Dab tsi yog tus ko taw hollow? Koj tuaj yeem pom cov duab ntawm no pathology hauv kab lus nthuav tawm. Peb tseem yuav txheeb xyuas tus kab mob hauv nqe lus nug, txheeb xyuas qhov ua rau nws tshwm sim, sau cov tsos mob thiab tham txog kev kho mob.
Cov ntaub ntawv tseem ceeb
Dab tsi yog tus ko taw hollow? Qhov no yog ib tug pathology uas implies deformation ntawm qis extremities. Nws yog tus cwj pwm los ntawm kev txo qis cov lus qhia ntawm cov ntiv tes thiab tsa lub pob taws. Raws li qhov tshwm sim ntawm qhov deformation no, qhov loj ntawm lub arched vault noticeably nce nyob rau hauv tus neeg mob.
Hollow ko taw tuaj yeem yog kab mob sib kis, thiab tseem muaj hnub nyoog (los ntawm 35 xyoo). Tus kab mob hauv nqe lus nug yog qhov txawv ntawm flatfoot.
theem ntawm deformation
Kev kho mob ntawm ko taw hollow nyob li cas? Cov kws tshaj lij hais tias qhov kev xaiv ntawm ib qho kev kho mob ncaj qha cuam tshuam rau theem ntawm tus kab mob nyob. Cov kws tshaj lij paub qhov txawv 2 theem ntawm deformation:
- Thaum pib ntawm tus kabmob, muaj kev hloov pauv ntawm cov ntaub so ntswg (morphological). Txhawm rau tshem tawm qhov teeb meem no, cov kws kho mob pom zoo kom tus neeg mob siv lub siab ntawm lub taub hau ntawm thawj metatarsalpob txha.
- Yog tias kev ntsuas los kho qhov kev txhim kho deformity tsis tau ua, ces qhov kev ruaj khov ntawm tus kab mob tshwm sim, uas yuav tsum tau muaj kev kho mob sai.
Kev tshwm sim
Vim li cas hollow ko taw txhim kho? Yog vim li cas thiab lub caij nyoog mechanism rau nce nyob rau hauv lub arched vault tseem tsis tau elucidated. Txawm li cas los xij, cov kws kho mob hais tias xws li pathology tuaj yeem tshwm sim vim qhov tsis txaus ntseeg (cov leeg nqaij) tawm tsam keeb kwm ntawm hypertonicity lossis tsis muaj zog (paretic) ntawm tus kheej cov leeg ntawm ko taw thiab sab ceg. Los ntawm txoj kev, qee cov kws tshaj lij tau sau tseg tias qee zaum thaum kuaj tus neeg mob nrog cov lus nug deformity, nws tsis tuaj yeem paub meej tias qhov txo qis lossis qhov sib txawv, qhov nce ntawm cov leeg nqaij.
Raws li kev xav ntawm cov kws kho mob feem ntau, feem ntau lub hollow ko taw yog tsim los ntawm pathology ntawm cov khoom siv neuromuscular thiab ntau cov kab mob, nrog rau cov leeg nqaij dystrophy, poliomyelitis, spinal dysrapia, Charcot-Marie-Tooth. kab mob, syringomyelia, polyneuropathy, Friedreich's ataxia, cerebral palsy, meningitis, meningoencephalitis, benign thiab malignant hlav ntawm tus txha caj qaum.
Tsis tshua muaj, xws li kab mob tshwm sim vim qhov kub hnyiab ntawm sab qis lossis tsis raug fused talus thiab calcaneus (tom qab tawg).
Nyob rau hauv 20% ntawm tag nrho cov xwm txheej, cov yam uas provoked lub hollow ko taw tseem unexplained.
Symptoms of disease
Hauv khw muag tshuaj thiab chaw kho mob, insoles rau hollow ko taw feem ntau muag. Lawv xav tau dab tsi rau? Lub ntsiab lus yog tias tus kab mob no tsis yoghla tsis tau ib txoj kab rau tus neeg mob.
Nrog rau qhov nce hauv qhov arched, tus neeg mob pheej yws yws ntawm qhov mob hauv ko taw, qaug zog thaum taug kev thiab tsis xis nyob hauv pob taws pob taws. Tsis tas li ntawd, qee tus neeg mob tau tshaj tawm tias lawv nyuaj heev rau kev xaiv khau zoo.
Thaum kuaj ib tus neeg nrog cov kab mob hauv qab kev saib xyuas, cov kws kho mob tshwj xeeb nthuav tawm qhov siab ntawm sab hauv thiab sab nraud, flattening, nthuav dav thiab me ntsis ntxiv ntawm cov leeg sab hauv, mob calluses (piv txwv li, ntawm lub hauv paus ntawm thawj tus ntiv taw thiab hauv cheeb tsam me ntsis ntiv tes), nrog rau deformity ntawm cov ntiv tes. Tsis tas li ntawd, tus neeg mob no feem ntau muaj mob hnyav ntawm ko taw.
