D kugawidwa kwa patella kumachitika pamene kneecap imachotsedwa kunja kwa phokoso kumapeto kwa fupa la ntchafu. Mthunzi wa kneewu nthawi zonse umatulutsira kunja kwa groove. Kamodzi kowonongeka kwa patella kumachitika, ndizovuta kwambiri kuti zichitike kachiwiri.
Kumvetsetsa chifukwa chake mawonekedwe a kneecap amachokera ndi chinsinsi chokhazikitsa chithandizo choyenera.
Kwa anthu ena, kugwirizana kwa mafupa kapena anatomy kungakhale vuto, mwa ena, pangakhale msempha wosweka. Ngati zatsimikiziridwa kuti opaleshoni ndiyo njira yabwino yoperekera chithandizo, ndiye kuti kuchitidwa opaleshoni yeniyeni ndiyo njira yofunikira kwambiri yothetsera kusamuka kwa mtsogolo.
Chithandizo chopanda chithandizo
Kawirikawiri, pambuyo pa kusamba kwa nthawi yoyamba ya patella, chithandizo chopanda opaleshoni chimalimbikitsidwa. Chithandizo chopanda opaleshoni kawirikawiri chimakhala ndi mankhwala othandizira kulimbikitsa minofu kuzungulira bondo komanso kugwiritsira ntchito chigoba chothandizira kugwiritsira ntchito mawotchi. Kugwira ntchito mosagwiritsidwa ntchito mopanda opaleshoni ndiko kuteteza kusokonezeka kwa mtsogolo kumakhala kovuta, koma madokotala ambiri amaona kuti ndikofunika kudziwa ngati ichi chinali chochitika chimodzi chokha, kapena ngati chingakhale vuto lobwerezabwereza. Kuchita opaleshoni mwamsanga pambuyo pa kusamba kwa nthawi yoyamba sikunapindule.
Madokotala ambiri amavomereza kuti, ngati mawondowa atasuntha maulendo angapo, ndiye kuti opaleshoni iyenera kuganiziridwa.
Pamene bondo limasuntha, n'zotheka kuwononga kadoti pamadondo, zomwe zimapangitsa ngozi yowopsya yamondo . Pamene kusokonezeka kochuluka kumachitika, opaleshoni yothandizira kuyenera kuiganiziridwa.
Kutulutsidwa Kwotsatira
Kutulutsidwa kwa pang'onopang'ono ndi opaleshoni yosavuta komanso yofala kwambiri kuti athetse vutoli .
Chifukwa chakuti mawotchi amawombera kunja kwa bondo, kumasulidwa kwazotsatira kumadula capsule wothandizira mawondo (retinaculum) kunja kwa mawondo . Lingaliro ndi kumasula zokokera kunja ndipo ndikuganiza kuti ndibwino kuika patsogolo bondo lamkati mkati mwa phokoso kumapeto kwa fupa la ntchafu. Kutulutsidwa kwapambuyo kumapangidwe pamodzi ndi kumangiriza pakati kapena MPFL yomanga (onani m'munsimu).
Matimati wa Zamankhwala / Zowonongeka
Kudalira kwachipatala ndi njira yolimbitsira minofu pambali mwa bondo. Monga momwe kumasulidwa kwazithunzi kumatsegula makompyuta akukoka mawondo awo kunja, kumangirira kwapakati kumamangiriza zomangira pambali mwa bondo. Njira yowonjezereka yowonjezera mbali yeniyeni ya bondo ikukweza chiyanjano cha minofu ya quadriceps pa mawondo pambali mwa bondo.
MPFL Kukonzanso / Kumangidwanso
Njira yatsopano yamakono yomwe ikugwiritsidwira ntchito pazowonongeka za patellar dislocation ndilo lofunika kwambiri lotchedwa medial patellofemoral ligament, kapena MPFL. MPFL ndizokhazikika pakati pa mapeto a ntchafu fupa (femur) ndi mbali yamkati ya kneecap (patella). Pamene kneecap imasunthira, MPFL nthawizonse imang'ambika.
