Wowonjezereka Chifukwa Chake Anthu Amakhala ndi Kufooka Kwambiri
Kupweteka kwapatsipa kwapatsiku ndi vuto lomwe limapezeka ku imodzi mwa mavitoni omwe ali pambali pa bondo.
Kuwunika momwe mumayambira mukuthandizira kumvetsetsa momwe izi zikuchitikira. Mitsempha yotsitsimula imayenda kumbuyo kwa fupa; chitsimikizo chotchedwa posterior tibial ndonon chimagwirizanitsa minofu imeneyi ndi mafupa a phazi. Iyo imadutsa kumbuyo kwa mwendo, osati kutali ndi tendyle Achilles, imatembenuka pansi pa kutchuka kwa mbali yamkati ya bondo.
Kenako imagwira fupa la mkati mwa phazi, pafupi ndi phazi la phazi.
Matenda omwe amatha kutuluka m'mimba amangochitika pambali pa kutchuka kwa mbali yamkati ya mitsempha, yomwe imatchedwa medile malleolus . Malleolus wamkati ndi mapeto a fupa lamatenda (tibia) ndipo nsomba ya posterior tibial imamanga pansi pa malleolus apakati. Mbali imeneyi ya tendon imakhala yovuta kuthetsa mavuto chifukwa imasowa magazi okwanira kuti azidyetsa ndi kukonzanso matope.
Mbali iyi ya tendon imakhala " m'mphepete mwa nyanja ," komwe magazi amalephera. Choncho, pamene tendon imakula, chifukwa cha kupsinjika mtima kapena kumwa mopitirira muyeso , thupi limakhala lovuta kulandira zakudya zoyenera kuchiritsa.
The Link With AAFD
Mukapanda kusamalidwa, matenda oterewa amatha kuyamba pang'onopang'ono kukhala ndi vuto lotchedwa wamkulu akupeza flatfoot deformity (AAFD). Matendawa amayamba ndi ululu ndi zofooka za posterior tibial tendon, koma mkhalidwewo ukapitirira, mitsempha ya phazi imakhudzidwa ndipo ziwalo za phazi zingathe kulangidwa ndi kupunduka.
Pa chifukwa chimenechi, madokotala ambiri amasankha chithandizo choyambirira pasanapite nthawi ya AAFD.
Zizindikiro za Tibial Posterior Tendonitis
Kawirikawiri, odwala omwe ali ndi matenda otchedwa posterior tibial tendonitis amadandaula ndi ululu mkati mwa phazi ndi mchira ndipo nthawi zina amakhala ndi mavuto okhudzana ndi malo osakhazikika.
Odwala ambiri amanena kuti ali ndi mitsempha ya posachedwa, ngakhale kuti ena sakhala akuvulazidwa posachedwapa.
Pamene mazira otchedwa posterior tibial tendonitis apitirira, phazi la phazi limatha kugwedezeka ndipo zala zazing'ono zikuyamba kutulukira kunja. Izi ndi zotsatira za matenda otchedwa posterior tibial tendon osagwira ntchito yake kuti athetse phazi la phazi.
Kuzindikira kuti matendawa amatha kutuluka m'mimba. Odwala ali ndi chikondi ndi kutupa panthawi yomwe amatha kutuluka. Kawirikawiri, amalephera kupotoza phazi lawo (akuwonetsa zala za mkati). Zomwe zimafala kwa odwala omwe ali ndi matenda otchedwa posterior tibial tendonitis ndi osakhoza kuima pazipinda zawo pa mbali yomwe yakhudzidwa.
Ngati kuyeza sikukudziwika bwino, kapena ngati wodwalayo akuganiza opaleshoni, akhoza kupeza MRI. MRI ndi njira yowunikira kuti azindikire kupweteka kwa tchutchutchu, ndipo ingasonyezenso kusintha kotupa komwe kumayambira pa tendon.
Miyeso ya Posterior Tibial Tendonitis
Kuperewera kwa mankhwala osapatsirana kumatha kusankhidwa molingana ndi siteji ya chikhalidwecho. Mndandandawo umachokera pa siteji 1 mpaka kugawo lachinayi ndi kuwonjezeka kwa phazi momwe chikhalidwe chikuyendera.
- Gawo 1: Malo oyambirira kwambiri a posterior tibial tendon kusakwanitsa ndikumva ululu ndi kutupa pamtunda. Phazi likhoza kuwonekera mwachibadwa, kapena anthu angazindikire phazi lawo liri lofooka la flatfoot, mwinamwake chinachake chimene iwo amamva kuti akhala nacho nthawizonse.
