I-Epiphysiolysis yisimo se-hip esithinta intsha, ikakhulukazi abafana abangakafiki. Kuxhunyaniswa nokungajwayelekile kwe-cartilage ekhulayo, kuphumela ekusheleleni kwekhanda le-femur (i-superior femoral epiphysis) ngokuhlobene nentamo ye-femur. Ukwelashwa kokuhlinzwa kufanele kwenziwe ngokushesha ngangokunokwenzeka ukuze kugwenywe isiliphu esikhulu esingase sikhubaze. 

Incazelo

I-Epiphysiolysis yisifo se-hip esithinta izingane ezineminyaka engu-9 kuya ku-18, ikakhulukazi ngesikhathi sokukhula kwangaphambi kokuthomba. Kuphumela ekusheleleni kwekhanda le-femur (i-femoral epiphysis ephakeme kakhulu) ngokuhlobene nentamo ye-femur. 

Kulesi sifo, kukhona ukushoda kwe-cartilage yokukhula - ebizwa nangokuthi i-cartilage yokukhula - okuthi ezinganeni ihlukanise ikhanda nentamo ye-femur futhi ivumele ithambo ukuba likhule. Ngenxa yalokho, ikhanda le-femur litshekela phansi, emuva, futhi liye endaweni yoqwanga olukhulayo. 

Lokhu kunyakaza kungaba ngokushesha noma kancane kancane. Sikhuluma nge-acute epiphysiolysis lapho izimpawu ziqala ngokushesha futhi ziphushela ukubonisana esikhathini esingaphansi kwamasonto amathathu, ngezinye izikhathi kulandela ukuhlukumezeka, kanye ne-epiphysiolysis engapheli lapho zithuthuka kancane, ngezinye izikhathi phakathi nezinyanga. Amanye amafomu ashubile angaphinda avele esimweni esingalapheki.

Kunezimo ezithambile (i-engeli yokufuduka <30 °), emaphakathi (phakathi kuka-30 ° no-60 °) noma ezinzima (> 60 °) ze-epiphysis.

I-Epiphysis ihlangene - ithinta zombili izinqe - ku-20% yamacala.

Izimbangela

Izimbangela ze-femoral epiphysis azaziwa kahle kodwa cishe zibandakanya izici zemishini, amahomoni kanye ne-metabolic.

kwesifo

Lapho izimpawu nezici eziyingozi kubangela ukusola kwe-epiphysis, udokotela ucela i-X-ray ye-pelvis kusukela ngaphambili futhi ikakhulukazi ye-hip ephrofayilini ukuze athole ukuxilongwa.

I-biology ijwayelekile.

Ukuskena kungase ku-odwe ngaphambi kokuhlinzwa ukuze kuhlolwe i-necrosis.

Abantu abathintekayo

Imvamisa yamacala amasha ilinganiselwa ku-2 kuye ku-3 kwayi-100 eFrance. Awavamisile ukuthi aphathe izingane ezingaphansi kweminyaka engu-000 ubudala, i-epiphysis eyenzeka ikakhulukazi ngesikhathi sangaphambi kokuthomba, emantombazaneni aphakathi kweminyaka eyi-10 kanye naneminyaka ephakathi kuka-11 kubafana, abaneminyaka emibili kuya kwemine ubudala. okuphindwe kathathu okuthintekile.

Izici zengozi

Ukukhuluphala kwezingane kuyisici esiyingozi esiyingozi, njengoba i-epiphysis ivame ukuhlasela izingane ezikhuluphele eziphuza ukuthomba (i-adipose-genital syndrome).

Ingozi iyanda futhi ezinganeni ezimnyama noma izingane ezihlushwa ukuphazamiseka kwama-hormone njenge-hypothyroidism, ukuntuleka kwe-testosterone (hypogonadism), ukungasebenzi kahle kwe-pituitary (panhypopituitarism), ukuntuleka kwe-hormone yokukhula noma ngisho ne-hyperparathyroidism. okwesibili kuya kokuhluleka kwezinso.

