Zinaphatikizidwa zala: Zoyambitsa ndi Chithandizo

Chifukwa ena makanda amabadwa zinaphatikizidwa zala? Kodi kudwala izi, ndipo ngati inu mukhoza kuchotsa izo? Mayankho a mafunso amenewa ndi ena za zolakwika otchulidwa zipangizo adzaphunzilanso pa nkhani imeneyi.

General zokhudza kudwala ndi

Zinaphatikizidwa zala - ndi kobadwa nako m'munsi nthambi chitukuko. zopatuka izi amakhala ndi maphatikizidwe tsankho kapena wathunthu wa zala ziwiri kapena zambiri. Mu yochizira matenda, zinaphatikizidwa zala ndi dzina wapadera - syndactyly.

Ndi matenda a anthu akhoza kukhala maphatikizidwe chala onse opunduka ndi underdeveloped ndipo anayamba bwino. Zotsatira za syndactyly ndi zinchito ndi zodzikongoletsera zopindika ya nthambi m'munsi.

Mwana ndi kupatuka ayenera nthawi zonse kufunsa ndi zachibadwa ndi dokotala mafupa. Kukhazikitsa mtundu wa syndactyly, ayenera idzachitika X-ray phazi. Chithandizo vuto ili imagwiridwa yekha ndi opaleshoni. Pankhaniyi, awiri zinaphatikizidwa zala anasiyanitsidwa ndi ntchito pulasitiki ndi kutsekedwa chilema kofunika kutero.

ena ziwerengero

Syndactyly otchedwa nthenda chitukuko cha zala, ndilo chifukwa cha kuswa lamanja la kulekana. Childs, izi zimachitika pa nthawi ya embryonic.

Zinaphatikizidwa zala za khanda anapezeka ndi pafupipafupi 1 3000. Kuyenera kudziŵika kuti syndactyly ndi pafupifupi theka la anomalies onse obadwa nawo. Chotero phazi kudwala ikhoza kukhala ndi kuchimwa palokha, ndipo pamodzi ndi zilema zina (mwachitsanzo, zala hypoplasia, polydactyly ndi polifalangiey, ectrodactyly, brachydactyly, brachioradialis synostosis, akuwaza wa maburashi, ulnar kapena zozungulira clubhand ndi zina zotero.).

Pafupifupi 60% ya ana omwe anali zala zinaphatikizidwa (chithunzi chilema m'nkhani ino), imakhudzana kuvutika kobadwa nako mu dongosolo minofu ndi mafupa (mwachitsanzo, pseudarthrosis, clubfoot, nthenda ananyema unsembe, etc.).

chifukwa cha chilema

N'chifukwa chiyani ana kukhala wachiwiri amenewo, mofanana ndi zala zinaphatikizidwa? Zimayambitsa zopatuka izi zikhoza kukhala zosiyana. Akatswiri akukhulupirira kuti 20% milandu izi chifukwa chibadwa. M'mawu ena, vuto onse a autosomal chitsanzo lalikulu la cholowa.

Ngati mbiri banja la syndactyly akusowa, ziyenera ankaganiza kuti kuyan'anila za zosiyanasiyana ndi mapangidwe nthambi m'munsi wa mwana wosabadwayo zinachitika pa embryogenesis. Kawirikawiri izi zimachitika pamene pali zotsatira za zinthu zosiyanasiyana chokhwima.

chilema A akufotokozera?

Chifukwa miyendo zinaphatikizidwa zala ndi kufotokozera chotero chitukuko ziwalo? sanabadwe mwana phazi tsamba kumachitika pa sabata 5 chitukuko intrauterine. Inali pa nthawi iyi mu wosabadwa ya khateyo syndactyly thupi.

Popeza chilema kale mu sabata ya 7 ya zala anapanga. Ichi ndi chifukwa kukula kunyezimira chala ndipo m'mbuyo chitukuko cha malo interdigital. Ngati kuchepetsa makoma interdigital wosweka, ndiye phalanx si anapatukana, kuti pali syndactyly.

zingayambitse chitukuko nthenda

Zinaphatikizidwa zala, mwanayo angayambe zotsatira poizoni pa thupi la mkazi wapakati. Nthawi zambiri izi zidzachitika kumwa mankhwala, mowa, komanso akumane zachilengedwe, zimaonetsa ntchito, X-ray walitsa matenda (mwachitsanzo, fuluwenza, chindoko, TB, etc.).

