Ukuhlukaniswa kwehlombe kuyingozi ekuhlanganyeleni kwe-acromioclavicular phezulu kwehlombe. Ukuhlanganiswa kwamahlombe kuhlanganiswa emathanjeni amathambo amathathu: i-collarbone (clavicle), i-shoulder blade (scapula), kanye nethambo lesandla (humerus). I-scapula ne-clavicle yakha isikhwama se-joint, kanti i-humerus inenhloko ejikelezayo ehambisana nalesi sikhwama.
Ukuhlukaniswa kwehlombe kwenzeka lapho i-clavicle ne-scapula behlangana ndawonye. Ukuphela kwe-scapula kuthiwa i-acromion, futhi ukuhlangana phakathi kwalesi sigaba se-scapula ne-clavicle kubizwa ngokuthi ukuhlanganiswa kwe-acromioclavicular . Uma lokhu kuhlangene kuphazanyiswa, kubizwa ngokuthi ukuhlukaniswa kwehlombe. Elinye igama lale ukulimala ukuhlukaniswa okuhlangene kwe-acromioclavicular noma ukuhlukaniswa kwe-AC.
Ukuhlukaniswa noma ukuhlukaniswa
Abantu bavame ukusebenzisa amagama ukuhlukaniswa nokuhlukaniswa kwehlombe ngokungafani. Nakuba lezi zingozi ezimbili zivame ukudideka, empeleni ziyizimo ezimbili ezihluke kakhulu. Njengoba kuchaziwe ngenhla, ukuhlangana kwehlombe kutholakala ekuhlanganiseni kwamathambo amathathu ahlukene: i-clavicle, i-scapula, ne-humerus. Ehlukanisweni kwehlombe , ukuhlangana kwe-clavicle ne-scapula kuphazamiseka. Ukuxoshwa kwehlombe , i-humerus (ithambo lesibindi) lisuke endaweni engaphandle. Akuyona nje ukulimala okungafani nemibandela ye-anatomic, kodwa impendulo yokwelashwa, ukululama, nezinkinga nazo zihlukile.
Ukuhlukaniswa kwehlombe cishe kuvele umphumela wesohlakalo esiphuthumayo, esiyingozi esingaba nesigameko esithile noma isenzo esithile. Izincazelo ezimbili ezivame kakhulu zokuhlukaniswa kwamapulangwe zingabhekana ngqo nehlombe (okuvame ukubonwa ebhola lebhola, i-rugby, noma i-hockey), noma ukuwela esandleni eseluliwe (okuvame ukubonakala ngemuva kokuwa kwebhayisikili noma ihhashi).
Izimpawu Zengxenye Ehlukanisiwe
Ubuhlungu yilona uphawu oluvame kakhulu lwamahlombe ahlukanisiwe futhi ngokuvamile lukhuni ngesikhathi sokulimala. Ubufakazi bokulimala okubuhlungu ehlombe, njengokuthumba nokulimala, kuvame ukutholakala. Indawo yobuhlungu ijwayele kakhulu kwiziguli eziye zaqhubeka nokulimala. Ubuhlungu bukhona ekuhlanganiseni kwe-collarbone ne-shoulder shoulder, ngokuqondile phezulu kwehlombe. Ngenkathi abantu abaye bahlala ngokuhlukana kwehlombe bangase babe nemizwelo yokuphefumula emzimbeni jikelele, ubuhlungu babo buvame ukuba bendawo kakhulu kuhlangene ne-AC.
Ukuxilongwa kokuhlukaniswa kwehlombe kuvame ukubonakala ngokuzwa indaba ejwayelekile yalokhu ukulimala, nokuhlolwa okulula ngokomzimba. I-x-ray kufanele yenziwe ukuze kuqinisekiswe ukuthi akukho ukuphulwa kwala mathambo. Uma ukuxilongwa kungacacile, i-x-ray ngenkathi inesisindo esandleni sakho ingasiza. Uma lolu hlobo lwe-x-ray lwenziwa, amandla esisisindo azokwandisa noma yikuphi ukungazinzi kokuhlanganyela kwehlombe futhi kungcono kubonise imiphumela yehlombe elihlukanisiwe.
