Izinhlobo Ezihlukahlukene Zokuhlinza Ngamahlombe

Ukwelashwa kungase kube ukwelashwa okunempilo kwezinkinga eziningi zezinhlanzi ezivamile . Ngenkathi isinyathelo sokuqala ekwelapheni akusiyo isixazululo sokuhlinzeka, ngokuvamile abantu baya endaweni lapho ukuhlinzwa kuba yindlela engcono kakhulu yokubhekana nesimo sabo sehlombe. Funda ngezinye zezinqubo zokuhlinzwa ezivamile ezenzelwe ukuxazulula izinkinga zezinhlanzi, futhi uma enye yazo ingakusiza ukuxazulula isimo sakho. Ezinye zalezi zindlela zokuhlinza zihlinzeka ngokuhlinzwa okuyingxenye encane ye-arthroscopic , kanti ezinye zihlinzekwa ngokujwayelekile zendabuko. Inqubo ngayinye inezinzuzo, ingozi, nezingozi ezihambisana nokwelapha. Lapha ungafunda ngalezi zinkinga nokukhathazeka.

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I-Arthroscopy: I-Bursitis / Impingement Treatment

Esinye sezizathu ezivame ukwenziwa ukuhlinzekwa kwehlombe kungokwelashwa kokuvuvukala emgqonyeni we-rotator. Abantu bavame ukusebenzisa amagama ahlukene ukuchaza lesi simo. Iningi odokotela lizobhekisela ku- 'impingement syndrome , 'isimo esibangela ukuvuvukala phakathi kwebhola lehlombe kanye nenhla yehlombe elingenhla. Kulesi sikhala kukhona ama-tendon e-rotator ne-bursa ehlanganisa ama-tendon. Amanye amagama abantu angasebenzisa ukuchaza impingement syndrome afaka i-rotator cuff tendonitis ne-bursitis.

Uma i-arthroscopy yehlombe isetshenziselwa ukuxazulula ukungena kwe-syndrome, abantu bayibiza ukucindezeleka okungahambi kahle. I-acromion yigama lesiphezulu se-shoulder blade, futhi isikhala esingaphansi lapho ukushicilelwa khona khona. Ngakho-ke ukucindezeleka okungahambi kahle kuvula leso sikhala esiqinile.

Uma wenza ukucindezeleka okungahambi kahle, udokotela wakho ohlinzayo angasusa i-bursa yedwa, noma angase asuse ezinye izinto ezingaphansi kwe-acromion. Umgomo ukukhipha ukuvuvukala nokudala isikhala somkhombe we-rotator ukugoqa ngaphandle kokuphonswa phakathi kwethambo. Le nqubo yokuhlinzwa ingenziwa ngokuzihlukanisa, noma njengengxenye yokuhlinzwa kwebhokisi lokujikeleza. Ngenkathi lokhu kwenziwa ngokomlando njengokuhlinzwa okuvulekile, ukucindezeleka okungahambi kahle kubhekwa njalo njengokuhlinzekwa kwe-arthroscopic kulezi zinsuku.

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I-arthroscopy: Ukulungiswa kwe-SLAP

Inyembezi ye-SLAP yehlombe iwukulimala emthonjeni we-cartilage ozungeza futhi ujulise isikhwama sehlombe esibizwa ngokuthi i-labrum. Inyembezi ye-SLAP ivela phezulu kwebhubhisi, ebizwa ngokuthi ingxenye engaphezulu yebramu. Igama le-SLAP livela kulesi sigama esiphezulu se-labrum esivela ku-anterior kuya ngemuva. Le ngxenye yebramu ibalulekile ngoba yindawo yokunamathiselwa kwekhanda elide le-tendon biceps, ngakho-ke libhekene nokucindezeleka okuyingqayizivele.

Kubantu abahlukunyezwa yi-SLAP izinyembezi, ukhetho olulodwa ukulungisa i-labrum . Ukwenza lokhu kuhilela ukuhlinzeka nge-arthroscopic ukulungisa lebrum eboshiwe emuva emgqeni wesikhwama sehlombe. I-Sutures ifakwe emathanjeni esikhwameni sehlombe, futhi i-labrum ivalwe ngokuqinile ngethambo. Uma umonakalo ungena ku-tendon biceps, hhayi nje i-labrum, ezinye izinketho zokuhlinzwa ukubhekana ne-tendon biceps (bheka ngezansi) zingacatshangelwa.

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I-arthroscopy: Ukususwa kwe-Dislocation

Lapho ukulimala kwehlombe kwehlombe kwenzeka, kukhona okonakalisiwe okuvumela ibhola ukuba liphume esitokisini somjoqo wehlombe. Ngokuvamile, umonakalo ungomunye wezakhiwo ezimbalwa, futhi umgomo wokuhlinzeka ukwelashwa kwe-shoulder dislocation ukulungisa lezo zakhiwo ezithile.

