He aha ka Clubfoot? Nā Hōʻailona, Nā Kumu, a me ka Lapaʻau

ʻO ka clubfoot he kīnā hānau ia kahi e huli ai kekahi kapuaʻi a ʻelua paha i loko a i lalo, e hana ana i kahi ʻano ʻōwili. Hoʻopili kēia kūlana ma kahi o 1 i kēlā me kēia 1,000 mau pēpē i hānau ʻia ma ka honua holoʻokoʻa, e lilo ana i kekahi o nā kīnā hānau musculoskeletal maʻamau loa.

ʻO ka ʻoiaʻiʻo maikaʻi, hiki ke mālama nui ʻia ka clubfoot ke hopu ʻia i ka wā mua. Me ka mālama kūpono a me ka lapaʻau, hiki i ka hapa nui o nā keiki me ka clubfoot ke hele, holo, a pāʻani e like me nā keiki ʻē aʻe. Hiki i ka hoʻomaopopo ʻana i kēia kūlana ke kōkua iā ʻoe e ʻike ʻoi aku ka hilinaʻi e pili ana i ka huakaʻi i mua.

He aha ka clubfoot?

Hana ʻia ka clubfoot i ka wā e pōkole a paʻa loa ai nā tendons a me nā ligaments i loko o ka wāwae o kāu pēpē ma mua o ka maʻamau. Huki kēia i ka wāwae i loko o kahi kūlana kūpono ʻole e like me ka huli ʻia ʻana o ka wāwae i loko.

ʻO ka huaʻōlelo lapaʻau no ka clubfoot, ʻo ia ka "congenital talipes equinovarus," akā, ʻo ka hapa nui o nā kauka a me nā ʻohana e kapa wale ia he clubfoot. ʻO ka wāwae maʻamau e kuhikuhi i lalo a i loko, me ka ʻaoʻao lalo e kū pono ana i ka wāwae ʻē aʻe.

Aia ʻelua ʻano nui o ka clubfoot. ʻO ka ʻano maʻamau loa, ʻo ia ka "idiopathic clubfoot," ʻo ia hoʻi, hana ia ma kona iho me ka ʻole o kekahi kūlana kumu. ʻO ka ʻano ʻaʻole maʻamau e hana pū me nā kūlana lapaʻau ʻē aʻe e like me ka spina bifida a i ʻole ka cerebral palsy.

He aha nā hōʻailona o ka clubfoot?

ʻIke maʻamau ʻia ka clubfoot i ka hānau ʻana, a e ʻike paha ʻoe i ka hiʻohiʻona kūikawā koke. E ʻike ʻia ka wāwae i hoʻopili ʻia he ʻokoʻa loa mai ka wāwae o kahi pēpē hou.

Eia nā hōʻailona nui āu e ʻike ai:

• Huli ka wāwae i loko a i lalo
• Ke kū pono ana ka ʻaoʻao lalo o ka wāwae i ka wāwae ʻē aʻe
• Hiki i ka wāwae i hoʻopili ʻia a me ka wāwae ke liʻiliʻi iki
• Ke ʻike ʻia ka heel cord (Achilles tendon) he paʻa
• Ke ʻike ʻia ka wāwae he paʻa a ʻaʻole neʻe maʻamau
• Hiki i ka ʻiʻo keiki ma ka ʻaoʻao i hoʻopili ʻia ke ʻike ʻia he liʻiliʻi

He mea nui e ʻike ʻaʻole hana ka clubfoot i ka ʻeha i nā pēpē hou. ʻAʻole e ʻoluʻolu ʻole kāu pēpē ma muli o ke kūlana o ka wāwae, ʻoiai hiki i kēia ke loli i ko lākou ulu ʻana inā ʻaʻole i mālama ʻia ke kūlana.

He aha nā ʻano o ka clubfoot?

Hoʻokano nā kauka i ka clubfoot ma nā ʻano like ʻole e kōkua ai i ka hoʻoholo ʻana i ke ala lapaʻau maikaʻi loa. Hiki i ka hoʻomaopopo ʻana i kēia mau ʻano ke kōkua iā ʻoe e kūkākūkā maikaʻi aku i ke kūlana kikoʻī o kāu keiki me kā lākou hui olakino.

