Inkcazo ye-epicondylitis esecaleni ye-humerus
Ikwabizwa ngokuba yi-tennis elbow, i-tendon strain ye-extensor carpi radialis muscle, okanye i-sprain ye-attachment point ye-extensor carpi tendon, i-brachioradial bursitis, eyaziwa ngokuba yi-lateral epicondyle syndrome. Ukuvuvukala okubuhlungu kwe-aseptic yezicubu ezithambileyo ezijikeleze i-epicondyle esecaleni ye-humerus ngenxa yokwenzakala okubuhlungu, okungapheliyo..
I-Pathogenesis
Inxulumene ngokusondeleyo nomsebenzi, ngakumbi kubasebenzi abasoloko bejikeleza i-forearm kwaye bandise kwaye bajike ingqiniba kunye namalungu esihlahla. Inkoliso yabo ngoomama bamakhaya, abachweli, abakhi, abangcibi, abasebenza ngemibhobho yamanzi neembaleki.
Dicandelo
Ukugqwesa kumacala omabini angaphantsi kwe-humerus yi-epicondyles ephakathi kunye ne-lateral, i-epicondyle ye-medial yi-attachment ye-tendon eqhelekileyo yemisipha ye-flexor ye-forearm, kunye ne-epicondyle esecaleni i-attachment ye-tendon eqhelekileyo ye-extensor muscles of forearm. Indawo yokuqala ye-brachioradialis muscle, i-flex forearm kunye ne-pronate kancane. Indawo yokuqala ye-extensor carpi radialis longus, i-extensor carpi radialis brevis muscle, i-extensor digitorum enkulu, i-extensor digitorum propria yomnwe omncinci, i-extensor carpi ulnaris, i-supinator muscle.
Pathogen
Ukuqala kwe-condyle kubangelwa i-sprain ebukhali kunye nokwelula, kodwa izigulane ezininzi ziqala ngokukhawuleza kwaye ngokuqhelekileyo azikho imbali ecacileyo yokulimala, kwaye ixhaphake kakhulu kubantu abadala abafuna ukujikeleza ngokuphindaphindiweyo i-forearm kunye nokwandisa isandla ngamandla. Iyakwazi ukunyanzeliswa okanye igxininiswe ngenxa yokwandiswa kwe-dorsal ngokuphindaphindiweyo kwi-wrist joint kunye nokwelula ngokugqithiseleyo kwe-tendon ye-wrist kwi-attachment ye-epicondyle ye-lateral ye-humerus xa i-forearm ikwindawo yokubiza.
Pi-athology
I-1.Ngenxa yokulimala okuphindaphindiweyo, i-epicondyle yecala le-fiber ye-muscle ikrazukile kwaye i-hemorrhage, yenza i-hematoma ye-subperiosteal, kwaye emva koko iququzelele kwaye i-ossifying, ibangele i-periosteitis kunye ne-bone hyperplasia ye-lateral epicondyle ye-humerus (ininzi ifom ye-nodule edge edge). Uvavanyo lwe-pathological tissue biopsy yi-hyaline degeneration ischemia, ngoko ikwabizwa ngokuba yi-ischemic inflammation. Ngamanye amaxesha ihamba kunye nokukrazula kwe-joint sac, kwaye i-membrane ye-synovial ye-joint iyanda kwaye igxininiswe ngenxa yokuvuselela ixesha elide yi-muscle.
2.Ukukrazula kwindawo yokuncamathela ithenda ye-extensor.
3.ukuvuvukala okubuhlungu okanye i-fibrohistolitis ye-ligament annular.
4. i-bursitis ye-brachioradial joint kunye ne-extensor ye-tendon eqhelekileyo.
5.Ukuvuvukala kwe-synovium ye-humerus kunye ne-radial joint ebangelwa ukudibanisa kwe-humerus kunye nentloko encinci ye-radius.
