Si wadajir ah jilibka The: seedaha iyo dhaawacyo la xiriira iyaga la. Sida loo daaweeyo jilibka ah jilibka

Isagoo ka hadlayay jilibka ah, dadka intooda badan qaadan wadajir jilibka. Indeed, waa qayb ka mid jidh muhiim ah, si kastaba ha ahaatee, ay shaqeynayaan oo aan murqaha iyo seedaha wax aan macquul aheyn. Marka socda, ordaya, isboortiga account gobolka qeexan u ciyaaro load weyn, taas oo kordhinaysa halista waxyeellada. Ha ka fikiro si aynu u wadajir jilibka, jilibka, nidaamka muruqa iyo dhibaato ay timaado inta lagu jiro muddada factor ee argagaxa leh.

anatomy

Aasaasidda wadajirka ah ee ku lug leedahay saddex lafaha: qayb ka mid ah lafta bawdada, qayb ka mid ah patella iyo tibial. Patella bidig-tibial soo bandhigay iyo bidig-suprapatellaris goysyada. Tilmaamo jidh kordhinayaan dhaqdhqaaq ah wadajira laba geesood ah oo lafihiisa in dhowr diyaaradood.

Menisci, carjawda bandhigay unugyo, waa "spacers" u dhexeeya madaxa lafta. Shaqadooda waa in ay bixiso celiyaha, qaybinta cadaadis iyo load markii baabuur-wadidda. On labada dhinac ee la ogeyn xilliga la xiriira kaabsal wadajirka ah oo ay seeduhu wadnaha.

xasiliya wadajir ah waxaa ka mid ah kooxaha muruqa socda, aqoonta taasoo loo arko arrin muhiim ah oo dhaawacyada qaabilsan:

1. muruqa bowdada degan hore ee bowdada. Waxaa loo arkaa qaabka ugu adag unit muruqa jidh aagga sheegay.
2. Sartorius waa dheer. Waxay bixisaa flexion iyo hip iyo shanshada, marayay agagaarka wadajir jilibka.
3. muruqa khafiif dambeeya iyo wax yar ka ag maraaba ilaa dhinaca reer wadajirka ah, jidaynayey hip iyo jilibka xoodaan hogaanka.
4. muruqa Magnus muruqa waa qayb keliya ma aha keeno miskaha ah, laakiin sidoo kale ay kordhin ama dheeraad ah ee miskaha ee la xiriirta bowdada.
5. Behind dhidibka transverse ku kordhiyay labo madax muruqa bowdada, jidaynayey laabaya shanshada, bowdada unbend, ku siin dhaqdhaqaaqa dibadda.
6. Behind iyo gudaha si wadajir ah u kordhiyay muruqa bowdada podsuhozhilnaya extensor soo gaaray hayalka san iyo bixinta addinka wareeg wareeg ah.
7. muruqa Semimembranosus fuliya hawlaha podsuhozhilnoy la mid ah.
8. soo gaaray Triceps lugta hoose ee jilibka oo cagta ee si wadajir ah anqawga flexes.
9. muruqa bowdada gaaban iyo guri ku yaal dusha danbe. Shaqada oo ka mid ah flexion oo wareeg ah oo soo gaaray.

function jilibka

tayada shaqo ee wadajirka ah jilibka ah oo muhiim u ah jidhka bini'aadamka. Waxaa suurto gal ah in ay u guuraan ah faasas toosan oo aad kaliga. Extension iyo flexion dhacdaa dariiq dhexaad hore, jiiftada - wareeg ee addinka.

flexion wadajir cagta u ogolaanaya qof si ay u sameeyaan tallaabo hore, garaacid addinka dhulka iyo si tartiib ah u geliya. Haddii kale, cagta aadanaha lagu soo rogi doono jihada verhneperednem by korinta bowdada.

seedaha

jilibka ayaa seedaha wadajir ah oo lagu matalayo by shan kooxood oo waaweyn waxaa loo arkaa qayb ka mid ah jirka ah ee qaab-dhismeedka jidh adag. Xubin ka mid ah xidhmo xidhmo isugu soo socda:

• rahaamad (tibial, peroneal);
• cruciform (hore, dib);
• jilibka transverse ee jilibka,
• gadaal (arcuate, popliteal, jilibka patellar, ka dillaac fudud iyo lateral);
• coronary (ogeyn-bidig, tibial-ogeyn).

Marka dhaawacyada, gaar ahaan dhaawac isboorti, load ugu weyn ee waxay dhacdaa at the seedaha cruciate jilibka. kabashada waqtiga iyo muddada baxnaaniska ku xiran tahay nooca dhaawaca iyo arrimo waxyeello, gaar ahaan jirka ah ee dhibbanaha, waarta 4 ilaa 6 bilood.

jilibka ka shaqeynayaan

jilibka jilibka u waasiciyo ka qayb danbe sare ee ogeyn ee lafta bawdada iyada oo loo marayo jilibka saabka si wadajir ah, lifaaqaaya in uu lugta ka, kaas oo la mid ah in conglomerate articular ah. Its shaqada waa in la xasiliyo si wadajir ah jilibka ah, la yareeyo dhaqdhaqaaqa hore ee uu lugta ka.

