Ukuhlanganiswa kwedolo

01

Le khasi I-Knee Joint inamathambo ama-4: i-femur, iTibia, Patella noFibula.

Siqukethe izingxenye ezi-3: igumbi laseTibiofeemoral, i-lateral tibiofemooral coarful, kanye negumbi le-patallofemaoural, futhi ama-compartments abelana nge-synovial cavity.

02.Joint Sakhiwo

Thayipha: I-Carreiccier Cong

Idolo linamalunga ama-3: I-Medial Tibiofemoemeal Joint, i-Tibiofemoemoral Joint kanye ne-Patellofemoral Joint.

I-Tibiofemoemeal Joint ixhumanisa i-distal femur eya eTibia, kanye nama-distal femur tapers ukwakha i-medial femoral conferal towle kanye ne-elengiseli yabesifazane. I-Tibia iyisicaba, kepha ama-meniscus athambekele awenza ukuthi asondelene kakhulu nezinhlobo zama-fomeral sowesifazane.

Izithonjana zowesifazane zihlukaniswe yi-intercondylar FOSSA, eyaziwa nangokuthi njenge-groove yesifazane noma i-femol feof Talus.

I-Patella iyithambo lembewu elishumeke ngaphakathi kwe-tendon yemisipha yama-quadriceps futhi yakha ukuhlangana nge-trochanterteric groove.

Kusebenza ukuthuthukisa inzuzo yemishini yemisipha ye-quadriceps. Inhloko ye-Fibula itholakala ngaphakathi kwe-knee capsule kepha ayivamisile ukusebenza njengendawo enobuhlakani obuthwala isisindo. Ama-Thower Shords neTakeleli yeTibial akha umugqa ohlanganyelwe.

03. Ukuqina okuhlangene

Ukuqina kwe-Knee Joint kugcinwa yizicubu ezahlukahlukene ezithambile ezihlinzeka ngokuvikelwa kwe-cushioning ngaphakathi kokuhlanganiswa.

I-Tibia kanye ne-femur embozwe nge-hyarilage edonsa kanzima ye-hyaline ngaphakathi kwe-knee ehlanganisiwe.

-I-Astal-Shaped Lateral and Medial Menisci nikeza ukumuncwa okwengeziwe ukushaqeka futhi futhi usabalalisa amabutho edolweni kulo lonke elasemadolweni.

-I-ligament ye-anterior ye-anterior (acl) ne-posterior rucate ligament (PCL) Statiling Standar anterior-posterior-posterior ukuthuthukiswa kokunyakaza kanye nokunwebeka.

-I-Medial Collateral Ligament kanye ne-lateal collateral ligament ziqinisa idolo ezipeleni zazo.

Izakhiwo -oter eziqinisa idolo zifaka phakathi inqwaba ye-iliotiotibial nengxenye yophondo lwangemuva lwangemuva.

04. Bursae kanye nezakhiwo ze-cystic

Izakhiwo eziningana ze-cystic zivame ukutholakala zizungeze idolo, kufaka phakathi i-tendon sheath cysts nama-bynovial bursae. I-Tendon Sheath Cystts i-Benign Afmormities enezicubu ezibucayi ezithintekayo futhi aqukethe i-mucus.

I-popliteal cyst (ie, i-Baker's Cyst) iyindlela evamile yokudlala emzimbeni. Isuka eBursa phakathi kwekhanda le-medial of the gastrocnemius umsipha kanye ne-semimembranosus tendon. Ama-Popliteal Cysts ngokuvamile ajwayele ukuhlotshaniswa ne-asymptomatic kodwa kuvame ukuhlotshaniswa nokuphazamiseka kwe-intra-acticular yedolo.

