Ubuthakathaka beLegg-Calve-Perthes? Izimpawu, Izimbangela, Nokwelapha

Ubuthakathaka beLegg-Calve-Perthes yisimo sezinhlungu zethambo lomntwana lapho ukunikezwa kwegazi engxenyeni yebhola yomhlangano wezinhlungu zethambo kuphazanyiswa okwesikhashana. Lokhu kuphazanyiswa kubangela ukuthi ithishu lethambo ekhanda le-femoral (ingxenye yebhola yethambo lomntwana wakho) liqale liwohloke bese liziakha kabusha kancane kancane ngokuhamba kwesikhathi.

Nakuba lokhu kungase kuzwakale kukhulu, abantwana abaningi abanesimo esinjalo bangaphila impilo evamile, esebenzayo ngokunakekelwa okufanele. Lesi simo sivame ukubathinta abantwana abaneminyaka engu-4 kuya kwengu-10, futhi ngesineke nendlela yokwelapha efanele, umhlangano wezinhlungu zethambo uyakhululeka kahle.

Ziyini izimpawu zokuthakathaka kweLegg-Calve-Perthes?

Isinyathelo sokuqala esivamile yilokhu kuqhwakuqhwaka okuza futhi kuhambe, ngokuvamile ngaphandle kokulimaza okucacile noma ukuwa. Umntanakho angaqala ukuqhwakuqhwaka ngemva komsebenzi womzimba noma ekupheleni kosuku olude, kodwa abonakale ekahle ekuseni.

Nazi izimpawu ongaziqaphela njengoba isimo siqhubeka:

• Ukuqhwakuqhwaka okuqala ukubonakala ngokuhamba kwesikhathi
• Ubuhlungu bethambo, i-groin, noma ubuhlungu benkaba oluqala ukuba luncane
• Ubuhlungu beqolo (okungase kudida ngoba inkinga isethambo lomhlangano)
• Ukukhuluphala noma ukunciphisa ukunyakaza kwethambo lomhlangano
• Ubuhlungu obukhulu ngomsebenzi futhi bube ngcono ngokuphumula
• Unyakaza olulodwa olufushane kunelolinye
• Ubuthakathaka bemisipha noma ukuncipha kwemisipha ekhanda

Into enzima ngalesi simo ukuthi izimpawu zivame ukuvela kancane kancane. Umntanakho angase angakhonondi kakhulu ngokubuhlungu ekuqaleni, kungakho ukuqhwakuqhwaka kuvame ukuba yisibonakaliso sokuqala sokuthi kukhona okudinga ukunakekelwa.

Yini ebangela ubuthakathaka beLegg-Calve-Perthes?

Imbangela eqondile yobunqunu beLegg-Calve-Perthes ayaziwa, kodwa siyazi ukuthi kwenzeka lapho ukunikezwa kwegazi ekhanda le-femoral kuphazanyiswa. Cabanga ngakho njengokuphuma kwamandla okwesikhashana kule ndawo ethile yethambo.

Izici eziningi zingase zifake isandla ekuphazanyisweni kokunikezwa kwegazi:

• Ukugandeka kwegazi okungavamile okuvimba imithambo emincane yegazi
• Ukulimala kwemithambo yegazi okuvela ekulimala okuncane okuphindaphindayo
• Izici zezofu ezithinta ukuthuthukiswa kwemithambo yegazi
• Ukuvuvukala okonakalisa imithambo yegazi emathanjeni
• Ithonya le-hormonal phakathi nezinkathi zokukhula

Kwezinye izimo ezingavamile, izimo ezithile zingase zikhulise ingozi. Lokhu kuhlanganisa izifo zegazi ezifana nesifo se-sickle cell, ukusetshenziswa kwe-steroid, noma ezinye izimo ezithinta ukujikeleza kwegazi. Noma kunjalo, abantwana abaningi abathuthukisa ubuthakathaka beLegg-Calve-Perthes banempilo ephelele.

