Ukwakhiwa nokwelashwa kwendololwane yethenisi

Incazelo ye-epicondylitis yangemuva ye-humerus

Okwaziwa nangokuthi indololwane yethenisi, i-tendon strain ye-extensor carpi radialis muscle, noma i-sprain yephoyinti elinamathiselwe le-extensor carpi tendon, i-brachioradial bursitis, eyaziwa nangokuthi i-lateral epicondyle syndrome. Ukuvuvukala kwe-aseptic okudabukisayo kwezicubu ezithambile ezizungeze i-epicondyle yangemuva ye-humerus ngenxa yokulimala okukhulu, okungapheli..

I-Pathogenesis

Ihlobene eduze nomsebenzi, ikakhulukazi kubasebenzi abavame ukuzungezisa ingalo futhi banwebe futhi bagobe indololwane nezihlakala. Iningi labo ngamakhosikazi asezindlini, ababazi, abakhi, abalinganisa, abasebenza ngamapayipi, nabasubathi.

Disiqephu

Ukuvelela ezinhlangothini zombili zokuphela okuphansi kwe-humerus yi-epicondyles ephakathi nendawo, i-epicondyle ephakathi iwukunamathiselwe kwe-tendon evamile yemisipha ye-flexor ye-forearm, futhi i-epicondyle ye-lateral iyisinamathiselo se-tendon evamile ye-extensor muscle ye-forearm. Indawo yokuqala ye-brachioradialis muscle, vula ingalo futhi uphendule kancane. Indawo yokuqala ye-extensor carpi radialis longus, i-extensor carpi radialis brevis muscle, i-extensor digitorum majoris, i-extensor digitorum propria yomunwe omncane, i-extensor carpi ulnaris, imisipha ye-supinator.

Pi-athogen

Ukuqala kwe-condyle kubangelwa i-sprain acute kanye nokwelula, kodwa iziguli eziningi ziqala kancane futhi ngokuvamile azikho umlando ocacile wokuhlukumezeka, futhi kuvame kakhulu kubantu abadala abadinga ukujikeleza ngokuphindaphindiwe i-forearm futhi banwebe isihlakala ngamandla. Kungase futhi kucindezelwe noma kuncishiswe ngenxa yokwelulwa okuphindaphindiwe komhlane wesihlakala kanye nokwelula ngokweqile kwethenda yesihlakala ekunamathiselwe kwe-epicondyle ye-lateral ye-humerus lapho umphambili usendaweni yokubiza.

Pi-athology

I-1.Ngenxa yokulimala okuphindaphindiwe, i-epicondyle ye-lateral ye-muscle fiber idabukile futhi yopha igazi, yenza i-hematoma engaphansi kwe-subperiosteal, bese ihlela futhi i-ossifying, okuholela ku-periosteitis kanye ne-bone hyperplasia ye-epicondyle ye-lateral ye-humerus (ikakhulukazi ngesimo se-nodule ebukhali ebukhali). Ukuhlolwa kwezicubu ze-pathological biopsy yi-hyaline degeneration ischemia, ngakho-ke kubizwa nangokuthi ukuvuvukala kwe-ischemic. Ngezinye izikhathi kuhambisana nokukhala kwesikhwama esihlangene, futhi i-synovial membrane ye-joint iyanda futhi iqiniswe ngenxa yokuvuselela isikhathi eside yi-muscle.
2.Dabhuka endaweni yokunamathisela ithenda ye-extensor. 
3.ukuvuvukala okubuhlungu noma i-fibrohistolitis ye-annular ligament. 
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 nekhanda elincane le-radius.
6. Ukuphumula kwe-humerioradial ligament kanye nokuhlukana okuncane kwe-proximal radial-ulnar joint nakho kungase kwenzeke, okuholela ekuhlakazeni kwekhanda le-cephalic radial. Lezi zinguquko ze-pathological zingabangela ukugoqa kwemisipha, ubuhlungu bendawo, ubuhlungu obukhiphayo kusukela emisipha enwetshiwe yesihlakala kuya engalweni.

