Bondo olowa: Mitsemphayi ndi kuvulala nawo. Kodi kuchitira mitsempha ya bondo

Ponena za bondo, anthu ambiri amaganiza bondo olowa. Inde, ndi yofunika anatomical gawo Komabe, magwiridwe ake popanda minofu ndi tendons zosatheka. Pamene mukuyenda, kuthamanga, kusewera masewera mu mwachindunji nkhani dera kwa katundu zikuluzikulu, zimene kumaonjezera ngozi ya kuwonongeka. Tiyeni tikambirane bondo olowa, mitsempha, dongosolo akulu ndi mavuto akuwuka pa mawu a chinthu zoopsa.

thunthu

Mapangidwe olowa kumafuna mafupa atatu: mbali femur, gawo la patella ndi tibial. Patella femoral-tibial zikukambidwa ndipo femoral-suprapatellaris mafupa. mbali anatomical zimathandiza kuti munthawi yomweyo reciprocal kayendedwe ka mafupa ndege angapo.

Menisci, chichereŵechereŵe anapereka minofu connective, ndi "spacers" pakati pa mutu fupa. Ntchito yawo ndi kupereka cushioning, kugawa kuthamanga ndi katundu pamene galimoto. Pa mbali zonse za meniscus kugwirizana ndi kapisozi olowa ndi Mitsemphayi inatsekeratu.

stabilizers olowa ndi izi magulu minofu, kudziŵa zimene anthu amati ndi mbali zofunika zoopsa:

1. Quadriceps minofu ali kutsogolo ntchafu. Amaona kwambiri akulu wagawo anatomical kapangidwe ka malo anati.
2. Sartorius ndi yaitali. Imakhala flexion ndi ntchafu ndi Shin, kuzungulira bondo olowa.
3. Woonda minofu akudutsa kumbuyo ndi pang'ono mbali ya olowa, kulola kutsogolera m'chiuno ndipo bondo unakhota.
4. Adductor Magnus minofu kumafuna osati kubweretsa chiuno, komanso kutambasuka kapena kutambasuka kwa mafupa a chiuno poyerekezera ndi ntchafu.
5. Kumbuyo olamulira ndi yopingasa chimafikira mitu iwiri ntchafu minofu, kulola kupinda Shin, ntchafu unbend, kupereka kayendedwe outwards.
6. Kumbuyo ndi mkati olowa chimafikira podsuhozhilnaya minofu extensor ntchafu Flex tibia ndi kupereka zozungulira kasinthasintha nthambi.
7. Semimembranosus minofu amagwira ntchito podsuhozhilnoy ofanana.
8. Triceps tibia flexes mwendo m'munsi pa bondo ndi phazi mu bondo olowa.
9. Short ndi lathyathyathya ntchafu minofu ili ku pamwamba kumbuyo. Ntchito ya flexion ndi kasinthasintha wa tibia lapansi.

bondo ntchito

Mwachangu bondo olowa ndi zofunika kwa thupi. N'zotheka kusuntha nkhwangwa ofukula ndi mazunzo. Extension ndi flexion kumachitika pa chitsulo chogwira matayala kutsogolo, ndi ofukula - kasinthasintha wa nthambi.

flexion olowa phazi zimathandiza munthu kuti apange sitepe patsogolo, kumenya pansi nthambi ndi modekha kuwayika. Apo ayi, phazi kangakhale chokhwima malangizo verhneperednem ndi kuukitsa ntchafu.

Mitsemphayi

Bondo Mitsemphayi olowa amene ankaimira ndi magulu asanu lalikulu ndi gawo la thupi la nyumba zovuta anatomical. umembala zimapezekanso mitolo zotsatirazi:

• ina (tibial, peroneal);
• chamtanda (kutsogolo, kumbuyo);
• yopingasa mitsempha ya bondo;
• kumbuyo (arcuate, popliteal, patellar mitsempha, ndi medial ndi lateral);
• inatsekeratu (meniscus-femoral, tibial-meniscus).

Pamene nsautso, makamaka kuvulala masewera, katundu waukulu kumachitika pa Mitsemphayi bondo cruciate. Nthawi achire komanso nthawi konzanso zimadalira chikhalidwe cha kuvulala ndi zinthu sichikupindulitsani, makamaka thupi la munthu ochitiridwayo, wosatha ku 4 miyezi 6.

