Ulnar drift, oo sidoo kale loo yaqaan ulnar sapi, waa deformity faraha gacanta . Gaar ahaan, wadnaha ulnar wuxuu dhacaa marka uu jiro isbedelka ulnar iyo sarruxida isbeddelka ah ee xirmooyinka metacarpophalangeal (MCP). Midkale ahaan, maqaarka proximal-ku wuxuu ku biiraa maadooyinka gacanta ee kudubyada jirka ee metacarpophalangeal. Isku-xirnaanta MCP ayaa badanaa loo yaqaannaa qoryaha.
Dhiigbaxa wadnaha ah ee isku dhafan ee wadajirka ah ayaa kobcaya marka uu jiro qayb ka mid ah kala-soocida wadajir ah - qallalka xuubka ayaa ka baxaya madaxa muraayadda, oo u dhaqaaqaya jihada gawaarida. Dhaqdhaqaaqyada dhexdhexaad ah iyo kuwa maqalaha ah waxay raacaan dhaqdhaqaaqa isbedbedelka shoogga.
Sida laga soo xigtay Kelley "Textbook of Rheumatology" , waxaa jira caddayn ah in cudurka rheumatic ee curcurku uu keenayo isbedelka ulnar ee xirmooyinka MCP. Waxaa loo maleynayaa in daciifinta muruqa ulnaris muruqyada ay sababto isbeddel dhab ah ee curcurka sida lafaha carpal isbedelaan (lafaha carpal proximal waxay u leexiyaan jihada ulnar iyo lafaha maqaarka ee gudaha jihada diirada ah). Ulnar khalkhalku wuxuu kobciyaa jawi jireed, isku dayaya in uu jilbaha jilicsan ku dhejiyo farsamada. Kaadida lafaha ama qandhada casriga ah waxay ka qayb qaadan kartaa qulqulka ulnar, laakiin sidoo kale waxay dhici kartaa iyada oo aan midna midkoodna. Sinboqada iyo daciifinta murqaha ayaa door ka ciyaari kara horumarinteeda.
Astaamaha hore ee ulnar-siga waxaa ka mid ah:
- daciifnimada koowaad ee interossei (interossei waa murqaha u dhexeeya lafaha gaarka ah)
- jilicsanaanta xididdada daboolka adag
- xoojinta murqaha ilayska
- ulnar barokicinta jilicsanaanta jilicsanaanta (caan ku ah calaamadaha iyo faraha dheer)
- Farogelinta ulnar ee faraha oo cad in marka la kordhiyo MCP
Calaamadaha ugu sarreeya ee ulnar waa:
- sarrufation volar subluxation (qayb ka mid ah qoondaynta) ee falaarta
- awood la'aanta in ay si buuxda u kordhiso xirmooyinka MCP ee keena qandho jaban
- ulnar roogga ama wareegga jilicsanaanta
- xoojinta murqaha hypothenar (koox ka mid ah saddex muruq oo geedka gacanta ee xakameynaya dhaqdhaqaaqa yar yar)
- isdhaafka shucaaca ee curcurka
- farsamooyinka gawaarida ah
- luminta awoodda suulka si looga soo horjeedo farta hoosta
Si loo qiimeeyo darnaanta ulnar, waxaa loo isticmaali karaa goniometer . Gacanta joogtada ee goniometer-ka ayaa la dhigayaa mareegta maskaxda halka kolka gacanta laga gooyo la dhigo barbardhac. Ka bacdi marka darajada loo yaqaan 'deformity', ayaa bukaanku badanaa la waydiiyaa si toos ah gacantooda, haddii ay suurtogal tahay, si firfircoon u saxo isku xirka iyo dib-u-cabbirid dib loo eego. Waxaa kale oo loo isticmaali karaa tijaabooyin kale oo gacanta gacanta lagu sameeyo si loo qiimeeyo darnaanta daacadnimada.
Yaa horumarinaya Ulnar Drift?
Ulnar drift waxaa ugu horreyn la xiriirta cudurka rheumatoid arthritis . Xanuunka joogtada ah ee isku-xirnaanta MCP wuxuu waxyeello u geystaa dhismaha kaabayaasha iyo dhismayaasha ku xeeran. Hase yeeshe, rheumatoid arthritis ma aha xaaladda keliya ee ku xiran ulnar drift. Waxaa laga yaabaa inay ku dhacdo xaalado kale oo barar ah ama cudurada xiriirka unugyada, sida lupus ama psoriasis arthritis .
Mid ka mid ah daraasadda kiisaska ayaa sidoo kale shaaca ka qaaday urur la socdo cillad aan caadi aheyn, synovitis pigmented podonodular (PVNS).
Fursadaha Daaweynta
Fursadaha lagu daweeyo bararka gacanta iyo xanuunka waxaa ka mid ah barafka, kuleylka qoyaanka, quraacda wax lagu dubo, TENS unit , iyo ultrasound. Leyliga gacanta, taas oo inta badan ku lug leh isku dhafka, waxaa lagula talinayaa in lagu ilaaliyo dhaqdhaqaaqa inta ugu badan ee suurtogalka ah.
Kabajinta ayaa mararka qaar lagula taliyaa in la yareeyo subluxation of biliijka, si habboon u dejiso xirmooyinka MCP ee dhexdhexaad ah oo dhexdhexaad ah, oo yareynaya subluxation of MCP isdul-gelyadooda iyagoo taageeraya fooriyooyinka proximal. Guud ahaan, kabadhada ayaa lagu xiraa habeenkii ama xilliyada nasashada ee maalintii.
Xakameyntu waxay ku caawin kartaa xanuunka habeenkii, lakabadaha looma muujinin inay ka hortagaan isbeddelka ulnar. Xitaa iyadoo la isku qurxiyo habeenkii, isbedelka ulnar ayaa laga yaabaa inuu horumaro.
> Ilo:
> Kelley ee buugta qoraalka ee Rheumatology. Qoraalka sagaalaad. Firestein et al. Elsevier Saunders. Qaababka Daaweynta Rheumatoid Arthritis. Cutubka 70aad. Gacmaha iyo walxaha. Page 1112.
> Volar Subluxation of Metacarpophalangeal Joint.
> Talooyin Tababarka ugu Fiican ee Maareynta Ulnar Drift Ciladda ee Rheumatoid Arthritis. Vancouver Coastal Health. Arthritis Society (Kanada).
> Isticmaalka Isticmaalka Nolturnal Dayactirida ee Daaweynta Ulnar Is-beddelka Gacanka Rheumatoid. Johnson M et al. Rheumatology Rugaha. March 1992.
> Cudurka Ulnar Marnaba Marna Rheumatoid . Zuber M et al. Annals of Cudurada Rheumatic. 1996.