Kwabadlali abasha, ingxenye emele ukujoyina ihlombe ibizwa ngokuthi i-labrum, futhi umonakalo ngokuvamile uvela engxenyeni ethile yebramu. Ukuze kuqiniswe ihlombe ngemva kokuxoshwa, laba bantu bazoqhubeka nenqubo yokuhlinzekwa okuthiwa i- Bankart ukukhanda . Lokhu kuhlinzekwa kungenziwa njengendlela yokuhlinza evulekile kepha kuvame ukuqhutshwa njengenqubo ye-arthroscopic.

Kubantu abaneminyaka engama-30 nangaphezulu, umonakalo ovame ukwenzeka kubhokisini lomjikelezi wehlombe. Uma lokhu kwenzeka, ukwelashwa okujwayelekile kuyindlela yokulungisa ikhanda lokujikeleza, njengoba kuchaziwe ngezansi.

Kukhona nabanye abantu abane-laxity ejwayelekile yomugqa wehlombe eliholela esimweni esibizwa ngokuthi ukungazinzeki kwe-multidirectional kwehlombe. Laba bantu banamahlombe angangena futhi aphume esikhwameni kalula futhi adinga lonke i- capsule elihlangene lehlombe lawo livalwe ukubhekana nesimo sabo.

Okokugcina, abantu abanomonakalo obaluleke kakhulu ehlombe, okubangelwa ukuphindaphindiwe okuningi, bangadinga ukuhlinzwa okukhulu ukuze bagcine ibhola ekhoneni. Kunezinketho eziningi ezihlukene, kodwa ngokuvamile lezi zibandakanya ithambo elihambayo elizungeze ihlombe ukuze libheke ibhola ngokuqinile ngaphakathi kwesikhombandlela sokujoyina.

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I-Arthroscopy: Ukwelashwa Okunezinwele Eziqinile

Ihlombe elinyanyisiwe liyisimo esifanayo sehlombe. Eqinisweni, kuyesibili kuphela ezinkingeni ze-rotator cuff njengesizathu esivame kakhulu sobuhlungu behlombe. Ngeshwa, amahlombe afriziwe avame ukungaqondakali kahle okuholela ekubambezelekeni ekukhoneni nasekwelapha. Ukwelashwa okuvamile kwehlombe elifriziwe kungenziwa ngezokwelapha okungenasidingo, kodwa, kwezinye izimo ezingavamile, ukwelapha ukwelashwa kuyindlela yokukhetha.

Uma ihlombe elifriziwe likhona, i-capsule ehambisana nomjoqo wehlombe iba yinkimbinkimbi futhi inkontileka. Umgomo wokuhlinzekwa ukukhulula lezi zicubu ezinenkontileka ukuze uvumele ihlombe lihambe kalula. Umqondo wokuhlinzeka uqondile kakhulu: uthathe i-capsule yehlombe nxazonke ukuze uvumele ihlombe lihambe ngokukhululekile. Ingxenye enzima ingenxa yokuthi ihlombe liqinile kangaka, lihamba phakathi kwehlombe ukusika i-capsule ngokuphepha kuyinselele yokuhlinza.

Enye inkinga ngokuhlinzeka nge-frozen frozen iwukuthi uma i-capsule isinqunywe, umzimba uzofuna ukwenza izicubu ezintsha zesikhumba. Ekuqaleni, ukwelashwa ngokomzimba okunomthelela kanye ne-rehab kubalulekile ukugcina ihlombe lihamba ngokujwayelekile.

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Ukulungiswa kwe-Rotator Cuff

Enye yezinqubo zokuhlinza ezijwayelekile kakhulu zehlombe i-rotator cuff yokukhanda. Kunezinketho eziningi zokulungisa umkhombe we-rotator owonakele , kanti udokotela ohlinzayo ngamunye angase abe namasu akhethandayo. Umgomo wanoma yikuphi ukuhlinzwa okuhlinzekwa ukukhanda kwe-cuffler ukukhomba ingxenye ewonakele yesikhumba se-rotator, bese uhlanza futhi uhlanganisa ithemponi eseduze. Lapho nje izicubu ezinempilo zikhonjisiwe, umgomo ukulungisa isici kulethenda ngaphandle kokulula ngokweqile ithethoni esele. Ezimweni eziningi, lokhu kungenziwa.

