Pob txha hauv ceg tuaj yeem ua rau ntau yam laj thawj. Qhov no yog ib qho kev tsis txaus siab heev ntawm cov neeg mob mus rau orthopedist, rheumatologist, traumatologist, arthrologist. Hauv cov poj niam, cov no feem ntau tsis txaus siab ntawm qhov mob ntawm tus ntiv taw loj. Thaum sib tham, tus kws kho mob feem ntau pom lawv tus cwj pwm taug kev hauv siab heels. Tau kawg, qhov no yog qhov zoo nkauj, tab sis ib txwm muaj kev hem thawj ntawm curvature ntawm thawj tus ntiv tes nyob rau hauv xws li mob.
Lub taub hau ntawm metatarsophalangeal sib koom tes ntawm tus ntiv tes xoo (pob txha) pib tawm sab nraud thiab qhov no hu ua "valgus deformity ntawm ko taw" lossis "halus valgus nres". Ntxiv mus, tus ntiv tes xoo yog deviated rau sab uas nws overlaps tus ntiv taw thib ob.
Cov poj niam muaj kev cuam tshuam rau cov kab mob no, vim tias lawv ligaments tsis muaj zog dua li cov txiv neej, uas, txawm tias lawv tsis taug kev hauv pob taws, tuaj yeem muaj kev ntxhov siab ntawm ko taw.
Etiology ntawm qhov tshwm sim
Nyob rau hauv 70% ntawm cov neeg mob muaj ib yam kab mob. Pob txha mos, uas ib txwm yuav tsum elastic thiab ruaj, nyob rau hauvRaws li qhov tshwm sim ntawm cov kab mob gene, nws tau them nrog mutated collagen, los ntawm qhov kev txhim kho ntawm kev sib koom ua ke yog cuam tshuam, cov pob txha sab hauv loj tuaj.
Qhov thib ob yog vim li cas tuaj yeem hu ua txhua yam pathologies ntawm pob qij txha, thaum cov txheej txheem degenerative, o, hemorrhages hauv cov tshuaj ntsiav, kev loj hlob ntawm osteophytes, osteoporosis, thiab lwm yam tshwm sim hauv lawv.
Lwm qhov laj thawj yog cov kab mob endocrine xws li ntshav qab zib lossis rog rog (lawv ua rau cov pob qij txha thiab pob qij txha nce ntxiv).
Dhau li ntawm qhov no, yuav tsum muaj qhov cuam tshuam:
- nkawm khau loj, khau siab, ua rau lub sijhawm ntev tsis zoo ntawm ko taw, ua rau lub hnab ntiv taw loj ua rau mob;
- mob rheumatism (triggered by heredity);
- raug mob thiab microtraumas ntawm ko taw nrog ligament mob (ua rau o thiab o ntawm pob txha);
- transverse flatfoot;
- hnub nyoog laus (ntau xyoo, collagen synthesis xyaum nres thiab sib koom ua ke tsis ruaj khov);
- climax (qis estrogen nce cov roj cholesterol thiab ua rau kev loj hlob ntawm atherosclerotic plaques ntawm phab ntsa ntawm cov hlab ntsha, ua rau pob txha pob txha);
- kev ntxhov siab thiab kev ua kis las;
- tsis muaj cov vitamins A, D, C, E;
- tsis muaj cov zaub mov (magnesium).
Signs of hallux valgus
Thawj harbiners:
- liab ntawm tus ntiv tes xoo ntawm sab;
- nkees ntawm txhais ceg thiab o ntawm nws;
- pob txha ib ncig ntawm ntiv taw loj mob ib hnub;
- ntiv tes xoo;
- muaglifting yog nrog los ntawm mob hnyav nyob rau hauv ko taw;
- ib tug tuab tshwm ntawm lub hauv paus ntawm tus ntiv tes.
Ntxiv mus, qhov mob tshwm thaum taug kev lossis sawv. Thaum tsiv, lameness tshwm sim, pob kws tshwm nyob rau ntawm plantar sab ntawm lub phalanges. Txawm thaum so, muaj qhov tsis xis nyob hauv ko taw, ntiv tes yog khoov.
Kev faib tawm
ntiv tes deflection yuav tsum tsis pub tshaj 10 degrees. Nrog pathology, qib nce. Osteophytes tshwm nyob rau hauv cov pob txha pob txha, lawv cuam tshuam qhov depreciation ntawm ko taw, uas ua rau mob. Articular pob txha mos swells, reddens thiab mob.
