Ukunyuka kwe-Ulnar, okubhekiswa kuthiwa ukuphambukiswa kwe-ulnar, kukukhubazeka kweminwe yesandla . Ngokukodwa, ukuqhuma kwe-ulnar kwenzeka xa kukho ukuphambuka kwe-ulnar kunye ne-volar subluxation yamalungu e-metacarpophalangeal (MCP). I-anatomically, i-phalanges ehamba phambili idibanisa ne-metacarpals yesandla kumalungu e-metacarpophalangeal. Amalungu e-MCP aqhelekileyo ngokubhekiselwe kuwo njengama-knuckles.
I-volar subluxation yombutho we-metacarpophalangeal ukhula xa kukho ukuhluthwa ngokukodwa kwe-joint - ukuhamba kweephalanx ukusuka kwintloko ye-metacarpal, ehamba kwisikhokelo sesundu. Iphakathi kunye ne-distal phalanges landela ukunyakaza kokuhamba kwephalanx.
Ngokutsho kweKley's Bookbook yeRheumatology , kukho ubungqina bokuba isifo se-rheumatic yesandla sikhokelela ekugqibeleni kokungahambi kwamalungu e-MCP. Kucingelwa ukuba ukunyanzeliswa kwe-carpi ulnaris muscle kubangelwa ukuphambuka kwendonga yesandla njengamathambo e-carpal ukujikeleza (amathambo e-carpal ahamba phambili ajikeleza kwi-ulnar direction and distal bones in the directional radial). Ukuphambukiswa kwe-Ulnar kukhula njengempendulo yomzimba, ukuzama ukugcina iithoni kwiiphalanges ngokuhambelana nomda. Ukuchithwa kwethambo okanye i-articular cartilage inokubangela ukuba i-ulnar ibhubhe, kodwa nayo ingenzeka ngaphandle. I-Synovitis kunye nobuthakathaka be-muscle inokudlala indima ekuphuhliseni kwayo.
Impawu zokuqala ze-ulnar drift ziquka:
- Ubuthathaka bokuqala kwe-interossei (i-interossei iyimisipha phakathi kwamathambo athile)
- ukukhwabanisa kweemitha zomda
- ukuqiniswa kwemisipha yangaphakathi
- ukufuduka kwe-tnar ye-flexor tendons (evelele kwi-index kunye neminwe ende)
- Ukuphambukiswa kweminwe ebonakalayo xa kuhlanganiswa amanxeba e-MCP
Izimpawu eziphambili ze-ulnar drift ziquka:
- i-volar subluxation (ukutshatyalaliswa okuyingxenye) ye-phalanges
- ukungakwazi ukuvelisa ngokupheleleyo i-MCP izihlanganisi ezibangelwa ukuvumelanisa ukuhamba
- slip okanye i-tendnar tensar
- ukuqiniswa kwezihlunu ze-hypothenar (iqela lezihlunu ezintathu entendeni yesandla esilawula ukunyakaza komnwe omncinci)
- ukuphambuka kwe-radial
- i-carpi ulnaris ithenda ye-tendon
- ukulahleka kwikhono lokuchasa umtsalane womnwe
Ukuhlola ubunzima be-ulnar drift, i- goniometer ingasetyenziswa. Ingalo eyimimandla ye-goniometer ifakwa phezu kwe-metacarpal ngelixa ingalo ehambayo ifakwa ngokuhambelana ne-phalange ehamba phambili. Emva kokuba iqondo lokukhubazeka ligqitywe, isiguli sivame ukucelwa ukuba siqondise isandla sabo, ukuba kunokwenzeka, ukulungisa ngokufanelekileyo ukulungelelaniswa kunye nokulinganiswa kwakhona. Ezinye iimvavanyo zomsebenzi wesandla zingasetyenziselwa ukuhlola ubunzima bokubola.
Ngubani Ophuhlisa Ulnar Drift?
Ukunyuka kwe-Ulnar kubandakanyeka ngokukodwa kwi- rheumatoid arthritis . Ukunyanyeka okungapheliyo kwamalungu e-MCP kulimaza i-capsule kunye kunye nezakhiwo ezungeleleyo. Kodwa, i-rheumatoid arthritis ayilona yodwa imeko ehambelana ne-ulnar drift. Kungenzeka nakwezinye iziganeko ezivuthayo okanye izifo zesisombululo, ezifana ne- lupus okanye i- psoriatic arthritis .
Olunye uphando lwezifundo lubonakalise ukudibanisa nesifo esingavamile, i-pigmented villonodular synovitis (PVNS).
Izinyango Zonyango
Izinketho zokuphatha ukuvuvukala kweentlungu kunye nentlungu kubandakanya iqhwa, ubushushu obumanzi, iibhafini ze-wax, i- TENS unit kunye ne-ultrasound. Ukusebenzisa izandla, oko kubandakanywa ngokulula, kunconywa ukuba kugcinwe uluhlu lwesincomo kangangoko kunokwenzeka.
Ngamanye amaxesha ukucetyiswa kunconywa ukunciphisa ukudluliswa kwesandla, ukubeka ngokufanelekileyo izihlanganisi ze-MCP ekuhambeni kwe-radial-ulnar ngokungathathi hlangothi, kunye nokunciphisa ukudibanisa kwamalungu angama-MCP ngokuxhasa ama-phalanges angaphantsi. Ngokuqhelekileyo, iziqwenga zigugu ebusuku okanye ngexesha lokuphumla emini.
Iziplintshi zinokukunceda ngeentlungu ebusuku kodwa ukugqithiswa akuzange kuboniswe ukukhusela ukuphazamiseka kwe-ulnar. Ngaphandle kwenkqantosi yobusuku, ukuphambuka kwe-ulnar kungaqhubela phambili.
> Imithombo:
> Kelley's Bookbook yeRheumatology. I-ninth edition. Firestein et al. Elsevier Saunders. Iimpawu zeCliniki ze-Rheumatoid Arthritis. Isahluko 70. Izandla kunye nezixhobo. Page 1112.
> I-Volar Subluxation ye-Metacarpophalangeal Joint.
> Ukusebenza ngokugqibeleleyo kwiNcomelo zoLawulo lwe-Ulnar Drift Deformity kwi-Rheumatoid Arthritis. KwiWancouver Coastal Health. I-Arthritis Society (Canada).
> Ukusetyenziswa kweeNtsalela zokuPhumla kweNtshonalanga kwiNyango ye-Ulnar Ukuphambuka kwesandla seRumatoid. Johnson M et al. Rheumatology Clinic. Matshi 1992.
> Ulnar Ukuphambuka akusoloko iRumatoid . Zuber M et al. Iziganeko zeeRheumatic Diseases. 1996.