Ukulimala Kwama-Ligament Okumnyama Kwama-Ligament we-Knee
I-posterior cruciate ligament, noma i-PCL, ingenye yemigqa emine ebalulekile ekuqineni kwamadolo . I- anterior cruciate ligament , noma i-ACL, ihlezi phambi kwe-PCL. I-ACL iyaziwa kangcono, ngokwengxenye ngoba izinyembezi ze-ACL zivame ukutholakala ukuthi kunezilimaza ku-PCL. Ngokuthakazelisayo, kucatshangwa ukuthi ukulimala kwe-PCL kubangelwa amaphesenti angaba ngu-20 okulimala kwamadolo, kodwa i-PCL ayikhulumi ngaso sonke isikhathi ngenxa yokuthi lokhu kulimala kuvame ukushiywa kungatholakali.
I-PCL yi-ligament evimbela i-tibia (ithambo lesifuba) ukusuka ekuthunyeleni kakhulu emuva. Kanye ne- ACL egcina i-tibia ingashiyi phambili kakhulu, i-PCL isiza ukugcina i-tibia esimweni esingezansi kwe-femur (ithambo lesthanga).
Izinyembezi ze-PCL
Indlela evame kakhulu yokulimala kwe-PCL yiyona okuthiwa "ukulimala kwedeshibhodi." Lokhu kwenzeka lapho idolo ligobile, futhi into enamandla ishaya umhlane emuva. Kubizwa ngokuthi 'ukulimala kwedashibhodi' ngoba lokhu kungabonakala ekushayweni kwemoto lapho i-shin ishaya ideshibhodi ngamandla. Enye indlela evamile yokulimala ukulimala kwezemidlalo lapho umgijimi ewa phambi kwamadolo. Kule ukulimala, idolo liyi-hyper flexed (libophe yonke indlela), ngezinyawo ezibheke phansi. Lezi zinhlobo zokulimala zicindezela i-PCL, futhi uma amandla ephakeme ngokwanele, izinyembezi ze-PCL zingaba umphumela.
Ukulimala kwe-PCL kubuye kubonakale kunesifo esibuhlungu esingabangela ukulimala emakhiweni amaningi edolo.
Izinyembezi ze-PCL zingathintana nezinye ukulimala kwamadolo, kuhlanganise nezinyembezi ze-ACL, izinyembezi ze-MCL , nezinyembezi ze-LCL . Zingatholakala nangamaphethini okulimala komgogodla we-ligament njenge- posterolateral rotatory instability . Ngaphezu kwalokho, ukulimala kwe-PCL kungase kuhlotshaniswe ne- meniscus izinyembezi nokulimala kwe-cartilage .
Ngokuvamile lezi amaphethini ezinzima kakhulu zokulimala zenzeka ngamadolo .
Izimpawu zezinyembezi ze-PCL
Izimpawu ezivame kakhulu zezinyembezi ze-PCL zifana neze nezimpawu zezinyembezi ze-ACL. Ubuhlungu obukhulu , ukuvuvukala nokunciphisa ukuvama kuvamile kokubili kokulimala. Iziguli zingase zibe nomuzwa wokuthi amadolo abo "aphelile" noma anikeze. Izinkinga zokungazinzi kwamadolo emavikini nasezinyangeni ezilandela ukulimala kwe-PCL akuvamile njengokungazinzi okulandela izinyembezi ze-ACL. Uma iziguli zinezinkinga emva kokulimala kwe-PCL zivame ukuthi azikwazi "ukwethemba" amadolo abo, noma ukuthi uzizwa sengathi amadolo angaphuma. Uma lesi sikhalazo sokungazinzi kuyinkinga emva kokulimala kwe-PCL, kungase kube inkomba yokuqhubeka nokuhlinzwa.
