Acetabulum o ka pelvic iwi

Kekahi o ka loa e like me nā palapū i alakai i ke kanaka i ka noho huila, e fractures o ka acetabular māhele. I kēia lā, ua aʻo i keia mea i kekahi hapa o ka Hip hui, e like me ka pono me kekahi therapies dysplasia 'ole' ē aʻe pilikia o ka wahi ma laila. I loaʻa mai kahi o ka acetabulum a me ka complications hiki i sclerosis paha fracture o ka indentation.

He aha ka hip-?

He mea i ka mana nui, a me ka nui i loko o ke kanaka kino. Ma waho aʻeo no nā hiʻona e like me flexion a me ka palena manawa, abduction puhaka, emi hope aku, imua, sideways, rotational neʻe, oia ua i komo i loko o nā kumu o ke kino.

Ke ano o keia ami kū hoʻokahi - ka mea, i ka hola 40% o kanaka ka neʻe 'ana.

Ua ua hana ia ma ke poo o ka femur, like hoʻi me kaumaha, i kapaʻia ka acetabulum. Ke Hip ami Uaʻoi like like me ka'ūhā mua. He mau D. kona hehee ai uhi ke cartilaginous'aʻaʻa, a hiki ka hoʻokemuʻana i ka haawe ana, ala apuupuu noi ana e hele ana, holo ana, a ua lele i 'ole.

'anatomia

Acetabulum mea he recess i loko o ka iliac iwi, i ka hapa o ka hipbone. Ua hanaʻia ka mea nui a me ka luna 'oihana i loko o ke kino paha, e like me ke kākoʻo a me ka neʻeʻana. Ua loaʻa he hemispherical kinona, kapa komo iā ia ma luna o ka loko cartilage. Kahuna lapaau kaʻawale alo a me ka hope paia o ka acetabulum, a me kona e pio. Ua haawiia i keia aoao o ka pelvic iwi hoʻolako kanaka neʻeʻana, ia mea nui e koke huai ae abnormalities i loko o kēia wahi, a hana koke.

Acetabulum ua hana pubis, ischium a ilium iwi ma ka wahi o ko lākou pili.

fracture

Loa pinepine, e like me ka pohāʻana o ka hoʻomauʻana o ka iwi ia lŘlŘ like me ka hopena o ka ulia. No hoi, i keia ino, e hana ana ma hope o ka haule ana mai o ka kiekie nui.

Fracture o ka acetabulum hiki ke maheleia i loko o 2 hoailona ia mea:

1. Simple poino. Kēia fractures ka mua kia, kūkulu, a waena paia transverse eha.
2. Complex poino. 'O kēia ka wā o ka fracture laina holo pololei i kekahi mau apana o ka iwi. Kēia nā ka mua pā poino, transverse, nā kolamu a me na mea e ae.

Symptoms o ka fracture nā:

- Pain i loko o ka groin a me ke ki kala.

- ka hoomanawanui mea ole, e hilinai aku ma luna o ka hana ino iki mai la na wawae.

- A akaka hoike ana o ka hua'ōleloʻo o ka lala, i ka manao ma ke ki kala a me ka iho ami. Uha mua ke ka ao ka waho.

fracture lapaʻau

- Inā i ka 'aʻe' manao pono o ka iwi ana me ka pāʻewaʻewa, laila, i ka hoʻomanawanui auhau ia lakou i ka hae kaʻa 'ohua, he ka leki, a me ka kūikawā palena manawa no ka lalo wāwae no ka wā o 1 mahina. E hōʻoia i ka hoʻokohu 'ia i ka papa o ka physiotherapy, electrophoresis.

- Inā Ua uhaʻiʻia ka acetabulum o ka pelvic iwi i loko o ka luna a me ka hope o kihi, huli ke ki kala dislocation, alaila, i ka iapaau ana ua lawe mai ma skeletal traction. Ke hoʻomalu hana loiloi hoʻohana olelo no epicondyles femur. Mahalo i kēia manipulation o na ami mea hōʻikeʻikeʻuʻuku ua'ōʻia, a ua kaomi aku i ka acetabulum, oa like na hakina. Duration kona mea IeAUPIIe, IAa IO 1.5 mahina.

- Inā he apana nahaha o ka nui, a he mea hiki ole ke hoohalike, lailaʻoki kino ua pono. It E e mālama 'ia i loko o ka mau pule mua hope o ka poino, i hope. E koho i ka pā koena ai, surgeons hoʻohana i ka una honua a me ka puakai nā kui nao.

Ma hope o lapaʻau, ka fracture mea nui loa i hoʻopulapula.

Hiki ke kōkua o ki ina hana like

Operative lapaʻau o fractures o ka recess like me ka acetabulum, Ua hana nui. Ka mea i ka mea, ka mea hiki ole ke heleia i ka hoʻomalu eha.

