Ulnar inokwakuka, iyo inonziwo kubuda kwechirwere, uku kuora kwemimwe yeruoko. Kunyanya, kudonha kweunnori kunoitika apo kune kubuda kwekune uye volar subluxation ye metacarpophalangeal joints (MCP). Anatomically, the proximal phalanges inobatana ne metacarpals yoruoko pamatanho e metacarpophalangeal. Nhengo dze MCP dzakawanda dzinowanzotaurwa nezvayo semakona.
Kufuridzirwa kweVolar yaMetacarpophalangeal joint inovapo apo pane zvishoma zvishoma zvinokonzera kusungirirwa - iyo yakawanda phalanx shift kure nemusoro wemetacarpal, inofamba mumugwagwa wemichindwe. Intermediate uye distal phalanges zvinotevera kushanduka kwechikwata chepulanx yakawanda.
Maererano neKelley's Textbook yeRheumatology , kune uchapupu hwekuti chirwere cherheumatic chekristin chinotungamirira kukanganisa kwemashure kwemasangano e MCP. Inofungidzirwa kuti kuderera kwe extensor carpi ulnaris muscle kunokonzera kuparadzaniswa kwemazara kwekristin sezvinoita mapfupa emapapiro anotenderera (anowedzera carpal mapfupa anotenderera mumugwagwa werinar and distal carpal bones in a radial direction). Kuparadzana kweUnar kunowedzera sechiitiko chemuviri, kuedza kuchengetedza maitiro kune phalanges mukuenzanirana neyero. Kusvibiswa kwepafu kana chetikiti yepamusoro kunogona kuita kuti hunar ikudonhe, asi inogonawo kuitika pasina. Synovitis uye musimba utera zvinogona kuita basa mukuvandudza kwayo.
Zviratidzo zvepakutanga zvekukurumidza kweminye zvinosanganisira:
- kushaya simba kwekutanga kokutanga dorsal interossei (interossei ndiwo mishonga pakati pemapfupa chaiwo)
- kusvibiswa kwemhepo inotyisa
- kusimbiswa kwemisungo yepfungwa
- ulnar kushanduka kweflexor tendons (inozivikanwa mumutsara uye neminwe yakareba)
- kubuda kweminwe kweminwe iyo inooneka apo masangano eCMP anowedzera
Zviratidzo zvakanyanyisa zvekudonsa kwekupedzisira zvinosanganisira:
- volar subluxation (partial dislocation) ye phalanges
- kutadza kukwanisa kuwedzera hutano hweMCP hunoita kuti bvumirano rivepo
- ulnar slip kana shift of extensor tendons
- kusimbiswa kwemakumbo emhuka (boka rezvitatu zvitatu muchanza cheruoko runotungamirira kufamba kwechidimbu chiduku)
- kudengenyeka kwezuva kwekristani
- extensor carpi ulnaris tendon dislocation
- kurasikirwa kwekwaniso kwechigunwe chekupikisa index index
Kuti uone kuoma kwekudonha kwegunnar, goniometer inogona kushandiswa. Nzvimbo yakasimudza ye goniometer inoiswa pamusoro pemetacarpal apo ruoko rwakasununguka runoenzaniswa nechepamusoro phalange. Mushure mokunge chiremera chichigadziriswa, murwere anowanzobvunzwa kururamisa ruoko rwavo, kana zvichibvira, kururamisa nekugadzirisa kurongeka uye kuongorora zvakare kunotorwa. Zvimwe zviyero zvekushanda kwemaoko zvinogona kushandiswawo kuongorora kuoma kwechirema.
Ndiani Anoita Ulnar Drift?
Ulnar drift inowanzobatanidzwa ne rheumatoid arthritis . Kurwara kusingaperi kwezvibatanidza zveMCP zvinokuvadza kubatana kwemajoni uye zvivako zvakapoteredza. Asi, rheumatoid arthritis haisi iyo mamiriro chete akabatana nekukurumidza kwekudonha. Izvo zvinogona kuitika nemamwe mamiriro ekuvhiringidza kana zvirwere zvinogadzirisa zvirwere, zvakadai se lupus kana psoriatic arthritis .
Chimwe chiitiko chekuongorora zvakaratidzawo kushamwaridzana nechirwere chisina kujairika, pigmented villonodular synovitis (PVNS).
Treatment Options
Zvisarudzo zvekurapa ruoko rwekudzivirira nekurwadziwa zvinosanganisira ice, kupisa kwakanyorova, parafini yakisi yewaini, TENS unit , uye ultrasound. Shandisa maitiro, izvo zvinonyanya kusanganisira kutambanudza, zvinokurudzirwa kuchengetedza kufamba kwemafambiro zvakanyanya.
Kunongororwa dzimwe nguva kunorudzirwa kuti kuderedze kugadziriswa kwekristani, kuisa zvakakwana masangano eCMP mune zvematongerwe enyika, uye kuderedza kusagadzikana kwezvibatanidza zveMMP nekutsigira zvakanyanya phalanges. Kazhinji, zvipfeko zvinopfekedzwa usiku kana panguva dzezororo masikati.
Zvirwere zvinogona kubatsira nemarwadzo usiku asi zviputi hazvina kuratidzirwa kuti zvidzivirire kuparara kwekupedzisira. Kunyangwe nekupenya kweusiku, kukanganisa kwekupedzisira kunogona kufambira mberi.
> Sources:
> Kelley's Textbook of Rheumatology. Ninth edition. Firestein et al. Elsevier Saunders. Clinical Features yeRheumatoid Arthritis. Chitsauko 70. Maoko uye Maoko. Peji 1112.
> Volar Subluxation yeMetacarpophalangeal Joint.
> Maitiro Akanakisisa Mazano Okutungamirira kweUnar Drift Deformity muRheumatoid Arthritis. Vancouver Coastal Health. The Arthritis Society (Canada).
> Kushandiswa kweKubata kweNocturnal Splints Mukurapa Kwekutsauka Kwekupedzisira kweRheumatoid Hand. Johnson M et al. Clinical Rheumatology. March 1992.
> Kutsauka kweIndaneti hakusi nguva dzose Rheumatoid . Zuber M et al. Annals weRheumatic Diseases. 1996.