Wāwae ʻōkū

I loko o ka wāwae ʻōwili, ua kuhikuhi ʻia ka mua o ka wāwae i lalo a i loko. Eia kekahi, hiki ke hoʻokiʻekiʻe ʻia ka ʻāʻī a huli ʻia ka kuʻekuʻe i loko. Hoʻopaʻa mau ʻia ka wāwae i kēia kūlana. Me ka ʻole o ka mālama, hiki i ke keiki ke hele ma ka ʻaoʻao a i ʻole ka luna o ka wāwae.

Ho'ākāka ka wāwae ʻōwili i kahi kūlana i loaʻa i ka hānau ʻana i loko o kahi mea hānau ʻia ka wāwae o ke pēpē i kuhikuhi ʻia i lalo a i loko. ʻO nā pūnaewele e hoʻopili ana i nā ʻiʻo i ka iwi i kapa ʻia he tendons. I loko o ka wāwae ʻōwili, ʻoi aku ka pōkole o nā tendons ma mua o ka maʻamau, e huki ana i ka wāwae mai ke kūlana.

I kapa ʻia hoʻi ʻo congenital talipes equinovarus (TAL-ih-peez e-kwie-no-VAY-rus), he kūlana wāwae maʻamau ka wāwae ʻōwili. Hiki ke loaʻa i kahi 1 i 1,000 mau pēpē. ʻAʻohe mau kūlana olakino ʻē aʻe i ka hapanui o nā pēpē hou me ka wāwae ʻōwili.

Hiki i ka wāwae ʻōwili ke māmā a i ʻole koʻikoʻi. Ma kahi o ka hapalua o nā keiki me ka wāwae ʻōwili, loaʻa iā lākou ma nā wāwae ʻelua. Inā loaʻa i ke keiki ka wāwae ʻōwili i mālama ʻole ʻia, hiki i ke keiki ke hele ma ka ʻaoʻao a i ʻole ka luna o ka wāwae. Hiki i kēia ke hana i ka ʻeha, nā ʻeha ʻili a i ʻole nā ​​calluses, a me nā pilikia i ka wā e komo ai i nā kāmaʻa.

ʻAʻole e maikaʻi ka wāwae ʻōwili me ka ʻole o ka mālama. Akā hiki ke mālama maikaʻi ʻia me ka hoʻohana ʻana i kahi ʻano kālai kūikawā. Ma ke ʻano maʻamau, pono pū nā pēpē i kahi kaʻina hana liʻiliʻi e hoʻolōʻihi i ka tendon kuʻekuʻe. ʻOi aku ka maikaʻi o nā hopena mālama me ka kālai ʻana e hoʻomaka i loko o kekahi mau pule ma hope o ka hānau ʻana.

Inā loaʻa i kāu keiki ka wāwae ʻōʻili, eia ka mea e like paha me ia: ʻO ka piko o ka wāwae e kuhikuhi pinepine ʻia i lalo a i loko. Hoʻokiʻekiʻe kēia i ka ʻāʻī a huli i ka kuʻekuʻe i loko. Hiki ke huli nui ʻia ka wāwae a like me ka huli ʻana i luna. Hiki paha ke pokole iki ka wāwae a i ʻole ka manamanalima ma mua o ka wāwae ʻē aʻe. ʻO nā ʻiʻo bipi ma ka wāwae me ka wāwae ʻōʻili e liʻiliʻi pinepine. I ka hānau ʻana, ʻaʻole e hoʻoulu i kekahi ʻeha a i ʻole ʻeha ka wāwae ʻōʻili. E ʻike paha kāu kauka mālama ola i ka wāwae ʻōʻili i ka wā o kahi hoʻokolokolo ma hope koke o ka hānau ʻana o kāu keiki. Hiki paha ke kuhikuhi ʻia ʻoe i ke kauka e kūikawā ana i nā kūlana iwi a me nā ʻiʻo i nā keiki i kapa ʻia he kauka orthopedic pediatric.

Loaʻa paha i kāu kauka mālama ola ke ʻike i ka wāwae ʻōpala i ka wā o ka nānā ʻana ma hope koke o ka hānau ʻana o kāu keiki. Hiki paha ke kuhikuhi ʻia ʻoe i ke kauka akamai i nā kūlana iwi a me nā ʻiʻo o nā keiki i kapa ʻia ʻo ke kauka ʻoki orthopedic pediatric.

ʻAʻole maopopo ke kumu o ka wāwae ʻōʻili, akā, he mea paha ia i nā kumu kūlohelohe a me nā mea pili i ke kaiapuni.