Cruciate mitsempha ndi magwiridwe

Zapambuyo mitsempha chochokera ndi kumbuyo gawo kumtunda kwa meniscus wa femur mwa bondo olowa M'mimbamo, kuika kwa tibia, amene m'gulu la articular yense. Ntchito yake ziziyenda bondo olowa, Kuchepetsa patsogolo kayendedwe ka tibia lapansi.

Mitsempha chimafikira kumbuyo kuchokera kutsogolo kwa femur protrusion fupa ndi kuwoloka mtsinje wa M'mimbamo limodzi ndi yomatidwa ndi tibia pa kumbuyo. Mitsempha kumathandiza tibia kwambiri ankatembenukira kumbuyo.

Vutoli cruciate mitsempha

kuvulala amenewa amaonedwa kukhala yovuta kwambiri ndi oopsa, napempha chithandizo chokwanira. A zolakwika kapena mwadzidzidzi anayamba mankhwala kumabweretsa chitukuko cha kupunduka ndi kulimbikira malire ntchito. Nthawi zambiri, kuvulala izi zimachitika Akatswiri pamene kutsetsereka, siketing'i, kudumpha ogwetsana azipeze powona momwe polojekitiyi amphamvu kapena kulephera kwa kukhota, kugwa.

Amphamvu koopsa ululu ndi pitani, ndi chiletso zakuthwa sayenda zingasonyeze kuti Mitsemphayi chinang'ambika bondo olowa. Wozunzidwayo sanayende paokha, chongodalira munthu.

zapambuyo mitsempha choipa kumachitika pamene amphamvu hyperextension bondo kapena pa zimakhudza kutsogolo padziko tibia lapansi. Kuwonongeka kwa zapambuyo cruciate mitsempha ndi ambiri. Zizindikiro za kuvulala lino m'gulu la "wa ku Turner" pamodzi ndi chotupa cha meniscus ndi ndi mitsempha akunja.

chithunzi matenda

Bondo olowa, mitsempha yomwe ndi tsankho kung'ambikako hyperemic, edematous kupweteka kwa kukhudza ndi pofuna kuyenda. Magazi articular M'mimbamo (hemarthrosis) amasonkhana. Sizikusokonezani kutukusira kwa Mitsemphayi bondo olowa, amene ali chipatala ofanana ndi zizindikiro za kuvulala kumene kunachitika masiku angapo apitawo.

Full cruciate mitsempha chotupa amachititsa sayenda kwambiri za tibia mu ndege zapambuyo-zapambuyo. Yotsimikiza wa chizindikiro ichi ndi akatswiri ankachititsa imodzi. Woyamba nayo kumbuyo kwa ntchafu ndi flexes nthambi zamizidwa ndi kusakhala pa bondo pa mlingo woyenerera. The dokotala chachiwiri limafufuza kayendedwe ka mwendo m'munsi mmbuyo ndi mtsogolo. Kwamakokedwe laceration kapena chizindikiro ofanana ndi negative.

Sprain kumaphatikizapo kuichotsa ka ulusi, limodzi ndi soreness zolimbitsa, pang'ono edema, pakalibe magazi. Kuchepetsa galimoto ntchito amapezeka Pamlingo yaing'ono.

diagnostics

Khama la limagwirira choipa amatilola kudziwa kuvulaza nyumba anatomical. Pamaso pa mosamala bondo ovulalawo Adokotala thanzi kulongosola maonekedwe a dongosolo la. Imawunikidwa chikhalidwe cha nyumba mkati ntchito ultrasound ndi Kujambula.

matenda masiyanidwe amapewa mafupa othyoka, patella, meniscus misozi. Pamene dislocation fupa kuchepetsa ndi ulemu wina ndi mnzake, palibe kuthekera kwa ntchito galimoto, pali kasupe kukana pofuna kayendedwe chabe. Kuwonongeka mitsempha si yodziwika ndi kupanda wathunthu kuyenda, ndi zochepa chifukwa cha ululu. Palinso palibe kukana masika.

Wovulala limodzi ndi mapindikidwe, maonekedwe a zoyendayenda nthenda ndi crepitation. Komabe, pali fractures amene alibe ziwalo. Pankhaniyi, chitsimikiziro cha matenda amafuna X-ray bwinobwino ultrasound kapena Kujambula.

