Ukuqina Kwezinyawo: Izimpawu, Izimbangela, Nokwelashwa

Ukuqina kwezinyawo yiphutha lokuzalwa lapho olunye noma womabili amaqhuqhu olukhulu luguquka ngaphakathi futhi olukhulu, okwenza kube nobukhulu obukhulu. Lesi simo sihlupha cishe ingane eyi-1 kuzo zonke izingane ezi-1,000 ezazalwa emhlabeni jikelele, okwenza kube omunye wemiphumela emibi kakhulu yokuzalwa kwemisipha.

Izindaba ezinhle ukuthi ukuqina kwezinyawo kunyakaziswa kakhulu uma kubanjwa ngokushesha. Ngokunakekelwa okulungile nokuphathwa, izingane eziningi ezinokuqina kwezinyawo zingakwazi ukuhamba, ukugijima, nokudlala njengezinye izingane. Ukuqonda lesi simo kungakusiza uzizwe ukhululekile ngokuhamba kwakho phambili.

Iyini ukuqina kwezinyawo?

Ukuqina kwezinyawo kwenzeka lapho ama-tendon nama-ligament esinyaweni somntanakho efushane futhi eqinile kunokujwayelekile. Lokhu kudonsa unyawo endaweni engavamile ebukeka sengathi unyawo luphendukile ngaphakathi.

Igama lesayensi lokuqina kwezinyawo yi "congenital talipes equinovarus," kodwa odokotela abaningi nemindeni babiza nje ukuqina kwezinyawo. Unyawo ngokuvamile luqondisa phansi nangaphakathi, ngesole eliqondisa kwenye unyawo.

Kunezinhlobo ezimbili eziyinhloko zokuqina kwezinyawo. Uhlobo oluvamile kakhulu lubizwa ngokuthi "idiopathic clubfoot," okusho ukuthi kwenzeka ngokwalo ngaphandle kwanoma yisiphi isimo esiyisisekelo. Uhlobo olungavamile kakhulu lwenzeka kanye nezinye izimo zezokwelapha njenge-spina bifida noma i-cerebral palsy.

Ziyini izimpawu zokuqina kwezinyawo?

Ukuqina kwezinyawo kuvame ukubonakala ngesikhathi sokuzalwa, futhi cishe uzobona ukubonakala okuhlukile ngokushesha. Unyawo oluthintekayo luzobonakala luhlukile kunenyawo lomntwana omusha.

Nazi izimpawu eziyinhloko ozobona:

• Unyawo luphenduka ngaphakathi futhi olukhulu
• Isole lonyawoluqondisa kwenye unyawo
• Unyawo oluthintekayo nenyawo kungaba lincane kancane
• I-heel cord (Achilles tendon) izizwa iqine
• Unyawo luzizwa luqine futhi aluyi ngokujwayelekile
• Imisipha yebhulukwe ohlangothini oluthintekayo ingabonakala incinyane

Kubalulekile ukwazi ukuthi ukuqina kwezinyawo ngokwalo akubangeli ubuhlungu kubantwana abasanda kuzalwa. Ingane yakho ngeke ibe buhlungu ngenxa yesikhundla sonyawolu, nakuba lokhu kungashintsha njengoba ikhula uma isimo singaphathwa.

Ziyini izinhlobo zokuqina kwezinyawo?

Odokotela bahlukanisa ukuqina kwezinyawo ngezindlela ezahlukene ukuze basize ekutholeni indlela yokwelapha engcono kakhulu. Ukuqonda lezi zinhlobo kungakusiza uxoxe kangcono ngesimo esithile sengane yakho neqembu labo lokunakekelwa kwezempilo.