Okubalulekile ukuqonda ukuthi lokhu akuyona into owenzile wena noma umntanakho. Akubangelwa yimisebenzi eminingi, ukulimala okuthile, noma noma yini engavimbeka ezimweni eziningi.

Nini okufanele ubona udokotela ngenxa yobunqunu beLegg-Calve-Perthes?

Kufanele uxhumane nodokotela womntanakho uma uqaphela ukuqhwakuqhwaka okuqhubekayo okuphela izinsuku ezimbalwa, ikakhulukazi uma kungekho ukulimala okuqondile. Ngisho noma umntanakho engakhonondi ngokubuhlungu, ukuqhwakuqhwaka okungachaziwe kudinga ukuhlolwa kwonyango.

Funani ukunakekelwa kwonyango ngokushesha uma umntanakho ehlangabezana nalokhu:

• Ukuqhwakuqhwaka okuya kubi kakhulu
• Ubuhlungu bethambo, i-groin, noma i-knee ephazamisa imisebenzi yansuku zonke
• Ubunzima bokubekela isisindo kanye unyawo
• Ubunzima ngemisebenzi efana nokunyuka izitebhisi noma ukuphuma embhedeni
• Ukukhuluphala okubonakalayo emhlanganweni wethambo

Ukuxilongwa kwasekuqaleni nokwelashwa kungenza umehluko omkhulu ekupheleni kwesikhathi eside somntanakho. Ungakhathazeki ngokuba oqaphile kakhulu. Kuhlale kungcono ukuba lezi zimpawu ziqalwe ngokushesha kunokuba kube sekwephuzile.

Ziyini izici ezingozi zokuthakathaka kweLegg-Calve-Perthes?

Izici ezithile zenza abanye abantwana babe nethuba elikhulu lokuthuthukisa lesi simo, nakuba ukuba nezici ezingozi akusho ukuthi umntanakho uzoba nesifo ngokuqinisekile. Ukuqonda lokhu kungakusiza ukwazi ukuthi yini okufanele uyilinde.

Izici ezingozi ezivamile zihlanganisa:

• Ubudala: Buvamile phakathi kweminyaka engu-4 kuya kwengu-10, ngokuphakama okukhulu ngeminyaka engu-6
• Ubulili: Abafana banethuba elingu-4 kuya ku-5 lokuba bathinteke kunemantombazane
• Uhlanga: Buvamile kubantwana baseCaucasian
• Umlando womndeni: Ukuba namalungu omndeni aneleli simo kukhuphula ingozi kancane
• Ubukhulu obuphansi ngokwezinkathi
• Ubudala bethambo obude uma kuqhathaniswa nobudala bokwenyama
• Ukuzalwa ngesisindo esincane

Ezinye izici zemvelo nezonyango zingase futhi zidlale indima, nakuba lokhu kungavamile. Lokhu kuhlanganisa ukukhishwa ukubhema okusekelwe, imithi ethile, noma izifo zokugandeka kwegazi.

Khumbula ukuthi abantwana abaningi abanezici ezingozi abazithuthukisi lesi simo. Lezi zici zisiza nje odokotela ukuqonda ukuthi ubani ongaqaphela kakhulu.

Ziyini izinhlanganisela ezingase zenzeke ngenxa yobunqunu beLegg-Calve-Perthes?

Nakuba abantwana abaningi baphila kahle ngokwelashwa okufanele, kuyinto yemvelo ukubuza ngemiphumela yesikhathi eside. Izindaba ezinhle ukuthi izinhlanganisela ezinkulu azivamile, ikakhulukazi ngokuxilongwa kwasekuqaleni nokukhathalelwa okufanele.

