Ukuqhuma kwe-Ulnar, okubizwa nangokuthi ukuguqulwa kwe-ulnar, ukukhubazeka kweminwe yesandla . Ngokuqondile, ukuqhuma kwe-ulnar kwenzeka uma kukhona ukuphambuka kwe-ulnar nokuhlukunyezwa kwe-volar yama-metacarpophalangeal joints (MCP). Ngokwemvelo, i-phalanges ehamba phambili ijoyina ama-metacarpals ezandleni ezithombeni ze-metacarpophalangeal. Amalungu e-MCP ajwayele ukubizwa ngokuthi ama-knuckles.
I-volar subluxation yomhlanganisi we-metacarpophalangeal iqala uma kuhlukaniswa okuyingxenye yehlanganiso - ama-phalanx shift shift away ekhanda le-metacarpal, ehamba esiqondeni sesundu. I-intermediate and distal phalanges landela ukunyakaza okuhambayo kwe-phalanx eseduze.
Ngokusho kukaKelley's Textbook of Rheumatology , kunobunye ubufakazi bokuthi isifo se-rheumatic of the wrist isholela ekuphambukeni kokugcina kwamalungu e-MCP. Kucatshangwa ukuthi ukuqina kwe-extensor carpi ulnaris muscle kubangela ukuphambuka kwe-radial njengamathambo e-carpal ajikeleze (amathambo e-carpal ahamba phambili ajikeleza ngendlela eqondile futhi ahlukanise amathambo e-carpal ngokuqondisa). Ukuphambuka kwe-Ulnar kuqala njengempendulo yangempela, ukuzama ukugcina ama-tendon kuya kuma-phalanges ekuhambisaneni ne-radius. Ukwehla kwamathambo noma i-articular cartilage kungabangela ukuqhuma kwe-ulnar, kodwa futhi kungase kwenzeke ngaphandle kokunye. I-Synovitis kanye nobuthakathaka bemisipha ingadlala indima ekuthuthukiseni kwayo.
Izibonakaliso zokuqala ze-ulnar drift zifaka:
- ubuthakathaka be-first dorsal interossei (i-interossei iyimisipha ephakathi kwamathambo athile)
- ukuxoshwa kwamagagasi omsakazo
- ukuqinisa imisipha yangaphakathi
- Ukufuduka kwe-flexible ye-flexor tendons (evelele ohlwini lwezinkomba kanye neminwe ende)
- ukuhlanekezela kweminwe eminwe ebonakalayo uma amalunga e-MCP enwetshiwe
Izimpawu ezithuthukisiwe zokudonsa kwe-ulnar zihlanganisa:
- i-volar subluxation (i-dislocation eyingxenye) yama-phalanges
- ukungakwazi ukuhlanganisa ngokugcwele izixhumanisi ze-MCP eziholela ekuvumelaneni kwe-flexion
- islayidi ye-ulnar noma i-shift of tendens extensor
- ukuqinisa imisipha ye-hypothenar (iqembu lemisipha emithathu yesandla esilawula ukunyakaza komunwe omncane)
- ukuphambuka kwe-radial kwesandla
- i-extensor carpi ulnaris ithoni ye-dislocation
- ukulahlekelwa ikhono lesithupha ukuphikisa umunwe wenkomba
Ukuhlola ubunzima be-ulnar drift, i- goniometer ingasetshenziswa. Ingalo yokumisa ye-goniometer ifakwa phezu kwe-metacarpal ngenkathi ingalo ehambayo ifakwa ngokufana ne-phalange eseduze. Ngemuva kokuthi izinga lokukhubazeka linqunywe, isiguli sivame ukucelwa ukuba siqondise isandla sabo, uma kungenzeka, ukulungisa ngokuqondile ukulungiswa nokulinganisa kabusha. Ezinye izivivinyo zomsebenzi wesandla zingasetshenziswa futhi ukuhlola ubunzima bokukhubazeka.
Ubani Othuthukisa Ulnar Drift?
Ukunyuka kwe-Ulnar kuhloswe ngokuyinhloko nge- arthritis ye-rheumatoid . Ukuvuvukala okungapheli kwamalungu e-MCP kulimaza i-capsule ehlangene nezakhiwo ezizungezile. Kodwa, isifo samathambo asisona kuphela isimo esixhunywe ukuqhuma kwe-ulnar. Kungenzeka ngezinye izimo ezivuthayo noma izifo ezixhumene nezicubu, njenge- lupus noma i- psoriatic arthritis .
Ucwaningo olulodwa lwamacala lubuye luveze ubudlelwane ne-disorder engavamile, i-pigmented villonodular synovitis (PVNS) ye-pigmented.
Izinketho zokwelapha
Izinketho zokuphatha ukuvuvukala kwesandla nobuhlungu zihlanganisa iqhwa, ukushisa okumanzi, amabhati we-paraffini, i- TENS unit kanye ne-ultrasound. Izandla zomzimba, ezibandakanya ukulula, zinconywa ukuba zilondoloze uhla lwezinyathelo ngangokunokwenzeka.
Ngezinye izikhathi kunconywa ukucwiliswa ukunciphisa ukuxoshwa kwesandla, ukubeka kahle izixhumanisi ze-MCP ekuxhumaneni kwe-radial-ulnar engathathi hlangothi, nokunciphisa ukuxhunyaniswa kwamalungu e-MCP ngokusekela i-phalanges ehamba phambili. Ngokujwayelekile, izigqoko zembethe ebusuku noma ngesikhathi sokuphumula emini.
Ama-splints angasiza ngobuhlungu ebusuku kodwa ubukhazikhazi abubonwanga ukuvimbela ukuphambuka kwe-ulnar. Ngisho nobukhazikhazi bebusuku, ukuphambuka kwe-ulnar kungathuthuka.
> Imithombo:
> Kelley's Bookbook of Rheumatology. Umagazini wesishiyagalolunye. Firestein et al. U-Elsevier Saunders. Izici zomtholampilo ze-Rheumatoid Arthritis. Isahluko 70. Izandla Nezikhali. Ikhasi 1112.
> I-Volar Subluxation ye-Metacarpophalangeal Joint.
> Izincomo Zokusebenza Ezinhle Zokuphathwa Kwe-Ulnar Drift Deformity ku-Rheumatoid Arthritis. I-Vancouver Health Coastal. I-Arthritis Society (Canada).
> Ukusetshenziswa Kwezinto Zokuphumula Emalanga Ebusuku Emthwalweni Wokuhlanekezela Kwe-Ulnar we-Hand Rheumatoid. UJohnson M et al. I-Rheumatology yezokwelapha. Mashi 1992.
> Ukwehlukana kwe-Ulnar akuyona njalo isifo somzimba . UZuber M et al. Ama-Annal of the Rheumatic Diseases. 1996.