I-Hip dysplasia yigama lezokwelapha elisetshenziselwa ukuchaza inkinga ngokubunjwa kokuhlanganiswa kwe-hip ezinganeni. Indawo yenkinga ingaba ibhola le-hip joint ( ikhanda labesifazane ), isikhombisi sokuhlanganiswa kwe-hip (i-acetabulum), noma kokubili.
Ngokomlando, odokotela abaningi baye babiza le nkinga ukuthi i-congenital dysplasia ye-hip, noma i- CDH. Muva nje, igama elivunyelwe yi-dysplasia yentuthuko ye-hip noma i-DDH.
Izimbangela ze-Hip Dysplasia
Isizathu esiqondile se-hip dysplasia akulula ukuchofoza, njengoba kucatshangwa ukuthi yizici eziningana ezibangela ekuthuthukiseni lesi simo. I-Hip dysplasia ivela cishe ngo-0.4% wabo bonke ukuzalwa futhi ivame kakhulu emantombazaneni okuzalwa okuqala. Ezinye izici eziyingozi zokuthi ingane ibe ne-hip dysplasia zifaka:
- Izingane ezinomlando womndeni we-hip dysplasia
- Amantombazane azalwa ngesibhakabhaka
- Izingane ezizalwa nezinye "izinkinga zokupakisha"
- Oligohydramnios (ukungabi nalutho lwe-intrauterine fluid)
"Izinkinga zokupakisha" yizimo eziholela engxenyeni ye-in-utero yengane; isibonelo, clubfoot kanye torticollis. I-Hip dysplasia ivame kakhulu kubantwana bokuqala, ivame kakhulu kubantu besifazane (80%) futhi kwenzeka ngokujwayelekile kakhulu ngakwesobunxele (60% eshiya i-hip kuphela, i-20% zombili izihenqo, 20% i-hip kwesokudla kuphela)
Ukuxilongwa kwe-Hip Dysplasia
Ukutholakala kwe-hip dysplasia ebusweni kusekelwe ekutholeni ukuhlolwa okusemzimbeni.
Udokotela wakho uzozizwa " ngokuchofoza kwe-hip " lapho enza ukukhetha okhethekile kokuhlanganiswa kwe-hip. Lezi zindlela, ezibizwa ngokuthi i-Barlow no-Ortolani, zizokwenza ukuthi i-hip engekho isikhundla ukuze "uchofoze" njengoba ihamba futhi iphuma endaweni efanele.
Uma uqhafaza u-hip uzizwa, udokotela wakho uzovame ukuthola i-hip ultrasound ukuze ahlole ukuhlanganyela kwe-hip.
I-x-ray ayibonisi amathambo enganeni encane kuze kube yilapho okungenani izinyanga eziyisithupha ubudala, ngakho-ke i-hip ultrasound ithandwa. I-ultrasound ye-hip izobonisa udokotela isikhundla nesimo se-joint hip. Esikhundleni sokujoyina okujwayelekile kwebhola-in-socket, i-ultrasound ingabonisa ibhola ngaphandle kwesikhombisi, nesokhethi esingahle (esingajulile). I-ultrasound ye-hip ingasetshenziselwa ukunquma ukuthi ukwelashwa kusebenza kahle kangakanani.
Ukwelashwa kwe-Hip Dysplasia
Ukwelashwa kwe-hip dysplasia kuncike eminyakeni yobudala. Umgomo wokwelashwa ukubeka ngokufanele ukuhlanganiswa kwe-hip ("ukunciphisa" umlenze). Uma sekutholakala ukunciphisa okwanele, udokotela uzobamba insipho kuleso simo esinciphile futhi avumele umzimba ukuba uvumelane nesimo esisha. Ingane encane, ikhono elingcono lokujwayela i-hip, nethuba elingcono lokuthola ngokugcwele. Ngokuhamba kwesikhathi, umzimba uhlala ungaphansi kokuphindaphindiwe kokuhlanganiswa kwe-hip. Ngenkathi ukwelashwa kwe-hip dysplasia kuhluka kumntwana ngamunye, uhlaka olulandelayo lulandela:
- Ukuzalwa kuya ezinyangeni ezingu-6
Ngokujwayelekile, ezinsana, i-hip dysplasia izokwehlisa ngokusetshenziswa kwe-brace ekhethekile ebizwa ngokuthi i- Pavlik harness . Lesi sikhonkwane sinamathele emntanini esimweni esenza ukuhlanganiswa kunciphise. Ngokuhamba kwesikhathi, umzimba uguqukela esimweni esifanele, futhi ukuhlanganiswa kwe-hip kuqala ukubunjwa okuvamile. Cishe amaphesenti angama-90% asanda kuzalwa ne-hip dysplasia ephathwa nge-Pavlik harness izosinda ngokugcwele. Odokotela abaningi ngeke baqale ukwelashwa kwe-Pavlik harry amasonto ambalwa ngemva kokuzalwa.
- Izinyanga ezingu-6 kuya ku-1 unyaka
Ezinganeni ezindala, ukwelashwa kwe-Pavlik harry kungenzeka ukuthi awuphumelele. Kulesi simo, udokotela ohlinzayo wamathambo uzobeka ingane ngaphansi kwe-anesthesia ejwayelekile. Lokhu ngokuvamile kuvumela ukuthi i-hip ithathe isikhundla esifanele. Ngesinye isikhathi kule ndawo, ingane izobekwa endaweni yokupaka . I-cast ifana ne-Pavlik harness kodwa ivumela ukuhamba kancane. Lokhu kuyadingeka ezinganeni ezindala ukugcina kangcono isikhundla se-hip joint. - Unyaka ongu-1
Izingane ezindala kunomunye oneminyaka engu-1 ubudala zivame ukudinga ukuhlinzwa ukuze kuncishiswe ukuhlanganiswa kwe-hip endaweni efanele. Umzimba ungenza izicubu ezibomvu ezivimbela u-hip ukuba angacabangi isikhundla sakhe esifanele, futhi ukuhlinzwa kuyadingeka ukuze ubeke kahle ukuhlanganiswa kwe-hip. Uma lokhu sekuqedile, ingane izoba ne- spica cast ukubamba iqhwa endaweni efanele.
Impumelelo yokwelashwa incike enkathini yengane kanye nokwanele kokunciphisa. Ensana esanda kuzalwa enokunciphisa okuhle, kunethuba elihle kakhulu lokuthola ngokugcwele. Lapho ukwelashwa kuqala ngesikhathi esidala, ithuba lokuthola ngokugcwele liyehla. Izingane eziphikisayo ze-hip dysplasia zinethuba lokuthuthukisa ubuhlungu kanye nesifo samathambo esiqalile kamuva ekuphileni. Ukwelashwa ukusika nokuguqula amathambo (i- hip osteotomy ), noma ukushintshwa kwe-hip , kungadingeka kamuva ekuphileni.
Imithombo:
UGuille JT, uPizzutillo PD, MacEwen GD "I-Dyplasia Yokuthuthukiswa Ye-Hip Kusuka Ekuzalweni Kuya Kuyizinyanga Eziyisithupha" J. Am. I-Acad. I-Ortho. Ukuhlinzwa, ngoJulayi / Agasti 2000; 8: 232 - 242.
I-Vitale MG ne-Skaggs DL "I-Dysplasia Yokuthuthukiswa Ye-Hip Kusukela Ezinyangeni Eziyisithupha kuya Eminyakeni Eyisine Yeminyaka" J. Am. I-Acad. I-Ortho. Ukuhlinzwa, Novemba / Disemba 2001; 9: 401 - 411.