Izinhlanganisela ezingase zenzeke zihlanganisa:

• Ukuvuvukala kwethambo lomhlangano kamuva ebuntwini (nakuba lokhu kungase kungenzeki amashumi eminyaka)
• Ukushintsha okumi phakade esimweni sethambo lomhlangano
• Umehluko wobubanzi benyawo obuqhubeka ube bukhulu ebuntwini
• Ukunciphisa ukunyakaza kwethambo lomhlangano oluthintekile
• Ukudinga ukufakwa kwethambo lomhlangano ebuntwini (ezimweni ezinkulu)

Ingozi yezinhlanganisela ixhomeke kakhulu ebudaleni bomntanakho lapho isifo siqala khona nokuthi yingakanani ingxenye yekhanda le-femoral ethintekile. Abantwana abaneminyaka emincane lapho baxilongwa khona bavame ukuba nemiphumela emihle ngoba amathambo abo anethuba eliningi namandla okubuyisela kabusha nokukhululeka.

I-orthopedic yakho izolandelela umntanakho ngokucophelela phakathi kokwelashwa ukuze inciphisa ingozi yalezi zinhlanganisela. Abantwana abaningi abaneLegg-Calve-Perthes disease bakhula babe abantu abadala abasebenzayo ngezinkinga ezincane noma azikho ezinde.

Ubuthakathaka beLegg-Calve-Perthes buxilongwa kanjani?

Ukuxilonga ubuthakathaka beLegg-Calve-Perthes kuqala ngodokotela wakho olalela ukukhathazeka kwakho futhi ahlole ukunyakaza kwethambo lomntanakho kanye nesimo sokuhamba. Bazohlola ubuhlungu, ukukhuluphala, nanoma yimiphi umehluko wobubanzi benyawo.

Inqubo yokuxilonga ivame ukufaka izilingo eziningi zokuthwebula izithombe:

1. Izithombe ze-X-ray zamathambo womabili ukuze kuqhathaniswe uhlangothi oluthintekile nohlangothi oluphilile
2. I-MRI scan ukuthola izithombe ezinemininingwane yethishu ebushelelezi nokufinyelela kwegazi
3. I-bone scan (okungavamile ukudingeka) ukuhlola ukunikezwa kwegazi emathanjeni
4. Izithombe ze-X-ray zokulandelela ngokuhamba kwesikhathi ukuqapha ukuqhubeka kwesifo

Udokotela wakho angase futhi ayalele ukuhlolwa kwegazi ukuze akhiphe ezinye izimo ezingase zibangele izimpawu ezifanayo. Ukuxilongwa kuvame ukuqinisekiswa ngokushintsha kwe-X-ray, nakuba ekuqaleni kwesifo, izithombe ze-X-ray zingase zibonakale zivamile.

Ukuthola ukuxilongwa okuqondile kungathatha isikhathi ngoba isimo siqhubeka ngezigaba ezahlukene. Udokotela wakho uzofuna ukubona umntanakho ngezikhathi zokulandelela ukuze alandele ukuthi isimo siqhubeka kanjani.

Yikuphi ukwelashwa kokuthakathaka kweLegg-Calve-Perthes?

Ukwelashwa kokuthakathaka kweLegg-Calve-Perthes kugxile ekuvikeleni ithambo lomhlangano ngenkathi ithambo liyaphila futhi lizibuyekeza ngokwemvelo. Umgomo ukugcina ingxenye yebhola yethambo lomhlangano iyingqimba futhi isibekwe kahle esokisini ngesikhathi senqubo yokwelapha.

Izinketho zokwelapha ziyahluka kuye ngobudala bomntanakho nobunzima besimo:

• Ukubuka ngokuqapha okuvamile kwezimo ezilula
• Ukushintsha komsebenzi ukuze kunciphise ukucindezela emathanjeni
• Ukwelashwa komzimba ukuze kulondolozwe ukuguquguquka kwethambo lomhlangano namandla
• Ama-braces noma ama-casts ukuze agcine ithambo lomhlangano sisendaweni efanele
• Imithi yokulwa nokuvuvukala yokunciphisa ubuhlungu
• Ukuhlinzwa ezimweni ezinkulu ukuthuthukisa isikhundla sethambo lomhlangano

Inqubo yokwelapha iyancipha, ngokuvamile ithatha iminyaka engu-2 kuya kwengu-4 ukuze ithambo lizibuyekeze ngokuphelele. Ngalesi sikhathi, umntanakho uzodinga ukuhlolwa okuvamile ngezithombe ze-X-ray ukuze alandele intuthuko.

