Ponseti hana o ka clubfoot

Ke Ponseti papa hana, a ua hoʻohana 'ia i loko o ka iapaau ana o congenital clubfoot'ōpiopio keiki, i keia la ike like me ka loa a me ka pono akahai no ka pēpē ka ola. Ma ke ao nei ia ua maliu like me ka "gula paʻamau" kanaka o ka clubfoot.

Definition o congenital clubfoot

Congenital clubfoot - luna 'kāna hana o ka' ole a me ka hana ana o ka wāwae, a malalo wawae. Aʻe 'ana i kēia manawa,ʻaʻole wale nō i loko o ka iwi, ami a me nāʻiʻo, akā, i loko o nā tendons, nā aʻalolo a hāʻule pahū a me nā ipu koko.

Wahi a ka 'ikepili helu, ua loaʻa clubfoot i loko o 5% o keiki keiki. Clubfoot ua hana ia ma ka loiloi mua pule o hāpai keiki, i ke kumu o ka mea i ole, ua manao. E like me kekahi nā mea mahuʻi, ia hana no ka mea, o ka manaʻo maikaʻiʻole nā kūpuna mai, 'ole. No ka. Ua mahuahua Ma ke alo o ia i ka maʻi i loko o kekahi makua i ka pahiki o ka maʻi ma ka 4%.

Congenital Clubfoot mea he hoʻokahiʻanuʻu a elua-kapakahi, a me ka mea nui, he pono ole i na keiki. Ka maʻi o ka pathological ulu o connective nā'aʻaʻa, no ka mea, o ka mea e hanaia a me ka mahana deformation. Ma keia hoopokole nāʻiʻo i pili, a hoʻi i wahīʻia i loko o ka hope, a me ka loko ili o ka wāwae. Ke keiki wale e loa e hiki ke kau i ka wāwae i loko o ka maʻamau kūlana.

Maʻamau ano o ka hana maikaʻi clubfoot

Mamua, ma mua o ka iaoiaeii ua hoʻomaka 'ana me ka hoʻohana' Ponseti, deformity? Iaea i na mea o ka puna lole wili corrective, a laila, laweia aku la oia i ka hana ana ma ka wāwae, ma a ka elongation a crosslinking mau Muscle tendons, ligaments wawae intersect ke ami 'imihana'. Aia he pinepine hihia o ka hoohuoi ana a me nā iwi i loko o ka wāwae i ka hana.

Ke mau hana o ka clubfoot komo ai na kēia mau kapuwai.

• Lapaʻau hoʻomaka me ka 1-pule-kahiko bebe;
• initially alakai aku ia massages (1-2 pule);
• alternating e hoolei i ka a me paraffin palapala noi, i hana no ka loihi o ka manawa, mai kekahi mau mahina i 2 makahiki, ke kaumaha ma muli o ka oolea o ka maʻi;
• ka hope hooleiia'na o ka wā o ka 5 mahina;
• ma haahaa laulā o ke lapaau i ka makahiki o ka 2 makahiki kahiko keiki hanaʻoki kino (Z-hoʻokino ea Achilles tendon).

Statistically, ka mea maʻamau ano o ka lapaʻau ka hoʻokōʻana o 58%.

He aha ka keʻano hana o Ponseti

Ignacio Ponseti - he poʻokela Amelika orthopedic surgeon, hoʻomohala i ka 1950-60 ka hou lapaʻau no clubfoot. Ua Ua nānā ma luna o ka piha study o ke keiki ka wāwae 'ole a me kona pathological loli. Haʻalele ku una ohe., I kēia papa hana e leie aku oe e hana i ka hoʻonaʻauao e aho koke: 1,5-2 mahina ua haawiia mai ai i ka piha? Iaea, akā, malalo o ia i ka 'eleu hoʻomaka' ana o ka gypsum.

Ponseti papa hana e leie aku e paʻipaʻi wawae deformities makeʻe kulana ano, ae ho'āʻo ana scarring i na ami, ka mea, e kokua i ka malama i ka Hawaii uea 'o ka wāwae, a me nā nāʻiʻo.

Ka loa nui ana no i ka ka hoʻokōʻana kiʻekiʻe o keia iaoia - i kakahiaka nuiʻike, o ka maʻi (i ka hebedoma mua o ke ola), a ami i ke keiki i ka a me nāʻiʻo i ke kiʻekiʻe elasticity. Lapaʻau e hoʻomaka i ka makahiki o ka 1-2 pule o ke ola pēpē, eʻoiaʻiʻo, e hoʻomaka me ka holoholo.

