Navicular. Amathambo unyawo: Anatomy

Xa umzimba inani elikhulu ngamathambo abantu. Ingakumbi ezininzi kwiindawo ezinjalo ihamba omzimba njengoko iinyawo nezihlahla. Kwamenywa amathambo eziqhagamshelene imisipha, ukunceda ukwenza umsebenzi, nto leyo ingafunyanwa zizilwanyana, ngaphandle ngaphandle iinkawu. Inkqubo entsonkothileyo izandla neenyawo, noxa isixa esikhulu kwizicwili ubethwa walimala kunye nezifo. Eyona njalo wadibana - a zaphuka. Ingcinga ezinxulumene amathambo nandzu kunye icala kunokwenzeka. Izandla neenyawo, njengokuba kuthiwe, kukho inani elikhulu kwezi kwezidumbu, musa kwahluka ubukhulu, ngoko ke kufuneka ukuba abaphathe ixesha elininzi. Navicular sifo sisifo nokulimala.

unyawo

ithambo umlenze lizisa isixa esikhulu. Ezinye zazo Simanywe igama oqhelekileyo unyawo. Navicular fanele nje kweli qela. Le ibekwe phakathi talus, cuboid, yaye amathambo ngoonobumba eliphakathi. Yeyona ndawo yonyawo, kungabandakanywa iinzwane, idla ithambekele waphuka.

Amathambo ye yonyawo, ukwakheka komzimba leyo iqulathe amaqela amathathu, kakhulu abaninzi: i eTarso, metatarsus neminwe. Amathambo amadeo kwenyawo ziquka nezikhundla zabo kunye scaphoid. Le ibekwe kufuphi kwicala elingaphakathi unyawo. On emphethweni walo wahambisa tuberosity wethambo navicular phantsi. Xa amayeza, lo msebenzi osemqoka isetyenziselwa ukugqiba igumbi, apho inesistophu. -X-reyi uncedo ukuqonda isakhiwo sale yinxalenye yomzimba.

ibrashi

ithambo Navicular, ukongeza, ukuba ibekwe brush. Ku fanele ku amathambo encinane esihlahleni. Kubaluleke kakhulu ezithandwa zaphuka, njengoko kubekwe esesiphelweni entendeni. Okubangel 'umdla kukuba, loo ndoda ayaphula ithambo, kungavakali intlungu kwaye uzive ukutyumka, nakuba omelele. Ngoko ke, oko anobungozi. Ukuba ngaba ubona ugqirha, kusenokubakho nemiphumela emibi kakhulu. Umzekelo, eli ithambo navicular zikhula ngokufanelekileyo kunye.

Sosana iqulathe amathambo 8. Zakha imikrozo emibini ngalinye kuquka abane kubo, ezithi zibekwe phakathi amathambo metacarpal kunye yengalo. Scaphoid lula ukufumana ngenxa kwindawo yayo. Kuyinto phakathi nemisipha extensor hallucis longus kunye abductor kwezihlunu elide.

Izifo amathambo yonyawo

Ukongeza ngokwaphulwa, unyawo ithambo navicular zakohlwaywa, kunye nezinye iingozi kunye nezifo. Umzekelo, isifo Kellerra. Osteohondropatija unako ukukhonza njengoko sinjalo isithunywa sifo. Oku kuchaphazela onke amathambo unyawo. Ngcembe siyitshabalalise kwithishyu. Ngexesha yokugula yakhe encinci yegazi nakwesiphi emathanjeni, kwaye, ngenxa yoko, ioksijini kunye nezondlo zilahlekile. Ngenxa yoko, iiseli musa ukufumana ngokwaneleyo kule gesi, kunye namanye amacandelo kuyimfuneko, ngokuthe ngcembe kufa. Noko ke, kwenzeka xa Kwimeko yokugula Keller, ngaphandle songenelelo unosulelo.

Ubangelwa sifo Keller

isifo Keller kaThixo awukwazi kwenzeke ngokwalo. Ngokuba kuye, kukho izizathu ezininzi ukuba ngandlel 'abayithintelayo sicatshulwa kwegazi emathanjeni. Kaninzi iba kukwenzakala ngeenyawo, umzekelo, ukutyumka eyomeleleyo okanye zaphuka. Kwakhona, esi sifo basengozini abo banxiba izihlangu ntofontofo ubungakanani omncinane. Arthrosis kwamalunga - nezifo nayo akhokelela sisifo Keller kaThixo. Ngaphandle zizathu ngasentla, deformation azalwa ngayo amathambo unyawo nako kusenokukhokelela kubola. Flat - enye yomonakalo eziphambili. Kodwa ke izizathu leyo echaphazela ngqo imbonakalo sifo, imbi nanamhlanje.

imilo

amathambo umlenze zaziswe iindidi ezimbini sifo Keller. Yonke into ixhomekeke yini na isahlulelo unyawo akafumani izondlo neoksijini eyaneleyo.

