Ingaba ithanga lomntwana wakho libuhlungu? Ngaba uyaqhwalela? Masifunde ngesifo sikaLegg-Calve-Perthes!

Ngaba umntwana wakho omncinci ngequbuliso uqalile ukuqhwalela? Okanye ingaba isinqe sakhe siyabuhlungu? Ngamanye amaxesha sisenokungazinaki kangako ezi zinto zincinci. Nangona kunjalo, ukuba ezi mpawu ziyaqhubeka, kubalulekile ukuba sikhathazeke kancinci. Kuba ezi zisenokuba ziimpawu zesifo esingaqhelekanga sesinqe ebantwaneni esibizwa ngokuba sisifo seLegg-Calve-Perthes . Ngoko ke, masithethe ngale nto ngokweenkcukacha namhlanje, akunjalo?

Yintoni isifo seLegg-Calve-Perthes?

Ngamafutshane, le yimeko echaphazela ilungu lesinqe kubantwana abaphakathi kweminyaka emi-2 neli-12 ubudala. Ilungu lethu lesinqe lenziwe yinxalenye efana nebhola phezulu kwethambo lethanga (esiyibiza ngokuba yi-'femoral head') kunye nenxalenye efana nesokhethi kwithambo lesinqe. Kufana nebhola efakwa kwikomityi. Ngoko ke, okwenzekayo kwisifo seLegg-Calve-Perthes kukuba ukuhanjiswa kwegazi kuloo nxalenye efana nebhola yethambo lesinqe kuncitshiswa okwethutyana okanye kuyekwe .

Cinga ngako oku, lonke ilungu lomzimba wethu lifuna igazi ukuze liphile. Kukuyo igazi apho sifumana khona ioksijini kunye nezondlo. Ngoko ke, xa ukuhamba kwegazi kuyeka ngale ndlela, izicwili zelo thambo ziqala ukufa kancinci kancinci. Oku kubizwa ngokuba yi-'avascular necrosis' okanye 'i-osteonecrosis' kwezonyango. Nangona kunjalo, emva kwexesha elithile, ukuhamba kwegazi kuqala kwakhona. Emva koko inxalenye yethambo eyonakeleyo iqala ukuzilungisa. Nangona kunjalo, ngamanye amaxesha ithambo elitsha lisenokungakhuli likwimo efanayo nangaphambili. Yiyo leyo ingxaki apha.

Esi sifo sikwiqela lezifo ezibizwa ngokuba yi-'osteochondroses'. Kwezi, kukho ukuwohloka nokuguqulwa kwesiphelo esikhulayo sethambo. Siqala ngequbuliso, ngaphandle kwesizathu esaziwayo. Esi sifo sikhula ngamanqanaba aliqela, kwaye yonke inkqubo ingathatha iminyaka eliqela. Ukuba oku kumchaphazela kangakanani umntwana wakho kuxhomekeke kubungakanani botshintsho lwethambo. Nangona kunjalo, ngonyango olufanelekileyo, uninzi lwabantwana lunokuphila kakuhle.

Esi sifo saziwa nangamanye amagama aliqela:

• Isifo sikaPerthes
• Isifo sikaPerthes
• Ithole leLegg
• ILegg-Perthes
• I-Calve-Perthes
• I-Coxa plana (isinqe esithe tyaba)

Ingaba isifo sikaPerthes sinqabile kangakanani? Ngubani odla ngokusifumana?

Ehlabathini lonke, esi sifo sichaphazela phantse umntwana omnye kwabayi-12 000. Abafana banamathuba aphindwe kahlanu okuba naso kunamantombazana.

Ngokweminyaka, ixhaphake kakhulu kubantwana abaphakathi kweminyaka emi-5 ne-7 ubudala. Nangona kunjalo, inokukhula kubantwana abaneminyaka emi-2 ubudala okanye abaneminyaka eli-12 ubudala.

Ingaba isifo seLegg-Calve-Perthes sihlala sihleli?

