Fused toes: Ua thiab Kev Kho Mob

Yog vim li cas ib txhia me nyuam mos yug los fused toes? Yuav ua li cas li no pathology, thiab seb koj yuav tau tshem ntawm nws? Cov lus teb rau cov no thiab lwm cov lus nug txog cov hloov hais ntaub ntawv uas koj yuav kawm tau los ntawm qhov tsab xov xwm.

General ntaub ntawv hais txog cov pathology

Fused toes - ib tug congenital qis povtseg txoj kev loj hlob. Qhov no sib txawv yog yus muaj los ntawm feem los sis tag fusion ntawm ob los yog ntau tshaj cov ntiv tes. Nyob rau hauv kev kho mob xyaum, fused toes muaj ib tug tshwj xeeb lub npe - syndactyly.

Nrog tus kab mob no nyob rau hauv tib neeg tej zaum yuav ua tau ib tug fusion ntawm ob deformed thiab underdeveloped ntiv tes thiab kom tsim. Qhov tsim nyog ntawm syndactyly yog kev haumxeeb thiab kom hniav zoo nkauj tsis xws luag lub sab limb.

Cov me nyuam yaus nrog cov sib txawv yuav tsum nco ntsoov yuav tau sab laj ib tug geneticist thiab ib tug orthopedic kws phais neeg. Yuav kom muab lub hom syndactyly, yuav tsum tau nqa tawm X-ray ntawm ko taw. Kev kho mob ntawm no defect yog ua tau tsuas yog los ntawm kev phais. Nyob rau hauv cov ntaub ntawv no, lub ob fused toes yog sib cais thiab siv yas thiab kho raws kaw thaum tsim nyog kiag li.

Ib txhia txheeb cais

Syndactyly hu ua txawv txav kev loj hlob ntawm cov ntiv tes, uas yog ib tug ntawm ib tug ua txhaum cai ntawm txoj cai ntawm kev sib cais. Feem ntau, qhov no tshwm sim thaum lub sij hawm embryonic lub sij hawm.

Fused toes ntawm ib tug me nyuam mos liab nyob nrog ib zaus ntawm 1 mus rau 3000. Nws yuav tsum tau muab sau tseg hais tias syndactyly yog hais txog ib nrab ntawm tag nrho cov congenital anomalies. Tej ko taw pathology tej zaum yuav yog ib qho kev ywj deflection, thiab ua ke nrog rau lwm cov tsis xws luag (e.g., ntiv tes hypoplasia, polydactyly thiab polifalangiey, ectrodactyly, brachydactyly, brachioradialis synostosis, splitting ntawm txhuam, ulnar los yog radial clubhand thiab thiaj li nyob.).

Kwv yees li 60% ntawm cov me nyuam uas twb muaj ib tug fused ntiv taw (yees duab blemish nyob rau hauv no tsab xov xwm), yog txuam congenital txawv txav nyob rau hauv lub licas (xws li, pseudarthrosis, clubfoot, txawv txav nres installation, thiab lwm yam).

ua kom muaj tus kho raws

Yog vim li cas cov me nyuam tsim xws li ib tug vice, zoo li fused toes? Cov ua rau qhov no txawv yuav txawv. Kws txawj ntseeg tau hais tias nyob rau hauv 20% ntawm cov neeg no yog vim raws roj ntsha yam. Nyob rau hauv lwm yam lus, tag nrho cov txhaum ntawm ib tug autosomal hom qauv ntawm qub txeeg qub teg.

Yog hais tias ib tsev neeg keeb kwm ntawm syndactyly yog uas ploj lawm, nws yuav tsum tau lam xav hais tias ua txhaum ntawm ntau yam thiab tsim lub sab nqua ntawm lub fetus tshwm sim thaum lub sij hawm embryogenesis. Feem ntau qhov no tshwm sim thaum muaj tej yam ntawm ntau yam kev phiv yam.

Ib tug kho raws kev?

