Patella, yomwe imadziwika kwambiri ngati bondo, ndi fupa la sesamoid lomwe limapangidwa mu tentrices tendon ndipo lilinso fupa lalikulu kwambiri m'thupi. Ndiwosankhidwa ndi mapira, omwe amakhala pansi pa khungu komanso losavuta kumva. Fupa ndi lalikulu kwambiri ndipo lolowera pansi, ndi kutsogolo ndi kumbuyo kosalala. Itha kusuntha mmwamba ndi pansi, kumanzere ndi kumanja, ndikuteteza bondo. Kumbuyo kwa patella ndi yosalala ndipo yokutidwa ndi cartilage, yolumikiza ndi pa paterate pamwamba pa femur. Kutsogolo kuli kovuta, ndipo ma tentericeps pa quadriceps amadutsa.
Patellar Chondromaalacia ndi nthenda yolumikizirana yolumikizirana. M'mbuyomu, matendawa anali ofala anthu azaka zapakati komanso okalamba. Tsopano, ndi kutchuka kwa masewera ndi kulimbitsa thupi, matendawa amakhalanso ndi kuchuluka kwakukulu pakati pa achinyamata.
I. Kodi tanthauzo lenileni ndi chifukwa cha chondromaalaci ndi chiyani pachala?
Chondromaalacia patellae (cmp) ndi cholumikizira cha Patelofmitrictires oyambitsidwa ndi kuwonongeka kwa carlarrate pamwamba, komwe kumayambitsa zotupa za carlallage, zomwe zimapangitsa, kusweka, kukokoloka, ndi kukhetsa. Pomaliza, ma carmler ogwirizana ndi achichepere a Clayle amasinthanso matenda omwewo. Tanthauzo lenileni la cmp ndilo: Pali kusintha kwa patellar kutenthedwa, ndipo nthawi yomweyo, pali zizindikiro ndi zizindikiro monga zowawa za patellar, ndipo quadriceps pospophy.
Popeza cartilagegeger yaunical alibe mphamvu, makina a ululu woyambitsidwa ndi chondromaalacia sadziwika. Cmp ndi zotsatira za zovuta zingapo. Zinthu zosiyanasiyana zomwe zimapangitsa kusintha kwa ma Paralofemoraturatura ndi zida zakunja, pomwe ma autoimmune amasintha, cartilage dystrophy, ndipo kusintha kwa zovuta zamkati pachalae.
II. gawo lofunikira kwambiri la chondromaalacia pateloe ndi kusintha kwa intaneti. Chifukwa chake kuchokera ku malingaliro a kusintha kwa matenda, kondromaalaciacia, matelae amayenda bwanji?
Medium adafotokoza magawo anayi a chifuwa cha CPT: Gawo Ndiri cartilage yoyambitsidwa ndi edema, steji ii ikuchitika m'malo ofewetsa, gawo iii ndi gawo la cartilal cartilage; Gawo iv limatanthawuza kusintha kwa zosintha za Osteoloarthritis ndi kuwonekera kwa mafupa a subchril kumtunda.
Njira yopanga zolimba ya Outerbridge ndiyothandiza kwambiri pakuwunika patelor articulage zojambulajambula motsogozedwa ndi mawonekedwe kapena arthroscopy. Makina opanga alonda akunja ali motere:
Grass I: Cartilage Cortilage yokhazikika (yotseka cartilage yofewa). Izi nthawi zambiri zimafuna mayankho osamala ndi probe kapena chida china kuti muyesetse.
Zovala za II: Zofooka pang'ono zosaposa 1.3 cm (0,5 mu mainchesi kapena kufikira fupa la subkeyral.
Grass III: Chipilala cha cartilage ndi chachikulu kuposa 1.3 cm (1/2 inchi) m'mimba mwake ndikufikira fupa la subkendoril.
Grass IV: Pulogalamu Yapamwamba.
Iii. Matendawa onse ndi ankhondo amawonetsa tanthauzo la chondromaalacia pachala. Ndiye zizindikiro zamawu ndi mayeso owunikira kwambiri ndi ziti pakupeza chondromaalaciacia pa mathela?
