Håndleddsskade behandling

Håndleddsskader er et vidt begrep som omfatter et spekter av tilstander som påvirker håndleddets komplekse struktur, bestående av åtte små bein (karpalbein), to underarmsbein (radius og ulna), leddbånd, sener og nerver. Disse skadene kan variere fra milde forstuvninger til mer alvorlige brudd, seneskader eller nervekompresjonssyndromer. Formålet med denne artikkelen er å gi en objektiv oversikt over vanlige behandlingsmetoder for håndleddsskader og å identifisere de faggruppene som typisk er involvert i behandlingen i Norge, med et fokus på utdanning og forståelse.

Konservativ behandling utgjør ofte førstevalget for mange håndleddsskader, spesielt de som ikke involverer alvorlige brudd med feilstilling eller betydelige leddbåndsskader. Målet med konservativ behandling er å redusere smerte, hevelse og inflammasjon, samt å fremme kroppens naturlige helingsprosess, og sette scenen for en gradvis retur til funksjon.

Hvileteknikker og Mobilitetsbegrensning

En av de mest grunnleggende og umiddelbare tiltakene ved akutte håndleddsskader er å gi håndleddet hvile. Dette kan oppnås gjennom ulike metoder for å begrense bevegelse og redusere belastningen på det skadede området.

Bruk av Mitts og Skinner

• Mitts (Håndleddsstøtter): Disse er ofte laget av elastisk materiale og gir lett kompresjon og støtte til håndleddet. De kan bidra til å redusere hevelse og gi en følelse av stabilitet, noe som kan være lindrende for mildere forstuvinger eller senebetennelser. Mittsen er vanligvis ikke stive og tillater en viss grad av bevegelse, og er derfor godt egnet for daglig bruk under rekonvalesens.
• Skinner (Ortoser): Skinner er mer rigide og gir ofte en høyere grad av immobilisering enn mitts. De kan være laget av plast, metall eller en kombinasjon av materialer, og er ofte tilpasset individets anatomi. Skinner kan være utformet for å holde håndleddet i en nøytral posisjon, noe som er avgjørende for å la brudd eller alvorlige leddbåndsskader hele korrekt. Varigheten av bruk av skinner varierer betydelig avhengig av skadetypen og helingsprogresjonen, og bestemmes av behandlende helsepersonell. Noen skinner er utformet for å kunne justeres for å tillate gradvis økende bevegelse etter hvert som helingen skrider frem, og fungerer som et brohode fra fullstendig immobilisering til full funksjon.

RICE-prinsippet (Rest, Ice, Compression, Elevation)

RICE-prinsippet er en veletablert protokoll for akuttbehandling av muskuloskeletale skader, inkludert mange håndleddsskader.

• Rest (Hvile): Som nevnt, er hvile essensielt for å unngå ytterligere skade og for å gi kroppen en sjanse til å begynne helingsprosessen. Dette innebærer å unngå aktiviteter som forverrer smerten.
• Ice (Is­­­­­­­­­­­­­­­­­­­­­­­­­­­behandling): Kjøling av det skadede området ved hjelp av isposer (pakket i et håndkle for å unngå direkte hudkontakt og frostskader) kan effektivt redusere smerte, hevelse og inflammasjon. Isbehandling bør vanligvis utføres i 15-20 minutters intervaller flere ganger om dagen, spesielt i de første 48-72 timene etter skaden.
• Compression (Kompresjon): Bruk av elastiske bandasjer eller kompresjonsmuffer kan bidra til å begrense hevelse ved å utøve et jevnt trykk rundt håndleddet. Kompresjon bør være fast, men ikke så stram at den hindrer blodsirkulasjonen (som kan merkes ved nummenhet eller misfarging av fingrene).
• Elevation (Heving): Å holde det skadede håndleddet over hjertehøyde hjelper tyngdekraften med å drenere overflødig væske vekk fra skadeområdet, noe som ytterligere bidrar til å redusere hevelse. Dette er spesielt viktig de første dagene etter skaden.

