Kia ako tātou i ngā mea katoa e pā ana ki te pokanga wheua (Osteotomy) i roto i te huarahi māmā!

Kei te whakaaro koe i ētahi wā mēnā ko te mamae e pā ana ki ētahi wāhanga o tō tinana, inā koa ō turi, ō hope, tō tuaiwi rānei, nā te he o te wheua, nā te whati rānei? Tērā pea kua kōrerotia e tō tākuta ki a koe tētahi pokanga e kiia nei ko te osteotomy. He āhua whakamataku pea te rongo i tēnei. Engari ina mōhio koe ki ngā taipitopito, ka tino heke taua wehi. Nō reira, i tēnei rā, me kōrero noa tātou mō tēnei pokanga?

He aha tēnei (Osteotomy)?

Āe, ki te kī māmā noa iho, he pokanga te osteotomy. Ko te tikanga he tapahi i te wheua, he tāpiri i ētahi wheua hou, kātahi ka hanga anō i te wheua, ka nekehia rānei ki tōna tūranga tika. Whakaarohia he rite ki te kāmura e tapahi ana i tētahi wahi rakau, e hanga anō ana, ā, ka hoatu he āhua hou, engari ka mahia tēnei ki ngā wheua o roto i tō tātou tinana.

Ka taea e tō taote pokanga te mahi i tētahi osteotomy ki tētahi wheua o tō tinana. Hei tauira, i roto i tō kauae, tuke, tuaiwi, pakihiwi, hope, turi, waewae, māikuku, waewae rānei. He maha ngā wā ka whakamahia hei rongoā i ngā raruraru o ō hononga – te wāhi e tūtaki ai ngā wheua e rua. He maha ngā momo osteotomy me ngā tikanga rerekē. He maha ngā wā ka tapaina ēnei i muri i te taote pokanga nāna i hanga te tikanga, i te huarahi rānei e tapahia ai, e hurihia ai te āhua o te wheua.

He aha i mahia ai tēnei pokanga (Osteotomy)?

Tērā pea kei te whakaaro koe, 'He aha koe i tapahi ai i ngā wheua pēnei?' He maha ngā take.

• Whakatikatika i te koki, te piko, te hurihuri rānei o ngā wheua: I ētahi wā ka āhua hē te tūnga o ngā wheua. Mā tēnei pokanga ka āwhina i te whakatika i tēnā. Whakaarohia, ko te āhua o ngā waewae o ētahi tāngata he rite ki te reta O (ngā waewae piko) he rite rānei ki te reta X (ngā turi piko). Ka whakamahia tēnei hei whakatika i ngā mea pērā.
• Whakatikahia he hononga kua hē te tūnga, te kore rānei o te tūnga: Ka whānau mai ētahi hononga me ngā hapa iti, ka hē rānei te tūnga nā tētahi raruraru i muri mai.
• Whakapotohia, whakaroahia rānei ngā wheua: He mea whakamiharo? Ae, i ētahi wā ka whakamahia hoki tēnei tikanga hei whakarerekē i te roa o ngā wheua.
• Whakatikahia he hononga kua pakaru: Mena kua pakaru te hononga nā tetahi aituā, nā tetahi atu take rānei.
• Hurihia te wāhi e mau ana te taumaha o te hononga: Whakaarohia kua memeha te kiriuhi i tetahi taha o tō turi. Koinā te wā ka mamae koe. Ka taea e tēnei pokanga te huri i te huarahi e kawe ai te taumaha, ā, ka huri anō ki te taha me te kiriuhi hauora. Mā tēnā ka whakaiti i te mamae.
• Whakaitihia te mamae e puta mai ana i te osteoarthritis: He otinga pai tēnei hei whakaiti i te mamae e puta mai ana i tēnei mate hononga pirau, inā koa i ngā turi me ngā hope.
• Whakaroahia te pokanga whakakapinga hononga mō te hunga rangatahi, hihiri: Mō ētahi rangatahi, mā te osteotomy ka taea e rātou te whakamahi i ō rātou hononga mō te wā roa, kaua e whakakapia tonutia te hononga ina tawhito te hononga.
• Whakatikahia ētahi atu raruraru wheua motuhake.

Me aha ahau i mua i te pokanga?