Inā ka deformation ua 'akomi i hope, i ka iapaau ana ma Ponseti mea i hiki, nae, ma ka manawa o ka kina hooponopono hou e e nui hou hoomanawanui.

Nāʻanuʻu o ka lapaau ma ke ano o Ponseti

Lapaʻau o clubfoot Ponseti iaoiaeii ninoieo o kekahi mau kahua o ka hoʻonaʻauao o ka lapaʻau.

1. deformation? iaea hoʻohana puna, i hoʻolei, a pono e hoʻololi kela 6-7 lā. Uha mua o ka keiki loa gypsum mai na manamana a hiki i ka luna'ūhā. Kēlā me kēia one mea i loko o ka kekahi kulana, hiki oe e hoʻomaʻa i ke kinona o ka wāwae, a hiki iwi. A pau e pono ai, e lawe mai 4-7 kaʻina hana gypsum wāwae, akā, i ko lākou helu hilinaʻi nui 'ana ma luna o ka degere o ka oolea o ka mai, a me ka makahiki o ke keiki.
2. I kekahi kahua - achillotomy, 'o ia hoʻi, hooloihiia mai o ka Achilles tendon, i mea mau ma ka clubfoot hoopokole ... Loa pinepine hana pili ana ma lalo o kūloko anesthesia (no na keiki i ka 2 makahiki). Ma hope oʻoki kino, e gypsum no 3 pule, e koho i ka hopena.
3. Ka hope nui ke kahua - i ka hoʻohana 'ana o ke koo aku iloko olaila a mau kamaa lele aku ma luna o ke kupaianaha ka hāʻuleʻana una honua.

I kumu hoʻomalu kiʻekiʻe hana a me ke ola, mai ka maʻi o ka nui o ka kiʻekiʻe makahiki paha o ke kauka lawelawe i ka hana.

ka puna 'ana i kūpono

Gypsum ma Ponseti iaoia alakai aku ia pule, a he mea hoʻopau ana i kekahi mauʻano o ka deformation o ka wāwae i loko o kēlā me kēia ka mea i hahai ana ka mea mamuli o kekahi palapala noi o gypsum. I ka uhi ana lole wili ke komo pū o kauka nana pono align i ka wāwae, a me ka hope koke hanaʻia gypsum.

Ka hoʻokō 'ana o gypsum mea i loko o ka palapala o ke kīpaku ma ka holoʻokoʻa loa o ka'ūhā, e waiho ana i ka phalanx noa wale o ka manamana lima ma luna o kona mau wāwae i ka mana i ka lako hou i ka moku i ke koko, a pale ia kinked gypsum.

Aia nō kekahi OAXA rula e pono e hahai ikaika e pale hewa i loko o ka iapaau ana o:

• gypsum mua actuating e hooponopono i ka huina o ka wawae a me kona kuapo i loko o ka maloko alo hapa (cavus);
• ia ka puna i ke kuli paa i loko o ke alo aku kulana, a e pale aku i ka lole wili, a offset e pakele anaanai i ka meaʻai ili o ke keiki;
• ka wā kēlā wāwae withdrawal ke kaʻina hana no ka makau e e emi ma mua o 15 degere;
• ka wā hoʻololi i ka holo ana puna pono ole ia i loko o ka noaʻoihana 1 chasa;
• 2-4 kūlana kanaka nona? Ee deflection maloko, manamana lima (varus deformity) a me ka wehe 'ia o ka plantar anuenue;
• KaʻAnuʻu Hana 5 - e leie aku e hoʻomaʻa i ka retraction o ke kuekue wawae o ka talus, ke kauka mea he fixation o ka wāwae i loko o ka maʻamauʻoihana hoʻohana splints (me ke koe o ka ma-pa ma ke kuʻekuʻe wāwae ku i ka hoopokole tendons).

Ka helu o nā kaʻina hana e e ole hou aku 6. ke kaʻina o ka noaia a me corrective gypsum, a i ka nānā 'ana ma luna o ka Ponseti ano, o ka Hawaii photo hōʻike aku.