Izinhlobo Zokuhlukaniswa Kwamahlombe
Amahlombe ahlukanisiwe ahlungwa ngokusho kokulimala kanye nesimo samathambo asukile.
Ukuhlukaniswa okuhlanjululwayo kuhlanganiswa kusuka kuhlobo I kuya ku-VI:
- Thayipha I Ukuhlukana Kwahlukana:
Uhlobo enginalo ukuhlukanisa ukulimala ukulimala kwe-capsule ejikeleze ukujoyina kwe-AC. Amathambo awasekho isikhundla futhi uphawu oluyinhloko lubuhlungu . - Thayipha II Ukuhlukana Kwamahlombe:
Uhlobo lwe-II lokuhlukanisa ukuhlukana luhilela ukulimala ku- capsule ye-AC ehlangene kanye nomunye wemigomo ebalulekile eqinisa i-clavicle. Leligament, i-ligament coracoclavicular, ihlukaniswe kancane. Iziguli ezine-type II ehlombe ihlombe elilodwa elihlukanisiwe lingase libe ne-bump encane phezu kokulimala. - Uhlobo III Ukuhlukana Kwamahlombe:
Uhlobo lwe-III lwamahlombe luhlukanisa uhlobo olufanayo lokulimala njengohlobo lwe-II oluhlukanisiwe, kodwa ukulimala kubaluleke nakakhulu. Lezi ziguli ngokuvamile zine-bump enkulu phezu kokujoyina kwe-AC eyalimala.
- Uhlobo IV Ukuhlukana Kwamahlombe:
Ukuhlukaniswa kwamaphethelo ehlobo IV kungukulimala okungavamile lapho i-clavicle iphoqelelwa ngemuva kokujoyina i-AC. - Thayipha V Ukuhlukana Kwamahlombe:
Uhlobo V ukuhlukaniswa kwamapulangwe kuyingozi yokulimala kwehlobo III. Kulolu hlobo lwamahlombe ahlukanisiwe, umsila ngaphezu kwe-AC ukuhlanganiswa kubanjwa ngokuphela kwe-clavicle obangela ukulimala okukhulu ngokulimala. - Thayipha VI Ukuhlukana Kwamahlombe:
Uhlobo lwe-VI lwamahlubuko ahlukaniswe kakhulu futhi aluvamile. Kulolu hlobo lokulimala, i-clavicle igxilizelwa phansi futhi ifakwe ngaphansi kwe-coracoid (ingxenye ye-scapula)
Ukwelapha
Ukwelashwa kwalokhu kulimala kuqondiswa kokubili kokulimala nokulindela komuntu ngamunye. Uhlobo oluthe xaxa I-I no-II luhlukana ngokwehlukana luphathwa ngaphandle kokuhlinzekwa, ngisho nasezinkundleni zezemidlalo. Kukhona ukungqubuzana okukhulu mayelana nokwelapha okungcono kakhulu kohlobo lwe-III ukuhlukaniswa kwehlombe, njengoba abanye odokotela abahlinzayo bancoma ukuthi bahlinzekwe, kanti abanye ngeke. Ngenkathi sivame ukukhuluma ngokuhlinzwa okwelapha uhlobo lwe-IV, V, no-VI ukuhlukaniswa kwamacala, iqiniso liwukuthi lezi zindlela zokulimala azivamile. Iningi lamahlombe ahlukanisiwe yizinhlobo ze-I kuya ku-III.
Imithombo:
Simovitch R, et al. Ukulimala Okuhlangene Kwama-Acromioclavicular: Ukuxilongwa Nokuphathwa "J Am Acad Orthop Surg April 2009; 17: 207-219.