I mua i te pokanga wheua, ka tonoa e tō taote pokanga ētahi whakamātautau hei tirotiro i tō hauora whānui. Ko ētahi o ēnei ko:

• Ngā whakamātautau toto: Ka tirohia e ēnei ngā taumata o ngā wāhanga rerekē i roto i tō toto me te mahi a ō whekau o roto.
• Ngā whakamātautau mimi: Ka āwhina ēnei ki te whakatau i tō hauora whānui me te kite i ngā āhuatanga e whakararuraru ana i te whakaora wheua, pērā i te mate pukupuku, te mate huka rānei.
• Whakamātautau ECG (Electrocardiogram): Ka tirohia te ngohe hiko o tō ngākau.
• X-ray o te uma: Hei tirotiro kei te mahi tika ō pukahukahu i mua i te pokanga.
• Ngā hihi-X, ngā matawai CT rānei: Ka whakamahia ēnei hei whakamahere i te pokanga mā te titiro mārama ki ō wheua/hononga. Me mōhio te taote pokanga ki te rahi, te roa, te whānui, me te koki o te wheua ka tangohia. I ētahi wā ka hangaia he tauira 3D mā te whakamahi i te rorohiko hei whakamahere i te pokanga.

He aha te tikanga o te pokanga Osteotomy?

Tuatahi, ka hoatu he rongoā whakamoe ki a koe. Ka taea tēnei te mahi i roto i ngā huarahi rerekē:

• Ko te whakangote ā-rohe ko te whakangote i te wāhi anake e mahia ai te pokanga.
• Te rongoā whakamoe tuaiwi.
• Te whakamoe i a koe kia tino moe (whakamoe whānui).
• Ka whakamahia te rongoā whakamoe ā-rohe hei whakangāwari i te wāhi e mahia ai te pokanga.

Mā te tākuta e whiriwhiri te tikanga e tino tika ana māu.

Kātahi ka horoia e te tīma pokanga te wāhi e karapoti ana i te pokanga ki tētahi wai huakita. Kātahi ka hipokina te wāhi ki tētahi kakahu pokanga.

Ka tapahia tō kiri e te taote pokanga. Ka whakamahia e rātou ngā waea ārahi hei tohu i te wāhi wheua e tangohia ana (he maha ngā wā he āhua poro, engari he rerekē tēnei i runga i te pokanga). Ka whakamahia he kani pokanga motuhake hei tango i tēnei wāhi wheua kua tohua.

I muri i te tango i te wheua mate, pakaru rānei, ka katihia te āputa mā te hono i ngā wāhanga toenga o te wheua i ia taha, i ia taha. I runga i te momo osteotomy e mahia ana e koe, ka taea te whakanoho i tētahi hononga wheua ki te wāhi i tangohia ai te wheua. Kātahi ka whakamahia ngā pine, ngā tīwiri, ngā tāpa, ngā pereti, ngā tokotoko rānei hei pupuri i te wheua kia ora rā anō. Ko ētahi o ēnei wahi whakarewa he rangitahi, ko ētahi he pumau.

He aha ngā momo matua o ngā pokanga osteotomy?

Ka taea e te pokanga osteotomy te rongoā i te tini o ngā raruraru wheua me ngā hononga. Me titiro tātou ki ētahi o ngā momo matua.

Te tango i te kauae

Ko te tikanga o tēnei ko te whakarite i ngā wheua o tō kauae raro (kauwae raro) o tō kauae runga rānei (kauwae runga) ki te toenga o tō mahunga me/ngā niho rānei. Ka taea e tēnei te whakatika i ngā raruraru pēnei i te ngau tuwhera, te uaua ki te ngaungau, ki te horomi rānei, te nui o te pakaru o ngā niho, te kauae e hoki whakamuri ana, te ngau o runga, te ngau o raro rānei. Tērā pea ka hiahiatia he whitiki niho i mua, i muri rānei i te pokanga hei whakarite i ō niho ki tō kauae.

• Ko te pokanga e mahia ana ki te kauae o raro ka kiia ko te mandibular osteotomy .
• Ko te pokanga e mahia ana ki te kauae o runga e kiia ana ko te maxillary osteotomy .
• He tikanga motuhake kei reira, hei tauira, ko te osteotomy LeFort he pokanga hei whakatika i te whati i waenganui o te mata i te wāhi e tūtaki ai te kauae o runga ki te kauae. Ko te osteotomy wehenga sagittal he momo pokanga kauae hei neke i te kauae o raro kia pai ake te tūnga ki ngā niho.

