Izimbangela Nezokwelashwa
Isivumelwano sikaDupuytren yisimiso esibangela ukuqinisa, noma ukuvumelanisa, i-fascia yesundu, izicubu ezixhumeneyo ezilele ngaphansi kwesikhumba esesandleni sakho. Ngenxa yesivumelwano, iminwe ingakwazi ukuguquka unomphela, futhi umsebenzi wesandla sakho uphelelwe amandla.
I-fascia yesundu iyisisindo esinyene esiphezu kwamathenda naphansi kwesikhumba sandla.
I-fascia ifakwe kokubili esikhumbeni ngenhla nakwezakhiwo ngezansi. I-fascia yesundu isisiza ukuhlinzeka ngesandla esinzima, esithinta isandla nesinwe.
Izimbangela
Akekho owazi ngempela ukuthi yini eyenza isivumelwano sikaDupuytren, kodwa saziwa kahle ukuthi sisebenza emindeni-amaphesenti angu-60 kuya kuma-70% abantu abanomlando womndeni wesimo. Ezinye izinto kuye kwasolakala ukuthi zenza isivumelwano sikaDupuytren, njengokudabuka, isifo sikashukela , ukuphuza ngokweqile, isifo sokuphuza ngokweqile nesifo sesibindi, kodwa akukho buhlobo obucacile.
Isimo sivame kakhulu kubantu asebekhulile (ngokuvamile ngemva kweminyaka yobudala engama-40), amadoda (avamile kakhulu kunabesifazane), nabokuzalwa baseNyakatho Yurophu. Iqembu elilodwa elivame ukushiwo yilabo abanezizukulwane ze-Viking, futhi kungabizwa ngokuthi yisifo sikaViking.
Kukhona ubufakazi bokuthi ukuhlukumezeka kungabangela ekuthuthukiseni isivumelwano sikaDupuytren. Kuye kwaphenywa uma izenzakalo ezibuhlungu noma umlando wobasebenzi bombhalo ungabangela le nkinga.
Okuncane kakhulu, kukhona ubufakazi bokuphaphaza ngaphakathi kwezicubu ezithintekile, ubufakazi bokuthi ukuhlukumezeka kungabangela lesi simo. Lokho kusho ukuthi i-Dupuytren ivame ukubonwa ezandleni zombili, futhi itholakale kaningi kaningi emandleni aphezulu nalawo angabonakali-ubufakazi bokuthi le nkinga ayiwona umphumela wokuhlukunyezwa okuphindaphindiwe.
Okufanele Ukulindele
Izibonakaliso zokuqala zomtholampilo ze-Dupuytren zivame ukuba nezincane ezincane, ezingenabuhlungu emlenzeni. Ama-nodules angase aqale ukugcoba, futhi isikhumba siba puckered. Ekugcineni, ezinyathelweni ezilandelayo zesifo, isikhumba kanye nezinkampani ezithintekayo zisebenza, kubangele ukukhubazeka komsebenzi nomunwe. Abantu abanesivumelwane sikaDupuytren baneminwe egibele phansi entendeni yesandla sabo.
Nakuba yonke iminwe ingabandakanyeka, isivumelwano sikaDupuytren sithinta kakhulu indandatho neminwe encane. Ukuqhubeka kwe-Dupuytren kuhloswe ukuba kuqhuma ngokushesha, kulandelwa izikhathi zokushintsha kancane. Inkontileka kaDupuytren ayinabuhlungu kaningi, kodwa kungaba yinkinga enkulu. I-Dupuytren ijwayele ukubandakanyeka kwesandla kodwa ingabandakanya nezinye izingxenye zomzimba, ikakhulukazi izinyawo zezinyawo. Cishe amaphesenti amahlanu weziguli ezinesivumelwano sikaDupuytren nazo zinesimo esifanayo sezinyawo ezinjenge-Lederhose's disease.
I-Dupuytren's Contracture vs. Izifo
Iningi labantu, odokotela bahlanganisa, sebenzisa la magama ngokungafani. Ukukhuluma ngokweqile, isifo sikaDupuytren sibhekisela ekusakazeni kwamangqamuzana abangela ukwakheka kwama-nodules nezivumelwano.
Isivumelwano sikaDupuytren siwumphumela walokhu kukhula kwesitembu kanye nokubonakaliswa okuvamile kwesifo sikaDupuytren. Ukwelashwa kwesivumelwano sikaDupuytren kungacatshangwa lapho isimo sibangela kanzima ukwenza imisebenzi evamile yansuku zonke.
Izinto Zokubikezela
| Heredity | Umlando walesi simo emndenini wakho kuyisibonakaliso sokuthi uzoba nobudlova. |
| Ubulili | I-Dupuytren ivame ukuqala kamuva futhi iqhubekela kancane kancane kwabesifazane. |
| Utshwala noma isisu | Lezi zimo zihlotshaniswa noDupuytren ohlukumezayo, futhi kungenzeka ukuthi aphinde abuyele. |
| Indawo yezifo | Uma ezandleni zombili zombili, noma lapho kunomthelela wezinyawo ezihlobene, ukuqhubekela phambili kuvame ukushesha ngokushesha. |
| Ukuziphatha kwezifo | Ama-Dupuytren amaningi anonya kakhulu ukubuyela ngemuva kokuhlinzwa futhi aqhubeke enobudlova. |
Iminyaka eminingi, ukwelashwa ezinyathelweni zakuqala zokuvumelanisa kukaDupuytren kwakuyi-watch futhi kulinda isimo. Ngenxa yokuthi ukwelashwa kokuhlinzwa kuyaphazamiseka futhi kungadinga ukutholakala okuqhubekayo nokuvuselelwa, ngokuvamile kwakugcinwe njengendlela yokugcina yokukhetha uma izimpawu zaqala ukuphazamiseka kakhulu ngemisebenzi yansuku zonke.
