Isivumelwano sikaDupuytren ngumqathango wesandla esichaphazela phantse iipesenti ezintathu zabantu. Ngokomlando, kuphela okukhethwa kunyango kwakungekho nto, okanye inkqubo enkulu yokupasa. Kule minyaka elishumi edlulileyo, ezinye iindawo ezinokungenakunqununu ziye zavela njengoko kunokwenzeka unyango. Enye yezo kunyango zanamhlanje yinkqubo encinci ye-invasive ebizwa nge-alex aponeurotomy.
Isivumelwano sakwaDupuytren yimeko echaphazela isandla; itholakala kubantu abanesifo sikaDupuytren. Yenza ukuba izicubu zibe ngaphantsi kwesikhumba esecaleni lesandla sandla ukuze zenzeke kwaye zenze isivumelwano. Ezi zicubu, i-fascia yesundu, ngokuqhelekileyo kunika amandla kunye nenkxaso yesikhumba. Nangona kunjalo, kwisivumelwano sikaDupuytren, i-fascia yesundu inganciphisa ngokukhawuleza, okwenza kube nzima ukulungisa iminwe. Le meko ixhaphakile kumadoda aseMntla Yurophu engama-50 ubudala.
Unyango luyivumelwano sikaDupuytren luxhomekeke kubukhulu beempawu. Uninzi lwezigulane ezithintekayo zithintela iigrafu zenza iibhola eziqinileyo zesikhumba esentendeni, okanye iintambo ezenza iindidi eziqinileyo eziphakamisa entendeni yomnwe. Iingqungquthela zeDupuytren zinokuphathwa ngonyango lwe-cortisone okanye lunokuhlolwa ngaphandle kwonyango oluthile.
Intambo yeDupuytren ingabangela ingxaki njengoko ezi ziqala ukudonsa iminwe phantsi ukuya entendeni yesandla.
Ngokuhamba kwexesha, ukuba isivumelwano siyaqhubeka, izigulane aziyi kukwazi ukulungisa iminwe. Oku kunokukwenza imisebenzi elula njengokuhlamba ubuso bakho, ukuxhaphaza izandla, okanye ukugqoka iiglavu, kungekudala.
Unyango
Ukunyangwa okusemgangathweni kwesivumelwano sikaDupuytren yinkqubo yokugada ebizwa ngokuba yi-palmic fasciectomy.
Isundu kunye neminwe echaphazelekayo iyavulwa ngokugqithisa okukhulu. I-fascia yesigqubuthelo engavumelekanga isuswe. Ngenxa yobume bokugqitywa ngokubanzi, utywala obunzima luya kufakwa esandleni naseminwe. Ukuhlinzwa kungadinga ukuvuselelwa ixesha elide. Ezinye izigulane zingadinga ukuthatha iinyanga ezimbini ukusuka emsebenzini, kuxhomekeke kwimisebenzi yazo.
I-needle aponeurotomy (NA) yinkqubo encinci ye-invasive esebenziselwa ukuphatha isivumelwano sikaDupuytren. E-NA, ugqirha usebenzisa i-tip yenaliti ukwahlula i-fascia yesigcawu. Oku kuyenziwa ngamanxeba amancinci. Ngokungafani nokuhlinzwa okuvulekileyo, isandla asivuli ngokubanzi, kwaye kukho ukubunjwa kwezinto ezinobumba obuncinane. Inkqubo eyenziwa kwiofisi yegqirha phantsi kwe-anesthesia yendawo. I-NA yaqala ukuphuhliswa eFransi kwiminyaka yee-1970 kwaye yaziswa e-United States nguDkt Charles Eaton waseJupiter, eFlorida.
I-Needle Aponeurotomy
Xa zenziwa ngugqirha oqeqeshiwe kwisigulane esifanelekileyo, i-NA ikhuselekile kwaye isebenza kakuhle. Izinga leengxaki, ezifana ne-tendon okanye ukulimala kwamantongomane, kuncinci kunobungcali bendabuko. Kukho inkcenkcesha exhaphakileyo yincinci eluswini, oluya kuphulukisa ngee-bandages ezilula.
Umlinganiselo weDupuytren wokuphindaphinda emva kokuba i-NA iphakamileyo xa kuthelekiswa nokuhlinzwa okuqhelekileyo. Emva kokuhlinzwa okuvulekileyo, iipesenti ezingama-50 zezigulane ziya kuphinda ziphindwe kwiminyaka emihlanu. Oku kuqhathaniswa nama-50 ekhulwini ngokuphindaphinda emva kweminyaka emithathu nge-NA. Isifo sikaDupuytren siya kubuya ngokunyanga, nje nje emva kwe-NA.
Ngokuqhelekileyo, unyango lwezandla olusemthethweni alufunwa emva kwe-NA. Izigulane zicelwa ukuba zigcine isandla esisebenzayo sinyuka iintsuku ezimbini emva kwenkqubo. Izigulana ziyakwazi ukubuyela kwimisebenzi yokukhanya ngokukhawuleza. Umsebenzi onzima, ezemidlalo okanye izinto zokuzilibazisa azivunyelwe ngeveki enye.
Ngamanye amaxesha, i-splint isenziwa ukuba igqoke ebusuku emva kwe-NA.
Imithombo:
I-Eaton C, Isixhobo soPhatha © 2007.
I-Mahoney JD, uLwazi loNxibelelwano loBuntu, iZiko leMiddle Orthopedic Centre, ludliwano-ndlebe 11/2007.
UMurphy K, "Ukulungiswa kweeNgqumbo eziBanjisiweyo, Akukho buChengechunge obufunekayo" I-New York Times ngoJulayi 24, 2007.