Oku kubizwa ngokuba kukonakala nokwakhiwa kwakhona kwentloko yefemur yomntwana. Le nkqubo ithatha iminyaka eliqela. Ngoko ke, esi sifo sesexeshana. Nangona kunjalo, sinokubangela utshintsho oluhlala luhleli kwimo yethambo.

Ngaba esi sifo sinokubangela iingxaki kwixesha elizayo?

Ewe, ngelishwa ngamanye amaxesha iyakwazi. Ukuba ibhola yethambo lethanga ayilunganga kakhulu, isenokungangeni kakuhle kwisokethi yelungu lesinqe. Nangona unyango lunokuyilungisa le nto kakhulu, ukuba oku kungahambi kakuhle kuyaqhubeka, kunokukhokelela kwiingxaki zelungu lesinqe njengoko umntwana ekhula, njenge -arthritis ngokuhamba kwexesha .

Zithini iimpawu zesifo seLegg-Calve-Perthes?

Iimpawu zesi sifo azibonakali ngaxeshanye. Zikhula kancinci kancinci. Ngamanye amaxesha, ekuqaleni, awukwazi nokuyicinga into eyenzekayo.

Iimpawu ezinokubonakala kwizigaba zokuqala:

• Ukuqhwalela: Umntwana usenokubonakala erhuqa umlenze omnye okanye enobunzima bokuhamba. Oku kwenzelwa ukunciphisa ubunzima kwinqulu echaphazelekayo. Rhoqo, ukuqhwalela luphawu lokuqala lwentlungu. Umntwana usenokungazi nokuba kutheni eqhwalela. Khawuthelekelele, unyana wakho, uSadeep, akasabaleki kwaye akasadlali njengoko wayesenza ngaphambili, kwaye ubonakala erhuqa umlenze omnye xa ehamba. Akatsho nokuba kuyabuhlungu ekuqaleni. Yindlela eqala ngayo.
• Intlungu yesinqe: Ukuba umntwana wakho unentlungu, kusenokwenzeka ukuba yingxaki yokuqala kwesi sifo. Kulapho ke igazi eliya emathanjeni liyancipha kwaye ithambo liqala ukuwohloka. Le ntlungu iyanda ngokuzilolonga, ukubaleka, nokudlala.
• Intlungu ebhekiselwe kuyo: Abanye abantwana banokuziva iintlungu edolweni, ethangeni, esinqeni, okanye esiswini endaweni yentlungu yesinqe.
• Ukuqaqamba kwemilenze: Intlungu yokuqina nokuqaqamba kwemisipha yemilenze edibene nelungu lesinqe inokwenzeka.

Iimpawu ezinokuvela kamva:

• Indlela yokuhamba yaseTrendelenburg: Le yindlela ethile yokuhamba ebonwa xa kukho iingxaki kwilungu lesinqe. Ngenxa yobuthathaka bemisipha yesinqe, i-pelvis kwicala elichaphazelekayo ithambekela ezantsi xa umntwana ehamba.
• Ukushukuma kwamalungu okulinganiselweyo: Umntwana unokuba nobunzima bokujikelezisa isinqe. Amandla okujikisa amathanga ngaphandle namadolo ngaphakathi anokuncipha.
• Ukuwohloka kwemisipha: Izihlunu ezisemathangeni nasezinqeni zomntwana zinokuncipha ngobukhulu kwaye zibonakale zincinci.
• Umahluko wobude bemilenze: Umlenze omnye ungabonakala umfutshane kunomnye.

Yintoni ebangela isifo seLegg-Calve-Perthes?

Sele sitshilo ukuba esi sifo sibangelwa kukuncipha okanye ukuyekiswa kokunikezelwa kwegazi okwethutyana entlokweni ye-femur (ischemia). Ekubeni ithambo lifumana ioksijini kunye nezondlo egazini, xa lilahlekelwa ligazi, izicubu zethambo ziqala ukufa kwaye ziqhekeke. Oku kubizwa ngokuba yi-'avascular necrosis' okanye i-'osteonecrosis'.

