Ukuhlukaniswa kwePatellar kungukufuduka kwayo okumi mpo, okuvundlile noma okuyi-torsional ukusuka kumgogodla we-intercondylar we-tibia (amakhodi M21.0 neM22.1 ngokokuhlukaniswa kwe-ICD-10). Ngokulimala okunjalo, kuba khona ubuhlungu obukhulu ngokushesha, ukuhamba kwamadolo kuvinjiwe, umsebenzi wokusekela womlenze ulahlekile ngokwengxenye noma ngokuphelele. Njengoba izimpawu zifana nezokuphuka kwamadolo, udokotela angenza ukuxilongwa okunembile esebenzisa ama-x-ray. Ngemuva kwalokho, i-patella ibuyiselwa endaweni yayo bese kunikezwa ukwelashwa okuqhubekayo - ukuqeda ngokuphelele isitho isikhathi esingamasonto amathathu kuye enyangeni eyodwa nohhafu noma ukuhlinzwa. Kuphela ku-25% wamacala lapho ukususwa okunjalo kwenzeka ngenxa yokulimala, konke okunye kungenxa yemisipha ebuthakathaka nemisipha, ukukhubazeka okuhlukahlukene kwedolo noma ukuhlangana kwe-femur.
I-anatomy ne-patella anatomy
Esinye sezitho eziyinhloko esihlinzeka ukuhamba okuqondile, ukugijima nokugxuma ukuhlangana kwamadolo. Inesakhiwo esiyinkimbinkimbi futhi iqukethe:
- I-Tibia, i-fibula ne-femur, i-patella (i-patella).
- Imigqa emibili ye-intra-articular neyesihlanu eyengeziwe.
- Izikhwama ezinhlanu ze-synovial.
- Amaqembu emisipha amathathu (ngaphambili, ngemuva nangaphakathi).
I-patella yakhiwa ngezicubu zomzimba ngesikhathi sokukhula komuntu (cishe iminyaka eyisikhombisa). Inokuma kwephiramidi elingunxantathu noma le-tetrahedral elinamakhona ayindilinga. Ingxenye yayo yangaphakathi (ukhalo olude olumbozwe uqwanga lwe-hyaline) itholakala emgodini we-intercondylar we-femur. Uhlangothi oluyisicaba lubheke ngaphandle kwejoyinti, futhi lunamathiselwe kusuka ngezansi nge-ligament yalo kuya ku-tibia, futhi ukusuka phezulu kuya kumathambo omsipha wethanga we-quadriceps. I-patella ihlinzeka ngokuvikelwa ekulimaleni futhi iqinise ukuma kwezingxenye zezitho zamadolo, futhi lapho inwetshiwe, idlulisela ngempumelelo amandla emisipha yethanga emlenzeni ongezansi.
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Izinhlobo
Ukulimala kwePatellar kwehlukaniswe kwaba:
- Ngenxa yesenzeko:
- umphumela wokuhlukumeza wangaphandle;
- ezelwe noma etholwe, ngenxa yalesi sifo, ushintsho lwe-pathological edolweni elihlangene.
- Ekuqondisweni kokufuduka:
- eceleni;
- rotary;
- mpo.
- Ngezinga lomonakalo:
- ukukhanya nokuphakathi - ushintsho oluncane endaweni ye-patella ngaphandle kokuqhekeka kwemisipha;
- i-acute - ukuhlukaniswa okuyisisekelo, okuhambisana nokuhanjiswa okuphelele kwe-patella nokubhujiswa kwezakhiwo ezizungezile: uqwanga, imisipha;
- ejwayelekile - ephindaphindwe kaningi ngenxa yezinguquko ze-pathological emvelweni, ukuhlukaniswa noma ukwehliswa.
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Izizathu
Ukudlala ibhola, ukuphakamisa izinsimbi, ukugxuma, ukuxhumana nobuciko bemidlalo kanye neminye imidlalo ehlotshaniswa nemiphunga ebukhali, ukuwa, ukushaya emadolweni kanye nemithwalo engaguquguquki edolweni ivame ukuholela ekuhlukaneni okubuhlungu kwe-patella kanye ne-pathologies efana ne-lateroposition (ukufuduka unomphela uhlangothi olungaphandle) kanye ne-osteochondropathy (izinguquko eziwohlokayo kwizicubu ze-cartilage).