ʻO ke ala maʻamau loa e hoʻokaʻawale ai i ka clubfoot, ʻo ia ma o kona kumu kumu:

• Idiopathic clubfoot: Hana kēia ma kona iho me ka ʻole o nā kūlana ʻē aʻe (ma kahi o 95% o nā hihia)
• Syndromic clubfoot: Hana kēia me nā kūlana lapaʻau ʻē aʻe e like me ka spina bifida a i ʻole nā ​​syndromes genetic
• Positional clubfoot: ʻO kēia ʻano palupalu loa ka hopena o ke kūlana i loko o ka ʻōpū a ʻoi aku ka maʻalahi

Ho'ākāka pū nā kauka i ka clubfoot ma ka nui. Hiki ke hoʻoneʻe ʻia ka clubfoot maʻalahi i kekahi manawa ma ka lima, ʻoiai he paʻa loa ka clubfoot paʻa a paʻakikī ke hoʻoneʻe hou.

He aha ka mea e hana ai i ka clubfoot?

Ke waiho nei ka kumu pololei o ka hapa nui o nā hihia clubfoot i ʻike ʻole ʻia, hiki ke manaʻo huhū no nā mākua e ʻimi ana i nā pane. ʻO ka mea a mākou i ʻike ai, ulu ka clubfoot i loko o nā mahina ʻekolu mua o ka hāpai ʻana i ka wā e hoʻokumu ai i nā ʻano o ka wāwae a me ka wāwae o kāu pēpē.

Hiki i kekahi mau mea ke komo i ka hoʻomohala ʻana o ka clubfoot:

• Nā mea genetic: Hoʻonui ka mōʻaukala ʻohana i ka pilikia, ʻoiai ʻaʻohe mōʻaukala ʻohana o ka hapa nui o nā pēpē me ka clubfoot
• Nā mea kaiapuni: Hiki i ka puhipaka i ka wā hāpai ke hoʻonui iki i ka pilikia
• Wahi palena ʻole i loko o ka ʻōpū: Hiki i nā kūlana e like me ka oligohydramnios (wai amniotic haʻahaʻa) ke pāʻani i kahi kuleana
• Nā kūlana kumu: Hiki i ka spina bifida, muscular dystrophy, a i ʻole nā ​​kūlana genetic ʻē aʻe ke hana i ka clubfoot

He mea nui e hoʻomaopopo ʻaʻole ʻoe i hana a i ʻole ʻaʻole i hana i ka wā hāpai i hana i ka clubfoot o kāu pēpē. ʻAʻole hiki ke pale ʻia kēia kūlana, a ʻaʻole pono nā mākua ke hoʻopiʻi iā lākou iho.

I ka wā e ʻike ai i ke kauka no ka clubfoot?

Hoʻomaopopo maʻamau ʻia ka clubfoot ma hope koke o ka hānau ʻana i ka wā o ka nānā kino mua o kāu pēpē. Eia naʻe, hiki ke ʻike ʻia i kekahi manawa i ka wā hāpai ma o ka ultrasound, maʻamau ma kahi o 18-20 mau wiki.

Pono ʻoe e ʻimi i ka mālama lapaʻau koke inā ʻike ʻoe i kekahi o kēia mau hōʻailona ma hope o ka hoʻomaka ʻana o ka mālama ʻana:

• Ke ʻōpū, ʻulaʻula, a i ʻole mahana ke pā i ka wāwae
• Ke manaʻo nei kāu keiki i ka ʻeha a i ʻole ka ʻoluʻolu ʻole
• Ke ulu nei nā blisters a i ʻole nā ​​ʻeha ma ka wāwae
• Ke hoʻoluhi ʻia, haki, a i ʻole hōʻino ʻia ka cast
• Ke loaʻa i kāu keiki kahi kuni i ka wā e komo ana i ka cast

He mea nui ka mālama mua no nā hopena maikaʻi loa. ʻOi aku ka nui o nā loea orthopedic e ʻōlelo e hoʻomaka i ka mālama ʻana i loko o nā wiki mua o ke ola i ka wā e ʻoi aku ka maʻalahi o nā iwi, nā hui, a me nā tendons o ka pēpē.

He aha nā mea pilikia no ka clubfoot?

ʻOiai hiki i ka clubfoot ke hana i kekahi pēpē, hiki i kekahi mau mea ke hoʻonui i ka nui o kēia kūlana. Hiki i ka hoʻomaopopo ʻana i kēia mau mea pilikia ke kōkua iā ʻoe e ʻike i ka mea e manaʻo ai, ʻoiai ʻaʻole hōʻoia ka loaʻa ʻana o nā mea pilikia e loaʻa i kāu pēpē ka clubfoot.

