underben (PH Indholdsside)

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      <HtmlField Name="FactContent"><![CDATA[<h2>Fakta</h2>
<ul>
    <li>Knoglebrud i underbenet kan involvere skinneben og l&aelig;gben. Brudtypen bestemmes af, hvordan skaden opst&aring;r, og som hovedregel kr&aelig;ver det en st&oslash;rre kraftp&aring;virkning</li>
    <li>Symptomerne p&aring; brud i underbenet er udtalte smerter, nedsat funktion og eventuel fejlstilling </li>
    <li>Hvis der ikke er st&oslash;rre fejlstillinger, behandler man med gips eller bandage</li>
    <li>Det er n&oslash;dvendigt at operere ved st&oslash;rre fejlstillinger, ved &aring;bne brud med store skader p&aring; muskler, sener og v&aelig;v, ved knusningsbrud og ved brud der g&aring;r ind i kn&aelig; eller ankelleddet</li>
    <li>
    Det er vigtigt at f&oslash;lge planen for behandling efter brud i underbenet for at forhindre fejlstilling, bet&aelig;ndelse eller at bruddet ikke heler op</li>
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      <HtmlField Name="PageContent"><![CDATA[<h2>Brud i underbenet</h2>
<p>Underbenet best&aring;r af to knogler, skinnebenet (tibia) og l&aelig;gbenet (fibula). </p>
<p>Skinnebenet er den kraftige knogle, som vi ser med en skarp kant p&aring; forsiden af underbenet. L&aelig;gbenet befinder sig p&aring; ydersiden af benet og m&aelig;rkes let lige nedenfor kn&aelig;ets yderside. </p>
<p>Begge knogler indg&aring;r i kn&aelig;leddet og ankelleddet. B&aring;de l&aelig;gbenet og skinnebenet er udsatte ved brud i kn&aelig;leddet og i ankelleddet. Disse brudtyper regnes dog ikke som underbensbrud. </p>
<p>Brud i underbenet kan v&aelig;re isolerede brud af l&aelig;gbenet eller skinnebenet eller brud, som omfatter begge knogler. Bruddene kan v&aelig;re tv&aelig;r-, skr&aring;-, spiral- eller knusningsbrud. Dertil kommer <a href="~/link.aspx?_id=5FD1E38F045E436C964D1362783330C0&amp;_z=z">tr&aelig;thedsbrud</a>&nbsp;og brud p&aring; grund af anden sygdom.</p>
<p><img alt="Skråfraktur af underarmsknogle" title="Skråbrud af underarmsknogle" src="12DD009258F64649B880C0D7A70BB6DE-260-533" style="height: 533px; width: 260px;" height="533" width="260"></p>
<ul>
</ul>
<h2>Hvad er symptomerne p&aring; underbensbrud?</h2>
<p>Udtalte smerter og nedsat funktion samt fejlstilling er almindeligt.</p>
<h2>Hvordan stilles diagnosen?</h2>
<p>Underbensbrud hos voksne ses stort set kun efter st&oslash;rre skader, men b&oslash;rn kan f&aring; brud selv ved mindre skader. </p>
<p>Hos b&oslash;rn kan det v&aelig;re vanskeligt at finde &aring;rsager til skaden. Men der skal altid unders&oslash;ges for underbensbrud hos b&oslash;rn, som ikke vil belaste p&aring; benet.</p>
<p>De typiske tegn p&aring; underbensbrud er:</p>
<ul>
    <li>Smerter</li>
    <li>At benet h&aelig;ver op</li>
    <li>Manglende evne til at belaste p&aring; benet</li>
    <li>Fejlstilling</li>
    <li>Forkortning </li>
    <li>Instabilitet</li>
</ul>
<p> Dertil forekommer &aring;bne brud med hudskader nok s&aring; hyppigt ved underbensbrud. Der er ved underbensbrud altid en risiko for, at huden kan trues af trykskade, hvis knoglebrudstykker trykker mod huden.</p>
<p>Ved l&aelig;geunders&oslash;gelsen er det vigtigt at kontrollere, at der ikke er opst&aring;et skade p&aring; blod&aring;rer eller nerver. </p>
<p>Underbensbrud kan ogs&aring; for&aring;rsage, at benet h&aelig;ver betydeligt op, hvilket kan standse blodforsyningen eller give nerveskader. Dette giver et s&aring;kaldt <a href="~/link.aspx?_id=5B15A7505B58400F8CDEF5E293D09402&amp;_z=z">kompartmentsyndrom</a>. Dette er en tilstand med:</p>
<ul>
    <li>Smerter</li>
    <li>F&oslash;lelsesl&oslash;shed i foden</li>
    <li>Manglende aktiv bev&aelig;gelse</li>
