Acetabulum la fupa m'chiuno

Mmodzi wa kuvulala ambiri kuti azitsogolera munthu chikuku, ndi fractures a m'dera acetabular. Lerolino timaphunzira kuti ili ndi gawo la m'chiuno limodzi komanso ena dysplasia mankhwala kapena mavuto ena a malo kumeneko. Komanso kukapeza komwe ndi acetabulum ndi zimene mavuto zingachititse sclerosis kapena wovulala indentation lapansi.

ncafu ndi chiyani?

Iye ndi wamphamvu kwambiri ndi yaikulu kwambiri ku thupi. Kuwonjezera mbali monga flexion ndipo powunikiridwa m'chiphiphiritso, atigwira Chiuno chammbuyo, cha mtsogolo, mmbali, kayendedwe rotational, iye analinso m'gulu la otsetsereka a thupi.

Makhalidwe a wapadera uwu olowa - iwo kupereka pafupifupi 40% kayendedwe anthu.

Iwo aumbike mwa mutu wa femur, komanso ngati maganizo, wotchedwa acetabulum. M'chiuno olowa chozama poyerekeza ndi phewa. Onse mchitidwe ake ataphimbidwa minofu cartilaginous, amene akhoza kuyamwa katundu, yosalala zoyenda pamene mukuyenda, kuthamanga, ndi kulumpha pamene T D..

thunthu

Acetabulum ndi recess mu iliac fupa, omwe ali mbali ya hipbone lapansi. Iwo amachita ntchito zofunika kwambiri ndi zovuta mu thupi, monga thandizo ndi kayendedwe. Iwo ali mawonekedwe hemispherical, TACHIMATA pa chichereŵechereŵe mkati. Madokotala olekanitsidwa kutsogolo ndi kumbuyo khoma la acetabulum, ndipo Chipilala ake. Popeza kuti gawo ili la fupa m'chiuno amapereka kayendedwe anthu, n'kofunika mwamsanga kudziwa kuvutika m'dera limeneli ndi kuchiza msanga.

Acetabulum aumbike pubis, ischium ndi mafupa ilium mu malo chaubale.

wovulala

Nthawi zambiri, monga kuswa Landilani fupa kumachitika chifukwa cha ngozi. Komanso, kuvulala izi zikhoza kupangidwa atagwa kuchokera kutalika kwambiri.

Wovulala acetabulum akhoza kugawidwa mu mitundu 2:

1. Zambiri kuwonongeka. Izi fractures mizati kutsogolo, kumbuyo ndi pakati khoma yopingasa choipa.
2. Zovuta kuwonongeka. Apa ndi pamene wovulala mzere akuthamanga monga angapo zidutswa za mafupa. Izi zikuphatikizapo kutsogolo khoma choipa, yopingasa, mizati ndi ena.

Zizindikiro za wovulala ndi monga:

- Chisoni mu groin ndi m'chiuno.

- Wodwala n'zovuta kudalira mwendo anavulala.

- A mawonetseredwe bwino kufupikitsa nthambi, amene akufunitsitsa pa ntchafu ndipo bondo mafupa. Mwendo zimayenda outwards.

wovulala chithandizo

- Ngati kuphwanya umphumphu wa fupa zinachitika popanda kukondera, ndiye wodwalayo akusokoneza basi muyezo tepi ndi kutambasuka wapadera wa mwendo m'munsi kwa zaka 1 mwezi. Onetsetsani kuti uzipereke njira ya physiotherapy, electrophoresis.

- Ngati acetabulum la fupa m'chiuno yathyoledwa m'mbali cham'mwamba ndi kumbuyo, anatembenuka m'chiuno dislocation, ndiye mankhwala ikuchitika ndi samatha chigoba. The amachititsa katswiri analankhula kwa epicondyles femur. Ndiyamika mpheto ili la kapisozi olowa lidakali, ndi makombo mwamtundu ndi acetabulum ndi mwachitsanzo chikufanana. Nthawi anatambasula zambiri miyezi 1.5.

- Ngati mpukutu wa lalikulu ndipo n'zosatheka kuyerekeza, ndiye opaleshoni chofunika. Izo ziyenera kuchitikira mu masabata awiri oyamba pambuyo zoipa, pambuyo pake. Kukonza ufa makombo, madokotala ntchito mbale ndi kumanga zomangira.

