Hallux Valgus. Valgus chilema ya chala choyamba

Zotupa mapazi akukhala mochulukirachulukira. Za mtundu wina ambiri kudwala zimfundo phazi ndi valgus chilema kapena Hallux Valgus.

Kodi valgus chilema?

Pansi valgus chilema zambiri amakhudza kusokoneza kapangidwe ka woyamba metatarsophalangeal olowa chifukwa cha kusamuka kwa mutu wa woyamba metatarsal laterally (kunja kwa phazi) ndi otsetsereka a phalanx proximal ya chala inwards.

Mapazi matenda mapazi akufotokozera zambiri chifukwa cha kuvala zolimba, nsapato yopapatiza. Chifukwa, mchikakamizo cha psinjika chikuchitika "mphamvu" ndi kusamutsidwa kwa proximal phalanx. Limodzi ndi izi ikusintha Tambasula Mitsemphayi ndi tendons chala, zomwe zina pofuna kukwaniritsa zolinga zinthu. Chinthu china mapindikidwe ndi kobadwa nako kutengera za kukhala matenda.

Chifukwa cha zinthu zina zimachitika flattening arches phazi, kenako akufotokozera transversely kotenga mosabisa, ndipo zimenezi zimapangitsa kuti kupotozedwa kwa chala chachikulu.

Lolani azimayi, kaya akhale a msinkhu (zambiri matenda akufotokozera mu moyo pakati ndipo kenako).

kusalekerera

Kukula, kupindika akhoza kulimbikitsa, zikubweretsa kwambiri kupsyinjika chala. The mwamphamvu anatsimikiza ndi mosiyanasiyana awiri zosintha lalikulu - phalanx ndi metatarsal-intertarsal (pakati 1 ndi 2 metatarsals) kumathandiza kupeza ngodya zabwino.

Mu chochitika cha fupa, motero 12 ndi 25 madigiri akufotokozera kusalekerera loyamba hallux valgus.

Ngati ndondomeko m'kati, ndi divergence ndi madigiri 18 (metatarsal-phalangeal mfundo) ndi madigiri oposa 25 pakati metatarsals, mu matenda a poyera digiri yachiwiri ya chitukuko cha matenda.

Ngati kumathandiza kupeza ngodya zabwino ndi zawonjezeka 18 ndi 35 digiri, motero, angaike digiri chachitatu cha kuwuma matenda.

Nthawi zina funso n'lakuti - zimene digiri ya kusalekerera ayenera kuikidwa, ngati kusintha mbali khalidwe la Mwachitsanzo, mlingo woyamba, komanso mbali zina ndi kuchuluka koposa kutero. Imeneyi, ayenera kuganizira kusintha mu metatarsal-phalanx limodzi kuti kusintha ndi lalikulu mu pathogenesis matendawa.

chipatala

Pa siteji koyamba za matenda mawonetseredwe chachikulu cha matenda kukhala ouma pa kuyenda, timafuna nkhawa. Ndi kupitirira kwa ndondomekoyi zimawonedwa mu chitukuko cha kutupa olowa kapisozi (bursitis), zomwe worsens matenda. Awonjezedwa ululu olowa, kukula ndi kuyenda, kulephera kwa ntchito depreciation. Ndi kupitirira, matenda akhoza kumva ndi chitukuko cha osachiritsika chimbale matenda, nyamakazi (chifukwa flattening ya chimbale intervertebral). Palibe kwambiri, kupweteka ululu msana, lingaliro la mphamvu yakukoka ndi loyenda patatha zina, komanso ululu pambuyo womberani.

Popita mu edema olowa: izo kumawonjezera kukula, ankawachotsera articular makutu. Ndi zikutha m'mayiko fupa la articular chichereŵechereŵe pamwamba kuyamba opaka wina ndi mzake, imbaenda kumva kuwawa kwa kali articular ndi chitukuko wotsatira wa osteophytes.

diagnostics

Kawirikawiri, matenda a valgus kupindika chala wodwala ndi madandaulo zokwanira anasonkhana mbiri ndi kuyendera masomphenya. Lathyathyathya-valgus chilema tileke anapezeka ntchito X-ray wa olowa akhudzidwa kudziwa kumathandiza kupeza ngodya zabwino kupatuka pakati pa mafupa komanso kusalekerera. Nthawi zina ntchito chapamwamba kwambiri ndi scintigraphy.

njira Monga zina za ntchito matenda masiyanidwe, ntchito wathunthu magazi, amuzolengedwa magazi kusanthula matenda puncture kafukufuku olowa synovial madzimadzi ndi inoculation wotsatira pa sing'anga michere (kwa mtima tizilombo). Adalipo zizindikiro zimene ziri zazikulu matenda yosayambitsa ndi mtima revmofaktora (matenda a nyamakazi), asidi uric (gout), komanso ena nyamakazi tizilombo toyambitsa matenda enieni.

chithandizo valgus

Hallux Valgus chithandizo ayenera kuyamba ndi normalization wa moyo. Mu kukhalapo kwa kulemera owonjezera bwino kuchotsa izo (athyathyathya ndipo osteochondrosis kuvutika matenda ndi kulimbikitsa kupitilira ake). Pankhaniyi, ngati akadali amapezeka Hallux Valgus, palibe ntchito mankhwala ingakhudze kwambiri.

Nsapato, mwina zinachititsa kuti mapindikidwe ngati n'kotheka ayenera kusiya ntchito.

Tiyenera kukana makhalidwe oipa.