Smertelindring og Betennelsesdempende Behandling

Smerte og inflammasjon er ofte fremtredende symptomer ved håndleddsskader, og håndtering av disse er en sentral del av behandlingen.

Medisinsk Behandling

• Reseptfrie Smertestillende: Legemidler som paracetamol kan være effektive for å lindre smerte uten å ha en uttalt betennelsesdempende effekt.
• Reseptpliktige Betennelsesdempende Midler (NSAIDs): Ikke-steroide antiinflammatoriske legemidler (NSAIDs), som ibuprofen eller naproksen, kan både lindre smerte og redusere betennelse. Disse fås både reseptfritt i lave doser og på resept i høyere doser. Langvarig bruk av NSAIDs bør skje i samråd med lege på grunn av potensielle bivirkninger, spesielt knyttet til mage- og tarmsystemet samt hjerte-karsystemet.

Lokal Behandling

• Topikale Midler: Kremer og geler som inneholder NSAIDs kan påføres direkte på huden over det skadede området. Disse kan gi lokal smertelindring og betennelsesdemping med redusert risiko for systemiske bivirkninger, sammenlignet med orale legemidler.
• Kortikosteroidinjeksjoner: I visse tilfeller, spesielt ved kronisk inflammasjon som karpaltunnelsyndrom eller senebetennelser, kan en lege vurdere å gi injeksjoner med kortikosteroider. Disse kraftige betennelsesdempende medikamentene kan gi rask og effektiv lindring av smerte og hevelse. Injiseringer er imidlertid ikke en kur for selve årsaken til inflammasjonen, og gjentatte injeksjoner bør unngås da de kan svekke vevet over tid.

Rehabilitering og Fysioterapi

Når den akutte fasen av skaden er over, og smerten og hevelsen er under kontroll, blir rehabilitering og gjenoppretting av funksjon avgjørende. Fysioterapi spiller en nøkkelrolle i denne fasen.

Bevegelsesøvelser

• Bevaring av Bevegelsesutslag (ROM – Range of Motion): Tidlig mobilisering, når det er forsvarlig, er viktig for å forhindre stivhet. Dette innebærer forsiktige, passive eller aktiv-assistive øvelser for å opprettholde håndleddets bevegelighet.
• Gradvis Økende Bevegelse: Etter hvert som helingsprosessen skrider frem, vil øvelsene bli mer aktive og utfordrende, med mål om å gjenopprette det fulle bevegelighetsutslaget i alle plan.

Styrkeøvelser

Når bevegelsesutslaget er noe gjenvunnet, fokuserer fysioterapeuten på å gradvis gjenoppbygge styrken i muskler og sener rundt håndleddet.

• Isometriske Øvelser: Disse øvelsene involverer muskelkontraksjon uten bevegelse i leddet. De er nyttige i tidlige stadier for å aktivere muskler uten å overbelaste det skadede vevet.
• Isotoniske Øvelser: Etter hvert som styrken øker, introduseres øvelser med motstand, som bruk av vekter, strikker eller klemballer, for å bygge opp muskelmasse og utholdenhet. Progressive øvelser, der motstanden gradvis økes, er sentrale.

Koordinasjons- og Funksjonelle Øvelser

Målet med disse øvelsene er å gjenopprette finmotorikk, grepstyrke og koordinasjon som er nødvendig for daglige aktiviteter.

• Grepstyrketrening: Øvelser spesifikt designet for å forbedre evnen til å gripe og holde gjenstander.
• Manipulasjonsøvelser: Øvelser som involverer finmotorikk, som å plukke opp små objekter eller stable byggeklosser, for å gjenopprette presisjon og kontroll.
• Aktivitetsspesifikke Øvelser: Etter hvert som pasienten nærmer seg full funksjon, kan fysioterapeuten introdusere øvelser som simulerer spesifikke daglige aktiviteter eller idrettsbevegelser for å sikre en trygg og effektiv retur til disse.

Kirurgiske Behandlingsmetoder for Håndleddsskader

Kirurgi blir vanligvis vurdert når konservativ behandling ikke gir tilfredsstillende resultater, eller for skader som i utgangspunktet krever kirurgisk intervensjon, som komplekse brudd eller betydelige nervekompresjoner. Målet med kirurgi er å gjenopprette stabilitet, redusere smerte, og forbedre funksjonen i håndleddet. Valg av kirurgisk metode avhenger av den spesifikke diagnosen.

