Ukulimala Kuhlangene Okuhlangene Njengomphumela Wokuxoshwa
Ukulimala kwe-Hill-Sachs ehlombe kwenzeka njengomphumela wokuhlukaniswa kwehlombe . Ukuphazamiseka kwehlombe kuvamise ukudideka ngehlombe elihlukene , kodwa lokhu kulimala kakhulu. Lapho kuvela ukuhlunga kwehlombe, ibhola lomjoqo wehlombe nebhokisi liphuma esikhundleni. Ngokuvamile, lapho lokhu kulimala kwenzeka okokuqala, omunye umuntu kufanele aphinde aphinde ahlangane nomjoqo , ngokuvamile esibhedlela noma emnyangweni ophuthumayo.
Ihlangene lehlombe lenziwe ibhola phezulu kwethambo lesandla (i-humerus), elibizwa ngokuthi ikhanda elikhukhumezayo. Ingxenyeni yehlombe iyingxenye ye-scapula (i-shoulder blade) ebizwa ngokuthi i-glenoid. Ukusiza ukubamba ibhola kulesi sikhwama kukhona izigulane, i-cartilage, nama-tendon.
Uma kuqhuma ihlombe, izakhiwo ezijwayelekile ezithinta ibhola ngaphakathi kwesikhwama sehlombe zilimazekile. Ukulimala kwehlombe kuncike kakhulu ekuguleni kwesiguli esilondoloze ukulimala. Ukulimala okujwayelekile kungakhathaliseki ukuthi yizigulane zehlombe, okuthiwa i- Bankart izinyembezi , ezenzeka ezigulini ezincane. Kubantu asebekhulile abahlukumeze amahlombe abo, ukulimala okuvamile kungokwezifiso ze- cuffler . Ngaphezu kokulimala komgogodla noma we- tendon , ithambo ne-cartilage nakho kungonakaliswa; uhlobo oluvame kakhulu lomonakalo lubhekwa njengesici se-Hill-Sachs.
Hill Sachs Defect
Ukukhubazeka kwe-Hill-Sachs kwenzeka lapho kunobungozi emthanjeni nasezinqabeni zekhanda elikhukhulayo.
Njengoba ikhanda elikhukhulayo lihlukana nesikhwameni senhlanganisela yehlombe, ikhanda eliyindilinga elizungezile liwela emaphethelweni ensikeni ngamandla. Lokhu kudala i-divot ekhanda eliqhakazile elibizwa ngokuthi i-compression fracture. Le divot ivame ukubonwa kwi-MRI, futhi ukulimala okukhulu kwe-Hill-Sachs kungabonakala nakwe-x-ray.
Ukukhubazeka kwe-Hill-Sachs akukhona ngokuzihlukanisa, okusho ukuthi kunomonakalo owake wavumela ukuba ihlombe livuleke. Ukukhubazeka kwe-Hill-Sachs kuvame ukusetshenziswa ukuze kuqinisekiswe ukuthi ihlombe livele liphuma ngaphandle, hhayi nje ukuxoshwa kancane, njengoba kwenzeka ku- subluxation . Ukukhubazeka kwe-Hill-Sachs kwenzeka cishe engxenyeni ye-shoulder time time dislocation futhi kubonakala njalo kubantu abanokungazinzi kokuphindaphindiwe kwamaphutha amaningi okudlule.
Isizathu sokubheka ukukhubazeka kwe-Hill-Sachs akugcini nje ukuqinisekisa ukulimala okusolakala ukuthi ukuhlwithwa kwehlombe, kepha nokuthi ukuhlonza ukulimala kwe-Hill-Sachs kubalulekile ukuqinisekisa ukuthi ukwelashwa okufanelekile kwe-shoulder dislocation .
Ukwelashwa Kwamahlombe Okuthintekayo
Njengoba kubonisiwe, kubalulekile ukuba udokotela wakho ohlinzayo aqaphele ukuba khona kwe-Hill-Sachs lesion ngaphambi kokuzama ukuhlinzwa ngokuphazamiseka kwehlombe . Uma ukukhubazeka kwe-Hill-Sachs kukhulu futhi kungashiywanga kungaqondakali, ukulungiswa kungase kuphumelele, futhi ukungazinzi kwehlombe okuphindaphindiwe kungenzeka.