Ngokwesiqhelo, xa umthambo wegazi uvalekile okanye uncipha, kusenokwenzeka ngenye yezi ndlela zimbini. Ungavaleka ngaphakathi, ngenxa yesifo semithambo yegazi okanye ihlwili legazi, okanye ungavaleka ngaphandle, ngenxa yokudumba. Nangona kunjalo, abaphandi abakayazi kakuhle into ebangela oku kuncipha kokunikezelwa kwegazi kwisifo seLegg-Calve-Perthes. Oku kungenzeka ngezizathu ezahlukeneyo kubantwana abahlukeneyo.

Izinto ezinobungozi

Uphando lubonisa ukuba malunga nesiqingatha sabantwana abanale meko banengxaki yokujiya kwegazi . Enye ingcamango kukuba le meko inokubangelwa kukwenzakala okubuhlungu okanye ukwenzakala okuphindaphindwayo, okunokuthintela ukuhamba kwegazi ukuya emathanjeni. Kwakhona kucingelwa ukuba malunga ne-10% yamatyala anxulunyaniswa nokuguqulwa kwezakhi zofuzo okuzuzwe njengelifa.

Nazi ezinye izinto ezinokunyusa umngcipheko womntwana wakho wokufumana isifo seLegg-Calve-Perthes:

• Ukukhula kwamathambo okulibazisekileyo.
• Ubunzima obuphantsi bokuzalwa.
• Ukuncipha kobude (ngokuthelekiswa nobudala).
• Ukungasebenzi kakuhle kwamazinyo.
• Ukuba kwinqanaba eliphantsi kwezoqoqosho.
• Ukuchanabeka kumsi ophuma komnye umntu.
• Iingxaki zokuqunjelwa kwegazi.
• Usulelo lwe-HIV.
• Ukuzibandakanya kwizinto ezifana nemidlalo okanye ijimnastiki (oku kuyaphikiswana ngako, kungekhona kuwo wonke umntu).
• Utshintsho oluzuzwe njengelifa kwi-gene `COL2A1`.

Kubalulekile: Ayingomntwana wonke oza kukhula esi sifo nangona enazo ezi zinto zinobungozi. Kunokwenzeka nokuba sikhule nangaphandle kwezi zinto. Kubalulekile ukuzazi ezi zinto kwaye ufune iingcebiso zonyango ngokukhawuleza ukuba kukho naziphi na iimpawu ezibonakala.

Esi sifo siza kumchaphazela njani umntwana wam?

Ngexesha lesifo seLegg-Calve-Perthes esisebenzayo, intloko ye-femur kwilungu lesinqe lomntwana wakho iyawohloka (iyaphuka) ize ilungiswe (yakhiwe ngokutsha). Eli nqanaba lokuwohloka lingathatha malunga nonyaka . Inqanaba lokuguqulwa nokwakheka lingathatha malunga neminyaka emibini ukuya kwemihlanu .

Abanye abantwana banomonakalo omkhulu kwizicubu zamathambo kunabanye. Oku kusenokuba kungenxa yokuba ukunqongophala kwabo kwegazi (ischemia) kukhulu, okanye kuba bekuqhubeka ixesha elide. Okanye, ukuba ithambo sele libuthathaka kwaye lithwele ubunzima obukhulu, lingonakala ngakumbi. Kwabanye abantwana, intloko engqukuva ye-femur iyawa kwaye ithambe. Emva koko ayingeni kakuhle kwisokethi yelungu lesinqe.

Xa ithambo liqala ukukhula kwakhona, linethuba lokukhula kwakhona kwimo yalo yokuqala. Nangona kunjalo, ayingawo onke amathambo abantwana akhula ngendlela efanayo. Amanye amathambo ethanga awabuyeli kubukhulu bawo bokuqala kunye nemo yawo yokuqala. Amanye anokukhula abe makhulu kunesokhethi yelungu lesinqe. Ugqirha wakho uya kuzama ukuphembelela ezi ziphumo aze azisondeze kwimo eqhelekileyo kangangoko kunokwenzeka.