Kind o fractures o ka indentation ka hailona, a, o papa, no kela mea keia mea i kona iaoia iho o ke kula. ʻO kēia mau 'ana i kūpono iʻano nui i hoʻohana:

- Front ke kula.

- ilioinguinal ala.

- Hope ke kula.

alo ala

Ma kekahi alanui ka mea, ua kapaia "ofemoralnaya alanui." Ua Ua hoʻohana 'ia e reposition a pau fractures hamama mua paia a me ke kolamu recesses kapa acetabulum. More mua ala i ke noi i loko o kaʻoki lāʻau lapaʻau lapaʻau o transverse fractures.

Ilioinguinal ke kōkua o

Ua Ua hoʻohana 'ia no ka weheʻana i ke alo, a me ka loko ili o ka acetabulum. Ua hiki ke hoʻohana pū no ka fracture fixation hookahi-ke kahua recess me waimaka a pau o ka sacroiliac ami. Naʻe, i kēia iaoia 'aʻole e haawi komo i ka poʻe mākaukau hoʻi e hooponopono kia a me ka pa cavities.

hope ala

Ua pili e wehe ka ho'ēmiʻana a me ka osteosynthesis, ina he mea poino i ka posterior paia o ka acetabulum, ma hope hoʻopau o ka hoʻoneʻe hip-dislocation. Nō hoʻi, i kēia papa hana ua hoʻohana 'ia e wehe mau mea o ka cartilage mai ke ami lua.

Inc hope lua lihi fracture

Aia ka ia i ka pathological hou 'loko o ka ulia ai ka haule mai ke kiekie. Prone i keia poino no ka hapanui o ka mea opiopio kanaka. Fracture pu ma ka naeaeaa koena ai dislocations o nā iwi, ka make o ka articular surfaces cartilage. Ke kae o ka acetabulum o ka anterior malama i ka noho kaʻawale hihia. Ka hapanui o Episode ia akulla fractures posterior kia ao.

Ma ka haukapila hoʻomalu, e nānā i ka luahi, ka hoʻohana 'ana i kekahi ana o ka pelvis X-kukuna. E like me ka mea o ka urgency ma lalo o epidural anesthesia ole intravenous anesthesia kauka ho'ēmi i ka dislocation. Ma hope i ka hope loaʻike, o ka hui poino, a me ka X-Ray i loko o ka ileum, Review, kēlā, a me ka lolouila tomography. Oia noiʻi ano kōkua 'Oihana kiʻi i ka piha kiʻi o ka poho ia mau recesses me ka acetabulum.

E kau aku i kekahi kanaka ma luna o kona wāwae i loko o keia hihia e waleʻoki kino. Ke Kauka i ka oki no ka laina ma ka apana nahaha ua IIeEeAIEUIeXAIIUE. A laila, i ka Kauka fixes ka hoʻohewa ai i ka allowable mīkini'opihia. E kaha makau i kumupaʻa apana nahaha fixation, a laila, sutures i kaʻeha.

ke ola

A hiki i ka acetabulum o ka pelvic iwi ma hope o kona ano hoopono 'aʻe i ola ae la ia, ia mea pono, e malama i ke kēia mau rula o ka hoʻopulapula:

- kela la i keia hana me ka kūikawā hanu kino.

- E aʻo i ka pono, e hele ma oaʻiʻo, e pani ma ka wawae.

- hua i ka kūikawā 'ia paha o nā kino ma lalo o ka hooponopono ana o ka podiatrist: flexion a me ka hoʻolōʻihi' ia 'ana o na manamana, kapuwaʻi o ka kuapo, hoala a hakumakuma na pelvis e kākoʻo i ke ola i ke kulou i ka lalo lala a me na lima elua.

Osteoarthritis o ka hip-

A hoailona o ka maʻi, he mau sclerosis o ka acetabulum, a ua malama wale i loko o ka X-Ray. Kēia manawa ua pinepine i loaʻa i loko o ka hōʻike o nā kiʻi i laweʻia e radiologists.

Kēia pilikia e hoʻomōhala ana i like me ka hopena o ka hoʻoʻino loli i loko o ka iwi me ka overgrowth o connective'aʻaʻa.

Acetabular sclerosis - he ano i loko i loaʻa nā ole ma waho symptoms o ka maʻi - arthrosis. Kēia pilikia mea typical no na kanaka kūpuna. I ka papa kuhikuhiE kumu o ke kaumaha, ua sclerosis:

- Thinning o cartilage.

- 'aʻe' ana i ke koko lako i nā wāwae a me illnesses pili i ka pūnao.

- Hereditary predisposition e arthritis, osteochondrosis.

- Dislocations i ka holoholo.

- Sedentary Aloha Hawaii.

- Congenital malformations o ami.

- nā palapū i nii? Wahie, e pōʻinoʻia ligamentous i hoʻomākaukauʻia.