Mu kuvulala koopsa , zingatheke kukonza MPFL.
Izi ndi zoona zokhazokha pa nthawi yoyamba yomwe imayambitsidwa ndi opaleshoni yomweyo. Chifukwa chake, madokotala ena opaleshoni amalimbikitsa opaleshoni yomweyo pambuyo poyambitsa matenda a patella kuti akonze MPFL, ngakhale kuti izi sizinawonetsedwe kuti zichepetse kusokoneza kubwereza.
Pambuyo pobweretsanso, kuti mukonze MPFL, mzere watsopano uyenera kupangidwa. Izi zikhoza kuchitika pogwiritsa ntchito ligament kapena tendon kuchokera kwina kulikonse m'thupi lanu, kapena kuchokera kwa wopereka (cadaver). Mitundu yatsopano ya MPFL imalengedwa ndipo imamangirizidwa ku ntchafu ndi kneecap. MPFL yatsopanoyo yatsopanoyo imagwiritsanso ntchito mawondo awo pansi.
Thupi Loyamba / Fulkerson Ndondomeko
Odwala ena, mawonekedwe awo amadziwika bwino ndipo amachititsa kuti kneecap isachoke pamodzi. Vuto likhoza kukhala losalala pang'ono pamapeto pa fupa la ntchafu kapena kugwirizana kosadziwika kwa kumapeto kwenikweni .
Muzochitika izi, opaleshoni yowonjezereka ikugwirizanitsa mapeto ndi kuika tibial tubercle pa fupa la fupa. Mphuno ya tibial, yomwe imakhala pamwamba pa fupa la fupa, imayikiranso thambo la patellar . Pogwiritsa ntchito tibial tubercle, patella imakoka kwambiri kumbali ya bondo.
Pali kusiyana kwakukulu kwa opaleshoni yomwe ikugwira ntchitoyi. Ndondomeko ya Fulkerson ndi yofala kwambiri ndipo imatchulidwa ndi dokotala yemwe adafotokoza njira iyi. Palinso njira zina zofanana zomwe zimayika tibial tubercle.
Rehab Pambuyo Opaleshoni
Rehab pambuyo pakuchita upaleshoni kuti uzindikiritse kuti patella imasintha. Kukhalitsa kwakanthawi kochepa kumakhala ndi kumasulidwa kwina, ndipo rehabitali kwambiri ndi njira yowonongeka. Ziribe kanthu zomwe ndondomekoyo inachita, vuto lofala kwambiri pambuyo pa opaleshoni ndi kuuma kwa bondo . Kupeza mphamvu zowonongeka ndi kuyendanso kumachitika pambuyo pa opaleshoni ikhoza kutenga miyezi kapena kupitilira.
Monga tafotokozera kumayambiriro kwa nkhaniyi, chinthu chofunika kwambiri ndikuwona opaleshoni yabwino kwambiri yochitidwa malinga ndi vuto lililonse. Osati mawotchi onse a kneecap amapezeka chifukwa chomwecho, choncho palibe mankhwala onse omwe ali ofanana. Kuwona dokotala wa opaleshoni yemwe amadziwa zoyambitsa ndi chithandizo cha mavulo a kneecap ndi ofunika.
Ngakhale kusokonezeka kwa patella kumachitika pambuyo pa opaleshoni, sizikhala zofala kwambiri. Odwala ambiri akhoza kuyambiranso ntchito yawo yowonongeka popanda kukhala ndi chiopsezo chotsegula mawondo awo.
Zotsatira:
Hing CB, et al. "Kuchita opaleshoni pogwiritsa ntchito njira zopanda opaleshoni zothandizira kuwonongeka kwapadera" Cochrane Database Syst Rev. 2011 Nov 9; 11: CD008106.
J. Andrish "Otsogolera kuwonongeka kwafupipafupi" Orthop Clin North Am. 2008 Jul; 39 (3): 313-27.