Ukufuduka kwePatella: izimpawu, izindlela zokwelashwa, ukubikezela

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:

1. Kukhona umuzwa wokungakhululeki endaweni yase patella. Mhlawumbe ukufuduka kwayo okwesikhashana, kuhambisana nobuhlungu obukhulu.
2. Ukukhubazeka kwamadolo kunqunywa yi-palpation. Ubuhlungu buphakathi. Kwenzeka ngokucindezeleka kwemishini endaweni yamadolo.
3. 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:

1. ukunciphisa i-patella yi-traumatologist;
2. ukusetshenziswa kwendawo emakhazeni (emahoreni angama-48 okuqala);
3. uma kunesidingo, ukusetshenziswa kwe-anesthetics (i-Novocaine derivatives) ne-analgesics (Diclofenac);
4. ukungasebenzi kwejoyinti elonakele ngamazinyo aqinile noma ukhonkolo (kungakapheli inyanga eyodwa, ukuhamba ngezinduku kuvunyelwe);
5. I-FZT (imvamisa - i-UHF, i-magnetic and laser therapy, i-electrophoresis);
6. 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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