Isivumelwano sikaDupuytren yisimo sesandla esithinta cishe amaphesenti amathathu wabantu. Ngokomlando, okuwukuphela kokukhethwa kokwelashwa kwakungeyona into, noma inqubo enkulu yokuhlinzwa. Kule minyaka eyishumi eyedlule, ezinye izinketho ezincane ezingenasidlangalaleni ziye zavela njengoba kunokwenzeka ukwelashwa. Enye yalezi zindlela zokwelapha zanamuhla yinkambiso encane yokuhlasela ebizwa ngokuthi i-needle aponeurotomy.
Isivumelwano sikaDupuytren yisimo esithinta isandla; itholakala kubantu abanesifo sikaDupuytren. Yenza izicubu zibe ngaphansi kwesikhumba esihlangothini sesandla sandla ukuze zikhule futhi zenze isivumelwano. Lezicubu, i-fascia yesundu, ngokuvamile ihlinzeka amandla nokusekela isikhumba. Kodwa-ke, esivumelwaneni sikaDupuytren, i-fascia yesundu ingahle ifinyelele ngokusheshisa, okwenza kube nzima ukuqondisa iminwe. Isimo sivame kakhulu emadodeni aseNyakatho Yurophu eminyakeni engama-50.
Ukwelashwa kungokwemvumelwano kaDupuytren kuncike ebuqilini bezimpawu. Iningi leziguli ezithintekayo zinama-nodules ezakha amabhola aqinile ezinsikeni ezibomvu entendeni, noma izintambo ezakha ama-tight bands agijima ngakwesokunene somunwe. Ama-nodules ka-Dupuytren angaphathwa nge-injection ye-cortisone noma angahlolwa ngaphandle kokwelashwa okuqondile.
Intambo kaDupuytren ingaba yinkinga njengoba lezi zingase ziqale ukudonsa iminwe phansi ukuya kwesandla sandla.
Ngokuhamba kwesikhathi, uma isivumelwano siqhubeka, iziguli ngeke zikwazi ukuqondisa iminwe ngokugcwele. Lokhu kungenza imisebenzi elula njengokugeza ubuso bakho, ukuxhaphaza izandla, noma ukugqoka amagilavu, cishe akunakwenzeka.
Ukwelapha
Ukwelashwa okujwayelekile kwesivumelwano sikaDupuytren kuyindlela yokuhlinzwa ebizwa ngokuthi i-fasciectomy yenxenye yesigcawu.
Isinkwa nesinwe esithintekayo sivulwe ngokuvulwa ngokubheka okukhulu. I-fascia yesigcawu engavamile engavamile isuswe. Ngenxa yokuchayeka okubanzi, izicubu ezibomvu zizokwakha esandleni neminwe. Ukuhlinzwa kungadinga ukuvuselelwa isikhathi eside. Ezinye iziguli zingadinga ukuthatha izinyanga ezimbili kuya kwezinyanga ezimbili emsebenzini, kuye ngemisebenzi yazo.
I-needle aponeurotomy (NA) inqubo encane engavamile yokusebenzisa isivumelwano sikaDupuytren. E-NA, udokotela ohlinzayo usebenzisa insipho yenaliti ukuze ahlukanise i-fascia yesigcawu esivumelwaneni. Lokhu kwenziwa ngokusebenzisa amanxeba amancane okugcoba. Ngokungafani nokuhlinzekwa okuvulekile, isandla asivuli kakhulu, futhi kukhona ukwakheka okuncane kakhulu kwesikhumba. Inqubo yenziwa ehhovisi likadokotela ngaphansi kwe-anesthesia yendawo. I-NA yasungulwa okokuqala eFrance ngawo-1970 futhi yalethwa e-United States nguDkt. Charles Eaton waseJupiter, eFlorida.
Needle Aponeurotomy
Uma kwenziwa udokotela ohlinzayo oqeqeshiwe esifundeni esifanele, i-NA iphephile kakhulu futhi isebenza kahle. Izinga lezinkinga, njenge-tendon noma ukulimala kwamagundane, lingaphansi kokuhlinzwa komdabu. Kunenkinga ejwayelekile kunazo zonke isikhumba esikhumbeni, esizophulukisa ngezingubo ezilula.
Isilinganiso sokuphindaphinda kukaDupuytren ngemuva kwe-NA siphezulu uma kuqhathaniswa nokuhlinzwa okuvamile. Ngemuva kokuhlinzwa okuvulekile, iziguli ezingu-50 zizophindaphinda eminyakeni emihlanu. Lokhu kuqhathaniswa nokuphindaphinda kwamaphesenti angu-50 emva kweminyaka emithathu nge-NA. Isifo sikaDupuytren sizobuya ngokuphuza, nje kancane ngemva kwe-NA.
Ngokujwayelekile, ukwelashwa kwesandla okusemthethweni akudingeki ngemuva kwe-NA. Iziguli zicelwa ukuba zigcine isandla sabo esisebenzayo sikhulisiwe izinsuku ezimbili emva kwenqubo. Iziguli zingabuyela emisebenzini yokukhanya okusheshayo ngokushesha. Umsebenzi onzima, ezemidlalo, noma ezokuzilibazisa azivunyelwe isonto elilodwa.
Ngezinye izikhathi, kwenziwa ubucwebe obugqamile ebusuku.
Imithombo:
I-Eaton C, I-Hand Center © 2007.
I-Mahoney JD, Ukuxhumana Komuntu siqu, Isikhungo seMidwest Orthopedic, Sixoxwa ngo-11/2007.
U-Murphy K, "Ukuguqulwa Kwama-Bent Fingers, Akukho Ukuhlinzwa Okudingekayo" I-New York Times July 24, 2007.