Kujambula bondo olowa monga kuchita zimene Kujambula wa bondo ndi chiyani?

Bondo olowa ndi osatetezeka kwambiri dongosolo anthu minofu ndi mafupa. N'chifukwa chake matenda a kuvulala bondo - ndi vuto lenileni la Traumatology. Yabwino bondo njira olowa kulingalira imatengedwa kumveka maginito kulingalira (Kujambula). Ndi inu mukhoza oterewa zosiyanasiyana kuvulala, kuyambira Mitsemphayi ong'ambika ndipo mathero fractures. Kujambula Kodi a bondo? Kodi mapanga sikani? Mu nkhani izi kuti zosankhidwa kunja.

Matenda a bondo olowa

pawiri Izi ndi yaikulu kwambiri ku thupi. Bone bondo maziko - ndi femur ndi tibia ndi patella. Fibula alibe poyerekezera ndi olowa. Pamwamba pa fupa kupanga pawiri, yokutidwa ndi chichereŵechereŵe. Ndiyamika izo amachepetsa mphamvu mikangano ndi chomasuka kayendedwe anaonetsetsa.

Kumapeto wapotalikira wa femur ndi ali awiri condyle - lateral (m'munsi) ndi medial (wamkulu). Ali ndi mawonekedwe chonse. Condyles kumeneko ndipo pamapeto proximal wa tibia lapansi. Iwo ali ndi lathyathyathya. Pakati pa mating ya kali ndi menisci (kunja ndi mkati) - falcate chichereŵechereŵe. Iwo ziziyenda bondo, anachita ntchito ya absorber mantha mu izo.

Bondo olowa anali olekanitsidwa zingwe angapo kuonetsetsa kukhazikika kwake:

• tibialis (medial) ina;
• fibula (lateral) ina;
• zapambuyo cruciate;
• zapambuyo cruciate.

Kapangidwe ilinso bondo tendon. Musanayambe kuganizira Kujambula bondo olowa, lomwe limasonyeza kuti Dziwani kuti nthawi zambiri kuonongeka ndi tendon a minofu quadriceps. yopuma yake chidule mwadzidzidzi minofu. Nthawi zina kuvulala amapezeka ndi wandiweyani yotakata tendon iliotibialnogo thirakiti. nyumba imeneyi ndi amphamvu lateral zazikulu olimba bondo olowa.

Zikuonetsa kuti Kujambula

Kuwonongeka kwa nyumba bondo zimachitika nthawi zambiri. The akatswiri amene makamaka kupempha achinyamata kutsogolera moyo yogwira ndi thupi. Isanafike makonzedwe a thandizo kwa madokotala ikuchitika m'mutu ndipo anamupeza. Izi ndi njira yolondola ndi odalirika matenda a kuvulala zosiyanasiyana.

Mu Kujambula wa bondo pali zizindikiro. Njirazi ndi monga:

• zotheka kuwonongeka kwa ina ndi cruciate Mitsemphayi;
• kuswa umphumphu wa meniscus kapena tendons;
• amaganiziridwa wovulala;
• ululu bondo;
• mfundo zambiri timapemphera radiography.

Contraindications kuphunzira

"Kodi Kujambula bondo olowa ndi phazi?" - funso limene yankho Mwina anafuna, si anthu onse, chifukwa njira imeneyi matenda pali contraindications:

• pamaso pa pacemaker (pacemaker), ntchito imene lingathetsedwe chifukwa cha phunziro;
• superimposed pa tatifupi Mitsempha zitsulo akhoza ankatembenukira chifukwa zochita za kuthengo maginito;
• vuto la mtima;
• claustrophobia;
• amadzala ferromagnetic, chifukwa cha zomwe zinapezeka mafanowo zoonadi molakwika zotsatira za kafukufuku;
• mimba mpaka milungu 12.

