Isizathu Esivamile Kunazo Zonke Abantu Bakha Ukukhubazeka Kwe-Flatfoot
Ukungasebenzi komthambo we-posterior tibial kuyinkinga eyenzeka kwenye yezintambo ezingxenyeni zangaphakathi ze-ankle.
Ukubuyekezwa kwe-anatomy yakho kuyasiza ekuqondeni ukuthi lokhu kwenzeka kanjani. Umswakama we- posterior tibial uhambela ngemuva kwethambo le-shin; i-posterior tibial tonon ixhuma le misipha kuya emathanjeni enyawo. Liwela phansi emlenzeni, hhayi kude ne-tendon Achille, bese liphenduka ngaphansi kobubanzi bezingxenyeni zangaphakathi.
I-ke ifaka emathanjeni ohlangothini lwangaphakathi lonyawo, eduze nomdwebo wonyawo.
Izinkinga ze-tendon tacal posterior zivame ukuvela nje ngaphansi kokubonakala kohlangothi lwangaphakathi lwe-ankle, okuthiwa i -malleolus engaphakathi . I-malleolus engokwemvelo iwukuphela kwethambo le-shin (i-tibia) kanye nesithoni se-posterior tibial ehamba ngaphansi nje kwe-malleolus engaphakathi. Le ndawo ye-tendon ijwayele ukuthuthukisa izinkinga ngenxa yokuthi ayinayo igazi elinamandla lokunakekela nokulungisa le tendon.
Le ngxenye yethenthoni ikhona " endaweni engaphansi komhlaba ," lapho igazi libuthakathaka khona. Ngakho-ke, lapho ithenda ilimala, ngenxa yokulimala noma ukuphuza ngokweqile , umzimba unenkinga yokuletha izakhi ezifanele zokuphulukiswa.
I-Link ne-AAFD
Uma kushiywe kungalashwa, i-tendonitis yangemva kwe-tibial yangasese ingancipha kancane kancane enkingeni ebizwa ngokuthi umuntu omdala othole i-flatfoot deformity (AAFD). Lesi simo ngokuvamile siqala ngobuhlungu nobuthakathaka besithoni se-posterior tibial, kodwa njengoba isimo sithuthuka, imigqa yonyawo iyathinteka futhi amalunga ezinyawo angakwazi ukugonywa futhi aguquke ngokuqinile.
Ngenxa yalesi sizathu, odokotela abaningi bakhetha ukwelashwa kokuqala ngaphambi kwezigaba ze-AAFD.
Izimpawu ze-Tibial Tendonitis ephansi
Ngokuvamile, iziguli ezine-tendonitis e-posterior tibial zikhononda ubuhlungu ezinyaweni nasezinyaweni futhi ngezikhathi ezithile zinenkinga ehambisana nokungahlali kahle.
Iziguli eziningi zibika ukuthi zinezinyosi zamuva, nakuba abanye bengenalo ukulimala kwamuva.
Njengoba i-tenderioritis posterior tibial iqhubekela phambili, ugobe lwenyawo lungahlelwa phansi futhi izinzwane ziqale ukukhomba ngaphandle. Lona umphumela wethenda le-posterior tibial engenzi umsebenzi wayo ukusekela umcintiswano wonyawo.
Ukuhlolisiswa kwe-tendonitis yangemva kwe-tibial ngokuvamile kuvame ukuhlolwa ngokomzimba. Iziguli zinomusa futhi zivuvukala phakathi nenkathi ye-tenderior tibial tendon. Ngokuvamile, banobuthakathaka bokuguqula izinyawo zabo (kubonisa izinzwane zangaphakathi). Okunye okuvamile ezigulini ezine-tendonitis e-posterior tibial ukuhluleka ukuma ezinzwaneni zabo ohlangothini oluthintekile.
Uma ukuhlolwa kungacacile, noma uma isiguli sicubungula ukuhlinzwa, i-MRI ingatholakala. I-MRI iyindlela ephumelelayo yokuthola ukuhlukumeza kwethenda, futhi ingabonisa nezinguquko zokuvuvukala ezungeze ithoni.
Izigaba ze-Tieral Tibial Tendonitis
Ukungafinyeleleki kwethenthini engaphansi kwe-tibial kungenziwa ngezigaba ngokwesimo sesimo. Ukuhlelwa kuvela esiteji 1 kuya kwesigaba 4 ngokukhuphuka kwenyawo njengoba isimo siqhubeka.
- Isigaba sokuqala: Isigaba sokuqala sokungasebenzi kahle kwe-tenderior tibial isifo futhi ukuvuvukala eceleni kwethenda. Unyawo lungase luvele luvame ngokuphelele, noma abantu bangabona ukuthi unyawo lwabo lunokukhubazeka okuncane, mhlawumbe into abathi bazizwa beyiyo njalo.
- Isigaba sesi-2: Njengoba isimo sithuthuka, umgodi wonyawo uqala ukuwa. Ngenkathi ugobe lonyawo lungalungiswa, lapho abantu bemi unyawo lubonakala luhlala phansi eceleni.