Kunemigodi emine evamile ngaphambili kwedolo. I-Suprapatellar Bursa iyi-proximal kwi-capsule ye-knee futhi ilele phakathi kwe-rectus femoris tendon kanye ne-femur, kanye nethrafikhi yayo nge-knee ukuhlangana kubantu abadala abaningi. I-Predatellar Bursa ilele nje e-Patella. I-superficf Infrapatellar Bursa isezingeni eliphakeme engxenyeni ye-patellar tendon kanye ne-tibial Tuberoluty, kanti i-fursatatellar bursa ejulile, i-fude infrapatellar bursa ijulile phakathi kwengxenye ye-patellar kanye ne-teterior tibial Tubeluty. I-Bursa engekho ngokweqile ingavuswa ngokweqile noma ngokuhlukumezeka, njengokuguqa ngamadolo isikhathi eside, ngenkathi ukugcwala ngokweqile kwamadolo kungaholela ekuvuvukeni kwe-fude infrapatellar bursa, njengokugxuma okuphindaphindiwe noma okusebenzayo.

Isici se-Medial sedolo siphethwe yi-Goosefoot Bursa, i-Semimembranosus Bursa, kanye ne-Suprapatellar Bursa. I-Goosefoot Bursa itholakala phakathi kokuma kweTibial kwe-lateral tibial collateral ligament kanye ne-distal fusion tandons ye-suture, imisipha yabesifazane bemincane neyesesemitendinosus. I-Semimembranosus Bursa ephakathi kwe-Semimembranosus Tendon kanye ne-Medial Tibial Condon, kanti i-Suprapatellar Bursa iyi-bursa enkulu kunazo zonke e-Bursa ehlanganayo futhi itholakala ngenhla kwe-patella nasekujuleni kwemisipha ye-quadriceps.

05 uhla oluhlangene lokuhamba

Ukuhlola ukuguquguquka kwe-knee esebenzayo, yiba nesiguli sithathe isikhundla esithambekele futhi siguqule kakhulu idolo ukuze isithende sisondelene ne-gluteal groove ngangokunokwenzeka; I-angle ejwayelekile yokuguquguquka icishe ibe ngu-130 °.

Ukuhlola ukunwetshwa kwamadolo kufanele isiguli sithathe isikhundla sokuhlala futhi sandise ukunwetshwa kwamadolo. Ukunwetshwa kwedolo elingaphezu komlenze oqondile noma isikhundla sokungathathi hlangothi (0 °) kujwayelekile kwezinye iziguli kepha kubizwa i-hypereXension. Ukweqisa kokungabi ngaphezu kuka-3 ° -5 °-5 ° kuphela kuyisethulo esivamile. I-HypereXtension edlula leli banga libizwa nge-knee retroflexion futhi isethulo esingajwayelekile.

Ukuhlolwa kweHomas kuvivinya ukuguquguquka kwama-quadriceps kanye nama-hip fleverors.

Uma inkohliso ye-hip flexion ikhona, ithanga eliphansi lokudonsa lizongena ophahleni kunokuba ligebheze noma liye phansi ngethebula lokuhlola.

I-angle yethanga elilengiswa etafuleni lokuhlolwa libonisa izinga lezinkomo ze-hip flexion.

Uma ukuqina kwama-quadriceps kukhona, umlenze ophansi wedrape uzongena kude etafuleni lokuhlolwa. I-angle eyenziwe ngumlenze ophansi odonsa nge-ground plum line ikhombisa izinga lokungezwani kwe-quadriceps.

06. Ukuhlolwa kokuqina okuhlangene

kwekhabethe ngemuva Ukuhlolwa Umhloli udlala iTibia yesiguli esenziwa ngezandla zombili ekubambeni okuyindilinga ngenkathi ebeka izithupha zombili izandla ze-TIBIAL TULULELY. Amandla abuyela emuva asetshenziswa eTibia Proximal Tibia. Ukuhanjiswa okungemuva kwe-tibia yama-cm angaphezu kuka-0.5-1 cm kanye nokuhanjiswa okungemuva okukhulu kunalokho okuhlangenwe nakho okunempilo kukhombisa izinyembezi noma eziphelele zangemva kokulimala kwedolo.

I-Quadriceps esebenzayo yokuzilolonga - izinzilo ezinyaweni zesiguli (imvamisa ehleli phezu konyawo) futhi inomzamo wesiguli ukuze ashelelezi etafuleni elihlolayo (elizoholela ekushintsheni kwe-tibia okungenani nge-geterial ebhuqayo ye-ligate.

