Ko taw muaj cov qauv nyuaj, thiab, txawm tias nws qhov me me, pathologies ntawm txhua yam hauv cheeb tsam no cuam tshuam rau kev ua haujlwm ntawm tag nrho cov ceg qis. Metatarsals tsis muaj qhov zam.
Nws muaj 26 pob txha thiab muab faib ua 3 ntu: tarsus, metatarsus thiab phalanges.
Cov pob txha ntawm tarsus suav nrog 3 lub ntsej muag zoo li, calcaneus, navicular, cuboid, talus (ib feem ntawm pob taws) pob txha. Lawv yog cov neeg nruab nrab ntawm kev hloov ntawm pob taws mus rau ko taw.
Metatarsal pob txha 5 - thawj cov pob txha metatarsal ntawm ko taw, tom qab ntawd thib ob, thib peb thiab lwm yam hauv kab ntiv tes. Lawv lub hom phiaj tseem ceeb yog tswj thiab tsim lub koov ntawm ko taw, yam tsis muaj kev txav ntawm tus neeg yuav ua tsis tau. Cov no yog cov pob txha me me, lawv tsis yooj yim heev. Muaj qhov chaw nruab nrab ntawm lawv.
Phalanges ntawm cov ntiv tes 14. Lawv yog cov pob qij txha txav tau, muaj pob txha mos. Tus ntiv tes xoo muaj 2 phalanges, lwm tus ntiv tes muaj 3. Cov ko taw ntawm ko taw ua haujlwm tseem ceeb heev vim tias lawv ua raws li kev poob siab thaum lub sij hawm txav ceg.
Kev mob
Yog cov pob txha metatarsal ntawm ko taw mob, qhov ua rau thiab kev kho mob ib txwm muaj kev cuam tshuam kom peb tuaj yeem tham txog kev kho etiopathogenetic. Mob yog txuam nrog ntau yam kab mob. Lawv txawv ntawm lawv qhov xwm txheej, lub sijhawm, thiab kev nthuav dav. Lawv tuaj yeem yog unilateral lossis ob sab, luv luv thiab ruaj khov, nyob rau hauv daim ntawv ntawm hlawv, paresthesia, thiab lwm yam.
Cov kab mob hauv qab no feem ntau tshwm sim:
- Kab mob ntawm cov kab mob plantar fascia. Yog vim li cas yog lub siab tsis tu ncua ntawm plantar aponeurosis, uas txhawb lub koov ntawm ko taw. Lub fascia occupies qhov chaw nruab nrab ntawm pob taws thiab metatarsus. Pathology yog tus yam ntxwv nrog hnyav hnyav, tiaj tus taw, ua si kis las. Mob hauv ko taw thiab pob taws tshwm sim tam sim tom qab pw tsaug zog.
- mob caj dab. Nws mob ob leeg nws tus kheej thiab ko taw. Qhov no tshwm sim los ntawm khaus thiab kub hnyiab.
- Ligamentosis - kev puas tsuaj rau ligaments ntawm ko taw, tuaj yeem ua 2 sab. Nws txhim kho nrog hnyav hnyav ntawm ko taw, tsis muaj ntshav ncig thiab microtrauma ntawm ligaments.
- Heel spurs - qhov pom ntawm pob txha loj hlob ntawm qhov taw tes ntawm kev txuas ntawm fascia rau calcaneus. Hauv qhov no, yuav luag ib txwm muaj mob fasciitis. Mob tshwm sim thaum taug kev.
- Tsis muaj ntshav txaus. Tib lub sijhawm, ko taw mob thaum taug kev thiab so.
- Pinching ntawm cov hlab ntsha ntawm cov pob txha ntawm ko taw lossis ntawm qhov chaw tawm ntawm lub vertebra. Feem ntau tom qab yug me nyuam.
- Nyob zoo neuromas. Mob tshwm sim ntawm 3rd thiab 4thntiv tes. Lawv tuaj yeem nyob rau hauv daim ntawv ntawm tingling, kub hnyiab, mob, ntau zaus ntawm ib sab. Hnav khau nruj ua rau mob hnyav.
- Fractures, dislocations.
- Metabolic Disorders nrog osteoporosis. Kev mob hnyav yog nias rau ntawm pob txha.