Pambuyo mankhwala, ndi fupa lothyoka ndi zofunika kwambiri pa konzanso.

njira zotheka kupeza

Ntchito mankhwala a fractures wa recess monga acetabulum, ndi zolimbikitsa. Mfundo yakuti zovuta kukwaniritsa choipa katswiri.

Mitundu ya fractures wa indentation kwambiri ndipo, ndithudi, kuti aliyense ali ndi njira yakeyake mwayi. njira zotsatirazi zimagwiritsa ntchito:

- kupeza Front.

- ilioinguinal njira.

- kupeza kumbuyo.

njira kutsogolo

Mu njira ina imatchedwa "ofemoralnaya msewu." Izo ntchito kuti muyike pena fractures onse lotseguka kutsogolo khoma ndi zamkati ndime otchedwa acetabulum. More njira kutsogolo angagwiritsidwe ntchito pa matenda opaleshoni ya fractures yopingasa.

mwayi Ilioinguinal

Izo ntchito kutsegula kutsogolo ndi pamwamba lamkati la acetabulum lapansi. Angagwiritsidwenso ntchito osakwatiwa gawo wovulala fixation recess ndi misozi kwa sacroiliac olowa. Komabe, njira imeneyi sapereka mwayi wodziwa kumbuyo ulamuliro mzati ndi mpanda cavities anthu.

njira kumbuyo

Agwiritsidwa kutsegula kuchepetsa ndi osteosynthesis, ngati pali kuwonongeka kwa zapambuyo khoma la acetabulum, pambuyo Kupha chosinthika m'chiuno dislocation. Komanso, njira imeneyi ntchito kuchotsa mbali ya chichereŵechereŵe ku M'mimbamo olowa.

Therapy kumbuyo M'mimbamo m'mphepete wovulala

Pali kusinthika pathological pa ngozi kapena kugwa kuchokera kumwamba ndi. Sachedwa choipa ichi ambiri a achinyamata. Wovulala limodzi ndi kosangalatsa zidutswa dislocations mafupa, chiwonongeko cha articular zili chichereŵechereŵe. M'mphepete mwa acetabulum la zapambuyo anaona milandu lakutali. Makanema kwambiri wapezeka fractures zapambuyo yachiwiri.

Mu katswiri kuchipatala zifotokoza ochitiridwayo, ntchito kafukufuku cha mafupa a chiuno X-ray. Monga nkhani yofunika pogonekedwa ndi mankhwala epidural kapena mtsempha ochititsa dzanzi dokotala kuchepetsa ndi dislocation. Pambuyo kuti matenda chomaliza cha kuwonongeka olowa, kuphatikizapo X-ray mu ileum ndi, Review, oblique, ndi kompyuta tomography. njira kafukufuku amenewa amathandiza akatswiri kutenga chithunzi zonse kuwonongeka zamkati monga acetabulum lapansi.

Kuika munthu wapansi Pankhaniyi kokha opaleshoni. dokotala zimapangitsa odulidwa mzere kumene mpukutu wa isanafalikire. Kenako dokotalayu atakhazikitsa ndi wononga kapena psinjika kololeka. Limafufuza bata mpukutu fixation, kenako sutures chilonda.

kuchira

Pamene acetabulum la fupa m'chiuno ataphwanya okhulupirika ake anatsitsimuka, ndikofunika kusunga Malamulo awa a konzanso;

- Daily athane ndi Zochita wapadera kupuma.

- Phunzirani yoyenera pa ndodo, kuti afike mapazi.

- Zinthu akonzedwa wapadera zokambirana kuyang'aniridwa ndi podiatrist ndi: flexion ndi kutambasuka kwa zala zidendene za kasinthasintha ndi kuukitsa ndi kutsitsa mafupa a chiuno kuthandiza msana wathanzi nthambi m'munsi ndi manja awiri.

Nyamakazi a m'chiuno

Chizindikiro cha matenda ndi angapo sclerosis wa acetabulum, amene kokha mu X-ray. Mawu amenewa amapezeka za mafano opangidwa ndi radiologists.

Vutoli akufotokozera chifukwa cha kusintha yotupa mu mafupa ndi overgrowth minofu connective.

Acetabular ofoola ziwalo - mkhalidwe umene palibe zizindikiro kunja kwa matenda - arthrosis. Vuto limeneli lililonse kwa anthu okalamba. Zimayambitsa zazikulu maganizo ndi sclerosis:

- Kupatulira wa chichereŵechereŵe.

- Kulakwila kusowa magazi miyendo ndi matenda okhudzana ndi kagayidwe.

- cholowa kutengera za ku nyamakazi, osteochondrosis.