Jilibka kordhiyay dib ugu soo laabtay hore ee protrusion ee lafta bawdada iyo gudbaya saabka si wadajir ah, waxaa ku xidhnaa in uu lugta kaga jira xaggiisa dambe. Jilibka ka hortagtaa soo gaaray ee xad-dhaafka ah dib u wareejiyay.

Trauma jilibka

dhaawacyo noocan oo kale ah waxaa loo tixgeliyaa in ay ugu adag oo khatar ah, oo u baahan daaweyn buuxda. therapy A khalad ama dhicis bilaabay keenaysaa in horumarka lameness iyo hawlgalka xaddidaadda joogto ah. Inta badan, dhaawacyo ka dhacaan ciyaaraha fudud xirfadeed marka barafka, kobaha, boodada, legdinta, ka timi saamaynta xoog ama failure of jeedo a, dayrta.

xanuun mindi Strong iyo click ah, xadaysan fiiqan ee dhaqdhaqaaqa ayaa tilmaamaya laga yaabaa in seedaha bakhtiisto wadajir jilibka. Dhibanaha si madax banaan aan la dhaqaajin karin, ku tiirsan kaliya on qof.

dhaawac dambena dhacdaa jilibka hyperextension markii xoog ama inta lagu jiro saamaynta on dusha hore ee uu lugta ka. Burburka u jilibka jilibka waa kuwa ugu badan. Calaamadaha dhaawaca waxaa ka mid ahaa in ay "triad Turner" ay la socdaan dillaac ah la ogeyn xilliga ay iyo jilibka dibadda.

sawir clinical

si wadajir ah jilibka, jilibka kaas oo ay leeyihiin ilmo kastuu ka qayb noqdo hyperemic, edematous, xanuun marka la taabto iyo markii uu isku dayay dhaqdhaqaaqa. saabka articular dhiigga (hemarthrosis) ururayaa. Ha isku qaldin astaantii ah seedaha wada jilibka, taas oo uu leeyahay xarun caafimaad oo la mid ah oo leh calaamado dhaawac, kaas oo ka dhacay dhowr maalmood ka hor.

dillaac jilibka Full keena socodka xad-dhaafka ah soo gaaray ee diyaarad jilibka-dambena ka. Xaqiijinta calaamad this by laba khabiir oo isku mar sameeyay. Midkii kowaad wuxuu u haystaa dambe ee bowdada iyo flexes addinka anesthetized jilibka xagasha midig. Dhakhtarku waxa ay hubinaysaa labaad dhaqdhaqaaqa lugta hoose iyo dib u. daqar siligga ama calaamad la mid yahay negative.

Murgacasho ku lug jeex yar oo Albers, Ulasocto xanuun dhexdhexaad ah, in yar barar ah, maqnaanshaha dhiigbax. Xaddididda shaqo motor dhacdaa ilaa xad yar.

Baadhista xanuunada

Determination of farsamo dhaawac oo noo ogolaadaa in si loo ogaado khasaaraha suurto gal ah in qaab-dhismeedka jidh. Ka hor inta baaritaanka jilibka dhaawac uu dhakhtarku baarayaa caafimaadka si loo caddeeyo sifooyinka of qaab-dhismeedka. Qiimeeyey xaaladda dhismeedka gudaha la isticmaalayo ultrasound iyo MRI.

cudurka kala fogaado lafaha jabay, patella, kusoo laabto. Marka laf-bax mowjadda si ixtiraam leh in midba midka kale, waxaa suuro gal ma shaqo motor, waxaa jira iska caabin ah il markii uu isku dayay dhaqdhaqaaqa dadban. Waayo, wax aan dhaawac lagu gartaa la'aan buuxda oo dhaqdhaqaaqa, waa xadidan sababtoo ah xanuunka. sidoo kale ma jiraan wax iska caabin ah guga.

Jab Ulasocto lahayo ku, muuqaalka kore ee dhaqdhaqaaqa aan caadi ahayn oo crepitation. Si kastaba ha ahaatee, waxaa jira jab aan lahayn qaababka sida. Xaaladdan oo kale, xaqiijinta cudurka u baahan yahay baaritaan X-ray, ultrasound ama MRI.