Kuzindikira kumatengera kupweteka kumbuyo kwa matella, komwe kumayambitsidwa ndi mayeso opera ndi mayeso amodzimodzi. Cholinga chake chimayenera kukhala pa kusiyanitsa ngati kuvulaza kophatikiza kwa meniscus ndi matenda a nyamakazi. Komabe, palibe kulumikizana pakati pa kuuma kwa Patellar Chondromalacia ndi matenda a bondo owawa. Mri ndi njira yodziwikiratu yodziwira.
Chizindikiro chodziwika bwino chimakhala kumbuyo kwa ma Patella ndi mkati mwa bondo, yomwe imawaonjezera kapena kumapita kumasitepe.
Kuyesedwa kwakuthupi kumavumbula chikondi chenicheni mu ma patella, malire a Patellar Margin ndi Kterlior Patella, omwe angadutse ndi Patanir Phokoso lolowera ndi phokoso losokosera. Pakhoza kukhala wolumikizidwa ndi zophatikizira ndi quadriceps posphy. Zovuta kwambiri, kusinthana kwa bondo ndi zowonjezera ndizochepa ndipo wodwala sangathe kuyimirira pa mwendo umodzi. Panthawi ya mayeso a patallar, pali kupweteka kwambiri kumbuyo kwa matellar kuwonongeka kwa cartulage, komwe kumakhala kofunikira kwambiri. Kuyesedwa koopsa nthawi zambiri kumakhala kosangalatsa, ndipo mayeso a squat ali ndi chiyembekezo. Bondo likasinthasintha 20 ° mpaka 30 °, ngati malo osiyanasiyana a mkati ndi kunja kwa matela amapitilira 1/4 panjira yosinthira kwa Patella, imawonetsa kuwonongeka kwa patellar. Kuyeza q ngodya ya 90 ° bondo kumatha kuwonetsa ma patellar kuyenda.
Kuyesedwa kodalirika kwambiri ndi MRI, yomwe pang'onopang'ono idasinthira a Arthroscopy ndikukhala njira zosawerengeka komanso zodalirika za cmp. Malingaliro Oyerekeza Makamaka pagawo la Patellar (Caton Index, PHA), Patani), PTA, ndi PTA a cmp oyambirira.
X-ray ndi MRI idagwiritsidwa ntchito kuyeza patellar kutalika (Catan Index, PH): a. Axial X-ray yokhala ndi kulemera kokhala ndi maimidwe osinthika pa 30 °, b. Mri paudindo wokhala ndi bondo losinthika pa 30 °. L1 ndi ma patellar ngodya, yomwe ili mtunda wotsika kwambiri wa pompopompor yapamwamba kwambiri ya tibial plateour, ndi kutalika kwa cholumikizira cha pateloformiral.
Zovala za femal Trochlear Groove Contle Contle Contle Contle Contle Contle Contle (PCA) adayesedwa ndi X-ray ndi MRI: A. Axial X-ray ndi bondo losinthika pa 30 ° patali ndi kulemera kwambiri; b. Mri wokhala ndi bondo losinthika pa 30 °. Chingwe chokazinga cha proklear grove chimapangidwa ndi mizere iwiri, ndiye kuti ndiye wotsika kwambiri wa crochlear poove, ndipo kwambiri b wa Trochlear Ariclear Padziko Lonse. ∠bac ndiye Trochlear Trochlear Groove. Trochlear Frochlear Groove Coven adakopeka pa chithunzi cha axial cha patella, kenako kutsatsa kwa wobisala wa ∠bac adakokedwa. Kenako mzere wowongoka ae unakokedwa kuchokera kotsika kwambiri a Trochlear Proove monga momwe adayambira pompopompo. Kutalika pakati pa mzere wotsatsa ndi AE (∠dae) ndiye pambalor yokwanira ngodya.
X-ray ndi MRI idagwiritsidwa ntchito kuyeza ngodya ya patellar yolowera (PTA): a. Axial X-ray yokhala ndi kulemera kokhala ndi maimidwe osinthika pa 30 °, b. Mri paudindo wokhala ndi bondo losinthika pa 30 °. Nyengo ya patelor yotseka ndi ngodya pakati pa mzere wolumikiza malo okhala ndi ma medlent ang'onoang'ono komanso maxis osinthika a patella, mwachitsanzo ∠abc.
