Dupuytren's contracture ndiyo mamiriro echanza chinokanganisa anenge anenge matatu muzana yevanhu. Nhoroondo yekare, izvo chete zvingasarudzwa zvekurapa zvaisava chinhu, kana chirongwa chikuru chokuvhiya. Kwemakore gumi adarika, mamwe maitiro mashoma-asina kuvhiringidza akabuda sezvinogona kurapwa. Chimwe chezvirapa zvemazuva ano ndechekuti zvishoma zvishoma zvinopedzisira zvichinzi inonzi apleurotomy.
Dupuytren's contract isimboti inobata ruoko; inowanikwa kune vanhu vane chirwere chaDupuytren. Inokonzera mhuka iri pasi peganda iri pamichindwe yoruoko kuti iwedzere uye ikatumirwa. Ichi chinyama, chipanga chemachinda, chinowanzopa simba uye kutsigirwa kweganda. Zvisinei, mubvumirano reDupuytren, ruvara rwemichindwe runogona kupfupisa zvakanyanya, zvichiita kuti zvibvirire kururamisa minwe. Mamiriro acho akawandisa kune varume vekuNorthern Europe madzitateguru anopfuura makore makumi mashanu.
Mishonga ndeyekubatana kwaDupuytren kunobva mukuoma kwezviratidzo. Vakawanda varwere vanobatwa vane mishonga inogadzika iyo inomira mipira yakasimba yezvivara zvitsvuku mumichindwe, kana tambo dzinoita mapoka akaoma anokwidza chikamu chechanza chomunwe. Dupuytren's nodules inogona kurapwa nechirwere che cortisone kana inogona kuongororwa pasina humwe hutano hwakananga.
Tsvimbo yeDupuytren inogona kuva yakaoma zvikuru sezvo izvi zvinogona kutanga kutora minwe pasi zvichienda kune rumwe rutivi rworuoko.
Nokufamba kwenguva, kana chibvumirano chichifambira mberi, varwere havachakwanisi kunyatsoruramisa minwe. Izvi zvinogona kuita mabasa akajeka akadai sekugeza chiso chako, kugunun'una maoko, kana kupfeka magirafu, zvisingabviri.
Kurapa
Mushonga wakazara weDupuytren's contract ndeye nzira yekuvhiya inonzi partial palmar fasciectomy.
Chikwende uye chinokanganiswa nemunwe zvinovhurwa zvakasununguka kuburikidza nekufungidzirwa kukuru. Icho chisina kukodzera chibvumirano chemachinda chinonzi fascia chinobva chabviswa. Nokuda kwekuvhara kwakapetwa kukuru, ruvara rwechivara ruchanyatsoiswa mumaoko uye neminwe. Kuvhiya kunogona kutora nguva refu yekugadzirisa. Vamwe varwere vangada kutora kwemwedzi miviri kubva kumabasa, zvichienderana nemabasa avo.
Needle aponeurotomy (NA) inoshandiswa zvishoma nezvishoma inoshandiswa kurapa Dupuytren's contract. Mu NA, chiremba anovhiya anoshandisa chikamu chetsono kuti aparadzanise chibvumirano chechindarichi fascia. Izvi zvinoitwa kuburikidza nemakumbo makuru ekuputika. Kusiyana nekuvhiyiwa kwakasununguka, ruoko haruna kuzarurirwa zvikuru, uye kune zvishoma zvishoma mavara zvigadzirwa. Nzira yacho inowanikwa muhofisi yechiremba pasi peanesthesia yemunharaunda. NA yakatanga kuumbwa muFrance muma1970 uye yakaendeswa kuUnited States naDr. Charles Eaton weJupiter, Florida.
Needle Aponeurotomy
Kana ichiitwa nachiremba anovhidzirwa pane murwere akakodzera, NA yakachengeteka uye inoshanda. Muyero wezvinetso, zvakadai sematoni kana kukuvara kwemigumisiro, hausi pasi pekuvhiyiwa kwetsika. Ikoko kusangana kwakanyanya kunonyanya kusvimvara mukati meganda, iro rinowanzoporesa nezvisungo zvisiri nyore.
Chiyero chekudzoka kwaDupuytren mushure meAA yakakwirira kana ichienzaniswa nekugadzirwa kwemaitiro akazaruka. Mushure mekuvhiyiwa pachena, 50 muzana yevarwere vacharamba vachidzoka pamakore mashanu. Izvi zvinofananidza ne50% zvekudzoka shure kwemakore matatu ne NA. Chirwere cheDupuytren chinogona kudzoka nekurapwa, kungosara zvishoma pashure pe NA.
Kazhinji, chirwere chemaoko chisina kutarisirwa mushure me NA. Varwere vanokumbirwa kuchengeta ruoko rwavo rwakashanda rwakakwira kwemazuva maviri mushure mekuita. Varwere vanogona kudzokera kumabasa ekushanda. Basa rakaoma, mitambo, kana zvinokuvaraidza hazvibvumirwi kwevhiki imwe chete.
Pane dzimwe nguva, kupenya kunoitwa kuti kupfeke usiku mushure meA NA.
Sources:
Eaton C, The Hand Center © 2007.
Mahoney JD, Kukurukurirana Kwevanhu, Midwest Orthopedic Center, Hurukuro 11/2007.
Murphy K, "Kururamisa Kwemitsetse Yakaitwa, Hapana Kuvhiya Kunodiwa" The New York Times July 24, 2007.