Ukulimala kwezemidlalo
2K 1 20.04.2019 (kugcine ukubuyekezwa: 20.04.2019)
I-patella (i-patella, i-patella) iyipuleti lamathambo elibanzi elitholakala ngaphakathi kwejoyinti futhi lenzelwe ukuvikela uqwanga. Imelela ithambo le-sesamoid - ukwakheka kwethambo ngaphakathi kwemicu yethenda ye-quadriceps yethanga. Ingaphakathi le-patella limbozwe ungqimba lwe-cartilage ebushelelezi, eshelelayo evumela ukuthi ama-condyles ahambe ngokukhululeka. Ukufuduka kwePatellar kuyisifo esingajwayelekile esibangelwa ukulimala okubuhlungu emadolweni noma okubangelwa izifo ezingalapheki zohlelo lomuntu lwe-musculoskeletal. Kusho ushintsho esimweni sezinto zokwakha ezihlobene nomunye ngenkathi kugcinwa ubuqotho babo.
Ukwahlukaniswa kokuhlukaniswa
Izinguquko ze-pathological endaweni ye-patella ngokusekelwe ezicini ze-pathogenic zingaba:
- umkhuba - ngokushintshwa okujwayelekile endaweni ye-patella, kuhambisane nenkinga yesifo esibuhlungu esiveziwe;
- okuyingxenye - enesimo esingazinzile se-patella, esivame ukufuduka nemiphumela emincane ekuhlanganyeleni kwamadolo;
- ukuzalwa - ngenxa yokulimala ngokuhlanganyela okuqhubekayo lapho kuzalwa.
Ngokuya ngesilinganiso, ukufuduka kuhlukaniswa:
- okuyingxenye - kucasulwa ukujika okubukhali komlenze;
- egcwele - imele ukuhlukaniswa kwe-patella ngokufuduswa kuye phambili noma emuva emuva ngenxa yethonya elinamandla.
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Izici ekwakhiweni kwezifo
Ukususwa kwe-patella kungabangelwa:
- ukulimala (ukuqhuma nokuwa);
- imithwalo ephezulu (ukuphakamisa izinsimbi noma i-triathlon);
- ukulimala kwamadoda, imisipha nemisipha, okwandisa ukuba sengozini kwe-patella;
- i-hypotrophy yemisipha yemilenze (i-quadriceps yethanga) ngenxa yokuphila ngokweqile;
- anomalies ekukhuleni kwemilenze, kufaka phakathi ukukhubazeka kwayo ngohlobo olumiswe nge-X;
- i-dysplasia yezindlela zesifazane;
- ukwenziwa kwendawo okungajwayelekile kwe-patella;
- izimila zamadolo;
- izilonda ezingapheli zamalunga emadolo (i-brucellosis), okuholela ekungazinzini kwabo.
Ukuhlukaniswa okwenziwe ukuhlukumezeka kwesinye isikhathi kuvame ukuhambisana nezinyembezi zemigudu eseceleni. Ngokufuduswa okuvundlile okuyi-torsional, imisipha ye-quadriceps enezinsimbi zomzimba ze-patella ilimele.
Izifo zokuzalwa ezibangelwa ukufuduka okuvamile kwe-patella zifaka:
- i-hallux valgus;
- patellar hypermobility;
- i-hyperextension yomlenze ongezansi;
- i-hypoplasia ye-femur.
Ukufuduswa kwe-patellar okuvundlile nokujwayelekile okuchazwe ngenhla kuyelashwa ngokuhlinzwa, kulandelwe isikhathi sokuvuselela izinyanga eziyisithupha.
Izimpawu ezijwayelekile zokuhlukaniswa
Esikhathini esiningi ukufuduka kwenzeka ngaphandle, kuyaqabukela - maphakathi. Ngakho-ke, kutholakala umfutho wegazi ophakeme noma ophakathi. Izimpawu zomtholampilo zinqunywa isigaba sesifo:
- Kukhona umuzwa wokungakhululeki endaweni yase patella. Mhlawumbe ukufuduka kwayo okwesikhashana, kuhambisana nobuhlungu obukhulu.
- Ukukhubazeka kwamadolo kunqunywa yi-palpation. Ubuhlungu buphakathi. Kwenzeka ngokucindezeleka kwemishini endaweni yamadolo.
- Ukuguqulwa kunqunywa ngokubukeka. Kuyabikwa ubuhlungu, ukunyakaza kuphoqelekile.
Izimpawu ezijwayelekile zifaka:
- ubuhlungu bendawo ezindaweni ezahlukahlukene zejoyinti, kuya ngesimo sendawo sokulimala;
- ukuqunjana noma ukuchofoza umuzwa lapho unyakaza;
- umkhawulo wokuhamba ngokuhlanganyela;
- ukunciphisa ukuzwela kwesikhumba ezindaweni ezilimele;
- shintsha ngesimo sedolo;
- i-hyperemia yesikhumba ne-periarticular edema.
