{"id":2564,"date":"2026-10-07T19:52:57","date_gmt":"2026-10-07T19:52:57","guid":{"rendered":"https:\/\/healkliinik.ee\/?p=2564"},"modified":"2026-10-07T19:59:13","modified_gmt":"2026-10-07T19:59:13","slug":"labajala-vigastus-mida-rontgenis-sageli-ei-nae","status":"publish","type":"post","link":"https:\/\/healkliinik.ee\/en\/labajala-vigastus-mida-rontgenis-sageli-ei-nae\/","title":{"rendered":"Labajala vigastus, mida r\u00f6ntgenis sageli ei n\u00e4e!"},"content":{"rendered":"<p class=\"wp-block-paragraph\">Jalalaba keskosa vigastused on traumapunktis \u00fched sagedasimine aladiagnoositud v\u00f5i valesti t\u00f5lgendatud vigastused \u2013 tavap\u00e4rane r\u00f6ntgenuuring v\u00f5ib j\u00e4tta m\u00e4rkamata ligi kolmandiku neist vigastustest. Sageli peetakse traumat esmapilgul \u201elihtsaks h\u00fcppeliigese nikastuseks\u201c, mist\u00f5ttu l\u00fckkub \u00f5ige diagnoos ja ravi edasi. \u00d5igeaegne sekkumine on jalalaba anatoomia ja funktsiooni s\u00e4ilitamiseks kriitilise t\u00e4htsusega. Allj\u00e4rgnevalt tutvustame l\u00e4hemalt Lisfranki ja Choparti liigeste olemust, vigastusmehhanisme ning t\u00e4nap\u00e4evaseid diagnostika- ja raviv\u00f5imalusi.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Mis on Lisfranki ja Choparti liigesed?<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">P\u00f6ia keskosas paiknevad kaks olulist anatoomilist liigestekompleksi:<br><br>\u25cf Lisfranki liiges (articulatio tarsometatarsalis ehk TMT-liiges): \u00fchendab p\u00e4kaosa luid jala keskosa metatarsaalluudega. Selle piirkonna tugevad sidemed (eriti Lisfranki ligament) hoiavad jalalaba pikiv\u00f5lvi stabiilsena ning jaotavad liikumisel koormust.<br>\u25cf Choparti liiges (articulatio tarsi transversa): paikneb Lisfranki liigesest veidi tagapool ning \u00fchendab kannaluu ja kontsluu eesmiste jala luudega. Choparti liiges vastutab jala kohanemisv\u00f5ime ja paindlikkuse eest ebatasasel pinnal k\u00f5ndimisel.<br>M\u00f5lemad liigestsoonid on kriitilise t\u00e4htsusega jalalaba kandev\u00f5ime, vetrumise ja efektiivse t\u00f5ukefaasi tagamisel.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img fetchpriority=\"high\" decoding=\"async\" width=\"735\" height=\"1024\" src=\"https:\/\/healkliinik.ee\/wp-content\/uploads\/2026\/10\/Lisfrank-ja-Chopart-liigesed-735x1024.jpg\" alt=\"\" class=\"wp-image-2565\" srcset=\"https:\/\/healkliinik.ee\/wp-content\/uploads\/2026\/10\/Lisfrank-ja-Chopart-liigesed-735x1024.jpg 735w, https:\/\/healkliinik.ee\/wp-content\/uploads\/2026\/10\/Lisfrank-ja-Chopart-liigesed-215x300.jpg 215w, https:\/\/healkliinik.ee\/wp-content\/uploads\/2026\/10\/Lisfrank-ja-Chopart-liigesed-767x1069.jpg 767w, https:\/\/healkliinik.ee\/wp-content\/uploads\/2026\/10\/Lisfrank-ja-Chopart-liigesed-9x12.jpg 9w, https:\/\/healkliinik.ee\/wp-content\/uploads\/2026\/10\/Lisfrank-ja-Chopart-liigesed.jpg 873w\" sizes=\"(max-width: 735px) 100vw, 735px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Joonis 1. Lisfrank ja Chopart liiges.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Kuidas vigastused tekivad ja millised on s\u00fcmptomid?