I-orthopedic yakho izokwakha uhlelo lokwelapha olufanele izidingo zomntanakho. Indlela ingase ishintshe njengoba isimo siqhubeka ngezigaba zalo ezahlukene zokwelapha.

Unganakekela kanjani ekhaya ngesikhathi sokuthakathaka kweLegg-Calve-Perthes?

Ukusekela umntanakho ekhaya kudlala indima ebalulekile ekubuyiselweni kwakhe nasempilweni yakhe yonke. Indlela yakho kufanele ibe yimbangela yokuvimba ithambo lomhlangano eliyaphila ngenkathi ulondoloza izipili zokuthakazelisa zomntanakho ngangokunokwenzeka.

Nazi izici eziyinhloko zokunakekelwa ekhaya:

• Khuthaza imisebenzi engathinti kakhulu njengokubhukuda, okuhle kakhulu ekuvikeleni impilo
• Siza umntanakho alandele imikhawulo yomsebenzi ngaphandle kokumenza azizwe ecindezelekile kakhulu
• Qinisekisa ukuthi uthatha imithi eyalelwe njengoba kuqondiswe
• Sekela ukwelashwa komzimba ekhaya
• Qaphela izimpawu zokwanda kobhlungu noma ubunzima bokuhamba
• Londoloza ukuxhumana okuvulekile mayelana nokuthi bazizwa kanjani ngokomzimba nangokomzwelo

Imisebenzi yokunciphisa ngesikhathi sokwelashwa okuqhubekayo ngokuvamile ihlanganisa ukugijima, ukuthoba, imidlalo yokuxhumana, nemisebenzi ebeka ukucindezela okukhulu emathanjeni. Noma kunjalo, umntanakho ngokuvamile angahlanganyela kwezinye imisebenzi ngezinguquko ezithile.

Ukusekela ngokomzwelo kubaluleke kakhulu njengokunakekelwa komzimba. Lesi simo singase sibe yinto ecasulayo kubantwana abasebenzayo abasuka kudingeka ukunciphisa imisebenzi yabo. Qinisekisa umntanakho ukuthi lokhu kuyasikhashana nokuthi bazokwazi ukubuyela emisebenzini yabo abayithandayo uma ukwelapha sekuphelile.

Kufanele ulungiselele kanjani isikhathi sakho sokuya kudokotela?

Ukuba ulungile ngezikhathi zakho zokubona udokotela kusiza ukuqinisekisa ukuthi uthola ukunakekelwa okuphelele kakhulu ngomntanakho. Letha uhlu lwemibuzo nokukhathazeka ukuze ungakhohlwa lutho olukhulu ngesikhathi sokuvakasha.

Ngaphambi kokuya kwakho, buthana nalolu lwazi:

• Lapho uqale ukubona izimpawu nokuthi zishintshe kanjani
• Imithi yamanje nanoma yikuphi ukwelashwa okwakulindeleke okwakulindeleke
• Umlando womndeni wezinkinga zethambo noma amathambo
• Izinga lomsebenzi womntanakho nanoma yimiphi imikhawulo abaye bahlangabezana nayo
• Imibuzo mayelana nezinketho zokwelapha, imikhawulo yomsebenzi, kanye nombono wesikhathi eside

Ungangabazi ukubuza nganoma yini ekukhathazayo, kusukela emibuzweni yokunakekelwa kwansuku zonke kuya ekubikezeleni kwesikhathi eside. Ukuqonda isimo somntanakho ngokuphelele kukusiza ukunikeza ukusekela okungcono kakhulu ekhaya.

Kusiza futhi ukulungiselela umntanakho ngokuchaza ukuthi yini engase ienzeke ngezindlela ezifanele ubudala. Lokhu kungasiza ukunciphisa ukukhathazeka kwabo ngokuya kudokotela.