Ukuhlukaniswa kungenzeka ngenxa yokuthuthuka okungajwayelekile noma ukungathuthuki kahle kwezingxenye ezihlangene. Ukulimala kwamadolo amadala noma izinguquko ezonakalisayo ezakhiweni zawo ngenxa yokugula noma ukuhlinzwa nakho kungadala ukulimala.
Izimpawu
Ezimweni zokuqala, ubuhlungu obungabekezeleleki buvele buvele ngokushesha, kukhona umuzwa wokuhlangana kwamadolo kuphuma futhi ukuhamba kwawo kuvinjiwe. Ngokulimala kanzima, kungenzeka ukuthi kuqhume ngokuphelele imisipha nokubhujiswa kwe-cartilage.
Ngokuhlukaniswa, i-patella ishiya ngokuphelele umbhede wayo nokushintsha:
- Ngakwesokudla noma kwesobunxele nge-lateral dislocation - ukucindezeleka kubonakala ngokubonakalayo phakathi kwamadolo, futhi i-tubercle engajwayelekile iyabonakala ohlangothini.
- Emaceleni kwe-eksisi ebheke phezulu ekuhlukanisweni kwe-torsional - ingxenye emaphakathi yelungu ikhulisiwe ngokwemvelo.
- Phezulu noma phansi ngokuhlukaniswa okuqondile - ngokulandelana, i-patella inesikhundla ngaphezulu noma ngaphansi kokujwayelekile.
Imvamisa i-kneecap ithatha isikhundla esijwayelekile iyodwa lapho umlenze welulwa. Ubukhulu bezinhlungu buyancipha, kuvela i-edema. Ukuhamba ngokuhlanganyela akubuyiswanga futhi ukopha emgodini wayo kungenzeka. Ngokuya ngohlobo lokulimala, ubuhlungu benziwa endaweni ye-medial retinaculum, i-lateral femyle condyle, noma umphetho ophakathi we-patella.
Ukuze ungadidanisi ukuqhekeka kokuhlukana kokuhlangana, ukuxilongwa kufanele kucaciswe kusetshenziswa i-X-ray.
Nge-subluxation, i-pain syndrome imnene. Ukuhamba kwamadolo cishe akunamkhawulo, ukususwa kwe-patella kuhluke kakhulu kunokujwayelekile. Lapho ugoba noma ugoba, kubonakala: ukuqunjana, umuzwa wokuwa komlenze nokungazinzi kokujoyina.
Ukuxilongwa
Ngezimpawu ezibonakalayo zokulimala okuncane, i-patella ivele iwele endaweni noma udokotela akwenze lokhu ngesikhathi sokuhlolwa kokuqala. Ukucacisa umonakalo ongaba khona, ama-X-ray ejoyini athathwa ngezindiza ezimbili noma ezintathu.
Uma kwenzeka imininingwane enganele yemininingwane ye-roentgenogram, kwenziwa ikhompiyutha noma i-resonance imaging imaging. Lapho kusolwa igazi emgodini we-patella, khona-ke kusetshenziswa ukubhoboza. I-arthroscopy isetshenziselwa ukuthola imininingwane eningiliziwe mayelana nesimo sezakhi zamadolo.
Uma imbangela yokuhlukaniswa kwaba izinguquko zokugula ezingezona ezihlukumezayo, lapho-ke izinyathelo zithathwa ukusungula lesi sifo esasibangele, futhi i-pathogenesis yaso ifundelwa kahle.
Insiza yezimo eziphuthumayo
Okokuqala, i-pain syndrome kufanele isuswe - i-compress ebandayo kufanele ifakwe edolweni futhi i-analgesic kufanele inikezwe isisulu. Ngemuva kwalokho kuyadingeka ukuqinisekisa ukunganyakazi kwejoyini kusetshenziswa noma iziphi izinto ezitholakalayo, ibhandeshi elinwebekayo, ibhandeshi elikhethekile noma intambo. Akufanele ugoqe umlenze ogobile noma ulungise ukususwa. Ukugwema izinkinga nokubonakala kokuhlukaniswa okujwayelekile, kubalulekile ukuletha isiguli egumbini lezimo eziphuthumayo ngokushesha okukhulu.