Yog vim li cas ob txhais ceg fused ntiv tes, thiab yuav ua li cas los mus piav qhia xws li ib tug povtseg txoj kev loj hlob? tus menyuam hauv plab ko taw tab tshwm sim nyob rau sis thib 5 ntawd lub lim tiam ntawm intrauterine txoj kev loj hlob. Nws yog nyob rau ntawm lub sij hawm nyob rau hauv lub fetus yuav tsim physiological syndactyly.

Nyob rau hauv lub qhaj ntawv ntawm ib tug kho raws twb nyob rau hauv lub 7 lub lim tiam ntawm cov ntiv tes yog tsim. Qhov no yog vim txoj kev loj hlob ntawm cov ntiv tes sab thiab qeeb txoj kev loj hlob ntawm interdigital tej qhov chaw. Yog hais tias cov yuav txo tau ntawm lub interdigital phab ntsa lawm, ces tus Phalanx yog tsis cais, uas yog, muaj yog syndactyly.

Tau ua txawv txav kev loj hlob

Fused toes, tus me nyuam yuav tshwm sim nyob rau hauv tshuaj lom los ntawm lub cev ntawm ib tug cev xeeb tub poj niam. Nyob rau hauv feem ntau qhov no tshwm sim thaum lub sij hawm noj tshuaj, haus dej haus cawv, raws li zoo raws li unfavorable ecology, nta profession, X-ray irradiation thiab kis kab mob (e.g., mob khaub thuas, syphilis, tuberculosis, etc.).

Feem ntau cov ua yug ntawm ib tug me nyuam nrog syndactyly nyob twj ywm tsis meej.

Fused toes - nws yog feem ntau pom defect tsis pub dhau lub qauv ntawm chromosomal thiab kev tshuaj ntsuam genetic syndromes.

Los ntawm txoj kev, yog heev tsis tshua muaj pom nyob rau hauv tib neeg mas yuav kis tau syndactyly. Feem ntau, xws li ib tug pathology tshwm sim tom qab ko taw kub nyhiab (thermal los yog tshuaj).

Fused toes - uas txhais tau tias qhov no pathology?

Muaj coob tus neeg uas muaj kev koom nyiam paub tsis meej, nws yog ntseeg hais tias qhov no pathology npaj tsis yog. Nws yog ntseeg hais tias qhov no hom ntawm kev hloov yog diabolical. Tseeb, fused ntiv tes yog heev reminiscent ntawm cov ko taw.

Txawm li cas los, cov kws kho mob hais tias tsis muaj dab tsi coj txawv txawv thiab txaus ntshai nyob rau hauv uas tus taw yog tsis loj hlob. Qhov no yog cia li ib tug anomaly povtseg, los ntawm uas yog heev yooj yim uas yuav tau tshem ntawm, tshwj xeeb tshaj yog nyob rau hauv thaum ntxov ua sawv ntawm ib tug me nyuam lub neej.

Yog li ntawd tsis txhob txhawj npaum li ntawd yog hais tias koj fused cov ntiv taw. Yuav ua li cas yog tias txhais li cas, koj yuav hais tias tsuas yog ib lub kws kho mob, tsis yog ib tug diabolical lovers ntawv.

kev faib uas tsis xws luag

Nyob rau hauv orthopedics syndactyly qhab-nees raws li qhov ntev, lub hom leeg, raws li zoo raws li lub xeev ntawm cov ntiv tes.

Tam sim no txawv:

• pob txha puab (thaum cov pob txha ntev tshwm sim);
• nqaij mos daim ntawv (tej zaum membranous thiab daim tawv nqaij).

defect kev faib ntev nyob rau hauv lub xov tooj thiab ntev ntawm phalanges fused leeg.