Bruddbehandling med Kirurgi

Brudd i håndleddet, spesielt radius- og ulnafrakturer, kan kreve kirurgisk behandling hvis de er forskjøvne, ustabile, eller hvis det involverer leddflaten.

Åpen Reduksjon og Intern Fiksering (ORIF)

• Prosedyren: Ved ORIF utfører kirurgen et innsnitt for å få direkte tilgang til bruddstedet. De forskjøvne bruddstykkene blir deretter forsiktig reponert (satt tilbake på plass). Bruddstedet stabiliseres deretter ved hjelp av metallplater, skruer, pinner eller stifter. Disse festemidlene holder bruddet stabilt mens det gror.
• Indikasjoner: Vanlig for mer komplekse håndleddsbrudd som ikke kan stables adequat ved lukket reposisjon, eller som er ustabile og har en høy risiko for feilstilling under helingsprosessen. Brudd som involverer artroseutvikling eller feilbelastning av leddet er også kandidater for ORIF.

Ekstern Fiksering

• Prosedyren: Denne metoden innebærer bruk av en ekstern ramme festet til beinet med pinner eller skruer som går gjennom huden og inn i bruddstedet. Rammen holder beinfragmentene på plass på utsiden av huden.
• Indikasjoner: Kan brukes for visse typer brudd, spesielt der det er betydelig bløtdelsskade, eller som en midlertidig løsning før eventuell intern fiksering. Det kan også være et alternativ for pasienter som ikke tåler intern fiksering grunnet andre medisinske tilstander.

Behandling av Seneskader og Leddbåndsskader

Alvorlige avrivninger av sener eller leddbånd i håndleddet kan kreve kirurgisk reparasjon.

Senerekonstruksjon

• Prosedyren: Ved seneskader kan kirurgen velge å sy sammen den skadede senen direkte, eller i tilfeller av lengre avrivninger, kan det være nødvendig å bruke en sene fra et annet sted i kroppen (en graft) for å erstatte eller forsterke den skadede senen.
• Indikasjoner: Ofte for idrettsutøvere eller personer med meget funksjonskrevende yrker der full gjenoppretting av senefunksjon er kritisk.

Leddbåndrekonstruksjon

• Prosedyren: Likt som ved seneskader, kan kirurgen reparere avrevne leddbånd, eventuelt ved hjelp av graftmateriale for å gjenopprette stabiliteten i håndleddet.
• Indikasjoner: Vanlig ved alvorlige forstuvinger, dislokasjoner eller instabilitet i håndleddet som ikke lar seg stabilisere konservativt.

Nervekompresjonsbehandling – Kirurgi

Tilstander som karpaltunnelsyndrom, hvor mediannerven blir komprimert i håndleddet, kan kreve kirurgisk inngrep dersom konservative tiltak ikke lindrer symptomene.

Karpal­tunne­lavlastning (Karpal­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­k­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ì**

• Prosedyren: Ved åpen kirurgisk karpal­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­¬ìnjasjon (CTR – Carpal Tunnel Release)

• Prosedyren: Dette er en minimalt invasiv prosedyre der kirurgen lager et lite innsnitt og deretter kutter det tverrgående karpal­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­band­det, som er den stramme hinnen som danner taket i karpaltunellen. Ved å kutte dette båndet, økes plassen i tunellen, og trykket på mediannerven reduseres. Metoden kan utføres åpent eller endoskopisk (ved hjelp av et lite kamera).
• Indikasjoner: Ved vedvarende, alvorlige symptomer på karpaltunnelsyndrom, inkludert nummenhet, prikking og smerte i fingrene (tommel, peke-, lang- og halve ringfinger), spesielt om natten, som ikke har forbedret seg med konservativ behandling.