Monga kupewa valgus kupindika ayenera kugwiritsidwa ntchito nsapato omasuka ndi zidendene zofewa popanda zitendene. Ena amagwiritsa ntchito ndipo adzakhala kuchititsa osambira miyendo ndipo kutikita phazi pambuyo katundu wolemera malo amodzi pa miyendo. Pakati pa zala akhoza adzaikidwa ziyangoyango wapadera mafupa yopewera kusamutsidwa kwa phalanx ya chala choyamba.

Ngati zonsezi ndiwofatsa ndithu, thandizo ntchito zina mankhwala symptomatic, umalimbana chikusintha amadza njira posindromnogo.

mankhwala

Kuti patsogolo kuchiza Hallux Valgus zambiri kutenga mankhwala osiyana.

Magulu waukulu wa mankhwala ali sanali steroidal odana ndi yotupa mankhwala (NSAIDs) - mankhwala "nimesulide" "meloxicam". Mankhwalawa amathandiza kuti mpumulo wa ndondomeko yotupa ndi kutsekereza cyclooxygenase-2 - waukulu ovomereza-yotupa mkhalapakati. Mankhwala akhoza kuchepetsa kutupa, kuchepetsa kutupa m'dera kuchepetsa ululu. Kugwiritsidwa ntchito kwa ntchito zonse m'kamwa ndi ntchito ndi (kondomu) za m'dera.

Komanso NSAIDs, ankagwiritsa ntchito njira electrolyte ndi mankhwala odana ndi yotupa, amene ntchito ndi electrophoresis. Njira imeneyi zimathandiza inu kupanga mankhwala mwachindunji malo a kutupa, anyalanyaza thirakiti m'mimba. Izi adzachotsa kotheratu mavuto obwera chifukwa cha NSAIDs pa mucosa chapamimba pamene mukumwa iwo mkati.

chithandizo opaleshoni

Ndi kupanda chithandizo ndiwofatsa amachita opaleshoni. Iwo ikuchitika zambiri m'njira zapamwamba za matenda pang'ono kutha kenako, komanso mapindikidwe choopsa cha zala.

Mwamsanga opaleshoni imagwiridwa, ndi yabwino kwambiri kuti madokotala ananena zawo.

Mu masiteji koyamba ntchito wokongola kwambiri ntchito pofuna kuchiza matenda. Hallux Valgus inathetsedwa ndi thandizo la resection chachikulu mitu olowa. Chifukwa ichi, zambiri yovulala, chifukwa mu kuyan'anila za ntchito zakutali. Pakali pano, patsogolo zapatsidwa kwa sustavosohranyayuschim ntchito amene cholinga - phukusi osachepera pa mafupa pa amadza pazipita pa tendons ndi Mitsemphayi. Chimagwiritsidwa ntchito Chevron ntchito mpango (kukonza osteotomy). Ngati inefficiency awo anadza ku chilengedwe cha arthrodesis lapansi. Lathyathyathya-valgus mapazi chilema mu Zikavuta kungafune apulasitiki akhudzidwa olowa.

Ntchito imachitika mu yofanana asanu ndi limodzi (ngakhale tsopano Adalenga zoposa 130, koma iwo alibe analidi).

Kuwonjezera pa excision mitu fupa unachitikira ndi chilangizo flattened Chipilala phazi.

Kulosera tsogolo la matenda pambuyo opaleshoni

Mu nthawi postoperative Ndi bwino kupewa ndithu ntchito thupi (amene angathandize kuti zosayenera kubwezeretsedwa kwa olowa). ayenera kutsegula phazi lako ndi theka kapena miyezi iwiri (osachepera olowa msoko pambuyo opaleshoni ya). nthawi yonseyi, tiyenera kuvala wapadera mafupa nsapato. Phunziro kwa zinthu izi kuti madokotala ananena zawo zabwino kwambiri.

Ngati chikhalidwe anapezeka mochedwa ndi ndondomeko patsogolo ndipo zinachititsa kuti zinthu zisinthe sizingasinthe, ndi Mapa pang'onopang'ono gulu salembedwa akumane. Mapazi matenda mapazi amalimbikitsa kulumala, kusokonezeka kuyenda. Pankhaniyi, ngakhale kuti zikutsutsana ndi madokotala amakhala osamveka chifukwa yekha kubweza kupitirira kwa ndondomekoyi, koma kuthetsa chifukwa.

Kaya kuchiza vuto limeneli?

Malinga ndi funso ndikuponyera ankakonda kuwafunsa anthu ambiri. Kwa ena, chitukuko chotero mavuto - ndi mavuto, ngati gulu lino la anthu mokhulupirika zimasunga chikuoneka ndipo tisalole molakwika zoipa asokoneza maonekedwe awo. Ena omasuka ndi kusintha mafupa ndi pachangu palibe anathawira ku phwando kwa dokotala. Kodi kukhala - kuchiza kapena kuchitira? Kodi ndigwiritsa ntchito kwa madokotala thandizo chitukuko cha Hallux Valgus? Reviews za matenda zosiyanasiyana komanso mwachindunji.

Pa dzanja limodzi, ndi bwino pa kusintha pang'ono m'njira yake ndi adiresi limodzi kwa zamafupa ndi traumatologist. Panthawi yake matenda a matenda akhoza kuchotsa popanda zovuta zilizonse chowawa. Kenako chikhalidwe ichi adzakhala wapezeka, zotsatira kwambiri kwa dongosolo minofu ndi mafupa izo zikhoza kutembenukira. N'chifukwa chake funso wa mankhwalawa hallux valgus chala chachikulu mwangwiro payekha. Aliyense kudzisankhira lokha ngati "kupita pansi mpeni" kapena bwino kuwasiya.