ʻO nā mea pilikia nui e komo pū ana:

• Ke kāne: ʻOi aku ka nui o nā keikikāne e loaʻa i ka clubfoot ma mua o nā kaikamahine
• Mōʻaukala ʻohana: Hoʻonui ka loaʻa ʻana o ka makua a i ʻole ke kaikuaʻana me ka clubfoot i ka pilikia
• Nā kīnā hānau ʻē aʻe: Loaʻa i nā pēpē me ka spina bifida a i ʻole nā ​​kūlana ʻē aʻe ka pilikia kiʻekiʻe
• Ka puhipaka i ka wā hāpai: Hiki i kēia ke hoʻonui iki i nā manawa
• Wai amniotic lawa ʻole: Nā pae wai haʻahaʻa (oligohydramnios) i ka wā hāpai

ʻOiai me kēia mau mea pilikia i loaʻa, hānau ʻia ka hapa nui o nā pēpē me ka ʻole o ka clubfoot. Hana pinepine ʻia ke kūlana me ka ʻole o ke kumu a i ʻole nā ​​mea pilikia i ʻike ʻia.

He aha nā pilikia hiki ke loaʻa i ka clubfoot?

Ke mālama pono ʻia a i ka wā mua ka clubfoot, ulu ka hapa nui o nā keiki me ka ʻole o nā pilikia lōʻihi nui. Eia naʻe, hiki i ka hoʻomaopopo ʻana i nā pilikia hiki ke kōkua iā ʻoe e makaʻala a hana pili pono me kāu hui olakino.

Me ka ʻole o ka mālama ʻana, hiki i ka clubfoot ke alakaʻi i kekahi mau pilikia koʻikoʻi:

• Nā pilikia hele: Hiki i ke keiki ke hele ma ka ʻaoʻao a i ʻole ka luna o ka wāwae ma mua o ka ʻaoʻao lalo
• Nā calluses ʻeha a me nā ʻeha: Hana ka hele ʻana kūpono ʻole i nā wahi kaomi e hiki ke maʻi
• Arthritis: Hiki i ke kūlana hui kūpono ʻole ke alakaʻi i ka ʻaʻahu a me ka haehae mua
• Hoʻemi ʻia ka neʻe ʻana: Hiki ke lilo ka kuʻekuʻe i ka liʻiliʻi o ka maʻalahi ma hope
• Nā pilikia hilinaʻi iā ia iho: Hiki i ka ʻokoʻa o ka hiʻohiʻona ke hoʻopili i ka hilinaʻi

ʻOiai me ka mālama kūpono, hiki i kekahi mau keiki ke loaʻa nā pilikia liʻiliʻi e like me nā ʻokoʻa liʻiliʻi i ka nui o ka wāwae a i ʻole ka hoʻemi ʻia o ka maʻalahi. Mālama maʻamau ʻia kēia mau pilikia a ʻaʻole hoʻopili nui i nā hana o kēlā me kēia lā.

Pehea ka hoʻomaopopo ʻana i ka clubfoot?

ʻO ka hoʻomaopopo ʻana i ka clubfoot he mea maʻalahi maʻamau no ka mea ʻike ʻia ke kūlana a loaʻa nā hiʻohiʻona kūikawā. Hiki i kāu kauka ke ʻike maʻamau i ka clubfoot ma o ka nānā kino wale nō.

ʻO ke kaʻina hana hoʻomaopopo e komo pū ana:

• Nānā ʻike: Ke nānā nei ke kauka i ke kūlana a me ke ʻano o ka wāwae
• Loiloi kino: Ke ho'āʻo nei i ka nui o ka hoʻoneʻe ʻana a me ke kūlana o ka wāwae
• Mōʻaukala lapaʻau: Ke kūkākūkā nei i ka mōʻaukala ʻohana a me nā kikoʻī hāpai
• Nā X-rays: Hoʻohana ʻia i kekahi manawa e ʻike i ke kūlana o ka iwi, ʻaʻole naʻe pono mau i nā pēpē hou

I kekahi mau hihia, hiki ke ʻike ʻia ka clubfoot ma mua o ka hānau ʻana i ka wā o nā ultrasounds prenatal maʻamau. Eia naʻe, ʻo ka hoʻomaopopo hope loa a me ka hoʻolālā mālama e hana mau ma hope o ka hānau ʻana i ka wā hiki i nā kauka ke nānā kino i ka wāwae.

He aha ka mālama ʻana no ka clubfoot?

ʻO ka mālama maʻamau no ka clubfoot, ʻo ia ka ʻano Ponseti, kahi i hoʻololi ai i ka mālama clubfoot i nā makahiki he nui i hala. Hoʻoponopono maikaʻi kēia ala i ka clubfoot ma kahi o 95% o nā hihia me ka ʻole o ka ʻoki nui.

