Hip dysplasia ndi dzina lachipatala lomwe limagwiritsidwa ntchito polongosola vuto ndi kupanga mapangidwe a chiuno pakati pa ana. Malo a vutoli akhoza kukhala mpira wa mgwirizano wa chiuno ( mutu wa chikazi ), chingwe cha mchiuno cha achule (acetabulum), kapena onse awiri.
M'mbuyomu, madokotala ambiri atchula vuto la congenital dysplasia m'chiuno, kapena CDH. Posachedwapa, mawu ovomerezeka akuthandizira dysplasia m'chiuno kapena DDH.
Zifukwa za Hip Dysplasia
Cholinga chenicheni cha chiuno cha dysplasia si chophweka kugwetsa pansi, monga momwe akuganiziridwa kuti ndi zinthu zingapo zomwe zimapangitsa kukhala ndi vutoli. Hip dysplasia imapezeka pafupifupi pafupifupi 0.4% mwa kubadwa konse ndipo imapezeka kwambiri kwa atsikana oyambirira. Zina mwazidzidzidzi zomwe zimapangitsa mwana kukhala ndi hip dysplasia ndi awa:
- Ana omwe ali ndi mbiri ya banja la hip dysplasia
- Ana omwe amaleredwa ndi mphepo
- Ana omwe amabadwa ndi mavuto ena okugulitsira "
- Oligohydramnios (kusowa kwa intrauterine madzi)
"Kupaka mavuto" ndizo zikhalidwe zomwe zimapangitsa kuti mukhale ndi gawo lochokera kwa mwana; Mwachitsanzo, clubfoot ndi torticollis. Hip dysplasia kawirikawiri imapezeka mwa ana oyamba kubadwa, amafala kwambiri pakati pa akazi (80%) ndipo amapezeka kawirikawiri kumanzere (60 peresenti yotsala m'chiuno, 20% onse m'chiuno, 20% mwala wokha)
Kuzindikira kwa Hip Dysplasia
Kuzindikira kwa chiuno cha dysplasia mu khanda kumayambira pa zofufuza za thupi.
Dokotala wanu adzamverera " chophika chakumapeto " pochita zochitika zapadera za mgwirizano wa m'chiuno. Zojambulazi, zotchedwa Barlow ndi Ortolani, zimayambitsa chiuno chomwe sichingatheke kuti "choka" pamene chikulowetsamo.
Ngati chophika cha chiuno chikumveka, dokotala wanu nthawi zambiri amapeza hip ultrasound kuti aone chophatikizira cha hip.
X-ray sichisonyeza mafupa ali mwana mpaka atakwanitsa miyezi isanu ndi umodzi, choncho chiwopsezo cha hip chimakonda. Chiuno cha ultrasound chidzawonetsa dokotala udindo ndi mawonekedwe a chiuno cha mchiuno. M'malo mwa mgwirizano wolowetsa mpira, ultrasound ikhoza kusonyeza mpira kunja kwa chingwe, ndi chingwe chopanda kanthu (chosadziwika). Chiuno cha ultrasound chingagwiritsidwe ntchito kugwiritsira ntchito momwe mankhwala akugwirira ntchito.
Kuchiza kwa Hip Dysplasia
Katemera wa dysplasia amadalira zaka za mwanayo. Cholinga cha chithandizo ndi kuyika bwino chiphatikizo ("kuchepetsa" chiuno). Akapeza kuchepetsa kokwanira, dokotalayo amatha kugwira chiuno mu malo omwe amachepetsedwa ndipo amalola kuti thupi lizigwirizana ndi malo atsopano. Mwana wamng'ono, mphamvu yabwino yosinthira mchiuno, komanso mwayi wabwino kwambiri wochira. Pakapita nthawi, thupi limakhala lochepetsetsa poyang'anitsitsa. Pamene chithandizo cha mchiuno cha dysplasia chimasiyanasiyana ndi mwana aliyense, ndondomeko yotsatira imatsatira:
- Kubadwa kwa miyezi isanu ndi umodzi
Kawirikawiri, pakhanda, ma dysplasia amatha kuchepetsa pogwiritsira ntchito chipangizo chapadera chotchedwa Pavlik harness . Izi zimapangitsa kuti mwanayo azisunga m'chiuno chomwe chimapangitsa kuti mgwirizano uchepetse. Pakapita nthawi, thupi limasinthira kumalo abwino, ndipo chophatikizira chija chimayambira bwino. Pafupifupi ana 90% omwe ali ndi hip dysplasia omwe amachitira nawo pa Pavlik harness adzachira. Madokotala ambiri sangayambe kulandira chithandizo cha Pavlik kwa milungu ingapo atabadwa.
- Miyezi 6 mpaka chaka chimodzi
Kwa ana achikulire, mankhwala a Pavlik amatha kupambana. Pachifukwa ichi, dokotala wanu wa opaleshoni amachititsa kuti mwanayo asamangidwe ndi anesthesia. Izi nthawi zambiri zimalola kuti mchiuno chikhale choyenera. Kamodzi mu malo awa, mwanayo adzaikidwa mu spica cast . The cast is similar to Pavlik harness koma amalola kuyenda pang'ono. Izi ndizofunika kwa ana okalamba kuti azikhala bwino bwino. - Kwa zaka zoposa 1 chaka
Ana okalamba omwe ali ndi zaka chimodzi amafunika opaleshoni kuti athetse mgwirizano wa chiuno mu malo abwino. Thupi limatha kupanga minofu yomwe imapangitsa kuti mchiuno usagwire malo ake abwino, ndipo opaleshoni imafunika kuti mugwirizane bwino. Izi zikatha, mwanayo adzakhala ndi spica kuti agwire mwendo.
Kupambana kwa chithandizo kumadalira msinkhu wa mwanayo komanso kukwanira kuchepetsa. Mwana wakhanda amene ali ndi vuto lochepa, ali ndi mwayi wabwino kwambiri wochira. Pamene mankhwala ayamba pa nthawi yayitali, mwayi wochira mokwanira umachepa. Ana omwe ali ndi hip dysplasia amakhala ndi mwayi wokhala ndi ululu komanso nyamakazi yoyambirira m'moyo. Kuchita opaleshoni kuti udulire mafupa ( chiuno cha osteotomy ), kapena malo ochizira , zingakhale zofunikira m'tsogolo.
Zotsatira:
Guille JT, Pizzutillo PD, MacEwen GD "Kupititsa patsogolo Dysplasia ya Hip Kuchokera ku Kubadwa kwa Miyezi Isanu ndi umodzi" J. Am. Acad. Ortho. Kukonza., July / August 2000; 8: 232 - 242.
Vitale MG ndi Skaggs DL "Kupanga Dyplasia yopambana ya Hip Kuchokera kwa Miyezi Isanu ndi Iwiri kwa Zaka Zinayi" J. Am. Acad. Ortho. Opaleshoni., November / December 2001; 9: 401 - 411.