Isizathu Esiqhelekileyo Abantu Bahlakulela Ukukhubazeka Kwe-Flatfoot
I-posterior tibial tysonction ingxaki yinto eyenzeka kwenye yeetoni kwihlangothi langaphakathi le-ankle.
Ukuhlaziywa kwe-anatomy yakho kukunceda ekuqondeni indlela oku kwenzeka ngayo. Umsi womzimba ongaphantsi we-tibial uhambela emva kweso s bone; i-posterior tibial tonon idibanisa le miscle ibe namathambo enyawo. Iyadlula emlenzeni womlenze, kungekude ne-tendon ye-Achille, iphinde iphinde iphinde iphinde ibukeke phantsi kwebala eliphakathi kwe-ankle.
Emva koko idibanisa ithambo lesigxina sangaphakathi lonyawo, kufuphi nendawo yeenyawo.
Iingxaki ze-tendon tibial zangaphantsi zivame ukuqhubela ngaphantsi kobukhulu be-side side ye-ankle, ebizwa ngokuba yi -malleolus . I-malleolus engumlambo iyisiphelo sesifuba se-shin (i-tibia) kunye ne-tendon-tibial tendon i-post-tibial yangena ngaphantsi kwe-malleolus ephakathi. Le ndawo yethoni ixhomeke ngakumbi ekuphuhliseni iingxaki kuba ingenayo igalelo legazi elinamandla lokutya nokulungisa i-tendon.
Le nxalenye yesithoni ikhona " kwindawo yamanzi ," apho igazi linikezele khona. Ngoko ke, xa ithenda ityala, ngenxa yexinzelelo okanye utywala , umzimba unzima ukuhambisa izondlo ezifanelekileyo zokuphilisa.
Ikhonkco kunye neAAFD
Xa ushiywe ungakhange ulandelwe, i-tendonitis yangaphantsi kwe-tibial inganciphisa inkqubela ekuthiwa ngumntu omdala ofumene i-flatfoot deformity (AAFD). Lo mqathango uqala ngokubandezeleka kunye nobuthathaka be-tendon tilal posterior, kodwa njengoko imeko iyaqhubeka, iigaments of foot zichaphazeleka kwaye amanxeba ezinyawo angakwazi ukunyanzelisa kwaye aphethwe kakubi.
Ngenxa yesi sizathu, uninzi lwamagqirha ukhetha unyango lokuqala ngaphambi kwee-AAFD.
Iimpawu zoThional Tendonitis
Ngokuqhelekileyo, izigulane ezine-tendonitis ezingapheliyo zikhalaza iintlungu eziphakathi kweenyawo kunye neenyawo kwaye ngezihlandlo ziba neengxaki ezinxulumene nentambo engazinziyo.
Izigulane ezininzi zibika ukuba zineengxube zamathambo ezandula , nangona ezinye ziza kuba zingekho ukulimala kwangoku.
Njengoko i-posterior tibial tendonitis iqhubekela phambili, umxhesho weenyawo unokuthi unqabile kwaye iinzwane ziqala ukukhomba ngaphandle. Esi sisiphumo sesithintelo esingasemva kwesithintelo singenzi umsebenzi walo ukuxhasa umgca wonyawo.
Ukuxilongwa kwe-tendonitis engaphantsi kwe-tibial ngokuqhelekileyo kwenziwa ngokuhlolwa komzimba. Izigulane zinobubele kunye nokuvuvukala kwikhosi ye-tendon post. Ngokuqhelekileyo, banobuthakathaka ukuguqula inyawo (ukukhomba iinzwane zangaphakathi). Kwakhona eziqhelekileyo kwizigulane ezine-tendonitis ezingaphaya kwe-tibial ukungakwazi ukuma ezinzwaneni zabo kwicala elichaphazelekayo.
Xa uviwo lungabonakali, okanye ukuba isigulane sicinga ukuhlinzwa, i-MRI ingatholakala. I-MRI yindlela ephumelelayo yokufumanisa ukuphuka kwethenda, kwaye ingabonakalisa utshintsho oluvuthayo olujikeleze i-tendon.
Izigaba ze-Posterior Tibial Tendonitis
I-posterior tibal tacal insufficiency ingabalwa ngokwemigangatho yesimo. Uluhlu luvela kwinqanaba 1 ukuya kwisigaba 4 ngokunyuka kokunyuka kweenyawo njengoko imeko iyaqhubeka.
- Isigaba se-1: Isigaba sokuqala sokuphelelwa kwesithintelo esingapheliyo sesithintelo sineentlungu kunye nokuvuvukala kwi-tendon. Unyawo lunokubonakala luqhelekileyo, okanye abantu banokubona isinyawo sabo sinokukhubazeka okulula, mhlawumbi into abavakalelwa ngayo.