Ngenxa ekubulaleni navicular bamathambo ngokuba sisifo Keller 1. Ukuba igazi akasinikanga nakwiintloko ngamathambo amadeo yesibini neyesithathu ekhokelela ukuyitshintsha kubo, ibizwa ngokuba sisifo Keller 2.

Ukongeza, zizakubalulwa izigaba ezininzi:

• Necrosis.
• Ucinezelo zaphuka.
• Ukuqhekeka.
• Ukubuyiselwa ithambo.

Ngelo kwinqanaba lokuqala kufa imiqadi osseous, ezisetyenziswa sezulu noshowo ngamathambo. Ngaphezu koko, ukuyilwa ezitsha ngethambo, rhoqo ndidilize ngenxa amandla amahlwempu. Emva koko ukunyibilika imiqadi ithambo. Kwaye ke nqanaba lokugqibela iyahambelana ngokupheleleyo kunye nesihloko.

unyango isifo Keller ngayo

Kufuneka phantsi yonyango amathambo unyawo. Anatomy of kubo entsonkothileyo kakhulu, ngoko ke akukho lula ukuba ukunyanga. Xa ukugula Keller 1, amaxesha amaninzi iba ukwaphuka wethambo navicular kwenzeka. Kunokuba ngokuphosakeleyo ukutyumka, yaye esi sifo kuba nzima kakhulu ukubona. Ukuba kuphela abagulayo ingozi musa ukufuna unyango. Emva kokuya kwi ikhosi unyango. Lithambo igama elifanayo isekhona esandleni, kodwa uya kubizwa ngokuba sele isifo Ireysera, nangona lo mgaqo unyango iyafana.

unyango Conservative - enye ndlela zisebenzayo unyango. Kwakhona wabeka a isamente. unyawo Uninzi akunconywa ukuya, kuba le fom encinane kunye non-ibhanile ithambo kunzima ukulungisa. Emva kokuba udaka, ukuze asindise iziphumo, udinga ixesha lokuba ahambe ngeentonga okanye udondolo, abantwana ayithunge insoles ezizodwa. Amachiza ukukhawulezisa nokumanyana. Iinkqubo eziluncedo kakhulu thermal.

nezinga

Akwenzeki ukujongana emva kokususa ingxabano udaka. Leg kufuneka uxolo esisigxina. Kwakhona kukho amathuba Fusion azichanekanga kwaye ukuyilwa sentlanganisela lobuxoki, kunzima ukunyanga. Ufuna uqhaqho. Ngoko ke, inkqubo yesiqhelo kufuneka zisingathwe ngononophelo unako. Ukongeza, ungakwazi ukuthatha kuphela ezo iziyobisi ezibekwa ngugqirha, kungenjalo ungenza kuphela izinto umlenze mbi. Awukwazi ngoyaba icebiso kagqirha, ngokuba umntu ngamnye inyama yakhe ethile. Ezinye amathambo zibuthathaka ukususela ekuzalweni, ngoko ke kufuneka ithathwe ingqalelo ekhethekileyo unyango lwesi sifo.

Bone ukwa esandleni sakhe

Njengoko sele kukhankanyiwe, i navicular izandla ithambo neenyawo basengozini zaphuka umngcipheko. Oku kungenxa yokuba ukuba unyawo, yaye amathambo ngesandla ezicwangciswe kwiindawo ezinjalo, ezithi zivele wenzakele kakhulu qho. Ukuba ujonga iinkcukacha-manani, xa kwimeko ngokwaphulwa nesixa ubunzima kwi-61-88% ngayo navicular.