Yimuphi udokotela ongamthinta
Ngokuya ngohlobo nezinga lomonakalo, ukususwa kwe-patella kuhilelekile:
- I-Traumatologist - ukuxilongwa okuyinhloko nokwelashwa.
- Imisebenzi yokwenza udokotela ohlinzayo.
- I-Orthopedist noma i-vertebrologist - ukuvuselela nokuvimbela ukubuyela emuva.
Ukwelashwa
Njengomthetho, ukuncishiswa kokuhlukaniswa okunamandla ngudokotela kuyashesha futhi akunabuhlungu. Ngemuva kwalokho kuthathwa i-X-ray yokulawula futhi, uma kungekho monakalo owengeziwe obonakalayo, ijoyini alinakubekwa ngopulasitela. Uma kwenzeka ufuna usizo lwezokwelapha kungalindelekile (ngaphezu kwamasonto amathathu ngemuva kokulimala) noma ezimweni ezinzima (ukuhlukaniswa okujwayelekile, ukuqhuma okuphelele kwemigqa, ukubhujiswa kwe-cartilage), kwenziwa ukuhlinzwa okuvulekile noma i-arthroscopy.
Ukuvuselela, imigomo yokuthola kabusha nokugqoka ukhonkolo
Isikhathi nezinhlobo zemicimbi eyenzeka ngemuva kokuhlukumezeka incike ngokuphelele ebucayi bokulimala nezindlela zokwelashwa. Isikhathi sokuhamba singaba kusuka emasontweni amathathu kuye ezinyangeni eziyisithupha. Enye yezinqubo zokuqala ezinqunyiwe ukusikhipha okwelaphayo, kwesinye isikhathi okuqala ukusetshenziswa ngobumnene emisipheni yethanga nasemlenzeni ophansi ngokushesha ngemuva kokuqedwa kobuhlungu nokuvuvukala. Ukubuyisela ithoni yemisipha nokuhamba kwamadolo ngemuva kokususwa kosimende, ngaphezu kokubhucungwa, baqala ukwakha amalunga, okokuqala ngosizo lukadokotela, bese bezimela ngosizo lokuzivocavoca okukhethekile.
Izinqubo ezahlukahlukene ze-physiotherapeutic zinomthelela omuhle ezinqubweni zokubuyisa ukuqina kwemisipha nemisipha evuselelayo: i-UHF, i-electrophoresis, ukuvezwa kwe-laser, ukusetshenziswa kwe-esokerite.
I-Physiotherapy (ukwelashwa kokuvivinya umzimba) kunqunyelwe amasonto ama-2-3 ngemuva kokukhipha usimende. Ekuqaleni, ngomthwalo omncane kanye nohla oluncane lokunyakaza. Ukugwema ukuphuma kwe-patella okuphindaphindiwe ngalesi sikhathi, kubalulekile ukugqoka ibhandishi lokulungisa. Bese kuthi, kungakapheli izinyanga ezingama-2-3, umthwalo nobubanzi bokuhamba benyuke kancane kancane. Ekupheleni kwesikhathi, amandla okuhamba ngokujwayelekile nge-bandage yokusekela abuyiselwe. Ukuze ungasusi i-patella futhi lapho wenza izivivinyo zomzimba ezingafaki ukuwa, kuyadingeka ukusebenzisa idolo. Ukululama okugcwele kokubekezelelana kokuzivocavoca kanye nokukwazi ukugijima nokugxuma kutholakala ngokuzivocavoca okunamandla kuma-gymnastics wezokwelapha izinyanga eziyi-6-12.
Imiphumela kanye nokulimala kwesibambiso
Ukwehlukaniswa kwe-patella kungaba nzima ngomonakalo omkhulu emithanjeni ezungezile, uqwanga, i-menisci. Ukwehluleka ukubonisana nodokotela noma ukunciphisa okungafanele kungadala ukujwayela okujwayelekile kanye nokulahleka kancane kokusebenza kwamadolo. Ezimweni ezinzima, ikakhulukazi ngemuva kokuhlinzwa, ukuvuvukala kwamathenda we-patella noma ulwelwesi lwe-articular cavity kungavela.