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Jalalaba keskosa traumad v\u00f5ivad tekkida v\u00e4ga erinevates olukordades:<br><br>\u25cf Madala energiaga traumad (sport ja igap\u00e4evaelu): auku v\u00f5i ebatasasusele astumine, jala v\u00e4ljav\u00e4\u00e4namine p\u00f6iat\u00f5uke hetkel v\u00f5i vastasm\u00e4ngija astumine jalalabale (tavap\u00e4rane nt jalgpallis). Raskema eseme kukkumine jalalabale.<br>\u25cf K\u00f5rge energiaga traumad: liiklus\u00f5nnetused (t\u00fc\u00fcpiliselt tugev ja \u00e4kiline piduripedaali vajutus kokkup\u00f5rkel) v\u00f5i k\u00f5rgelt kukkumised otse p\u00e4kale.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Millal kindlasti kahtlustada jalalaba keskosa vigastust?<\/strong> <br>&#8211; Jalalabal v\u00f5i tallav\u00f5lvis esineb p\u00e4rast traumat ebaharilikult tugev valu ja turse.<br>&#8211; Jalale toetumine v\u00f5i t\u00e4iskoormuse kandmine on oluliselt valulik v\u00f5i t\u00e4iesti v\u00f5imatu.<br>&#8211; Jalatallale v\u00f5i p\u00f6ia peale tekib verevalum (verevalum jalatallal ehk plantaarne hematoom viitab suure t\u00f5en\u00e4osusega Lisfranki piirkonna traumale!).<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Miks need vigastused nii sageli m\u00e4rkamata j\u00e4\u00e4vad?<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Statistika ja rahvusvahelised teadusuuringud kinnitavad, et kuni 20\u201340% jalalaba keskosa vigastustest j\u00e4\u00e4b esmasel p\u00f6\u00f6rdumisel diagnoosimata. T\u00f5en\u00e4oliselt on m\u00e4rkamata vigastuste arv veel suurem. Peamised riskikohad diagnostikas on:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>S\u00fcmptomite sarnasus h\u00fcppeliigese nikastusega:<\/strong> valu ja turse aetakse erakorralises meditsiinis kergesti segi tavap\u00e4rase h\u00fcppeliigese k\u00fclgmiste sidemete venitusega.<\/li>\n\n\n\n<li><strong>Tavalise r\u00f6ntgeni piiratud tundlikkus:<\/strong> uuringud (nt Ponkilainen jt, 2020) n\u00e4itavad, et lausa 24% Lisfranki vigastustest j\u00e4\u00e4b koormuseta r\u00f6ntgenil tuvastamata. Eriti ohtlikud on nihkumata v\u00f5i minimaalse nihkega vigastused, mis tavapildil ei eristu.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>T\u00e4nap\u00e4evane diagnostika: r\u00f6ntgen, KT ja MRT<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">\u00d5ige ravistrateegia eelduseks on t\u00e4pne anatoomiline visualiseerimine. Kaasaegne k\u00e4sitlus h\u00f5lmab j\u00e4rgmisi uuringuid:<br><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Uuringumeetod<\/strong><\/td><td><strong>Eesm\u00e4rk ja tugevus<\/strong><\/td><td><strong>Teadusp\u00f5hine t\u00e4psus &amp; roll<\/strong><\/td><\/tr><tr><td><strong>Natiiv-r\u00f6ntgen (3 suunda)<\/strong><\/td><td>Otse-, kald- ja k\u00fclgvaade. V\u00f5imalusel sooritatakse keharaskuse all (weight-bearing).<\/td><td>Esmane triaa\u017e. Koormuseta piltidel j\u00e4\u00e4b ligikaudu 24% vigastustest m\u00e4rkamata; peente nihkete avastamisel madal tundlikkus (alla 30-50%). Isoleeritud sidemevigastused ei tule n\u00e4htavale.<\/td><\/tr><tr><td><strong>Kompuutertomograafia (KT \/ CT)<\/strong><\/td><td>Kuldne standard luuliste detailide, peente nihkumata murdude ja subluksatsioonide avastamiseks.