Abesifazane Abathintekayo Kakhulu Kunamadoda
Kunezimbangela eziningi zokuhlunguphazwa kwezinyawo, kepha uma ubhekene nobuhlungu obuhlabayo obuhlabayo obuzwa kangcono uma uyeka ukuhamba nokusikhipha unyawo lwakho, kungenzeka ukuthi uyaziwa ngokuthi i-neuroma ka-Morton. Ngenkathi inegama elizwakalayo elizwakalayo, lesi simo sinobungozi futhi ngenhlanhla siyaphathwa kahle.
Ngokwemigomo eyisisekelo, i-neuroma iyandiso noma ukuqina kwezinzwa ezinyaweni endaweni ephakathi kwezinzwani, ngokuvamile okwesithathu ngaphakathi phakathi kweyesithathu neyesine izinzwane, ezilandelwa yi-second space ngaphakathi kweyesibili noyesithathu.
I-neuromas ka-Morton ayinakuphazamiseka ngokungajwayelekile ezingxenyeni ezine zezine.
Kanti futhi ngezinye izikhathi kuthiwa i-neuroma ye-intermetatarsal, i- neuroma engaphakathi , i-metatarsalgia yakwa-Morton (ubuhlungu endaweni ye-metatarsal), i-perineural fibrosis (izicubu ezibomvu ezungeze isisindo) noma i-neuropathy ye-entrapment (inzwa engavamile ngenxa yokucindezela).
Uma une-neuroma ka-Morton, kunezithuba ezingu-15% ozothola kuzo zombili izinyawo. I-neuromas ka-Morton yenzeke kakhulu kubantu besifazane abaneminyaka engama-30 kuya kwengu-50 ubudala, ngokuvamile ngenxa yezicathulo ezifanelekayo .
Izimbangela
I-neuroma ka-Morton kucatshangwa ukuthi ibangelwa ukulimala komzimba, kodwa ososayensi abakasaqiniseki ngokuqondene nesizathu esiqondile sokulimala. Ukulimala kungabangelwa ukulimala kwamakhanda e-metatarsal, i-ligament ejulile ye-intermetatarsal (ibamba amakhanda we-metatarsal ndawonye) noma i-bursa ye-intermetatarsal (isaka eligcwele amanzi). Zonke lezi zakhiwo zingabangela ukucindezela nokulimala emndenini, kuqala ukudala ukuvuvukala nokulimaza inzwa.
Ngokuhamba kwesikhathi, uma ukucindezela / ukulimala kuqhubeka, le nerve iyazilungisa ngezicubu ezinamafutha kakhulu okuholela ekwandiseni nasekukhuleni kwesibindi.
Ezinye izimbangela zokulimala emndenini zingabandakanya ukumane ube nesitayela sokuhamba esingalungile noma isakhiwo sezinyawo esingathandeki, njengokwenqatshwa kweminyango (ezinyaweni zokungena ngaphakathi), ukungahambi kahle (ukunyakaza okukhulu), i-cavo varus ( inyawo eliphakeme kakhulu) ne-dorsiflexion ngokweqile (izinyosi zezinyosi phezulu) kwezinzwane.
Lezi zinhlobo ze-biomechanical (indlela inyawo elihamba ngayo) izimbangela zingase zidale ukulimala kwenzalo ngesinyathelo ngasinye. Uma le nerve icasuliwe futhi ikhuliswe, ke kuthatha isikhala esiningi futhi iyancipha ngisho nokucindezeleka. Kuba umjikelezo ononya.
Izimpawu
Ekuqaleni, lezi zimpawu zingase zenzeke ngesikhathi esisodwa, kodwa njengoba isimo siba sibi kakhulu, izimpawu zingase zenzeke sonke isikhathi. Ngokuvamile uzizwa kangcono ngokukhipha isicathulo sakho futhi uhlakulele unyawo lwakho .
- Ubuhlungu (obukhali, ukugwaza, ukubhoboza, ukudubula)
- Ubumbulu
- Ukulinganisa noma "izikhonkwane & izinaliti"
- Ukuvutha
- Ukugubha
- Ukuzwa ukuthi uhamba okuthile noma ukuthi kukhona okusesiswini sakho
Ukuxilongwa
Umsizi wakho wezinyawo (udokotela onyawo) uzobuza imibuzo eminingi mayelana nezibonakaliso zakho nezimpawu zakho futhi uzokwenza ukuhlola ngokomzimba. Ezinye zezivivinyo zingabandakanya ukuhlola ukucindezela isikhala sewebhu. Lokhu kwenziwa ngokucindezela i-metatarsals (amathambo nje ngezansi kwezwanezwane) kanye nesandla esisodwa bese usebenzisa isithupha nesigqebhezana somunwe ngakolunye uhlangothi ukucindezela indawo ethintekile ukuzala ubuhlungu / izimpawu. Ukuchofoza okunamathelayo (ukuchofoza kuka-Mulder) kuvame ukukhona. Lokhu kuhlolwa kungabangela ubuhlungu ukudubula ezinzwaneni futhi okuthiwa uphawu lukaTinel. Ukuhlolwa kukaGauthier kuhilela ukucindezela imitha yokuhlangana kanye nokuyihambisa phezulu naphansi imizuzwana engu-30.