6. Ukuphumla kwe-humerioradial ligament kunye nokuhlukana kancinci kwe-proximal radial-ulnar joint nako kunokwenzeka, okubangelwa ukuchithwa kwentloko ye-cephalic ye-radial. Olu tshintsho lwe-pathological lunokubangela i-muscle spasms, intlungu yendawo, intlungu ephuma kwimisipha eyandisiweyo yesandla ukuya kwi-forearm.
Inkcazo yeklinikhi
I-1.Intlungu engaphandle kwendawo ye-elbow iyancipha xa i-pronation, ngakumbi xa ujikeleza ukwandiswa kwangasemva, ukuphakamisa, ukutsala, ukuphelisa, ukutyhala kunye nezinye izenzo, kunye nokuphuma phantsi kunye ne-wrist extensor muscle. Ekuqaleni, ndihlala ndiziva iintlungu kunye nobuthathaka kwilungu elenzakeleyo, kwaye ngokuthe ngcembe ndiphuhlisa intlungu ngaphandle kwengqiniba, eyona nto ibuhlungu kakhulu ngokunyuka komthambo. (Ubume bentlungu kukuqaqamba okanye ukuntlitheka)
2.Iyandiswa emva kokuzibhokoxa kwaye iyakhululeka emva kokuphumla.
3.Ukujikeleza kwe-Forearm kunye nobuthathaka ekubambeni izinto, kunye nokuwa kunye nezinto.
Iimpawu
I-1.I-Lateral epicondyle ye-humeral I-posterolateral ye-epicondyle ye-lateral ye-humerus, indawo ye-humeral-radial joint, i-cephalic cephalic kunye ne-lateral edge ye-condyle yentamo ye-radial inokuthi ifakwe, kunye ne-musculosis kunye nenyama yenyama kwi-radial side ye-pastilation engaphezulu okanye i-pastiftness engaphezulu, inokuthi ifakwe kwi-pastilation engaphezulu. Ngamanye amaxesha imiphetho ebukhali ye-hyperostosis inokuvakala kwi-epicondyle esecaleni ye-humerus, kwaye ithambile kakhulu.
2.Uvavanyo lweMills luthi positive. Goba umphambili wakho kancinci kwaye wenze isiqingatha senqindi, jija isandla sakho kangangoko, emva koko uphakamise umphambili wakho kwaye wolule ingqiniba yakho. Ukuba intlungu iyenzeka kwicala elisecaleni le-brachioradial joint xa i-elbow iqondiswe, ilungile.
Uvavanyo lwe-3.Positive extensor resistance test: isigulane sibambe inqindi kwaye siguqule isandla sakhe, kwaye umhloli ucinezele umva wesandla somguli ngesandla sakhe ukuze enze isigulane sixhathise ukuxhathisa kunye nokwandisa isandla, njengentlungu engaphandle kwe-elbow ilungile.
4. Uviwo lwe-X-ray lunokuthi ngamaxesha athile lubonise i-periosteal irregularity, okanye inani elincinci lamanqaku okubalwa ngaphandle kweperiosteum.
Unyango
Unyango olulondolozayo:
1. Yeka ukuqeqeshwa kwendawo yokuvuselela kwangaphambili, kwaye ezinye izigulane zinokukhululeka ngokuphumla okanye i-condyle ye-plaster immobilization condyle.
2.Unyango lwe-massage, sebenzisa iindlela zokutyhala kunye nokuxova ukukhulula i-spasm kunye nokunciphisa intlungu ye-extensor yemisipha ye-forearm, kwaye usebenzise uxinzelelo lwamanqaku kunye neendlela zokuxova kwi-epicondyle esecaleni ye-humerus kunye namanqaku eentlungu ezikufutshane.