Ukulungiswa kwezinkomishi ze-Rotator kungenziwa ngezindlela eziningana ezahlukene. Indlela yendabuko yokwenza ukuhlinzekwa ngokukwenza ukukhungulwa okukhulu, ukuvimbela umsizi oseduze, nokulungisa isitsha se-rotator ngokubona ngokuqondile inkinga. Lokhu kubizwa ngokuthi i-rotator cuff yokukhanda. Ukhetho olusha ukwenza ukwenziwa kwe-arthroscopically. Kule nqubo, kusetshenziselwa ukucubungula okuncane kuphela ukufaka ikhamera nezinsimbi ezincane. Ukulungiswa kwenziwa ngokungaqondile, ngokubukela esikrinini kunokuba ubheke ngqo kule nkinga.

Kukhona nenketho ye-hybrid, ebizwa ngokuthi ukulungiswa kwekhanda lokuvula i-mini-ovulekile, elihlinzeka ezinye izinzuzo zokuhlinzeka nge-arthroscopic ngenkathi zivumela ukulungiswa okuqondile kwezicubu. Ayikho inketho eyodwa engcono kakhulu. Abanye odokotela abahlinzayo banolwazi oluthe xaxa kolunye uhlobo lokulungiswa kunolunye, futhi ezinye izinyembezi zingase zibhekiswe kangcono ngenqubo eyodwa noma enye.

Kunezinye izimo lapho ukulungiswa kungenakwenzeka. Kulezi zikhala ezinyembezi ezinkulu, okuthiwa izinyembezi ezinkulu ze-rotator , ukuzama ukuvala imbobo emgodini we-rotator akufanelekile njengoba izicubu ziphinda zihoxiswe futhi zihlaselwe. Kunezinketho zokwelapha le nkinga, kodwa lezi zikhala ngokuvamile azikwazi ukulungiswa.

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Izinkinga ezihlangene ze-Acromioclavicular

Ukuhlanganiswa kwe-acromioclavicular (ngokuvamile okubizwa ngokuthi ukujoyina i-AC) kungumbuthano wokuphela kwe-clavicle (i-collarbone) kanye nenhla ye-shoulder (i-acromion). Lokhu kuhlangene yingxenye ebalulekile yehlangothini lwezintambo, nakuba lihamba kancane kakhulu lihambisana nebhola kanye nesixhumi sehlombe.

Kunezinkinga eziningana ezingase zenzeke ekuhlanganyeleni kwe-acromioclavicular. Okokuqala ukuthi kungakwazi ukuphela. Ngezinye izikhathi lokhu kwenzeka njengomphumela we- arthritis we-AC joint , ezinye izikhathi ngenxa yengozi yangaphambilini yalokho okuhlangene. Ukuhlanganyela kwe-AC kungaphelelwa amandla ngenxa yemisebenzi ethize eyenza ukucindezeleka kuhlangene, njengokunciphisa umzimba. Lesi simo okuthiwa i- distal clavicle i-osteolysis iholela ekubuthakatheni kwethambo nxazonke. Uma lezi zinkinga zenzeka, ukwelashwa okujwayelekile ukukhipha ukuphela kwe-collarbone ukukhulisa isikhala sokuhlanganyela kwe-AC.

Enye inkinga evamile eyenzeka ekuhlanganyeleni kwe-AC ukusimama, okuthiwa ukuhlukaniswa kwehlombe . Lokhu kwenzeka kaningi ngenxa yokulimala esifundeni sehlombe esiholela ekulimazeni emigodini ehlanganisa ukuphela kwe-clavicle ehlombe lehlombe. Ukuhlukana ngokweqile kungaphathwa ngendlela engavamile, kodwa uma kwenziwa ukuhlinzwa, indlela evamile ukulungisa noma ukuvuselela imigudu esekela ukuphela kwe-clavicle .

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Ukuguquka Kwamahlombe

Ukuhlinzeka ngamathambo esikhundleni sokuhlinzwa kuyindlela yokwelashwa evame ukugcinwa kwesifo samathambo esihambile sehlangene, futhi singasetshenziselwa ukuhlukunyezwa okuyinkimbinkimbi kwehlombe nezinye izinkinga ezingenakulungiswa ngokwanele. Ukushintshwa kwamahlombe okujwayelekile kuzosusa ibhola eligugile kanye nokuhlanganiswa kwesigxobo ngebheyili yokufakelwa eyenziwe ngensimbi, nesokhethi esenziwe ngepulasitiki. Ukufakelwa kwehlombe kuklanyelwe ukusebenza njengehlombe elijwayelekile.

Ngezinye izikhathi, ibhola lonke nokuhlanganiswa kwehlombe elingenalutho kungase kungadingi ukushintshwa. Lokhu kungase kwenzeke nge-arthritis yangaphambili noma uma kwenzeka ukuphuka kwethambo lesifuba. Kulezi zimo, ukushintshwa kwehlombe okuyingxenye kungase kube ukhetho olufanele lokuphathwa kwesimo sakho. Le nqubo, ebizwa ngokuthi i- hemiarthroplasty , isanda esikhundleni sebhola lehlombe, futhi isokhethi ishiywe yedwa.

