Te whakamāramatanga o te epicondylitis taha o te humerus
E mōhiotia ana hoki ko te tennis elbow, te uaua o te uaua extensor carpi radialis, te whāwhā rānei o te pūwāhi piri o te uaua extensor carpi, te brachioradial bursitis, e mōhiotia ana hoki ko te lateral epicondyle syndrome. He mumura aseptic whara o ngā kiko ngohengohe e karapoti ana i te lateral epicondyle o te humerus nā te whara whakapeka, mau tonu..
Te whanaketanga o te mate
He hononga tata tēnei ki te mahi, inā koa ko ngā kaimahi e hurihuri ana i te ringaringa, e totoro ana, e piko ana hoki i ngā hononga o te tuke me te ringaringa. Ko te nuinga o rātou he wāhine noho whare, he kāmura, he kaihanga pereki, he kaiwhakapaipai, he kaimahi paipa, he kaitākaro hākinakina hoki.
Dpepeke
Ko ngā tohu i ngā taha e rua o te pito o raro o te humerus ko ngā epicondyles medial me lateral, ko te epicondyle medial te hononga o te uaua noa o ngā uaua flexor o te ringaringa, ā, ko te epicondyle lateral te hononga o te uaua noa o ngā uaua extensor o te ringaringa. Ko te tīmatanga o te uaua brachioradialis, piko te ringaringa me te paku pronate. Ko te tīmatanga o te extensor carpi radialis longus, te uaua extensor carpi radialis brevis, te extensor digitorum majoris, te extensor digitorum propria o te maihao iti, te extensor carpi ulnaris, te uaua supinator.
Pātōkeni
Ko te tīmatanga o te hononga o te ringa ka puta mai i te whāwhā me te totoro tere, engari he puhoi te tīmatanga o te nuinga o ngā tūroro, ā, kāore he hītori whara e kitea ana, ā, he nui ake te kitea i roto i ngā pakeke e hiahia ana ki te huri i te ringaringa me te totoro kaha i te ringaringa. Ka taea hoki te whāwhā, te whāwhā rānei nā te toronga o te hononga o te ringaringa ki muri me te totoro nui o te uaua o te ringaringa i te hononga o te epicondyle taha o te humerus ina kei te tūranga pronation te ringaringa.
Pte pūtaiao
1. Nā te whara tonu, ka haehae te taha o te uaua epicondyle, ka totohu, ka hanga he hematoma subperiosteal, kātahi ka whakarite me te whakapūmau, ka hua ake he periosteitis me te hyperplasia wheua o te taha o te humerus (ko te nuinga he pona mata koi). Ko te tirotiro i te koiora kiko pathological he hyaline degeneration ischemia, nō reira ka kiia hoki ko te mumura ischemic. I ētahi wā ka haere tahi me te haehae o te putea hononga, ā, ka horapa te kiriuhi synovial o te hononga me te matotoru nā te whakaohooho roa a te uaua.
2. Haehae i te pūwāhi whakapiri o te uaua toronga.
3.mumura whara, fibrohistolitis rānei o te ligament annular.
4. te bursitis o te hononga brachioradial me te uaua whānui o te hononga extensor.
5. Te mumura o te hononga synovium o te humerus me te hononga radial i puta mai i te whakaurunga o te humerus me te pane iti o te radius.
6. Ka taea hoki te whakangāwari o te hononga humerioradial me te wehenga ngāwari o te hononga radial-ulnar proximal, ka puta te nekehanga o te pane radial cephalic. Ka taea e ēnei huringa mate te whakaputa i ngā uaua pupuhi, te mamae ā-rohe, te mamae e horapa ana mai i ngā uaua o te ringaringa ki te ringaringa.
Te whakaaturanga haumanu
1. Ka nui haere te mamae o waho o te hononga tuke i te wā e piko ana, inā koa i te wā e hurihuri ana te tuara, e hiki ana, e tō ana, e whakamutu ana, e pana ana me ētahi atu mahi, ā, e horapa ana ki raro i te uaua toronga o te ringaringa. I te tīmatanga, he maha ngā wā ka pāngia e te mamae me te ngoikore o te peka kua whara, ā, ka piki haere te mamae o waho o te tuke, ka nui haere te mamae i te nui haere o te whakakori tinana. (Ko te āhua o te mamae he mamae, he ngau rānei)
2. Ka kino haere i muri i te whakapau kaha, ā, ka marino ake i muri i te okiokinga.
3. Te hurihuri o te ringaringa me te ngoikore ki te pupuri i ngā mea, tae noa ki te hinga tahi me ngā mea.
Ngā Tohu
1. Te taha o te humerus epicondyle Ka taea te pā atu ki te taha o muri o te taha o te humerus, te wāhi o te hononga humerus-radial, te taha o te humerus me te taha o te radial caulette o te kaki, ā, ka taea hoki te pā atu ki te uaua me te kiko kikokiko i te taha radial o te ringa o runga me te pupuhi ngawari, te ngawari, te pakari rānei. I ētahi wā ka taea te pā atu ki ngā taha koi o te hyperostosis i te taha o te humerus, ā, he tino ngawari.
2. He pai te whakamātautau a Mills. Pikohia mārire tō ringaringa, ka hanga he haurua-ringa, pikohia tō ringaringa kia rite ki te taea, kātahi ka whakatōkia tō ringaringa, ka whakatikahia tō tuke. Mena ka mamae te taha taha o te hononga brachioradial ina whakatikahia te tuke, he pai.