- Gawo 2: Pamene chikhalidwe chikupita, phazi la phazi limayamba kugwa. Pamene phazi la phazi likhoza kukonzedwa, pamene anthu ayimilira phazi amawonekera pakhomo pambali pake.
- Gawo 3: Kamodzi kalowa siteji 3, matendawa sangathe kuwongolera mosavuta, chikhalidwe chotchedwa rigid flatfoot deformity.
- Gawo 4: Kamodzi pa siteji yachinayi, osati phazi lokhalo, koma mgwirizano wapafupi wa mitsempha umatenganso mbali.
Pamene magawowa akupita, chithandizo chothandizira kuthetsa vutochi chimawonjezeka kwambiri. Ngakhale mankhwala osamalidwa angagwiritsidwe ntchito panthawi ina iliyonse, mwayi wodalirika ndi mankhwala ochepa ochepa akhoza kuchepa ngati chikhalidwe chikupitirira.
Kuchiza kwa Posterior Tibial Tendonitis
Njira yoyamba yothandizira kutuluka kwa tizilombo tomwe timayambitsa matendawa ngati tikufuna kuti tipeze machiritso. Mwamwayi, ngakhale kuyenda mwachizolowezi sikungalole kuti tendon ipumule mokwanira. Zikatero, buluyo liyenera kukhala losavomerezeka kuti likhale lopuma mokwanira. Zosankha za mankhwala oyambirira ndi awa:
- Kuyika nsalu ndi nsalu zimathandiza
- Kuyenda nsapato
- Zimasintha
Pogwiritsa ntchito nsanja yolimba ya phazi, nsapato zowika ndi nsapato zoyenda zimapewa kuyenda pakati pa midfoot ndi hindfoot. Kupewa kuyendetsa uku kuyenera kuchepetsa kutupa komwe kumayambitsanso matenda oterewa. Mavuto ndi ovuta kwambiri, koma mwinamwake ndi njira yabwino kwambiri yowonetsetsa kuti thambo la posterior tibial likhale lokwanira.
Mankhwala ena ochiritsira kumayambiriro oyamba pambuyo pake tibial tendonitis ndi mankhwala odana ndi kutupa ndi kusintha kwa ntchito. Mankhwalawa onse angathandize kuchepetsa kutupa kuzungulira thambo lochedwa posterior tibial.
Njira Zothandizira
Chithandizo cha opaleshoni cha posterior tibial tendinitis chimatsutsana ndipo chimasiyana malinga ndi momwe ziririli. Kumayambiriro kwa mazira otchedwa post-tibial tendonitis, madokotala ena opaleshoni angapangire njira yoyeretsera kutukuta komwe kumatchedwa kukangana . Panthawi yamakono, minofu yotentha ndi tinthu yonyansa imachotsedwa kuti athandize machiritso a thambo lowonongeka.
Pazigawo zowonjezereka kwambiri za matenda othamanga pambuyo pake, phazi la phazi lagonjetsedwa ndipo kugwedezeka kwa mitsempha yosavuta kungakhale kosakwanira kuti athetse vutoli. Kumangidwanso kwa posterior tibial tendon nthawi zina kumachitika.
Mu njira zowonongeka, tendon yoyandikana nayo, yomwe imatchedwa flexor digitorum longus, imasunthira kuti ilowe m'malo m'malo owonongeka a posterior tibial tendon. Ndondomekoyi imaphatikizidwanso ndi kukonzanso mafupa. Pamapeto pake, m'matenda apamwamba kwambiri omwe amatuluka m'mimba mwamsanga, pamene phazi la phazi lakhala lolimba, njira yothandizira ndiyo njira yabwino.
Mawu Ochokera
Matenda osakanikirana otsika, komanso akuluakulu omwe amapeza kupunduka kwafooka, zingakhale zokhumudwitsa. Kawirikawiri, anthu amawona kuti zizindikiro zawo zimanyalanyazidwa ndi dokotala yemwe sangaone zambiri mwa njira yopunduka, koma anthu amavutika ndi kusakhazikika kwa mkondo.
Kamodzi muzigawo zotsatila, chithandizo chingathe kukhala chosokoneza ndi kuchepetsa pa ntchito ya phazi. Pazifukwa izi, kuyesayesa koyambirira ndi mankhwala osagwira ntchito, kuphatikizapo nsapato zosinthidwa ndi ntchito zothandizira, ndizo njira zoyenera kuziletsa zizindikiro za chikhalidwe.
> Chitsime:
> Deland JT. Kukula kwafooka kwa anthu akuluakulu. J Am Acad Kupatula Opaleshoni. 2008 Jul; 16 (7): 399-406.