Enye indlela ebizwa ngokuthi i- backverse shoulder shoulder substitution . Lokhu kuhlinzwa, njengoba kuzwakala egameni layo, kugodlulela indawo ibhola nesokhethi ukuze ibhola elithatha indawo liye lapho isisekelo sitholakala khona, futhi isikhwama esiphezulu siya lapho ibhola lehlombe likhona. Isizathu sokwenza le nqubo ukuthi singanikeza inzuzo kumakhambi kubantu abanomonakalo omkhulu ekotini lokujikeleza. Lesi yisisombululo esikhulu kubantu abanesimo esibizwa ngokuthi i- rotator cuff i-arthropathy yezinyembezi , inhlanganisela yomonakalo ku-cartilage ehlangene nehlombe kanye ne-rotator cuff.

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I-Biceps Tendon Surgery

I-tendon biceps iyisiphazamiso esingaphambi kwesandla sakho. I-muscle ixhunywe ngethambo ngamathenda, futhi phezulu kwesisipha, kunezinamathiselo ezimbili ze-tendon. Enye ingaphambi kwehlombe, ebizwa ngokuthi ikhanda elifushane le-biceps. Enye i-tendon, ebizwa ngokuthi ikhanda elide le-biceps, lijulile ngaphakathi kwehlombe. Le nhloko ende ye-biceps tendon ihamba ngenduku yokujikeleza, idlula ngaphakathi kwehlombe, iphinde ifakwe ebhodini phezulu kwesikhwama sehlombe. Ubuhlobo obuyinkimbinkimbi kuya ehlombe kwenza inhloko ende ye- biceps tendon isifo esivamile sezinkinga ezihlangene .

Ukuhlinzwa kwi-tendon ye-biceps kungenziwa ngokuzihlukanisa, noma kungenziwa njengengxenye yocwaningo olulodwa lwezinhlanzi ezifana nokulungiswa kwekhanda lokujikeleza. Ngokuvamile kunezinketho ezimbili uma i-tendon biceps idinga ukuhlinzwa. Enye ukusika i-tendon ngaphakathi kwehlombe bese uphinde uhlanganise ithemponi ngaphandle kombuthano. Okunye okuwukukhetha ukusika umthambo bese uvumela ukuba uhlehlise phansi ingalo.

Kukhona izinzuzo nezindleko zokhetho ngalunye, futhi kokubili izinketho kungaba nemiphumela emihle kakhulu. Nakuba abantu abaningi becabanga nje ukuthi ukusika i-tendon kuzoholela ekunciphiseni amandla nokusebenza, kunemibiko eminingi yezemidlalo abadlali abaphethe i-tenotomy futhi bebuya ngokushesha kakhulu ukuze bancintisane ngokuncintisana komsebenzi!

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Ukulungiswa Kwezinsalela Emaphethelweni

Ama-fractures azungeze umhlanganiso wehlombe angadinga ukuhlinzwa ngokuya ngobukhulu bokulimala kanye nokulindela isiguli. Ezinye zezinsalela ezivame kakhulu ezingase zenzeke emahlombe zihlanganisa:

• I-humerus ehamba phambili ihlukana
• I-Clavicle fractures
• Ama-fractures ama-scapular
• I-Glenoid fractures

Ukunquma ukwelashwa okungcono kungabandakanya izici eziningana, kepha ukuhlinza kuvame ukusetshenziswa ekunakekeleni le ngozi.

Izingozi Nezinkinga Zokuhlinzwa

Zonke lezi zinqubo zokuhlinzekwa ngenhla zingenziwa ngokuphepha nangempumelelo, kodwa azikho engozini yokubhekana nezinkinga . Nakuba izinkinga zingavamile ngemva kwezinhlobo eziningi zokuhlinzwa kwezinyosi, zingenzeka.

Ngaphambi kokuhlinzwa, kufanele ukhulume nodokotela wakho ohlinzayo mayelana nokuthi kungenzeka yini ukuhlukumezeka nokuthi yiziphi izinhlobo zokwelapha nemiphumela ongalindelwa uma kwenzeka ukuhlukumezeka. Ngaphezu kwalokho, iningi lamahlombe ukwelapha ukwelashwa kukhethwa-kufanele kube nethuba lokuxoxisana ngenzuzo kanye nokukhubazeka kokwelapha okuhlinzekwa ngukuhlinzwa nokungahambi kahle ngodokotela wakho ukuze wazi kahle ukuthi uyini.

> Umthombo:

> Tonino PM, et al. "Ukucindezeleka Kwamahlombe Okuncintisana: Ukuhlolwa Nokunakekelwa" J Am Acad Orthop Surg March 2009; 17: 125-136.