Lokhu kuzovame ukubangela ubuhlungu noma kuzoletha ezinye izimpawu zakho. Isibonakaliso sikaSullivan siphumelele uma uma futhi izinzwane ezithintekile zisakaze eceleni.
I-neuroma ka-Morton ivame ukutholakala ngokusekelwe emlandweni kanye nokuhlola okubonakalayo ngokomzimba, kodwa ngezinye izikhathi ezinye izivivinyo ezifana ne-x ray, i-ultrasound noma i-MRI ziyadingeka.
Ukwelapha
- Gqoka izicathulo ezibanzi futhi ezijulile ebhokisini lezinzwane ukuze zingabeki ukucindezela ezinzwaneni zakho kanye nemetatarsal. Gwema ukugqoka izithende eziphakeme ngoba zibangela ukucindezela okwandayo kwibhola lonyawo lwakho (forefoot).
- Amapayipi e-Metatarsal: Lezi zindlela zokuphakamisa nokuhlukanisa amakhanda e-metatarsal ukuze athathe ingcindezi yezinzwa. Zibekwa ngemuva lapho uzizwa ubuhlungu, hhayi phezulu kwendawo ebuhlungu.
- Ukuguqulwa komsebenzi: Isibonelo, ungase uzame ukubhukuda esikhundleni sokusebenza kuze kube yilapho izimpawu zakho ziphela.
- Ukuthayipha nge-tape yezemidlalo
- Icing
- Ama-NSAID (imithi elwa nokuvuvukala): Aleve, ibuprofen, njll.
- I-Arch isekela noma izintambo: Lezi zindlela zokulawula ezinye zokuhamba okungavamile ezinyaweni zakho. Ukuhamba okungavamile kungaholela ekwenzeni i-torque eyengeziwe kanye nengcindezi ku-nerve.
- Ukwelapha ngokomzimba
- Umjovo we-Cortisone: Usiza ukunciphisa usayizi wezinzwa ezicasuliwe, ezikhulisiwe.
- Injola yokujozwa: Usiza ukubhubhisa imithi yamakhemikhali.
- Ukuhlinzwa: Uma ukwelashwa okulondolozayo kungasiza ekuhlinzekeni kungadingeka. Ukuhlinzwa kungase kubandakanye ukukhipha inzwa noma ukusika i-ligam intermetatarsal. Izifundo zibonise ukuthi ukuhlinzwa kunesilinganiso sokuphumelela sama-80-85%.
Ukuvimbela
- Gwema ukugqoka izicathulo ezincane ezikhonjiwe
- Gwema ukugqoka izicathulo ezithendeni
Imithombo:
> Hughes RJ, Ali K, Jones H, Kendall S, Connell DA. Ukwelashwa kwe-Morton's neuroma nge-injection injection ngaphansi kwesiqondiso somlando: ukulandelwa kwamacala angu-101. I-AJR Am J Roentgenol . 2007 Jun; 188 (6): 1535-9.
> Kim JY, Choi JH, Park J, Wang J, Lee. Ukufundwa kwe-anatomical nge-neuroma ye-Morton's interdigital: ubuhlobo phakathi kwesayithi evele kanye nomgudu we-metatarsal ojulile (DTML). I-Foot Ankle Int . 2007 Sep; 28 (9): 1007-10.
> Morscher E, Ulrich J, ne-neuroma ye-intermetatarsal kaDick W. Morton: i-morphology kanye ne- histological > substrate. I-Foot Ankle Int . 2000 Jul; 21 (7): 558-62.
> UMoena JD, uClafford JT. Ukusebenza kwe-chemical neurolysis ekwelapheni ukucindezeleka kwamanqina omzimba we-interdigital: ukutadisha okuphindaphindiwe. J Am Podiatr Med Assoc . 2007 Meyi-Jun; 97 (3): 203-6.
> U-Spina R, uCameron M, u-Alexander R. Umphumela wokusebenza okuthakazelisayo okuthinta i-neuroma ka-Morton. Ama-Australas Chiropr Osteopathy . 2002 Jul; 10 (1): 45-50.
> Wu KK. I-neuroma ye-Morton ye-interdigital: ukubuyekezwa komtholampilo we-etiology yayo, ukwelashwa, nemiphumela. J Foot Ankle Surg . 1996 Mar-Apr; 35 (2): 112-9; ingxoxo 187-8.