Kuyambira mndandanda Tiyenera kutchura claustrophobia. Si contraindication mtheradi. Pamene chiwonetsero cha kuopa chatsekedwa ndi kumangidwanso danga ntchito sedation kapena mankhwala ochititsa dzanzi wodwalayo si lakuya.

akafufuza

Kodi Kujambula wa bondo - mutu otentha kwa anthu amene amaikidwa ndi njirayi. Choncho asanayambe kugwira Kujambula odwala kupereka kuvala zovala zapadera. Mukhoza kukhala ndi zinthu zawo, ngati iwo alibe mabatani zitsulo, zippers. Pamaso kuphunzira kupeza kuchotsa zodzikongoletsera onse, magalasi, ulonda, kuchotsa kuchokera matumba a makiyi, foni.

Chindodo imagwiridwa ndi supine mtima. miyendo anayikidwa mu chida cha. Pa phunzirolo mwendo zowonongeka ndi mu koyilo wailesi pafupipafupi. Healthy nthambi likufanana ndi izo. Pansi pa ntchafu kufufuza ndi akachita wodzigudubuza wamng'ono. Ndi koyenera kuti zowonera zabwino cruciate mitsempha.

Ngati pali kukayikirana pamaso pa chotupacho, ndiye anachita mosiyana Kujambula. Pamaso kudziyesa mu mtsempha wa wodwala kutumikiridwa chinthu chapadera. M'pofunika kuonetsetsa kuti bondo Kujambula anasonyeza chotupa.

Kujambula thunthu bondo olowa

Pakuti matenda lolondola ndi kofunika kudziwa kuti Kujambula adzakusonyezani bondo yachibadwa. Apa ndi malongosoledwe a zigawo zikuluzikulu za bondo:

1. Mu yachibadwa zapambuyo cruciate mitsempha pa T2-T1 ndi VI-VI zikuwoneka ngati dongosolo wakuda ndi homogenous otsika Mwamphamvu chizindikiro. Zapambuyo cruciate mitsempha mu mafano akamagwira Kujambula, izo visualized mu mawonekedwe a bwino chimatanthauza homogeneous wakuda chingwe.
2. Tibial ndi fibular ina mitsempha zambiri kupereka pa T2-T1 ndi VI-VI homogeneous otsika Mwamphamvu chizindikiro.
3. menisci Normal pa T2-T1 ndi VI-VI visualized nyumba monga homogeneously hypointense (mpaka wakuda) ndi mitolo chapakati mitsempha ndi mitsempha ya magazi. The contours ya menisci omveka bwino, pamwamba ndi yosalala.
4. Tendons zambiri otsika kwambiri chibadidwe chizindikiro. Mwinanso sindikupatsani zifanizo za inaimitsidwa pa T1 ndi T2.
5. Articular chichereŵechereŵe amakhala ndi otsika Mwamphamvu chizindikiro pa T2-VI ndi pafupifupi chizindikiro mwamphamvu pa T1-VI.

kuwononga mitsempha

The kuvulala ambiri mitsempha ndi zapambuyo cruciate. Kujambula limasonyeza kuti bondo olowa chawonongeka nyumba imeneyi? Pa yopuma kuchuluka chizindikiro mwamphamvu mu gulu. Pakhoza kukhala discontinuity kapena kusapezeka kwa mbendera yachibadwa. Pamene kuvulala atsopano kobvuta ndi zotsatira Kujambula amachitsimikizira kukhalapo kapena kusapezeka yopuma, chifukwa pamene mitsempha choipa umachuluka kukula (pali kutupa).

Ngozi ina mitsempha angakhale timapuma, ndi tsankho kuichotsa ndi kusiyana intraligamentous. Mukayamba kuonongeka tibial ina mitsempha, ndiye izo anaona thickening. mbali Chimaonekera kuonjezera chizindikiro. Izi ndi zimene zikusonyeza bondo Kujambula pa tsiku loyamba. Kenako, zigawo izi kutha chifukwa mayamwidwe madzimadzi owonjezera mu ozungulira kuvulala minofu.

