I-Ulnar Collateral Ligament Reconstruction (UCLR)
I-Ulnar Collateral Ligament Reconstruction, noma u-UCLR, ubizwa ngokuthi u-Tommy John. Yinkqubo eyenziwa ukulungisa umgodi owonakele emgqeni obizwa ngokuthi i-ulnar collateral ligament (abanye basebenzisa igama elithi medial collateral ligament). Lokhu ukulimala ngokuvamile kwenza i-elbow ibonakale ingaqiniseki futhi idinga ukwelashwa ngokomzimba. Uma ukulimala kungaphenduli ukwelapha ngokomzimba, ukuhlinzeka ngokuvamile kuwukuthi ukwelashwa okulandelayo kucatshangelwe.
Izimbangela ze-Ulnar zemigulane zivame ukugijimela "abagijimi" abathintekayo, njengama-pitchers we-baseball. Ukuphonsa imisebenzi kubeka amazinga angavamile okucindezeleka emgqeni, okwenza ukulimala endaweni kunamanye emidlalo. Kwabaningi abagijimi, ukuhlinzwa kukaTommy John kungabuyisa umsebenzi ogcwele futhi kwabanye, ukutholakala okuphelele kungenzeka.
Kwezinye iziguli, ukuhlinzwa akukwenziwa ukuze kuvunyelwe ukuba baqhubeke ukwenza njengomdlali, kodwa ukunciphisa izimpawu zokulimala-ikakhulukazi ubuhlungu be-elbow kanye ne-numbness esandleni sengalo ethintekile.
I-Ligament le-Ulnar Collateral
I-ulnar collateral ligament iyinhlangano eqondile yezicubu ezifana nebhola le-rubber elinamandla kakhulu. Isebenza ne-latal collateral ligament ukuzinza nokuqinisa i-elbow. I-ligament ingalimazwa ngokuklebhula, ukwelula nokwehlukanisa. Ukulimala ngokweqile, lapho i-ligament ibonakaliswa ukunyakaza okuphindaphindiwe, ingenye yezinhlobo ezivame kakhulu zezinkinga ze-ulnar zemigulane.
Kungani Kuthiwa I-Tommy John Surgery?
U-Tommy John wayengumgodi ochwepheshe we-Los Angeles Dodgers. Ngo-1974 wonakalisa i-lignar collateral ligament, okwakubhekwa njengokulimala okuqeda umqeqeshi wezembiza. UJohn, kodwa wakhethwa ukuba abe nenqubo eyayivivinya ngaleso sikhathi, esikhundleni salo ligament elimele nge-tendon kusuka engxenyeni yakhe.
Ngethemba elincane lokuthi uzoke akwazi ukuphinda abuyele emuva, uTommy John wavuma ukuba uDkt Frank Jobe enze inqubo. Wabe esethatha isikhathi esisele sango-1974 bese sekuqeda inkathi ye-1975 baseball ukuze avuselele ingalo yakhe. Umphumela wokuphela wawuyizinguquko-uJohn wabeka umsebenzi kuze kube ngu-1989-futhi inqubo manje ibizwa ngokuthi uTommy John ukuhlinzwa.
Inqubo
Ukuhlinzwa kukaTommy John kwenziwa ngaphansi kwe-anesthesia ejwayelekile ngudokotela ohlinzayo wamazinyo. Uma isiguli sesifakwe kahle futhi i-anesthesia isebenze ngokugcwele, inqubo iqala ngokuchofoza ebusweni obungaphakathi kwendwangu, lapho i-ligament eyonakalisiwe isuswa khona. Inqubo yinto encane encane , ngakho-ke, ukukhwabanisa kuyinto encane, njengoba inqubo kwenziwa ngokusebenzisa i-laparoscope.
