The ibvi vagari: nemarunda uye kukuvara chokuita navo. How kurapa shwashwa of ibvi

Achitaura pamusoro pebvi, vanhu vakawanda vanoti ibvi rwakashodoka. Zvechokwadi, izvozvo chinokosha anatomical chikamu Zvisinei, functionality ayo pasina tsandanyama nemarunda zvisingabviri. Kana tichifamba, kumhanya, kutamba mitambo iri yakanatsa nharaunda nhoroondo kuti mutoro, izvo kunowedzera ngozi yokubatwa kukuvara guru. Ngatikurukurei ibvi vadyi, shwashwa, tsandanyama maitiro uye matambudziko anomuka panguva izwi iri wakapona chinhu.

anatomi

Paumbwe muhudyu kunosanganisira mapfupa nhatu: femur chikamu, chikamu patella uye tibial. Patella femoral-tibial nechipiriso uye femoral-suprapatellaris majoini. Anatomical zvinhu pave mawa itirana kufamba mapfupa ndege dzakawanda.

Menisci, shwashwa akapa connective zvinyama, vari "spacers" pakati mafupa musoro. basa ravo kupa cushioning, kuparadzirwa kufurirwa uye mutoro kana uchityaira. On mativi ose meniscus chokuita mekamudzira aka parutivi coronary nemarunda.

vagari stabilizers zvinosanganisira zvinotevera mapoka tsandanyama, ruzivo iyo anonzi chinhu chinokosha mu kunotevera:

1. Quadriceps tsandanyama inoremekedzwa kumberi yehudyu. It anonzi yakasimba tsandanyama chikwata anatomical maumbirwo akati nzvimbo.
2. Sartorius ndiye wakarebesa. Inopa flexion uye muhudyu uye mupambare, paaifamba ibvi rwakashodoka.
3. Mutete tsandanyama rinopfuura shure uye zvishoma kurutivi muhudyu, vachibvumira vatungamirire muhudyu uye ibvi vanobwembura.
4. Adductor Magnus tsandanyama rinobatanidzwa kwete chete kuunza muhudyu, asi zvaro kuwedzera kana kuwedzera chiuno chokuita nebandauko.
5. Zvinokonzera transverse akabatana kunosvika maviri misoro pechidya tsandanyama, vachibvumira vachikotama mupambare, chidya unbend, zvinopa kufamba outwards.
6. Shure uye mukati pejoinhi kunosvika podsuhozhilnaya tsandanyama extensor yehudyu flex tibia uye kupa dzeraundi kutenderera richiripo.
7. Semimembranosus tsandanyama anoita mabasa podsuhozhilnoy zvakafanana.
8. Triceps tibia flexes rezasi gumbo panguva ibvi uye tsoka iri neketani rwakashodoka.
9. Pfupi uye sandara rorudyi tsandanyama riri rwemberi pamusoro. Zvaiitwa flexion uye vachishandisa kutenderera tibia.

ibvi basa

The kunyatsoshanda of ibvi muhudyu kunokosha kuti muviri womunhu. Zvinokwanisika kuita kuti kutwasuka uye frontal namasanhu. Extension uye flexion kunoitika pamberi ekisero, hunyambiri - vachishandisa kutenderera richiripo.

vadyi flexion norutsoka anobvumira munhu kuti danho mberi, kurova pasi richiripo uye zvinyoronyoro akaisa. Zvikasadaro, rutsoka yevanhu kunzi mune verhneperednem mirayiridzo nokumutsa nebandauko.

nemarunda

The ibvi vagari nemarunda ayo anomiririrwa mapoka makuru mashanu anonzi chikamu chomuviri kunzwisisa anatomical hurongwa. nhengo dzaro inosanganisira tsapo zvinotevera:

• rubatso (tibial, peroneal);
• cruciform (kumberi, kumashure);
• transverse shwashwa of ibvi;
• shure (arcuate, popliteal, patellar shwashwa, kuti medial uye lateral);
• coronary (meniscus-femoral, tibial-meniscus).

Kana kunotevera, kunyanya mitambo kukuvara, chikuru mutoro kunoitika panguva ibvi cruciate nemarunda. Nguva kupora uye vapore nguva kuvimba yezvakaita kukuvara inokuvadza zvikonzero, zvikurukuru mutumbi wacho, zvechigarire kubva 4 kusvika 6 mwedzi.