Yini eyinhloko mayelana nobuthakathaka beLegg-Calve-Perthes?

Ubuthakathaka beLegg-Calve-Perthes, nakuba bukhulu, yisimo esiphilisa abantwana abaningi kahle ngokunakekelwa okufanele nesineke. Okubalulekile ukuxilongwa kwasekuqaleni nokulandelwa kohlelo lwakho lokwelapha ngokuqhubekayo, ngisho noma intuthuko ibonakala iyancipha.

Khumbula ukuthi ukwelapha kuthatha isikhathi, ngokuvamile iminyaka engu-2 kuya kwengu-4, kodwa abantwana abaningi baqhubeka bephila impilo esebenzayo, evamile. Umntanakho omncane lapho exilongwa khona, amathuba akhe okuphulukiswa ngokuphelele ngaphandle kwezinhlanganisela zesikhathi eside.

Hlala uxhumene neqembu lakho lochwepheshe bezempilo, landela imiyalo yomsebenzi, futhi unikeze ukusekela okuningi ngokomzwelo umntanakho ngalesi sikhathi esinzima. Ngokwelashwa okufanele nokukhathalela kwakho kothando, umntanakho angadlula lesi simo futhi abuyele kuzo zonke imisebenzi ayithandayo.

Imibuzo evamile ebuzwa mayelana nobuthakathaka beLegg-Calve-Perthes

Ingabe umntanakho uzokwazi ukudlala imidlalo futhi?

Abantwana abaningi bangabuyela emidlalweni nasemisebenzini ephelele uma ithambo lomhlangano liseliphilile ngokuphelele, okuthatha iminyaka engu-2 kuya kwengu-4. Udokotela wakho uzokwazisa uma kuphephile ukubuyela kancane emisebenzini efuna kakhulu. Abantu abaningi abake baba nesimo esinjalo baqhubeka bedlala imidlalo yokuncintisana futhi baqhuba impilo esebenzayo kakhulu.

Ingabe lesi simo siyadluliselwa?

Nakuba kungase kube nokuhlanganiswa kwezofu okuncane, ubuthakathaka beLegg-Calve-Perthes abudluliselwa ngokuqondile kubazali kubantwana. Ukuba nelungu lomndeni elinesimo kukhuphula ingozi kancane, kodwa abantwana abaningi abaluthuthukisa abanawo umlando womndeni wesifo.

Ingabe amathambo womabili angathinteka ngesikhathi esifanayo?

Yebo, nakuba lokhu kwenzeka kuphela ku-10-15% yezimo. Uma amathambo womabili ethintekile, ngokuvamile awathuthukisi lesi simo ngesikhathi esifanayo. Ngokuvamile, uma ithambo lesibili lihileleka, kwenzeka ngezinyanga noma ngeminyaka ngemva kwethambo lokuqala.

Ukude kangakanani umntanakho uzodinga ukunciphisa imisebenzi yakhe?

Imikhawulo yomsebenzi ngokuvamile ihlala isikhathi sonke senqubo yokwelapha esebenzayo, engaba iminyaka engu-2 kuya kwengu-4 kuye ngobudala bomntanakho nobunzima besimo sakhe. Udokotela wakho uzokhipha imikhawulo kancane njengoba ukwelapha kuqhubeka, uqale ngemisebenzi engathinti kakhulu bese ekugcineni uvumela ukuhlanganyela okuphelele emidlalweni.

Kwenzekani uma isimo singelaphiwa?

Ngaphandle kokwelashwa okufanele, ikhanda le-femoral lingase lingaphili ngesimo esingqimba, okungase kubeka izinkinga zethambo lomhlangano ebuntwini kuhlanganise nokuvuvukala kwethambo lomhlangano nokudingeka kokufakwa kwethambo lomhlangano. Ngokwelashwa okufanele, abantwana abaningi bagwema lezi zinhlanganisela zesikhathi eside futhi balondoloze ukusebenza kwethambo lomhlangano oluphilile impilo yabo yonke.