- Kev ua haujlwm tsis txaus ntawm ko taw yog teeb meem ntawm cov neeg rog, cov poj niam cev xeeb tub, lub cev tsis muaj zog thiab hnyav ntawm ob txhais ceg. Tom qab sawv tau ntev, qhov mob tshwm sim hauv ko taw.
- Pav ca - muaj qhov flattening ntawm ko taw, cov duab ntawm ko taw hloov. Lub ci ntsa iab thiab ko taw tau nkees sai thiab mob heev.
- Pathological ntshawv siab - warts, ingrown toenail, curvature ntawm tus ntiv tes xoo. Puas yog qhov tshwm sim ntawm khau tsis xis nyob.
- Hnub nyoog hloov pauv hauv ko taw - cov ntaub so ntswg adipose ntawm ko taw txo qis nrog lub hnub nyoog, deformation ntawm metatarsus, circulatory disorders thiab osteoporosis tshwm sim. Lub luag haujlwm yog ua los ntawm kev khaus khaus ntawm ko taw.
Cov tsos mob thiab kev kho mob ntawm cov kab mob feem ntau
Ib feem ntawm cov pob txha metatarsal tsim cov pob qij txha txav tau nrog cov phalanges. Ib yam li lwm cov pob qij txha, muaj pob txha pob txha pob txha thiab ib lub hnab sib koom ua ke. Nrog rau qhov khaus lossis lub caij nplooj zeeg, lub taub hau tuaj yeem txav mus, thiab qhov mob hnyav tshwm sim ntawm qhov chaw raug mob. Kev txav mus los ntawm kev sib koom ua ke yog qhov tsis zoo, nws tsis tuaj yeem txav ntawm ko taw thiab txav cov ntiv taw.
Cov pob qij txha o, nce qhov loj, daim tawv nqaij dhau los ua liab. Lub taub hau nws tus kheej tuaj yeem deformed nrog cov tsos ntawm kev loj hlob ntawm nws.
Kev kho mob ntawm cov pob txha metatarsal ntawm ko taw yog txiav txim siab los ntawm daim duab x-ray. tshwm sim ntau zausqhov xav tau kev phais. Thiab txawm hais tias nws tau ua nrog tshuaj loog hauv zos, nws yog ib daim ntawv kho mob.
Kev kho mob ntawm cov pob txha metatarsal ntawm ko taw yog tom qab ntawd qhia txog kev rov qab los ntawm lub taub hau ntawm cov pob txha mus rau qhov chaw anatomically raug thiab nws kho nrog rab koob hlau.
pob txha outgrowth raug tshem tawm. Nkawm khau tom qab qhov kev cuam tshuam no tsuas yog tsim rau orthopedic los tswj cov pob txha ntawm ko taw.
tiaj tus taw tsim rau ntau yam laj thawj:
- kev tsis sib haum xeeb hauv cov qauv ntawm ko taw txij thaum yug;
- hnav khau nruj lossis heels siab;
- obesity;
- nce lub nra thaum lub sijhawm kawm;
- ceg raug mob nrog cov leeg tsis muaj zog.
Kev kho mob feem ntau yog kev saib xyuas. Tus neeg mob ua ib ce tshwj xeeb los cob qhia lub koov, tsis tu ncua siv orthopedic insoles. Taug kev taw liab qab ntawm cov xuab zeb lossis pebbles thiab ua luam dej yog pab tau.
Nws muaj peev xwm tshem tawm cov ko taw tiaj tiaj nkaus xwb hauv cov menyuam yaus, thaum cov pob txha loj hlob. Cov neeg laus tsuas tuaj yeem ua kom paub tseeb tias cov kab mob pathology tsis vam meej. Pav ca tuaj yeem ua rau hallux valgus, uas ua rau qhov mob hnyav dua.
Pathology ntawm pob qij txha
Kev mob caj dab - mob ntawm pob qij txha, arthrosis - degenerative hloov hauv pob txha mos. Kev kho mob ntawm arthrosis ntawm cov pob txha metatarsal ntawm ko taw suav nrog kev siv chondroprotectors. Lawv txhawb cov seem ntawm pob txha mos. Cov kab mob sib kis kuj swells, loj, kub rau qhov kov, thiab mob thaum taug kev.