Isivivinyo sokujikeleza kwangaphandle kweTibial - Isivivinyo sokujikeleza kwangaphandle seTibial sisetshenziselwa ukuthola ukulimala kwangemuva kokulimala kwe-lateral lateral kanye nokulimala kwangemuva kokulimala kwe-ligate. I-Tibia ijikelezwa ngaphandle kwangaphandle ngo-30 ° no-90 ° kaFnee Flexion. Ukuhlolwa kulungile uma uhlangothi oluthintekile lujikelezwa ngaphandle ngaphezulu kwe-10 ° -15 ° ngaphezu kohlangothi olunempilo. Okuhle ku-30 ​​° of Flee Flexion kanye ne-90 ° kuphakamisa ukulimala okulula kwe-PLC, futhi okuhle ku-30 ​​° kanti ama-90 ° ° no-90

07. I-Periarticular Ligaments

I-CAPSULE LIGAMENTES

I-Patellar Ligament, i-Medial Patellar Ligament, i-Patellar Ligament

Ama-ligaments we-intracappur

i-ligament ebabazekayo ye-ligament, i-ligament ebaluleke kakhulu ye-ligament

Ama-ligaments e-extracapsapsar

I-Medial Collateral Ligament, i-lateral ligament, i-popliteal ligament, popliteal oblique ligament, i-fibular collatal ligament

08. Ukulondolozwa kokuhlanganiswa

Isakhiwo se-Neurovascular

Isigaxa se-neurovascular esine-artery popliteal, i-popliteal vein, kanye ne-tibial nerve (ukuqhubeka kwezinzwa ze-sciatic) kuhamba nje ngemuva kokuhlanganiswa kwedolo.

I-Peroneal Nerve ejwayelekile yigatsha lamuva lezinzwa zesayensi.

09. Imisipha ehambisana nayo

I-anterior latelal

I-Quadriceps iqukethe i-rectus femoris, i-vastos medialis, i-vastos latalis, kanye ne-Intermedius femoris.

Uhlangothi lwangemuva

Ama-hamstrings

kufaka phakathi ama-biceps wemvelo, amaSemitendinosus kanye ne-Semimembranosus;

Gastrocnemius.

Somela

Tibialis anterior.

Imisipha egcina ukuqina kokuhlanganiswa kwedolo, kufaka phakathi ama-quadriceps, amamisipha athululayo, ama-hamstrings, izicubu zabesifazane abancane, ama-biceps femoris, ama-semitendinosus, kanye ne-semimembranosus.

10. Ukuhlolwa ngokomzimba

1. Ukuhlolwa okubukwayo

Bheka ukuhamba nokulinganisa kwamalunga amadolo ohlangothini oluthintekile kanye nalolohlangothi oluphambene nesiguli, bese unaka ukuthi ngabe kukhona ukuvuvukala kwasendaweni, umbala ongejwayelekile wesikhumba, kanye ne-gait engajwayelekile, njll. 3.

2. I-palpation

Hlola ubuhlungu kanye nesayithi lokuvuvukala, ukujula, ubukhulu kanye nemvelo, ngohlangothi oluthintekile lwesiguli endaweni evuselelekayo ngangokunokwenzeka.

3. Ukuhlanganisa

Hlola ukuhamba kwe-Knee Joint ngokusebenzisa imisebenzi esebenzayo nengenamanzi yesiguli.

4. Ukulinganiswa

Ukukala ubude bengxenye ngayinye ye-limb kanye nobude obuphelele, ukujikeleza kwemlenzeni, ububanzi bokuhamba kwamalunga, amandla emisipha, ukulahleka kwendawo yemizwa, njll., Nokwenza amarekhodi.

5. Ukuhlolwa okukhethekile

 - Ukuhlolwa kwe-Patella entantayo: Bheka ukuthi ngabe kukhona ukugcwala edolweni lesiguli elihlanganisiwe.

Ukuhlola inqubo

Ngemuva kokufaka i-suprapatellar bursa ukuvumela uketshezi ukuthi luqongelele, uma i-patella icindezelwe ngobumnene ngomunwe we-fluid, futhi uma ingcindezi ikhishwa, i-patella izoba nomuzwa wokuphuma noma ontantayo ngenxa yamabutho aphumayo

- Ukuhlolwa kwekhabethe: ukubona ukuthi ngabe kunomonakalo we-ligament ebaluleke kakhulu.

