Ukuguqulwa komnwe emva kokulimala
I-Boutonniere deformity yomnwe yiphumo lokulimala kwiitoni ezisebenza ukulungisa amanyathelo omunwe. Ngokuqhelekileyo abantu balondoloza olu hlobo lokulimala ngexesha lezemidlalo okanye emsebenzini kwaye bacinga ukuba 'badibanise' ngomunwe wabo . Nangona kunjalo, ngokuhamba kwexesha, ukukhubazeka kweBoutonniere kungaphumelela, kwaye ibe yinto engunaphakade. Ngethamsanqa, ukuba ifunyanwe ngokukhawuleza, kukho unyango olunokusebenza.
Kwenzekani
I-Boutonniere deformity iyenzeka emva kokulimala okuthe ngqo kwiitoni zomnwe. Iminwe yakho iguqa emva kwaye ihamba ngamathambo edonsa amathambo. I-flexor tendon zisezintendeni zomnwe, kwaye zidonsa iminwe phantsi-isisombululo esibizwa ngokuba yi-finger floxion. I-tendens-extensor tonson ingasemva komnwe kwaye isebenze ukulungisa umnwe-isilumkiso esibizwa ngokuba yongezwa ngomunwe. Umnwe ngamnye unesithonti saso sophula, kwaye i-tendon nganye ixhomekeke kwisithambo kwiindawo ezininzi.
Amathambo amathathu eminwe abizwa ngokuba yi-phalanges (ngamnye kuthiwa yi-phalanx) kwaye abizwa ngokubhekiselele kwindawo. I-phalanx ye-distal iyinsipho yomnwe, i-phalanx ephakathi iphakathi kwee-knuckles, kwaye i-phalanx ephezulu isiseko somnwe. Ithenda ye-extensor ifakwa kwi-phalanx ephakathi kunye ne-phalanx ye-distal. Xa ukuxhaswa kwe-phalanx ye-distal kwenzakalisiwe, ibizwa ngokuba ngumlenze we- mallet .
Xa isalathisi esilulayo se-phalanx ephakathi sikhatywe, umphumo yi-Boutonniere deformity. Ikhonkco elithile le-tendon elidlulayo phakathi kwe-phalanx libizwa ngokuba yi-slip central-ngoko-technically, i-Boutonniere deformity ibangelwa kukulimala kwisithuba sokuqala.
Kutheni I-Finger ibonakala ingalunganga
Isalathisi esisisiseko siqhotyoshelweyo esibaluleke kakhulu kwisithoni esiphezulu.
Le nxalenye ye-tendon ye-extensor idonsa kwi-phalanx ephakathi yenza ukuba inxalenye yomnwe iqondise. Xa isalathisi esiyinhloko sikhatywe, i-knuckle yokuqala (i-joint PIP) ayikwazi ukuyiqonda ngokuzeleyo kwaye ibukeka ilungelelaniswe ngamaxesha onke.
Nangona kunjalo, loo nto iyingxenye yeBoutonniere deformity. Imijelo yeminwe yinkimbinkimbi kakhulu, kwaye xa enye inxalenye yomnwe ibonakaliswe, ezinye iinxalenye zomnwe zingase zisebenze ngokuqhelekileyo. Kwimeko ye-Boutonniere deformity, kuba ukujoyina i-PIP ayikwazi ukulungiswa, iigaments ngaphandle komnwe zitshintshwa kwindawo yazo. Esikhundleni sokusebenza ukugoba iqhosha lokugcina (i-DIP ngokudibeneyo) iigaments ziqala ukutsala i-knuckle yokugqibela ehamba phambili ngqo (i-hyperextension). Ngako oko, ukukhubazeka komunwe weBoutonniere kuluhlu lwe-PIP ngokubambisana, kunye ne-hyperextension ye-DIP ngokubambisana. Whew!
Kwenzeka njani
Ngokuqhelekileyo, inamandla ephosakeleyo isetyenziselwa emveni komunwe otyumkileyo yimbangela ye-Boutonniere deformity. Njengoko kubonisiwe, oku kudla ngokuba ngumdlalo okanye ukulimala komsebenzi. Ukulimala okubukhali, okunjengekhenkce, kungabangela ukubola kweBoutonniere.
Iimpawu eziqhelekileyo zeBoutonniere deformity ziquka:
- Ubuhlungu ngaphaya kwe-phalanx ephakathi komnwe
- Ukuvuvukala ngaphezu kwesithuba sokuqala
- Ukungakwazi ukulungisa iqhagamshelo le-PIP okanye ukugoba udibaniso lwe-DIP
Unyango lweBoutonniere Deformity
Ukuqaphela kwangaphambili le nzakalo kubalulekile, njengokuba kuqalwa unyango ngaphakathi kwenyanga yokulimala kudla ngokwaneleyo ukuvumela unyango olungaphelelanga lusebenze. Unyango lubandakanya ukutyunjwa kwe-PIP ngokubambisana ngokukodwa ngokuthe ngqo kwiiveki ezi-4-6. Uninzi lwamaxesha amaninzi, ukulimala kancinci ukuphathwa ngokukhawulelana kuya kuphelisa kwaye kuphilise ngokupheleleyo.
Ukulimala okuye kwangexesha elide kuncinci ukuba kuphuculwe ngokukhawulelana, kwaye akuze kuphinde kubuyele kwizinto eziqhelekileyo. Izinketho zokuphanda ukulungisa i-tendon kunye nokuvuselela i-ligament zinokuba luncedo.
Ukongeza, utyando lunokucetyiswa ngenxa yezizathu ezithile ze-Boutonniere deformities kuquka ukulimala kwangaphakathi, i-rheumatoid arthritis, kunye ne-Boutonniere deformities ezenzeka kunye nomonakalo ngomnwe.
Imithombo:
UBoyer MI kunye noGelberman RH. "Ukulungiswa komsebenzi we-swan-neck kunye ne-boutonniere deformities kwisandla se-rhumatoid" J Am Acad Orthop Surg ngoMashi 1999; 7: 92-100.