Arthrosis yog tus cwj pwm los ntawm kev sib tsoo thaum tsiv. Nyob rau hauv tus txheej txheem ntawm onyob ib puag ncig cov ntaub so ntswg, ligaments, cov leeg muaj kev koom tes. Qhov no hu ua periarthritis thiab periarthrosis. Yog hais tias mob caj dab yog kho tau tag nrho, ces qhov no tsis yog nrog arthrosis, cov txheej txheem tsuas yog yuav qeeb. Tom qab ntawd tsuas yog kev kho mob ntawm cov pob txha metatarsal ntawm ko taw yog siv tau.
Rau kev kho mob ntawm kev raug mob, siv cov ntaub qhwv tshwj xeeb kho. Cov hauv paus hniav kuj tseem ceeb rau kev kho mob. Yog tias nws yog tus kab mob, kev kho tshuaj tua kab mob yog sau tseg. Hauv lwm qhov xwm txheej, koj tuaj yeem tau txais los ntawm kev kho mob hauv zos hauv daim ntawv ntawm cov tshuaj pleev thiab cov gels, thiab lwm yam. Analgesics raug muab tshuaj los txo qhov mob. Kev kho mob ntawm cov pob txha metatarsal ntawm ko taw raws li cov tswv yim tsuas yog kws kho mob tau sau tseg.
Ntshai ntshai
Kev ua txhaum ntawm kev ua ntawm cov hlab ntsha impulses nrog qhov tsos mob tuaj yeem tshwm sim hauv cov xwm txheej hauv qab no:
- paj hlwb pinched ntawm cov pob txha metatarsal;
- pinch hlab ntsha ntawm theem ntawm vertebrae;
- mob ntawm lub paj hlwb thaum lub sijhawm hypothermia, hnav khau nruj;
- neurinoma nruab nrab ntawm phalanges ntawm tus ntiv tes.
Kev kho mob yuav suav nrog kev zaws, kho lub cev, khaub ncaws raws caij nyoog thiab khau xis. Nrog rau qhov mob, koj tuaj yeem siv cov tshuaj pleev thiab cov gels uas sov thiab tiv thaiv kab mob.
Kev kho mob ntawm cov pob txha metatarsal ntawm ko taw yuav suav nrog kev kho phau ntawv yog tias lub pinching yog nyob rau hauv tus txha nraub qaum thiab yog nrog los ntawm kev hloov ntawm lub vertebrae. Lub hom phiaj yog xa rov qab cov vertebrae rau lawv qhov chaw.
Metabolic ntshawv siab nyob rau hauv cov pob txha
Lawv cuam tshuam nrog kev tsis txaus ntawm cov vitamins, Ca, zinc, phosphorus, thiab lwm yam. Feem ntau, pob txha pob txha tshwm sim. Hauv qhov no, cov pob txha ua nkig thiab ua rau tawg. Pathologyfeem ntau yog symmetrical thiab cuam tshuam cov pob txha me ua ntej.
Mob tshwm sim thaum tawm dag zog thiab thaum kawg ntawm hnub. Visually, ko taw tsis hloov, tab sis tag nrho cov kev ua txhaum cai yog pom ntawm x-ray.
Kev kho mob, yuav tsum tau noj cov tshuaj Ca thiab cov vitamins nrog cov zaub mov, khoom noj kom zoo. Tsis tseem ceeb tsawg yog qhov siab ntawm pob taws, uas yuav tsum tsis txhob ntau tshaj 4-5 cm.
Kev kho cov pob txha metatarsal ntawm ko taw yog txhawm rau tiv thaiv kev puas tsuaj ntxiv ntawm pob txha. Cov neeg mob zoo li no yuav tsum tsis txhob ua si kis las thiab muaj qhov hnyav hnyav. Koj kuj yuav tsum normalize qhov hnyav.
kab mob vascular
Feem ntau, qhov mob yog txuam nrog varicose leeg. Nrog nws, cov ntshav tawm ntawm ko taw yog cuam tshuam. Lub hom phiaj ntawm kev kho mob yog los kho lub suab ntawm cov leeg, ntxiv dag zog rau cov phab ntsa ntawm cov hlab ntsha, thiab faib cov load ntawm ob txhais ceg.