Cruciate shwashwa uye functionality

Anterior shwashwa rinoenderera kubva veshure yokumusoro chikamu meniscus zviri femur kuburikidza ibvi pamwe mhango, vakaiisa kuna tibia, iyo rwuripowo articular conglomerate. Its basa iri kudzikamisa ibvi vadyi, Kuderedza mberi kwebasa tibia.

Shwashwa kunosvika kubva pamberi femur mapfupa protrusion uye kuyambuka vadyi mhango, ari vakasungirira kusvikira tibia pakupedzisira. Shwashwa kunodzivisa ari tibia zvakanyanyisa haachatauri shure.

Kunotevera cruciate shwashwa

Kukuvara vakadaro kuonekwa chinonetsa uye ngozi, rinoda zvizere kurapwa. A zvakaipa kana kukurumidza atanga kurapa inotungamirira kutanga lameness uye anosimbirira kukamurwa oparesheni. Kakawanda, makuvaro izvi zvichiitika vakwikwidzi vane unyanzvi kana Skiing, Skating, achisvetukasvetuka, mutsimba, kunobva simba kukanganisa kana kutadza ane dzoro, kuwa.

Strong kubaya-baya marwadzo uye kombiyuta, rakapinza akavarambidza kufamba zvingaratidza kuti nemarunda ari ibvi muhudyu kubvaruka. Munhu wacho haagoni kufamba vakazvimiririra, yokungovimba munhu.

posterior shwashwa kukuvara kunoitika apo simba hyperextension ibvi kana panguva nezvainoita pamberi pechiso tibia. Kuvadza Anterior cruciate shwashwa ndicho. Zviratidzo uku vanobatanidzwa "vanamwari vatatu vatatu Turner" pamwe atsamwira iri meniscus uye chokunze shwashwa.

zvekuchipatara mufananidzo

The ibvi vadyi, shwashwa vane kukwana misodzi anova hyperemic, edematous, zvinorwadza kuti kubatwa uye pavaiedza kufamba. Ropa articular mhango (hemarthrosis) rinoungana. Regai kunyonganisa chinhu kuzvimba nemarunda ari ibvi muhudyu, iyo ine zvakafanana kiriniki nezviratidzo zvinokuvadza, kwakaitika mumazuva mashoma apfuura.

Full cruciate shwashwa atsamwira kunokonzera kunyanya mufambo zviri tibia iri Anterior-posterior ndege. Verification kuti chiratidzo ichi vanachiremba miviri inoitwa panguva imwe chete. Wokutanga anobata musana yehudyu uye flexes ari anesthetized mutezo panguva ibvi pane zvakanaka akachinjikana. chiremba wechipiri achaongorora sangano repasi gumbo nokuku. Tensile kwetsika kana chiratidzo chakafanana kunaka.

Kuminyuka kunosanganisira duku misodzi fibers, achiperekedzwa mwero soreness, zvishoma edema, kusavapo ropa. Kuderedza gwenya basa kunoitika muduku pamwero.

Diagnostics

Kutsunga kukuvara mashandiro kunotibvumira kuziva zvinoita kukuvara anatomical hurongwa. chiremba pamberi Kuongorora akuvara ibvi anoongorora utano kujekesa zvinhu chacho. Kuongororwa mamiriro munyika hurongwa vachishandisa Ultrasound uye MRI.

Differential chirwere haambotauri mapfupa akaputsika, patella, meniscus misodzi. Kana dislocation mapfupa zvaizopedza noruremekedzo vakataurirana, hapana mukana gwenya basa, pane chitubu nemishonga pavaiedza pusa kufamba. Nokuti kukuvara shwashwa hakuna dzinoratidzwa kushaya sangano kwakakwana, zviri zvishoma nekurwadzwa. Panewo hapana chitubu nemishonga.

Kutsemuka achiperekedzwa deformation, chitarisiko zvemamiriro famba uye crepitation. Zvisinei, pane mitswe kuti havana zvakadaro zvinhu. Muchiitiko chino, nokusimbisa nechirwere kunoda X-ray ongororo, Ultrasound kana MRI.

kurapwa Guidelines

Apo zvishoma zvakakuvadza (tensile, misodzi) rubatsiro inopiwa muna zvashata mukamuri. Muzvidimbu fanira iri imwe yakakwirira, mazuva mashoma okutanga - mubhedha zororo. The zuva rokutanga pashure makuvaro achida kuda kuti chando pamusoro zvakakanganisa nzvimbo. Joinhi yakasimbiswa neboka zvakasimba kwakavharwa nenyama bhandeji, vachibvumira vanorichengeta vasiri nzvimbo richiripo pavaitama. Siya mucheka usiku haagoni kuva kuti hapana kukanganisa wokufambisa. Marwadzo Kutarisira zvinoda kushandiswa analgesics ( "Ketanov", "Ketalong", "nalbuphine").