Ukuhlolwa kwekhabethe le-Aterior: Isiguli silele embhedeni, edonswe ngamadolo 90 °, izinyawo zicaba embhedeni, zigcine zikhululekile. UMhloli ezinyaweni zesiguli ukulenza lilungiswe, izandla zibambe ukuphela kwedolo ngokuhlanganiswa kwedolo, zidonsele ithole eliphambi kwalo-5mm okunempilo (inothi: Ukuhlolwa kweLachman kungukuhlolwa kwekhabethe kwe-knee aflee 30 °).

Ukuhlolwa kwekhabethe ngemuva

- Ukuhlolwa kokugaya: ukucacisa ukuthi ngabe kukhona yini ukulimala kwamanzi edolo.

Ukuhlolwa kokugaya okuhlangene okuhlangene

Isiguli sisesimweni esithambekele egunjini elithintekile aguqulwe ku-90 °.

1. Ukuhlola okujikelezayo kokuphakamisa

Umhloli ucindezela ithole ethangeni lesiguli futhi aphethe isithende ngezandla zombili ukuphakamisa ithole eduze kwesethuli elide yethole, ngenkathi enza ukunyakaza kokujikeleza kwangaphakathi nangaphandle; Uma ubuhlungu benzeka ezinhlangothini zombili zedolo, kusolwa ukuthi kulimale ngokulimala kwe-collateral ligament.

2. Ukuhlolwa kokucindezela okujikelezayo

Umhloli ubamba unyawo lwezandla ezithintekile ngezandla zombili, ukuze idolo elithintekile liguqulwe ku-90 ° kanti ithole lisesimweni esiqondile ngesinyawo phezulu. Bese ucwilisa i-Knee ngokuhlangene phansi bese ujikeleza ithole ngaphakathi nangaphandle ngasikhathi sinye. Uma kunobuhlungu ohlangothini lwangaphakathi nangaphandle lwedolo ngokuhlanganiswa kwedolo, kukhombisa ukuthi i-meniscus yangaphakathi nangaphandle yonakele.

Uma idolo lisenkingeni enkulu, kusolwa uphondo lwangemva kokuphoqelelwa; Uma kungo-90 °, ukuqhuma okuphakathi kusolwa; Uma ubuhlungu benzeka lapho usondela esimweni esiqondile, kusolwa ukuthi kuvulwe izilinganiso zophondo zangezingaphandle.

- Ukuhlolwa kwengcindezi ye-lateral: Ukubona isiguli ngomonakalo we-lateral ligament.

Isivivinyo sokucindezelwa kwe-lateral knee kuwukuhlolwa ngokomzimba okusetshenziselwa ukubheka ama-ligaments ahlanganayo edolo.

Isikhundla: Isiguli sisezingeni eliphakeme embhedeni wokuhlola, futhi umlenze othintekile wethulwe kahle ukuze umlenze ophansi othintekile ubekwe ngaphandle kombhede.

Isikhundla esihlangene: Idolo libekwe endaweni enwetshiwe ngokuphelele kanye nesikhundla esiguquguqukayo esingu-30 °.

Isicelo se-Force: Kulezi zikhundla ezimbili ezinamadolo, umhloli uphethe umlenze ophansi wesiguli ngezandla zombili futhi asebenzisa ukucindezelwa ezinhlangothini ezihlangene kanye nale ndawo ngokulandelana, okusho ukuthi izivivinyo ze-Valgus ne-Valgus zenziwa futhi ziqhathaniswa nohlangothi olunempilo.