Tshuaj tuaj yeem siv rau qhov ncauj thiab qhov ncauj. Lawv siv cov tshuaj los txhim kho microcirculation, phlebotonics, vitamins, antiplatelet agents, thiab lwm yam. Feem ntau, nws yuav tsum tau hais tias qhov ua rau mob ntawm cov pob txha metatarsal ntawm ko taw txawv, thiab kev kho mob tuaj yeem yog kev saib xyuas thiab radical.
Diagnosis
Kev kuaj pom pom yuav tsis muab cov ntaub ntawv txaus los kuaj xyuas. X-ray yog muab rau hauv 2 qhov projections. Nov yog txoj kev kuaj mob tseem ceeb.
Ultrasound kuj tseem siv, yog tias tsim nyog, MRI lossis CT. Qhov nyuaj ntawm kev kuaj mob yog tias cov neeg mob feem ntau tuaj nrog cov txheej txheem ntawm pathologies, vim hais tias, piv txwv li, nyob rau hauv cov ntaub ntawv ntawm cov pob txha me me, ntau tus tsis mus ntsib kws kho mob thiab mus txuas ntxiv nrog kev puas tsuaj.
cov ntsiab cai dav davkho mob
Kev kho mob ntawm cov pob txha metatarsal ntawm ko taw yog ib txwm thiab txhua yam ntawm tus kheej. Nws tag nrho pib nrog kev saib xyuas kev kho mob, lawv tsis tshua sim ua haujlwm rau kev ua haujlwm.
Tus kws kho mob tau sau cov kev kho mob tsim nyog rau qhov mob ntawm cov pob txha metatarsal ntawm ko taw tsuas yog tom qab txiav txim qhov ua rau. Kev kho mob pib nrog txwv kev thauj khoom ntawm ko taw. Kev mob yuav tsum tau siv cov tshuaj tiv thaiv kab mob, tawg - daim ntawv thov ntawm plaster, dislocations - ib tug elastic bandage.
Cov kab mob metabolic tau kho nrog cov tshuaj hormones, vitamin-mineral complexes, angioprotectors, chondroprotectors, thiab lwm yam. Cov ko taw tiaj tus yuav tsum hnav tshwj xeeb insoles thiab khau. Sab nraum lub exacerbation ntawm cov kab mob, qoj ib ce kho mob, massage, physiotherapy yuav tsum tau.
Circulatory disorders, neuromas, ingrown toenail yuav tsum tau kho radical phais.
Fractures in nthuav dav
Metatarsal pob txha yog tubular thiab me, yog li lawv nquag ua pob txha. Thiab qhov no tsis nyob ntawm hnub nyoog, poj niam txiv neej thiab kev ua haujlwm. Metatarsal fractures tshwm sim nyob rau hauv 5% ntawm tag nrho cov pob txha thiab nyob rau hauv 20% ntawm ceg pob txha. Cov tsos mob txawv heev uas ntau tus tsis paub txog qhov tawg. Yuav tsum mus ntsib kws kho mob qhov no.
Metatarsal fracture statistics
4th thiab 5th metatarsal pob txha tawg feem ntau. Lawv tawg ntau zaus. Kev tawg ntawm cov pob txha 5th sab nrauv feem ntau nyuaj los ntawm kev hloov chaw. Lub sijhawm kho kom rov zoo li no yog qhov ntev tshaj plaws.
Tsawg tshaj yog pob txha pob txha 1. Cov pob txha thib 2 thiab 3 yog qhov cuam tshuam tsawg tshaj plaws. Lawv nyob nruab nrab thiab tiv thaiv zoo dua.
2nd, 3rd thiab 4th metatarsalscov pob txha raug kev txom nyem nyob rau hauv cov kev taw qhia ncaj qha ntawm kev cuam tshuam (ntog ntawm ko taw ntawm ib qho khoom hnyav lossis kev sib tsoo). Nrog rau kev cuam tshuam tsis ncaj, cov pob txha thib 1 thiab 5 raug puas tsuaj. Kev ntxhov siab tawg tshwm sim hauv pob txha thib 4.
