I-Hip dysplasia ligama lonyango elisetyenziselwa ukuchaza ingxaki ngokubunjwa kwe-hip kunye nabantwana. Indawo yenkinga ingaba ibhola lomxube we-hip ( intloko ye-wesifazane ), isiseko se-hip joint (i-acetabulum), okanye zombini.
Ngokomlando, oogqirha abaninzi baye babiza ingxaki yokuzalwa kwengqondo ye-dysplasia ye-hip, okanye i-CDH. Ngoku kutshanje, isigama esivumelekileyo siphuculi-dysplasia yentuthuko ye-hip okanye iDDH.
Izizathu ze-Hip Dysplasia
Isizathu esicacileyo se-hip dysplasia akulula ukuyifaka, njengoko kukho iingcamango ezininzi ezibangela ukuphuhlisa le meko. I-dysplasia ye-Hip iyenzeka malunga ne-0.4% yazo zonke izibeleko kwaye ixhaphake kakhulu kwiintombi zokuzalwa. Ezinye izinto eziziwayo zengozi yokuba umntwana abe ne-hip dysplasia zibandakanya:
- Abantwana abanembali yentsapho ye-hip dysplasia
- Iintsana ezizalwe ngesibhakabhaka
- Iintsana ezizalwe nezinye "iingxaki zokupakisha"
- U-Oligohydramnios (ukungabikho kwe-intrauterine fluid)
"Iingxaki zokupakisha" yimiqathango ebangela inxalenye esuka kwi-in-utero isikhundla somntwana; umzekelo, i- clubfoot kunye ne-torticollis. I-Hip dysplasia edlala kakhulu kubantwana bokuqala, ixhaphake kakhulu kubafazi (80%) kwaye ibonakala ngokuqhelekileyo kwicala lasekhohlo (i-60% ishiya i-hip kuphela, i-20% zombini isisindo, i-20% i-hip efanelekileyo kuphela)
Ukuxilongwa kwe-Hip Dysplasia
Ukuxilongwa kwe-hip dysplasia kwintsana kusekelwe ekufunyanweni kweemviwo.
Ugqirha wakho uya kuziva " ngecala lokuqhafaza " xa wenza ulungelelaniso olukhethekileyo lwe-hip joint. Ezi ndlela, ezibizwa ngokuba yi-Barlow no-Ortolani, ziza kwenza i-hip engekho indawo ukuba "nqakraza" njengoko ihamba kwaye iphuma kwindawo efanelekileyo.
Ukuba iqhosha le-hip livalelwa, ugqirha wakho uya kufumana i-hip ultrasound ukuvavanya ukuhlanganiswa kwe-hip.
I-x-ray ayibonisi amathambo kwintsana encinci de ubuncinane kwiinyanga ezili-6 ubudala, ngoko ke i-hip ultrasound ithandwa. I-hip ultrasound iya kubonisa ugqirha isikhundla kunye nokuma kwendibano ye-hip. Esikhundleni somxhelo oqhelekileyo webhola-in-socket, i-ultrasound ingabonisa ibhola ngaphandle kwesikhokelo, kunye nesiseko esingafanelekanga (esingenalutho). I-ultrasound ye-hip ingasetyenziselwa ukuchonga ukuba unyango lusebenza njani.
Unyango lwe-Hip Dysplasia
Ukunyangwa kwe-hip dysplasia kuxhomekeke kwiminyaka yomntwana. Injongo yonyango ukubeka ngokufanelekileyo umxube we-hip ("ukunciphisa" umlenze). Xa kuthotywe ukuncitshiswa okwaneleyo, ugqirha uya kubamba iqhosha elithile kwisithuba esincinci kwaye avumele umzimba ukuba uhambelane nesimo esitsha. Umncinci umntwana, amandla angcono ukulungelelanisa umlenze, kunye nethuba elingcono lokubuyisela ngokupheleleyo. Ngethuba lexesha, umzimba uhlala ungaphantsi ukuhlaziywa kwe-joint hip. Ngoxa unyango lwe-hip dysplasia luhluka kumntwana ngamnye, umhlathi olandelayo ulandela:
- Ukuzalwa ukuya kwiinyanga ezili-6
Ngokuqhelekileyo, kwiintsana ezisanda kuzalwa, i-hip dysplasia iya kunciphisa kunye nokusetyenziswa kwe-brace ekhethekileyo ebizwa ngokuba yi- Pavlik harness . Esi sikhonkwane senza iinqabana zentsana kwindawo egcina isondlo sinciphile. Ngokuhamba kwexesha, umzimba uhambelana nesimo esilungileyo, kwaye iqhagamshelo le-hip liqala ukwakheka ngokuqhelekileyo. Phantse i-90% yabantwana abatsha kunye ne-hip dysplasia ephathwe kwi-harlik i-Pavlik iya kuphulukana ngokupheleleyo. Oogqirha abaninzi abayi kuqalisa unyango lwe-Pavlik unyango kwiiveki ezimbalwa emva kokuzalwa.
- 6 inyanga ukuya ku-1 unyaka
Kwiintsana ezindala, unyango lwe-Pavlik lonyango alukwazi ukuphumelela. Kule meko, ugqirha wakho wamazinyo uza kufaka umntwana phantsi kwe-anesthesia jikelele. Oku kuvame ukuvumela ukuba i-hip ithathe isikhundla esifanelekileyo. Ngesinye sezi ndawo, umntwana uya kufakwa kwi- spica cast . Ukuphosa kufana neharki yePavlik kodwa ivumela ukunyakaza okungaphantsi. Oku kuyadingeka kubantwana abadala ukuba bagcine kakuhle indawo yokubambisana kwe-hip. - Ngaphezulu kweminyaka engama-1
Abantwana abadala kunomnye oneminyaka elilodwa badinga ukuhlinzwa ukuze banciphise ukudibanisa i-hip kwindawo efanelekileyo. Umzimba unokwenza iisitiki ezibomvu ezithintela umlenze ukuba uthathe isikhundla sakhe esifanelekileyo, kwaye utyando luyadingeka ukubeka ngokufanelekileyo umxube we-hip. Emva kokuba oko kwenziwa, umntwana uya kuba ne- spica cast ukuze abambe iqhosha kwindawo efanelekileyo.
Impumelelo yonyango incike kwiminyaka yomntwana kunye nokwanela kokunciphisa. Kwiintsana ezisandul 'ukuzalwa ezinokunciphisa okuhle, kukho ithuba elihle lokufumana ngokutsha. Xa unyango luqala ngexesha elidala, ithuba lokuhlaziya ngokupheleleyo liyehla. Abantwana abanomdla we-hip dysplasia banethuba lokuhlakulela intlungu kunye nesifo se-arthritis esifutshane ebomini. Ugqirha ukusika kunye nokuguqula amathambo (i- hip osteotomy ), okanye ukutshintshwa kwe-hip , kunokufunwa kamva ebomini.
Imithombo:
UGuille JT, uPizzutillo PD, MacEwen GD "iDysplasia yophuhliso ye-Hip ukusuka ekuzalweni ukuya kwiinyanga ezithandathu" J. Am. Acad. IOrn. Ugqirha., UJulayi / Agasti 2000; 8: 232 - 242.
I-Vitale MG kunye ne-Skaggs DL "I-Dysplasia yophuhliso ye-Hip ukusuka kwiinyanga ezi-6 ukuya kwiminyaka emine yobudala" J. Am. Acad. IOrn. Ugqirha, Novemba / Disemba 2001; 9: 401 - 411.