ʻOi aku ka nui o ka nui o nā keikikāne ma mua o nā kaikamahine i loaʻa ka clubfoot ma kahi o ʻelua mau manawa.

ʻO nā mea pilikia kekahi:

• Mōʻaukala ʻohana. Inā loaʻa i ke keiki ka makua kāne, ke kaikuaʻana a i ʻole ka kaikuaʻana me ka clubfoot, ʻoi aku ka nui o ka loaʻa ʻana i ke keiki.
• Māhele o nā kūlana ʻē aʻe. I kekahi manawa, hiki ke loaʻa ka clubfoot me nā kūlana iwi ʻē aʻe i loaʻa i ka wā hānau. Hoʻokahi laʻana, ʻo ia ka spina bifida, kahi kūlana e hana ai i ka wā e ulu ʻole ai a pani pono ʻole paha ke kua a me ke kua i mua o ka hānau ʻana. Hiki i kekahi mau kūlana e pili ana i nā loli i nā chromosomes ke hoʻonui i ka pilikia o ka clubfoot.
• Kaiapuni. Hiki i ka puhipaka i ka wā hāpai ke hoʻonui i ka pilikia o ke keiki i ka clubfoot.
• ʻAʻohe wai amniotic lawa i ka wā hāpai. ʻO ka wai amniotic ka wai e hoʻopuni ana i ke keiki i loko o ka ʻōpū. ʻO ka nele o ka wai amniotic lawa ke hoʻonui i ka pilikia o ka clubfoot.

ʻO ka wāwae ʻōʻiliʻili maʻamau ʻaʻole ia e hoʻoulu i kekahi pilikia a hiki i ka wā e hoʻomaka ai ke keiki e kū a hele. Hiki i ka mālama ke lawe mai i ka wāwae i ka kūlana kūpono a kōkua i ke keiki e hele maikaʻi. Akā, hiki i ke keiki ke loaʻa mau kekahi pilikia me:

• Neʻe. Hiki i ka wāwae ke liʻiliʻi iki a ʻaʻole e kulou maʻalahi.
• Lōʻihi o ka wāwae. Hiki i ka wāwae me ka wāwae ʻōʻiliʻili ke pōkole iki, akā ʻaʻole kēia e pale aku i ke keiki mai ke aʻo ʻana e hele.
• Nui o nā kāmaʻa. Hiki i ka wāwae ke hiki i ka 1 1/2 nui o nā kāmaʻa ma mua o ka wāwae ʻē aʻe.
• Nui o ka ʻiʻo pipi. Hiki i nā ʻiʻo o ka pipi ma ka ʻaoʻao me ka wāwae ʻōʻiliʻili ke liʻiliʻi mau ma mua o nā mea ma ka ʻaoʻao ʻē aʻe.
• ʻAno o ka wāwae. He mea maʻamau no ka wāwae ke loaʻa i kahi ʻano pīni a me kahi kiko liʻiliʻi i loko, ʻoiai ma hope o ka mālama.

Inā ʻaʻole i mālama ʻia ka wāwae ʻōʻiliʻili, hiki i nā pilikia ʻoi aku ka nui ke hana. Hiki i kēia ke komo:

• Nā pilikia hele. I ka wā ʻaʻole i mālama ʻia ka wāwae ʻōʻiliʻili, hiki i nā keiki me ke kūlana ke hele akā hiki iā lākou ke kau i ko lākou kaumaha ma ka ʻaoʻao o ka wāwae a i ʻole ka piko o ka wāwae. Hiki i kēia ke hoʻoulu i nā ʻeha a i ʻole nā ​​calluses, nā pilikia e ʻimi ana i nā kāmaʻa, a me ka limp.
• Nā pilikia me ka mālama lohi. Hiki i ka mālama lohi ʻana i ka wāwae ʻōʻiliʻili ke hopena i ka pono ʻana i nā kāʻei hou aʻe a me ka ʻoki kino e hoʻoponopono ai i ka wāwae. ʻOi aku ka maikaʻi o nā hopena me ka mālama mua ma mua o ka hoʻololi ʻana o nā iwi o ka wāwae mai ke kūlana wāwae maikaʻi ʻole.
• ʻArthritis. Hiki paha i ka pehu a me ka palahalaha i hoʻokahi a ʻoi aku paha nā hui.
• Kiʻi ponoʻī maikaʻi ʻole. Hiki i ke ʻano kūikawā o ka wāwae ke hoʻolilo i ke kiʻi kino i mea hopohopo i nā makahiki ʻōpio.

