Ama-Fractures we-Hip Joint ye-Ball-and-Socket
I-femoral fracture fracture yinye uhlobo lwe- hip fracture . Uma kwenzeka ukwehluleka kwentamo yezinsikazi, ukulimala kungaphansi kwebhola lomhlanganiso we-hip; lesi sifunda sethanga lesenzeni kuthiwa yi-femal neck. Uma kwenzeka ukwephulwa kwentamo yezinsikazi, ibhola lixhunyiwe kusuka kulo lonke leli thambo lesiteni (i-femur).
Inkinga ebalulekile ne-femoral neck fractures yukuthi igazi elihlinzekwa yingxenye yethambo livame ukulimala ngesikhathi sokulimala.
Ngenxa yokuthi ukugeleza kwegazi kuphazanyiswa, lezi zincipha zisesengozini enkulu yokungaphuluki , ikakhulukazi uma ukuphuka kungasebenzi kahle. Ngenxa yenkinga yegazi nge-femoral neck fractures, abantu abaningi bazophathwa nge-hip esikhundleni sendawo.
Ukwelashwa kwe-Femoral Neck Ukuhlukunyezwa
Ukwelashwa kwesifo sensikazi ukuphuka kuncike ezintweni eziningana. Imigomo ebaluleke kakhulu yokucatshangelwa ihlanganisa:
- Inani lokufuduka kwephutha
- Ubudala besiguli
Ezigulini ezincane, labo abangaphansi kweminyaka engama-60 kuya kwengu-65 ubudala, yonke imizamo izokwenziwa ukugwema ukushintshwa kwe-hip okuyingxenye. Ukushintshwa kwe-Hip kusebenza kahle kakhulu ezigulini ezingasebenzi, kodwa zijwayele ukuguga iziguli ezincane, ezisebenzayo. Ngakho-ke, ezigulini ezincane, kungenzeka ukuthi kuthathwe ithuba lokugwema indawo ye-hip ngisho noma kunengozi enkulu yokuphulukiswa okungenakuphulukiswa.
Izinketho zokuhlinza
I-Hip Pinning (Ukulungisa I-Fracture)
I-hip pinning yinkqubo eyenziwe ukufaka izikhwama eziningana kulo lonke ithambo eliphukile.
I-hip pinning ngokuvamile iyenziwa kuphela ezigulini ezinezintambo ezithinta izinsikazi ezihambisana kahle futhi zihamba kancane. Ezigulini ezincane, njengoba kuchazwe ngenhla, ukuqubuka kwe-hip kungenziwa ukuzama ngisho noma amathambo awahambisani kahle. Kodwa-ke, ngisho nakule ndlela, ukufakwa esikhundleni se-hip kungadingeka.
Uma kukhishwa isifuba, isiguli sivame ukuba ngaphansi kwe-anesthesia ejwayelekile noma yomgogodla . Ukucubungula okuncane kwenziwa ngaphandle kwethanga. Usebenzisa i-x-ray ukuze uqondise udokotela wakho ohlinzayo, izikhwama eziningana zidluliselwa ngaphesheya kwephuka ukuze kuqiniswe amathambo aphukile.
Iziguli zingakwazi ukubeka isisindo esiningi ku-hip elungisiwe njengoba kukhuthazwe, kodwa lokhu kuzohluka kwezinye izimo. Hlola nodokotela wakho ohlinzayo ngaphambi kokuqala noma yikuphi ukwelashwa noma ukuzivocavoca. Njengoba amathambo ephulukisa, ubuhlungu ngokuvamile buyophela. Ukukhathazeka okuyinhloko nge-femoral neck fractures wukuthi ukuhlinzeka kwegazi okonakele emthanjeni kuzoholela ekungeneni ukuphulukisa noma ekufeni (i- hip osteonecrosis ) yekhanda lesifazane. Kulezi zimo, iziguli zingadinga ukuhlinzeka ngokuhlinzwa esikhundleni somgwaqo phansi komgwaqo.
I-Hip Hemiarthroplasty (i-Hip Replacement ehlukile)
I-hemiarthroplasty ye-hip ichaza ingxenye yesigqila se-hip. Kule nqubo, ibhola lomshini we-ball-and-socket lisusiwe, futhi ukufakelwa kwensimbi kufakwa kuhlangene. I-Hip hemiarthroplasty iyathandwa kwiziguli ezinezinkinga eziphumile endaweni ngenxa yezinkinga ezichazwe ngenhla ngokuzama ukulungisa lezi ziphuphu.
I-hemiarthroplasty ye-hip yenziwa ngaphansi kwe-anesthesia jikelele noma i-anesthesia yomgogodla.
I-incision yenziwa ngaphezu kwe-hip. Inhloko ye-femal ephukile isuswe, futhi ithathelwe indawo yokufakelwa kwensimbi. Esikhathini sokuhlinzwa okujwayelekile okuqhutshwa esikhundleni se-hip , i-socket ye-pelvis izophinde ishintshwe. Lokhu kungenziwa ezigulini ezine- arthritis ekhona ngaphambili, kodwa ezimweni eziningi ze-femal neck fractures, isikhwama sishiywe yedwa. I-stem stem ingafakwa emathanjeni ezigulini ezinezintambo ezincane, amathambo angaphezu kwe-osteoporotic, noma ukucindezela iziguli ezinezinga eliphakeme lamathambo.
Ukulungiswa kabusha kuqaliswa ngokushesha futhi iziguli zivame ukuhamba ngesisindo saso esigcwele ekufakweni.
Iziguli zivame ukuzizwa zingcono ngemva kokuhlinzwa, futhi ngokuvamile zibuye zihambe ngokushesha.
Imithombo:
UKJ Koval noJD Zuckerman; "Ama-Hip Fractures: I. Uhlolojikelele nokuHlola nokuPhathwa kwe-Femoral-Neck Fractures" J. Am. I-Acad. I-Ortho. Ukuhlinzwa., Meyi 1994; 2: 141 - 149.