Uma ubuhlungu benzeka e-Knee Joint ngesikhathi senqubo yokufaka isicelo, noma uma i-Inversion kanye ne-englession angle evuthiwe iphuma ebangeni elijwayelekile futhi kukhona umuzwa wokuphuma, kuphakamisa ukuthi kukhona i-Sprain noma i-Flaing ye-Lateral Ligament. Lapho ukuhlolwa kwengcindezi yangaphandle kwe-rotation kuyinto enhle, kukhombisa ukuthi indlela eqondile ye-medial ayizinzile, futhi kungahle kube nezilonda ze-Medial Collatal Ligament, Meniscus Mediscus kanye ne-capsule ehlanganisiwe; Lapho ukuhlolwa kwengcindezi yokujikeleza kwangaphakathi kunethemba, kukhombisa ukuthi indlela eqondile eqondile ayizinzile, futhi kungalimala kuma-meniscus alandelanayo noma i-carticular ye-articular yangaphandle.

11. Ukucabanga ngamadolo

1. Ukuhlolwa kwe-X-ray

isetshenziselwe ukubheka ama-fractures kanye ne-osteoarthropathy enobungozi. Isisindo esithwala isisindo (ukuma) isikhundla se-Knee Fronce Front kanye nefilimu yokubuka eseceleni kungabheka ithambo, i-knee arliap gat nokunye.

2. I-complen tomography (CT)

Iskena se-CT singasiza ekuhloleni izinkinga zamathambo nokuqhekeka okucashile. Uhlobo olukhethekile lwe-CT SCAN lungakhomba ngokunembile i-gout, noma ngabe ukuhlangana kungabi khona.

3. I-Ultrasound

Isebenzisa amaza omsindo ukukhiqiza izithombe zesikhathi sangempela zezakhiwo ezithambile zezicubu ngaphakathi naseduze kwedolo. I-Ultrasound ingabona ngeso lengqondo izinguquko ze-pathologic ezinjenge-bony mastoids kuma-margins ahlanganyelwe, i-cartilage degeneration, i-synonititis, ukugcwala okuhlangene, ukuvuvukala kwe-popliscal fossa, nokufafaza okungamazwi.

4. I-Magnetic Resonance imaging (MRI)

Lokhu kuhlola kusiza ukuthola ukulimala kwezicubu ezithambile, njengezinsimu, ama-tendon, i-cartilage nemisipha.

Ukuhlolwa kwelebhu: Uma udokotela esola ukutheleleka noma ukuvuvukala, ukuhlolwa kwegazi futhi kwesinye isikhathi i-arthrocentis °, inqubo esusa inani elincane lamanzi ahlanganayo elihlangene lokuhlaziywa kwedolo, lingadingeka.

12. Izimbangela ezijwayelekile zobuhlungu obuhlangene

1. Ukulimala okuhlobene

Ukulimala kwe-ligament njenge-anterior ne-posterior elukethe i-ligament kanye ne-latelial ligament ngohlobo nezinyembezi; Ukulimala kwe-Meniscus; I-Patellar TETONONITIS nezinyembezi; amathambo fractures nokunye.

2. Kuhlobene ne-Arthritis

I-Osteoarthritis ebangelwa ukugqokwa nokudabula i-cartilage ehlangene; I-Rheumatoid arthritis ibangelwa amasosha omzimba ahlasela amalunga; I-Gout ibangelwa ukwakheka kwamakristalu kusuka ku-uric acid ephezulu ethinta amalunga.

3. Ezinye izimbangela

I-Synovitis ibangela ubuhlungu obuhlangene nokuvuvukala; Izinkinga ze-Patellar njengokuhlanzeka kanye nokugqoka kwe-cartilage; ama-tumors ahlasela ukuhlangana; I-Edema ebangelwa ukuvuvukala, njll; ukuma okulungile okuhlala isikhathi eside; I-Iliotiotibial Fascia Syndrome ebangelwa ukungqubuzana okuphindaphindayo okuholela ezinhlungwini ngaphandle kwedolo.

13. Izindlela zokwelashwa ezivame ukusetshenziswa

Ukwelashwa okubonakalayo

-Rest kanye ne-braking

-Kwenza ama-compress ashisayo futhi ashisayo

-Redrug Therapy

I-Phristal Therapy

I-Exercise Therapy

-Ukusebenzisa kwamadivayisi asiza

2.Surgery

Ukuhlinzwa kwe -rthroscopic

-Arthroplasty

3.Kopha ukwelashwa

I-Chinese Chinese Chinese (TCM)

Ukwelapha