Incazelo ye-lateral epicondylitis ye-humerus
Eyaziwa nangokuthi i-tennis elbow, uhlobo lwe-tendon lwemisipha ye-extensor carpi radialis, noma ukuklwebheka kwendawo yokunamathisela ye-extensor carpi tendon, i-brachioradial bursitis, eyaziwa nangokuthi i-lateral epicondyle syndrome. Ukuvuvukala okubuhlungu kwezicubu ezithambile ezizungeze i-lateral epicondyle ye-humerus ngenxa yokulimala okungapheli nokunzima..
I-Pathogenesis
Kuhlobene kakhulu nomsebenzi, ikakhulukazi kubasebenzi abavame ukuzungeza ingalo futhi banwebe futhi bagobe indololwane kanye namalunga esihlakala. Iningi labo lingabesifazane basekhaya, ababazi, abakhi bezitini, abalungisi bamapayipi, abaphayi kanye nabadlali bezemidlalo.
Dinsect
Okuvelele kuzo zombili izinhlangothi zomphetho ongezansi we-humerus yi-medial kanye ne-lateral epicondyles, i-medial epicondyle iyisinamathiselo se-common tendon yemisipha ye-flexor yengalo, kanti i-lateral epicondyle iyisinamathiselo se-common tendon yemisipha ye-extensor yengalo. Indawo yokuqala yomsipha we-brachioradialis, cindezela ingalo bese uphinda kancane. Indawo yokuqala yomsipha we-extensor carpi radialis longus, i-extensor carpi radialis brevis, i-extensor digitorum majoris, i-extensor digitorum propria yomunwe omncane, i-extensor carpi ulnaris, imisipha ye-supinator.
Pi-athogen
Ukuqala kwe-condyle kubangelwa ukuklwebheka okukhulu kanye nokunwebeka, kodwa iziguli eziningi ziqala kancane futhi ngokuvamile azinawo umlando ocacile wokulimala, futhi kuvame kakhulu kubantu abadala abadinga ukuzungeza ingalo ngokuphindaphindiwe futhi banwebe isihlakala ngamandla. Kungaphinde kucindezelwe noma kuklwebheke ngenxa yokwelulwa okuphindaphindiwe kwengxenye yesihlakala kanye nokwelulwa ngokweqile kwe-tendon yesihlakala ekunamathiselweni kwe-lateral epicondyle ye-humerus lapho ingalo isesimweni sokuphimisela.
Pi-atology
1.Ngenxa yokulimala okuphindaphindiwe, i-lateral epicondyle ye-muscle fiber iyadabuka futhi yophe, yakha i-subperiosteal hematoma, bese ihlela futhi i-ossifying, okuholela ku-periosteitis kanye ne-bone hyperplasia ye-lateral epicondyle ye-humerus (ikakhulukazi ngesimo se-nodule ebukhali). Ukuhlolwa kwe-pathological tissue biopsy yi-hyaline degeneration ischemia, ngakho-ke ibizwa nangokuthi ukuvuvukala kwe-ischemic. Ngezinye izikhathi kuhambisana nokudabuka kwesikhwama samalunga, kanti i-synovial membrane yamalunga iyanda futhi iqine ngenxa yokukhuthazwa isikhathi eside yimisipha.
2. Dabula endaweni yokunamathela kwe-extensor tendon.
3.ukuvuvukala okubuhlungu noma i-fibrohistolitis ye-ligament ye-annular.
4. i-bursitis ye-brachioradial joint kanye ne-extensor common tendon.
5. Ukuvuvukala kwe-synovium ye-humerus kanye ne-radial joint okubangelwa ukuhlangana kwe-humerus kanye nekhanda elincane le-radius.
6. Ukukhululeka kwe-humerioradial ligament kanye nokuhlukaniswa okuncane kwejoyinti le-proximal radial-ulnar nakho kungenzeka, okuholela ekuqhekekeni kwekhanda le-radial cephalic. Lezi zinguquko ze-pathological zingabangela ukuqaqamba kwemisipha, ubuhlungu bendawo, ubuhlungu obuvela emisipheni yesandla enwetshiwe kuya engalweni.