Abanye abantwana banokufuna ukuba izinqe zabo zingasebenzi kwi-cast okwethutyana. Abanye banokufuna utyando. Olu nyango lunceda ukuba ithambo likhule kakuhle. Abantwana abanamalungu esinqe angapholi kakuhle banokuqhubeka benazo iimpawu. I-hip dysplasia inokukhokelela kwiingxaki ezifana ne-arthritis kwixesha elizayo.

Isifo seLegg-Calve-Perthes sifunyanwa njani?

Into yokuqala eyenziwa ngugqirha kukunika umntwana wakho uvavanyo olucokisekileyo lomzimba . Emva koko, bathatha ii-X-reyi ukujonga amathambo omntwana wakho. Ii-X-reyi zinokubonisa ukuba isifo sikaPerthes sikhona na, sikwinqanaba elingakanani, kwaye sibi kangakanani. Ngamanye amaxesha, ugqirha unokucebisa ukuba kwenziwe i -MRI (Magnetic Resonance Imaging) scan ukuze kufunyanwe inkcazelo engakumbi.

Ziziphi iindlela zonyango zesifo seLegg-Calve-Perthes?

Unyango luxhomekeke kubukhulu besifo, inqanaba esikulo, kunye nobudala bomntwana. Abantwana abancinci badla ngokuba ngcono ngokungenelela okuncinci kuba amathambo abo akhula ngokukhawuleza. Abantwana abadala banokufuna unyango olungakumbi. Iqela loogqirha liza kusebenzisana ukwenza isicwangciso sonyango esifanelekileyo kumntwana wakho.

Esi sicwangciso sonyango singabandakanya:

• Ukuphumza isinqe esichaphazelekileyo kunye nokunciphisa ukuthwala ubunzima: Umntwana usenokufuna ukuyeka okanye ukunciphisa ukuhamba okwethutyana, okanye usenokufuna ukusebenzisa inkxaso efana neenduku zokusila.
• Amayeza angengowe-steroidal alwa nokuvuvukala (ii-NSAID): La ngamayeza okuphelisa iintlungu athengiswa ngaphandle kwemvume kagqirha kunye namayeza okuphelisa ukudumba (afana ne-aspirin kunye ne-ibuprofen). Anokunceda ukulawula iintlungu kunye nokudumba kwilungu lesinqe.
• Unyango lomzimba: Ingcali yonyango lomzimba iya kufundisa umntwana wakho imithambo ekhethekileyo ukunceda isinqe sibuyele esiqhelweni. Kusenokufuneka uncede umntwana wakho aqhelisele le mithambo.
• Ukutsala: Oku kuquka ukusebenzisa isixhobo sokutsala samathambo ukutsala kancinci isinqe endaweni yaso. Olu nyango lwenziwa kangangeentsuku ezininzi.
• Iintsimbi zeplasta okanye iibraces:Ngelixa ithambo litshintsha, ugqirha wakho unokucebisa ukuba usebenzise isamente okanye i-brace ukuze ithambo lihlale liqinile kwindawo yalo kwi-socket ye-hip joint. Oku kuya kunceda ithambo likhule libuyele kwimo yalo efanelekileyo njengoko likhula liphuma kwi-socket.
• Utyando: Abanye abantwana banokufuna utyando lokutshintsha ithambo baze balilungise endaweni yalo kwilungu. Oku kubizwa ngokuba yi-osteotomy. Abanye banokufuna utyando lokwandisa okanye ukuphinda babumbe i-hip socket, ebizwa ngokuba yi-arthroplasty.

Isifo sikaLegg-Calve-Perthes sinyangwa njani?

Ukuba umntwana wakho unesifo iLegg-Calve-Perthes, uza kujongana nohambo lwezonyango olunokuhlala iminyaka eliqela, olunezigaba ezahlukeneyo. Oku kuya kuchaphazela ubuntwana bomntwana ngandlela thile – abanye bangabi nangxaki, abanye bangabi nangxaki. Nangona kunjalo, xa konke oku kuphelile, uninzi lwabantwana luyakwazi ukuqhubeka nemisebenzi yabo yesiqhelo ngaphandle kwemida okanye iimpawu eziqhubekayo.