I-criteria evamile esetshenziselwa ukucacisa ukuthi ukulimala kwe-Hill-Sachs kudinga ukwelashwa okwengeziwe ngenkathi yokuhlinzeka ubukhulu besilonda. Ukulimala okubandakanya ngaphansi kwezingu-20% zekhanda elikhukhumezayo cishe kungashiywa yedwa ngaphandle kokudinga ukwelashwa okuqhubekayo.
Lokhu kusho ukuthi ukwelashwa okujwayelekile kwe-shoulder dislocation (okungenzeka noma kungasho ukuhlinzeka) kungase kuqhubekele ngaphandle kokufaka inkohlakalo e-Hill-Sachs.
Ukulimala okubandakanya ngaphezu kwezingu-40% zekhanda elikhukhulayo cishe njalo kudinga ukwelashwa okwengeziwe. Ezimweni lapho ukukhubazeka kwe-Hill-Sachs kuhilela khona phakathi kuka-20-40% wekhanda elikhukhumezayo, udokotela ohlinzayo kufanele anqume ukuthi ukukhubazeka kubangele ukungazinzi. Ukukhubazeka kwe-Hill-Sachs okubangela ukuba ibhola lihambe ngokungavamile ngaphakathi kwesikhwama kuthiwa "ukubandakanya," futhi lokhu kulimala kwe-Hill-Sachs kudinga ukwelashwa okungeziwe okwengeziwe.
Izinketho zokwelashwa ukuphatha ukukhubazeka kwe-Hill-Sachs kufaka phakathi:
- Ukwenza lutho
Ukuqaphela ukuphathwa okuvamile, futhi kuvame ukuphumelela. Ikakhulukazi uma ukulimala kwe-Hill-Sachs kubandakanya okungaphansi kwezingu-20% zekhanda elikhukhumezayo, ukungenzi lutho ngokuvamile kuyindlela yokwelashwa engcono kakhulu. - I-Capsular Shift
Ukushintsha i-capsule ye-shoulder is ngokuyinhloko ukuhlinzwa ukuqinisa izicubu endaweni ye-Hill-Sachs ukukhubazeka ukuvimbela ukujikeleza ngokweqile kwehlombe. Ngokunciphisa ukujikeleza, ukukhubazeka kwe-Hill-Sachs kungase kungabi yisici esithintekayo. - I-Bone Grafting / I-Tissue Ukugcwalisa
Uma isici sikhulu, futhi ukumane nje kuqinisa ihlombe akusile, into kumele isetshenziselwe ukugcwalisa isici senhloko ekhukhulayo. Abanye odokotela bahlinza amathambo, ngokuvamile abavela ekhanda, noma ezinye izicubu ezithambile ukugcwalisa okungekho. - Ukungafuni
Ukungayitholi inqubo yindlela yokuhlinzwa ephakamisa ithambo elicindezelekile ukuze uzame ukusetha kabusha isimo esivamile sekhanda eliqhakazile. - Ukushintshwa Kwamahlombe
Kwezinye izimo ezingavamile, ukukhubazeka okukhulu kakhulu kweziguli ezindala, ukhetho olungcono lungase lube ukuhlinzwa okumele kube khona. Le nqubo ivame ukugcinwa isinqumo sokugcina kweziguli ezincane.
Ukunquma ukwelashwa okungcono kuncike ezintweni eziningi ezibandakanya ukubukeka kokulimala kwizifundo ze-imaging, ukutholakala kokuhlolwa komzimba, ukulindela ukujoyina ama-athletics esizayo, nokuthandwa kwabahlinzayo.
Imithombo:
I-Provencher MT, et al. "I-Hill-Sachs Lesion: Ukuxilongwa, Ukuhlukaniswa, Nokuphathwa" J Am Acad Orthop Surg April 2012 vol. 20 cha. 4 242-252