Te tango wheua o te kauae

Ka mahia tēnei pokanga hei whakarerekē i te āhua o te kauae. He tikanga tēnei hei whakaroa i te kauae mēnā he iti rawa, hei whakapoto rānei i te kauae whaiti. Ka taea e tēnei te neke i te kauae ki mua, ki tētahi atu huarahi rānei. I ētahi wā he pai ake tēnei i te whakauru i te kauae ki roto. I tēnei pokanga, ka tapahia tō kauae, ka nekehia. Ka tapahia e te taote pokanga he wahi ki roto i te waha. Tērā pea ka ngaro te rongo i ō ngutu mō ētahi marama.

Te tango wheua o te tuke

Mena kei te raru te tūnga o tō ringa o raro i ngā raruraru o te hononga tuke, pērā i te mea kei te tata rawa te ringa ki te tinana (cubitus varus) kei tawhiti rawa rānei i te tinana (cubitus valgus), ka mahia tēnei pokanga hei whakatika i aua raruraru. He rerekē ngā momo osteotomy i runga i te raruraru.

Te tango wheua tuaiwi

Ka mahia tēnei pokanga hei whakatika i ngā piko o te tuaiwi. Mā ngā piko tūturu o tō tātou tuaiwi ka āwhina i te pupuri i te pokapū taumaha o te tinana ki runga ake i te hope. Mena ka piki ake, ka heke iho rānei te piko o tētahi wāhanga, neke atu rānei o te tuaiwi, kāore te tuaiwi e tika. Ka pā mai pea te mamae, te ngenge, me te pēhanga ki ngā whekau o roto. Ko te whāinga o tēnei pokanga he whakahoki i te taurite ki te tuaiwi, te whakaiti i te mamae, me te ārai i te hokinga mai, te kino haere rānei o te mate.

• Hei tauira, i roto i tētahi āhuatanga pēnei i te Ankylosing Spondylitis , ka taea e te tuaiwi te piko tonu ki mua, ā, ka taea e te kauae te pā ki te uma. Ka taea te whakaaro ki tēnei pokanga hei whakatika i aua raruraru koki.
• He maha ngā momo matua:
• Te pokanga wheua o muri: Ka puta he lordosis i te tuara o raro me te kyphosis i te tuara o runga. He tikanga motuhake te ponte osteotomy e whakamahia ana hei whakatika i te kyphosis.
• (Te pokanga wheua o Smith-Petersen):He tikanga motuhake tēnei hei whakatika i te lordosis. Ka tangohia he wheua mai i te tuara o te tuaiwi hei whakahuri i te tuaiwi ki muri.
• Te tango i te waewae o te waewae: Ka puta he piko kaha ki roto (lordosis) i te tuara o raro.
• (Osteotomy wheua-kōpae-wheua): Ko te tikanga o tēnei ko te hanga i tētahi wheua i runga ake, i raro hoki i te kōpae i waenganui i ngā tuaiwi. I te wā o te pokanga, ka tangohia te kōpae me ōna pereti pito e tata ana.
• (Taehanga o te pou tuaiwi): I tēnei mahi, ka tangohia katoatia tētahi, neke atu rānei o ngā tuaiwi. Koinei pea te whakatikatika nui rawa atu. Nā te mea he nui te wheua ka tangohia, ka whakakīia tēnei wāhi e te taote pokanga ki tētahi hononga wheua, ki tētahi kēti whakarewa rānei.

Te tango wheua hope

Ko te mahi tēnei ko te whakahou i te āhua o tō acetabulum, o tō pane femur rānei. Koinei te hononga hope porowhita-me-te-kōhao i roto i tō hope. Ka tapahia, ka hangaia, ka tangohia rānei te wheua e te taote pokanga hei whakatikatika i ngā mata e mau ana i te taumaha o te hononga.

• Ngā momo matua:
• Periacetabular osteotomy: Ka mahia tēnei hei whakatika i te hip dysplasia, he āhuatanga kāore e kapi katoa te pōro o te wheua huha i te kōpuku hope. I te wā o te pokanga, ka tapahia tētahi wāhanga o te wheua hope, ka nekehia te tūranga, ka mau ki ngā tīwiri.
• Te pokanga wheua o te huha: Ko te tapahi me te hanga anō i te wheua o te huha o runga (femur) hei āwhina i te whakaora i te mahi a te hope.