    <li>Voldsomme smerter ved passiv bev&aelig;gelse af t&aelig;er/fodled - det vil sige ved str&aelig;k af muskler og sener</li>
</ul>
<p>Det er ogs&aring; vigtigt ved l&aelig;geunders&oslash;gelsen at sikre sig, at der ikke er skade p&aring; ankel- eller kn&aelig;led.</p>
<p>R&oslash;ntgenunders&oslash;gelsen omfatter hele benet, kn&aelig;et og anklen. Man ser efter fremmedlegemer, som kan forekomme ved &aring;bne skader. R&oslash;ntgenbilledet vurderes med henblik p&aring;, om bruddet kan blive stabilt uden operation. </p>
<p>S&aelig;rligt spiralbrud eller knuste brud vil ofte kr&aelig;ve operation.</p>
<h2>Hvordan opst&aring;r skaden?</h2>
<ul>
    <li>Tv&aelig;rbrud og korte skr&aring;brud skyldes direkte kraftp&aring;virkning eller som st&oslash;vlekantbrud ved slalomulykker</li>
    <li>Spiralbrud opst&aring;r som oftest ved indirekte kraftp&aring;virkning som ved vrid (rotationsskader)</li>
    <li>Isoleret brud p&aring; l&aelig;gbenet ses efter direkte skade mod underbenets yderside eller ved kraftig indadvridning, det vil sige "forstuvning", i anklen</li>
    <li>Knusningsbrud opst&aring;r ved kraftige ulykker som fx trafikulykker</li>
    <li>Tr&aelig;thedsbrud kan opst&aring; ved langvarig monoton belastning</li>
    <li>Knoglesvulster kan v&aelig;re &aring;rsag til brud, fordi knoglestrukturen bliver sv&aelig;kket</li>
</ul>
<h2>Hvordan behandles brud p&aring; underbenet?</h2>
<p>M&aring;let med behandlingen er at f&aring; sat bruddet tilfredsstillende p&aring; plads, f&aring; knogledelene stabiliseret og undg&aring; fremtidige komplikationer. </p>
<p>Behandlingen foreg&aring;r normalt p&aring; hospital. </p>
<p>Hvis der ikke er st&oslash;rre fejlstillinger, behandler man med gips eller bandage - s&aring;kaldt konservativ behandling. </p>
<p>Det er n&oslash;dvendigt at operere ved st&oslash;rre fejlstillinger, ved &aring;bne brud med store skader p&aring; muskler og sener, ved knusningsbrud og ved brud inde i leddet.</p>
<h3>Behandling med gips </h3>
<p>Hvis bruddet sidder sk&aelig;vt, s&aelig;ttes det p&aring; plads, mens patienten er bed&oslash;vet (i narkose). Derefter anl&aelig;gger man en h&oslash;j gips fra l&aring;r til t&aelig;er med let b&oslash;jet kn&aelig; og 90 grader i anklen. </p>
<p>Hvis der er skader p&aring; muskler og led, venter man nogle d&oslash;gn med at s&aelig;tte gipsen hele vejen rundt om benet, da den ellers kan komme til at klemme. </p>
<p>Behandlingen er gips i 2-4 uger, afh&aelig;ngig af bruddets stabilitet. </p>
<p>N&aring;r bruddet er stabilt nok til at t&aring;le v&aelig;gtbelastning, skal man have en ortop&aelig;disk bandage p&aring; (ortose) i stedet for gipsen. Ortosen og bruddet kontrolleres med 3-4 ugers mellemrum. Man bruger eventuelt en mindre polstret gips med g&aring;s&aring;l til gipsbandager i endnu 4-6 uger. </p>
<p>Du skal til kontrol med r&oslash;ntgen typisk 1. og 2. uge efter skaden, derefter ved skift af gips og n&aring;r gipsen skal fjernes. </p>
<p>Du b&oslash;r ikke dyrke kontaktidr&aelig;t f&oslash;r tidligst 3 m&aring;neder efter, at gipsen er fjernet, p&aring; grund af risikoen for at knoglen br&aelig;kker igen.</p>
<h3>Behandling med operation</h3>
<p>Ved &aring;bent underbensbrud skal s&aring;rene behandles. Sm&aring; s&aring;r lukkes med rensning og syning. St&oslash;rre s&aring;r kan d&aelig;kkes med forskellige former for transplantater. </p>
<p>Amputation er meget sj&aelig;lden. Man udf&oslash;rer kun amputation umiddelbart efter skaden, hvis der er komplet nerveskade eller en skade p&aring; blodkarrene, som ikke kan behandles. </p>
<p>Operation benyttes ved st&oslash;rre &aring;bne og komplicerede brud, ved knusningsbrud, eller hvis der opst&aring;r fejlstilling ved gipsbehandling. </p>
<p>Der findes forskellige operationsmetoder, som inkluderer marvs&oslash;mning, skinne/skruer og s&aring;kaldt ekstern fiksation. </p>