Inā ke kauka i oi ke kaʻina hana, a laila ia e e hana ole ma ke ano Amelika, a me ka i e nā palapala. Ma ka hope kahua o ka hoʻonaʻauao mea achillotomy a me ke koho koo aku.

achillotomy

Lapaʻau ma Ponseti iaoiaeii komo ai, ma kekahi hihia, imua o 4 a me 5 ke kahua gypsum e paʻa ana Achilles tenotomy, ma i:

• ua hoʻopaʻa pipi 'ka calcaneal tendon (percutaneous hana);
• uea ka mālama a hāʻule pahū wale poino ligaments;
• ʻoki kino ua hana ma lalo o kūloko anesthesia;
• i ka pau ana o ka hana ua i ka gypsum no ka mea e hiki mai ana 3 pule.

Kēia hana nei nō okoa mai ka haeʻoki lāʻau lapaʻau 'uao, a ua mālama' ia ma ka maʻamau e hooponopono hana. Iloko o ia o ke keiki mea i mau anesthesia, a ma hope o ka mea, ua haʻalele i ka nui me ka makaʻu no, i hope i hookuu hoʻohaiki ana i ka ka hoʻoneʻe o ka hoʻomanawanui ka wāwae.

E ho ohana ana o ke koo aku

Ponseti iaoiaeii komo ai me ke kahua hope o ua hoʻokomoʻia ka koo aku, kūikawā kamaa, a oe ke koho i kekahi māhele i loko o kulana kulana o ka wawae a me nā wāwae, e pale aku i ka hoi ana mai o ka clubfoot. i kohoia Shoes, a hoʻonohonoho ponoʻia ma mua.

Komo i ke koo aku e eʻaneʻane puni ka uaki no na malama ekolu, e pana wale i auau a ua kahikoia a nani.

A laila, ka mea e e pohole wale i ka hiamoe (lā a me ka po,) - ka loaa au mau no 2-4 makahiki i mea e pale aku relapse.

hoʻokau '

Manaʻo Kōkua mai na makua mea i hoʻohana ma o ka iapaau ana o ka clubfoot keiki Ponseti iaoia, keakea e like penei:

• ka mea kiʻekiʻe lilo o kūikawā kamaa (koo aku), a i ana i kuai ai, mai Manufacturers ma Germany a me ka Amerika Huipuia;
• ka lōʻihi o kona haawi ana i nā'āina,
• ka hoahanau fragility o ka 'ole.

Ma nā makahiki, ka poe "Bear" ka hoʻomaka 'ana ka hana lulu popilikia counterparts, a me ka loaʻa o ke koo mea hiki, e kuai ia ma ka nohona lapaʻau puu dala.

pono o ka iaoiaeii

ʻO ka hoʻokōʻana kiʻekiʻe o ke ano o ka clubfoot? Iaea hoao iho la ia i ka hopena o ka 50 makahiki o ka noiʻi i loko o ka hana kūikawā konu o Dr. Ponseti (Iowa State University, USA), e like me ka hoʻomanaʻo i ua hoao ma na mea he nui 'inikua kulanui i loko o ke ao nei.

No a pau i nā kiʻina hana, a ua malamaia lakou nei, congenital clubfoot Ponseti iaoiaeii mea, ke'ōlelo mai emi traumatic, palekana, a 'aʻole e hilinaʻi ma ka oolea o ke kanana nei o ke kumu. oiai e komo ana i ka nou ana la o ka nui emi aku me nā ki ina hana like. Ka laulā i? Ee deformity ka 95% o ka hihia.

Ka wā pono 'ana i mālama maikaʻiʻole o kekahi hai deformations o ke keiki e ole e:ʻo ia ke komo ano o na kamaa, aole e ole contraindications i ka haʻuki a me physical hana.

Ponseti Na Huaolelo: hōʻike manaʻo

E hoopono ana ma na hōʻike manaʻo o ka makua nāna i hana i nā keiki, mai congenital clubfoot Amelika iaoia, i ka hookoia Ua kokoke pau maikaʻi. Special ohohia i hoike makuahine i ho'āʻo e hana keiki mua i loko o ka maʻamau ala (lomilomi + gypsum), ma hope a kekahi e hoomanawanui i aneane lilo ka polokalamu JavaScript. Ua haawiia hope i ka 'inikua ioauoa i kauka i oihana' o ia e hoʻohana i ka Ponseti ano o ka clubfoot lapaʻau, ua hiki ke hoola i ka wawae i kāʻoukou poʻe keiki oo na makua.