Uma ukulungiswa kuyadingeka, lokhu kuhlanganiswa okuncane kusetshenziselwa ukufaka izinsimbi endaweni ehlangene nokulungisa umgudu oqhekekile. Uma kudingwa kabusha ukuvuselelwa, kuhlanganiswa okwenziwe ngokwengeziwe, ngokuvamile ekhoneni elingaphansi kwengalo ephikisanayo, ukubuyisela ithemponi endaweni engaphazanyiswa yomzimba. Ngenkathi i-forearm yinto ejwayelekile kakhulu, ezinye izindawo ezingase zibe khona zihlanganisa umlenze ophezulu nangaphezulu. Ngokuvamile, i-tendon ye-donor ingase isetshenziswe esikhundleni se-tendon yesiguli.
Uma ithenda yesithwathwa isitholiwe, ikhonjiswe endaweni njenge-substitution for the ulnar collateral ligament esususwe. Kwezinye iziguli ezithola izimpawu zokungena nokugubha ngesandla, i-ulnar nerve ingasuswa kancane ukusiza ukubuya okugcwele kokuzwa.
Izingozi
Ngaphandle kwezingozi ezijwayelekile zokuhlinzwa kanye nezingozi ze-anesthesia , ukuhlinzwa kukaTommy John kunezinselelo eziyingqayizivele zesiguli. Kwabanye, i-neuropathy, noma ukuntuleka kwemizwa, kungashiya isandla esithintekile, isibindi, noma / noma ubuthakathaka. Lesi simo singase sithuthuke ngokuhamba kwesikhathi noma singaba yingcindezi engunaphakade yokulimala kwangempela.
Kwezinye iziguli, ukungabi nokuguquguquka kuyaphawuleka ngemuva kokuhlinzwa, kanti abanye bangase babe nomuzwa wokungazinzi okuzungeze isigqoko. Nakuba kuvamile ngemuva kokuhlinzwa ukuthi kunzima ukulungisa ingalo ngokuphelele, le ntshukumo ngeke ibuyele ekuhambeni kokuhamba okukhona ngaphambi kokulimala.
Ukubuyisela
Ukuthola emva kokuhlinzwa kwalolu hlobo lokulimala kuqondana ngqo. Ukuhlinzwa kukaTommy John kudinga ukuhlala ubusuku bonke esibhedlela, kulandelwa ukwelashwa okunamandla okuvuselela. Emasontweni ambalwa okuqala, igoli lingase lingabi nhlobo, ligcine i-elbow lisekelwa futhi ligcinwe endaweni. I-graft entsha idangele kakhulu phakathi kwamasonto okuqala ngemva kokuhlinzwa, ngakho-ke kubalulekile ukulandela imiyalelo yokuhlinza ukuvikela isayithi lokuhlinzwa.
Ungase unikezwe imithi ebuhlungu ngesikhathi sokuqala sokuphumula, emva kwalokho ukushisa neqhwa kusetshenziselwa ukunciphisa ubuhlungu. Uma isakhiwo sokungasebenzi singasadingeki, ukwelashwa ngokomzimba kuqala ukuthola amandla nokuhamba okuningi. Kwabanye, uhla lwezinyathelo lubuyela emavikini angu-6-8, noma kunjalo, kumdlali wezokuncintisana, ukuvuselelwa okubanzi kungadlulela ngaphezu konyaka ukubuyela emsebenzini ogcwele.
Abagijimi abaningi bezokuzilibazisa banomuzwa wokuthi banamandla kunawo ngaphambi kokuba bahlinzekwe, ngoba "babamba" ingalo ekuphenduleni ubuhlungu. Abaningi baphila ngokugcwele futhi bakwazi ukubuyela emisebenzini yabo evamile.
Imithombo
I-Ulnar Collateral Ligament Ukwakhiwa kabusha. CA Bush Joseph, MD. Kufinyelelwe ngo-Ephreli, 2012. http://www.rushortho.com/forms/Ulnar_Collateral_Ligament_Reconstruction_Protocol.pdf