Te tango wheua o te turi

Ko te pokanga wheua he tapahi me te hanga anō i tētahi o ngā wheua e rua kei raro i te taupoki turi – te tibia, te femur rānei. He maha ngā wā ka mahia tēnei hei whakatika i ngā kino i puta mai i te rumatiki. Ka whakatikatikahia e tēnei pokanga te hononga turi, ka nekehia te taumaha me te pēhanga mai i te taha kua pakaru o te turi ki te taha hauora. Ko te pokanga wheua turi he tikanga ka mahia i ngā wāhanga tōmua o te osteoarthritis, ina ko te kino kei te taha kotahi o te turi anake.

• Ko te wāhi o te osteotomy ka whakawhirinaki ki te wāhi i pakaru ai. Hei tauira, i roto i te osteotomy tibial teitei , mena kei roto i te turi te pakaru o te kiriuhi, ka tangohia he wahi wheua āhua poro i waho o te turi, ka whakatuwheratia rānei te wheua i roto i te āhua poro i roto o te turi. Ka whakatikatika tēnei i te waewae, ā, ka ārai i te kino haere o te rumatiki.
• Ko ētahi momo turi (Osteotomy):
• Osteotomy Tibial: Ka hangaia he hononga piko o te waewae e tuku ana i te pehanga nui ki roto o te turi.
• Te osteotomy tibial teitei: Ka whakamahia tēnei hei whakatikatika i te hononga turi i roto i te hunga whai mate rumatiki turi. Ka taea e tēnei pokanga te ārai, te whakaroa rānei i te hiahia mō te whakakapinga turi wāhanga, whakakapinga katoa rānei.
• (Te pokanga wheua o Fulkerson):He tikanga motuhake tēnei. Ka tangohia tētahi wāhanga o tētahi wāhi motuhake o te tibia (tibial tubercle). Ka huri tēnei i te tūranga o te uaua o te turi e piri ana ki te tibia, ka whakaiti i te pēhanga ki runga i te turi, ā, ka ārai i te nekenekehanga.

Ngā osteotomy o te māikuku nui me te waewae

Ko te hallux osteotomy he tikanga e tango ana i te wheua mai i te māhunga nui me te whakatikatika. Ko te calcaneus osteotomy he tikanga e hanga hou ana i te waewae hei whakatika i ngā waewae papatahi, i ngā waewae rānei he teitei ake te āwhata i te tikanga.

• He maha ngā tikanga motuhake (Osteotomy) mō te rongoā i ngā raruraru waewae:
• Ngā pokanga wheua Chevron me Akin: Ka whakatikahia e ēnei pokanga ngā āhua ngoikore ngawari ki te āhua ngoikore o te māikuku nui i puta mai i ngā bunion (hallux valgus).
• (Dwyer osteotomy): Ka hurihia te āhua o te waewae kia whakaitihia ai te kōpiko teitei rawa.
• (Weil osteotomy): Ka whakatikahia ngā māikuku o ngā maihao me te mamae i raro i te pōro o tō waewae.
• (Te pokanga wheua miro): Ka āwhina tēnei ki te hanga i tētahi āwhata i te waewae.

He aha ngā mōrearea o tēnei pokanga?

Pērā i ngā pokanga katoa, ka pā mai ētahi mōrearea i te tango i te wheua. Kaua e manukanuka, ka whakapau kaha ngā tākuta ki te whakaiti i ēnei mōrearea. Ko ngā mōrearea matua ko:

• Ngā raruraru ki te rongoā whakamoe.
• Te mate urutā.
• Ngā toto totoka.
• Te whara o te io, o te uaua rānei.
• Kāore he aha mēnā kāore ngā wheua e whakatū tika ana, e kore rānei e ora tika ina ora.
• Te mumura me te pakari o ngā hononga.
• Mamae roa.
• Te hanganga o te kiko whara.

He mea tino nui kia kōrero koe ki tō tākuta mō ēnei mōrearea, me te pātai atu i ō pātai katoa.

Kia pēhea te roa e ora ai? Me aha ahau?

Ka rerekē te roa o te wā whakaora i ia tangata, i ia tangata. He maha ngā mea e whakawhirinaki ana ki tēnei, tae atu ki te momo osteotomy i mahia ki a koe, te tikanga pokanga, te whānuitanga me te kaha o te kino ki ō wheua, tō kaha, me tō hiahia ki te whakaora.

Ka roa te wā e ora ai te wheua. Ka mamae te wāhi i pokangahia ai, ā, ka mamae tonu kia ora rā anō te patunga.