<\/td><td>Eriti k\u00f5rge diagnostiline t\u00e4psus luumurdude korral (tundlikkus 87%).<\/td><\/tr><tr><td><strong>Magnetresonantstomograafia (MRT \/ MRI)<\/strong><\/td><td>Parim meetod pehmete kudede, sidemete (sh Lisfranki ligamendi) ja liigesek\u00f5hre hindamiseks. V\u00e4listab ka luumurrud.<\/td><td>K\u00f5rgeim t\u00e4psus varjatud sidemevigastuste korral (tundlikkus kuni 96,8%). V\u00e4listab luumurrud.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Ravi p\u00f5him\u00f5tted: konservatiivne vs kirurgiline<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>1. Mitterirurgiline (konservatiivne) ravi<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u00e4ielikult nihkumata ja stabiilsed vigastused (heas asendis luumurrud, osalised sidemerebendid ilma liigese avanemiseta) alluvad h\u00e4sti konservatiivsele ravile:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Fikseerimine:<\/strong> j\u00e4ik kips v\u00f5i spetsiaalne fikseeriv ortoos reeglina 6 n\u00e4dalat.<\/li>\n\n\n\n<li><strong>Koormuspiirang:<\/strong> k\u00f5ige kindlam raviefekt saavutatakse jalale t\u00e4iskoormuse v\u00e4ltimisega immobilisatsiooniperioodil. Koormuse j\u00e4rkj\u00e4rguline lubamine toimub kontrollitult arsti j\u00e4lgimisel. Siiski on oluline s\u00e4ilitada k\u00f5nnimuster kohe ravi alustades. Viimast saab teha kasutades \u00f5igesti karke.<\/li>\n\n\n\n<li><strong>Taastumise ajaraam:<\/strong> kuigi esmane immobilisatsioon kestab 6 n\u00e4dalat, p\u00fcsib jalalaba tundlikkus ja taastumisprotsess sageli m\u00e4rksa pikemalt \u2013 t\u00fc\u00fcpiliselt 10\u201316 n\u00e4dalat ja vahel ka rohkem.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>2. Kirurgiline ravi<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nihkunud luudega, liigespindade ebastabiilsusega v\u00f5i killustunud murdude korral on funktsiooni s\u00e4ilitamiseks reeglina vajalik operatsioon:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Operatsioon ja murru fikseerimine implantaadiga:<\/strong> standardne l\u00e4henemine, mille eesm\u00e4rk on anatoomia millimeetrit\u00e4pne taastamine. T\u00e4nap\u00e4eval eelistatakse sildplaate (bridge plating) ja kruvisid v\u00f5i elastseid fiksaatoreid (suture button meetod), mis s\u00e4ilitavad paremini jalalaba loomulikku elastsust.<\/li>\n\n\n\n<li><strong>Primaarne artrodees (luustamine):<\/strong> ulatuslike ja tugevalt killustunud liigesevigastuste korral kaalutakse kohest kahjustatud liigese luustamist. Seda tuleb teha siiski harva.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Mis juhtub, kui vigastus j\u00e4\u00e4b ravita?<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Diagnoosimata labajala vigastus&nbsp; v\u00f5i valesti ravitud trauma v\u00f5ib kaasa tuua pikaajalise elukvaliteedi languse ja kroonilise valu:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Jalalaba krooniline ja valulik ebastabiilsus liikumisel.<\/li>\n\n\n\n<li>P\u00f6iav\u00f5lvi lamenemine ja p\u00fcsivad asendih\u00e4ired (deformatsioonid).<\/li>\n\n\n\n<li>Enneaegne posttraumaatiline liigesekulumine (artroos), mis v\u00f5ib hilisemas eas n\u00f5uda ulatuslikku korrigeerivat kirurgiat.