Nhau - Zvakajairwa Tendon Kukuvara

Tendon kuputika uye kukanganisa zvirwere zvinowanzoitika, zvinowanzokonzerwa nekukuvadzwa kana kuputika, kuitira kuti udzorere basa remuviri, tambo yakaputika kana yakashata inofanira kugadziriswa nenguva. Tendon suturing inzira yakaoma uye yakaoma yekuvhiya. Nekuti iyo tendon inonyanya kuumbwa nelongitudinal fibers, iyo yakatyoka magumo inowanzo kupatsanurwa kana suture elongation panguva yesuture. Iyo suture iri pasi pekunetseka uye inoramba iripo kusvikira tendon yapora, uye kusarudzwa kwe suture kunokosha zvikuru. Nhasi, ini ndichagoverana newe 12 kukuvara kwakajairwa kwetendon uye misimboti, nguva, nzira uye maitiro ekugadzirisa tendon yetendon sutures.
I.Cufftear
1. Pathogeny:
Kukuvara kwenguva refu kwepfudzi;
Trauma: kukuvadza kwakanyanya kune rotator cuff tendon kana kuwira nepamusoro pegumbo rakawedzerwa uye rakasungirirwa pasi, nechisimba zvichiita kuti musoro wehumeral upinde uye kubvarura chikamu chepamusoro che rotator cuff;
Chikonzero chekurapa: kukuvara kune rotator cuff tendon nekuda kwesimba rakawandisa panguva yekurapa kwemanyorero;
2.Clinical chimiro:
Zviratidzo: Kurwadziwa kwepafudzi mushure mekukuvara, kubvarura-kufanana nekurwadziwa;
Zviratidzo: 60º～120º yakanaka arc yechiratidzo chemarwadzo; kubviswa kwepfudzi uye kurwadziwa kwemukati nekunze kwekutenderera kwekutenderera; kudzvinyirira kurwadziwa pamuganhu wepamberi we acromion uye yakakura tuberosity ye humerus;
3.Clinical kutaipa:
Nyora I: Hapana marwadzo ane basa rakawanda, kurwadziwa kana uchikanda kana kushandura fudzi. Kuongorora ndeyekurwadza kwe-retro-arch chete;
Rudzi rwechipiri: Pamusoro pekurwadziwa paunodzokorora kufamba kwakakuvadzwa, kune rotator cuff resistance pain, uye kufamba kwebendekete kwakajairika.
Rudzi rwechitatu: zvinowanzojairika, zviratidzo zvinosanganisira kurwadziwa kwepfudzi uye kudzikisira kwekufamba, uye kune kudzvinyirirwa uye kurwadziwa kwekudzivirira pakuongorora.

4.Rotator cuff tendon kuputika:
① Kuputika zvachose:
Zviratidzo : Kurwadziwa kwakanyanya kwepanzvimbo panguva yekukuvara, kusunungurwa kwemarwadzo mushure mekukuvara, kuteverwa nekuwedzera zvishoma nezvishoma muzinga rekurwadziwa.
Zviratidzo zvemuviri: Kupararira kwekutambudzika kunorwadza mumapfudzi, kurwadziwa kwakanyanya muchikamu chinoputika chetendon;
Kazhinji palpable fissure uye abnormal bhonzo rubbing inzwi;

Kushaya simba kana kusakwanisa kubvuta ruoko rwepamusoro kusvika 90º parutivi rwakakanganisika.
X-rays: Matanho ekutanga kazhinji haana chinjo dzisiri dzenguva dzose;
Kunonoka kuoneka humeral tuberosity osteosclerosis cystic degeneration kana tendon ossification.

② Kuputika kusina kukwana: pfudzi arthrography inogona kubatsira kusimbisa kuongororwa.
5. Kuzivikanwa kwe rotator cuff tendons ine uye isina kuputika
①1% procaine 10 ml marwadzo ekuvhara nzvimbo;
② Upper ruoko kudonha bvunzo.

