E aʻo kākou e pili ana i ke ʻoki kino (Fasciectomy) no ka maʻi e kūlou ai nā manamana lima i loko?

Ua manaʻo paha ʻoe e kūlou mālie ana kekahi a ʻoi aku paha o kou mau manamana lima i loko a lilo i mea paʻakikī ke hoʻopololei? Me he mea lā e huki ʻia ana kou manamana lima i loko a paʻa, ʻeā? ʻO kēia ka mea a mākou e kapa nei he maʻi ʻo Dupuytren. Hiki i kēia ʻano ke paʻakikī i ka hana ʻana i nā hana o kēlā me kēia lā. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi ʻoki kūikawā i hana ʻia ma ke ʻano he hopena no kēia ʻano, i kapa ʻia ʻo Fasciectomy.

ʻO ka mea mua, he aha ka Fasciectomy?

I ka ʻōlelo maʻalahi, ʻo ka fasciectomy kahi hana ʻoki e wehe ai i kahi papa o nā ʻiʻo (i kapa ʻia ʻo fascia) i lilo i paʻa a mānoanoa ma loko o kou lima ma muli o ka maʻi ʻo Dupuytren. ʻO kēia kūlana ke kumu o kekahi a ʻoi aku paha o kou mau manamana lima e kūlou me ka manaʻo ʻole i ka ʻaoʻao o kou lima. I kekahi mau hihia koʻikoʻi, hiki i kou mau manamana lima ke lilo i mea hiki ʻole ke pololei. No laila, ma hope o kēia fasciectomy, wehe ʻia ka ʻiʻo paʻa, e hoʻokuʻu ana i kou mau manamana lima a e ʻae iā ʻoe e hoʻi hou i ka hana maʻamau i kou lima.

He aha maoli ka maʻi o Dupuytren?

He maʻi ʻiʻo pili ka maʻi ʻo Dupuytren e ʻoi mālie ana ka ʻino i ka hala ʻana o ka manawa. I kēia manawa ke noʻonoʻo nei paha ʻoe i ke ʻano o ka ʻiʻo pili. He ʻano ʻiʻo ia e hoʻopili a kākoʻo i nā ʻiʻo, nā ʻōpū, nā hono, a me ka ʻili a pau o ko kākou kino.

Hoʻokumu ʻia kēia kūlana e ka mānoanoa a me ka paʻa ʻana o ka fascia, kahi papa o nā ʻiʻo ma lalo o ka ʻili o ka pāma. Hiki i kekahi poʻe ke hoʻoilina i kēia kūlana mai ko lākou mau mākua ma o kahi hoʻololi ʻana o ka gene . Hiki i kekahi ke loaʻa i ke kūlana me ke kumu ʻole.

I ka hoʻomaka ʻana o ka maʻi, ʻike ʻia nā nodules liʻiliʻi ma lalo o ka ʻili o ka pāma. I ka hala ʻana o ka manawa, hui pū kēia mau nodules e hana i nā kaula paʻa . A laila hoʻomaka kēia mau kaula e ʻūlū, e huki ana i loko o nā manamana lima i hoʻopaʻa ʻia iā lākou. Ua kapa pū nā kauka i kēia ʻano ʻo Dupuytren's contracture .

ʻO wai ka mea e pono ai ke ʻoki fasciectomy?

No ka mea he maʻi holomua kēia, e hoʻāʻo mua kāu kauka i nā lāʻau lapaʻau ʻoki ʻole, e like me nā inikini steroid a i ʻole nā ​​​​inikini e loaʻa ana kahi enzyme i kapa ʻia ʻo collagenase.

Eia nō naʻe, inā ʻaʻole kōkua kēia mau lāʻau lapaʻau, a ua kūlou loa kou mau manamana lima a hiki ʻole iā ʻoe ke hana i nā hana maʻalahi e like me ke komo ʻana i loko o kāu ʻeke a holoi paha i kou maka, e kūkākūkā kāu kauka i nā koho ʻoki kino me ʻoe, e like me ka fasciectomy.

He aha ka ʻokoʻa ma waena o ka Fasciectomy a me ka Fasciotomy?

Aia kekahi mau ʻano hana lapaʻau no ka maʻi ʻo Dupuytren. E hoʻomaopopo pōkole kākou i nā ʻokoʻa nui ma waena o lākou.

