Nhazi na ọgwụgwọ nke ikpere tenis

Nkọwa nke mpụta epicondylitis nke humerus

A makwaara dị ka ikiaka tenis, eriri akwara nke akwara extensor carpi radialis, ma ọ bụ ịgbatị ebe mgbakwunye nke akwara extensor carpi, brachioradial bursitis, nke a makwaara dị ka ọrịa epicondyle mpụta. Ọrịa aseptic traumatic nke anụ ahụ dị nro gbara gburugburu epicondyle mpụta nke humerus n'ihi nnukwu mmerụ ahụ na-adịghị ala ala..

pathogenesis

Ọ nwere njikọ chiri anya na ọrụ, ọkachasị ndị ọrụ na-atụgharịkarị aka n'ihu wee gbatịa ma na-atụgharị ikpere na nkwonkwo aka. Ọtụtụ n’ime ha bụ ndị nwunye ụlọ, ndị ọkwá nkà, ndị na-akpụ brik, ndị na-akpa ákwà, ndị na-akụ pọmbụ, na ndị na-eme egwuregwu.

Dngalaba

Ihe ndị a ma ama n'akụkụ abụọ nke njedebe ala nke humerus bụ medial na mpụta epicondyles, medial epicondyle bụ njikọ nke akwara nkịtị nke akwara na-emegharị ahụ nke ihu, na epicondyle nke dị n'akụkụ bụ njikọ nke nkwonkwo nkịtị nke akwara extensor nke ogwe aka. Ebe mmalite nke uru ahụ brachioradialis, gbatịa aka ya ma na-agbapụta ntakịrị. Ebe mmalite nke extensor carpi radialis longus, extensor carpi radialis brevis muscle, extensor digitorum majoris, extensor digitorum propria nke obere mkpịsị aka, extensor carpi ulnaris, muscle supinator.

Pathogen

Nmalite nke condyle bụ n'ihi nnukwu mgbaka na ịgbatị, ma ọtụtụ ndị ọrịa na-amalite ngwa ngwa na n'ozuzu ha enweghị akụkọ ihe mere eme doro anya nke trauma, ọ na-adịkarịkwa na ndị okenye bụ ndị ọ dị mkpa ka ha na-atụgharị aka ugboro ugboro ma gbatịa nkwojiaka ike. Enwere ike ịgbatị ya ma ọ bụ gbatịa ya n'ihi mgbatị azụ azụ nke nkwonkwo nkwojiaka ugboro ugboro na oke mgbatị nke akaị aka aka na mgbakwunye nke mpụta epicondyle nke humerus mgbe ọkpọ ya nọ n'ọnọdụ mpụta.

Pnkà mmụta ọgwụ

1.Due ka ugboro ugboro mmerụ ahụ, mpụta epicondyle nke muscle eriri na-adọwa na hemorrhage, na-akpụ a subperiosteal hematoma, na mgbe ahụ na-ahazi na ossifying, na-akpata periosteitis na ọkpụkpụ hyperplasia nke mpụta epicondyle nke humerus (kasị n'ụdị a nkọ onu nodule). Nnyocha anụ ahụ nke pathological biopsy bụ hyaline degeneration ischemia, ya mere a na-akpọkwa ya ischemic mbufụt. Mgbe ụfọdụ, ọ na-esonyere ya na akwa akwa nke akpa nkwonkwo, na akpụkpọ anụ synovial nke nkwonkwo na-amụba ma na-agbakọta n'ihi mkpali ogologo oge site na akwara.
2.Adọka na ebe mgbakwụnye akaịnụ. 
3.traumatic mbufụt ma ọ bụ fibrohistolitis nke annular ligament. 
4. bursitis nke nkwonkwo brachioradial na extensor nkịtị akwara.
5.Mbufụt nke synovium nke humerus na radial nkwonkwo kpatara site na intercalation nke humerus na obere isi nke radius.
6. Ntụrụndụ nke ligament humerioradial na nkewa dị nro nke nkwonkwo radial-ulnar proximal nwekwara ike ime, na-ebute nkwụsị nke isi cephalic radial. Mgbanwe ndị a na-ahụ maka ọrịa nwere ike ịkpata spasms muscle, mgbu mpaghara, na-egbukepụ mgbu site na akwara nkwoji aka gbatịa ruo n'ihu.