Izinto ezibangela zaphuka

Kodwa ngenxa yesizathu esithile kukho ukwaphuka amathambo? Njengoko yokusebenza ibonisa, abaninzi zilimale Esiwa ezingalweni zakhe. Kulo mzekelo, umthwalo phantse kulala ngokupheleleyo kwi ithambo. Kwakhona kwahluka ngokwabo Ukophuka: articular and intra-articular.

iimpawu

Navicular rhoqo kakhulu ngokwasemphefumlweni. Kodwa emva kokuba kwenziwe breaking phantse buhlungu. Eyona nje awuboni ukungaphatheki ndicinga ukuba nje ngomvumbo. Noko ke, udibane nogqirha ngokukhawuleza kangangoko kunokwenzeka. Navicular kakuhle kunyango, kwaye ukuba ngaba bungasifumani Fusion wayo, kodwa ibe nemiphumo noqhekeko. Ngelishwa, asingabo bonke yiya esibhedlele. Kakhulu wayesoloko yaphuka kunini na. Ungakhetha ezinye iimpawu ezinokusinceda ukubona okubi:

• Intlungu ithambo navicular.
• Ngokuphazamiseka intshukumo kwamalungu ezandleni.
• ukwandiswa kakhulu ezibuhlungu kwirediyasi.
• Plumpness kummandla ochaphazelekayo.

ekuxilongweni

Njengokuba kwamathambo kwi esihlahleni, nobubi ithambo navicular emlenzeni ayeke kakhulu ukubandezeleka. -X-reyi uncedo ukufumana unobangela intlungu. Ekuqaleni lwenziwa e 3D kwelivi isixhobo, apho kuphandwa ummandla e uqikelelo ezintathu. Xa inyathelo lokugqibela ngokucacileyo ngokwaphulwa ebonakalayo (ityala) amathambo navicular. Yonke le ikhutshwa phandle ngenxa yokuba i ithambo navicular ayiqondakali kakhulu kunyango, oko singqongwe ngamanye amaqumrhu. Ukuze ngokufanelekileyo nangokuchanekileyo nokusebenzisa isamente, kufuneka nje 3D kwingqikelelo.

Kukhona ubuqili. Umzekelo, iminwe kufuneka zixinaniswe kwi ngenqindi. Ukuba ezinjengokwaphuka ibonakala kwaoko andibhekisanga yi X-reyi, yaye zonke iimpawu zibonisa ukuba, yinto isamente malunga nesi-2 iiveki ixhoba, ngoko uqabe oko mazitshekishwe kwakhona. Eyona nto kukuba ngeli xesha kukho resorption kwaye ukwaphulwa nto ibonakala ngokucacileyo, ngaphandle kokuba, kakade, nokubanjwa onke. Imisebenzi incede ukuseka afunyaniswe isifo kwaye zibeka unyango.

unyango bone

ithambo Navicular kwi esihlahleni lwaphulwa rhoqo zokuva nzima kakhulu. Ukuze ukubona ezinjengokwaphuka kufuneka ukubhenela 3D kwingqikelelo. Kodwa ke unyango ukwaphuka kwaye ixesha elide nzima. Ukuhlanganiswa wethambo eza ngenxa kuphela ukuba endosteal callus yakha ngokucothayo kakhulu, kwaye ufuna izixa ezikhulu izondlo (igazi). ukubana kunokwenzeka-ngqangi distal. Zonke umkhondo ngentla kuseko pseudoarthrosis, yaye ngaloo ndlela lukhuni sele asinto unyango lula.

1 indlela. Unyango yokwenzakala ezintsha

Indlela elula nokwanda izandla scaphoid - ke nokubekwa maka. Kwenzeka qho, kusetyenziswa 90-95% yamatyala. Woleke livela iintloko amathambo metacarpal ukusa engqinibeni, kwaye nokuhlutha olugunyazisiweyo eso isandla yokuhlasela ngomnwe encinane. Ngebrashi uhlala fixed, kodwa lula, ixhoba yobume yakhe ngokohlobo ukwandiswa encinane. Immobolizatsiya ibhrashi ithatha malunga 11 iiveki. Ukuba ezinjengokwaphuka kwenzeka kunye tubercle, oko ziiveki-4 kuphela. Emva kokususa ngesamente inyanzelekile x-reyi yesifuba, nto leyo iya kubonisa ukuba ngaba kukho ilungelo nokumanyana. Ukuba umsantsa wabonakala, walisusa ityatyekwe lisetyenziswa kwakhona, kodwa iinyanga 1-2, kunye nolawulo fusion lwenzeka nyanga zonke. Emva kwekhosi unyango kuthatha indawo lulama.

Outs zonyango elondoloza zezi:

• isicelo.
• ulawulo isigxina koogqirha.