- Dislocations kuyenda.

- amangokhala moyo.

- kobadwa nako malformations zimfundo.

- amavulala pa katundu zamasewera kuwononga zida ligamentous.

- Fractures mu mafupa.

- Kunenepa.

Mankhwala a nyamakazi a m'chiuno, MS

Chithandizo zikuphatikizapo:

- minofu.

- ZOCHITA (popanda ya mwendo wopindidwa mu malo supine).

- njira Physiotherapeutic (mchere sera, maginito).

- Kugwiritsa Ntchito osambira wapadera ndi radon, sulfide wa hydrogen.

- Mavuto Chithandizo NSAIDs "diclofenac", "Nimesulide" ndi ena.

Muyeneranso kuchepetsa zitsulo ndikoletsedwa kwa nthawi yaitali kuti mukhale pansi. Kulumpha, kuthamanga amadziwikanso yoletsedwa.

matenda Otto ndi

Mu njira ina matenda amatchedwa "acetabular dysplasia." Ndipo dzina lake, monga matenda Otto, kudwala izi analandira pambuyo wolemba amene anali woyamba kufotokoza izo mmbuyo mu 1824 ndi matenda obadwa amenewa amapezeka mwapadera mu akazi. vuto kumaonekera mu kuletsa kayendedwe ka m'chiuno olowa (atigwira, adduction, kasinthasintha, zowononga nthambi m'munsi). Pankhaniyi, kupweteka akazi okongola asaone.

Kutsimikiza matenda "maganizo dysplasia" M'pofunika kuchita kafukufuku:

- X-ray a m'chiuno olowa mu zolosera chofunika.

- Kujambula.

- ultrasound.

Acetabulum: Otto ndi matenda chithandizo

Chithandizo ndi opaleshoni alowererepo, yomwe ingakhale monga iyi:

- pakanema kuchepetsa dislocation.

- kukonza opaleshoni kuti Hiari.

- Open kuchepetsa dislocation.

- chigoba samatha.

- m'chiuno arthroplasty.

mankhwala wowonjezera amagwiritsidwa ntchito:

- A wapadera nsalu.

- zolimbitsa thupi achire, olimbitsa.

- minofu.

- Chithandizo ndi mankhwala.

Wovulala ndi mavuto

The kusamuka kwa acetabulum ndi kumachitika mu kugwa kwa chinthu chachikulu mu mafupa a chiuno, ndi kufinya mu ndege mazunzo kapena Mwachitsanzo, pamene ngozi ya galimoto.

Mu fractures zovuta wosweka contours a m'chiuno olowa. Pamene zapambuyo dislocation wamkulu trochanter ukusunthira patsogolo. Ngati dislocation wa pakati, ndiye kumulavulira limalephera zakuya. Kuti timvetse kuti fupa lothyoka zawo, m'pofunika kuchita ndi x-ray mu zolosera awiri, chifukwa vuto ikhoza kukhala mu patsogolo kapena rearward.

Symptomatology mavuto:

- Amalalikira mwendo zoyenda koletsedweratu.

- m'munsi nthambi ndi zinthu mwankhanza.

Chithandizo mu nkhani iyi ndi izi:

- Kugwiritsa dongosolo chigoba samatha. Analankhulana anagwira supracondylar dera la ntchafu ndi cholinga cha makilogalamu 4.

- mwendo The aikidwa ndi udindo flexion ndi kubweretsa mu ntchafu ndipo bondo mafupa.

- Pofuna kudziwa mutu kufunika akatswiri malo kuchita samatha wa olamulira khosi ndi hinge kapena chigoba samatha ndi katundu koyamba makilogalamu 4.

- Pambuyo katundu kuchepetsa ndi kunditumiza ku samatha chigoba kusiya gwero sinker pa khosi olamulira.

- Mwendo kwa sabata 1 zapatsidwa kwa makona a madigiri 95.

Nthawi anatambasula ndi milungu 8 mpaka 10. masabata ngakhale pambuyo 2 saloledwa kuyenda mu olowa. Full katundu wapansi amaloledwa yekha patapita miyezi isanu. Ndi luso ntchito abwezeretsedwa m'miyezi 7.

coxarthrosis

matenda ndi osachiritsika chilengedwe, izi zimakhudza anthu okalamba ndi wazaka zapakati. Kudwala matenda pang'onopang'ono zaka zingapo.

Zizindikiro Koksartroza ndi:

- ubwenzi pathological pakati pa mutu femoral ndi acetabulum.

