kumadalira zinthu zingapo, kuphatikizapo pakati pa malo ophwanyika (articular kapena extra-articular), geometry yake (yodutsa, yozungulira kapena yozungulira, yophwanyika) kapena mapindikidwe.

Nthawi zambiri, chithandizo cha fractures izi ndi mafupa, ndi ntchito splinting. Nthawi zambiri, opaleshoni iyenera kugwiritsidwa ntchito, makamaka ngati pali zotupa zokhudzana ndi mitsempha kapena tendons. Kusasunthika kuyenera kukhala pakati pa milungu inayi ndi isanu ndi itatu, osatinso kuti zisawonekere kuuma kwamagulu.

Kuvulala koyambako nthawi zambiri kumasonyeza kuti wathyoka, ndipo wodwala wothyoka chala sangathe kuchisuntha.

• Zizindikiro zachipatala: kuchipatala, yang'anani kukhalapo kwa kutupa, kupunduka, hematoma, kuchepa kwa ntchito komanso kupweteka kwa palpation ya fupa. Kuyeza kwachipatala kudzakhalanso kothandiza kufotokoza kuti ndi zithunzi ziti za radiographic zomwe ziyenera kutengedwa;
• Radiology: Nthawi zambiri ma X-ray osavuta amakhala okwanira kutsimikizira kuti pali phalanges imodzi kapena zingapo. Nthawi zina padzakhala kofunika, nthawi zina, kupempha CT kapena MRI kuti ichitidwe kuti afotokoze maonekedwe a fracture. Mayeso owonjezerawa apangitsanso kuti athe kumaliza mayesowo musanachitepo kanthu.

Count Jean-François de La Pérouse ndi wofufuza wa ku France wa m'zaka za m'ma XVIII^e zaka zana. Iye anasimba m’buku lake lina lofotokoza za maulendo ake ozungulira dziko ( Voyage, Tome III, p. 214) chidziŵitso chodabwitsa: “Mwambo wodula phalanges wa chala chaching'ono uli ponseponse pakati pa anthu awa monga momwe uliri pakati pa Cocos ndi Traitor Islands, ndipo chizindikiro ichi chachisoni chifukwa cha imfa ya wachibale kapena bwenzi sichidziwika pazilumba za Osakatuli.“, Iye akulemba.

Kuphatikiza apo, nthano ina yokhudzana ndi phalanges imakhudza woyenda zakuthambo wamkulu: motero, mu 1979, Neil Armstrong akugwira ntchito pafamu yake, adang'amba phalanx, pomwe mphete yake yaukwati idakakamira m'mbali mwa ngolo ya thirakitala yake. pamene akudumphira pansi. Modekha, akutenga nsonga ya chala chake cha mphete, naiika mu ayezi, napita kuchipatala. Madokotala ochita opaleshoni adzatha kumusoka.

Pomaliza, wopenda zakuthambo wina waku America adakumananso ndi nkhani yodabwitsa: ndi Donald Slayton. Ali ndi zaka zisanu zokha, Donald Kent Slayton, wopenda zakuthambo wamtsogolo wa ntchito ya Apollo-Soyuz, adadula kwambiri chala chake chakumanzere cha mphete pomwe akuyesera kuthandiza abambo ake pa chotchera udzu chokokedwa ndi akavalo awiri. Pamene, zaka khumi ndi zitatu pambuyo pake, mu 1942, adapambana mayeso achipatala ndi cholinga chophatikizapo maphunziro a woyendetsa ndege zankhondo, adawopa kuti adzalephera chifukwa cha phalanx yake yosowa. sizili choncho. Madokotala omwe amayang'anira zowunikira atayang'ana malamulo a Air Force, adapeza modabwa kuti chala cham'manja chakumanzere ngati chili chakumanja (kapena chala cham'manja chakumanja ngati 'tikumanzere- handed) ndicho chala chokhacho chodulidwa chomwe sichibweretsa vuto lililonse. Motero Air Force inalingalira kuti, mwanjira ina, chala chokhacho "chopanda ntchito"! Mwayi kwa Donal Slayton yemwe amapeza mapiko ake oyendetsa ndege chaka chotsatira, mu 1943, asanaphunzire zaka zingapo pambuyo pake, mu April 1953, kuti adzakhala m'gulu la astronaut oyambirira asanu ndi awiri. Ndipo, mwa mbiri, dziwani kuti adzavala mphete yake yaukwati ... pa chala chaching'ono.