• Me mau pea koe i te mea whakakikorua, i te mea whakatārewatanga, i te tokotoko rānei. Mā ēnei ka āwhina i te whakawhāiti i te nekehanga o ngā wheua me ngā hononga, ka whakaiti i te taumaha o te wheua kua pokaina, ā, ka taea e ngā wheua te ora tika. Ko te tikanga ka roa ēnei mai i ētahi wiki ki te rua marama pea.
• Ahakoa kei roto koe i te maka, i te whitiki rānei, me whai rongoā tinana koe i roto i ngā rā torutoru i muri i te pokanga.Ka whakanui ake te whakaora tinana i te kaha me te nekenekehanga o ō hononga.
• Mena i pokaina tō turi, tō hope rānei, me whakamahi pea koe i ngā tokotoko mō ētahi marama. Me haere tonu te whakaora tinana kia hoki mai ai tō kaha me tō taurite.
• Mena kua pokangahia tō kauae (osteotomy kauae), ka kati te taura o tō kauae, ā, ka kai koe i te wai mō te ono wiki pea. Mena kua pokangahia tō māhunga waewae, kāore e taea e koe te mau hu, te taraiwa rānei mō te rua ki te ono wiki pea.

Me pēhea e taea ai e koe te āwhina i te tukanga whakaora?

Ka taea hoki e koe te āwhina i tēnei wā whakaora.

• Kaua e momi hikareti: Ka whakaroa te nikotīni i te tukanga whakaora, ā, ka taea hoki te whakararuraru i te whakaora tika o te wheua. Nō reira, karohia rawatia te momi hikareti .
• Kai i tētahi kai pai, hauora: Kai i tētahi kai taurite, pērā i te kai Mediterranean, me te nui o ngā huawhenua me ngā hua.
• Kia tino whai i ngā tohutohu a tō tākuta.
• Kia mau tonu te taumaha hauora.

He aha ngā hua ka taea te tumanako?

Ko ngā hua ka puta i a koe ka whakawhirinaki ki ngā āhuatanga pēnei i tō hauora whānui, te kaha o tō raruraru wheua, te pokanga motuhake i mahia ki a koe, me te pūkenga o tō taote pokanga. Ka kōrero tō tākuta ki a koe mō te pokanga ka mahia ki a koe me ngā mea ka tumanakohia i muri i te pokanga. Kaua e mangere ki te pātai ki tō tākuta, ki te whakapuaki rānei i ō āwangawanga, i ō wehi rānei.

He maha ngā momo pokanga osteotomy me ētahi atu tikanga pokanga hei whakatikatika me te hanga anō i ngā wheua me ngā hononga. Ka kōrero tō tākuta ki a koe mō tō raruraru wheua, hononga rānei, me ngā kōwhiringa e wātea ana. I runga i te āhua o tō raruraru wheua, ka taea te rongoā tuatahi ki a koe mā te whakamahi i ngā maimoatanga kore-pokanga (ngā maimoatanga ā-pūmau). Kei roto pea i ēnei ko te okiokinga, te hukapapa, ngā rongoā ārai-mumura me te mamae, me ngā werohanga corticosteroid. Mena kāore ēnei maimoatanga e whakahaere i ō raruraru hononga, ki te mea rānei he mate tōu kāore e taea te rongoā, kia mahara kei reira tō taote pokanga wheua hei āwhina i a koe. He kōwhiringa pokanga ā rātou hei whakapai ake i tō nekehanga me te whakaiti i tō mamae me tō kore whakamarie.

Ngā mea tino nui hei maumahara māu i roto i tēnei tuhinga

Nō reira, he mea noa te mataku i te whakaaro mō te tango wheua. Heoi, he tikanga hauora nui tēnei ka taea te whakapai ake i te kounga o tō oranga, te whakaiti i te mamae, me te whakaora anō i ō wheua me ō hononga.

• Kia mōhio koe: Kōrero ki tō tākuta mō tō āhua, te pokanga ka mahia ki a koe, ōna painga me ōna huakore, me te roa o te wā e ora ai.
• Whāia ngā tohutohu a tō tākuta: He mea tino nui kia tere ai te ora me te āta whai i ngā tohutohu a tō tākuta, i mua atu, i muri mai hoki i te pokanga.
• Kia manawanui: He roa te wā e ora ai ngā wheua. I taua wā, me mahi tika ngā mahi pēnei i te whakaora tinana, kia kaha hoki.
• Kaua e kai paipa: He mea tino tika tēnei māu.

Mena he pātai anō āu mō tēnei, kaua e wehi ki te pātai atu ki tō tākuta. Kei reira rātou hei āwhina i a koe.

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