ʻO nā ʻano nui o ke ʻoki fasciectomy

Aia kekahi mau ala e hana ai i kahi fasciectomy. E koho kāu kauka i ke ʻano kūpono loa e pili ana i kou kūlana.

• ʻO ka fasciectomy Segmental (hapa): Ma kēia kaʻina hana, hana ʻia kekahi mau ʻoki liʻiliʻi ma nā ʻāpana kūlohelohe o ka lima a ua wehe ʻia kahi ʻāpana liʻiliʻi o ka fascia mānoanoa.
• ʻO ka subtotal palmar fasciectomy: Hana ʻia kahi ʻoki zigzag ma nā ʻāpana o ka pāma a me nā manamana lima, e wehe ana i ka nui o nā ʻiʻo maʻi e like me ka hiki. I kēia hihia, hiki ke hoʻohana ʻia kahi graft ʻili e kōkua i ka ho'ōla ʻana o ka ʻeha.
• Dermofasciectomy: Hana ʻia kēia i nā hihia o ka maʻi hou. Ma kēia, wehe ʻia ka ʻiʻo maʻi me ka ʻili ma luna. ʻO ka maʻamau, pono kēia i kahi hoʻopili ʻili.

Pehea ka manawa ho'ōla ma hope o ke ʻoki kino?

He mea maʻamau ka ʻike ʻana i kekahi ʻeha, pehu, a me ka ʻoʻoleʻa ma kou lima ma hope o ke ʻoki ʻana. Hiki paha iā ʻoe ke manaʻo i ka mae ʻana ma kou lima a me nā manamana lima. Loaʻa kēia mae ʻana i ka wā e hoʻi ai nā aʻalolo i hohola ʻia no ka manawa lōʻihi i ka maʻamau, a hiki ke hala kekahi mau mahina e hele ai. Ma muli o ke ʻano o kāu hana, pono paha ʻoe e hoʻomaha no ʻelua a ʻumikūmālua pule (3 mahina).

He mea nui loa e hahai pololei i nā ʻōlelo a kāu kauka.

• E hoʻokiʻekiʻe i kou lima a kau i ka hau.
• Ka mālama ʻana i ka ʻeha maʻemaʻe.
• E mālama i ka ʻeha a me nā humuhumu i maloʻo, me ka hoʻopā ʻole ʻana iā lākou me ka wai.
• E hōʻoia e hele i ka hoʻoikaika kino (hoʻōla lima) a hana pono i nā hoʻomaʻamaʻa i hāʻawi ʻia ma ka home.
• Hoʻohana kūpono i nā lāʻau lapaʻau ʻeha a, inā pono, nā antibiotics.
• Ke kau nei i kahi ʻāpana palai ma kou lima no ka lōʻihi e like me ka ʻōlelo a ke kauka.

Aia kekahi mau pilikia i ke ʻoki kino?

E like me nā ʻoki kino āpau, aia kekahi mau pilikia. He mea maʻamau ka nalowale ʻana o ka ʻike a i ʻole ka mae ʻana o nā manamana lima, kahi e hoʻomaikaʻi ʻia i ka hala ʻana o ka manawa. Eia nō naʻe, aia kekahi mau pilikia koʻikoʻi e hiki ke hana pinepine ʻole ʻia.

• Ka maʻi ʻaleka i ka anesthesia.
• Ka maʻi ʻana.
• Nā ʻōpala a me ka hypersensitivity o ka ʻili ma kahi o ke ʻoki ʻana.
• Ka pehu ʻana (edema) a me ka ʻeha.
• He mea kākaʻikahi loa, hiki ke hōʻeha ʻia nā aʻalolo a i ʻole nā ​​​​kīʻaha koko kokoke i ka wahi ʻoki.

I ka manawa e ʻimi koke ai i ke aʻo lapaʻau

Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei ma hope o ke ʻoki ʻana, pono ʻoe e kāhea koke aku i kāu kauka.

• Nā hōʻailona o ka maʻi (e like me ke kuni, ka wai melemele e kahe ana mai ka ʻeha, nā kaha ʻulaʻula).
• ʻEha nui o nā ʻiʻo.
• Ka nalowale ʻana o ka manaʻo a i ʻole ka hiki ʻole ke hoʻoneʻe i nā manamana lima.
• Inā loaʻa iā ʻoe ka ʻeha o ka umauma a i ʻole ka paʻakikī o ka hanu ʻana, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa.
• Nā maʻi ʻili (e.g., ka ʻūhū ʻana).