II.Injory yebecips brachii refu musoro tendon
1. Pathogeny:
Kukuvadza kunokonzerwa nekudzokorora kuwandisa kwepamusoro-soro kutenderera kwefudzi uye kufamba kwakasimba kwekubatana kwepafudzi, zvichiita kuti kudzokororwa kupfeka uye kubvarura kwetendon mu inter-nodal sulcus;
Kukuvara kunokonzerwa nekudhonza kwakanyanyisa kamwe kamwe;
Zvimwe: kuchembera, rotator cuff kuzvimba, subscapularis tendon kumira kukuvara, akawanda emuno zvisimbiso, nezvimwe.
2.Clinical chimiro:
Tendonitis uye/kana tenosynovitis yemhasuru refu yemusoro webiceps:
Zviratidzo: kurwadziwa uye kusagadzikana pamberi pefudzi , kupenya kumusoro uye pasi pe deltoid kana biceps.
Zviratidzo zvemuviri:
Inter-nodal sulcus uye biceps refu musoro tendon unyoro;
Localized striae inogona kunzwika;
Kubata zvakanaka kwepamusoro ruoko uye kurwadziwa kwepashure kwekuwedzera;
Positive Yergason chiratidzo;
Nhamba shoma yekufamba kwekubatana kwefudzi.

Kuputika kwetendon yemusoro wakareba webiceps:
Zviratidzo:

Avo vanoputika tendon nekuderera kwakanyanya: kazhinji kazhinji hapana nhoroondo yakajeka yekutambudzika kana kukuvadzwa kuduku chete, uye zviratidzo hazvisi pachena;

Avo vane kuputika kunokonzerwa nekuputika kwakasimba kwebiceps pakupikisa: murwere ane manzwiro ekubvarura kana kunzwa kurira kwepfudzi mufudzi, uye kurwadziwa kwepfudzi kunooneka uye kunopenya kumberi kweruoko rwepamusoro.

Zviratidzo zvemuviri:

Kuzvimba, ecchymosis uye unyoro pane inter-nodal sulcus;

Kusakwanisa kushandura gokora kana kuderera kwegokora;

Asymmetry muchimiro che biceps tsandanyama kumativi ose panguva yekubatana nesimba;

Chimiro chisina kujairika chebiceps tsandanyama dumbu parutivi rwakakanganisika, iyo inogona kufamba ichidzika kusvika kuzasi 1/3 yeruoko rwepamusoro;

Rutivi rwakakanganisika rune huturu hwetsandanyama yakaderera pane rutivi rune utano, uye dumbu retsandanyama rinowedzera kufefeterwa kupfuura rimwe divi rakapesana panguva yekumanikana zvine simba.

X-ray firimu: kazhinji hapana shanduko isina kujairika.

III.Injory ofiyo becips brachii tendon

1.Etiology:

Enthesiopathy ye triceps brachii tendon (enthesiopathy ye triceps brachii tendon): iyo triceps brachii tendon inodzokororwa kakawanda.

Kuputika kwe triceps brachii tendon (kuputika kwe triceps brachii tendon): iyo triceps brachii tendon yakabvamburwa nekamwe kamwe uye nechisimba chisina kunanga kunze kwesimba.

2.Clinical zviratidzo:

Triceps tendon endopathy:

Zviratidzo: kurwadziwa kumashure kwepfudzi iyo inogona kupenya kune deltoid, kushaya simba kwepanzvimbo kana zvimwe zvisizvo zvekunzwa;

Zviratidzo:

Kushungurudzika kwekutambudzika mumusoro wakareba tendon ye triceps brachii pakutanga kwemuganhu wakaderera we scapular glenoid patafura yekunze yeruoko rwepamusoro;

Positive elbow extension resistive pain; triceps kurwadziwa kunokonzerwa nekusazvibata kwakanyanyisa kududzira kwepamusoro ruoko.

X-ray: dzimwe nguva kune hyperdense mumvuri pakutanga kwe triceps tsandanyama.

Triceps tendon kuputika:

Zviratidzo:

Kurira kwakawanda kuseri kwegokora panguva yekukuvara;

Kurwadziwa uye kuzvimba panzvimbo yekukuvara;

Kushaya simba mukuwedzera kwegokora kana kusakwanisa kushingaira kuwedzera gokora zvizere;

Marwadzo akawedzerwa nekuramba kuwedzera kwegokora.