<p>Af og til kan der v&aelig;re brug for knogletransplantation, hvis der er defekter i knoglen. </p>
<p>Ved store s&aring;rskader eller s&aring;r som har st&aring;et &aring;bent i mere end 8 timer, anvender man normalt ekstern fiksation.&nbsp;</p>
<p>Opf&oslash;lgning og kontroller aftales i hvert enkelt tilf&aelig;lde.</p>
<h2>Hvilke komplikationer kan der opst&aring;?</h2>
<p>Skader p&aring; blodkar kan give forstyrrelser af kredsl&oslash;bet og varige skader p&aring; sener og muskler. </p>
<p>Der kan opst&aring; blodprop i underbenet. </p>
<p>Infektion med knoglebet&aelig;ndelse (<a href="~/link.aspx?_id=0464322996A74C41884332D364D6634D&amp;_z=z">osteomyelit</a>) forekommer is&aelig;r ved &aring;bne brud, hvor bakterierne kan komme ind gennem s&aring;r i huden. </p>
<p>Skader p&aring; nerver kan ogs&aring; forekomme. Forsinket heling og manglende heling (pseudartrose) kan ses b&aring;de efter behandling med gips og efter operation. </p>
<p>Ellers afh&aelig;nger prognosen af, hvilken type brud det er og behandlingen.</p>
<h3>Hvad kan jeg selv g&oslash;re?</h3>
<p>Hold benet i ro, og s&oslash;rg for at det stabiliseres, indtil l&aelig;gen har set p&aring; det. </p>
<p>Hvis der er s&aring;r p&aring; benet, s&aring; fors&oslash;g at l&aelig;gge en forbinding p&aring;, s&aring; der ikke kommer snavs i s&aring;ret.</p>
<h3>Hvordan undg&aring;r jeg at f&aring; eller forv&aelig;rre underbensbrud?</h3>
<p>Du skal f&oslash;lge planen for behandling n&oslash;je for at forhindre komplikationer med fejlstilling, bet&aelig;ndelse eller manglende heling af bruddet.</p>
<p>Desuden b&oslash;r du undg&aring; at ryge. Rygning h&aelig;mmer knoglehelingen, og &oslash;ger risikoen for manglende heling af bruddet.</p>
<h3>Hvorn&aring;r skal jeg s&oslash;ge hj&aelig;lp?&nbsp;</h3>
<p>Hvis du kommer til skade, og smerterne ikke forsvinder, eller hvis der er synlig fejlstilling af benet.</p>
<h3>Hvad kan l&aelig;gen eller en anden behandler g&oslash;re?</h3>
<p>L&aelig;gen unders&oslash;ger dit ben, og afg&oslash;r om der er brug for en r&oslash;ntgenunders&oslash;gelse.</p>
<h3>Hvorn&aring;r behandler man underbensbrud?</h3>
<p>Alle underbensbrud behandles.</p>
<h2>Hvordan udvikler sygdommen sig?</h2>
<p>Generelt er prognosen god for langt de fleste brud.</p>
<p>Ved st&oslash;rre forskudte underbensbrud er forl&oslash;bet af behandlingen dog ofte langvarigt og med mulige komplikationer. </p>
<p>Har man h&aring;rdere fysisk arbejde, er et l&aelig;ngerevarende sygefrav&aelig;r ikke us&aelig;dvanligt.</p>
<p>Ved st&oslash;rre skader p&aring; muskler og sener kan der opst&aring; varige m&eacute;n med nedsat kraft og p&aring;virket gangfunktion. </p>
<p>I sj&aelig;ldne tilf&aelig;lde kan en underbensamputation v&aelig;re den bedste l&oslash;sning, hvis benet er pr&aelig;get af skader p&aring; bl&oslash;ddele, p&aring;virkning af nerver og eventuel infektion i knogle.</p>
<h3>Hvor hyppige er brud i underbenet?</h3>
<p>Er ret almindelige, men er v&aelig;sentligt sj&aelig;ldnere end brud i ankelleddet.</p>
<h2>Vil du vide mere?</h2>
<ul>
    <li>
    <a href="~/link.aspx?_id=E23B707C0C964DAF8A23644B2B097C52&amp;_z=z">Gipsbehandling, mulige komplikationer</a> </li>
    <li>
    <a href="~/link.aspx?_id=49D9481731BB4A1AA7FC70CA395C119D&amp;_z=z">Gipsbehandling - anl&aelig;ggelse af gips</a> </li>
    <li><a href="~/link.aspx?_id=644C672AB52A464796C4449AA38F727F&amp;_z=z">R&oslash;ntgen af knoglerne</a></li>
    <li>
    <a href="~/link.aspx?_id=FC7E438EE1E243D8AA35573DF6F77242&amp;_z=z">Generelt om benbrud</a> </li>
    <li>
    <a href="~/link.aspx?_id=718E4C49B8D24BB286FE7846B1A2E2E6&amp;_z=z">Underbensbrud - for sundhedsfaglige</a></li>
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