Yopuma fibular ina mitsempha matenda, kawirikawiri kwambiri kawirikawiri. kuvulala amenewa amaphatikizidwa ndi fractures chachikulu comminuted wa tibial condyle fupa imfa ozungulira zimakhala zofewa.

kuwonongeka kwa menisci ndi

Pakuti kuvulala kwa bondo nyumba olowa amaonedwa kukhala mafano kwambiri nkhani zopezera ndege sagittal ndi coronal. Kuwunika kodi Kujambula wa bondo, ndi matenda, madokotala kulabadira makhalidwe zotsatirazi:

• meniscus kukula;
• kasinthidwe awo, chikhalidwe cha chizindikiro;
• makulidwe ndi kuya chizindikiro kusinthidwa;
• kutanthauzira kusintha mkati meniscus lapansi.

Kupeza angapo madigiri meniscus kuwonongeka :

1. digiri yoyamba - asanawonetseredwebe chapakati alibe. Pa Kujambula n'kusintha wapezeka mkati meniscus lapansi. Iwo akuwonetseredwa kumatheka chizindikiro mwamphamvu.
2. Chachiwiri digiri - wamba chapakati alibe. Mkati meniscus analimasulira timapangira dera la kuonetsa kukhudzika chizindikiro.
3. Mlingo lachitatu - chinang'ambika meniscus. Mkati meniscus chowululidwa chodziwa chizindikiro mwamphamvu. The mizere ya kwapakati pa-articular danga wosweka. Nthawi zina udindo wa makombo meniscus.

kuwonongeka kwa tendons

Investigation bondo tendon imagwiridwa mu ndege sagittal ndi ofananira. Woyamba wa kusintha awa visualized bwino. Chionongeko anatsimikizira ngati izi MR zizindikiro wapezeka pa kulingalira maginito kumveka:

• effusion tendon m'chimake (munthu amene amaika kuti zimamuchulukira) kapena edema peritendinoznoy mu minofu synovial (m'madera amene palibe Kakhungu);
• thickening kapena kupatulira wa tendon ya;
• chizindikiro kusintha (ndi osachiritsika kudwala wa tendon m'dera lapakati kunachokera longitudinally kuwala, yodziwika ndi hyperintensive chizindikiro pa T1-VI);
• zonse tendon chotupa (anawerengedwa tendon zidutswa thickening ndi asintha mwamphamvu chizindikiro ndiponso wavy mizere).

fractures fupa

Ena mwa kuvulala ambiri - ndi mafupa othyoka kuti apange bondo olowa. Ngati fractures woona anaona kuchepa liniya cha chizindikiro ndi yopuma fupa yokhudza kotekisi. Nthawi zina osamukira zidutswa. Kungakhale hemarthrosis - magazi kuti patsekeke olowa. Ndi pa zithunzi T1-kulemetsedwa umakhala ndi chizindikiro apamwamba poyerekeza ndi madzimadzi serous.

Chapadera ndi aakulu (Kale) fractures, chifukwa anthu ena atalandira kuwonongeka, safuna chithandizo cha akatswiri. Pakuti kuvulala ngati yodziwika hypointense, nonuniform kusintha ndi zizindikiro za minofu fibrous sclerosis ndi danga medullary.

Ndi zothandiza ndipo contusion choipa (mikwingwirima) fupa. Kodi Kujambula bondo pa milanduyi? Mu kuvulala izi zimachitika intraosseous zochepa kutupa. Iwo amakhala ndi akakufunsani chofooka chizindikiro dontho pa T1-kulemetsedwa zithunzi ndi kuwonjezeka mwamphamvu ake pa zithunzi T2-kulemetsedwa. Pathological chizindikiro zikhoza kusungidwa kwa miyezi 3-10.

Pomaliza, tiyenera kudziwa kuti bondo olowa yavulala zambiri. Imodzi mwa njira zabwino matenda a zotupa osiyana ndi kumveka maginito kulingalira. Iwo angapo ubwino. Poyamba, kafukufuku ndi nkhani kwambiri. Timatha akatswiri kuti aone mmene mafupa ndi zimakhala zofewa. Kachiwiri maginito kumveka kulingalira kulibe vuto odwala (pakalibe contraindications). Ichi ndi chifukwa chake anatumizidwa Kujambula bondo ana ndi akulu.