Epiphysiolysis chirwere chehudyu chinokanganisa vechidiki, kunyanya vakomana vasati vasvika. Yakabatana nekusagadzikana kwekashwa yekukura, inokonzeresa kutsvedza kwemusoro wefemu (superior femoral epiphysis) maererano nemutsipa wefemu. Kuvhiya kunofanirwa kuitwa nekukurumidza sezvinobvira kudzivirira kutsvedza kukuru kunobvira. 

tsananguro

Epiphysiolysis chirwere chehudyu chinobata vana vane makore 9 kusvika ku18, kunyanya panguva yekuyaruka kwekutanga. Zvinokonzera kutsvedza kwemusoro wemukadzi (superior femoral epiphysis) maererano nemutsipa wemukadzi. 

Muchirwere ichi, pane kushomeka kwegomarara rekukura - iro rinonziwo kukura shwashwa - iro muvana rinoparadzanisa musoro kubva pamutsipa wefemu uye rinobvumira bhonzo kukura. Nekuda kweizvozvo, musoro wefemur unorerekera pasi, kumashure, uye kusvika panzvimbo yecartilage inokura. 

Kufamba uku kunogona kukurumidza kana zvishoma nezvishoma. Isu tinotaura nezve acute epiphysiolysis apo zviratidzo zvinotanga nekukurumidza uye zvinosundidzira kubvunza musingasviki mavhiki matatu, dzimwe nguva zvichitevera kukuvadzwa, uye chisingaperi epiphysiolysis kana ichifambira mberi zvishoma nezvishoma, dzimwe nguva nemwedzi. Mamwe mafomu akaomesesa anogonawo kuoneka muchimiro chisingaperi.

Pane zvinyoro zvishoma (angle of displacement <30 °), zvine mwero (pakati pe30 ° ne60 °) kana zvakanyanya (> 60 °) epiphysis.

Epiphysis iri bilateral - inobata mahudyu ose - mu20% yezviitiko.

Zvinokonzera

Zvinokonzera femoral epiphysis hazvinyatso zivikanwa asi pamwe zvinosanganisira mechanical, hormonal and metabolic factors.

chirwere

Kana zviratidzo uye njodzi zvinokonzeresa kunyumwira epiphysis, chiremba anokumbira X-ray yepelvis kubva kumberi uye kunyanya yehudyu muprofile kuti atange kuongororwa.

Biology yakajairika.

Scan inogona kurairwa kuvhiyiwa kusati kwaitwa kutarisa necrosis.

Vanhu vane hanya

Kuwanda kwenyaya nyowani kunofungidzirwa pa2 kusvika ku3 pa100 muFrance. Havawanzobata vana vari pasi pemakore 000 ezera, epiphysis inowanzoitika panguva yekuyaruka, kutenderera zera regumi muvasikana uye kutenderera zera re10 muvakomana, vane makore maviri kusvika mana. zvakapetwa katatu zvakakanganiswa.

Zvinhu zvinotyisa

Kufutisa kwevacheche idambudziko guru, sezvo epiphysis inowanzobata vana vakafuta vane kunonoka kuyaruka (adipose-genital syndrome).

Ngozi inowedzerawo muvana vatema kana vana vanotambura nehomoni yehomoni yakadai se hypothyroidism, testosterone deficiency (hypogonadism), pasi rose pituitary insufficiency (panhypopituitarism), kukura kwehomoni kusakwana kana kunyange hyperparathyroidism. yechipiri kusvika kune renal kukundikana.

Radiotherapy inowedzerawo njodzi yekutambura kubva epiphysis maererano nedosi yakagamuchirwa.

Pakupedzisira, zvimwe zvinhu zveatomical zvakadai sekudzoka kwemutsipa wemukadzi, unoratidzwa nemabvi uye tsoka dzakatarisa kunze, zvinogona kukurudzira kutanga kwepiphysis.

Pain

Chiratidzo chekutanga chenyevero kazhinji kurwadziwa, kwekusimba kwakasiyana kubva kune imwe nyaya kuenda kune imwe. Inogona kunge iri marwadzo emagetsi ehudyu, asi kazhinji kazhinji hainawo kunyatsojeka uye inopenya munharaunda yegororo kana nzvimbo dzepamberi dzehudyu nemabvi.

Muacute epiphysis, kutsvedza kwemusoro kwechikadzi kunogona kukonzera kurwadziwa kwakanyanya, kutevedzera marwadzo ekutyoka. Marwadzo anonyanya kujeka mune zvisingaperi mafomu.

Kusashanda zvakanaka

Kukamhina kunowanikwa zvakanyanya, kunyanya mune chisingaperi epiphysis. Kune zvakare kazhinji kutenderera kwekunze kwehudyu kunoperekedzwa nekuderera kweamplitude yekufamba mukuchinjika, kutorwa (kutsauka kubva muakisi yemuviri mundege yepamberi) uye kutenderera kwemukati.

Epiphysiolysis isina kugadzikana imamiriro ekukurumidzira, umo kurwadziwa kwakanyanya, kutevedzera kushungurudzika, kunoperekedzwa nekushaya simba kukuru kwekushanda, nekusakwanisa kuisa tsoka.

Evhangeri uye matambudziko

Early osteoarthritis ndiyo inonyanya kukosha yepiphysis isina kurapwa.

Nekuda kwekutadza kutenderera kweropa, necrosis yemusoro wechikadzi inowanzoitika mushure mekuvhiya kurapwa kwemafomu asina kugadzikana. Inokonzera deformation yemusoro wechikadzi, sosi ye osteoarthritis munguva yepakati.

Chondrolysis inoratidzwa nekuparadzwa kwejojo ​​cartilage, zvichikonzera kuoma kwehudyu.

Kurapa kwe epiphysiolysis kunogara kuchivhiya. Kupindira kunopindira nokukurumidza sezvinobvira mushure mekuongororwa, kudzivirira kutsvedza kubva pakuwedzera. Chiremba anovhiya achasarudza nzira yakakodzera kunyanya zvichienderana nekukura kwekutsvedza, iyo yakaoma kana isingaperi ye epiphysiolysis uye kuvapo kana kusavapo kwekukura kweshwashwa.

Muchiitiko chekutsvedza zvishoma, musoro wechikadzi uchagadziriswa panzvimbo nekuputira, pasi pekutonga kweradiological. Yakaiswa mumutsipa wefemur, screw inopfuura nepakati uye inopera mumusoro wefemur. Dzimwe nguva pini inotsiva sikuruu.

Kana kutsvedza kwakakosha, musoro wemukadzi unogona kuiswa pamutsipa. Iko kupindira kunorema, nekubuda kwehudyu nekudhonza kwemwedzi ye3, uye njodzi huru yezvinetso.

Epiphysis haigoni kudziviswa. Kune rumwe rutivi, kuipa kwekutsvedza kwemusoro wefemur kunogona kudziviswa nekuda kwekukurumidza kuongororwa. Zviratidzo, kunyange pazvinenge zviri pakati nepakati kana kuti zvisinganyanyi kuoneka (kuremara zvishomanana, kurwadziwa mumabvi, nezvimwewo) hazvifanirwe kufuratirwa.