- First degree. Tus ntiv tes xoo offset tsawg dua 20 degrees. Visually, nws tsis hloov, tsuas yog yuav luag imperceptible thickening. Qhov tsis yooj yim yog tsis ntau lub cev raws li kev zoo nkauj. Tom qab ua haujlwm ntev, muaj qhov tsis xis nyob me ntsis.
- Second degree. Ntiv tes offset - 20-30 degrees. Los ntawm cov tsos mob: pob txha hloov liab, tsis xis nyob ua ntu zus, taug kev ntev ua rau mob me ntsis.
- Third degree. Offset - mus txog 30-50 degrees. Cov tsos mob: cov pob txha mob, nws swells thiab tig liab, kev txav ntawm kev sib koom tes yog txwv. Txoj kev mob no tolerable, txawm tas li.
- Plaub degree. Offset yog tshaj 50 degrees. Cov tsos mob: pob txha ntawm tus ntiv taw mob heev thaum taug kev, tej zaum yuav lameness. Calluses tshwm rau ntawm lub ntsis ntiv tes. Nkawm khau yuav nyuaj vim mob.
Qhov teeb meem txaus ntshai npaum li cas yam tsis tau kho?
Thaum pob txha hauv ceg mob, ntautsis quav ntsej, tab sis qhov teeb meem yuav tsis ua rau koj tos:
- ntau qhov txhab ntawm cov pob qij txha ntawm ob txhais ceg nrog kev loj hlob ntawm arthrosis;
- nce ntiv tes deformity;
- kev tsis sib haum xeeb.
Yog ob txhais ceg mob ntawm ko taw los saum toj no, kuv yuav ua li cas?
Kev kho mob ntawm hallux valgus siv sijhawm ntev, lub hom phiaj ntawm kev kho yog ua kom qeeb ntawm cov txheej txheem thiab txhim kho kev sib koom ua haujlwm. Kev kho mob zoo heev nyob ntawm qhov muaj hnub nyoog ntawm tus neeg mob, nws txoj haujlwm thiab qib ntawm kev hloov ntawm tus ntiv tes.
mob caj dab lossis mob caj dab xav tau kev kho mob ntev. Kev kho cov kab mob tua kab mob yog siv rau cov kab mob sib kis, cov tshuaj tua kab mob yog siv rau kev tiv thaiv kab mob.
Kev kho mob thiab mob hauv zos kho mob yog ua los ntawm kev siv cov tshuaj uas tsis yog-steroidal anti-inflammatory corticosteroid ointments.
Thaum cov txheej txheem mob hnyav zuj zus, chondroprotectors raug tshuaj kom normalize cov metabolism hauv cov pob qij txha. Tsis ntev los no, "Hondrolon" feem ntau pom zoo rau qhov no. Cov tshuaj nquag ntawm cov tshuaj tiv thaiv kab mob no yog chondroitin sulfate. Cov tshuaj yog tsim nyob rau hauv Russia.
Pharmacological action
Cov tshuaj "Chondrolon" muaj cov tshuaj proteoglycans, uas tiv thaiv cov pob txha mos, inhibit qhov kev ua ntawm cov enzyme uas rhuav tshem nws, thiab lawv kuj txhim kho cov metabolism hauv cov ntaub so ntswg. Cov tshuaj txo qhov mob thiab mob, kho pob txha mos saum npoo, tswj cov kua dej synovial.
Tsiparaffin da dej, ce kho mob, massage, vitamin therapy yog siv rau kev kho mob. Nrog rau 1-2 degrees ntawm kev hloov pauv, kev saib xyuas kev kho mob zoo. Qhov no yog siv orthopedic fixators, insoles thiab interdigital daim hlau. Lawv sib npaug faib lub nra ntawm ko taw thiab tiv thaiv cov ntiv taw los ntawm kev khoov, ua kom yooj yim taug kev thiab txo qhov mob.
Taw zaws hauv daim ntawv ntawm kauv kneading ntawm cov pob txha txhim kho cov ntshav ncig thiab ua kom cov khoom noj khoom haus rau cov leeg, pab kom cov leeg thiab ligaments. Kev kawm yog 10 hnub rau 20 feeb, ces so rau 3 lub lis piam.
gymnastic exercises
kev tawm dag zog tshwj xeeb tau ua txhua hnub. Lawv maj mam rov ua kom muaj zog thiab ntxiv dag zog rau kev sib koom ua ke.