Lwm cov paib
Ib qho ko taw hollow vim poliomyelitis tuaj yeem nrog me me unilateral paresis ua ke nrog ko taw equinus. Tib lub sijhawm, lub suab ntawm cov leeg nqaij raug txo, thiab qhov deformation tsis vam meej.
Yog tias ib tus neeg muaj mob hlwb, ces nws yuav muaj qhov tshwm sim spastic, nce cov leeg nqaij thiab nce reflexes (tendon). Cov txheej txheem zoo li no tsis muaj kev vam meej thiab ib leeg.
Nyob rau hauv congenital malformations, lub pathology feem ntau yog ob sab. Nws nyhav zuj zus, tshwj xeeb tshaj yog thaum lub sij hawm muaj kev loj hlob (piv txwv li, ntawm 5-8 xyoo thiab ntawm 11-15).
Nrog rau kev kuaj mob ntawm Friedreich tus kab mob, lub hollow ko taw yog 2-sided thiab nce zuj zus. Feem ntau, tsev neeg ntawm tus neeg mob kuj muaj tus kab mob no.
Kev nce ntawm ko taw ko taw feem ntau ua ke nrog ataxia thiab gait disorders. Tsis tas li ntawd, tus kab mob no yog tus cwj pwm los ntawm kev hnov mob me me thiab cov kab mob ntawm cov kab mob pyramidal.
Nyob rau hauv kab mob Charcot-Marie-Tooth, ib tug neeg muaj 2-sided thiab loj zuj zus deformity ntawm ob txhais taw, nrog rau cov leeg nqaij atrophy, uas kis tau los ntawm hauv qab mus rau saum.
Nws kuaj tau li cas?
Kev qoj ib ce nrog lub hollow ko taw yuav tsum tau ua yam tsis poob. Txawm li cas los xij, qhov no yuav tsum tau ua tsuas yog tom qab kuaj pom tseeb los ntawm tus kws kho mob paub txog. Raws li txoj cai, rau lub hom phiaj no, tus neeg mob raug xa mus rau kev cog qoob loo thiab radiography ntawm ko taw.
Nrog rau qhov me me deformity, lub plantogram qhia tau hais tias muaj kev nyuaj siab loj ntawm lub concave arc ntawm sab hauv, nrog rau ib qho protrusion raws ntug sab nrauv ntawm ko taw. Nrog me ntsis pathology, concavity yog pom mus txog rau sab ntug. Hais txog tus kab mob uas hais tawm, qhov imprint ntawm tus tib neeg yog muab faib ua 2 ntu.
Tseem muaj cov xwm txheej siab heev thaum cov ntiv tes ntawm cov ntiv tes ploj tag nrho ntawm tus hneev taw. Qhov no yog vim lawv cov claw zoo li deformation.
Yog tus kws kho mob ntseeg tias qhov ua rau muaj teeb meem yog kab mob ntawm cov khoom siv neuromuscular, ces tus neeg mob raug xa mus rau kws kho mob hlwb. Cov tom kawg ua tiav kev kuaj mob hlwb, ua X-rays ntawm tus txha caj qaum, MRI thiab CT scans, nrog rau electromyography thiab lwm yam kev tshawb fawb.
Kev raug mob tarsal qub tuaj yeem xav tau ko taw CT scan.
Yog tias qhov khoob ko taw raug kuaj pom thawj zaug thiab tib lub sijhawmtus neeg mob tsis muaj kab mob ntawm cov kab mob neuromuscular, thiab tsis muaj kev raug mob yav dhau los, qhov no qhia tau hais tias muaj tshwm sim ntawm cov qog ntawm tus txha caj qaum. Hauv qhov no, tus neeg raug xa mus rau tus kws kho mob oncologist kom kuaj.
Yuav kho li cas?
Txoj kev kho cov kab mob ko taw yog txiav txim siab los ntawm qhov ua rau nws txoj kev loj hlob, nrog rau qib ntawm kev nce hauv koov koov thiab lub hnub nyoog ntawm tus neeg mob.
Nrog rau cov kab mob me me thiab mob me, tus neeg mob tau muab tshuaj kho lub cev, kho lub cev thiab zaws. Cov ntaub ntawv tsis kho ntawm tus kab mob no tuaj yeem hloov kho kom zoo los ntawm kev hnav cov khau tshwj xeeb nrog cov ntug sab hauv.
Tus kab mob muaj zog, tshwj xeeb tshaj yog rau cov neeg laus, raug kev kho mob phais.
Nyob ntawm hom kab mob thiab qhov ua rau ntawm nws txoj kev loj hlob, arthrodesis, osteotomy, crescent lossis wedge resection ntawm cov pob txha tarsal, tendon grafting thiab dissection ntawm plantar fascia tuaj yeem ua tau. Ntau yam kev sib txuas ntawm cov txheej txheem no kuj tau siv.