Hais txog lub xeev ntawm fused ntiv tes, lub syndactyly no yuav nyuaj thiab yooj yim. Nyob rau hauv lub caij nyoog kawg no cov ntaub ntawv muaj ib tug fusion ntawm lub cev ntiv tes, thiab nyob rau hauv thawj - nrog kev txawv txav ntawm cov pob txha, sib koom tes, txog leeg los yog ligament apparatus.

kev tshuaj ntsuam genetic hom

Syndactyly txwv kom muab zais thiab kev tshuaj ntsuam genetic hom:

• Tus thawj hom - zigodaktiliya. Feem los sis tag fusion (membranous) 2 thiab thib 3 ntiv taw xoo. Tsis tas li ntawd tsis kav tawm lwm webbed ntiv tes.
• Qhov thib ob hom - sinpolidaktiliya. Fusion ntawm 4 thiab 5 toes nrog ib tug doubling sis thib 5 ntawd. Rau no pathology yog yus muaj los ntawm: ib tug ua txhaum ntawm reliefs tawv qab xib taws thiab hypoplasia ntawm nruab nrab Phalanx.
• Qhov thib peb hom. Ob sab sib dho tag syndactyly ntawm 4 thiab 5 tug ntiv tes. Nyob rau hauv cov ntaub ntawv no, tus taw yog tsis cuam tshuam.
• Qhov thib plaub hom - syndactyly Sawb. Tag nrho ob sab sib dho cutaneous syndactyly txhais tes. Nyob rau tib lub sij hawm yog tsis muaj nres tsis tau.
• Lub tsib hom. Merge metatarsal thiab metacarpal cov pob txha. Nyob rau hauv ob txhais tes yog ntau 3-4 fusion ntawm cov ntiv tes thiab lub taw - 2 thiab 3.

kho raws cov tsos mob

Thaum syndactyly ntawm tus taw nyob rau hauv ib tug me nyuam yog feem ntau feem ntau pom fusion ntawm lub 2nd thiab 3rd cov ntiv taw. Nyob rau tib lub undivided Phalanx yuav tsum yog underdeveloped los yog tsim feem ntau sib xws. Nyob rau hauv tej rooj plaub, muaj yog ib tug txo nyob rau hauv lub xov tooj ntawm cov ntiv tes, vim hais tias ntawm lawv cov amniotic amputation.

Tsis zoo li cov me nyuam nrog syndactyly nyob rau hauv lub ob txhais tes ntawm cov me nyuam nrog syndactyly ntawm tus taw tsim heev feem ntau. Lawv muaj tsis muaj teeb meem nrog rau cov kev siv ntawm ib tug ntau ntawm kev ua. Nyob rau hauv no haumxeeb tsis muaj peev xwm ntawm tus taw tsis hamper lawv cov kev tshawb fawb, raws li zoo raws li luag yeej tsis txwv cov kev xaiv ntawm yav tom ntej hauj lwm.

Yuav ua li cas rau kev tshawb nrhiav?

Yuav ua li cas rau kev tshawb nrhiav fused ntiv taw (ib tug kos npe rau hais tias xws li kev kho raws tau piav saum toj no cia)? Syndactyly kuaj neonatologist tam sim ntawd tom qab yug me nyuam ntawm tus me nyuam. Ntxiv kev soj xyuas tus me nyuam yog nqa xyuas orthopedics los yog kev phais. Yuav kom tshem tawm chromosomal thiab noob txawv txav yuav kev cob cog rua thiab ib tug geneticist.

Txawm tias muaj tseeb hais tias xws li ib tug mob yog ua tom qab ib tug kev soj ntsuam hais hom kev kho raws, raws li zoo raws li cov kev loj hlob ntawm kev kho mob zoo, nws yog tsim nyog los ua kev cai ib txoj kev tshawb no lub cuab tam.

Radiography ko taw nyob rau hauv ob qhov tso cai ua hauj lwm los laij rau tus ceev ntawm cov pob txha, ob leeg noj qab haus huv, qhov ntev thiab muaj cov pob txha fusion. Yuav kom qhia tau tias cov yam ntxwv ntawm cov ntshav txaus thiab leeg tshav network nyob rau hauv tus ntiv tes ua UZDG, reovasography, angiography thiab hluav taws xob pas ntsuas kub.

kab mob kev kho mob

Yog muaj ib tug kho fused toes? Lag luam cais cov phalanges - qhov no yog tsuas tau cov kua. Txawm li cas los, nws yuav tsum tau muab sau tseg tias txoj kev phais no yog siv tsuas yog thaum syndactyly ntawm tus ntiv tes. Hais txog fused phalanges tsis txhob, ces lub lag luam yog tsis muaj. Yog hais tias xws abnormality tes nrog rau tej kev taug kev, cov kev pab yog tseem nqa tawm.