- Isigaba sesi-2: Njengoko imeko iqhubekela phambili, umxhesho wonyawo uqala ukuwa. Ngoxa i-arch of foot ingalungiswa, xa abantu bemi unyawo lubonakala luhlala lucala ngapha nangapha.
- Isigaba sesi-3: Kanye ukuya kwisigaba 3 semeko, unyawo alukwazi ukulungiswa lula, imeko ebizwa ngokuba yi-flatfoot deformity.
- Isigaba sesi-4: Kanye kwisigaba se-4, kungekhona nje inyawo elithintekayo, kodwa iqhagamshelo le-ankle elikufutshane nalo libandakanyeka kwimeko.
Njengoko ezi zigaba ziqhubeka, unyango ukulungisa ingxaki luba lukhulu. Nangona unyango olungasetyenziswa ngonyango lungasetyenziselwa nawaphi na umgangatho, amathuba okuphumelela kunye nokunyanga okungaphantsi kwamanyango angancipha njengoko imeko iyaqhubeka.
Unyango lwe-Tieral Tibial Tendonitis
Unyango lokuqala lothando lwe-tibial tendonitis xa lujolise ekuphumleni kwethenda ukuvumela ukuphilisa. Ngelishwa, ukuhamba ngokuqhelekileyo kunokungavumeli ngokwaneleyo ukuba ithenda ithole ngokufanelekileyo. Kule meko, i-ankle kufuneka ikhutshwe ukuze ivumele ukuphumla okwaneleyo. Izinketho zokufumana unyango lokuqala ziquka:
- Ukufakwa kwezicathulo kunye neengqungquthela
- Ukuhamba ngeebhuthi
- ICapets
Ngokubonelela ngesigxina esinyanzele inyawo, ukufaka isicathulo nokuhamba ngeebhuthi kuthintela ukunyakaza phakathi kwe-midfoot kunye ne-hindfoot. Ukukhusela le ntshukumo kufuneka kunciphise ukuvuvukala okunxulumene ne-tendonitis yangemva kwe-tibial. Iipasti zilukhuni, kodwa mhlawumbi yindlela ekhuselekileyo yokuqinisekisa ukuba ithenda ye-posterior tibial ephumayo iyanelisekile ngokwaneleyo.
Olunye unyango oluqhelekileyo lwe-tendonitis yangaphambili lwe-posterior tibial luquka imishanguzo yokuchasana nokuguqulwa komsebenzi. Zomibini zonyango ziyakunceda ukulawula ukuvuvukala kwi-tendon ye-posterior tibial.
Izinketho zokuphanda
Unyango olusandululweyo lwe-posterior tibial tendinitis luphikisana kwaye luyahlukahluka kuxhomekeka kubukhulu bomqathango. Kwimigangatho yokuqala ye-tendonitis yangemva kwe-tibial, abanye oogqirha banokucebisa inkqubo yokucoca ukuvuvukala okubizwa ngokuba yi- debridement . Ngethuba lexesha elidityanisiweyo, izicubu ezivuthayo kunye neetoni ezingavumelekanga zisuswe ukuza kunceda ukuphulukiswa kwethenda enonakele.
Kwinqanaba eliphambili le-tendonitis yangasemva kwe-tibial umxhesho weenyawo uye wawa kunye ne-tendon ye-tendon elula ayinakho ukulungisa ingxaki. Ukulungiswa kwakhona kwetoni ye-posterior tibial ngezinye iinkqubo kwenziwa.
Kwiinkqubo zokuvuselela, i-tendon esondelene nayo, ebizwa ngokuthi i-flexor digitorum longus, ishukunyiswa ukuba ithathe indawo ye-tendon ethintekayo. Le nkqubo ihlala idibaniswa kunye nokwakhiwa kwethambo kwakhona. Ekugqibeleni, kwiimeko eziphambili kwi-tendonitis yangemva kwe-tibial, xa i-foot of foot isingqineki, inkqubo ye- fusion yonyango olukhethiweyo.
ILizwi
I-posterior tbial tysonction, kwaye umntu omdala ufumene ukubola kwe-flatfoot, kunokukhathaza iingxaki. Ngokuqhelekileyo, abantu baziva ukuba iimpawu zabo zinyanzeliswa ngugqirha onokuthi angaboni kakhulu indlela yokukhubazeka, kodwa abantu baziva bexhatshazwa kunye nokungazinzi kwesikhumba.
Ngesinye sezigaba zonyango, unyango lunokungena kunye nokukhawulela ngokwemisebenzi yonyawo. Ngenxa yezi zizathu, iinzame zokuqala zonyango ezingabonakaliyo, eziquka izicathulo zokuguqulwa kunye nemisebenzi yokwelapha, ziindlela ezikhethwa kakhulu ukulawula iimpawu zeso simo.
> Umthombo:
> Deland JT. Ukukhubazeka kwe-flatfoot yabantu abadala. J Am Acad Orthop Surgery. 2008 Julayi; 16 (7): 399-406.