Surgery
Kev ua haujlwm los kho ko taw yog ua raws li kev npaj raws li kev siv tshuaj loog. Qhov kev xaiv zoo tshaj plaws yog kev sib koom ua ke kev phais raws li Chaklin lossis Kuslik. Cov txheej txheem tom kawg suav nrog kev qhib kev txiav tawm lossis rov kho dua ntawm plantar aponeurosis ua ke nrog falciform lossis wedge resection ntawm cov pob txha cuboid. Sai li qhov chaw resected raug tshem tawm, sab nraub qaum ntawm ko taw yog khoov rau ntawm ib sab, thiab pem hauv ntej - rau tom qab. Tom qab ntawdlub qhov txhab yog sutured, drained, thiab ib tug cam khwb cia yog thov mus rau lub qis qis, uas tsis tau muab tshem tawm rau 6-7 lub lis piam.
Nyob hauv kev ua haujlwm raws li txoj kev Chaklin, lub plantar aponeurosis kuj tau kho dua lossis txiav tawm. Tom qab ntawd, cov pob txha ntawm tarsus raug nthuav tawm. Nyob rau hauv cov ntaub ntawv no, lub extensor tendons yog retracted rau ob sab, thiab ces ib tug wedge-puab resection ntawm ib feem ntawm cov pob txha cuboid thiab lub taub hau ntawm lub talus yog ua.
Raws li cov pob txha navicular, nws raug tshem tawm ib nrab lossis tag nrho, nyob ntawm qhov hnyav ntawm qhov deformity.
Nyob rau hauv rooj plaub uas muaj zog prolapse ntawm thawj metatarsal pob txha, nws (ntxiv) osteotomy yog nqa tawm. Thaum soj ntsuam equinus, ib qho Achilles tendon tenotomy tau ua.
Yog tias thaum lub sijhawm phais kev cuam tshuam txoj haujlwm ntawm ko taw tsis tuaj yeem kho tau, lub cam khwb cia yog siv rau ntawm txhais ceg rau 3 lub lis piam, tom qab ntawd nws raug tshem tawm thiab kho qhov kawg. Tom qab ntawd daim ntaub qhwv rov qab siv dua 4 lub lis piam.
Insoles thiab exercises
Pob txhais ko taw puas kho tau? Insoles thiab nkawm khau kom haum yog ib txoj hauv kev yooj yim tshaj plaws kom tshem tau cov ko taw deformity, nrog rau kev tiv thaiv.
Raws li cov kws tshaj lij, nrog lub qhov khoob ko taw, cov neeg mob yuav tsum muab lawv nyiam rau khau nrog lub platform dav thiab pob taws. Qhov no yuav pab kom ob txhais ceg nyob rau hauv qhov tseeb.
Nws tseem yuav tsum tau muab sau tseg tias yuav khau orthopedic yuav tsum tsuas yog nyob rau hauv kev saib xyuas ntawm kws kho mob. Los ntawm txoj kev, tom kawg tuaj yeem pom zoo rau khau nrog tsa sab hauv ntug. Txhawm rau muab kev txhawb nqa kom raugarches ntawm ko taw, orthoses yuav tsum tau, uas yog, tshwj xeeb insoles ua los txiav txim.
Yuav ua li cas txo qhov mob tshwm sim los ntawm ib tug hollow ko taw? Kev tawm dag zog thiab cov txheej txheem physiological rau kev kho mob ntawm tus kab mob no raug xaiv los ntawm tus kheej, raws li kev pom zoo ntawm tus kws kho mob tuaj koom. Nov yog qee qhov piv txwv:
- Pib txoj hauj lwm zaum. Kev tawm dag zog yog ua tau ywj siab, tom qab ntawd nrog kev ua haujlwm (taw qhov hnyav yog siv rau ko taw, gymnastic elastic).
- Kev txav ntawm cov ntiv tes thiab ob txhais taw ntawm ntau yam khoom (ntoo, roj hmab, cov pob hlau sib txawv, cov nplaum, thiab lwm yam) hauv qee qhov sib lawv liag - lawv qhov loj me yuav tsum maj mam txo, thiab lawv qhov hnyav yuav tsum tau nce ntxiv.
- Pib txoj hauj lwm sawv. Cov ntiv taw hauv, pob taws tawm, qhov siab tshaj plaws kev sib hloov ntawm lub shins, ces hloov mus rau sab ntug ntawm ko taw. Tom ntej no - txo qis rau saum npoo ntawm lub hauv siab.
Tsis tas li, txhawm rau tshem tawm qhov tsis xis nyob, tus neeg mob tau sau cov tshuaj paraffin da dej, da dej sov thiab kho phau ntawv kho deformity hauv daim ntawv ntawm kev zaws.