Nrog lawv:
- khaws cov khoom me hauv pem teb nrog ntiv taw;
- kos nrog xaum ntawm tus ntiv taw ntawm tus lej lossis cov ntawv;
- nthuav tawm cov ntaub npog rau hauv pem teb nrog koj cov ntiv taw;
- toe taug kev.
Kuj txhim kho cov mob ntawm cov tshuaj da dej thiab txwv kev thauj khoom ntawm ko taw.
Kev ua haujlwm
Tus kws phais mob orthopedic txiav txim siab ua haujlwm tom qab kuaj x-ray. Kho qhov deformity yog hu ua osteotomy. Qhov no feem ntau tshwm sim thaum kev kho mob tsis zoo.
Muaj ntau tshaj 150 txoj hauv kev los kho hallux valgus: chevron osteotomy, tshem tawm osteophytes, arthrodesis, thiab lwm yam. Hom kev ua haujlwm yog xaiv los ntawm tus kws kho mob. Osteotomy tuaj yeem kaw lossis qhib.
Kaw yog tuav yam tsis muajincisions los ntawm punctures, qhov no yog ib tug tsawg-tawg txoj kev. Tus neeg mob raug tso tawm hnub tom qab tom qab qhov txheej txheem.
Yuav ua li cas hauv tsev?
Kev kho pob txha hauv tsev yog siv cov khoom tuav, insoles thiab daim hlau ntawm cov ntiv taw.
Retainer muaj txiaj ntsig:
- ntawm 1-2 theem ntawm pathology, thaum tseem tsis muaj qhov mob mus tas li;
- nrog rog dhau ib ntus kom txog thaum tus neeg mob normalizes qhov hnyav;
- tom qab kev phais, thaum lub sijhawm rov ua haujlwm, tus tuav pov hwm muab kev thaj yeeb rau ko taw.
Kev Tiv Thaiv
Cov lus pom zoo yooj yim:
- Khau yuav tsum haum. Nws yuav tsum tau ua los ntawm cov khoom siv ntuj tsim, nrog lub ntsej muag tuab, dav dav, nrog kev txhawb nqa koov.
- Koj yuav tsum mus ko taw ntau dua.
- Thaum yav tsaus ntuj koj tuaj yeem ua ko taw zaws thiab da dej ntsev.
- Tsis txhob muaj calcium.
- sawv tsawg, taug kev ntau.
Nws mob hauv caug: laj thawj
Vim li cas cov pob txha hauv kuv ob txhais ceg ua mob hauv qab hauv caug? Ua txhaum ntawm no:
- Lub cev hnyav ntawm cov leeg ntawm ob txhais ceg, piv txwv li, thaum muaj kev cob qhia ntau dhau. Qhov no ua rau myalgias thiab convulsions.
- mob pob txha tuaj yeem tshwm sim los ntawm cov pob txha tawg lossis tawg ligaments.
- Nws tuaj yeem ua rau khaus.
- mob pob txha hauv qab lub hauv caug tuaj yeem tshwm sim los ntawm qhov nqaij tawv heev. Ob peb hnub, o thiab hematoma yuav ntxiv rau qhov no.
- Cov pob txha ntawm ob txhais ceg ntawm lub hauv caug mus rau ko taw mob nrog mob caj dab, mob caj dab lossiso ntawm meniscus ntawm lub hauv caug. Mob hauv qab ntawm lub hauv caug ze rau ntawm ko taw feem ntau tshwm sim los ntawm varicose leeg thiab thrombosis.
- Cov pob txha ntawm ceg mob vim yog ua txhaum ntawm cov dej-ntsev sib npaug, thaum cov tshuaj tiv thaiv kab mob tshwm sim hauv cov rog subcutaneous, piv txwv li, nrog sciatica thiab cev xeeb tub.
Nws yog contraindicated rau tendons kom ncab zog thiab ntev, txawm tias lawv muaj zog.
Mob hauv lub hauv caug pem hauv ntej kuj tuaj yeem tshwm sim vim qhov mob ntawm cov leeg (tendinitis). Qhov no yog qhov tshwj xeeb tshaj yog thaum qoj ib ce lossis nce (kub) ntaiv.
Cov pob txha mob hauv pem hauv ntej nrog qhov tsis zoo ntawm kev mob caj dab ua rau lub hauv caug pob qij txha, ua rau mob hnyav.
Menisci tuaj yeem tsim kua muag thaum lub cev ua haujlwm hnyav. Lub menisci ua lub cushion pads.
Mob hauv qab lub hauv caug tuaj yeem tshwm sim vim qhov tawg ntawm calyx nyob rau thaj tsam no.