Utredningsprosessen for Håndleddsskader

Før en effektiv behandlingsplan kan utarbeides, er det avgjørende med en grundig utredning for å fastslå den nøyaktige diagnosen. Dette innebærer en kombinasjon av fysisk undersøkelse, pasientens sykehistorie og bildediagnostikk.

Sykehistorie og Klinisk Undersøkelse

• Anamnese: Behandleren innhenter detaljert informasjon om skaden, inkludert hvordan den oppstod, symptomenes natur (smerte, hevelse, nummenhet, stivhet), når symptomene startet, og hva som forverrer eller lindrer dem. Pasientens tidligere medisinske historie, yrkeshistorie og aktivitetsnivå er også relevant.
• Fysisk Undersøkelse: Dette omfatter en visuell inspeksjon av håndleddet for tegn på hevelse, misfarging eller deformitet. Videre vurderes bevegelsesutslaget i ulike retninger, palp­asjon for å identifisere smertefulle punkter, og spesifikke tester for å vurdere nervefunksjon, senefunksjon og stabilitet i leddbåndene.

Bildediagnostikk

Bildediagnostiske metoder er en uunnværlig del av utredningen for å visualisere benstrukturer, leddbånd, sener og nerver.

Røntgenundersøkelse

• Beskrivelse: Røntgenbilder er den mest vanlige og tilgjengelige metoden for å vurdere benstrukturen. Det brukes til å identifisere brudd, dislokasjoner og tegn på slitasjegikt (artrose). Flere forskjellige projeksjoner (vinkler) tas vanligvis for å få et komplett bilde av håndleddet.
• Nyttespekter: Effektiv for å påvise brudd og feilstillinger i beinene. Det kan også gi indikasjoner på degenerativ leddsykdom.

Ultralyd

• Beskrivelse: Ultralyd bruker lydbølger til å skape bilder av bløtvev som sener, leddbånd og nerver. Det er en dynamisk undersøkelse som kan utføres mens pasienten beveger håndleddet, noe som gir muligheter for å vurdere seners bevegelighet og påvise inflammasjon eller skade i sene­skjeder.
• Nyttespekter: Spesielt nyttig for å diagnostisere senebetennelser, delvise seneskader, og for å vurdere væskeansamlinger eller inflammasjon rundt sener og nerver. Det er også en god metode for å vurdere diagnostiske injeksjoner.

MR (Magnetisk Resonans)

• Beskrivelse: MR gir detaljerte tverrsnittsbilder av vevet ved hjelp av kraftige magnetfelt og radiobølger. Det gir en utmerket visualisering av både ben, leddbånd, sener, brusk og nerver.
• Nyttespekter: Kan gi presis informasjon om skader på leddbånd, meniskskader i håndleddet, bruskforandringer, svulster og mer subtile brudd som kanskje ikke er tydelige på røntgen. MR er ofte avgjørende for å vurdere omfanget av komplekse skader.

CT (Datatomografi)

• Beskrivelse: CT-skanning bruker røntgenstråler for å skape detaljerte tverrsnittsbilder av kroppen. Den er spesielt god til å visualisere benstruktur og detaljer i brudd.
• Nyttespekter: Ofte brukt for å få en tredimensjonal oversikt over mer komplekse brudd, vurdere fragmentering av brudd eller for å evaluere tilheling av brudd som ikke er tilfredsstillende på standard røntgenbilder.

Spesialiserte Behandlingsmetoder

Innenfor det medisinske feltet finnes det ytterligere behandlingsmetoder som kan anvendes avhengig av den spesifikke håndleddsskaden.

Injektjonsbehandling

I tillegg til kortikosteroidinjeksjoner, finnes det andre typer injeksjoner som kan vurderes.

PRP (Platelet-Rich Plasma) Injisering

• Beskrivelse: PRP-behandling innebærer å ta en blodprøve fra pasienten, sentrifugere den for å konsentrere blodplatene (som er rike på vekstfaktorer), og deretter injisere dette konsentratet tilbake i det skadede området. Tanken er at vekstfaktorene skal stimulere kroppens egen helingsprosess.
• Indikasjoner: Brukes primært for senebetennelser, visse typer leddbåndsskader og degenerativ leddsykdom. 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