Khumbula, ukuba umntwana wakho ungaphantsi kweminyaka esi-7 ubudala, kunokwenzeka ukuba aphile ngokupheleleyo ngonyango oluqhelekileyo. Ukuba ungaphezulu kweminyaka esi-7 ubudala, kunokwenzeka ukuba adinge utyando. Ukuba akafumani unyango olufanelekileyo ngexesha elifanelekileyo, kwaye ithambo lesinqe lihlala likhubazekile, unokuba ne-hip osteoarthritis njengoko ekhula.

Ngaba isifo sikaPerthes singathintelwa?

Ngelishwa, akunjalo. Okwangoku akukho ndlela eyaziwayo yokuthintela isifo sikaPerthes.

Ndingayibuza ntoni ugqirha wam ngesifo sikaPerthes?

Ukuba umntwana wakho unesifo iLegg-Calve-Perthes, uya kuba nemibuzo emininzi malunga nonyango kunye nento onokuyilindela xa echacha. Ugqirha wakho uya kwenza konke okusemandleni akhe ukucacisa iinkcukacha ngomntwana wakho.

Ungabuza imibuzo efana nale:

• "Gqirha, isifo somntwana wam sikuliphi inqanaba ngoku?"
• "Imbi kangakanani le meko?"
• "Singayitshintsha njani indlela yokuphila yomntwana kunye nemidlalo ayidlalayo?"
• "Ucinga ukuba zeziphi izinto ezinokuba nefuthe kule meko?"
• "Zeziphi iimpawu okanye utshintsho esifanele silujonge ngexesha lonyango?"
• "Ndingamfundisa njani umntwana wam ngale nto, into afanele ayilindele?"

Ekubeni iLegg-Calve-Perthes iyinto eyenzeka ngequbuliso, kuyinto eqhelekileyo ukuba nemibuzo emininzi. Nje ukuba ugqirha wakho achaze imeko yomntwana wakho, uya kuba nombono ocacileyo wokuba ulindele ntoni. Inyathelo elilandelayo kukuchazela umntwana wakho ngendlela anokuyiqonda.

Zininzi izizathu zokuba novuyo. Uninzi lwabantwana aluziva buhlungu kangako emva kokuqala unyango. Basenokuba nemida ethile, kodwa ihlala iyinto yexeshana. Basenokufuna uhlobo oluthile lonyango lwamathambo. Kodwa ekugqibeleni, banokuphila ngokupheleleyo.

Umyalezo Wokuya Ekhaya

Usenokuba noloyiko kancinci xa uva ngesifo iLegg-Calve-Perthes. Nangona kunjalo, eyona nto ibalulekileyo kukwazi ngaso kwangethuba.

• Qaphela iimpawu zokuqala: Ukuba umntwana wakho uyaqhwalela okanye uthi isinqe sakhe sibuhlungu, musa ukuyityeshela nje loo nto uze ufune ingcebiso kagqirha.
• Unyango olufanelekileyo lubalulekile: Landela imiyalelo kagqirha ngqo. Unyango lungathatha ixesha kwaye lunokuba buhlungu, kodwa luyimfuneko kwimpilo-ntle yomntwana kwixesha elizayo.
• Xhasa umntwana wakho: Umntwana wakho udinga uthando lwakho, inkathalo, kunye namandla engqondo ngeli xesha. Basenokuziva belusizi xa bengakwazi ukudlala, ukubaleka, okanye ukutsiba. Yiba nokuqonda kwaye ube lapho ngenxa yabo ngeli xesha.
• Hlala unethemba: Uninzi lwabantwana luyaphola ngokupheleleyo kule meko kwaye baphila ubomi obuqhelekileyo. Ngoko ke, kubalulekile ukuhlala unethemba.

Ukuba uneminye imibuzo malunga noku, ungabi nazintloni zokubuza ugqirha wakho. Baya kukuvuyela ukukunceda.

I- Legg-Calve-Perthes, isifo sePerthes, iintlungu zesinqe, izifo zabantwana, izifo zamathambo, ukuqhwalela, impilo yabantwana