- Isiteji sesi-3: Ngesinye isikhathi esesiteji sesi-3 salesi simo, unyawo alukwazi ukulungiswa kalula, isimo esibizwa ngokuthi i-flatfoot enzima yokukhubazeka.
- Isiteji sesi-4: Ngesinye isikhathi esiteji sesine, akukhona nje ukuthi unyawo luhilelekile, kodwa ukuhlanganiswa kwe-ankle eseduze nakho kuhileleka esimweni.
Njengoba lezi zigaba zithuthuka, ukwelashwa ukulungisa inkinga kuba yinto engavamile. Ngenkathi ukwelashwa okungenasidakamizwa kungasetshenziswa kunoma yisiphi isigaba, amathuba okuphumelela anezokwelapha ezingenasidingo angancipha njengoba isimo siqhubeka.
Ukuphathwa Kwe-Tibial Tendonitis Ephansi
Ukwelashwa kokuqala kwe-posterior tibial tendonitis uma kugxile ekuphumuleni isithoni sokuvumela ukuphulukiswa. Ngeshwa, ngisho nokuhamba okuvamile kungase kungavumeli ngokwanele ukuba ithenda liphumule ngokwanele. Kulezi zimo, i-ankle kumele ingabi namandla ukuze ivumele ukuphumula okwanele. Okukhethwa kukho ukwelashwa kokuqala kufaka:
- Ukufakwa kwezicathulo kanye nokusekela kwe-arch
- Ukuhamba amabhuzu
- I-Casts
Ngokuhlinzeka ngesiteji esinzima sonyawo, ukufakwa kwezihlangu nokuhamba amabhuzu kuvimbela ukuhamba phakathi kwe-midfoot ne-hindfoot. Ukuvimbela lesi sinyathelo kufanele kunciphise ukuvuvukala okuhlobene ne-posterior tibial tendonitis. Ama-casts ayingozi kakhulu, kodwa cishe indlela ephephile kakhulu ukuqinisekisa ukuthi ithenda le-posterior tibial liphumule ngokwanele.
Eminye imithi ejwayelekile ye-posterior tibial tendonitis yasemuva ihlanganisa imithi yokulwa nokuvuvukala nokuguqulwa komsebenzi. Zombili lezi zelako zingasiza ukulawula ukuvuvukala eduze kwethenda le-posterior tibial.
Izinketho zokuhlinza
Ukunakekelwa kokuhlinzwa kwe-posterior tibial tendinitis kunengxabano futhi kuyahlukahluka kuye ngokuthi izinga lini. Ekuqaleni kwe-tendonitis ye-posterior tibial, abanye odokotela bangase batusa inqubo yokuhlanza ukuvuvukala okuthiwa i- debridement . Ngesikhathi sokudiliza, izicubu ezivuthayo kanye nethenthoni engavamile zisuswe ukuze kusize ukuvumela ukuphulukiswa kwethenda elimelekile.
Ezimweni ezithuthukisiwe kakhulu ze-tendonitis e-posterior tibial umqubu wonyawo wehlile futhi ukwehlukaniswa kwamathenda okulula kungase kungeneli ukulungisa inkinga. Ukwakhiwa kabusha kwethemoni ye-posterior tibial ngezinye izikhathi kwenziwa.
Ezinkambisweni zokuvuselela, ithethoni engomakhelwane, ebizwa ngokuthi i-flexor digitorum longus, ishukunyiselwa ukuba ithathe isikhundla sesithoni se-posterior tibial esonakalisiwe. Le nqubo ivame ukuhlanganiswa nokuvuselelwa kwamathambo. Okokugcina, ezimweni ezithuthukisiwe kakhulu ze-tendonitis e-posterior tibial, lapho umgudu wonyawo usuqine, inqubo ye-fusion iyindlela yokwelashwa ethandwayo.
Izwi elivela
Ukukhubazeka kwamathambo we-posterior tibial, kanye nomuntu omdala othole i-flatfoot deformity, kungaba izinkinga eziphazamisayo. Ngokuvamile, abantu bazizwa izimpawu zabo zingayinaki udokotela ongase angaboni kakhulu endleleni yokukhubazeka, kodwa abantu bazizwa behluleka nokungazinzi kwekhanda.
Kanye ngezigaba kamuva, ukwelashwa kungabangela ukungena futhi kunciphise ngokwemisebenzi yonyawo. Ngenxa yalezi zizathu, imizamo yokuqala ngezokwelapha ezingenasidingo, kuhlanganise nezicathulo zokuguqulwa kanye nemisebenzi yokwelapha, yizona izindlela ezikhethwa kakhulu ukulawula izimpawu zesimo.
> Umthombo:
> Deland JT. Ukukhubazeka kwe-adultsfoot etholakale ngabantu abadala. J Am Acad Orthop Surg. 2008 Jul; 16 (7): 399-406.