Ezinye iindlela. Unyango yokwenzakala ezindala

Ukuba ezinjengokwaphuka eshiyekileyo ifunyanwa kuphela emva kweenyanga ezi-3, loo nto ithathwa ubudala. Ngelo xesha, ixesha bakhule nti lobuxoki. Oku nzima unyango. Ukusebenzisa X-ray kwisiza ngokwaphulwa, kwakunye ukubona ubukho nemingxuma cystoid kunye diastasis phakathi iziqwenga. Kulo mzekelo, ukunyanzelwa maka ayikwazi ukunceda. Sebenzisa enye kwiindlela ezininzi, edume:

1. Bone akayicingi lenkohlakalo cortical.
2. Bone yokumilisela of uMatti-Russe.

Bone akayicingi lenkohlakalo cortical

Le ndlela owavela emva ngo-1928. Isetyenziswa kunye Ukophuka non-United kunye amalungu zobuxoki ithambo navicular. ukufikelela Back-beam sisetyenziselwa zomzimba xa kusenziwa utyando. Ngaphandle umonakalo, ngaphandle kokuchaphazela luvo iphiramidi, kukho ukufikelela kunene. Rassekanie philisi wakhe kunceda ukubona joint zobuxoki. Emva kokuba nokusebenza lwenziwe uphose ngendlela efanayo naleyo echazwe ngasentla. Nalo, kufuneka uthathe malunga neentsuku ezili-14. Emva koko susa beentanda kunye nokusetyenziswa unalo nokubopha setyhula. Indima kwipleyiti ithambo rhoqo iphatha lenkohlakalo nomsi-.

Bone yokumilisela of uMatti-Russe

Enye imisebenzi kakhulu ngempumelelo. Kodwa ilula. Yena wopha entsimini, kodwa ukuhamba kwegazi ngaloo ngokoqobo akuthethi ukuba zimbi. Kuzinziswe scaphoid usebenzisa izinto zokubamba. Le ezintweni lenkohlakalo ithambo. Pre-zibekwe iiasi akavumeli nobutyobo ukuba ihlangane. Immobolizatsiya kuthatha malunga-10 iiveki. ekhuluma Ukususa kwenzeka kuphela emva kweeveki-8.

unyawo zaphuka

Njengoko sele kukhankanyiwe, amathambo tarsal sifo kwiintlobo ezahlukeneyo iingozi. Amaninzi ukwa kwenzeka emva kokuwa into enzima phezu kwawo. Ngamanye amaxesha inesifo ithambo mnye, kodwa eziliqela, njengoko zibekwe kufutshane nenye kwaye abe nobukhulu encinane. Njengoko ithambo navicular izihlahla, musa ukulibala unyango. Noko ke, unyawo kulula kakhulu ukuba ukunyanga. Ngoko nangoko ukwa navicular kwenzeka mhlawumbi ngenxa ukuwa into yokuba ubunzima enkulu okanye ngenxa ucinezelo ngayo phakathi kwabanye. bone kakhulu ngeentlobo le komzimba unyawo has inqwaba eziphilayo.

iimpawu

Atyhila ukwaphuka ithambo navicular yonyawo kulula kakhulu ibrashi. Xa kukho umdlali olimeleyo yale hlobo phantse akunakwenzeka ukuhamba ngokuqhelekileyo, kukho ubuhlungu. Ukongeza, le stupnoy eshukumayo setyhula, kucacile ukuba ekugqibeleni yaphulwe, lo ithambo uzenza ngayo. Kodwa phantse lonke Igumbi scaphoid kudityaniswe ukwenzakala nezinye amathambo yonyawo kwaye, ingakumbi, i waseTarso.

unyango bone unyawo

Ukuze ukwazi ubungakanani kunye nendawo sibange, ngokwaneleyo ukuba wenze i-X-ray e uqikelelo-2, 3, njengoko waba ibhrashi ithambo navicular. Ngaphandle kokuba kukho shift, ngoko enyanzeliswa maka njengesiqhelo. Kodwa ke ukuba le nto yenzeke, oko wenza misa. Kwiimeko ezininzi kakhulu, kwamathambo luyenziwa. Cast lisetyenziswa ngomyinge kwiiveki 4.

Xa ndiqukumbela, sinokuthi ngaphezulu kunayo nayiphi na enye amathambo navicular izihlahla kunye unyawo ubethwa yokwenzakala. Kuba unyango yayo kuthatha ixesha elide, kaninzi kuye kufuneke ukuba bangabheneli imisebenzi. Noko ke, kudityaniswe wethambo kwi unyawo ngokukhawuleza kwaye kube lula kakhulu. Awayiboni ukwa kwelinye icala kunzima kakhulu, kwaye amaxesha amaninzi oku kwenzeka ngamabona-ndenzile. lithambo Navicular yonyawo xa neentanda buhlungu ngamandla.