- medial nusu la mutu kumbali.

- The padenga la acetabulum imbricate chagona pa dzenje, chokhala ndi mulomo.

- The kutalika maenje ndi denga wathyoka.

- yokhudza kotekisi wosanjikiza mu matendawa, denga unakhuthala.

Coxarthrosis limodzi ndi ululu ndi malire kuyenda olowa.

Mu masiteji ina ya matenda pali manja a minofu ya ntchafu.

Zimayambitsa matenda anawagawa mitundu 2:

1. Pulayimale coxarthrosis. Zimachitika pa zifukwa mankhwala osadziwika.
2. Secondary coxarthrosis. Umapezeka chifukwa cha matenda ena.

Mtundu yotsirizira ya matenda chifukwa cha mavuto monga:

- kobadwa nako m'chiuno dislocation.

- m'chiuno dysplasia.

- Aseptic necrosis mutu femoral.

- m'chiuno nyamakazi.

- Perthes Disease.

- zoopsa (fupa lothyoka la m'chiuno, mafupa a chiuno, sprains).

Pakuti coxarthrosis m'kati. Mukayamba chithandizo pa siteji oyambirira, ndiyeno inu mukhoza kuchita chithandizo ndiwofatsa. Pa nthawi ndi njira kokha opaleshoni.

coxarthrosis chithandizo

Chithandizo cha matenda nawo orthopedists. Kusankha chithandizo kumatengera siteji ya matenda.

1. Pa siteji 1 ndi 2 amagwira ntchito mankhwala zotsatirazi:

- The kukhazikitsidwa kwa mankhwala odana ndi yotupa. Komabe, kwa nthawi yaitali sindigwiritsa ntchito chifukwa amakhala ndi zotsatira zoipa ziwalo mkati.

- (. Mankhwala monga "Arteparon", "rumalon", "chondroitin," "Struktum") hondroprotektorov ntchito

- vasoconstrictor mankhwala (kutanthauza "Trental", "Cinnarizine").

- mankhwala kumasuka minofu.

- kwapakati pa-articular jakisoni ntchito wothandizila m'thupi, monga "Kenalog", "hydrocortisone".

- Gwiritsani ntchito kwanyengo mafuta.

- Ndime ya mankhwala physiotherapy (laser-, kuwala mankhwala UHF, maginito mankhwala), komanso zofikisa, olimbitsa wapadera.

2. amachita pa siteji 3 njira yokhayo ndiyotani pakuchotsa coxarthrosis. Wodwala m'malo anawononga olowa endoprosthesis. opaleshoni imagwiridwa pogonekedwa ndi mankhwala ambiri m'njira anakonza. Sutures amachotsedwa pa tsiku 10, kenako mtima wa imatumizidwa chithandizo outpatient. miyeso konzanso pambuyo ntchito n'kofunika. Pafupifupi 100% ya opaleshoni olowa m'malo amapereka kubwezeretsedwa kwathunthu ntchito zowonongeka mwendo. Pa yomweyo anthu m'tsogolo akhoza ntchito mwakhama kusuntha ngakhalenso kusewera masewera. Kuvala prosthesis, iye angathe zaka 20 ngati malangizo dokotala. Pambuyo nthawi yaitali iyi ntchito mobwerezabwereza n'kofunika m'malo ndi endoprosthesis kale zakutha.

Zovuta za fractures acetabular

Vuto, ndi njira, zimachitika kawirikawiri, komabe anthu kudziwa za iwo. Ndi mavuto postoperative monga:

- Sepsis.

- zamafinya zinangoti mabala.

- Thromboembolism.

- Kuwonongeka kwa mitsempha.

- aseptic necrosis wa femoral mutu ndi acetabulum khoma.

- wodwala manjenje glute ang'ono ndi sing'anga.

Kuteteza zosayembekezereka wa mavuto amenewa, madokotala ambiri kupereka odwala awo yomweyo arthroplasty.

Pomaliza

Pamene kusuntha, ichi kukulitsa monga acetabulum, ndi zofunika kwambiri diagnostics oyambirira, kuphatikizapo X-ray, ultrasound, chapamwamba kwambiri. Kuchokera pa maphunziro awa, dokotala ayenera kusankha njira yoyenera mankhwala: a mosamalitsa ndiwofatsa kapena aukali - opareshoni. M'pofunikanso kwambiri mankhwala ndi konzanso nthawi, chifukwa zovuta anapanga munthu mofulumira afika pa mapazi ake.