Nthawi zambiri zimayambitsa kubadwa kwa mwana ndi syndactyly kukhala bwinobwino.

Zinaphatikizidwa zala - nthawi zambiri anati chilema mwa dongosolo la chromosomal ndi syndromes chibadwa.

Mwa njira, sikawirikawiri kwambiri anapeza anthu kuthi syndactyly. Childs, chotero kudwala ukapezeka pambuyo amayaka phazi (matenthedwe kapena mankhwala).

Zinaphatikizidwa zala - kutanthauza kudwala izi?

anthu ambiri amene mwakhama amasangalala chinsinsi, akukhulupirira kuti kudwala izi akufotokozera osati. Amakhulupirira kuti mtundu uwu wa kusintha ndi wamakani. Ndithudi, zinaphatikizidwa zala ndithu amatikumbutsa zogawanika.

Komabe, madokotala amanena kuti palibe chachilendo ndi zoyipa kuti phazi si chitukuko. Izi zikungofanana ndi anomaly nthambi, kumene N'zosavuta kuchotsa, makamaka magawo oyambirira a moyo wa mwana.

Kotero musadandaule kwambiri ngati muli zinaphatikizidwa zala. Zimatanthauza chiyani, inu mukhoza kunena yekha dokotala, osati wamakani okonda zolemba.

Gawo ziwonongeke

Mu zamafupa syndactyly m'magulumagulu malinga ndi kutalika, mtundu wa msoko, komanso chikhalidwe cha zala.

Panopa wolemekezeka:

• fupa mawonekedwe (pamene fupa kukwera amapezeka);
• minofu zofewa mawonekedwe (nthawizina membranous ndi khungu).

chilema gulu kutalika zimadalira chiwerengero ndi kutalika phalanges zinaphatikizidwa msoko.

Ponena za boma chala zinaphatikizidwa, ndi syndactyly n'kovuta kwambiri. Zikatero pali maphatikizidwe wa chala wabwinobwino, ndipo choyamba - ndi kuvutika fupa, limodzi tendon kapena zida mitsempha.

mitundu majini

Syndactyly wachinsinsi ndi chibadwa mitundu:

• Yoyamba - zigodaktiliya. Tsankho kapena wathunthu maphatikizidwe (membranous) 2 ndi chala 3. Komanso salamulidwa kunja zala zina Ngati a Bakha.
• Mtundu chachiwiri - sinpolidaktiliya. Zisudzo za zala 4 ndi 5 ndi anawaonjezera kuwirikiza kawiri pa 5 ndi. Pakuti kudwala imeneyi amakhala ndi: kuphwanya reliefs chikopa zidendene ndi hypoplasia wa phalanx pakati.
• Mtundu wachitatu. Amgwirizano wathunthu syndactyly wa 4 ndi zala 5. Pankhaniyi, phazi si bwanji.
• Wachinayi mtundu - syndactyly Mzere. Full amgwirizano cutaneous syndactyly dzanja. Pa nthawi yomweyo palibe imfa amasiya.
• Mtundu wachisanu. Kuphatikiza metatarsal ndi mafupa metacarpal. Pa manja ndi ambiri 3-4 maphatikizidwe zala ndi mapazi - 2 ndi 3.

zizindikiro chilema

Pamene syndactyly mapazi mwana nthawi zambiri anati maphatikizidwe wa 2 ndi 3 zala. Pa yemweyo chosagawanika phalanx akhoza kukhala mwina underdeveloped kapena anayamba bwinobwino. Nthawi zina, pali kuchepa kwa chiwerengero cha zala chifukwa cha amputation awo amniotic.

Mosiyana ndi ana ndi syndactyly m'manja mwa ana ndi syndactyly mapazi kukhala ndithu bwinobwino. Iwo alibe vuto ndi kukhazikitsa osiyanasiyana zochita. Mu vuto limeneli zinchito phazi si choopsa maphunziro awo, komanso pafupifupi konse zimasokoneza kusankha ntchito m'tsogolo.

Kodi matenda?

