Matenda a Dupuytren ndi matenda omwe amachititsa kuti chala chimodzi kapena zingapo za dzanja zigwedezeke mosalekeza. Matendawa amakhudza chala chachinayi ndi chachisanu. Kuwukiraku kumalepheretsa mu mawonekedwe ake owopsa (pamene chala chikupindika pachikhatho), koma nthawi zambiri sichikhala chopweteka. Chiyambi cha matendawa, otchedwa Baron Guillaume de Dupuytren yemwe adalongosola mu 1831, sichidziwika mpaka lero. Kuchita opaleshoni kungakhale kofunikira kubwezeretsa chala chokhudzidwa kuti chizitha kusuntha, koma zobwerezabwereza ndizofala.

Matenda a Dupuytren amadziwika ndi kukhuthala kwa minofu pakati pa khungu ndi tendons padzanja lamanja pamlingo wa zala (palmar fascia). Pamene imasintha (nthawi zambiri mosasinthasintha koma mosapeŵeka), "imapindika" chala kapena zala kumbali ya kanjedza ndikuletsa kufalikira kwawo, koma osati kuwombana kwawo. Kubwerera kwapang'onopang'ono kwa minofu kumadziwika ndi maso mwa kupanga "zingwe".

Nthawi zambiri zimakhala pafupi zaka 50 pomwe zizindikiro zoyamba za matenda a Dupuytren zimawonekera. Tikumbukenso kuti akazi amakonda kukhala matenda mochedwa kuposa amuna. Ngakhale zitakhala choncho, kuukira koyambirira kudzakhala kofunika kwambiri.

Zala zonse za dzanja zimatha kukhudzidwa, koma mu 75% ya milandu kukhudzidwa kumayamba ndi chala chachinayi ndi chachisanu. (1) Ndizovuta kwambiri, koma matenda a Dupuytren amatha kukhudza kumbuyo kwa zala, mapazi a mapazi (Ledderhose matenda) ndi kugonana kwachimuna (Peyronie's disease).

Chiyambi cha matenda a Dupuytren sichidziwikabe mpaka pano. Zingakhale zina (ngati siziri zonse) za chibadwa, mamembala angapo a m'banja amakhudzidwa nthawi zambiri.

Kumwa mowa ndi fodya kumazindikiridwa ngati chinthu chowopsa, monga momwe zimawonekera kuti matenda angapo nthawi zina amagwirizanitsidwa ndi matenda a Dupuytren, monga khunyu ndi shuga. Mkangano umasokoneza dziko lachipatala chifukwa chokhudzidwa ndi ntchito ya biomechanical monga chiwopsezo cha matenda a Dupuytren. Zowonadi, kafukufuku wasayansi wopangidwa pakati pa ogwira ntchito amawonetsa mgwirizano pakati pa kugwedezeka kwamphamvu ndi matenda a Dupuytren, koma ntchito zamanja sizikudziwika - mpaka lero - ngati choyambitsa kapena chowopsa. (2) (3)

Zomwe zimayambitsa matendawa sizikudziwika, palibe chithandizo chomwe chilipo mpaka pano, kupatulapo opaleshoni. Zowonadi, kubwezako kukalepheretsa kukulitsa chala chimodzi kapena zingapo, opareshoni imaganiziridwa. Cholinga chake ndi kubwezeretsa kayendedwe ka chala chomwe chakhudzidwa ndikuchepetsa chiopsezo cha kufalikira kwa zala zina. Mayeso osavuta ndikutha kuyika dzanja lanu lathyathyathya pamtunda wathyathyathya. Mtundu wa alowererepo zimadalira siteji ya matenda.

• Gawo lazingwe (aponeurotomy): izi zimachitidwa pansi pa anesthesia yakomweko, koma zimapereka chiwopsezo cha kuvulala kwa ziwiya, mitsempha ndi tendon.
• Kuchotsa zingwe (aponevrectomy): opaleshoni imatha pakati pa mphindi 30 mpaka 2 hours. Mu mawonekedwe owopsa, ablation amatsagana ndi kumezanitsa khungu. Opaleshoni "yolemetsa" iyi ili ndi ubwino wochepetsera chiopsezo chobwereza, koma kuipa kosiya zotsatira zochititsa chidwi kwambiri.

Pamene matendawa akupita patsogolo ndipo opaleshoni sichitha zomwe zimayambitsa, chiopsezo chobwereza chimakhala chachikulu, makamaka pa nkhani ya aponeurotomy. Chiwerengero cha recidivism chimasiyana pakati pa 41% ndi 66% kutengera magwero. (1) Koma n’zotheka kubwereza njira zingapo panthaŵi ya matendawo.

Opaleshoni ikatha, wodwalayo ayenera kuvala orthosis kwa milungu ingapo, chipangizo chomwe chimathandiza kuti chalacho chiwonjezeke. Amapangidwa ndi occupational therapist. Kukonzanso zala kumayikidwa kuti abwezeretsenso kayendedwe kake chala. Opaleshoniyo imakhala pachiwopsezo, mu 3% ya milandu, kuwulula trophic matenda (osauka vascularization) kapena algodystrophy. (IFCM)