Ua rau pob txha
Qhov laj thawj tseem ceeb ntawm pob txha yog:
- foot strike;
- poob ntawm ceg;
- muag tsaws tom qab poob lossis dhia;
- kev raug mob me me (piv txwv li seev cev, kis las).
Nrog cov kab mob ntawm lub cev pob txha.
Kev faib tawm ntawm pob txha
Fractures raws kab ntawm pob txha tuaj yeem yog: transverse, T-shaped, oblique, helical thiab wedge-shaped. Cov pob txha tawg yog nrog lossis tsis muaj cov khib nyiab pov tseg.
Nyob ntawm pob txha
Raws li qhov xwm txheej ntawm kev puas tsuaj, qhov tawg yog kev puas tsuaj thiab qaug zog (kev ntxhov siab tawg). Kev puas tsuaj tshwm sim nrog lub tshuab ncaj qha, ntog ntawm qhov siab, ntaus ko taw, subluxation.
Kev qaug zog pob txha tshwm sim nrog kev sib tsoo thiab kev ntxhov siab tas li. Nws tseem yog hu ua Deutschelander's fracture lossis March fracture.
Kev kuaj mob feem ntau hauv cov neeg sau ntawv, vim tias lawv ua rau muaj kev nce siab ntawm ko taw. Tsis tas li ntawd muaj kev pheej hmoo nrog xws li pob txha yog ballerinas, dancers, ncaws pob, gymnasts, football players. Kev ntxhov siab tawg feem ntau yog hloov maj mam thiab feem ntau tsis quav ntsej, ua rau muaj teeb meem. Lawv raug qhia nyob rau hauv kev hloov ntawm pob txha thiab raug mob rau cov pob txha nyob sib ze.
Lwm hom kev puas tsuaj los ntawm txoj cai anatomical
Nyob rau hauv Jones pob txha, cov pob txha raug mob ntawm lub hauv paus ntawm 5th metatarsal. Cov pob txha no ib txwm muaj ntau qhov sib cais, thiab tom qab nws cov pob txha tsis loj hlob ua ke. Kev kho mob pob txha metatarsal thib tsib tsuas yog ua tiav yog tias qhov kev kuaj mob raug, uas nyuaj heev.
Thaum muaj pob txha tawg ntawm ko taw, cov pob txha tawg ntawm cov pob txha raug tshem tawm nrog lub zog nruj ntawm cov leeg. Kev kuaj mob pathology kuj tseem nyuaj, vim tias tag nrho cov tsos mob zoo li pob txha. Feem ntau cuam tshuam nrog pob taws pob taws.
Nrog rau qhov tawg tawg, kab tawg yog hla, tsis muaj kev hloov pauv. Nyob rau tib lub sijhawm, ntawm lub hauv paus ntawm 5th metatarsal pob txha, pob taws pob taws tshwm sim nyob rau hauv parallel.
A subcapital tawg ua rau lub caj dab ntawm cov pob txha metatarsal.
Kuj, pob txha qhib thiab kaw.
Symptoms and signs
Thaum raug mob, koj tuaj yeem hnov tus yam ntxwv crunch thiab hnov mob hnyav. Tus ntiv tes raug mob tuaj yeem ua kom luv, sib txawv tsis zoo rau sab, thiab edema thiab hematoma sai sai ntawm qhov chaw tawg. Kev txav mus los ua tsis tau.
Kev pab ib zaug
Immobilization ntawm ko taw nrog splints los yog lwm yam improvised txhais tau tias yog tam sim ntawd. Kev kho yog nqa tawm raws tag nrho cov ko taw mus rau sab sauv thib peb ntawm pob taws. Cov ceg raug mob yuav tsum tau siab me ntsis. Qhov no txo qis kev pheej hmoo ntawm kev mob hnyav thiab ua rau nws yooj yim rau kev thauj tus neeg raug tsim txom.
Ice tuaj yeem siv rau ntawm qhov chaw raug mob rau 20 feeb, uas yuav txo qhov mob thiab tiv thaiv qhov o ntawm kev loj hlob sai.
Rov ua dej khov tom qab 10 feeb. Yog muaj qhov txhabNws yog ib qho tsim nyog yuav tau siv cov ntaub qhwv aseptic.