ʻAʻole maopopo i nā limahana olakino ke kumu o ka wāwae ʻōwili, no laila ʻaʻohe ala maopopo e pale aku ai. Akā inā hāpai ʻoe, hiki iā ʻoe ke hana i nā mea e loaʻa ai kahi hāpai olakino a hoʻemi i ka pilikia o kāu pēpē i nā pilikia e hoʻopilikia i ka ulu ʻana o ka pēpē:

• Mai puhi paka a mai noho i nā wahi me ka uahi paka.
• Mai inu waiʻona.
• Mai hoʻohana i nā lāʻau lapaʻau kū kānāwai a kū kānāwai ʻole paha i kūʻai ʻia ma ke alanui a mai lawe i nā lāʻau lapaʻau i ʻae ʻole ʻia e kāu limahana olakino.

I ka manawa pinepine, ua ʻike koke ka poʻe loea olakino i ka wāwae ʻōʻili ma hope koke o ka hānau ʻana ma o ka nānā ʻana i ke ʻano a me ke kūlana o ka wāwae o ke pēpē. I kekahi manawa, lawe ʻia nā kiʻi X-ray e hoʻomaopopo piha i ka nui o ka wāwae ʻōʻili. Akā ʻaʻole pinepine e pono nā kiʻi X-ray.

Hoʻomaka pinepine ʻia ka ʻike ʻana i ka wāwae ʻōʻili ma mua o ka hānau ʻana i ka wā o kahi hoʻokolokolo ultrasound maʻamau i ka hebedoma 20 o ka hāpai ʻana. ʻOiai ʻaʻole hiki ke mālama ʻia ke kūlana ma mua o ka hānau ʻana, hiki i ka ʻike ʻana i ke kūlana ke hāʻawi iā ʻoe i ka manawa e aʻo hou ai e pili ana i ka wāwae ʻōʻili. E loaʻa iā ʻoe ka manawa e kamaʻilio me nā loea olakino, e like me ka kauka ʻoki kino pediatric, e hoʻolālā i ka mālama ʻana. Inā pono, hiki i kahi kākāʻōlelo genetics lapaʻau ke kamaʻilio pū me ʻoe e pili ana i nā hopena hoʻokolohua genetics a me kou pilikia o ka loaʻa ʻana o kahi pēpē me ka wāwae ʻōʻili i nā hāpai ʻana i ka wā e hiki mai ana.

