Taylor's deformity lossis "tailor's foot" - deviations nyob rau hauv thaj tsam ntawm tsib metatarsal pob txha. Raws li qhov tshwm sim ntawm cov kab mob no, lub pob tshwm hauv thaj tsam ntawm lub hauv paus ntawm tus ntiv taw me ntawm ko taw. Hom kab mob no tsis muaj tsawg dua li kev hloov pauv ntawm tus ntiv tes xoo, tab sis cov tsos mob hnyav dua.
Tus kab mob lub npe tau muab ntau pua xyoo dhau los. Qhov no yog vim lub fact tias lub deformation feem ntau tshwm nyob rau hauv tailors, uas zaum cross-legged thoob plaws hauv lub hnub ua hauj lwm. Yog li ntawd, lawv tau so cov npoo sab nraud ntawm lawv txhais taw rau hauv pem teb, thiab lawv tau "pob" nyob ze ntawm tus ntiv tes me me, uas ua rau muaj kev ntxhov siab ntau.
Yuav ua rau muaj kab mob
Taylor's deformity feem ntau tshwm sim tawm tsam keeb kwm ntawm caj ces predisposition. Txawm li cas los xij, kev hloov pauv hauv cov qauv ntawm cov pob txha ceg tuaj yeem tshwm sim tawm tsam keeb kwm yav dhau los ntawm qhov muaj cov ko taw tiaj tus lossis microtraumas. Yog vim li cas tej zaum yuav yog qhov tsis ncaj ncees lawm ntawm ob txhais ceg, hnav khau nruj.
Hauv kev kho mob, muaj peb lub laj thawj tseem ceeb:
|
Npe |
Ntse |
| Post-traumatic | Yam ntxwv rau cov pob txha tsis raug cai ntawm ko taw. Hauv qhov no, tsuas muaj ib txoj hauv kev tawm - kho osteotomy, uas yog, pob txha tawg ntawm cov pob txha tsis raug. |
| Structural los yog innate | tshwm sim tawm tsam keeb kwm ntawm cov leeg tsis muaj zog, nyob rau hauv cov xwm txheej zoo li no, cov cuab yeej ligamentous tsuas yog tsis tuaj yeem tuav cov pob txha hauv txoj haujlwm raug. Nyob rau hauv cov xwm txheej zoo li no, nws yog qhov txaus ntshai heev rau hnav khau nqaim, uas ua rau muaj kev puas tsuaj loj. |
| Nyob zoo | Feem ntau tshwm sim tawm tsam keeb kwm ntawm kev tsis ruaj khov ntawm 5th ray ntawm ko taw. Nws kuj tuaj yeem yog ib qho tsis tau them nyiaj varus daim ntawv ntawm ko taw los yog qhov tsis xws luag ntawm cov pob txha metatarsal, tsis muaj zog ntawm cov leeg. |
Symptomatics
Taylor's deformity yog tus yam ntxwv ntawm qhov liab liab ntawm thaj tsam ntawm tus ntiv taw thib tsib. Puffiness yuav tshwm sim thiab ib pob tuaj yeem tsim, qhov mob tsis tu ncua.
Kev mob hnyav ntawm cov tsos mob yog qhov tshwm sim hauv cov txheej txheem thiab tom qab hnav khau nruj, mus txog rau kev txhim kho ntawm cov txheej txheem inflammatory. Txawm hais tias qee tus neeg mob tau tshaj tawm tias nws nyuaj rau lawv txav mus txawm tias khau khiab.
Rau ntau tus neeg mob, xws li deformities feem ntau yog kev kho kom zoo nkauj, ntxiv rau, nrog tus kab mob no nws nyuaj heev rau kev nrhiav khau.
Diagnosis
Feem ntau tsis nyuaj rau kev kuaj mob yog tias muajTaylor deformity tsis tshwm sim. Tom qab tag nrho, kev hloov ntawm cov pob txha cov ntaub so ntswg yog pom ntawm qhov muag liab qab. Ntawm palpation, tus kws kho mob tshwj xeeb yuav pom qhov tuab ntawm lub taub hau metatarsal lossis teeb meem hauv cov tshuaj ntsiav nyob ze ntawm qhov sib koom ua ke.
X-ray kuaj
Txawm li cas los xij, txawm tias tom qab kev kuaj mob tuaj yeem kuaj pom muaj teeb meem hauv thaj tsam ntawm tus ntiv taw thib tsib, tus neeg mob raug xa mus kuaj X-ray. Hom kev kuaj no tso cai rau koj los txiav txim siab qhov xav tau rau kev ua haujlwm Taylor deformity thiab qib ntawm cov pob txha puas, tshwj xeeb:
- rau qhov sib txawv ntawm cov ces kaum sab;
- muaj lossis tsis muaj pob txha, los ntawm txoj kev, uas tus neeg mob yuav tsis paub txog;
- yog lub taub hau metatarsal loj;
- kaum ntawm 4th thiab 5 ntiv tes;
- puas muaj arthrosis ntawm cov pob qij txha.
Kev ntsuas ntsuas
Qhov kev ntsuas tseem ceeb rau kev ntsuas tus neeg mob tus mob yog lub kaum sab xis ntawm tus ntiv tes. Qhov zoo tshaj plaws, qhov kev ncua deb ntawm 2nd thiab 5th beam yuav tsum yog 14-18 degrees, thiab nruab nrab ntawm 4th thiab 5th - 7-9 degrees. Yog tias muaj kev sib txawv ntawm cov qauv, peb tuaj yeem tham txog qhov muaj tus kabmob.
