Avascular Necrosis ya Hip
Hip osteonecrosis, yomwe imatchedwanso avascular necrosis, ndi vuto ndi magazi omwe amaphatikizapo fupa la chiuno . Matendawa amapezeka pakakhala kusokonezeka kwa magazi kupita kumutu kwa chikazi (mpira, mzere wachitsulo). Kuperewera kwa magazi ku maselo a mafupa kumachepetsa kuchepa kwa oxygen ndi zakudya ku fupa, ndipo maselo a mafupa amafa.
Pamene maselo a phungu akuwonongeka, mphamvu ya fupa imachepa kwambiri, ndipo fupa limatha kugwa.
Zimayambitsa
Palibe amene amadziwa chomwe chimayambitsa hip osteonecrosis. Pamene chiuno cha osteonecrosis chimachitika, fupa limagwa ndipo palimodzi, khungu, limataya chithandizo chake. Chifukwa chakuti mtembowu umataya pang'onopang'ono, mafupawa amatha msinkhu, ndipo nyamakazi imakula mwamsanga.
Odwala ambiri omwe ali ndi hip osteonecrosis amagwiritsidwa ntchito ndi uchidakwa kapena ntchito ya steroid . Zina mwazifukwa zomwe zimayambitsa hip osteonecrosis zimaphatikizapo matenda a sickle cell, kupweteka kwa m'chiuno (dislocation kapena fracture), lupus, ndi matenda ena.
Zizindikiro
Hip osteonecrosis nthawi zambiri imakhala ndi zizindikiro zochepa zochenjeza. Odwala nthawi zambiri amadandaula za ululu watsopano watsopano komanso kuyenda kovuta. Zizindikiro zofala za hip osteonecrosis ndizo:
- Ndikumva ululu mu kubuula
- Ululu ndi kuyenda kwa m'chiuno
- Kuvuta kuyenda kapena kupuma
Mayesero awiri omwe amathandiza kwambiri pakudziwa ndi kuchiza chiuno cha osteonecrosis ndi x-ray ndi MRIs . X-ray ikhoza kukhala yachilendo, kapena ikhoza kusokoneza kwambiri kuphatikizana. Ngati x-ray ndi yachilendo, MRI ikhoza kuchitidwa pofuna kuyang'ana zizindikiro zoyambirira za mchiuno osteonecrosis.
Matenda oyambirira osteonecrosis sangathe kuwonekera pa x-ray, koma nthawi zonse ayenera kuyesedwa pa mayeso a MRI. Pambuyo pake mapepala a osteonecrosis amawoneka mosavuta pa x-ray, ndipo ma CDIs sali oyenera ndipo sakhala othandiza. Mwamwayi, nthawi zambiri nthawi yochuluka ya osteonecrosis ikuwoneka pa x-ray, mankhwala okhawo omwe angakhalepo ndi njira zowonjezera.
Zochitika zina zomwe zingakhale ndi zizindikiro zomwezo zimaphatikizapo osteoarthritis wa m'chiuno , matenda otupa mitsempha ya mchiuno , ndi mavuto obwerera .
Chithandizo
Chithandizo cha mchiuno osteonecrosis n'chovuta chifukwa vuto limapitabe patsogolo mofulumira ngakhale mutalowapo. Kumayambiriro kwa chiuno cha osteonecrosis, mankhwala ndi mankhwala odana ndi kutupa angakhale othandiza.
Njira zopangira opaleshoni kumayambiriro koyamba a chiuno osteonecrosis zimaphatikizapo chipsinjo cha hip ndi kuphatikiza mafupa. Kugonjetsa kwa Hip kumapangidwira kuthetsa kuwonjezeka kwapakati pa mutu wa chikazi zomwe zingakhale zikuthandizira kusowa kwa magazi. Kuchulukanso kwa chiuno kumachitika ndi wodwala akugona mu chipinda chogwiritsira ntchito. Mabowo ang'onoang'ono amalowetsedwa m'dera la chiuno cha osteonecrosis kuti athetse vuto la mutu wa chikazi.
Mabokosi a mafupa a vascularized amachititsa fupa la thanzi la m'munsi (kuphatikizapo mitsempha ya magazi yomwe ili pamphongo), ndipo amaika izi m'dera la chiuno cha osteonecrosis.
Cholinga cha opaleshoni imeneyi ndi kupereka magazi nthawi zonse ku mchiuno wakhudzidwa. Ochita opaleshoni ayesanso mitundu ina yowonjezera (kuphatikizapo cadaver bone ndi synthetic grafts) kuti apange machiritso a fupa mumutu wa chikazi. Njirazi zimangoyamba kumapeto kwa chiuno cha osteonecrosis; ngati katsamba kakagwera kale, opaleshoni imeneyi sizingatheke.
Chithandizo chofala kwambiri cha opaleshoni ya hip osteonecrosis ndichochitsitsimutsa chikho. Ngati pangakhale kuwonongeka kwa kagawoti kamodzi, ndiye kuti kubwezeretsa nsalu ndibwino kwambiri. Pamene kubwezeretsa ntchafu kumagwira ntchito bwino, m'malo mwake adzataya nthawi.
Izi zimaonetsa vuto lalikulu kwa odwala omwe ali ndi hip osteonecrosis. Njira ina kwa odwala ang'onoang'ono amatchedwa hip resurfacing opaleshoni . Ndondomekoyi ndi yofanana ndi yotsalira , koma imachotsa fupa lochepa.
Zotsatira:
Zalavras CG ndi Lieberman JR. "Osteonecrosis ya Women's Head: Kufufuza ndi Chithandizo" J Am Acad Orthop Surgery July 2014 vol. 22 no. 745-464.
CJ Lavernia, RJ Sierra, ndi FR Grieco "Osteonecrosis wa mutu wachikazi" J. Am. Acad. Ortho. Kukonza., Jul 1999; 7: 250 - 261.