Yog tsis paub meej tias yog vim li cas ob txhais ceg hauv qab lub hauv caug mob rau pem hauv ntej, ces xav txog qhov muaj peev xwm dislocation thaum lub caij nplooj zeeg, kev sib tsoo, thaum ua haujlwm, thiab lwm yam. Kev rog kuj tuaj yeem ua rau tsis xis nyob hauv ob txhais ceg hauv qab hauv caug.. Nrog rau qhov normalization ntawm qhov hnyav, qhov mob ploj mus ntawm nws tus kheej.
Cov ceg hauv qab lub hauv caug pem hauv ntej mob heev thiab thaum lub periosteum detaches. Lub hauv caug pob qij txha yuav pib mob vim muaj kev cuam tshuam ntawm lub duav sib koom los yog pinching ntawm cov hlab ntsha. Tab sis cov no tsis yog vim li cas xwb.
Vim li cas cov pob txha ntawm kuv ob txhais ceg tseem mob? Piv txwv li, vim qhov tsis muaj zog ntawm lub taub hau nruab nrab ntawm cov leeg extensor, uas nias rau ntawm patella thiab ua rau mob nrog kev txav mus los.
Kab mob nrog mobhauv cov pob txha
Lawv sib txawv:
- Kev raug mob: bruises, pob txha, dislocations. Twisted fractures ntawm tibia thiab pob taws yog qhov ntau tshaj.
- pob txha hlav. Lawv tuaj yeem nyob hauv cov pob txha lawv tus kheej los yog metastases.
- Kab mob ntawm cov ntshav. Cov pob txha tubular muaj cov pob txha liab. Nws swb kuj ua rau mob pob txha.
- Kab mob khaub thuas thiab kis kab mob. Qhov no feem ntau yog hematogenous osteomyelitis. Nrog rau tus kab mob no, cov txheej txheem purulent-necrotic tsim tsis tsuas yog hauv cov pob txha pob txha, tab sis kuj nyob hauv cov pob txha.
- Txawm tias muaj mob khaub thuas, pob txha thiab cov leeg tuaj yeem mob thaum noj los ntawm tus kab mob nkag mus rau hauv cov ntshav.
- mob pob txha raug sau tseg hauv syphilis (thaum hmo ntuj) thiab tuberculosis.
- YHypovitaminosis. Nrog rau qhov tsis muaj cov vitamins D thiab B1, cov hlab ntsha peripheral raug rhuav tshem, thiab qhov no ua rau mob thiab kub hnyiab hauv cov leeg thiab pob txha ntawm ob txhais ceg thiab ko taw.
- Tus kab mob Osgood-Schlatter. Nws essence yog hais tias muaj ib tug resorption ntawm tuberosity ntawm tibia. Qhov no yog qhov chaw nyob rau sab saum toj ntawm cov pob txha uas cov leeg txuas nrog. Hauv qee cov tub ntxhais hluas, muaj kev loj hlob ntawm cov hlab ntsha hauv cov ceg, cov pob txha noj qab haus huv thiab cov ntshav tau cuam tshuam. Qhov tshwm sim yog qhov resorption ntawm tuberosity. Tsis muaj kev puas tsuaj tshwj xeeb hauv qhov no, tab sis mob hnyav tshwm sim hauv cov pob txha ntawm sab ceg. Tom qab ntawd, cov ntshav tau rov qab los, yog li kev kho mob sab nraud nrog tus kws kho mob orthopedist. Qhia kho physiotherapy. Thaum lub resorption ntawm tuberosity xaus, qhov tsis zoo tshwm sim ploj tag.
- Nyob hauv cov neeg lausQhov mob pob qij txha feem ntau tshwm sim los ntawm kev puas siab puas ntsws lossis vascular pathologies. Tag nrho cov kab mob no muaj ib qho kev tshwm sim nyob rau hauv daim ntawv ntawm intermittent claudication.
- Kuj tsis tshua muaj, tab sis muaj qhov mob ntawm cov pob txha ntawm sab ceg vim Volyn kub taub hau. Nws yog tshwm sim los ntawm lub cev ntshauv. Manifested los ntawm txias, tawm hws, hyperthermia.
- Ntau dhau ntawm cov tshuaj hormones parathyroid (hauv cov qog parathyroid), cov tshuaj hormones hauv cov thyroid caj pas thiab adrenal cortex ua rau pob txha.
Diagnosis
Nws suav nrog:
- X-ray. Siv sijhawm li 30 feeb, qhov tseeb yog li 70%.