Isici esiyinhloko ekwenzeni ukuxilongwa kwe-PCL izinyembezi kungukuthi ukulimala kwenzeka kanjani. Ukwazi indaba yokulimala (isibonelo, isikhundla somlenze nesenzo esenzekayo) kuzosiza ekwenzeni ukuxilongwa. Ukuhamba okucacile kungaba ukuhlola umsebenzi we-PCL. Okuthenjelwa kunayo yonke ukuhlolwa kwe-drawer yangasese . Uma uguqa ngamadolo, udokotela wakho uzodinga i-tibia emuva; lokhu kugcizelela i-PCL. Uma i-PCL ingenamkhawulo noma idwenguliwe, i-tibia izogxila emuva kakhulu, futhi ikhombise ukulimala ku-PCL.
Ama-X kanye nama-MRIs nawo ayasiza ekucaciseni ukuxilongwa nokuthola noma yiziphi ezinye izakhiwo zamadolo angalimala. Kuvame ukuthola ezinye ukulimala kwegamentali noma umonakalo we- cartilage lapho kutholakala izinyembezi ze-PCL.
Izinyembezi ze-PCL zihanjiswe ubunzima bokulimala, ibanga I ukuya kwebanga lesi-III. Ibanga linqunywa ubukhulu bokulahla okulinganiselwe phakathi nokuhlolwa kwakho. Ngokuvamile, ukufakwa kokulimala kufana nalokhu okulandelayo:
- I-Grade I: Izinyembezi ezithile ze-PCL.
- Ibanga lesibili: Isolated, iphelele izinyembezi ku-PCL.
- Ibanga III: Izinyembezi ze-PCL nezinye izimo ezilimalayo zegament.
Ukwelashwa kwekhanda le-PCL
Ukwelashwa kwezinyembezi ze-PCL kuyinkinga, futhi, ngokungafani nokwelashwa kwe-ACL izinyembezi, akuvunyelwana kancane mayelana nokwelashwa okulungile kwazo zonke iziguli.
Ukwelashwa kokuqala kobuhlungu nokuvuvukala kuqukethe ukusetshenziswa kwamathanga , iqhwa, nokuphakama. Uma lezi zimpawu sezixazululwe, ukwelashwa ngokomzimba kuzuzisa ukuthuthukisa ukuguquka kwamadolo namandla. Ukunakekelwa okungeyona inqubo Kunconywa izinyembezi eziningi zeBanga le-I neBanga II.
Ukuvuselelwa kabusha kwe-PCL kuyinkinga, futhi kuvame ukuphakanyiswa kuphela izinyembezi ze-PCL zeBanga III. Ngenxa yobunzima bokusebenza kwezobuchwepheshe, odokotela abahlinzayo bama-orthopedic abakuboni inzuzo yokuvuselelwa kwe-PCL. Abanye, noma kunjalo, bakholelwa ukuthi ukuvuselelwa kwe-PCL kungaholela ekuqiniseni kwamadolo nokunciphisa amathuba ezinkinga ngaphansi komgwaqo.
Ukuvuselelwa kwe-PCL yokuhlinzwa kunzima ngokwengxenye ngenxa yesimo se-PCL emadolweni. Ukuzama ukubeka i-PCL entsha ye-graft kulesi sikhundla kunzima, futhi ngokuhamba kwesikhathi lezi ziqhumane ziyaziwa kakhulu ngokusabalalisa nokusebenza kancane. Ngokuvamile, ukuvuselelwa kwe-PCL yokuhlinzekwa kugcinwe iziguli ezilimaze amagogi amancane amadolo , noma kulabo abangakwazi ukwenza imisebenzi yabo evamile ngenxa yokungazinzi kwamadolo okuphikelela.
Imithombo:
I-Cosgarea AJ, Jay PR "Ukulimala KwamaLigament Emuva Kwangemva Kwama-Ligament: Ukuhlolwa Nokuphathwa" J Am Acad Orthop Surg, Vol 9, No 5, Septemba / Okthoba 2001, 297-307.