Mitundu yowonongeka ndi tinthu timene timagwirizanitsa minofu ya kunja kwa ng'ombe ndi phazi. Mitundu ikuluikulu ikuluikulu (peroneus longus ndi peroneus brevis) ili kunja kwa mwendo, pafupi ndi minofu ya ng'ombe. Minofu imagwirizanitsidwa ndi fupa ndi tendons , yomwe imayenda pambali pa bondo ndikugwirana ndi phazi.
Minofu yokhayokha ndi yofunikira poyendetsa phazi -chiyendedwe cha kugwedeza phazi kunja kuchokera pamakolo. Mwachizoloŵezi chokhalitsa, kuyenda kwa minofu yowonongeka kumakhala koyendera bwino ndi minofu yomwe imapangitsa phazi kuti lichepetse (phokoso phazi mkati mwake).
Mitundu iŵiri yokhayokhayo imakhala yogwirizana kwambiri-inde, imakhala pamwamba pamtundu wina pambuyo pa fibula. Ubale wapamtimawu umaganiziridwa kuti umayambitsa mavuto ena omwe amawoneka pazinthu zowonongeka, pamene akuphatikizana pamodzi pambuyo pa bondo.
Tendonitis Yowonongeka
Vuto lofala kwambiri lomwe limapezeka ndi mavenda omwe amatha kuwonongeka ndi kutupa kapena tetonitis . Mitunduyi imakonda kutsogolo kwa fupa la chifuwa pamatumbo. Mbali iyi ya fibula ndi mphuno kunja kwa mkondo (womwe umatchulidwanso kuti lateral malleolus ), ndipo matope omwe amatha kukhalapo ali pambuyo pamtundawu.
Matenda oterewa angakhale chifukwa cha kubwereza mobwerezabwereza kapena kuvulala koopsa .
Zizindikiro zofanana za matenda oterewa amapwetekedwa m'mimba, kutupa pamatope, ndi kutulutsa mtima. Kupweteka kumakhala kovuta kwambiri ngati phazi limagwedezeka ndi kulowa mkati, kutambasula tinthu tomwe timapanga. Zilonda za m'kati zimakhala zachilendo, ndipo MRI ingasonyeze kutupa ndi madzimadzi pamtunda.
Chithandizo chotheka cha tizilombo toyambitsa matenda chimakhala ndi njira zosavuta, kuphatikizapo:
- Ice App
Kugwiritsa ntchito ayezi kumalo kungathandize kuchepetsa kutupa ndi kuthandiza kuchepetsa ululu. - Kupumula
Mpumulo ndi wofunikira ndipo nthawi zambiri amathandizidwa pogwiritsa ntchito ziboda kapena ndodo . - Mankhwala Oletsa Kupweteka
Mankhwala, monga Motrin kapena Aleve, amatsutsa-kutupa ndipo amachepetsa kutupa pamtunda. - Thandizo la Thupi
Thandizo la thupi lingakhale lothandiza kuthandizira kubwezeretsa mawotchi amodzi. - Kuyenda Maboti / Ankle Brace
Nsonga ndi nsapato ndi njira ina yochepetsera nkhawa pa tendon ndikulola mpumulo ndi kutupa kuti zitha. - Cortisone Injections
Zilangizi za Cortisone zimagwiritsidwa ntchito mosalekeza, chifukwa zingayambitse kuwonongeka kwa tendon. Komabe, ngati matendawa amatha kusintha, phokoso la cortisone lingaganizidwe.
Misozi Yowonongeka
Misozi yodabwitsa kwambiri ndi yachilendo, ndipo nthawi zambiri imapezeka pamtundu wa breone tendon. Misozi imalingalira kuti ndi zotsatira za nkhani ziwiri ndi tendon. Magazini imodzi ndi magazi. Misozi ya breyoni imapezeka nthawi zambiri m'magazi omwe madzi amagawira , ndipo motero zakudya zamtunduwu ndizosauka kwambiri. Chachiwiri, ndi mgwirizano wapamtima wa tendon ziwiri, zomwe zimapangitsa kuti mtundu wa peroneus brevis ukhale pakati pa puloteni ya longone ndi mfupa.
Madokotala ambiri amayesa kulira misozi ya breone peroneus ndi mankhwala ofanana ndi tendonitis omwe atchulidwa pamwambapa. Mwamwayi, ambiri mwa odwalawa sapeza mpumulo wosatha wa zizindikiro, choncho opaleshoni ikhoza kukhala yofunikira. Pali njira ziwiri zopangira opaleshoni za misozi:
- Tendon Debridement ndi Repair
Panthawi yamatope, tinthu tawonongeke ndi matumbo opweteka omwe ali pafupi akhoza kuchotsedwa. Misozi imatha kukonzedwa, ndipo tendon imakhala "yokonzedwanso" kubwezeretsa mawonekedwe ake. Kukonzekera ndi kukonzanso kwa tendoni kumapindulitsa kwambiri pamene tchuthi zosachepera 50% zimang'ambika. - Tenodesis
Ma tenodeis ndi njira yomwe tinthu yowonongeka imayikidwa ku tendon yachibadwa. Pachifukwa ichi, gawo lowonongeka la peroneus brevis limachotsedwa (kawirikawiri masentimita angapo), ndipo malekezero omwe amatsalira amatsindikizidwira kumbali yeniyeni yowona. Zomwe zimapangidwa ndi tenodesis ndi misonzi yomwe imaphatikizapo tchuthi zopitirira 50%.
Kubwezeretsa pambuyo pochita opaleshoni kumaphatikizapo milungu ingapo yolemetsa yolemetsa komanso yosasintha, malinga ndi mtundu wa opaleshoni yomwe inachitidwa. Potsata zoletsedwa, mankhwala akhoza kuyamba. Nthawi yowononga nthawi zambiri ndi masabata 6-12, malinga ndi kukula kwa opaleshoni. Ngozi za opaleshoni zimaphatikizapo matenda, kuuma, ndi kupweteka kosalekeza . Izi zinati, opaleshoniyi imakhala yopambana kwambiri, ndipo odwala akulipira 85-95%.
Zotsatira:
Philbin TM, ndi al. "Zowonongeka Zonongeka Zokha" J Am Acad Orthop Surgery May 2009; 17: 306-317.