Zomwe zimatchedwanso calcaneal kapena Lenoir's spine, calcaneal enthesophyte ndi kukula kwa fupa komwe kumakhala kumbuyo kwa calcaneum, fupa lomwe lili pachidendene cha mapazi. Zimayambitsidwa ndi kutupa kosatha kwa plantar fascia yomwe imagwirizanitsa chidendene ndi zala ndikuthandizira phazi lonse. Mafotokozedwe.

Kukhuthala kwa plantar fascia (nembanemba ya fibrous yomwe imayendetsa phazi lonse la phazi), calcaneal enthesophyte imapezeka ngati msana wa fupa womwe uli kumapeto kwa calcaneus. Ndilo fupa la mbali yakumbuyo ya phazi lomwe limapanga chidendene.

Msana wa fupa uwu umapangidwa pamlingo wa kutupa kwapang'onopang'ono kwa plantar aponeurosis, kutsatira ma microtraumas obwerezabwereza monga panthawi ya masewera omwe amaika katundu mobwerezabwereza pa chidendene monga kuthamanga, kuvala nsapato zosagwirizana ndi mapazi kapena kukwera pamtunda wa miyala. . Fascia iyi imathandizira phazi lonse la phazi ndi phazi, kuchokera ku chidendene mpaka kumapazi, ndipo imatumiza mphamvu yofunikira yoyendetsa phazi kuchokera kumbuyo kupita kutsogolo. Imafunika kwambiri pothamanga.

Mapangidwe a calcaneal enthesophyte ndiye chifukwa cha vuto lothandizira panthawi yosuntha mobwerezabwereza phazi lodzaza.

Zifukwa za calcaneal enthesophyte ndi zingapo:

• kugwiritsa ntchito mopitirira muyeso chidendene ndi plantar fascia pochita masewera monga kuthamanga, kuyenda pamtunda wa miyala, basketball, kuthamanga monga sprinting, etc. Mwachidule, masewera aliwonse pa chiyambi cha microtrauma yobwerezabwereza ya phazi limodzi;
• nsapato zomwe sizingagwirizane bwino ndi mapazi, nsapato zomwe zimakhala zazikulu kwambiri, zopapatiza kwambiri, zokhala ndi zokhazokha zomwe zimakhala zolimba kwambiri kapena mosiyana kwambiri, kuthandizira bwino kwa akakolo, chidendene chokwera kwambiri kapena chochepa kwambiri, etc. Anthu 40% okha kukhala ndi phazi “labwinobwino,” ndiko kunena kuti palibe phazi lathyathyathya, kapena lophwanyika kwambiri, kapena losatembenuzika kwambiri mkati (kutchulidwa), kapena kutembenuzira kunja kwambiri (kutsogola);
• Kunenepa kwambiri komwe kumayika katundu wambiri pamalumikizidwe onse onyamula katundu monga msana (lumbar spine), chiuno, mawondo ndi akakolo. Kuchulukitsitsa kumeneku kungakhale chifukwa, m'kupita kwa nthawi, kugwedezeka kwa phazi la phazi ndi kusalinganika kwa chithandizo cha phazi pansi.

Pomaliza, okalamba, kukhalapo kwa calcaneal enthesophyte pachidendene kumachitika pafupipafupi chifukwa cha kupunduka kwa phazi (osteoarthritis), kunenepa kwambiri, nsapato zosasinthika bwino komanso kuchepetsa mphamvu ya minofu ndi mitsempha.

Kupweteka kwakukulu pachidendene pamene kulemera pamene mukuyenda ndi chizindikiro chachikulu. Kupweteka kumeneku kumatha kukhala ngati kung'ambika, kumva kuwawa kwa phazi koma kokulirapo pachidendene, ululu wakuthwa ngati msomali wokhazikika pachidendene.

Zitha kuwoneka mwadzidzidzi m'mawa mutadzuka pabedi, koma osati m'mawa uliwonse, kapena mutakhala nthawi yayitali pampando kapena mpando. Pambuyo pa masitepe angapo, ululuwo umatha. Ndiko kutupa kwa aponeurosis ya phazi la phazi lomwe limapereka zowawa zowawa zomwe zingathe kukhazikitsidwa, kapena kutulutsa kuchokera kumbuyo kupita kutsogolo kwa phazi.

Palibe zizindikiro zotupa pakhungu la chidendene pamlingo wa chidendene spur. Zoonadi, ndi plantar aponeurosis yomwe imakhala yotupa ndipo minofu ya chidendene pamlingo wake siili. Koma nthawi zina kutupa pang'ono kwa dera lomwe lakhudzidwa limatha kuwonedwa.

Kuyeza kwa thupi kumapeza kupweteka kwakukulu ndi kupanikizika kwa chidendene ndipo nthawi zina kuuma kwa bondo. N'zotheka kutambasula plantar fascia mwa kuika zala zala mu dorsiflexion (mmwamba). Palpation yake yolunjika imayambitsa kupweteka kwambiri.

Koma ndi X-ray ya phazi yomwe idzatsimikizira matendawa mwa kusonyeza kashiamu kakang'ono pamunsi pa calcaneum, kukula kosiyana. Imachitira umboni za ossification ya kuyika kwa minofu pa calcaneum. Komabe, odwala ena amakhala ndi mungawu popanda zizindikiro zowawa. Si nthawi zonse chifukwa cha ululu.

Ndiko makamaka kutupa kwa plantar fascia yomwe ili pa chiyambi cha ululu. Magnetic Resonance Imaging (MRI) ikhoza kuchitidwa yomwe ingatsimikizire kukhuthala kwake komwe kumalumikizidwa ndi kutupa kwake. Koma nthawi zambiri, sikofunikira kuti adziwe matenda a calcaneal enthesophyte.

Njira yoyamba yothandizira ndikuchepetsa zochitika zamasewera zomwe zingasokoneze kwambiri fascia ndi phazi la phazi. Kenako, ma insoles a mafupa ayenera kupangidwa pambuyo poyang'aniridwa ndi podiatrist. Ntchito yawo idzakhala kumasula plantar aponeurosis. Miyendo iyi idzakhala ndi dome yaying'ono kapena chidendene chododometsa pazidendene kuti muchepetse chithandizo.

Ngati ululu ukupitirira, n`zotheka kuchita corticosteroid infiltrations kwanuko.

Physiotherapy ingathandizenso kuchiza mwa kutambasula mobwerezabwereza kwa mwana wa ng'ombe-Achilles tendon ndi plantar fascia. Kudzipaka minofu ya phazi pogwiritsa ntchito mpira wa tenisi ndizotheka kutambasula fascia ndikuchotsa ululu. Kuonda pamaso pa kunenepa kumalimbikitsidwanso kwambiri kuti muchepetse katundu pazidendene ndi phazi la phazi.

Pomaliza, opaleshoni sawonetsedwa kawirikawiri. Ngakhale nthawi zina amakanidwa ndi madokotala ochita opaleshoni pokhapokha ngati chithandizo china chalephera komanso kupweteka kwakukulu movutikira kuyenda.