Ngenxa yethonya lezici ezihlukahlukene, ukubhujiswa kwezicubu ze-pelvic kanye nekhanda lesifuba nesifuba kwenzeka. Ihambisane nezinqubo ezishisa ukuguga-dystrophic, lapho ama-osteophyte (ama-outgrowths) akha khona futhi i-arthrosis iqala. Lesi sifo, i-aseptic necrosis yekhanda le-femur, ngokuhambisana nesiteji sokufa kwezicubu, ingaholela emiphumeleni eyingozi, kuze kube sekukhubazekeni.
Izimbangela ze-aseptic necrosis yenhloko yesifazane wesobunxele noma kwesokudla
I-pathology echazayo ye-bone tissue iqala lapho inhlanganisela yezici eziningana zibalulwe ngezansi:
- ukwamukelwa kwe- corticosteroids ;
- ukulimala komshini wokuhlanganiswa kwe-hip;
- ukwephula izinqubo zokushintshanisa;
- ukuvezwa kwemisebe ye-ionizing;
- ukuphathwa kabi kotshwala;
- i-sickle-cell anemia;
- i-pancreatitis;
- i-bone disease;
- ukugcwala okuqhubekayo kokuhlanganiswa kwe-hip;
- izifo zesistimu yemisipha.
Uma ungeke ukwazi ukubona imbangela yalesi sifo, kubhekwa njenge-idiopathic.
Izimpawu ze-aseptic necrosis yenhloko yesifazane
Izimpawu eziyinhloko zesifo:
- i-atrophy yezicubu ezithambile nemisipha ye-hip;
- isifo sobuhlungu;
- ukudlulisela iningi lomthwalo emlenzeni onempilo;
- ukwehla ukuhamba kwejoyina.
Futhi, inkambo ye-aseptic necrosis yenhloko yesifazane ixhomeke esiteji sayo, kunezine kuphela zazo:
- Ezigaba zokuqala zesifo lesi sifo umuntu uzizwa ebuhlungu obukhulu, obonakala ngokuzikhandla ngokomzimba futhi angabuyiselwa emuva. Ngesikhathi esifanayo, ukuphakama okujwayelekile okuhambayo ekudleni okuhlangene, isisindo somzimba sisatshalaliswa ngokufanayo emilenzeni yomabili.
- Isigaba sesibili sibonakala ngokuqiniswa kobuhlungu be-syndrome, obuhlala unomphela. Ngenxa yalokho, ukuhamba kwesibambisene kunciphisa, isiguli sizama ukulayisha umlenze okalimele, okubangela i-atrophy ebalulekile emisipha ye-hip.
- Isigaba sesithathu sihambisana nobuhlungu obukhulu, okwenzeka ngisho nangaphansi kwemithwalo encane. Ngenxa yalokhu, umsebenzi we-joint we-joint uhlahloka, uhloniphekile futhi u-atrophy wemisipha hhayi nje kuphela kwethanga, kodwa futhi ne-shin. Ngezinye izikhathi ukunciphisa umlenze osondayo kubonakala ngokuphawulekayo.
- Esigabeni sesine, ukukhubazeka kubangela ukubhujiswa okuphelele kwetincuba zamathambo, umuntu akakwazi ukuhamba ngaphandle kosizo noma ukulungiswa okukhethekile.
I-X-ray ku-aseptic necrosis yenhloko yesifazane
Ukuhlolwa kwe-X-ray yiyona ndlela yokufundisa nokuqonda okunembile kakhulu.
Lezi zithombe zibonisa ngokucacile izindawo ze-necrosis nethambo elingavamile noma elinyanyisiwe ekuhlanganyeleni kwesifazane, ikhanda elingenalutho, izinguquko ekujuleni kwesigxobo se-femur, ama-osteophyte angaphakathi. Ngenxa ye-X-ray, ungakwazi ukunquma ngokunembile isigaba sesifo.
Izindlela zokuxilonga ezengeziwe:
- I-Podography;
- ukulinganisa kokusekela kanye nemigomo yokuhamba;
- I-MRI;
- incazelo yomshoshaphansi we-intraosseous.
Ukwelashwa nokulungiswa okuhlinzekwa kwe-aseptic necrosis yekhanda lesifazane
Indlela edidiyelwe ekwelapheni ukwelashwa okubhekwe ngayo kanje:
- Ukuzivocavoca kwezokwelapha nokuhambisana nemigomo yamazinyo. Ukucindezeleka okulinganiselwe kokuhlanganyela okuthintekile kuboniswa.
- Ukulungiswa kokuhamba. Ukunconywa kagesi okukhulunywe ngokukhethekile.
- Ukwelapha izidakamizwa. I-Vascular (i-Kurantil), ukukhulisa ubuhlungu (i-Ibuprofen), izimbonisi (i-Rumalon, i-Mukartrin), abalawuli
i-calcium metabolism (i-Alfacalcidol ne-Xidiphon). - Ukunciphisa ukuxhuma ngokuvimbela isikhathi eside (i-autograft inhlanganisela noNovokain, i-Kurantil).
- Izifo zangaphakathi. I-vitreous ene-oxygen isetshenziswa.
Okubalulekile kanye ne-physiotherapy ye-aseptic necrosis yenhloko ye-femer - laser, magnetic, EHF.
Uma uhlelo lwezokwelapha olwethulwe lungasebenzi, ukungenelela kokuhlinzekwa kunqunywe:
- i-osteotomy yokujikeleza;
- i-autoplasty yekhanda lesifazane lehlobo le-subchondral.