- Fractures ma ami.

- Obesity.

Lapaʻau o osteoarthritis o ka hip-, HI

Iapaau ana nā:

- lomilomi.

- kino ( 'Aʻohe wai iaʻu o ke alo aku wāwae i loko o ka supine kūlana).

- Physiotherapeutic kaʻina hana (mea pōhaku nahaehae,ʻume mākenēki).

- apono o kūikawā nā bato me ka radon, hydrogen sulfide.

- pilikia iapaau ana NSAIDs "diclofenac", "Nimesulide" a me na mea e ae.

Oe E hoi kaupalena ua hookapuia ke kaupaona punohu i ka lōʻihi manawa e e noho. Ua lele komo, holo ua hoi banned.

Otto ka maʻi

Ma kekahiʻaoʻao i kēia maʻi ua kapaia "acetabular dysplasia." A me kona inoa, e like me ka maʻi Otto, ua loaa ma hope o ka mea kākau, e hōʻike ana mua ia hoʻi i loko o 1824 He He congenital maʻi e ia lŘlŘ wale nō i loko o nā wāhine i kēia pathology. Ka pilikia hoike mai ai ia ia iho i loko o ka palena o ka neʻe 'ana o ka Hip hui (abduction, adduction, kuapo, hua'ōleloʻo ka lalo lala). Ma keia hihia, i kaʻeha o ka maikai ke keka, aole ia i haha aku.

E hoʻokūpaʻa i kaʻike, "kaumaha dysplasia" Ua pono, e hoʻomaka i ke ana manaʻo:

- X-Ray o ka Hip ke ami hoi i loko o ke koi 'ia nā wānana waiwai.

- MRI.

- ultrasound.

Acetabulum: Otto ka maʻi lapaau

Lapaʻau Uaʻoki lāʻau lapaʻau 'uao, a e like me:

- e haapau nei i ka ho'ēmiʻana o ka dislocation.

- Correctiveʻoki kino no Hiari.

- Open ka ho'ēmiʻana o ka dislocation.

- skeletal traction.

- Hip arthroplasty.

i mea manuahi therapies mea hoʻohana:

- A kūikawā ano o ke keiki.

- pākōlea hoounauna, gymnastics.

- lomilomi.

- lapaʻau me ka lāʻau.

Fracture me complications

Ke pohupani hale o ka acetabulum kānāwai i loko o ka haule ana o kekahi mea nui i loko o ka pelvis,'ōpā ia i loko o ka frontal pelane paha, no kekahi laʻana, ka wā i kaʻa ulia.

Ma kēia huikau fractures, uhai aku contours o ka hip-ami. I ka posterior dislocation nui trochanter höʻike ana. Inā ka dislocation o ka konu, alaila, kuha e poholo malalo iho. E maopopo i ka hoʻoneʻe fracture, ia mea pono ke hana i ka m-Ray i loko o nā nā wānana waiwai, no ka mea, o ka pilikia e e kekahi i loko o ka mua a me ka hope.

Symptomatology complications:

-ʻeleu wāwae noi loa pūʻulu.

- haʻahaʻa lala mea i loko o ka vicious kulana home 'ole.

Lapaʻau ma keia hihia o ke kēia:

- noi o ka'ōnaehana skeletal traction. Olelo lawe supracondylar māhele o ka uha me ka hou o ka 4 kg.

- ka uha ua waiho ia ma ka oihana o ka flexion, a lawe mai i loko o ke ki kala a me ka iho ami.

- No ka hoʻoholo 'ana i ke poʻo a hiki i ka makemake wahi hoʻomalu hana traction o ka'ā'ī iho (axis) ma ke ami a skeletal traction me ka loiloi mua haawe ana o ka 4 kg.

- Ma hope o ka mea, ua hoololiia ke ka ho'ēmiʻana wahie, a hiki i ka skeletal traction e waiho ana i ke kumu paka ma luna o ka'ā'ī iho (axis).

- wāwae no ka 1 pule ua haawiia mai i ka huina o ka 95 degere.

Duration kona mea mai ka 8 a hiki i 10 pule. ma hope o ke ahiahi, 2 pule i 'ae' ana i loko o ka ami. Full haawe ana ma ka wāwae ua ae wale ma hope o eono mahina. A me ka hiki i ka hana a ua hoihoi hou ia i loko o 7 mahina.

coxarthrosis

Kēia maʻi He degenerative ano, i loli ai ka kūpuna a me ka waena-elemakule. ? Ac? Aaioea maʻi i nā luna o kekahi mau makahiki.

Koksartroza na hoailona i:

- pathological pilina ma waena o ka femoral poo, a me ka acetabulum.

- medial quadrant o ka poo mea ma kaʻaoʻao.

- Ke kaupaku o ka acetabulum imbricate kēkahi ma luna o ka lua, like i ka nuku.

