Ծնկի վնասվածքները շատ տարածված են սպորտով զբաղվող երեխաների մոտ, ներառյալ կապանների վնասվածքները և գերձգումները։ Բոլոր այս տեսակի վնասվածքները կարող են լինել բավականին լուրջ՝ հատկապես, եթե երեխան չի կարողանում քայլել կամ նրա ծունկը անկայուն է։
Այդ իսկ պատճառով, երբ երեխայի ծունկը ցավում է, ծնողները պետք է տանեն նրան մանկաբույժի մոտ։ Օսգուդ-Շլատտերի հիվանդությունը նույնպես հանդիսանում է ծնկի ցավի տարածված պատճառ, բայց ի տարբերություն գերձգումների կամ այլ վնասվածքների, այն հիմնականում այդքան էլ լուրջ չէ և հետագայում գրեթե չի ունենում որևէ հետևանքներ։
Ախտանիշները
Օսգուդ-Շլատտերի հիվանդությամբ երեխաները ունենում են ցավոտ, այտուցված թմբիկ անմիջապես ծնկահոդից ներքև՝ ոլոքային թմբկության վրա։ Չնայած այն հաճախ տեղակայված է լինում մեկ ծնկի վրա, սակայն լինում են դեպքեր, երբ երկու ծունկն էլ ախտահարվում են։
Ի տարբերություն ծնկի ցավ առաջացնող այլ խնդիրների, Օսգուդ-Շլատտերի հիվանդությամբ երեխաների մոտ ցավը առկա է լինում միայն որոշակի ակտիվությունների ժամանակ, օրինակ՝ վազելու, ծնկելու, թռչկոտելու, կքանստելու և աստիճան բարձրանալու ժամանակ։ Երկար ժամանակ նստած մնալը նույնպես կարող է բերել ցավի առաջացման, սակայն այս հիվանդությամբ երեխաները սովորաբար կարողանում են նորմալ քայլել՝ առանց ցավի կամ կաղալու։
Սա կոտրվածքի կամ ծնկի կապանների գերձգման ամբողջովին հակառակ պատկերն է, որոնց դեպքում ցանկացած ակտիվություն՝ անգամ քայլելը բավականին ցավոտ է և կարող է ստիպել երեխային կաղալ։
Ախտորոշում
Իհարկե, կարելի է իրականացնել ռենտգեն հետազոտություն, սակայն Օսգուդ-Շլատտերի հիվանդությունը սովորաբար ախտորոշվում է հիմնվելով հիվանդության դասական դրսևորումների առկայության վրա՝ երիտասարդ դեռահասի ոլոքային թմբկության վրա առկա է այտուցված թմբիկ, որը սկսում է ցավել ֆիզիկական ակտիվություն կատարելիս։ Այլ, ավելի լուրջ խնդիրներ ևս կարող են այս շրջանում առաջացնել ցավոտ թմբիկ, օրինակ՝ ուռուցքը, ինֆեկցիան կամ կոտրվածքը, սակայն այդ դեպքում ցավը առկա կլինի անգամ հանգստի կամ պարզապես քայլելու ժամանակ։
Բուժում
Հիմնականում բուժումը սիմպտոմատիկ է, որը ներառում է ոչ ստերոիդային հակաբորբոքային դեղորայքի կիրառում, օրինակ՝ իբուպրոֆեն, հանգիստ և սպորտով զբաղվելուց հետո այդ հատվածում սառը դնել։
Չնայած նրան, որ հանգիստը շատ կարևոր է՝ հատկապես այն ակտիվություններից խուսափելը, որոնք բերում են ցավի ուժեղացման, միևնույնն է, որքանով ձեր երեխան զերծ կմնա ֆիզիկական ակտիվությունից կախված է միայն նրանից, թե որքան ուժեղ է ցավը։ Եթե նա ունակ է արագ քայլելու, վազելու կամ սպորտով զբաղվելու առանց կաղալու կամ ուժեղ ցավի, ապա նա կարող է շարունակել իր սովորական ակտիվությունը։ Բայց եթե նա այս ակտիվությունների ժամանակ ունենում է սաստիկ ցավեր կամ սկսում է կաղալ, ապա գուցե մի քանի շաբաթ կամ ամիս հանգստի կարիք լինի։ Վերջին տարբերակով ձեր երեխան կարող է խուսափել այնպիսի ակտիվություններից, որոնք սաստիկ ցավ են առաջացնում՝ հատկապես այն ակտիվություններից, որոնք ներառում են ցատկոտելը, կքանստելը կամ ծնկելը։ Սա համարվում է հարաբերական հանգիստ։