3. Unyango lweTuina, isigulane sihleli. Ugqirha usebenzisa ukuqengqeleka okuthambileyo kunye nokuxova ukwenza emqolo nangaphandle kwengqiniba kunye nokubuyisela ecaleni kwicala lomqolo lomphambili. Ugqirha usebenzisa incam yesithupha ukuze acinezele kwaye aqhube u-Ah Shi (i-epicondyle esecaleni), i-Qi Ze, i-Quchi, i-Hand Sanli, i-Waiguan, i-Hegu acupoint, njl. Tsala kwaye wolule, phila iingqiniba. Ekugqibeleni, sebenzisa indlela yokuxubha i-thenar yokucoca i-epicondyle esecaleni ye-elbow kunye nezihlunu ze-extensor ze-forearm, kwaye ukushisa kwendawo kusetyenziswe kwinqanaba.
4. Unyango lweziyobisi, iziyobisi zomlomo ezingenayo i-steroidal ezichasayo kwinqanaba elibukhali.
5. Unyango olungenasiphelo: i-glucocorticoids (njenge-injection ye-betamethasone edibeneyo) ijojowe kwindawo yethenda kwaye ifakwe kwindawo yokufaka i-tendon kunye nesithuba se-subaponeurosis (ngaphantsi okanye ilingana namaxesha e-3), enokuthi idlale i-anti-inflammatory kunye ne-analgesic effect, kunye ne-betamethasone edibeneyo kunye ne-ropivacaine kunye ne-levopivacaine okanye i-levopivacaine ekhawulezayo okanye i-levopivacaine ekhawulezayo. ixesha elide, i-anti-inflammatory titer ephezulu, kunye nelona xesha likhuselekileyo, ixesha elide lokuthintela, ukusabela okuncinci okunetyhefu kunye nentlungu ephantsi yokubuyisela ukuhambelana kweziyobisi kwi-occlusion yendawo.
6. Ukunyangwa kwe-acupuncture, i-incision isondele kumphezulu wethambo ukukhupha i-adhesion soft tissue ejikeleze inkqubo yamathambo, i-dredge i-extensor wrist muscle, i-extensor finger muscle ye-tendon eqhelekileyo kunye ne-tendon ye-supinator, kwaye ukhuphe imela ngengqiqo yokukhululeka. Unyango lotyando: lufanelekile kwizigulane ezingaphenduliyo kunyango olulondolozayo.
1. Indlela ye-Body & Meleod, umsebenzi ubandakanya phantse zonke izicubu ze-lesion, kubandakanywa ukuchithwa kwe-2mm lateral epicondyle, ukukhululwa kwendawo yokuqala ye-tendon eqhelekileyo ye-tendon, ukutshatyalaliswa kwenxalenye yesigxina sokuphela kwe-ligament annular, ukufakwa kwe-humeroradial joint kwi-synovium ye-bubble okanye i-substace grasanu, kunye ne-substance ye-synovium.
2. Indlela ye-Nischl, i-tendon ye-extensor eqhelekileyo kunye ne-extensor carpi longus radialis tendon ihlukaniswe ixesha elide, i-deep extensor carpi radialis brevis tendon ibonakaliswe, indawo yokufakela ikhutshwe ukusuka kumbindi we-epicondyle esecaleni, i-tendon ehlanjululweyo ihlanjululwa, inxalenye yethambo i-cortex ejikelezayo kunye ne-tendon isuswe ngaphambili kunye ne-tendon. i-sutured okanye yakhiwe ngokutsha kwithambo. Ukubandakanyeka kwe-intra-articular akukhuthazwa.
Pisifo sengqondo
Ikhosi yesifo ide kwaye ijwayele ukuphindaphinda.
Note
1.Naka ukufudumala kwaye uphephe ukubanda;
2.Ukunciphisa izinto ze-pathogenic;
3.Umthambo osebenzayo;
4. Kwinqanaba elibukhali, ubuchule kufuneka bube mnene, kwaye ubuchule bonyango kufuneka buqhubele phambili ngokuthe ngcembe kwabo bagula ixesha elide, oko kukuthi, ubuchule kufuneka buthambile ngokungqongqo, ukuqina kunye nokuthamba, kunye nokuqina kunye nokuthamba kufuneka kudityaniswe.
Ixesha lokuposa: Feb-19-2025