Isethulo sezokwelapha
1. Ubuhlungu obungaphandle kwejoyinti lendololwane buyakhula lapho kukhulunywa, ikakhulukazi lapho kujikeleziswa isandiso sangemuva, kuphakanyiswa, kudonswa, kuqedwa, kusunduzwa kanye nezinye izenzo, futhi kuphuma phansi ngemisipha ye-extensor yesihlakala. Ekuqaleni, ngivame ukuzwa ubuhlungu nobuthakathaka esithweni esilimele, futhi kancane kancane ngiba nobuhlungu ngaphandle kwendololwane, okwanda kakhulu ngokwanda kokuzilolonga. (Uhlobo lobuhlungu ubuhlungu noma ukuqaqamba)
2. Kuyaqina ngemva kokuzikhandla futhi kukhululeke ngemva kokuphumula.
3.Ukujikeleza kwengalo kanye nobuthakathaka ekubambeni izinto, ngisho nokuwa nezinto.
Izimpawu
1. I-epicondyle ye-humeral eseceleni Isici se-posterolateral se-epicondyle eseceleni ye-humerus, isikhala sejoyinti le-humeral-radial, i-cephalic cephalic kanye nomphetho oseceleni we-condyle yentamo ye-radial kungaphathwa ngesandla, kanti imisipha kanye nezicubu zenyama ohlangothini lwe-radial lwengalo engenhla nazo zingaphathwa ngesandla ngokuvuvukala okuncane, ububele noma ukuqina. Ngezinye izikhathi imiphetho ebukhali ye-hyperostosis ingazwakala ku-epicondyle eseceleni ye-humerus, futhi ithambile kakhulu.
2. Ukuhlolwa kwe-Mills kuqinisekile. Goba ingalo yakho kancane bese wenza isigamu sesibhakela, phakamisa isihlakala sakho ngangokunokwenzeka, bese uphakamisa ingalo yakho ngokuphelele bese uqondisa indololwane yakho. Uma kuvela ubuhlungu ohlangothini oluseceleni lwe-brachioradial joint lapho indololwane iqondile, kuyiqiniso.
3. Ukuhlolwa kokumelana kwe-extensor okuhle: isiguli saqinisa isibhakela saso sagoba isihlakala saso, kanti umhloli wacindezela isandla sangemuva sesiguli ngesandla sakhe ukuze isiguli simelane nokumelana futhi selule isihlakala, njengokuthi ubuhlungu obungaphandle kwendololwane bubonakala kahle.
4. Ukuhlolwa kwe-X-ray ngezinye izikhathi kungabonisa ukungalingani kwe-periosteal, noma inani elincane lamaphuzu e-calcification ngaphandle kwe-periosteum.
Ukwelashwa
Ukwelashwa okulondolozayo:
1. Yeka ukuqeqeshwa kwendawo kokuvuselela kusenesikhathi, futhi ezinye iziguli zingakhululeka ngokuphumula noma nge-condyle yokuvimbela ukunyakaza kweplasta yendawo.
2. Ukwelashwa ngokubhucunga, sebenzisa amasu okusunduza nokuxova ukuze unciphise ukuqaqamba nobuhlungu bemisipha yengalo, bese usebenzisa amasu okucindezela nokuxova e-epicondyle eseceleni ye-humerus kanye namaphuzu obuhlungu aseduze.
3. Ukwelashwa kwe-Tuina, isiguli sihlala phansi. Udokotela usebenzisa ukugoqa nokuxova kancane ukuze asebenze ngemuva nangaphandle kwendololwane bese ephinda ohlangothini lwangemuva lwengalo. Udokotela usebenzisa isihloko sesithupha ukucindezela nokuhlikihla i-Ah Shi (i-lateral epicondyle), i-Qi Ze, i-Quchi, i-Hand Sanli, i-Waiguan, i-Hegu acupoint, njll. Isiguli sihleli phansi, bese udokotela ekhipha indawo yokuqala yesiguli ye-extensor carpi kanye ne-extensor carpi longus kanye ne-brevis radialis. Donsa futhi welule, izindololwane eziphilayo. Okokugcina, sebenzisa indlela yokuhlikihla ye-thenar ukuze uhlikihle i-lateral epicondyle yendololwane kanye nemisipha ye-extensor yengalo, bese kusetshenziswa ukushisa kwendawo ngezinga elithile.
