Ukukhubazeka Kwenhlanhla Ngemva Kokulimala
Ukukhubazeka komunwe we-Boutonniere kungumphumela wokulimala kumathenda asebenza ekuqondiseni amalunga eminwe. Ngokuvamile abantu balondoloza lolu hlobo lokulimala phakathi kwezemidlalo noma emsebenzini futhi bacabanga ukuthi bavele 'bagxila' umunwe wabo . Nokho, ngokuhamba kwesikhathi, ukukhubazeka kwe-Boutonniere kungathuthuka, futhi kube yinkinga enomphela. Ngenhlanhla, uma kutholakala ngokushesha, kunezindlela zokwelapha ezingasebenza.
Kwenzakalani
Ukukhubazeka kwe-Boutonniere kwenzeka ngemuva kokulimala okuqondile kumathenda omunwe. Iminwe yakho igoba emuva nangemva ngama- tendon edonsa amathambo. I-flexor tendon isesandleni somunwe, futhi idonsela iminwe phansi - isimemo esibizwa ngokuthi i-finger flexion. I-tendens extensor isemuva komunwe bese isebenza ukuqondisa umunwe - isisindo esibizwa ngokuthi isandiso somunwe. Umunwe ngamunye unomthelela we-extensor yayo, futhi i-tendon ngayinye ehlanganisa i-bone ezindaweni eziningana.
Amathambo amathathu omunwe abizwa ngokuthi i-phalanges (ngayinye ibizwa ngokuthi i-phalanx) futhi ibizwa ngokuya endaweni. I-phalanx ye-distal iyinhloko yomunwe, i-phalanx ephakathi iphakathi kwe-knuckles, futhi i-phalanx ehamba phambili iyisisekelo somunwe. I-tendon extensor ifinyelela kokubili i-phalanx ephakathi ne-phalanx ye-distal. Lapho ukunamathiselwa kwe-phalanx ye-distal kwalimala, kubizwa ngokuthi i- mallet finger .
Uma i-tendon extensor ithenda ye-phalanx ephakathi ilimala, umphumela yi-Boutonniere deformity. I-attachment ethize ye-tendon extensor emkhatsini we-phalanx ophakathi ubizwa ngokuthi i-slip central-ngakho ngokoqobo, ukukhubazeka kwe-Boutonniere kubangelwa ukulimala kwesigcawu esisezingeni eliphakathi.
Okwenza I-Finger ibheke okungalungile
Isikhwama esiphakathi singumkhonkwane obalulekile we-tendon extensor.
Le ngxenye ye-tendon extensor idonsa emaphalanx ophakathi okwenza ukuba ingxenye ephakathi yomunwe iqonde. Lapho isikhala sendawo esilimazayo silimala, i-knuckle yokuqala (ihlangene le-PIP) ayikwazi ukuqondisa ngokugcwele futhi ibheke kancane igobile ngaso sonke isikhathi.
Noma kunjalo, lokho kuyingxenye ye-Boutonniere deformity. Imishini yeminwe yinkimbinkimbi kakhulu, futhi uma ingxenye ethile yomunwe ibonakalisiwe, ezinye izingxenye zomunwe zingase zingasebenzi ngendlela evamile. Endabeni ye-Boutonniere deformity, ngoba ukuhlanganyela kwe-PIP akukwazi ukuqondisa, imigqa engaphandle komunwe ishintshwe esikhundleni sayo. Esikhundleni sokusebenza ukugoba i-knuckle yokugcina (ukujoyina i-DIP) lezi zitshalo ziqala ukudonsa i-knuckle yokugcina eyedlule ngqo (ukuxubusha kwe-hyperextension). Ngakho-ke, ukukhubazeka komunwe we-Boutonniere kufakazela ukuhlanganiswa kwe-PIP, ne-hyperextension yenhlanganisela ye-DIP. Whew!
Kwenzeka Kanjani
Ngokujwayelekile, amandla aphikisayo asetshenziswe ngemuva komunwe ogobile yiyona imbangela ye-Boutonniere deformity. Njengoba kushiwo, lokhu kuvame ukulimala kwezemidlalo noma emsebenzini. Ukulimala okubukhali, okunomthelela okufana nokuchotshozwa , kungabangela nokukhubazeka kweBoutonniere.
Izimpawu ezijwayelekile ze-Boutonniere deformity zifaka:
- Ukubuhlungu ngemuva kwe-phalanx ephakathi komunwe
- Ukuvuvukala ngenhla kwesibhamu esiphezulu
- Ukuhluleka ukuqondisa ukuhlanganiswa kwe-PIP noma ukugoba ukuhlanganiswa kwe-DIP
Ukwelashwa kwe-Boutonniere Deformity
Ukuqaphela kokuqala lokhu kulimala kubalulekile, njengoba ukuqala ukwelashwa ngaphakathi kwenyanga yokulimala kuvame ukuvumela ukwelashwa okungeyona ukuhlinzwa ukuthi kuphumelele. Ukwelashwa kubandakanya ukugoqa ukuhlanganiswa kwe-PIP ngokugcwele ngokuqondile okungenani amasonto amane kuya kwangu-6. Ngokuvamile, ukulimala kanzima okuphathwa ngokugqama kuyonquma futhi kuphulukise ngokuphelele.
Ukulimala okuye kube sekude isikhathi eside kuncane kakhulu okuzokwenza ngcono ngebukhazikhazi, futhi angeke ubuyele esimweni esijwayelekile. Izinketho zokuhlinza ukulungisa i-tendon nokuvuselela i-ligament zingasiza.
Ngaphezu kwalokho, ukuhlinzwa kungase kunconywe ngezimbangela ezithile ezithize ze-Boutonniere deformities kuhlanganise nokulimala okungenayo, i-rheumatoid arthritis, ne-Boutonniere deformities ezenzeka kanye nomunye umonakalo emunwe.
Imithombo:
UBoyer MI noGelberman RH. "Ukulungiswa kokusebenza kwe-swan-neck kanye ne-boutonniere deformities esandleni sesibhedlela" J Am Acad Orthop Surg ngoMashi 1999; 7: 92-100.