Tilmaamaha daweynta

Marka qayb ahaan burburay (siligga, jeex) kaalmo la geeyo qolka xaaladda degdegga ah. Addinka waa waa in meel kacsantahay, dhowrkii maalmood ee ugu horreeya - nasashada sariirta. Maalintii ugu horraysay ka dib markii dhaawac uu u baahan yahay lifaaqa of qabow on meesha ay dhibaatadu saameysey. si wadajir ah waxaa u xaqiijiyay by a faashad laastikada dhagan, jidaynayey hayn addinka booska jir halka guuraya. Leave faashadda habeenkii ma noqon karto in ay jirto xadgudub ma wareegga. maamulka Xanuun baahan yahay isticmaalka analgesics ( "Ketanov", "Ketalong", "nalbuphine").

si wadajir ah jilibka, jilibka kaas oo u baahan daaweynta muxaafidka ah ma aha oo kaliya, laakiin qaliin, wuxuu u baahan yahay muddo dheer dhaqan celinta. Ka dib oo dhan oo ka mid ah hawlaha la mid ah sida in ay qayb ahaan dhaawacan, codsan tallaabooyin daaweynta dabiiciga ah, oo ay ku jiraan massage, daaweynta dabiiciga ah, electrophoresis daawooyin.

Marar badan, qalliin ayaa loo baahan yahay marka dillaacda jilibka ah jilibka. Hawlgalka ayaa si loo soo celiyo sharafta jidh dhismeedka waa lagama maarmaanka u ah hawlaha caadiga ah. Qaliinka waxaa lagu fuliyaa muddo lix bilood ah ka dib markii dhaawac wadajir ah.

Musharaxa ku haboon waxaa loo arkaa for Orodyahanka dhallinyaro ah oo u baahan dhaqdhaqaaqa waxqabadka matago of adimada in uu cayaaraha. dadka waayeelka ah kuwaas oo aan haysan dhaqdhaqaaqa jirka weyn, dheeraad ah oo ku haboon therapy muxaafid iyo isticmaalka daaweynta jirka yihiin.

Caaga jilibka dhaawac jilibka ah waxay u baahan tahay isticmaalka jab soo qaatay jilibka patella ama seed muruqa (autograft). Waxa kale oo suuragal ah in la isticmaalo Maqaar dardaro, si kastaba ha ahaatee, ay u isticmaalaan la diidi karaa by jirka bukaanka.

Galinta Maqaar dardaro waa marka bakhtiistay jilibka lateral of jilibka nidaam caadi ah. Daaweynta hawlaha hawl waxaa loo arkaa inay habka doorashada ay dhacdo noocan oo kale ah.

dhaqanka Qalliinka ayaa muujisay in si fudud tola dhismeedka dhaawacan ficil celinayo shaqeynayaan.

Maxay noqon karaan dhibaatooyinka ka mid ah dhaawac jilibka ah?

Dhibaatooyinka soo noqnoqda ee dhaawac jilibka ah waxaa soo socda:

1. Horumarinta ee arthritis suurto gal 2-3 toddobaad ka dib markii dhaawac wadajir ah. Jawaabta bararka dhacaa sabab u rabshooyin wareegga dhiigga iyo ingress ee sheyga bahal aaga dhaawaca. Waxa lagu gartaa xanuun, muuqaalka kore ee barara, guduudasho, dhaqdhaqaaqa kooban ay sabab u tahay xanuun.
2. muuqaalka kore ee isbedel side qaab arthrosis waxaa ku weheliyay formation of osteophytes, carjawda khafiifinta.

Odoroska

Ka dib markii dhaawac uu inta badan dhibanayaasha yaabay: "jebi jilibka ah ku bogsiiyaan badan?" Arrinta la mid ah waxaa looga hadlay kiis kasta oo caafimaad oo gaar ah. Iyada oo ku xidhan nooca dhaawaca iyo sifooyinka of shaqeeyo Oxperts buuxa iman karo dib in muddo lix bilood ah, iyo waxaa laga yaabaa in dhowr bilood.

farsamo dhaawac Muhiim ah laftiisa oo sida dhibanaha helay nasasho seedaha jilibka. Sidee bogsata dhaawac ayaa sidoo kale ku xiran tahay sax ah ee talo ku takhasusay daweynta. daaweynta Early, qaata daawada loo baahan yahay iyo u hogaansanaanta la dedejiyo bogsiinta iyo ka hortagga dhibaatooyin.

ka hortagga

Liiska tallaabooyin ka hortag ah loo isticmaalo si loo yareeyo waxyeello ku kala goysyada waxaa uu hoos ugu hawlaha soo socda:

• dhaqdhaqaaqa jirka ku filan,
• caabuq ku seedaha jilibka waa in laga dambeeyo kan amarka daaweynta waqtigii;
• cunto isku dheeli tiran,
• diidmada khamriga iyo tubaakada,
• ka fogaanshaha hypothermia,
• addimada gacanta ku joogtid ugu yaraan in jagooyinka ma guurto ah,
• doorashada saxda ah ee kabaha, diidmada u gaddoomaysaan Cidhibtiinii sare.

dhaawac jilibka ah waa laga hortagi karaa, taas waxaa loola jeedaa in ay tallaabooyin ka sahlan yahay dib u soo celinta ee ay ka shaqeynayaan sabab u ah burburka.