No ka mea, ua mālie loa nā iwi, nā hono a me nā ʻiʻo o ka pēpē hou, hoʻomaka pinepine ʻia ka mālama ʻana i ka wāwae ʻāʻī i loko o ka hebedoma mua a ʻelua paha ma hope o ka hānau ʻana. ʻO nā pahuhopu o ka mālama ʻana, ʻo ia ka hoʻoneʻe ʻana i ka wāwae o ke keiki i kahi kūlana i hoʻoponopono ʻia me ka lalo o ka wāwae e kū pono ana i ka honua. ʻO ka mālama ʻana me ka kāʻei ʻana e hāʻawi i ka neʻe maikaʻi loa o ka wāwae a me nā hopena maikaʻi loa i ka wā lōʻihi. ʻOi aku ka maikaʻi o ka mālama ʻana inā hana ʻia i loko o nā mahina mua o ke ola. ʻO nā koho mālama ʻana e komo pū ana: Ke kīloi ʻana a me ke kāʻei ʻana, i kapa ʻia ʻo ke ʻano Ponseti. Ke kīloi ʻana, ke kāʻei ʻana a me ke kāpili ʻana, i kapa ʻia ʻo ke ʻano Farani. ʻO ka ʻoki kino. Ke kāʻei ʻana: ʻO ke ʻano Ponseti ʻO ke kāʻei ʻana ka mālama nui no ka wāwae ʻāʻī. ʻO ka mea mālama ola maʻamau: E hoʻoneʻe i ka wāwae o kāu pēpē i kahi kūlana i hoʻomaikaʻi ʻia a laila kau i loko o ka kāʻei e hoʻopaʻa ai ma laila. E hoʻololi hou a kāʻei hou i ka wāwae o kāu pēpē i hoʻokahi pule no kekahi mau mahina. E hana i kahi kaʻina hana liʻiliʻi e hoʻolōʻihi i ka ʻiʻo kuʻekuʻe, i kapa ʻia ʻo ka ʻiʻo Achilles, i ka hopena o kēia kaʻina hana. Ma hope o ka hoʻomaikaʻi ʻia ʻana o ke ʻano o ka wāwae o kāu pēpē, pono e noho ka wāwae i kahi kūlana. No ke kōkua ʻana i kāu keiki e mālama i ka wāwae i kahi kūlana: E kau i kāu keiki i nā kāmaʻa kūikawā a me nā kāʻei. E hōʻoia e komo kāu keiki i nā kāmaʻa a me nā kāʻei i ka lōʻihi e pono ai. ʻO ka mea maʻamau, ʻo ia ka lā a pau a me ka pō a pau no 3 a 6 mau mahina, a laila i ka pō a me nā hiamoe a hiki i kāu keiki i 3 a 4 mau makahiki. No ka holomua o kēia ʻano, pono e komo pono ʻia nā kāʻei e like me ke kuhikuhi ʻia e ʻaʻole e hoʻi ka wāwae i kona kūlana huli mua. Ke hana ʻole ke ʻano kāʻei ʻana Ponseti, ʻo ke kumu nui, ʻaʻole i komo ʻia nā kāʻei e like me ke kuhikuhi ʻia. Inā ʻaʻole hiki i kāu keiki ke komo i nā kāʻei a i ʻole e ulu nui nā kāʻei, e kamaʻilio koke me kāu mea mālama ola. ʻOiai me ka mālama ʻana, ʻaʻole paha e hoʻoponopono piha ʻia ka wāwae ʻāʻī. No kekahi mau keiki, hiki ke hoʻomaka hou ke huli ʻana o ka wāwae. Inā hana kēia ma mua o 2 mau makahiki, hiki ke koi ʻia ka kāʻei ʻana hou aku e hoʻihoʻi i ka wāwae i kahi kūlana kūpono. Akā ʻo ka hapa nui o ka manawa, ulu nā pēpē i mālama ʻia i ka wā ʻōpio e komo i nā kāmaʻa maʻamau me ka ʻole o nā kāʻei, komo i nā haʻuki, a alakaʻi i nā ola piha a hana nui. Ke kīloi ʻana, ke kāʻei ʻana a me ke kāpili ʻana: ʻO ke ʻano Farani Ua hoʻomohala ʻia ke ʻano Farani ma Farani a hoʻohana pinepine ʻia ma Farani wale nō. He ʻano mālama kīloi ia e kūpono loa no ka wāwae ʻāʻī māmā. Kīloi ʻia ka wāwae i kahi kūlana, a laila kāpili ʻia a kāʻei ʻia i kēlā me kēia lā. Hoʻokomo ka ʻano i nā hālāwai lapaʻau kino pinepine a me nā mālama i kēlā me kēia lā i hana ʻia e nā mākua a hiki i ka keiki i 2 a 3 mau makahiki. ʻO ka mea maʻamau, pono kahi kaʻina hana liʻiliʻi e hoʻolōʻihi i ka ʻiʻo kuʻekuʻe, i kapa ʻia ʻo ka ʻiʻo Achilles. ʻO ka ʻoki kino Inā ʻaʻole hoʻomaikaʻi ka wāwae ʻāʻī o ka pēpē me ke ʻano kāʻei ʻana a i ʻole inā ʻaʻole loaʻa i ke keiki ka hoʻoponopono piha ma hope i ke ola, pono paha ka ʻoki kino. ʻOiai me ka hopena holomua i ka wā kamaliʻi, pono kekahi manawa ka ʻoki kino ma kahi o 3 a 5 mau makahiki inā ke huli nei ka wāwae o ke keiki. I ka wā o ka ʻoki kino, hoʻololi hou ka kauka orthopedic i nā ʻiʻo e kōkua i ka mālama ʻana i ka wāwae i kahi kūlana maikaʻi aʻe. Kīloi ʻia kēia ʻoki kino he tibialis anterior tendon transfer a loaʻa nā hopena maikaʻi loa. ʻAʻole pinepine no ka wāwae ʻāʻī koʻikoʻi a i ʻole no ka wāwae ʻāʻī he ʻāpana o kahi syndrome a i ʻole nā ​​kūlana olakino ʻē aʻe, pono paha ka ʻoki kino nui aʻe i ka wā kamaliʻi. Kīloi ʻia kēia ʻoki kino he posterior release a i ʻole posteromedial release. Hoʻoluhi kēia ʻoki kino i nā ligament ma ke kua a me ka ʻaoʻao o ke kuʻekuʻe a hiki ke hopena i ka hoʻoponopono nui ʻana o ka wāwae. ʻOiai ua kūpono ka wāwae i kahi kūlana maikaʻi aʻe, hiki ke paʻakikī ka wāwae a ʻoi aku ka nui o ka ʻeha i ka wāwae ma hope i ke ola. Ma hope o ka ʻoki kino, aia ke keiki i kahi kāʻei no ʻelua mahina. A laila komo ke keiki i kahi kāʻei no kekahi mau makahiki a pēlā aku e pale ai i ka wāwae ʻāʻī mai ka hoʻi ʻana mai. Noi i kahi hālāwai