- Ultrasound. Lub sij hawm 30 feeb, qhov tseeb txog 60%;
- CT. Siv sijhawm li 15 feeb, 60 txog 80% raug;
- MRI. Lub sijhawm ua haujlwm 20 feeb, qhov tseeb 97%.
Txhua txoj kev kuaj mob uas tau teev tseg tuaj yeem muab ib lossis lwm cov ntaub ntawv hais txog cov leeg nqaij, pob txha, cov hlab ntsha thiab cov leeg, nrog rau daim tawv nqaij.
Txoj kev pheej yig tshaj yog ultrasound. Kev tshawb fawb kim yog tsim nyog los ntawm qhov raug siab. Yog hais tias vascular pathologies nyob rau hauv ob txhais ceg xav tias, vascular angiography yog ntxiv qhia, nrog rau radionuclide diagnostics.
Kev kho mob ntawm cov pob txha hauv qab ntawm lub hauv caug
Kev kho yog ua nrog kev pab ntawm cov tshuaj rau cov pob txha mob, kho lub cev, kev kho lub cev. Thawj 3 hnub, txias compresses thiab txhuam nrog ib daim ntawm cov dej khov yog siv los txo qhov o, qhov sib koom yuav tsum tau kho.
Koj tuaj yeem noj cov tshuaj tua kab mob kom mob pob txha. Piv txwv li, NSAIDs: Ibuprofen lossis Diclofenac. Hauv cov kab mob hnyav, siv sijhawm luv luvCov tshuaj glucocorticosteroids.
Txhaj "Diprospan": cov lus qhia rau kev siv
Qhov no yog cov tshuaj noj, muaj nyob rau hauv ampoules. Chaw tsim tshuaj paus - Russia. Cov khoom xyaw nquag: betamethasone disodium phosphate, ntsig txog GCS. Nws yog tus cwj pwm los ntawm kev nce glucocorticoid thiab, rau qhov tsawg dua, kev ua haujlwm mineralocorticoid. Cov cuab yeej muaj anti-inflammatory, anti-allergic thiab immunoprotective teebmeem. Nws muaj cov txiaj ntsig zoo ntawm cov metabolism. Tshem tawm ntawm lub cev los ntawm lub raum. Cov lus qhia rau kev siv: pathologies ntawm cov pob txha thiab cov leeg.
Cov lus qhia rau kev siv tshuaj "Diprospan" hais tias nws yog siv rau kev txhaj tshuaj intramuscularly, intraarticularly, periarticularly, intrabursally, intradermally. Cov tshuaj tsis raug muab tso rau hauv cov hlab ntsha thiab subcutaneously.
Thaum muaj kab mob etiology, kev kho tshuaj tua kab mob yog qhia. Zoo heev ntxiv dag zog rau cov leeg thiab stabilizes kev sib koom ua ke physiotherapy. Nws yog ib qho tseem ceeb rau kev ua physiotherapy ce, uas yuav ua rau cov nqaij ntshiv tsim nyog thiab nres kev loj hlob ntawm atrophy. Rau kev raug mob hnyav thiab siab heev, kev kho mob phais.
Kev Tiv Thaiv
Kev tiv thaiv kev mob ntawm ceg hauv qab hauv caug, nws raug pom zoo:
- hnav lub hauv caug tiv thaiv thaum ua si;
- nrog rau kev sib tw ntawm ko taw taw, ib ntus nco ntsoov muab lawv so thiab ua kom sov;
- zam hypothermia ntawm qis extremities.
Thaum zaum, koj tsis tuaj yeem khoov koj ob txhais ceg thiab muab pov rau ib leeg. Nyob rau tib lub sijhawm, koj yuav tsum ua ib ce, sawv thiab ua kom sov. Txoj kev ua neej noj qab nyob zoo thiab kev cia siabkev ua si. Nws raug nquahu kom tso tus cwj pwm phem, vim lawv ua rau ntau yam kab mob.
Mob pob txha ntawm ob txhais ceg tuaj yeem qhia ntau yam kab mob. Txhawm rau txheeb xyuas qhov tseeb, koj yuav tsum mus ntsib lub tsev kho mob. Tsuas yog ib tus kws kho mob tshwj xeeb yuav tuaj yeem ua qhov kev kuaj mob kom raug thiab sau cov kev kho kom tsim nyog. Kev noj tshuaj rau tus kheej yam tsis tau sab laj nrog kws kho mob tsis tuaj yeem lees txais.