Ukwephuka kwe-patellar okushiye indawo yokuhlala kuyinkinga enkulu. Kuboniswa yi-edema ephakanyisiwe ne-hemarthrosis. Njengomphumela wokusikwa okuguqukayo kwemisipha ye-quadriceps, ucezu olungaphezulu lwe-patella ludluliselwe phezulu, futhi umhuzuko okhula ngokushesha uwela phansi onyaweni.
Ukufuduka kwe-patellar kwe-Congenital
Ukuhlukaniswa okuzalwa kungavamile kakhulu. Imvamisa iqondiswa ngaphandle. Kungaba olulodwa noma emaceleni amabili. Kunezigaba ezintathu zalesi sifo:
- izikhalazo kungenzeka zingabikho, idolo lihamba ngokungajwayelekile;
- kunokungazinzi lapho uhamba ne-patella iqhubeka ngaphandle;
- kukhona ukuvinjelwa ngezikhathi okuvimbela ukugoba; i-calyx isesimweni esingeyona eyemvelo nokuphambuka kwe-pathological lateral komlenze ongezansi.
Kuyenzeka ukuthi kuhlolwe ukufuduka okuzelwe kwe-patella ngemuva kokuba isiguli esincane siqale ukuhamba. Ngakho-ke, ukuxilongwa kokuqala kwezifo kunzima.
Imvamisa ukwelashwa okulondolozayo kunqunyelwe ukuqinisa imisipha nemisipha:
- i-electromyostimulation;
- ukubhucungwa umzimba;
- ukuzivocavoca ukwelashwa okuyinkimbinkimbi.
Uma ukufuduka okuzelwe kungumkhuba, ukuhlinzwa kuyakhonjiswa.
Ukuhlolwa ngudokotela wamathambo, ukuhlaziya nokuxilonga
Ukuxilongwa kusekelwe ku:
- izikhalazo ezivamile zesiguli;
- idatha ye-anamnestic ekhombisa iqiniso kanye nendlela yokulimala;
- imiphumela yokuhlolwa okunenhloso;
- idatha yezindlela zokucwaninga ezinsimbi:
- i-radiography (womabili amalunga esesimweni sokuma kokuqagela kwangaphakathi nangaphandle);
- I-Ultrasound (ukuqinisekisa ukulimala kwezicubu ezithambile);
- I-CT (ingenziwa ngokuhlangana okuguqukayo)
- I-MRI (indlela enembile kunazo zonke, ikuvumela ukuthi ubone ukulimala kwamathambo nemisipha);
- imiphumela yezifundo zamakhemikhali abonisa inqubo yokuvuvukala endaweni ehlanganisiwe:
- ukuhlolwa koketshezi oluhlangene (ukwenziwa kwe-articular kwenziwa);
- ukuhlolwa kwegazi kwamakhemikhali kanye nokujwayelekile.
Izindlela zokwelapha
Uhlobo lwemithi yakudala yokufuduswa kwe-patellar yile:
- ukunciphisa i-patella yi-traumatologist;
- ukusetshenziswa kwendawo emakhazeni (emahoreni angama-48 okuqala);
- uma kunesidingo, ukusetshenziswa kwe-anesthetics (i-Novocaine derivatives) ne-analgesics (Diclofenac);
- ukungasebenzi kwejoyinti elonakele ngamazinyo aqinile noma ukhonkolo (kungakapheli inyanga eyodwa, ukuhamba ngezinduku kuvunyelwe);
- I-FZT (imvamisa - i-UHF, i-magnetic and laser therapy, i-electrophoresis);
- Zilolonge ngokwelashwa nangokubhucunga umzimba ukuze ukhulise kancane ilunga elonakele futhi uqinise izinsimbi zomculo we-musculo-ligamentous.
Ukwelashwa okuhlinzekwayo kukhonjisiwe:
- ukulimala kwezicubu ezithambile;
- ukungabi nomphumela ekwelashweni okulondolozayo.
Indlela yokuzikhethela i-arthroscopy - indlela encane yokuhlasela esebenzisa i-arthroscope, ngaphansi kokulawulwa kwezinqubo zokuhlinzwa ezenziwa.
Isibikezelo
Uma kungalashwa, ukulimala kungaba nzima yizinguquko ezilandelayo ze-pathological kujoyini:
- i-synovitis;
- isifo samathambo;
- i-arthrosis;
- ukusonteka;
- ukungazinzi okungapheli.
Isikhathi sokwelashwa nokuvuselelwa sithatha kusuka ezinyangeni eziyisithupha kuya onyakeni, kuya ngobukhona bokulimala okuhambisanayo. Imisebenzi yokuvuselela yenziwa ngaphansi kweso le-traumatologist. Ukugqoka okusekelayo kungasetshenziselwa ukuvimbela. Ekupheleni kwesikhathi sokululama, kunconywa ukwelashwa kwe-spa. Isibikezelo siyathandeka. Imvamisa ngemuva kwezinyanga eziyi-6-9, ukusebenza kahle kuyabuyiselwa.
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