Ma radiogographs ndi ovuta kudziwa chivundikiro choyambirira mpaka magawo opita patsogolo, pomwe cartilage yolumikizira, ndikugwiritsa ntchito malo otsetsereka, kusintha kwa masinthedwe kumaonekera. Arthroscopy amatha kukwaniritsa zomveka chifukwa zimapereka mawonekedwe abwino osokera paterako; Komabe, palibe kuphatikizidwa kowonekera pakati pa kuuma kwa patellar chondromalacia ndi kuchuluka kwa zizindikiro. Chifukwa chake, zizindikirozi siziyenera kukhala chizindikiro cha arhhroscopy. Kuphatikiza apo, arthrographicy, monga njira yodziwikiratu yofufuzira komanso kusinthika, nthawi zambiri imagwiritsidwa ntchito ndi magawo apamwamba a matendawa. MRI ndi njira yodziwikiratu yomwe imalonjeza kuthekera kwapadera kuti azindikire ma carsilage zotupa komanso zosafunikira mkati mwa ma cartological cardilage ikuwoneka kwa maliseche.
Iv. Chondromaalacia patelae atha kukhala osinthika kapena atha kupita ku Florofemis nyamakazi. Kugwiritsa ntchito molimbika kuyenera kupatsidwa mwachangu m'masiku oyambira matenda. Ndiye, kodi chidziwitso chokhudza kuphatikizira ndi chiyani?
Nthawi zambiri amakhulupirira kuti kumanda koyambirira (gawo ku II), carcilage ya patellar gwiritsani ntchito, ndipo osachita opaleshoni sayenera kuchitidwa. Izi zimaphatikizapo kuletsa kapena kupumula, komanso kugwiritsa ntchito mankhwala osagwiritsa ntchito mankhwala osokoneza bongo ngati pakufunika kutero. Kuphatikiza apo, odwala akuyenera kulimbikitsidwa kuti azikhala oyang'anira olimbitsa thupi kuti alimbikitse minofu ya quadriceps ndikuwonjezera bondo.
Ndikofunika kudziwa kuti pa nthawi yosinthika, mabondo a bondo kapena ma bondo nthawi zambiri amavalidwa, ndipo pa pulasitala ya pulasitala imapeweka kwambiri, chifukwa imangoyambitsa kuvulaza cartilage ya aluso; Ngakhale mankhwalawa amatha kuthetsa zizindikiro, mahomoni sayenera kugwiritsidwa ntchito kapena kugwiritsidwa ntchito mosavuta, chifukwa amalepheretsa kapangidwe ka glycoterroteins ndikusokoneza kukonzanso cartilage; Kutupa kolowera ndi zowawa modzidzimutsa, ma compress ayezi akhoza kuyikidwa, ndipo mathandizo otha thupi ndi ma compress amatha kugwiritsidwa ntchito pambuyo maola 48.
V. M'masiku omaliza, odwala cartilage owoneka bwino ndi osauka, motero mankhwala osokoneza bongo nthawi zambiri amakhala osagwira ntchito komanso opaleshoni mankhwala amafunikira. Kodi opaleshoni mankhwala amaphatikizapo chiyani?
Zowunikira Opaleshoni zikuphatikiza: Patatha miyezi ingapo yothandizira chithandizo chokhazikika, ululu wa patellar adakalipo; Ngati pali zokhala ndi zotsalira kapena zopaleshoni, opaleshoni ingaganizidwe. Ngati Outridge III-IV Cartilage kuwonongeka kwa IV, chilema sichingadzazidwe ndi cartilage yeniyeni ya aluso. Pakadali pano, kungopanga malo owonongeka a cartilage omwe amadzaza kwambiri sikungalepheretse kusintha kwa mawonekedwe a armular.
Njira zochitira opaleshoni zimaphatikizapo:
. Itha kuwona mosapita m'mbali kusintha kwa cartilage pansi pansi pa maikulosikopu. M'malo ofatsa, zotupa zazing'ono zokoka pa Patellar zojambula za patelor zojambula zimatha kukakamizidwa kupititsa patsogolo kukonza.
. (3) patellar Carllage Padziko lonse. Opaleshoni iyi imachitidwa kwa odwala omwe ali ndi zowonongeka zazing'onoting'ono polimbikitsa kutembenuza cartilage; .
Post Nthawi: Nov-15-2024