The ibvi vadyi, shwashwa izvo zvinoda kuchinja kurapa kwete chete, asi kuvhiyiwa, inoda yakareba vapore nguva. Pashure vose zvakafanana mabasa sezvo vari zvishomanana tagovera, kushandisa physiotherapy matanho, kusanganisira masaja, physiotherapy, electrophoresis zvinodhaka.

Kazhinji, kuvhiya kupindira kunodiwa kana ruptured cruciate shwashwa yacho ibvi. The oparesheni rokudzorera anatomical kuvimbika chivako inodikanwa dzose kushanda. Kuvhiya rinoitwa mwedzi mitanhatu pashure kwemajoini kukuvara.

Akakodzera masango ichaongororwa kuti mutambi wechidiki uyo anoda kuita jerky kufamba Mbabvu mumutambo wake. vanhu vakwegura vasina basa rakawanda, muri nani kuti kuchinja kurapa uye kushandisa miviri mishonga.

Plastic ibvi cruciate shwashwa zvinoda kushandiswa batanidza wakatorwa kubva patella shwashwa kana marunda mudzira (autograft). Zvinogonekawo kuti kushandisa chakaita zvokugadzirwa grafts Zvisinei, avo kushandiswa anogona orambwa muviri murwere.

Kuisa chakaita zvokugadzirwa grafts vanowanzochema muitiro kana chakabvamburanyiwa lateral shwashwa yacho ibvi. Treatment pamwe operative mabasa anonzi kuva nzira chisarudzo pakadai.

Kuvhiya tsika kwakaratidza kuti kungotaura stitching wakuvara hurongwa kunova anodzoreredza functionality.

Chii chingava nemamwe matambudziko ari ibvi zvinokuvadza?

Kakawanda matambudziko anoitika ibvi kukuvara vari kutevera:

1. Kukura yemajoini inobvira 2-3 mavhiki pashure kwemajoini kukuvara. The anogumbura mhinduro kunoitika nokuda kweropa vachivavhiringidza uye ingress pamusoro pathological zvigare zviri zvinokuvadza wongoramba. Kunoratidzwa marwadzo, chimiro puffiness, akatsvuka, zvava kundiomera kufambisa muviri nokuda marwadzo.
2. The pakuonekwa chinopedza kuchinja muchimiro arthrosis iri pamwe inotungamirwa osteophytes, shwashwa rive dete.

mataridzikiro

Mushure zvinokuvadza vakawanda vanobatwa akashamisika: "Putsa ibvi nemarunda kuporesa zvikuru?" A yakafanana nyaya inokurukurwa kurapwa nyaya mumwe nomumwe. Zvichienderana ari kukuvara zvinoitwa nhengo operability yakazara vanogona kudzoka pane mwedzi mitanhatu, uye pamwe pane mwedzi mishomanana.

Hunokosha zvakakanganisika mashandiro pachahwo uye sei munhu vakawana zororo kubva ibvi nemarunda. Sei zvinokuvadza haanga- inobvawo pane nemagadzirirwo ari kurapa zano mazvikokota. Early kurapwa, kugamuchira zvakafanira mishonga uye kuomerera rikurumidze apore uye kudzivirira matambudziko.

dziviriro

The mazita matanho inoshandiswa kuderedza kukuvadza kuti majoini ipfupi kune zvinotevera mabasa:

• yakakwana kurovedza muviri;
• kuzvimba nemarunda ari ibvi kunofanira pasi nenguva kurapwa;
• zvokudya zvinovaka muviri;
• kurambwa doro uye fodya;
• kurega hypothermia;
• kuzvidzora Mbabvu Minimum kugara kunofambira mberi munzvimbo;
• zvakarurama kusarudza shangu, Kurambwa shangu dzakakwirira.

zvinokuvadza ibvi inogona kudziviswa, iro rinoreva nyore zviyero pane kudzorerwa kwaro functionality nokuda kukuvara.