4. Ukwelashwa ngezidakamizwa, imithi yokulwa nokuvuvukala engeyona eye-steroidal esigabeni esibucayi.
5. Ukwelashwa okuvalekile: ama-glucocorticoids (njengomjovo we-betamethasone ohlanganisiwe) afakwa endaweni ethambile bese efakwa endaweni yokufaka i-tendon kanye nesikhala se-subaponeurosis (ngaphansi noma okulingana nezikhathi ezi-3), okungadlala umphumela wokulwa nokuvuvukala kanye nobuhlungu, kanti i-betamethasone ehlanganisiwe kanye ne-ropivacaine noma ukuhambisana ne-levobupivacaine okwamanje kubhekwa njenge-titer esebenza ngokushesha, esebenza isikhathi eside, ephezulu yokulwa nokuvuvukala, kanye nesikhathi esiphephile, eside kakhulu sokuvimba, ukusabela okunobuthi obuncane kanye nokuhambisana kwemithi yobuhlungu ephansi kakhulu yokuvaleka kwendawo.
6. Ukwelashwa nge-acupuncture, ukusikwa kuseduze nobuso bethambo ukuze kukhishwe izicubu ezithambile ezinamathelayo ezizungeze inqubo yethambo, kukhishwe imisipha yesandla se-extensor, imisipha yomunwe we-extensor i-common tendon kanye ne-supinator tendon, bese kudonswa ummese ngomuzwa wokuxega. Ukwelashwa ngokuhlinzwa: kufanelekile ezigulini ezingasabeli ekwelashweni okulondolozayo.
1. Indlela ye-Body & Meleod, ukuhlinzwa kuhilela cishe zonke izicubu zesilonda, okuhlanganisa ukususwa kwe-epicondyle eseceleni engu-2mm, ukukhululwa kwendawo yokuqala ye-tendon evamile ye-extensor, ukususwa kwengxenye yengxenye ye-proximal end ye-annular ligament, ukufakwa kwe-humeroradial joint ku-synovium, kanye nokususwa kwezicubu ze-granulation noma i-bursa esikhaleni esingaphansi kwe-tendinous.
2. Indlela ye-Nischl, i-tendon evamile ye-extensor kanye ne-tendon ye-extensor carpi longus radialis zihlukaniswa ngobude, i-tendon ejulile ye-extensor carpi radialis brevis iyavezwa, indawo yokufaka iyasuswa enkabeni ye-lateral epicondyle, izicubu ze-tendon eziwohlokile ziyasuswa, ingxenye ye-bone cortex engaphambili iyasuswa, bese i-tendon esele kanye ne-fascia ezungezile kuyathungwa noma kwakhiwe kabusha ethanjeni. Ukubandakanyeka kwe-intra-articular akukhuthazwa.
Pi-rognosis
Isikhathi sokuqhubeka kwalesi sifo side futhi sivame ukuphinda sibuye.
Ni-ote
1.Naka ukugcina ufudumele futhi ugweme ukubanda;
2.Nciphisa izinto ezibangela izifo;
3. Ukuzivocavoca okusebenzayo;
4. Esigabeni esibucayi, inqubo kufanele ibe mnene, futhi inqubo yokwelapha kufanele iqhubeke kancane kancane kulabo asebegule isikhathi eside, okungukuthi, inqubo kufanele ithambe ngokuqina, ukuqina ngokuqina, kanye nokuqina nobumnene kufanele kuhlanganiswe.
Isikhathi sokuthunyelwe: Feb-19-2025
