Tsanangudzo ye lateral epicondylitis yehumerus
Inozivikanwawo se tennis elbow, tendon strain ye extensor carpi radialis muscle, kana kuti kutsemuka kwe attachment point ye extensor carpi tendon, brachioradial bursitis, inozivikanwawo se lateral epicondyle syndrome. Kuzvimba kwetsinga dzakapfava dzakakomberedza lateral epicondyle yehumerus nekuda kwekukuvara kwakakomba, kwenguva refu..
Pathogenesis
Zvine chekuita nebasa, kunyanya muvashandi vanowanzo tenderedza ruoko uye kutambanudza nekukwenya majoini egokora nemaoko. Vazhinji vavo madzimai epamba, vavezi, vanovaka zvidhinha, vanoisa mapombi, uye vatambi.
Dzvipembenene
Zvinonyanya kukosha kumativi ese emucheto wezasi wehumerus ndee epicondyles dzepakati nedzepadivi, epicondyle yepakati ndiyo inosungirirwa patendon yakajairika yemhasuru dzinochinjika dzeruoko, uye epicondyle yepadivi ndiyo inosungirirwa patendon yakajairika yemhasuru dzinochinjika dzeruoko. Panotangira tsandanyama yebrachioradialis, tenderedza ruoko uye taura zvishoma. Panotangira extensor carpi radialis longus, extensor carpi radialis brevis tsandanyama, extensor digitorum majoris, extensor digitorum propria yemunwe mudiki, extensor carpi ulnaris, supinator tsandanyama.
Pathogen
Kutanga kwe condyle kunokonzerwa nekukwenya nekutambanudza mutsipa zvakanyanya, asi varwere vazhinji vanotanga zvishoma nezvishoma uye kazhinji havana nhoroondo yakajeka yekukuvara, uye zvinowanzoitika kune vanhu vakuru vanoda kutenderera ruoko kakawanda uye kutambanudza ruoko nesimba. Inogonawo kumanikidzwa kana kusvetwa nekuda kwekuwedzerwa kwechiuno kakawanda uye kutambanudza zvakanyanya tendon yeruoko pakubatanidzwa kwe lateral epicondyle yehumerus kana ruoko rwacho rwuri panzvimbo yekumiririra.
Pdzidziso dzezvemagariro evanhu
1. Nekuda kwekukuvara kakawanda, lateral epicondyle yemhasuru inobvaruka yobuda ropa, zvichiita subperiosteal hematoma, uye yozoronga uye yoita ossifying, zvichikonzera periosteitis uye bone hyperplasia yelateral epicondyle yehumerus (kunyanya muchimiro che sharp edge nodule). Pathological tissue biopsy exam ihyaline degeneration ischemia, saka inonziwo ischemic inflammation. Dzimwe nguva inoperekedzwa nekubvaruka kwejoint sac, uye synovial membrane yejoint inowanda uye inokora nekuda kwekukurudzirwa kwenguva refu netsandanyama.
2.Bvarura panzvimbo yekunamatira tendon extensor.
3.kuzvimba kunorwadza kana fibrohistolitis ye annular ligament.
4. bursitis ye brachioradial joint uye extensor common tendon.
5. Kuzvimba kwe synovium ye humerus ne radial joint kunokonzerwa nekupindirana kwe humerus nemusoro mudiki we radius.
6. Kurerukirwa kwehumerioradial ligament uye kupatsanurwa kudiki kweproximal radial-ulnar joint kunogonawo kuitika, zvichikonzera kuputsika kwemusoro we radial cephalic. Kuchinja uku kunogona kukonzera kupwanyika kwetsandanyama, kurwadziwa kwenzvimbo, kurwadziwa kunobva mutsandanyama dzeruoko dzakatambanudzwa kuenda kuruoko rweruoko.
Mharidzo yekiriniki
1. Marwadzo ari kunze kwegokora anowedzera kana uchitsanangura, kunyanya kana uchitenderedza musana, uchisimudza, uchidhonza, uchipedzisa, uchisunda nezvimwe zviito, uye uchidzika pasi uchitevedza tsandanyama dzechiwoko. Pakutanga, ndinowanzonzwa kurwadziwa uye kushaya simba mugumbo rakakuvara, uye zvishoma nezvishoma ndinotanga kurwadziwa kunze kwegokora, izvo zvinonyanya kuwedzera nekuwedzera kwekurovedza muviri. (Hunhu hwekurwadziwa uku kurwadziwa kana kuti kukwenya)
2. Zvinowedzera simba mushure mekushanda nesimba uye zvinorerutswa mushure mekuzorora.
3.Kutenderera kweruoko uye kushaya simba pakubata zvinhu, uye kutodonha nezvinhu.
Zviratidzo
1. Epicondyle yechipfuva chechipfuva chepadivi repa ...
2. Bvunzo yeMills inoratidza kuti munhu ane chirwere. Kota ruoko rwako zvishoma woita hafu yeruoko, tambanudza ruoko rwako zvakanyanya sezvinobvira, wobva wanyatsoburitsa ruoko rwako woruramisa gokora rako. Kana kurwadziwa kukaitika parutivi rwe brachioradial joint kana gokora rakatwasuka, zvinoreva kuti munhu ane chirwere.