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Heal Kliiniku spetsialistide n\u00f5uanne patsiendile<\/strong>:<br>Kui oled saanud jalalaba trauma ning sellega kaasneb tugev turse, tallav\u00f5lvi valu v\u00f5i verevalum jalatallal, \u00e4ra j\u00e4\u00e4 lootma, et tegemist on iseenesest paraneva vigastusega. \u00d5igeaegne p\u00f6\u00f6rdumine labajala- ja h\u00fcppeliigese spetsialisti poole ning vajadusel t\u00e4iendavate uuringute (KT v\u00f5i MRT) teostamine on oluline vigastuse diagnoosimisel ja \u00f5ige ravi alustamisel, v\u00e4hendades hilisemate t\u00fcsistuste ja p\u00f6\u00f6rdumatu liigesekahjustuse tekkimise riski.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Kasulik kirjandus:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ponkilainen VT, Partio N, Salonen EE, Riuttanen A, Luoma EL, Kask G, Laine HJ, M\u00e4enp\u00e4\u00e4 H, P\u00e4iv\u00e4niemi O, Mattila VM, Haapasalo HH. Inter- and intraobserver reliability of non-weight-bearing foot radiographs compared with CT in Lisfranc injuries. Arch Orthop Trauma Surg. 2020 Oct;140(10):1423-1429. doi: 10.1007\/s00402-020-03391-w. Epub 2020 Mar 5. PMID: 32140830; PMCID: PMC7505866.<\/li>\n\n\n\n<li>Poutoglidou F, van Groningen B, McMenemy L, Elliot R, Marsland D. Acute Lisfranc injury management. Bone Joint J. 2024 Dec 1;106-B(12):1431-1442. doi: 10.1302\/0301-620X.106B12.BJJ-2024-0581.R1. PMID: 39615511.<\/li>\n\n\n\n<li>Sripanich Y, Weinberg MW, Kr\u00e4henb\u00fchl N, Rungprai C, Mills MK, Saltzman CL, Barg A. Imaging in Lisfranc injury: a systematic literature review. Skeletal Radiol. 2020 Jan;49(1):31-53. doi: 10.1007\/s00256-019-03282-1. Epub 2019 Jul 31. PMID: 31368007.<\/li>\n\n\n\n<li>Tang L, Zhou W, Bai L, Wu C, Xiong C, Yan Y, Chen S. Comparison of diagnostic performance of X\u2011ray, CT and MRI in patients with surgically confirmed subtle Lisfranc injuries. Exp Ther Med. 2024 Feb 29;27(4):174. doi: 10.3892\/etm.2024.12462. PMID: 38476900; PMCID: PMC10928826.<\/li>\n\n\n\n<li>Abs B, Ferreira Branco D, Gamulin A, Botti P, Buzzi M, Poletti PA, Bouredoucen H, Boudabbous S. The missed chapter on midfoot: Chopart injuries. Radiol Med. 2024 Dec;129(12):1840-1848. doi: 10.1007\/s11547-024-01905-9. Epub 2024 Nov 4. PMID: 39496885; PMCID: PMC11649826.<\/li>\n\n\n\n<li>Kirjavainen M, Haapasalo H. Jalkater\u00e4n keskiosan alidiagnosoidut vammat. Duodecim 2018;134:2467\u201374.<\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Jalalaba keskosa vigastused on traumapunktis \u00fched sagedasimine aladiagnoositud v\u00f5i valesti t\u00f5lgendatud vigastused.<\/p>","protected":false},"author":1,"featured_media":2568,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2564","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Labajala vigastus, mida r\u00f6ntgenis sageli ei n\u00e4e! - Heal Kliinik<\/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:\/\/healkliinik.ee\/en\/labajala-vigastus-mida-rontgenis-sageli-ei-nae\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Labajala vigastus, mida r\u00f6ntgenis sageli ei n\u00e4e! 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