Rheumatoid Foot Deformity Isingawanzoitiki
Hazvishamisi kuti vanhu vane rheumatoid arthritis kukudziridza matambudziko epamusoro nepamusoro. Maererano neAAOS (American Association of Orthopedic Surgeons), vanopfuura 90 kubva muzana yevanhu vane rheumatoid arthritis vanoita zviratidzo zvetsoka uye zvepachika pamusoro pechirwere chacho. Pasinei nehuwandu hwakawanda, zvinetso zvetsoka zvinowanzoregererwa kana kusaregererwa.
Kazhinji uye Maitiro Mashoma Maitiro
Netsoka imwe neimwe ine mapfupa makumi maviri nemaviri, akaparadzana muzvikamu zvitatu: hindfoot (talus uye calcaneus), midfoot (navicular, cuneiforms, uye cuboid), uye forefoot (metatarsals uye inowirirana nendima mapfupa kana phalanges). Nezvakanaka zvekuita (semuenzaniso, kufamba uye kumhanya), nzvimbo dzetsoka dzinopindirana. Sezvaunofamba kana kumhanyira, rutsoka rwako runopinda mumutambo wekududzira (tsoka dzezvigumburu mukati) uye kuchenesa (tsoka dzinoputika kunze) iyo inobvumira rutsoka kugadzirisa kune zvisizvo zvisina kufanira uye kunotyisa kushamiswa, kuteverwa nekufambisa mberi kufamba. Asi, pane dzimwe zvirwere uye nemamiriro ezvinhu anokonzera tsoka (semuenzaniso, rheumatoid arthritis), izwi rekududzira / kunyorera rinogona kukanganiswa, zvichiita kuti tsoka dzisina kukodzera dzive dzakanyanyisa (kunyanya kuwedzerwa), midfoot uye forefoot kusagadzikana, kuwedzera kurema kunobata mukati (mukati rutsoka) kana kupfuura kupfurikidza (kune kunze kwetsoka).
Izvi zvisingakanganisi zvinogona kuchinja kugoverwa kwehutano uye kukonzera marwadzo akabatana, zvinetso zvinyoro zvishoma (tendon sheaths, bursae, kana inheses), kana ganda risina kunaka (corns uye calluses). Zvinetso zvesimba zvakanyanya zvinowanzoitika kumativi ose, sezvakaita plantar fasciitis, peroneal tendinitis, kana bursitis . Rheumatoid nodules inogona kuumba Achilles 'tendon.
Rheumatoid Arthritis uye Foot Zvakaipa
Ne rheumatoid arthritis, kusagadzikana kakawanda kunowanzobatanidza mberi, kunyanya kubudiswa kwemasatarsophalangeal (MTP) majoints, clawing yezvigunwe (hammertoes), uye bunion (hallux valgus). Kukanganiswa kwakadaro kunowanzoitika pamwe chete, kunyanya mune zvakanyanya rheumatoid arthritis, zvichikonzera marwadzo uye mamwe zviratidzo zvingangodaro zvakabatana nechinangwa chechimiro kupfuura chirwere chairo. Kubatanidzwa kwemaoko emakumbo (mutauro we talotibial) hawanzwisisiki, zvichibata 10-20 kubva muzana yevanhu vane rheumatoid arthritis. Izvo zvinyorwa zvinowanikwa zvinowanzobatanidzwa ne rheumatoid arthritis, inobata 33-75 muzana yevanhu vane chirwere.
Kuparadzaniswa kwezvigunwe, nekubvumirana kwekudzivirira kwetendon kukonzera kujekesa, kunokonzera metatarsal ichikwira mumunda wepanyika, zvichida kubvisa metatarsal arch. Zvakanyanya, zvinoshungurudza zvinogona kuumba sezvinoita misatarsal misoro inosundirwa pasi kusvika kune imwe netsoka.
Kuongororwa Nemaoko Kusakanganisika
Chiremba anokwanisa kuona valgus kupera kwechidzitiro uye hindfoot (tsoka yakadzika kunze) kubva kumashure apo murwere akamira. Chikamu chekudzivirira uye unyoro pamakumbo echidiki chiratidzo che synoviti .
Hondo uye hindfoot inofanirawo kuongororwa nekuda kwekufamba . Murwere anogona kuongororwa nokuda kwetsitsi kuburikidza neAlexlles tendon uye chitsitsinho zvakare.
Kusakanganiswa kwemukati uye forefoot kunogona kuonekwa zvakare nekucherechedza murwere ari pachigaro. Panova neuchapupu hwe pes planus (yakaputsika arch kana gumbo rakadzika) kana pes cavus (yakakwirira arch) kana iripo.
Kufuridzira kwemasati metatarsophalangeal kunokonzera kupararira kwezvigunwe zvezvigunwe, zvinowanzonzi sechiedza chemasikati. Kushandisa zvakananga kumanikidzira kumatanho emetatarsophalangeal kucharatidzawo unyoro kana huripo.
Treatment Options
Nhengo dzemakumbo dzinogona kubatsira kuderedza marwadzo nekuvandudza basa kune vanhu vane rheumatoid arthritis foot deformity.
Kukosha kwezvipfeko zvakakodzera hazvikwanisi kupera. Kunyange zvazvo shangu dzokurapa dzinogona kuderedza marwadzo nekuvandudza basa, kazhinji kazhinji kusagamuchirwa nekuda kwekusagutsikana nehutano uye chimiro.
Pamatambudziko akaoma, apo nzira dzakachengetedza dzinoisa pazvipfeko kana mutsara dzinokundikana, kuvhiyirwa kunogona kusarudzwa. Forefoot resection uye fusion inonzi inogona kunge inogutsa yekusarudza nzira.
Sources:
The Foot and Ankle in Rheumatology. Philip Helliwell et al. Arthritis Research UK. Nyaya 8. Spring 2011.
http://www.arthritisresearchuk.org/health-professionals-and-students/reports/topical-reviews/topical-reviews-spring-2011.aspx
Rheumatoid Kuchinja Kwemakumbo. Leonard Marmor. Arthritis uye Rheumatism. Vol. 6. Nha. 6. December 1963. (Yokutanga yakabudiswa paIndaneti musi wa21, 2005.)
http://onlinelibrary.wiley.com/doi/10.1002/art.1780060610/pdf
Rheumatoid Arthritis of the Foot and Ankle. OrthoInfo. AAOS. December 2011.
http://orthoinfo.aaos.org/topic.cfm?topic=a00163
Primer paRheumatic Diseases. Arthritis Foundation. Yegumi nemitatu edition. Chitsauko 2. Kuongorora kwevarwere. P.13-14.