Malangizo chithandizo

Pamene pang'ono kuonongeka (kwamakokedwe, kuichotsa) thandizo amaperekedwa mu chipinda mwadzidzidzi. Ziwalo ayenera ali ndi malo apamwamba, woyamba masiku angapo - bedi zina. Tsiku loyamba pambuyo zifukwa amafuna kuphatikana ozizira pa zinkakhala m'dera. The olowa ndi wotetezedwa ndi zolimba zotanuka bandeji, kulola kusunga thupi udindo nthambi pamene ikuyenda. Kusiya bandeji usiku sangakhale kuti palibe kuphwanya kufalitsidwa. kasamalidwe ululu amafuna kugwiritsa ntchito analgesics ( "Ketanov", "Ketalong", "nalbuphine").

Bondo olowa, mitsempha yomwe amafuna osati ndiwofatsa mankhwala, koma opaleshoni, pamafunika yaitali konzanso. Pambuyo pa zonsezi ntchito mofanana mu pang'ono zowonongeka, ntchito miyeso physiotherapy, kuphatikizapo kutikitirako physiotherapy, electrophoresis ndi mankhwala.

Nthawi zambiri, alowererepo opaleshoni chofunika pamene utaphulika cruciate mitsempha ya bondo. ntchito zobwezeretsa anatomical kukhulupirika kwa kapangidwe ndi koyenera kuti kugwira ntchito bwinobwino. Opaleshoni ikuchitika Patangotha miyezi isanu ndi choipa olowa.

Munthuyo abwino imatengedwa kwa wothamanga wina amene ayenera kayendedwe ntchito jerky wa miyendo pa masewera ake. Anthu achikulire amene alibe ntchito yaikulu thupi, ndi yabwino kwambiri kuti mankhwala ndiwofatsa komanso kugwiritsa ntchito mankhwala thupi.

Pulasitiki bondo cruciate mitsempha amafuna kugwiritsa ntchito kumezanitsa anatengedwa kuchokera patella mitsempha kapena hamstring tendon (autograft). Ndi zotheka kugwiritsa ntchito grafts kupanga Komabe, ntchito zawo mwina adzakanidwa ndi thupi la wodwalayo.

Kulowetsa grafts kupanga ndi njira yofala pamene chinang'ambika lateral mitsempha ya bondo. Chithandizo zochita ntchito amaona kuti njira kusankha zikachitika.

Opaleshoni mchitidwe wasonyeza kuti chabe stitching ndondomeko ovulalawo pafupifupi limabwezeretsa magwiridwe a.

Kodi pangakhale mavuto kuvulazidwa bondo?

zosokonezeka pafupipafupi kuvulala bondo ndi izi:

1. Kukula kwa nyamakazi zotheka masabata 2-3 pambuyo choipa olowa. Kuyankha yotupa kumachitika chifukwa chisokonezo magazi ndi ingress wa tizilombo pathological m'dera zoipa. Amakhala ndi ululu, maonekedwe a puffiness, redness, kusuntha pang'ono chifukwa ululu.
2. Maonekedwe a kusintha osachiritsika mu mawonekedwe a arthrosis limodzi ndi mapangidwe osteophytes, chichereŵechereŵe kupatulira.

kaonedwe

Pambuyo kuvulala kwambiri mwa anthu ankadzifunsa kuti: "phwanya bondo Mitsemphayi kuchiritsa kwambiri?" A nkhani zofanana lafotokozedwa iliyonse matenda payekha. Malinga zoipa ndi makhalidwe a chamoyo operability zonse tikhoza kubwerera mu miyezi sikisi ndipo mwina mu miyezi ingapo.

Zofunika kuwonongeka limagwirira palokha ndipo mmene wovulalayo ali yopuma wa Mitsemphayi bondo. Kodi zoipa amachiritsa komanso zimadalira mwatsatanetsatane za kuchitira malangizo katswiri. chithandizo mwamsanga, kulandira mankhwala zofunika ndiponso kutsatira kufulumizitsa Kuchiritsidwa ndi kupewa mavuto.

kupewa

Mndandanda wa njira zodzitetezera ntchito siziwononga kwambiri malo yafupika zinthu zotsatirazi:

• chokwanira thupi ntchito;
• kutupa kwa Mitsemphayi wa bondo ayenera kukhala pansi chithandizo yake;
• moyenera zakudya;
• kukanidwa mowa ndi fodya;
• kupeŵa hypothermia;
• ulamuliro miyendo osachepera kukhala m'malo malo amodzi;
• kusankha lamanja la nsapato, kukana zidendene mkulu.

zoipa bondo angathe kupewedwa, kutanthauza miyeso chosavuta kuposa kubwezeretsa magwiridwe ake chifukwa kuwonongeka.