3. Whakamātautau ātete toronga pai: ka pūmau te ringa o te tūroro, ka piko tōna ringaringa, ā, ka pēhi te kaimātai i te tuara o te ringa o te tūroro ki tōna ringa kia ātete te tūroro ki te ātete, kia totoro hoki te ringaringa, pērā i te mamae o waho o te tuke.
4. I ētahi wā, ka kitea pea e te whakamātautau hihi-X te koretake o te periosteal, te iti rānei o ngā pūwāhi whakapūngā i waho o te periosteum.
Te maimoatanga
Maimoatanga ā-pūmau:
1. Katihia te whakangungu whakaohooho ā-rohe i te wā tika, ā, ka taea te whakaora i ētahi tūroro mā te okioki, te whakaū rānei i te kiriuhi o te papa rākau.
2. Mirimiri, whakamahia ngā tikanga pana me te pokepoke hei whakamamae i te māuiui me te whakamamae i te mamae o ngā uaua torotika o te ringaringa, kātahi ka whakamahia ngā tikanga pēhi me te pokepoke ki te taha o te epicondyle o te humerus me ngā wāhi mamae e tata ana.
3. Te whakaora Tuina, ka noho te tūroro. Ka whakamahia e te tākuta te hurihuri mārie me te pokepoke hei mahi i te tuara me waho o te tuke, ka hoki whakamuri i te taha tuara o te ringaringa. Ka whakamahia e te tākuta te pito o te koromatua hei pēhi me te miri i te Ah Shi (te taha o te epicondyle), Qi Ze, Quchi, Hand Sanli, Waiguan, Hegu acupoint, me ētahi atu. Ka noho te tūroro, ā, ka hutia e te tākuta te tīmatanga o te tūroro o te extensor carpi me te extensor carpi longus me te brevis radialis. Tōia me te totoro, kia ora ngā tuke. Hei whakamutunga, whakamahia te tikanga miri thenar hei miri i te taha o te epicondyle o te tuke me ngā uaua extensor o te ringaringa, ā, ka whakamahia te wera ā-rohe ki te taumata e hiahiatia ana.
4. Te rongoā, te tango i ngā rongoā anti-inflammatory kore-steroidal ā-waha i te wāhanga whakapeka.
5. Maimoatanga ārai: ka werohia ngā glucocorticoids (pērā i te werohanga betamethasone matū) ki roto i te pūwāhi ngawari, ka werohia ki roto i te pūwāhi whakauru uaua me te wāhi subaponurosis (iti iho i te 3 ngā wā, e ōrite ana rānei), ka taea te whai pānga ārai-mumura me te whakamamae mamae, ā, ko te betamethasone matū me te ropivacaine, te hototahi rānei ki te levobupivacaine, e mōhiotia ana i tēnei wā he tere te mahi, he roa te mahi, he teitei te taitara ārai-mumura, ā, ko te mea haumaru, he roa te wā aukati, he iti rawa te tauhohenga paitini, ā, he iti rawa te hototahi rongoā whakaora mamae mō te ārai ā-rohe.
6. Maimoatanga wero ngira, ka tapahia te wheua ki te mata o te wheua hei tango i te kiko ngohengohe e piri ana ki te tukanga wheua, ka keri i te uaua o te ringaringa o waho, te uaua o te maihao o waho me te uaua o te hope, ka unuhia te maripi me te ahua o te wetekina. Maimoatanga pokanga: he pai mō ngā tūroro kāore e aro ki te maimoatanga matatapu.
1. Te tikanga Body & Meleod, ko te mahi pokanga e pā ana ki te nuinga o ngā kiko o te whara, tae atu ki te tango i te epicondyle taha 2mm, te tukunga o te pūwāhi tīmatanga o te uaua whānui extensor, te tango wāhanga wāhanga o te pito proximal o te ligament annular, te whakaurunga o te hononga humeroradial ki roto i te synovium, me te tango i te kiko granulation, te bursa rānei i roto i te wāhi subtendinous.
2. Mā te tikanga Nischl, ka wehea te uaua toronga noa me te uaua toronga carpi longus radialis ki te taha roa, ka whakaaturia te uaua toronga carpi radialis brevis hōhonu, ka tihorea te pūwāhi whakauru mai i waenganui o te epicondyle taha, ka horoia te kiko uaua kua pakaru, ka tangohia tetahi wāhanga o te kiri wheua o mua, ā, ka tuia, ka hangaia anō rānei te uaua toenga me te fascia e karapoti ana i te wheua. Kāore e taunakihia te whai wāhi ki roto i ngā hononga.
Prognosis
He roa te roanga o te mate, ā, he ngāwari ki te hoki mai anō.
Note
1. Kia tūpato ki te noho mahana, kia kore ai e mātao;
2. Whakaitihia ngā āhuatanga mate;
3. Whakakorikori tinana;
4. I te wāhanga whakapeka, me ngāwari te tikanga, ā, me piki haere te kino o te tikanga maimoatanga mō te hunga kua roa e pāngia ana e te mate, arā, me ngawari te tikanga ki te pakari, ki te pakari ki te ngawari, ā, me whakakotahi te pakari me te ngawari.
Te wā tuku: 19-Pepuere-2025