Indlela evamile kakhulu yokuhlela ukuqina kwezinyawo yiyona imbangela yayo:

• Ukuqina kwezinyawo okuyi-Idiopathic: Lokhu kwenzeka ngokwalo ngaphandle kwanoma yiziphi ezinye izimo (cishe ama-95% ezimo)
• Ukuqina kwezinyawo kwe-Syndromic: Lokhu kwenzeka kanye nezinye izimo zezokwelapha njenge-spina bifida noma izifo ezihambisana ne-genetic
• Ukuqina kwezinyawo kwe-Positional: Lolu hlobo oluthambile luvela endaweni esizalweni futhi lubuthakathaka kakhulu

Odokotela bachaza futhi ukuqina kwezinyawo ngokubaluleka. Ukuqina kwezinyawo okuthambile kunganyakaziswa kancane ngesandla, kuyilapho ukuqina kwezinyawo okuqinile kuqine kakhulu futhi kunzima ukulibuyisela. Udokotela wakho uzoqonda ukuthi iyiphi inhlobo ingane yakho enayo ngesikhathi sokuhlolwa kokuqala.

Yini ebangela ukuqina kwezinyawo?

Imbangela eqondile yazo zonke izimo zokuqina kwezinyawo isalungile, okungase kube nzima kubazali abafuna izimpendulo. Okwaziyo ukuthi ukuqina kwezinyawo kuthuthukiswa phakathi kwezinyanga ezintathu zokuqala zokukhulelwa lapho izakhiwo zonyawolunye nenyawo zikhahlela.

Izici eziningi zingase zinikezele ekuthuthukiseni ukuqina kwezinyawo:

• Izici ze-genetic: Umlando womndeni ukhuphula ingozi, nakuba izingane eziningi ezinokuqina kwezinyawo zingenawo umlando womndeni
• Izici ze-Environmental: Ukubhema ngesikhathi sokukhulelwa kungase kukhuphule kancane ingozi
• Indawo encane esizalweni: Izimo ezinjenge-oligohydramnios (amanzi amancane okuzalwa) zingase zidlale indima
• Izimo eziyisisekelo: I-Spina bifida, i-muscular dystrophy, noma ezinye izimo ze-genetic zingabangela ukuqina kwezinyawo

Kubalulekile ukuqonda ukuthi akukho lutho olukwenzile noma awukwenzanga ngesikhathi sokukhulelwa okubangele ukuqina kwezinyawo kwengane yakho. Lesi simo asivikileki, futhi abazali akufanele bazisole.

Nini okufanele ubona udokotela ngokuqina kwezinyawo?

Ukuqina kwezinyawo ngokuvamile kuqondwa ngokushesha ngemva kokuzalwa ngesikhathi sokuhlolwa komzimba kokuqala kwengane yakho. Noma kunjalo, ngezinye izikhathi kungatholakala ngesikhathi sokukhulelwa nge-ultrasound, ngokuvamile cishe emavikini angu-18-20.

Kufanele ufuna ukunakekelwa kwezokwelapha ngokushesha uma ubona noma yiziphi izimpawu ngemva kokuba ukwelashwa kuqalile:

• Unyawo luqina, lubomvu, noma lufudumele ukuthinta
• Ingane yakho ibonakala ibuhlungu noma ingakhululekile
• Ama-blisters noma ama-sores athuthukiswa enyaweni
• I-cast ihlala ihlala, iqhekeka, noma yonakele
• Ingane yakho ithuthukisa umkhuhlane ngenkathi igqoka i-cast

Ukuphathwa kwasekuqaleni kubalulekile ukuze kube nemiphumela emihle. Ochwepheshe abaningi be-orthopedic bancoma ukuqala ukwelashwa phakathi kwamasonto ambalwa okuqala okuphila lapho amathambo, izintambo, nama-tendon engane eguquguquka kakhulu.

Ziyini izici ezingozi zokuqina kwezinyawo?

Ngenkathi ukuqina kwezinyawo kungase kwenzeke kunoma yimuphi umntwana, izici ezithile zingase zikhuphule amathuba alesimimo. Ukuqonda lezi zici ezingozi kungakusiza wazi ukuthi yini okulindeleke, nakuba ukuba nezici ezingozi akusho ukuthi ingane yakho izoba nokuqina kwezinyawo.