Kodi matenda zala zinaphatikizidwa (chizindikiro kuti chilema ngati wafotokozedwapo pamwamba chabe)? Syndactyly wapezeka neonatologist yomweyo pambuyo pa kubadwa kwa mwana. Ataona Komanso wa mwana ikuchitika zamafupa Dokotala kapena opaleshoni. Kuti achotse chromosomal ndi kuvutika jini akhoza chokhudzana ndi zachibadwa.

Ngakhale kuti matenda anapangidwa pambuyo kuyendera zithunzi kulongosolerana mtundu vuto, komanso chitukuko cha njira mankhwala, m'pofunika kuchita chida kuphunzira.

Radiography phazi zolosera awiri zimathandiza akatswiri amanena osalimba a fupa, thanzi olowa, kutalika ndi kukhalapo kwa fupa maphatikizidwe. Kuzindikira makhalidwe a magazi ndi mtima maukonde zala kuchita UZDG, reovasography, angiography ndi thermometer magetsi.

chithandizo matenda

Kodi pali mankhwala zinaphatikizidwa zala? Opaleshoni kuti asiyanitse phalanges - ichi ndi chokhacho zotheka njira. Komabe, tisaiwale kuti opaleshoni ntchito kokha pamene syndactyly ya zala. Ponena zinaphatikizidwa phalanges tileke, ndiye opaleshoni sitingachisonyeze. Ngati chosayenerera ngati zina ndi kuyenda bwinobwino, alowererepo ukadali ikuchitika.

Pamene opaleshoni zikuchitikazi?

Terms ndi njira za phukusi opaleshoni atsimikiziridwa potengera chikhalidwe ndi mawonekedwe a chirema. Cholinga cha njira imeneyi ndi kuthetsa chilema zodzikongoletsera, komanso kutukula ntchito ya phazi kapena dzanja.

Nthawi akadakwanitsira ntchito za - zaka 4-5. Ngati mwana wakhanda zimawonedwa syndactyly yotsiriza, phukusi la ikuchitika mu theka lachiwiri la moyo wake. Zimenezi zimathandiza mapindikidwe chala sekondale ndi kukula m'goli la phalanges lapansi.

likuyandikira opaleshoni

Pa ntchito opaleshoni ikuyandikira izi zingagwiritsidwe ntchito:

• kulekana kwa zala conjoined ndi khungu plasty ndi zimakhala kuderalo;
• membranous kulekana msoko skinless mapulasitiki;
• zinaphatikizidwa kulekana zala, amene lowonjezera ntchito ophatikizana a khungu kumezetsanitsa ndi autografts ufulu ndi zimakhala kuderalo;
• kulekana kwa zala conjoined, amene lowonjezera ndi ufulu khungu kumezetsanitsa polnosloynym kapena kugawanika khungu kumezanitsa;
• multistage kusokonezedwa ndi tendon-minofu, khungu ndi fupa kumezetsanitsa.

Nthawi postoperative

Pambuyo pa opaleshoni kugwetsa zala anapambulwa pa chiwalo zoika zochotseka pulasitala splint. Ndi bwino kuvala miyezi 3-4.

Pafupifupi masiku 15 pambuyo opaleshoni kuyamba kuchira wodwalayo. Kuchita izi, ntchito manja kutikita kapena mapazi thupi mankhwala phonophoresis ndi Lydasum, magetsi kukondoweza kwa minofu ya zala ozokerite, paraffin ndi matope opangidwa.

The chifukwa cha opaleshoni

Njira ntchito opaleshoni zamakono zochizira syndactyly kupereka zodzikongoletsera zabwino ndi zotsatira zinchito. Ndi phukusi yake kwathunthu kubwezeretsedwa osati kapangidwe yachibadwa, komanso burashi ntchito ya phazi.

Opaleshoni kuti achotse syndactyly wopambana ngati wodwalayo alibe zipsera kumanga ndi lateral chilema kwa zala, ndipo pali uthunthu wonse wa kutengeka mu interphalangeal olowa (adduction, atigwira, extension flexion), kumvetsa ntchito (mu nkhani ya burashi ndi), tilinazo wabwino ndi mawonekedwe a chirengedwe m'mipatamu pakati pa zala.

Ngati mankhwala a syndactyly anaganiza kuchita, izo zikanakhoza kungasokoneze pa chitukuko ndi kukula kwa nthambi mwana.