- ka lōʻihi o ka lua, a me ka hale, i kona.

- cortical, ahu iho i loko o ka hale kaumahaʻia naʻe.

Coxarthrosis pū ma kaʻeha a me ka hoʻokumu 'ana i olelo neʻeʻana.

Ma nā kahua o ka hoʻonaʻauao ma hope o ka maʻi he mea atrophy o na nāʻiʻo o ka uha.

Kumu o keia maʻi e māheleʻia i loko o 2 hoailona ia mea:

1. Helu coxarthrosis. Ua lŘlŘ no kumu ike lapaau.
2. Secondary coxarthrosis. Ua Ua loaʻa like me ka hopena o nā maʻi puʻuwai.

Ka hopeʻano o ka maʻi hiki ia i ka hopena o ka pilikia e like me:

- Congenital hip-dislocation.

- Hip dysplasia.

- Aseptic necrosis o ka femoral poo.

- hip-arthritis.

- Perthes maʻi.

- trauma (fracture o ke ki kala, pelvis, sprains).

No ka coxarthrosis progresses. Inā e hoʻomaka lapaʻau i ka kakahiaka nui ke kahua, a laila 'oe ke hana makeʻe kulana lapaau. Ma ka hope ke kahua e i ka hoʻokō iaoia waleʻoki kino.

coxarthrosis lapaʻau

Lapaau ana i ka maʻi 'ole orthopedists. Ke koho ana o ka lapaau hilinaʻi nui ma luna o ke kahua o ka maʻi.

1. Ma ka 1st a me ka 2nd ke kahua me ua häʻawi mai ai iä ka kēia hana:

- ka hookamaia o Anati-hoʻoʻino ai '. Eia naʻe, no ka manawa lōʻihi mai, mai hana ia, no ka mea, ke i ka hopena maikaʻi ia ma luna o ka mea na nā loko.

- (. Ia ai 'me "Arteparon", "rumalon", "chondroitin," "Struktum") hondroprotektorov o ka i

- vasoconstrictor ai '(' o ia hoʻi "Trental", "Cinnarizine").

- lapaʻauʻia e hoʻonānea na nāʻiʻo.

- ke kūʻai '-articular injections me ka hoʻohana' ana o hormonal konohiki, e like me "Kenalog", "hydrocortisone".

- E hoʻohana i ka mea poni lalana ana ia ia.

- Ala o physiotherapy ohe. (Laser-, kukui Inc, UHF,ʻume mākenēki Inc), e like me ka pono me massages, kūikawā gymnastics.

2. Ka hana mea ma luna o ka 3rd ke kahua o ka wale ala o ka noho pakele o ka coxarthrosis. Ke hoomanawanui auou caiaiai i ka luku ami endoprosthesis. Ke hana ua hana ma lalo mau anesthesia i loko o ka n ieaie? Ano. Sutures i wehe 'ia ma luna o 10th ka lā, ma hope i ka hoʻomanawanui ua hoouna mai i ka outpatient lapaau. Hoʻopulapula ana ma hope o ka hana ka pono. Ua aneane 100% o kaʻoki lāʻau lapaʻau ami hope hoʻolako piha hoihoi hou ia ana o ka'ūhā kuleana pili i ka pōʻino mai. I ka Ia manawa kanaka i loko o ka wā e hiki mai ke hana 'Imi hoʻoneʻe a hiki paani haʻuki. Komo i ka prosthesis, e hiki mai i ka 20 makahiki ina mea a pau i ke kauka mau koi. Ma hope iho o kēia wā lōʻihi o ka hai hana mea pono e puku i ua pohole endoprosthesis.

Complications o acetabular fractures

Pilikia, ma ke ala, i hoʻomaka ai kākaʻikahi, akā, no kanaka pono, e ike no ia. Ma postoperative complications loaʻa:

- Sepsis.

- Festering eha.

- Thromboembolism.

- poino i na nā aʻalolo.

- aseptic necrosis o ka femoral poo a me ka acetabulum pa.

- lōlō o ka poe liilii, a me ka meakino glute.

E pale aku i ka hanana o ia mau complications, he nui kauka kaumaha lākou nā mea maʻi koke arthroplasty.

ka hopena

I kaʻalo ana, huli i kēia Wa Mamua me ka acetabulum, ka mea nui i kakahiaka nui lapaʻau 'ana, a me X-Ray, ultrasound,ʻume mākenēki resonance kiʻi. Ma muli o kēia haʻawina, ke kauka pono koho i ka iaoiaeii kūpono o ka hana: he pololei makeʻe kulana aʻano pākīkē - hana. Ua mea i nui loa ma hope o lapaau a me ka hoʻopulapula manawa, no ka mea, i loko o ka luna 'i i ke kanaka koke loaʻa ma luna o kona mau wāwae.