Ranch Ki An Sante

June 17, 2018
Health and Mental Care
News

Doktè Eric Eisner, MD, Chirijyen òtopedik pedyatrik e espesyalis nan prezèvasyon ranch, lopital pou timoun Joe DiMaggio Children’s Hospital, Depatman chiriji òtopedik ak Sant pou prezèvasyon ranch


Pi fò moun gen yon zanmi oubyen yon fanmi ki fè operasyon pou ranplase ranch yo. Pou byen di w, anvan 2030 rive, yo prevwa valè Ameriken ki pral bezwen operasyon ranplasman ranch ap prèske 600.000. Men, gen anpil maladi ki mete moun an dispozisyon pou yo vin fè yon fòm rimatis yo rele atrit, se maladi yo kapab idantifye e trete depi byen bonè nan lavi moun. Malgre pi fò moun pa wè atrit kòm yon pwoblèm yo kab soulaje avèk swen medikal anvan maladi a rive, lè doktè ki espesyalize nan ranch timoun fè egzaminasyon ak tretman pou pasyan ki gen gwo chans pou yo vin gen atrit nan ranch ak anpil doulè, sa ka ede yo anpil. Yon fason senp pou w wè jwenti ranch se imajine yon boul won nan yon sòkèt won. Imajine yon kawotchou machin; si kawotchou a difòm oubyen si aliyman machin nan pa bon, kawotchou a ap fini vit. Ranch lan menm jan. Nenpòt ti dezajistaj ki genyen ant fòm boul la ak sòkèt la ap lakòz ranch lan kòmanse mache mal. Maladi ranch yo kab trete se maladi moun kab genyen nan nenpòt laj, depi nan piti jis nan granmoun. Tout tibebe ki fèk fèt gen yon pedyat ki egzaminen yo pou wè si ranch yo anfòm, oubyen pou wè si ranch lan pa gen displazi (malfòmasyon). Pedyat la ap asire li boul la (tèt femoral) byen chita nan sòkèt la (cavite kotiloyid). Avèk yon bon konsiltasyon, yon doktè ki gen esperyans kapab detekte ata ti anomali ki anba chal. Si pedyat la enkyete pou ranch tibebe a, lepli souvan l ap voye timoun nan bay yon chirijyen òtopedik pedyatrik pou konfime sa l wè a epi pou yo fètretman. Yo sèvi ak iltrason (yo pa fè timoun nan pase anba radiyasyon) sou tibebe ki fèk fèt pou yo kab jwenn plis enfòmasyon sou fòm ak pozisyon ranch lan. Si sa nesesè, tretman ki pa makawon an jeneral konn byen reyisi, epi tou anwetan egzamen suivi òdinè pandan timoun nan piti, tretman ki mande operasyon pa nesesè. Kwak gen anpil pasyan se pandan yo tibebe doktè wè ranch yo pa nòmal, gen lòt timoun ki ka pa montre okenn sentòm jiskaske yo gen ant 1 an ak 3 an ki aktif anpil oubyen ti jennjan ti jennfi ki aktif anpil. Sa ki kab reprezante premye siy yon timoun ki gen laj pou l al lekòl gen displazi ranch, se lè li kòmanse santi ti doulè bò ranch li san li pa t pran okenn chòk oubyen san okenn lòt maladi. Pou timoun nan gen yon bon ranch ki estab e ki kab dire tout vi li, l ap bezwen bon jan egzamen ak tretman nan men yon chirijyen òtopedik pedyatrik. Pou timoun ki pi gran, tretman an ka doktè ap suiv li, kad, oubyen ata operasyon. Anplis displazi, gen plizyè maladi ranch ki kapab lakòz doulè nan tout bò ranch lan, bò lenn nan, epi ata bò jenou an. Enfeksyon bakteri lakòz nan jwenti ranch lan se yon ijans toutbon, e enfeksyon kon sa mande tretman ijan pou anpeche domaj ki kab dire lontan. Lepli souvan, reyaksyon kò a bay lè yon timoun fè enfeksyon respiratwa, yon maladi yo rele sinovit egi tranzitwa (rim nan ranch), ka lakòz doulè nan ranch epi tou sa ka lakòz timoun nan bwete. Sa ka difisil pou yo fè diferans ant 2 maladi sa yo, youn nan yo se yon ijans epi lòt la kab geri pou kont li. Sa ki enpòtan anpil pou anpeche timoun nan gen domaj ki kab dire lontan, se konsiltasyon kay doktè prensipal li, doktè saldijans oubyen chirijyen òtopedik pedyatrik. Pwoblèm sikilasyon san ki ale nan boul jwenti ranch lan (Maladi Legg-Calvé-Perthes) kapab parèt sou fòm ti doulè ki kòmanse tou dousman nan ranch lan, rediksyon nan kapasite ranch lan pou l fè mouvman, oubyen sou fòm yon mache bwete. Lè yo bay timoun nantretman depi byen bonè pou prezève fòm boul la pandan doktè ap chacheretabli sikilasyon san an, sa kapab anpec  he pwoblèm pi devan nan lavi timoun nan, tankou atrit ki bay anpil doulè. Gen yon lòt maladi yo jwenn souvan nan pi gran timoun ak ti jennjan ti jennfi ki rele slipped capital femoral epiphysis (SCFE). Prensipalman, boul sòkèt ranch lan soti nan plas li. Sa kab lakòz yon defòmasyon ki grav anpil ak yon deteryorasyon rapid jwenti ranch lan. Sentòm yo ka kòmanse byen dousman, men yo ka parèt bridsoukou, epi tou operasyon oblije fèt pou anpeche sentòm yo vin pi grav. Malgre doktè detekte yon bon valè maladi ranch sa yo byen bonè nan timoun piti, malgre yo kòmanse tretman byen bonè, sèten pasyan vin gen defòmasyon kanmèm swa nan boul oubyen nan sòkèt jwenti ranch lan. Anpil nan pasyan sa yo se atlèt ki fè ranch yo travay anpil. Lontan, timoun sa yo te oblije sispann jwe espò yo renmen an epi yo te destine pou yo fè operasyon pou ranplase ranch yo pandan you tou jèn. Men, kounye a yo parèt avèk nouvo teknik operasyon pou ede timoun sa yo tounen sou teren espò, epi tou pou ranvwaye operasyon pou ranplase ranch lan oubyen anpeche sa fèt nèt. Chirijyen òtopedik pedyatrik ki gen fòmasyon espesyalize nan operasyon pou prezève ranch, fè tretman pou soulaje doulè, amelyore fonksyònman ranch lan epi bay pasyan an yon ranch ki an sante e ki kapab dire pandan tout vi pasyan an. Chirijyen espesyalize sa yo sèvi ak teknik atwoskopik (ki pa twò makawon) e ki ouvè, kon sa yo gen okazyon pou yo pote gwo chanjman nan lavi anpil pasyan. Avèk deteksyon epi ak tretman maladi ranch pou timoun ki malad, gen posiblite pou nou ranvèse epidemi atrit nan ranch ki egziste kounye a. 

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