Muva nje, izinketho zokwelapha ezingenasidingo zinikeze ithemba lokuthi isivumelwano sikaDupuytren singaphathwa kahle, ikakhulukazi uma siphathwa ezinyathelweni zangaphambili zenkinga.
Siyazi ukuthi okubi kakhulu kunesivumelwano, kuyoba nzima nakakhulu ukuphinde ube nomsebenzi wesandla ojwayelekile futhi. Ngakho-ke, abantu abaningi bafuna ukwelashwa okuncane okungenasidingo, ikakhulukazi esivumelwaneni sokuqala sikaDupuytren.
Ukwelapha
Kunezinketho ezine eziyinhloko zokwelapha okwamanje ezitholakalayo zokwelapha kwesivumelwano sikaDupuytren:
- Ukuqaphela: Ukuqaphelwa kuvame ukucatshangelwa ekuqaleni kwesivumelwano sikaDupuytren. Ngokuvamile lokhu kuyindlela engcono kunazo zonke kubantu abangasebenzi ngenxa yesandla sabo. Lokhu kungabandakanya abantu abanesivumelwano esincane, noma abantu abangasebenzisi izandla zabo, futhi bangenza yonke imisebenzi yabo evamile.
- I-Needle Aponeurotomy : I- Needle aponeurotomy yinqubo eyenziwa eFrance, esanda kutholakala kakhulu e-United States. Ukusebenzisa akukho ukucubungula, inaliti isetshenziselwa ukwehlukanisa izintambo zikaDupuytren, futhi ubuyisele ezinye noma zonke izinyathelo zomunwe. I-needle aponeurotomy iphumelele kakhulu ezinyathelweni zangaphambili zokuvumelanisa kukaDupuytren.
- I-Collagenase Injections : I-Collagenase iyin-enzyme eyenziwa yi-bacteria ejojowe emthonjeni we-Dupuytren. I-enzyme isebenza ekuqothuleni izicubu eziqinile zikaDupuytren. Ngolunye usuku ngemuva kokujola, ngemuva kokuba i-enzyme yenze umsebenzi wayo, ubuyela kudokotela ukuze ube nomunwe owenziwe ukuze uqede izicubu eziqinisiwe, futhi ubuyekeze ukuhamba komunwe.
- Ukuhlinzwa: Kuhlinzwa ukwelashwa ukuze ususe i-fascia yesundu esesandleni sesandla. Ukuhlinzwa kungasebenza ngempumelelo ekubuyiseleni umsebenzi, futhi kungadingeka ngezigaba kamuva ze-Dupuytren. Ukuhlinzwa ngokuvamile kunokuvuselelwa isikhathi eside.
Ukuhlinzwa
Kwezinye iziguli, ukwelashwa okuncane okungenasidingo kungase kungalungile. Futhi, akubona bonke odokotela abaqaphela ukuthi inalutho ye-needle aponeurotomy iyindlela yokwelashwa yesivumelwano sikaDupuytren. Kukhona ukungqubuzana mayelana nokusetshenziswa kwalokhu ukwelashwa, ngakho-ke akubona bonke odokotela batusa i-needle aponeurotomy. Uma ufuna ukuxoxa nge-needle aponeurotomy nge-physicain, ungathola uhlu lwadokotela abenza le nqubo kwiwebhusayithi yeDupuytren's-Online.
Inqubo yokuhlinzekwa kwesivumelwano sikaDupuytren yaziwa ngokuthi i-fasciectomy, lapho izingxenye ze-fascia zesundu zisuswa khona. Ukuphazamiseka kokuhlinzwa ukuthi kukhona izingozi ezibalulekile ezihambisana nenqubo. Okuvamile ukuthi izicubu ezinomzimba zingase zakhiwe ngemuva kokuhlinzwa, okuholela enkingeni efana nesivumelwano sikaDupuytren, kodwa ngokubunjwa kwezicubu ezibomvu. Futhi, i-Dupuytren ingabuya, futhi ukuhlinzwa okwesibini kugcwele izinkinga. Ezinye izinkinga zokuhlinza zihlanganisa ukulimala kwenzwa, ukutheleleka, nokuphulukiswa isikhathi eside.
Ukuvuselelwa
Ukuvuselelwa emva kwe-needle aponeurotomy kuyashesha. Ngokuvamile, iziguli zingabuyekeza imisebenzi evamile ngokushesha, futhi ziyalwe ukuba zigweme ezemidlalo nasemisebenzini enzima cishe isonto. Kuye ngokuthi uhlobo lwenkontileka, ukuhlukaniswa okukhishwayo kunganikezwa ukuba kugqoke amahora ambalwa ngosuku ngalunye.
Ukuvuselelwa ngemva kokuhlinzwa kuhluka kakhulu. Iziguli ezinezinkontileka ezincane zingase zikwazi ukuqhubeka nemisebenzi evamile lapho izifo ziphulukiswa, kungakapheli amasonto ambalwa. Izivumelwano ezinzima zingadinga izinyanga zokuqhaqhazela nokuvuselelwa ngomuthi wesandla ukuvimbela ukubunjwa kwezinto ezincane.
Imithombo:
Benson LS, et al. "Isivumelwano sikaDupuytren" J. Am. I-Acad. I-Ortho. Ukuhlinzwa; 6: 24 - 35.
I-Eaton C, I-Hand Center © 2007.
U-Murphy K, "Ukuguqulwa Kwama-Bent Fingers, Akukho Ukuhlinzwa Okudingekayo" I-New York Times July 24, 2007.