Izici eziyinhloko ezingozi zihlanganisa:

• Ukuba owesilisa: Abasilisa banethuba elingaphezulu kabili lokuba nokuqina kwezinyawo kunabesifazane
• Umlando womndeni: Ukuba nomzali noma umfowethu onokuqina kwezinyawo kukhuphula ingozi
• Ezinye izifo zokuzalwa: Izingane ezinoku-spina bifida noma ezinye izimo zinethuba elikhulu
• Ukubhema ngesikhathi sokukhulelwa: Lokhu kungase kukhuphule kancane amathuba
• Amanzi amancane okuzalwa: Amazinga amancane amanzi (oligohydramnios) ngesikhathi sokukhulelwa

Ngisho nalapho lezi zici ezingozi zikhona, izingane eziningi zizalwa zingenawo ukuqina kwezinyawo. Isimo ngokuvamile sivela ngokungahleliwe ngaphandle kwanoma yimuphi umbangela noma izici ezingozi ezibonakalayo.

Ziyini izinkinga ezingase zenzeke ngokuqina kwezinyawo?

Uma ukuqina kwezinyawo kuphathwa kahle futhi ngokushesha, izingane eziningi zikhula zingabi nazinkinga ezinkulu zesikhathi eside. Noma kunjalo, ukuqonda izinkinga ezingase zenzeke kungakusiza uhlale ulindile futhi usebenze eduze neqembu lakho lokunakekelwa kwezempilo.

Ngaphandle kokwelashwa, ukuqina kwezinyawo kungabangela izinkinga eziningi ezinkulu:

• Ubunzima bokuhamba: Ingane ingase ihambe eceleni noma phezulu kwenyawo esikhundleni sesole
• Ubuhlungu be-calluses nama-sores: Ukuhamba okungavamile kudala amaphuzu engcindezi angase athele
• I-Arthritis: Ukubekwa okungavamile kwezindwangu kungabangela ukugqoka nokukleliswa kwasekuqaleni
• Ukunciphisa ukuhamba: I-ankle ingase ibe lula kakhulu ngokuhamba kwesikhathi
• Izinkinga zokuzethemba: Umehluko wokubonakala ungase uthinte ukuzethemba

Ngisho nalapho kunokwelashwa okulungile, ezinye izingane zingase zibe nezinkinga ezincane ezinjengokuhluka okuncane ekusayizini kwenyawo noma ukunciphisa ukuqina. Lezi zinkinga ngokuvamile ziphatheka futhi azithinti kakhulu imisebenzi yansuku zonke.

Ukuqina kwezinyawo kuqondwa kanjani?

Ukuqonda ukuqina kwezinyawo ngokuvamile kulula ngoba isimo sibonakala futhi sinezimpawu ezihlukile. Udokotela wakho ngokuvamile angakwazi ukuqonda ukuqina kwezinyawo ngokuhlolwa komzimba kuphela.

Inqubo yokuxilonga ngokuvamile ihlanganisa:

• Ukuhlolwa ngamehlo: Udokotela ubona isikhundla nesimo sonyawolu
• Ukuhlolwa komzimba: Ukuhlola ukuthi unyawo lunganyakaziswa kangakanani futhi lubekwe
• Umlando wezokwelapha: Ukuxoxa ngomlando womndeni nemininingwane yokukhulelwa
• Ama-X-rays: Ngezinye izikhathi asebenza ukubona isikhundla samathambo, nakuba kungadingeki njalo kubantwana abasanda kuzalwa

Ngezinye izikhathi, ukuqina kwezinyawo kungatholakala ngaphambi kokuzalwa ngesikhathi se-ultrasounds yokuqala yokukhulelwa. Noma kunjalo, ukuqondwa kokugcina nokucwaninga kokwelashwa kuhlale kwenzeka ngemva kokuzalwa lapho odokotela bengakwazi ukuhlola unyawo ngokomzimba.

Iyini ukwelashwa kokuqina kwezinyawo?

Ukuphathwa okuyisisekelo kokuqina kwezinyawo kubizwa ngokuthi i-Ponseti method, okuye kwaguqula ukunakekelwa kokuqina kwezinyawo phakathi kwamashumi eminyaka adlule. Le ndlela iphumelela ekuqondiseni ukuqina kwezinyawo cishe kuma-95% ezimo ngaphandle kokuthunga okukhulu.