Thaum cov pob txha tawg tau txav los yog qhib pob txha, nws tsis tuaj yeem tsim qhov pob txha ntawm koj tus kheej. Qhov no tsuas yog ua los ntawm kws kho mob tom qab x-ray.
Txhawm rau txo qhov mob, koj tuaj yeem haus "Pentalgin", "Analgin". Thauj tsuas yog nyob rau hauv txoj hauj lwm kab rov tav ntawm lub stretcher.
Txoj Cai Kev Kho Mob
Kev kho mob dav dav:
- ko taw immobilization nrog nrum;
- kaw rov qab (cov pob txha tawg yog sib luag yam tsis muaj cov ntaub so ntswg incision).
Osteosynthesis yog ua tiav nrog ntau yam kev puas tsuaj thiab kev hloov pauv loj. Qhov no yog ib qho kev ua haujlwm nyob rau hauv uas cov fragments tau rov qab los raws li lawv qhov chaw anatomical. Cov pob txha tawg yog tsau nrog cov phaj tshwj xeeb, pins lossis screws. Thiab tsuas yog tom qab cov synthesis, plaster yog siv.
Gypsum
Kev kho mob ntawm 5th metatarsal pob txha yuav tsum tau cam khwb cia. Nws yog siv nyob rau hauv feem ntau cov pob txha pob txha. Nrog rau pob txha pob txha ntawm 5 lub metatarsal, lawv taug kev hauv cam khwb cia rau 1.5 lub hlis.
Brace
Orthosis yog siv rau kev raug mob me me. Nws stabilizes ko taw thiab txo cov load ntawm nws.
Ntev npaum li cas pob txha kho?
Qhov nruab nrab nws siv sijhawm 6-8 lub lis piam. Qhov ceev ntawm fusion nyob ntawm lub hnub nyoog, qib calcium hauv ntshav, muaj cov kab mob sib xyaw ua ke thiab qhov tseeb ntawm kev ua raws li tus kws kho mob cov lus qhia.
Kev ua haujlwm
Kev phais kev kho mob ntawm pob txha pob txha ntawm pob txha metatarsal thib tsib ntawm ko taw tsuas yog yuav tsum tau muaj zog txav ntawm 3rd thiab 4thcov pob txha metatarsal. Feem ntau qhov no tshwm sim thaum lub taub hau pob txha tawg.
Kev kho mob thiab rov qab
Txhawm rau tshem tawm ko taw yuav tsum siv lub cuab yeej kom txog thaum lub pob txha zoo tag. Rehabilitation aims kom rov ua haujlwm ntawm cov leeg thiab cov leeg ntawm ko taw, normalize kev sib koom ua ke. Ua raws li kev saib xyuas ntawm tus kws kho mob orthopedist.
Ib qho qauv kho dua tshiab suav nrog:
- Physiotherapy - txhawb kev loj hlob thiab kho cov pob txha pob txha.
- Kev kho mob gymnastics thiab kev tawm dag zog kho mob tau pom lawm ib hlis tom qab raug mob. Cov txheej txheem ntxiv dag zog rau cov leeg, nce kev sib koom ua ke. Cov kev tawm dag zog tseem ceeb yog flexion thiab txuas ntxiv ntawm cov ntiv tes, nqa thiab txo qis ntawm cov ntiv taw.
- Massage pib tom qab tshem tawm ntawm immobilization. Nws txhim kho cov ntshav ncig thiab txo qhov o, ua kom cov leeg nqaij.
- Hnav insoles ua qhov tseeb ntawm ko taw thiab sib npaug faib cov khoom. Lawv yuav tsum hnav 6-12 lub hlis.
Kev nyuaj siab
Yog tias pob txha pob txha metatarsal ntawm ko taw tsis kho kom zoo lossis kho kom rov zoo li qub, qhov tawg yog qhov teeb meem. Ntawm lawv:
- mob caj dab thiab mob caj dab;
- deformation ntawm cov pob txha ntawm ko taw;
- mob ko taw;
- tsim pob txha spikes;
- necrosis thiab osteomyelitis.
Kev kho kom zoo thiab rov zoo yog qhov tseem ceeb hauv kev kho mob ntawm cov pob txha metatarsal.