Եթե ցավը շատ ուժեղ չէ, ապա երեխան կարող է դիմանալ ցավին, եթե ունի Օսգուդ-Շլատտերի հիվանդություն։
Ծնկի կամ ծնկահոդի ջլերի ֆիքսատորները նույնպես կարող են բավականին արդյունավետ լինել։ Օսգուդ-Շլատտերի հիվանդությամբ երեխայի համար լավագույն ընտրությունը սովորաբար ծնկի ֆիքսատորն է, որը կապվում է ծնկահոդի պարկի անմիջապես ներքևում։ Ծնկային բարձիկը, որը տեղադրվում է ցավոտ հատվածում՝ վերջինս պաշտպանելու համար, նույնպես արդյունավետ է։
Շատ հազվադեպ՝ հատուկենտ դեպքերում, հարկավոր է լինում անշարժացնել ծունկը։ Վիրահատության կարիք գրեթե չի լինում։
Ի՞նչ պետք է իմանալ
Ստորև նշված է մնացած այն ամենն, ինչ պետք է իմանաք Օսգուդ-Շլատտերի հիվանդության մասին․
- Օսգուդ-Շլատտերի հիվանդությունը սովորաբար սկսվում է զարգանալ երեխայի ակտիվ աճի ժամանակահատվածում՝ 9-14 տարեկան, սպորտով զբաղվող երեխաների մոտ։
- Չնայած ժամանակին կար կարծիք, որ այս հիվանդությունը ախտահարում է միայն տղա երեխաներին, սակայն, քանզի գնալով աղջիկները ավելի շատ են մասնակցում սպորտային միջոցառումներին, Օսգուդ-Շլատտերի հիվանդությունը սկսել է բավականին հաճախ ախտորոշվել նաև աղջիկ երեխաների մոտ։ Ի դեպ, աղջիկների մոտ այս հիվանդությունը սկսվում է ավելի վաղ տարիքում՝ 10-11 տարեկանում, համեմատած տղաների 13-14 տարեկանի հետ։ Սա ամենայն հավանականությամբ կապված է նրա հետ, որ աղջիկների մոտ ակտիվ աճը ավելի վաղ տարիքում է սկսվում։
- Օսգուդ-Շլատտերի հիվանդությունը առաջանում է քրոնիկ միկրոտրավմաների հետևանքով, ինչի պատճառով այն համարվում է գերօգտագործման հիվանդություն։
- Ախտանիշները սովորաբար տևում են 12-18 ամիս և երեխաներից շատերի մոտ դրսևորվում են անցավ թմբիկի առկայությամբ։ Ըստ վերջերս կատարված հետազոտության՝ որոշ երեխաների մոտ Օսգուդ-Շլատտերի հիվանդությամբ ախտորոշվելուց 4 տարի անց կարող է սկսել առաջանալ ցավ։
- Ձկնամկանների, քառագլուխ մկանների (ազդրի առաջային հատված) և ազդրի հետին մկանախմբերի ձգող և պնդացնող վարժությունները կարող են կանխարգելել Օսգուդ-Շլատտերի հիվանդության առաջացումը։
- Ժամանակին կատարված ճշգրիտ ախտորոշումը թույլ կտա խուսափել անիմաստ հետազոտություններից և բուժումներից։
- Սինդինգ-Լարսեն-Ջոհանսոնի կամ «ցատկողի ծունկ» հիվանդությունը շատ նման է այս հիվանդությանը, սակայն այդ դեպքում ծավը սովորաբար տեղակայվում է ծնկահոդի ստորին հատվածում, այլ ոչ թե ծնկահոդից ներքև՝ ինչպես Օսգուդ-Շլատտերի հիվանդության ժամանակ։
Ինչպես նաև, եթե ձեր երեխան ունի Օսգուդ-Շլատտերի հիվանդություն, ապա դուք պետք է նաև զգուշանաք նմանատիպ վիճակից՝ Սևերի հիվանդությունից, հատկապես եթե նա դեռ չունի այդ հիվանդությունը։
Արդյո՞ք ձեր երեխան միաժամանակ զբաղվում է տարբեր մարզաձևերով, կամ նա միաժամանակ մասնակցում է նույն մարզաձևի տարբեր թիմերի խաղերին։ Արդյո՞ք նա ամեն օր գնում է մարզումների կամ տարվա ընթացքում չի ունենում արձակուրդ։ Այս բոլորը այն գործոններն են, որոնք երեխաներին դնում են այս հիվանդության զարգացման ռիսկի տակ։ Ակտիվ լինելը, մարզվելը և սպորտով զբաղվելը, անշուշտ, շատ լավ է՝ միայն պետք չէ չարաշահել։
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