Ponseti clubfoot chithandizo pa

Polongosola chilema khalidwe pamene phazi liti lidzasandulike mkati kwa olamulira kotenga wa tibia ndi Mawu akuti "clubfoot".

Kobadwa nako clubfoot amatanthauza gulu nthambi malformations ndi osakaniza a deformations osiyana phazi, kuchita zambiri supination wa miyendo ndipo atavalanso zoteteza minofu chosayenerera. Clubfoot awiri amasiya amapezeka pafupifupi 50 peresenti ya milandu. The azachipatala kwa wamba kapena "tingachipeze powerenga" mawonekedwe a clubfoot - Talipes ekvinoravus (Talipes equinovarus). Kawirikawiri kobadwa nako kudwala kumachitika kawirikawiri anyamata kuposa atsikana (2: 1 chiŵerengero). The zimayambitsa matenda si bwino.

Pamodzi ndi chilema kobadwa nako, palinso anapeza mawonekedwe, zotchedwa neurogenic clubfoot, amayambitsidwa kwambiri milandu kuphwanya innervation.

Matendawa vuto lililonse kwa dokotala phazi amaika yomweyo pambuyo pa kubadwa. Clubfoot sadzakhala Musiyeni mwana, mpaka akuphunzira kuima ndi kuyenda. Komabe, mankhwala a clubfoot Amasankhidwa posachedwapa pambuyo pa kubadwa kwa amapondereza elasticity wa zimakhala kuti apange kapisozi limodzi Mitsemphayi ndi tendons, ndipo akupitiriza sequentially. Nkofunika kuti tikwaniritse zotsatira zabwino, monga sasiya anachiritsa kukhalabe yokhota kumapeto, izi zimakhudza gulu lonse mu miyendo, wopita ku ululu wotsatira nyamakazi.

Ana zambiri yesani kuchiza popanda opaleshoni, njira ndiwofatsa linkadziwika Ponseti clubfoot chithandizo (achire kutikita ndi pulasitala amatulutsa).

Ambiri clubfoot angathe kuchiritsidwa kutangoyamba mu masabata asanu asanu ndi atatu pambuyo pa kubadwa. Mafupa dokotala ikufotokoza ndi makolo zosiyanasiyana chithandizo. bwana wake kwa kukonza deformities phazi zikhazikitsidwe kumvetsa bwino zinchito thunthu phazi, ndi zochita zamoyo minofu, Mitsemphayi, mafupa.

Ponseti clubfoot chithandizo pa - njira ankalamulira mwakuchita Dr. Ignacio Ponseti zaka zoposa 50 pa yunivesite ya Iowa (USA), ndipo kwambiri bwino kutsimikiziridwa. Ponseti njira unayamba mu UK mu 1990s mochedwa ndipo atchukitsa m'dzikolo thupi National Health Service ndi Steve Wilde. Mu 2000s, ndi njira wakhala chimagwiritsidwa ntchito kuthokoza Dr. John Herzenbergu mu US ndi Europe, ndipo chifukwa dokotala ku UK National Health Service Steve Mannayonu - mu Africa.

Tsopano pa Ponseti chithandizo cha clubfoot chimaonedwabe "golide muyezo" m'mayiko ambiri otukuka.

Chithandizo akuyamba pa sabata woyamba kapena wachiwiri wa moyo wa mwanayo, ndi gawo ataweramuka, pamene mpheto kwa tendons ndi Mitsemphayi mapazi mulibe chisoni. Pambuyo aliyense ndondomeko likukhudza osewera kukhala digiri akwaniritsa chilango. Amanena ndi zala phazi kuti groin ndi kamodzi pa sabata udindo watsopano kwa masabata awiri (malingana ndi mlingo wa kukula kwa clubfoot a). Pa ndondomekoyi, mafupa phazi pang'onopang'ono limagwirizana.

Ngati redressatsii safuna chilango chilichonse, ndiye nthawi zambiri ikuchitika tenotomy - magawano opaleshoni Achilles tendon, chimene chimafuna kutalikitsa, monga nthawi zonse truncated mu clubfoot lapansi. Mu mankhwala oletsa ululu pamalopo, ndi alinso ndi njira yonse kudutsa scalpel lapansi. Akwaniritsa zonse dorsal kutambasuka kwa phazi. Ndiye kukakamiza phazi kamodzinso kuponyedwa kwa masabata atatu kapena anayi.

Pambuyo kukonza sitepe amapezeka tenotomy kudzudzulidwa zotsatira ndi wapadera achire nsapato (kulimba kapena "Denisa Brauna tayala") kutsetsereka pa njanji zitsulo, omwe chili oyima mu malo anakonzeratu malangizo mavuto yotsalira m'chigawo cha kumwendo wa. Patatha miyezi itatu kapena inayi atavala kulimba zikhoza kuchepetsedwa kwa maola khumi ndi tsiku, m'tsogolo akhoza kugwiritsidwa ntchito usiku. Kuvala kulimba kwa zaka ziwiri kapena zinayi kuteteza zisadzachitikenso wa clubfoot.

Pachaka dziko amabadwa ndi clubfoot pafupifupi 150 000 ana. Ponseti clubfoot chithandizo pa - sabweretsa chisoni ndi bwino pafupifupi 100 milandu onse kuvutika kobadwa nako, kupulumutsa pa ntchito mtengo makina.