I-Ponseti method ihlanganisa izigaba eziningi:

1. Isigaba sokuphosa: Ukuqina okuthambile nokuphosa masonto onke amasonto angu-6-8
2. I-Tenotomy: Inqubo encane yokukhulula i-Achilles tendon eqinile
3. Isigaba sokuqina: Ukugqoka izicathulo ezikhethekile ezihlanganiswe ngebha, ekuqaleni amahora angu-23 nsuku zonke
4. Ukuqina kwesikhathi eside: Ukuqina kwobusuku nangesikhathi sokulala kuze kube eminyakeni engu-4-5

Inqubo yokuphosa idinga isineke nokuzimisela emindenini. Njalo ngesonto, udokotela wakho uzonyakazisa unyawo kancane futhi afake i-cast entsha. Le ndlela eyandelayo ivumela izicubu ezithambile ukuba ziguquke kancane futhi ngokuphepha.

Ngezinye izikhathi lapho i-Ponseti method ingasebenzi ngokuphelele, izinqubo ezengeziwe zingase zidingeke. Lokhu kungase kuhlanganise ukudlulisa ama-tendon noma ezinye izinqubo ezincane zokulungisa isikhundla nomsebenzi wonyawolu.

Indlela yokuphatha ukwelashwa kokuqina kwezinyawo ekhaya?

Ukuphatha ukwelashwa kokuqina kwezinyawo ekhaya kudinga ukunakekelwa kwezincazelo nokuzinza, kodwa imindeni eminingi ilungele kahle kule ndlela. Iqembu lakho lokunakekelwa kwezempilo lizonika imiyalo ekhethekile yesimo sengane yakho.

Phakathi nesigaba sokuphosa, yilokhu ongakwenza:

• Gcina i-cast yomile futhi icocekile ngaso sonke isikhathi
• Qaphela izimpawu zokucasuka, ukuqina, noma izinkinga zokujikeleza
• Hlola izithupha zengane yakho njalo ngombala nokufudumeza
• Ungalokothi uzame ukususa noma ulungise i-cast ngokwakho
• Xhumana nodokotela wakho ngokushesha uma ubona noma yiziphi izinkinga

Phakathi nesigaba sokuqina, ukuzinza kuba kubalulekile ekuvimbeleni ukubuyela emuva. I-brace ingase ibonakale ingakhululekile ekuqaleni, kodwa izingane eziningi ziyalungele ngemva kwamalanga ambalwa. Ukulandela isimiso sokuqina esibekiwe kusiza ekuqinisekiseni imiphumela emihle yesikhathi eside.

Kufanele ulungiselele kanjani i-appointment yakho yodokotela?

Ukulungiselela ama-appointment okuqina kwezinyawo kungakusiza wenze okuningi ngesikhathi sakho neqembu lokunakekelwa kwezempilo futhi uqiniseke ukuthi uthola yonke imibuzo yakho iphendulwe. Ukuba uhleli kunciphisa ukucindezeleka kokubili wena nengane yakho.

Ngaphambi kwanoma yisiphi i-appointment, cabanga ukulungiselela:

• Uhlu lwemibuzo noma izinkinga ofuna ukuzixoxa
• Ulwazi lokuthi ingane yakho iphendule kanjani ekwelapheni
• Izithombe noma amanothi nganoma yiziphi izinkinga zesikhumba noma izinguquko ozibonile
• Izinto zokunethezeka zengane yakho ezinjengezinto zokudlala ozithandayo noma amabhande
• Noma yiluphi ulwazi loku-insurance noma amafomu okudlulisela adingekayo

Ngama-appointment okuphosa, gqoka ingane yakho ngezingubo ezilula ukususa ezinyaweni. Letha ukudla nokudlala ngezikhathi ezinde, njengoba inqubo ingathatha isikhathi esithile.

Iyini into ebaluleke kakhulu ngokuqina kwezinyawo?

Into ebaluleke kakhulu okufanele uyikhumbule ngokuqina kwezinyawo ukuthi kunyakaziswa kakhulu uma kubanjwa ngokushesha futhi kuphathwa kahle. Ngokusebenzisa i-Ponseti method, iningi lezingane ezinokuqina kwezinyawo zikhula zihola impilo evamile, esebenzayo.