ʻO ke ʻano Ponseti e komo pū ana i kekahi mau kahua:

1. Casting phase: Hoʻonui mālie a me ka casting i kēlā me kēia wiki no 6-8 mau wiki
2. Tenotomy: Kahi kaʻina hana liʻiliʻi e hoʻokuʻu i ka Achilles tendon paʻa
3. Bracing phase: Ke komo nei i nā kāmaʻa kūikawā i hoʻohui ʻia e kahi pā, ma mua o 23 mau hola i kēlā me kēia lā
4. Long-term bracing: Ke komo nei i ka pō a me ka wā moe a hiki i ka makahiki 4-5

Pono ka kaʻina hana casting i ka hoʻomanawanui a me ka hoʻohiki mai nā ʻohana. I kēlā me kēia wiki, e hoʻonui mālie ke kauka i ka wāwae a kau i kahi cast hou. ʻAe kēia ala mālie i nā ʻiʻo palupalu e hoʻololi mālie a palekana.

I nā hihia kakaikahi kahi ʻaʻole hana piha ka ʻano Ponseti, pono paha nā kaʻina hana hou. Hiki i kēia ke komo pū me nā hoʻololi tendon a i ʻole nā ​​ʻoki liʻiliʻi ʻē aʻe e hoʻomaikaʻi i ke kūlana a me ka hana o ka wāwae.

Pehea e mālama ai i ka mālama clubfoot ma ka home?

Pono ka mālama ʻana i ka mālama clubfoot ma ka home i ka nānā kikoʻī a me ka kūpaʻa, akā hoʻololi maikaʻi ka hapa nui o nā ʻohana i ka hana maʻamau. E hāʻawi kāu hui olakino i nā ʻōlelo aʻo kikoʻī no ke kūlana o kāu keiki.

I ka wā o ke kahua casting, eia ka mea hiki iā ʻoe ke hana:

• E mālama i ka cast maloʻo a maʻemaʻe i nā manawa a pau
• E nānā i nā hōʻailona o ka huhū, ʻōpū, a i ʻole nā ​​pilikia kahe koko
• E nānā i nā manamana wāwae o kāu pēpē i kēlā me kēia manawa no ke kala a me ka mahana
• Mai ho'āʻo e wehe a hoʻoponopono i ka cast iā ʻoe iho
• E kelepona koke i kāu kauka inā ʻike ʻoe i kekahi pilikia

I ka wā o ke kahua bracing, lilo ka kūpaʻa i mea nui no ka pale ʻana i ka relapse. Hiki i ka brace ke manaʻo ʻoluʻolu ʻole i ka wā mua, akā hoʻololi maikaʻi ka hapa nui o nā pēpē i loko o kekahi mau lā. Ke mālama nei i ka papa hoʻokomo i kuhikuhi ʻia e kōkua i ka hōʻoia ʻana i nā hopena maikaʻi loa i ka wā lōʻihi.

Pehea ʻoe e hoʻomākaukau ai no kāu kūkā kauka?

Hiki i ka hoʻomākaukau ʻana no nā kūkā clubfoot ke kōkua iā ʻoe e hana i ka hapa nui o kāu manawa me ka hui olakino a hōʻoia iā ʻoe e loaʻa nā pane a pau i kāu mau nīnau. Ke hoʻonohonoho ʻia, hoʻemi ʻia ka pilikia no ʻoe a me kāu keiki.

Ma mua o kēlā me kēia kūkā, e noʻonoʻo e hoʻomākaukau:

• Kahi papa inoa o nā nīnau a i ʻole nā ​​hopohopo āu e makemake ai e kūkākūkā
• ʻIke e pili ana i ke ʻano o ka pane ʻana o kāu keiki i ka mālama ʻana
• Nā kiʻi a i ʻole nā ​​memo e pili ana i nā pilikia ʻili a i ʻole nā ​​loli āu i ʻike ai
• Nā mea hōʻoluʻolu o kāu keiki e like me nā pāʻani punahele a i ʻole nā ​​pale
• Kekahi ʻike ʻinikua a i ʻole nā ​​palapala kuhikuhi i pono ʻia

No nā kūkā casting, e kāhiko i kāu pēpē i nā lole maʻalahi e wehe mai nā wāwae. E lawe mai i nā meaʻai māmā a me ka leʻaleʻa no nā kipa lōʻihi, ʻoiai hiki i ke kaʻina hana ke lawe i kekahi manawa.

He aha ka mea nui e pili ana i ka clubfoot?

ʻO ka mea nui loa e hoʻomanaʻo e pili ana i ka clubfoot, ʻo ia ka mea hiki ke mālama nui ʻia ke hopu ʻia i ka wā mua a mālama pono ʻia. Me ke ʻano Ponseti, ulu ka hapa nui o nā keiki me ka clubfoot e alakaʻi i nā ola maʻamau a hana nui.