Thaum lub lag luam yog yuav mus nyob rau?

Cov ntsiab lus uas thiab tus qauv ntawm kev phais kev pab yog muab raws li qhov xwm thiab zoo ntawm lub defect. Lub hom phiaj ntawm qhov kev kho no yog los tshem tawm qhov kom hniav zoo nkauj kho raws, raws li zoo raws li kev txhim kho cov kev ua ntawm tus taw los yog txhais tes.

Lub zoo sij hawm rau lub lag luam - muaj hnub nyoog ntawm 4-5 xyoo. Yog hais tias ib tug me nyuam mos liab muaj cai syndactyly kawg, cov kev pab yog nqa tawm nyob rau hauv lub thib ob ib nrab ntawm nws lub neej. Qhov no tiv thaiv deformation ntawm ob tug ntiv tes thiab sis tsis ncaj txoj kev loj hlob ntawm lub phalanges.

phais le caag

Thaum lub sij hawm kev phais haujlwm hauv qab no le caag yuav siv tau:

• sib cais ntawm conjoined ntiv tes ntawm daim tawv nqaij plasty nrog rau hauv zos ntaub so ntswg;
• membranous sib cais leeg skinless yas;
• fused sib cais ntiv tes, uas yog complemented los ntawm lub neej coj siv ntawm daim tawv nqaij grafting nrog dawb autografts thiab lub zos ntaub so ntswg;
• sib cais ntawm conjoined ntiv tes, uas yog complemented los ntawm free daim tawv nqaij grafting polnosloynym los yog phua daim tawv nqaij graft;
• multistage cuam nrog txog leeg-leeg, daim tawv nqaij thiab pob txha grafting.

Lub postoperative lub sij hawm

Tom qab muab hlais tawm lawm rau immobilize lub sib cais ntiv tes rau ntawm ib tug povtseg kom ib tug tshem tau plaster txheem. Nws yog pom zoo kom coj tsawg kawg yog 3-4 lub hlis.

Kwv yees li 15 hnub tom qab lub lag luam pib rau tus neeg mob lub rov qab. Ua li no, siv cov massage ob txhais tes los yog taw, qoj ib ce kho, phonophoresis nrog Lydasum, hluav taws xob stimulation ntawm cov leeg ntawm cov ntiv tes, ozokerite, paraffin thiab av nkos ntaub yas.

Cov tshwm sim ntawm lub lag luam

Txoj kev siv nyob rau hauv niaj hnub phais kho mob ntawm syndactyly muab zoo kom hniav zoo nkauj thiab ua haujlwm zoo tau. Nrog raws sij hawm kev pab no yog kom rov qab los tsis tau tsuas yog cov ib txwm qauv, tab sis kuj txhuam muaj nuj nqi ntawm ko taw.

Phais kom tshem tawm syndactyly yog kev vam meej yog hais tias tus neeg mob twb tsis muaj zawm nti thiab sab deformity ntawm cov ntiv tes, thiab muaj ib tug tag nrho cov ntau yam ntawm cov lus tsa suab nyob rau hauv interphalangeal ob leeg (adduction, abduction, extension thiab flexion), niag cov nuj nqi (nyob rau hauv cov ntaub ntawv ntawm tus txhuam), zoo rhiab heev thiab tej yam ntuj tso daim ntawv rau tej qhov chaw ntawm lub toes.

Yog hais tias cov kev kho mob ntawm syndactyly txiav txim siab tsis mus nqa tawm, nws yuav muaj ib tug tsis zoo feem nyob rau txoj kev loj hlob thiab kev loj hlob ntawm tus me nyuam nqua.