I-Radiotherapy iphinde inyuse ingozi yokuphathwa yi-epiphysis ngokulingana nomthamo owamukelwe.

Okokugcina, izici ezithile ze-anatomical ezifana nokuguqulwa kwentamo ye-femoral, ebonakala ngama-kneecaps nezinyawo eziqondiswe ngaphandle, zingakhuthaza ukuqala kwe-epiphysis.

Ubuhlungu

Uphawu lokuqala oluyisixwayiso ngokuvamile ubuhlungu, obunamandla ahlukahlukene ukusuka kwesinye isihloko kuya kwesinye. Kungaba ubuhlungu bemishini ye-hip, kodwa ngokuvamile kakhulu futhi ayicacisi kakhulu futhi ikhanya endaweni ye-groin noma indawo yangaphambili yethanga nasemadolweni.

Ku-acute epiphysis, ukushelela ngokuzumayo kwekhanda le-femur kungabangela ubuhlungu obubukhali, ukulingisa ubuhlungu bokuphuka. Ubuhlungu abucaci ngendlela engapheli.

Ukonakala kokusebenza

Ubuqhwala buvame kakhulu, ikakhulukazi ku-epiphysis engapheli. Kukhona futhi ukujikeleza kwangaphandle kwe-hip okuhambisana nokuncipha kwe-amplitude yokunyakaza kwe-flexion, ukuthunjwa (ukuphambuka eksisi yomzimba endizeni yangaphambili) kanye nokujikeleza kwangaphakathi.

I-epiphysiolysis engazinzile yisimo esiphuthumayo, lapho ubuhlungu obunzima, ukulingisa ukuhlukumezeka, kuhambisana nokungabi namandla okusebenzayo, ngokungakwazi ukubeka unyawo.

Ukuziphendukela kwemvelo kanye nezinkinga

I-osteoarthritis yasekuqaleni iyinkinga eyinhloko ye-epiphysis engalashwa.

Ngenxa yokuphazamiseka kokujikeleza kwegazi, i-necrosis yekhanda lesifazane ivame ukwenzeka ngemva kokwelashwa kokuhlinzwa kwamafomu angazinzile. Kubangela ukuguqulwa kwekhanda lesifazane, umthombo we-osteoarthritis esikhathini esimaphakathi.

I-Chondrolysis ibonakala ngokubhujiswa kwe-cartilage ehlangene, okubangela ukuqina kwe-hip.

Ukwelashwa kwe-epiphysiolysis kuhlale kuhlinzwa. Ukungenelela kungenelela ngokushesha ngangokunokwenzeka ngemva kokuxilongwa, ukuvimbela ukushelela ukuba kungabi kubi kakhulu. Udokotela ohlinzayo uzokhetha indlela efanele ikakhulukazi ngokwezinga lokushelela, isimo esibucayi noma esingapheli se-epiphysiolysis kanye nokuba khona noma ukungabikho kwe-cartilage yokukhula.

Uma kwenzeka ukushelela kancane, ikhanda lesifazane lizomiswa endaweni ngokukrufulwa, ngaphansi kokulawulwa kwe-radiological. Kwethulwa entanyeni ye-femur, isikulufu sidlula ku-cartilage futhi sigcine ekhanda le-femur. Kwesinye isikhathi iphinikhodi ithatha indawo yesikulufu.

Lapho i-slippage ibalulekile, ikhanda le-femur lingabuyiselwa entanyeni. Ukungenelela okunzima kakhulu, ngokukhishwa kwe-hip ngokudonsa izinyanga ezingu-3, ​​kanye nengozi enkulu yezinkinga.

I-epiphysis ayikwazi ukuvinjelwa. Ngakolunye uhlangothi, ukuwohloka kokushelela kwekhanda le-femur kungagwenywa ngenxa yokuxilongwa ngokushesha. Izimpawu, ngisho noma zisesilinganisweni noma zingajwayelekile kakhulu (ukukhubazeka okuncane, ubuhlungu edolweni, njll.) ngakho-ke akufanele zishaywe indiva.