Impumelelo ixhomeke kakhulu ekulandeleni uhlelo lokwelapha ngokuqhubekayo, ikakhulukazi phakathi nesigaba sokuqina. Ngenkathi uhambo ludinga isineke nokuzimisela, imiphumela ngokuvamile iyahle. Izingane eziningi eziphathwe kahle ukuqina kwezinyawo zingabamba iqhaza kuzo zonke imisebenzi, kufaka phakathi imidlalo yokuncintisana.

Khumbula ukuthi uhambo lwengane ngayinye olune-clubfoot luhlukile. Abanye bangase bathuthuke ngokushesha ngokwelashwa, kuyilapho abanye bedinga isikhathi esengeziwe noma izinqubo. Ukusebenza eduze neqembu lakho le-orthopedic nokukhuthazela ohlelweni lokwelapha kunikeza ingane yakho ithuba elihle kakhulu lemiphumela emihle.

Imibuzo evame ukubuzwa ngokuqina kwezinyawo

Ingane yami izokwazi ukuhamba ngokujwayelekile ngemva kokwelashwa kokuqina kwezinyawo?

Yebo, iningi lezingane eziswelashwe ngokuqina kwezinyawo lihamba ngokujwayelekile ngokuphelele. Ngokwelashwa okulungile ngokusebenzisa i-Ponseti method, izingane eziningi zingagijima, zigxume, futhi zidlale imidlalo njengezinye izingane. Ngenkathi unyawo oluthintekayo lungase luhlale luncane noma lungenamandla, lokhu akubangeli lutho emsebenzini noma emisebenzini yansuku zonke.

Ukuphathwa kokuqina kwezinyawo kuthatha isikhathi esingakanani?

Ukuphathwa okuqina okuqala ngokuvamile kuthatha izinyanga ezingu-2-3, kufaka phakathi amasonto angu-6-8 okuphosa okulandelelwa inqubo encane. Noma kunjalo, isigaba sokuqina siqhubeka kuze kube eminyakeni engu-4-5 ukuvimbela ukubuyela emuva. Imindeni eminingi ithola ukuthi ngenkathi isimiso sibonakala sibude, umthelela wansuku zonke uyancipha kakhulu ngemva kwamasonto ambalwa okuqala.

Ukuphathwa kokuqina kwezinyawo kubangela ubuhlungu kubantwana bami?

Inqubo yokuphosa nokuqina ngokuvamile ayibangeli ubuhlungu kubantwana, nakuba abanye bangase badideke ngesikhathi se-cast changes. Inqubo ye-Achilles tenotomy yenziwa ngaphansi kwe-anesthesia yendawo, ngakho izingane azizwa ubuhlungu ngesikhathi senqubo. Izingane eziningi ziyalungele ama-brace ngemva kwesikhathi esifushane sokulungiswa.

Ukuqina kwezinyawo kungabuya ngemva kokwelashwa?

Ukuqina kwezinyawo kungabuya uma isimiso sokuqina singalandelwa ngokuqhubekayo, kungakho isigaba sokuqina ebusuku sibaluleke kangaka. Lapho imindeni inamathela esimisweni sokuqina esikhuthazwayo, amanani okubuyela emuva aphansi kakhulu. Uma ukubuyela emuva kwenzeka, ngokuvamile kungaphathwa ngokuphumelelayo ngokuphosa okwengeziwe noma izinqubo ezincane.

Ingane yami izodinga izicathulo noma imishini ekhethekile kamuva ekuphileni?

Izingane eziningi eziphathwe kahle ukuqina kwezinyawo azidingi izicathulo noma imishini ekhethekile njengoba zikhula. Phakathi nesigaba sokuqina, zizogqoka izicathulo ze-brace ezibekiwe, kodwa ngemva kokuba ukwelashwa kuphelile, izicathulo eziqondile ngokuvamile zisebenza kahle. Ezinye izingane zingase zithande izitayela zezicathulo ezithile zokunethezeka, kodwa lokhu kuya ngokuthanda komuntu kunokuba yidingo yezokwelapha.