Qhov kev ntsuas thib ob yog cov duab ntawm lub taub hau metatarsal. Ib txwm sib txawv yuav tsum tsis txhob siab tshaj 2-3 degrees, nyob rau hauv lub xub ntiag ntawm pathology, lub kaum sab xis tuaj yeem ncav cuag 8-9 degrees.
ntsuas ntsuas
Kev kho mob ntawm Taylor's deformity nyob rau hauv tsis heev kis mob pib nrog cov txheej txheem uas tsis yog phais. Ua ntejNyob rau hauv tag nrho, qhov mob raug tso tseg thiab cov txheej txheem inflammatory raug tshem tawm. Nyob rau hauv lub neej yav tom ntej, tus kws kho mob pab tus neeg mob xaiv cov khau zoo, uas yuav tsum muaj cov ntiv taw dav. Cov khau khau orthopedic kuj tseem raug pom zoo kom txo qis kev sib txhuam ntawm tus ntiv taw thib tsib.
Cov tshuaj tsis-steroidal tshuaj tiv thaiv kab mob tuaj yeem raug pom zoo los txo qhov mob. Tsis tas li ntawd, qhov mob tuaj yeem kho tau nrog kev pab ntawm txias, qhwv ob txhais ceg thaum yav tsaus ntuj nrog ib daim phuam nrog cov dej khov. Cov txheej txheem no tsis tuaj yeem ntev dua 20 feeb. Qee zaum, kev thaiv tuaj yeem ua tau, uas yog, kev txhaj tshuaj loog yog siv rau hauv cheeb tsam periarticular. Hauv cov xwm txheej zoo li no, corticosteroids tau siv.
Surgery
Raws li kev tshuaj xyuas, Taylor deformation ua haujlwm tso cai rau koj tshem tawm qhov teeb meem ib zaug thiab rau tag nrho. Lub ntsiab lus ntawm kev cuam tshuam kev phais yog qhov exostosis raug tshem tawm, uas yog tsim rau ntawm lub taub hau ntawm cov pob txha metatarsal thib tsib. Tom qab tshem tawm, cov pob txha nws tus kheej raug txiav thiab hloov mus rau qhov chaw uas nws yuav tsum tau ua. Fragments yog tsau nrog ib tug ntsia hlau.
Tom qab kev ua haujlwm zoo li no, tsis muaj kev kho mob mus ntev, raws li txoj cai, tus neeg mob tau nce mus rau nws ko taw twb nyob rau hnub ob. Tib lub sijhawm, nws tsis xav tau immobilization lossis kev txhawb nqa ntxiv rau kev txav mus los.
Nyob rau thawj lub hlis tom qab ua haujlwm, cov khau tshwj xeeb yuav tsum tau ua kom lub siab tawm ntawm lub hauv ntej ntawm ko taw. Kev taug kev tag nrho twb ua tau rau 4-6 lub lis piam tom qab kev phais.
cov txuj ci niaj hnub
Tam sim noNyob rau hauv kev kho mob ntawm Taylor varus deformity, muaj ntau txoj kev phais, kev xaiv uas nyob ntawm seb curvature, tus neeg mob lub cev ua si thiab hnub nyoog.
Ntxiv rau qhov exostosectomies, uas yog, tshem tawm ntawm txoj kev loj hlob, tuaj yeem ua tiav osteotomy. Qhov kev ua haujlwm no tau qhia nyob rau hauv muaj hom I thiab II curvature.
Nyob rau hauv lub xub ntiag ntawm hom II lossis III curvature, ib qho osteotomy tau ua. Thiab proximal osteotomy yog ua rau hom IV thiab V hom curvature.
Kev Tiv Thaiv
Txawm hais tias qhov tseeb tias feem ntau qhov deformation tshwm sim tawm tsam keeb kwm ntawm caj ces predisposition, tus kab mob tseem tuaj yeem tshwm sim los ntawm qee yam. Kev xaiv zoo ntawm nkawm khau yog qhov tseem ceeb heev. Saib ntawm daim duab nrog Taylor lub deformation, nws pom tseeb tias cov khau nqaim tsis haum rau cov neeg zoo li no, thiab hnav heels tsis pom zoo. Koj tuaj yeem hnav lub platform qis. Nkawm khau yuav tsum tsis txhob nias rau ntawm cov hlab ntsha thiab cov pob qij txha ntawm ob txhais ceg, tso cai rau koj kom faib lub nra ntawm tag nrho ko taw.
Yog tias muaj kev xav tias qhov deformation tuaj yeem tshwm sim, koj tuaj yeem ua gymnastics rau ko taw, tab sis tsuas yog ua ntu zus. Koj tsev neeg tus kws kho mob lossis tus kws kho mob orthopedist yuav qhia koj txog cov kev tawm dag zog li no. Raws li kev tiv thaiv kev tiv thaiv, taug kev ko taw ntawm qhov chaw tsis sib xws.
Thiab tseem ceeb tshaj, yog tias koj mam li nco dheev pom liab los yog pob hauv thaj tsam ntawm cov ntiv taw me me ntawm ko taw, nco ntsoov sab laj nrog kws kho mob txhawm rau tiv thaiv kev txhim kho ntawm deformity thiab tsis txiav txim siab seb puas yog. txiav txim rauphais.