Ke hilinaʻi nui nei ka holomua i ka hahai ʻana i ka papahana mālama me ka kūpaʻa, ʻoi aku hoʻi i ka wā bracing. ʻOiai ke koi nei ka huakaʻi i ka hoʻomanawanui a me ka hoʻohiki, maikaʻi maʻamau nā hopena. Hiki i ka hapa nui o nā keiki me ka clubfoot i mālama pono ʻia ke komo i nā hana a pau, me nā haʻuki hoʻokūkū.

E hoʻomanaʻo he kūikawā ka huakaʻi o kēlā me kēia keiki me ka clubfoot. Hiki i kekahi ke holomua wikiwiki ma o ka mālama ʻana, ʻoiai pono kekahi i ka manawa a i ʻole nā ​​kaʻina hana hou. Ke hana pili pono me kāu hui orthopedic a ke hoʻohiki nei i ka papahana mālama e hāʻawi i kāu keiki i ka manawa maikaʻi loa no nā hopena maikaʻi loa.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka clubfoot

E hiki anei i kaʻu keiki ke hele maʻamau ma hope o ka mālama ʻana i ka clubfoot?

ʻAe, hele maʻamau loa ka hapa nui o nā keiki i mālama ʻia no ka clubfoot. Me ka mālama kūpono me ke ʻano Ponseti, hiki i ka hapa nui o nā keiki ke holo, lele, a pāʻani i nā haʻuki e like me nā keiki ʻē aʻe. ʻOiai hiki ke waiho iki ka wāwae i hoʻopili ʻia a i ʻole ka liʻiliʻi o ka maʻalahi, ʻaʻole pinepine kēia e hoʻopili i ka hana a i ʻole nā ​​hana o kēlā me kēia lā.

Pehea ka lōʻihi o ka mālama ʻana i ka clubfoot?

ʻO ka mālama ikaika mua e lawe maʻamau i kahi o 2-3 mau mahina, me 6-8 mau wiki o ka casting ma hope ʻia e kahi kaʻina hana liʻiliʻi. Eia naʻe, ke hoʻomau nei ke kahua bracing a hiki i ka makahiki 4-5 e pale aku i ka relapse. ʻIke ka hapa nui o nā ʻohana ʻoiai ke lōʻihi nei ka manawa, emi nui ka hopena o kēlā me kēia lā ma hope o nā mahina mua.

He ʻeha anei ka mālama ʻana i ka clubfoot no kaʻu pēpē?

ʻAʻole maʻamau ka ʻeha o ke kaʻina hana casting a me ka hoʻonui ʻana no nā pēpē, ʻoiai hiki i kekahi ke huhū i ka wā o nā loli cast. Hana ʻia ke kaʻina hana Achilles tenotomy ma lalo o ka anesthesia kūloko, no laila ʻaʻole ʻike nā pēpē i ka ʻeha i ka wā o ke kaʻina hana. Hoʻololi maikaʻi ka hapa nui o nā pēpē i nā braces ma hope o kahi manawa hoʻoponopono pōkole.

Hiki anei i ka clubfoot ke hoʻi mai ma hope o ka mālama ʻana?

Hiki i ka clubfoot ke relapse inā ʻaʻole hahai kūpaʻa ʻia ka protocol bracing, ʻo ia ke kumu nui o ke kahua bracing pō. Ke hoʻopili nei nā ʻohana i ka papa hoʻokomo i kuhikuhi ʻia, haʻahaʻa loa nā helu relapse. Inā hana ʻia ka relapse, hiki ke mālama maikaʻi ʻia me ka casting hou a i ʻole nā ​​kaʻina hana liʻiliʻi.

E pono anei i kaʻu keiki nā kāmaʻa kūikawā a i ʻole nā ​​mea hana ma hope i ke ola?

ʻAʻole pono ka hapa nui o nā keiki me ka clubfoot i mālama pono ʻia nā kāmaʻa kūikawā a i ʻole nā ​​mea hana i ko lākou ulu ʻana. I ka wā bracing, e komo lākou i nā kāmaʻa brace i kuhikuhi ʻia, akā ma hope o ka pau ʻana o ka mālama ʻana, hana maʻamau nā kāmaʻa maʻamau. Hiki i kekahi mau keiki ke makemake i kekahi mau ʻano kāmaʻa no ka hōʻoluʻolu, akā ʻokoʻa kēia ma muli o ka makemake pilikino ma mua o ka pono lapaʻau.