Isethulo somtholampilo

1.Ubuhlungu obungaphandle kwendololwane buyabhebhetheka lapho ukubiza, ikakhulukazi uma uzungezisa isandiso sangemuva, uphakamisa, udonsa, uphetha, uphusha nezinye izenzo, futhi uphuma phansi eduze komsipha wesihlakala sesihlakala. Ekuqaleni, ngivame ukuzwa ubuhlungu nobuthakathaka esithweni esilimele, futhi kancane kancane ngiba nobuhlungu ngaphandle kwendololwane, okuvame ukubhebhetheka ngokwanda kokuzivocavoca. (Imvelo yobuhlungu ibuhlungu noma ukuluma)
2.Iyathuthukiswa ngemva kokuzikhandla futhi iyakhululeka ngemva kokuphumula.
3.Ukuzungeza kwengalo kanye nokuba buthakathaka ekubambeni izinto, ngisho nokuwa nezinto.

Izimpawu

1.I-Lateral humeral epicondyle Isici se-posterolateral se-lateral epicondyle ye-humerus, isikhala se-humeral-radial joint, i-cephalic cephalic kanye ne-lateral edge ye-condyle yentamo ye-radial ingashaywa, futhi izicubu ze-musculosis nenyama ohlangothini lwe-radial lwe-pastiness engenhla noma i-pastiated engenhla ingakwazi ukugoqa. Kwesinye isikhathi imiphetho ebukhali ye-hyperostosis ingazwakala ku-epicondyle yangemuva ye-humerus, futhi ithenda kakhulu.
2.Ukuhlolwa kweMills ku-positive. Gobisa umphambili wakho kancane wenze isibhakela esiyingxenye, ugobe isihlakala sakho ngangokunokwenzeka, bese uphimisa umphambili wakho ngokugcwele futhi uqondise indololwane yakho. Uma ubuhlungu buvela ohlangothini oluhlangothini lwe-brachioradial joint lapho indololwane iqondiswe, kuhle.
I-3.Isivivinyo sokumelana ne-extensor e-Positive: isiguli sabamba isibhakela saso futhi sagoba isihlakala, futhi umhloli wacindezela ngemuva kwesandla sesiguli ngesandla sakhe ukuze enze isiguli simelane nokumelana nokwandisa isihlakala, njengobuhlungu obungaphandle kwendololwane bubuhle.
4.Ukuhlolwa kwe-X-ray ngezinye izikhathi kungase kubonise ukungahambi kahle kwe-periosteal, noma inombolo encane yamaphoyinti wokubala ngaphandle kwe-periosteum.

Ukwelashwa

Ukwelashwa kwe-Conservative:

1. Misa ukuqeqeshwa kwendawo yokuvuselela kusenesikhathi, futhi ezinye iziguli zingakhululeka ngokuphumula noma i-condyle ye-plaster immobilization yasendaweni.
2.Ukwelapha ngokubhucunga, sebenzisa amasu okusunduza nokuxova ukuze ukhulule i-spasm kanye nokuphumula kobuhlungu bemisipha ye-extensor yengalo, bese usebenzisa ingcindezi yamaphuzu kanye namasu okuxova ku-epicondyle engemuva ye-humerus kanye namaphuzu obuhlungu aseduze.
3. Ukwelashwa kwe-Tuina, isiguli sihlezi. Udokotela usebenzisa ukugoqa nokuxova okuthambile ukuze enze ngemuva nangaphandle kwendololwane futhi abuyisele eceleni komphambili wengalo. Udokotela usebenzisa ichopho lesithupha ukuze acindezele futhi ahlikihle i-Ah Shi (i-epicondyle ehlangothini), i-Qi Ze, i-Quchi, i-Hand Sanli, i-Waiguan, i-Hegu acupoint, njll. Isiguli sihlezi, futhi udokotela uhlwitha indawo yokuqala yesiguli ye-extensor carpi ne-extensor carpi longus ne-brevis radialis. Donsa futhi welule, izindololwane bukhoma. Okokugcina, sebenzisa indlela yokuhlikihla ye-nar ukuze uhlikihle i-epicondyle engemuva yendololwane kanye nemisipha ye-extensor yengalo, futhi ukushisa kwendawo kusetshenziselwa izinga.
4. Ukwelashwa kwezidakamizwa, izidakamizwa ezingezona ukuvuvukala ngomlomo ezingezona ukuvuvukala esigabeni esibucayi.
5. Ukwelashwa okungenangqondo: i-glucocorticoids (efana nomjovo we-betamethasone ehlanganisiwe) ijova endaweni yethenda futhi ifakwe endaweni yokufaka i-tendon kanye nesikhala se-subaponeurosis (ngaphansi noma elingana nezikhathi ze-3), engadlala umphumela wokulwa nokuvuvukala kanye ne-analgesic, kanye ne-betamethasone ehlanganisiwe ne-ropivacaine ne-ropivacaine noma i-levopivacaine esheshayo noma i-levopivacaine esheshayo. esebenza isikhathi eside, i-titer ephezulu elwa nokuvuvukala, kanye nesikhathi sokuvimbela esiphephe kunazo zonke, eside kunazo zonke, ukusabela okunobuthi obuncane kanye nokuhambisana kwezidakamizwa okuphindisela emuva kobuhlungu obuphansi kakhulu bokuvala indawo.
6. Ukwelashwa kwe-acupuncture, i-acupuncture iseduze nendawo yethambo ukuze kukhishwe izicubu ezithambile ezinamathelayo ezizungeze inqubo yethambo, dredge umsipha wesandla esinwebekayo, i-extensor finger muscle common tendon ne-supinator tendon, futhi ukhiphe ummese ngomqondo wokuxega. Ukwelashwa okuhlinzayo: kulungele iziguli ezingaphenduli ekwelashweni kwe-conservative.

1. Indlela ye-Body & Meleod, ukusebenza kuhilela cishe zonke izicubu ze-lesion, kuhlanganise nokukhishwa kwe-2mm lateral epicondyle, ukukhululwa kwendawo yokuqala ye-tendon evamile ye-extensor, ukukhishwa okuyingxenye kokuphela kwe-proximal ligament ye-annular, ukufakwa kwe-humeroradial joint ku-synovium ye-substance noma i-sub-sinovium, kanye nokukhishwa kwe-substrate ye-substrate.

2. Indlela ye-Nischl, i-tendon evamile ye-extensor kanye ne-extensor carpi longus radialis tendon ihlukaniswa ubude, i-deep extensor carpi radialis brevis tendon ivuliwe, iphuzu lokufaka likhishwa phakathi nendawo ye-epicondyle ehlangene, izicubu ze-tendon eziwohlokayo ziyasuswa, ingxenye ye-bone cortex ezungezile, futhi i-tendon i-fast cortex. i-sutured noma yakhiwe kabusha ethanjeni. Ukubandakanyeka kwe-intra-articular akukhuthazwa.

Pi-rognosis

Inkambo yalesi sifo yinde futhi ijwayele ukuphindaphinda.

Nothi

1.Naka ukufudumala futhi ugweme ukubanda;
2.Yehlisa izici ze-pathogenic;
3.Ukuzivocavoca okusebenzayo;
4. Esigabeni esibucayi, inqubo kufanele ibe mnene, futhi inqubo yokwelapha kufanele ikhule kancane kancane kulabo asebegule isikhathi eside, okungukuthi, inqubo kufanele ibe mnene ngokuqina, ukuqina nokuthambile, futhi ukuqina nokuthambile kufanele kuhlanganiswe.