Kuora Kwemwenje Mushure mekukuvara
A Boutonniere deformity yemunwe ndiwo mugumisiro wekukuvadza kune teteons inoshandiswa kururamisa zvigunwe zvemunwe. Kazhinji vanhu vanotsigira rudzi urwu rwekukuvadza panguva yemitambo kana basa uye vanofunga kuti 'vakanganisa' minwe yavo . Zvisinei, nokufamba kwenguva, Boutonniere kukuvadzwa kunogona kufambira mberi, uye kunyange kuva dambudziko rinogara nokusingaperi. Nenzira yakanaka, kana ichinge ichiongororwa nokukurumidza, kune marapirwo anogona kuitwa.
Chii Chinoitika
A Boutonniere deformity inoitika mushure mekukuvadza kwakanyanya kumatoni emunwe. Zvigunwe zvako zvinonamatira kumashure uye zvichienda nematoni achidonha pamapfupa. Izvo zvinokonzera mafungiro zviri pachigadziko chemunwe, uye inodhonza minwe pasi - chirevo chinonzi finger flexion. Izvo zvinoshandiswa zvinoshandiswa pamusana wemunwe uye zvinoshanda kururamisa munwe - chirevo chinonzi minimi yekuwedzera. Munwe woga woga unogadziriswa wake, uye imwe neimwe inotenderera inosvika kumapfupa munzvimbo dzakawanda.
Mapfupa matatu emunwe aya anonzi phalanges (rimwe nerimwe rinonzi phalanx) uye anonzi mazita maererano nenzvimbo. Iyo distal phalanx iyo inopinza yemunwe, iyo phalanx yepakati iri pakati pemakona, uye iyo yakawanda phalanx ndiyo nheyo yemunwe. Izvo zvinoshandiswa zvinosungirirwa kune zvose zviri pakati nepalanx uye distal phalanx. Apo kubudiswa kwekudzivirira kweparal phalanx kwakakuvara, inonzi " mallet finger" .
Apo iyo inoshandiswa inowedzera kusungirirwa kwepakati phalanx yakakuvara, mhedzisiro ndeye Boutonniere deformity. Izvo zvakasungirirwa zve-extensor tendon pakati pephalanx inonzi inonzi slip central - saka zvepamusoro, boutonniere kukuvadzwa kunokonzerwa nekukuvadzwa kusvika mukati.
Chikonzero Nei Chimiro Chichitarisa Chakaipa
Pakati pekukanda ndeyekubatanidza kunokosha kwekuwedzera kwetendon.
Iyi chikamu chetsitsi chinoputika chinokwevera pamapalanx ari pakati zvichiita kuti chikamu chepakati chomunwe chigadzirwe. Apo bhiri rinoputika rinokuvadzwa, yekutanga kuvhara (mubatanidzwa wePIP) haikwanise kumira zvakakwana uye inotarisa zvishoma zvakakotama nguva dzose.
Zvisinei, iyo inongova chikamu cheBoutonniere deformity. Finger mechanics yakaoma zvikuru, uye kana imwe chikamu chemunwe ichikuvara, zvimwe zvikamu zvemuinwe zvingasashanda zvakajeka. Munyaya yeBoutonniere deformity, nokuti kubatana kwePIP hakukwanisi kururamisa, mitsipa iri panze yemunwe inoshandiswa munzvimbo yavo. Panzvimbo yekushanda kuti ugove bhero yekupedzisira (DIP joint) mitsara inotanga kukwevera yekupedzisira yakakosha yakananga (hyperextension). Nokudaro, kuora kwemuviri weBoutonniere ndiko kwepakati pekubatana kwePIP, nekutengesa kwekubatana kweDIP. Whew!
Zvinoitika Sei
Kazhinji, simba rakajeka rinoshandiswa kumusana wemunwe wakabhurwa ndiro chikonzero cheBoutonniere deformity. Sezvakataurwa, izvi zvinowanzova mitambo kana kushanda kwebasa. Kukuvadza kwakakomba, kunopinda kwakadai sekucheka , kunogona kukonzera Boutonniere kukura.
Zvinowanzoitika zviratidzo zveBoutonniere deformity zvinosanganisira:
- Pain pamusoro pemusana wepalanx wepakati wemunwe
- Kurerera pamusoro pepakati pepakati
- Kusakwanisa kururamisa sangano rePIP kana kukotamisa dIP pamwe chete
Kurapa kweBoutonniere Deformity
Kuzivikanwa kwokutanga kwekukuvara uku kwakakosha, sezvo kutanga kurapwa mukati memwedzi wekukuvara kunowanzokwanisa kubvumira kurapa kusina kupirisa kuchibudirira. Kurapa kunosanganisira kupenya kubatana kwePIP munzvimbo yakakwana zvakakwana kwevhiki 4-6. Kazhinji kacho, kukuvadzwa kwakanyanya kunorapwa nekupenya kuchagadzirisa uye kuporesa zvakakwana.
Kukuvadza kwakange kwave kwakapoteredza kwenguva yakareba hazvikwanisi kuvandudza nekupenya, uye haungatongozodzokera kune yakasikwa. Zvokuvhiya zvinoshandiswa pakugadzirisa tete uye kugadzirisa doro rinogona kubatsira.
Mukuwedzera, chirwere chinogona kukurudzirwa zvimwe zvikonzero zvinokonzerwa neBoutonniere deformities kusanganisira kukuvadza kunopinda, rheumatoid arthritis, uye Boutonniere kukuvadza kunoitika pamwe nekumwe kukanganisa kumunwe.
Sources:
Boyer MI naGelberman RH. "Kushandisa kugadziriswa kwebvudzi-mitsipa uye boutonniere kuora kwemaoko echirwere" J Am Acad Orthop Surg March 1999; 7: 92-100.