3. Kuongororwa kwekudzivirira kwe extensor: murwere akabata chibhakera chake ndokupfumbata ruoko rwake, uye muongorori akadzvanya kumashure kweruoko rwemurwere neruoko rwake kuti murwere arambe kuramba uye atambanudze ruoko, sekunge kurwadziwa kwekunze kwegokora kwakanaka.
4. Kuongororwa kweX-ray dzimwe nguva kunogona kuratidza kusagadzikana kweperiosteal, kana nhamba shoma yenzvimbo dze calcification dziri kunze kweperiosteum.
Kurapa
Kurapa kwekuchengetedza:
1. Mirai kudzidziswa kwekubatsira vanhu kuti vashande nekukurumidza, uye vamwe varwere vanogona kuzorora kana kuti plaster immobilization condyle.
2. Kurapa nekushandisa masaji, shandisa nzira dzekusundidzira nekukanya kuti ubvise marwadzo emhasuru dze extensor dzeruoko, wobva washandisa nzira dzekumanikidza nekukanya pa lateral epicondyle yehumerus nenzvimbo dziri pedyo dzekurwadziwa.
3. Kurapa kweTuina, murwere anogara. Chiremba anoshandisa kukwenya zvinyoro nyoro kuti ashande kumusana nekunze kwegokora uye achidzokorora parutivi rweruoko. Chiremba anoshandisa muromo wechigunwe kudzvanya nekukwenya Ah Shi (lateral epicondyle), Qi Ze, Quchi, Hand Sanli, Waiguan, Hegu acupoint, nezvimwewo. Murwere anogara pasi, uye chiremba anokwenya nzvimbo yekutanga yemurwere ye extensor carpi ne extensor carpi longus ne brevis radialis. Dhonza uye tambanudza, magokora ari mupenyu. Pakupedzisira, shandisa nzira ye thenar rubbing kuti ukunye lateral epicondyle yegokora netsandanyama dze extensor dzeruoko, uye kupisa kwemuno kunoshandiswa kusvika padanho.
4. Kurapwa nemishonga, mishonga inonwiwa isiri steroidal inoderedza kuzvimba panguva yekukurumidza.
5. Kurapa kweOcclusive: glucocorticoids (senge jekiseni re betamethasone rakagadzirwa) inopinzwa munzvimbo inonyorova yopinzwa munzvimbo inopinzwa tendon uye nzvimbo ye subaponeurosis (isingasviki kana yakaenzana katatu), izvo zvinogona kuita basa rekudzivirira kuzvimba uye marwadzo, uye betamethasone rakagadzirwa ne ropivacaine kana kuti kuenderana ne levobupivacaine parizvino zvinozivikanwa semishonga inokurumidza kushanda, inoshanda kwenguva refu, ine simba rekudzivirira kuzvimba, uye yakachengeteka, inovhara kwenguva yakareba, ine chepfu shoma uye inoenderana nekurwadziwa kwakanyanya kwemushonga wekudzivirira kwenzvimbo.
6. Kurapa neAcupuncture, kucheka kuri pedyo nepamusoro pemapfupa kuti kubvise mapfupa akapfava anonamatira, kudhonza tsandanyama dzeruoko, tsandanyama dzemunwe dzinoshandiswa pakuwedzera mapfupa, tsandanyama dzemunwe dzinoshandiswa pakuwedzera mapfupa, uye kudhonza banga nepfungwa yekureruka. Kurapa kwekuvhiya: kwakakodzera varwere vasingapindure kurapwa kwakarongeka.
1. Nzira yeBody & Meleod, kuvhiyiwa uku kunosanganisira dzinenge nyama dzese dzechironda, kusanganisira kubviswa kwe2mm lateral epicondyle, kuburitswa kwenzvimbo yekutanga ye extensor common tendon, kubviswa kwechikamu chechikamu cheproximal end yeannular ligament, kuiswa kwehumeroradial joint mu synovium, uye kubviswa kwegranulation tissue kana bursa munzvimbo iri pasi petendonius.
2. Nzira yeNischl, tendon yakajairika ye extensor uye tendon ye extensor carpi longus radialis zvinoparadzaniswa kwenguva refu, tendon yakadzika ye extensor carpi radialis brevis inoonekwa, nzvimbo yekuisa inobviswa kubva pakati pe lateral epicondyle, tishu ye tendon yakaora inobviswa, chikamu che bone cortex chiri pamberi chinobviswa, uye tendon yakasara ne fascia yakapoteredza zvinosungirirwa kana kugadzirwa patsva papfupa. Kubatanidzwa kwemukati me articular hakukurudzirwi.
Prognosis
Kufamba kwechirwere ichi kwenguva refu uye chinowanzo dzoka.
Note
1.Chenjerera kuti udziye uye usatonhorwe;
2. Deredza zvinhu zvinokonzera hutachiona;
3. Kurovedza muviri;
4. Padanho rekukurumidza, nzira yacho inofanira kunge yakapfava, uye nzira yekurapa inofanira kuwedzera zvishoma nezvishoma kune avo vanga vachirwara kwenguva yakareba, kureva kuti, nzira yacho inofanira kunge yakapfava nekuomarara, kuomarara nekupfava, uye kuomarara nekupfava kunofanira kubatanidzwa.
Nguva yekutumira: Kukadzi-19-2025