Ngosipụta ụlọ ọgwụ

1.Mgbu dị n'èzí nke nkwonkwo ikpere na-akawanye njọ mgbe pronation, karịsịa mgbe a na-atụgharị azụ ndọtị, ebuli, ịdọrọ, agwụcha, ịkwanye na omume ndị ọzọ, na radiating ala tinyere nkwojiaka extensor muscle. Na mmalite, m na-enwekarị mgbu na adịghị ike na akụkụ ahụ merụrụ ahụ, ma jiri nwayọọ nwayọọ na-enwe ihe mgbu n'èzí nke ikpere ụkwụ, nke na-akawanye njọ na mmụba nke mmega ahụ. (Ụdị mgbu ahụ bụ mgbu ma ọ bụ tingling)
2.Ọ na-akawanye njọ mgbe a rụsịrị ọrụ na ahụ efe mgbe ezumike.
3.Forearm ntụgharị na adịghị ike na-ejide ihe, na ọbụna ịda na ihe.

Ihe ịrịba ama

1.Lateral humeral epicondyle The posterolateral akụkụ nke mpụta epicondyle nke humerus, ohere nke humeral-radial nkwonkwo, cephalic cephalic na mpụta nsọtụ nke radial olu condyle nwere ike palpated, na musculosis na anụ ahụ anụ ahụ na radial n'akụkụ nke elu forelpared na-enwekwa ike bed nro. Mgbe ụfọdụ, a na-enwe mmetụta dị nkọ nke hyperostosis na mpụta epicondyle nke humerus, ha dịkwa nro.
2.The Mills ule dị mma. Tụgharịa aka gị ntakịrị wee mee ọkara ọkpọ, gbatịa nkwojiaka gị ka o kwere mee, wee gbasaa ogologo ihu gị nke ọma wee gbatịa ikpere gị. Ọ bụrụ na ihe mgbu na-eme n'akụkụ akụkụ nke nkwonkwo brachioradial mgbe a na-agbatị ikpere aka, ọ dị mma.
3.Positive extensor resistance test: onye ọrịa ahụ kechie aka ya ma na-atụgharị aka ya, onye nyocha wee jiri aka ya pịa azụ aka onye ọrịa ahụ iji mee ka onye ọrịa na-eguzogide nguzogide ma gbatịa nkwojiaka, dị ka ihe mgbu dị n'èzí nke ikpere ụkwụ dị mma.
Nyocha 4.X-ray nwere ike na-egosi mgbe ụfọdụ periosteal irregularity, ma ọ bụ ọnụ ọgụgụ dị nta nke calcification ihe n'èzí periosteum.

Ọgwụgwọ

Ọgwụgwọ nchekwa nchekwa:

1. Kwụsị ọzụzụ mkpali mpaghara n'oge, na ụfọdụ ndị ọrịa nwere ike nweta ahụ iru ala site na izu ike ma ọ bụ plasta immobilization condyle.
2.Ọhịa ịhịa aka n'ahụ, na-eji usoro ịkụgharị na ịhịa aka n'ahụ na-ebelata spasm na mgbu mgbu nke akwara extensor nke ogwe aka, wee jiri usoro nrụgide na igwakorita na mpụta epicondyle nke humerus na ihe mgbu dị nso.
3. Ọgwụgwọ Tuina, onye ọrịa na-anọdụ ala. Dọkịta na-eji nwayọọ na-atụgharị na igwakota agwa na-eme ihe n'azụ na n'èzí n'ikpere aka ma na-emegharị n'akụkụ azụ nke ọkpọ ya. Dọkịta na-eji n'ọnụ isi mkpịsị aka pịa ma na-ete Ah Shi (mpụta epicondyle), Qi Ze, Quchi, Hand Sanli, Waiguan, Hegu acupoint, wdg Onye ọrịa ahụ nọ ọdụ, dọkịta na-ewepụkwa ebe mmalite nke onye ọrịa nke extensor carpi na extensor carpi longus na brevis radialis. Dọrọ na gbatịa, ndụ nku aka. N'ikpeazụ, jiri usoro ịhịa aka n'ahụ ahụ wee kpoo epicondyle mpụta nke ikiaka na akwara extensor nke ogwe aka, a na-ejikwa okpomọkụ dị n'ógbè ahụ ruo ogo.
4. Ọgwụgwọ ọgwụ, ọnụ na-abụghị steroidal mgbochi mkpali ọgwụ na nnukwu ogbo.
5. Ọgwụgwọ na-adịghị ahụkebe: glucocorticoids (dị ka ọgwụ betamethasone injection) na-agbanye n'ime ebe dị nro ma tinye ya n'ime ebe ntinye aka aka na oghere subaponeurosis (ihe na-erughị ma ọ bụ hà nhata 3), nke nwere ike ịme ihe mgbochi mkpali na analgesic mmetụta, na compound betamethasone na ropivacaine ma ọ bụ ngwa ngwa ghọtara dị ka levoacting ugbu a. elu mgbochi mkpali titer, na kasị dịrị nchebe, ogologo oge igbochi, kacha nta nsi mmeghachi omume na kasị ala mgbu rebound ndakọrịta ọgwụ maka occlusion mpaghara.
6. Ọgwụgwọ acupuncture, mbepụ ahụ dị nso n'elu ọkpụkpụ iji kpochapụ anụ ahụ dị nro nke dị n'akụkụ usoro ọkpụkpụ, dredge muscle wrist extensor, extensor muscle muscle common tendon na supinator, ma wepụ mma ahụ n'echiche nke ịdị nro. Ọgwụgwọ ịwa ahụ: dabara adaba maka ndị ọrịa na-anabataghị ọgwụgwọ mgbanwe.

1. Usoro ahụ & Meleod, ọrụ ahụ na-agụnye ihe fọrọ nke nta ka ọ bụrụ anụ ahụ niile nke ọnya ahụ, gụnyere nkwụsị nke 2mm mpụta epicondyle, ntọhapụ nke mmalite nke mgbatị ahụ nkịtị, akụkụ akụkụ nke akụkụ nke njedebe nke nso nso nke eriri afọ, ntinye nke humeroradial nkwonkwo n'ime synovgranous ma ọ bụ subten anụ ahụ.

2. Usoro Nischl, eriri anụ ahụ na-emekarị na ọkpụkpụ carpi longus radialis na-ekewa ogologo ogologo oge, a na-ekpuchi ọkpụkpụ anụ ahụ dị omimi nke carpi radialis brevis, a na-ewepụ ihe ntinye n'etiti etiti epicondyle mpụta, a na-ekpochapụ anụ ahụ na-emebi emebi, akụkụ nke ọkpụkpụ azụ ma ọ bụ ọkpụkpụ azụ na-ewepụ ya n'ihu. arụgharịrị n'ọkpụkpụ. A naghị akwado itinye aka n'intra-articular.

Prognosis

Usoro nke ọrịa ahụ dị ogologo ma na-adịkarị mfe ịmaliteghachi.

Note

1.Lezienụ anya ka ị na-ekpo ọkụ ma zere oyi;
2.Reduce pathogenic ihe;
3.mmega ahụ na-arụ ọrụ;
4. N'ọnọdụ dị oke njọ, usoro ahụ kwesịrị ịdị nwayọọ, na usoro ọgwụgwọ ahụ kwesịrị iji nwayọọ nwayọọ na-akawanye njọ maka ndị na-arịa ọrịa ogologo oge, ya bụ, usoro ahụ kwesịrị ịdị nro na nke siri ike, nke siri ike na ịdị nro, na ịdị nro na ịdị nro kwesịrị ijikọta.