Inqubo Engaphansi Kwangaphandle Yokuvulwa Kwe-Hip Yokuguqulwa Kwama-Hip
Ukuhlinza ukuhlinzwa esikhundleni sokuqasha kungenye yezindlela zamuva zokusebenzisa izindlela ezincane zokuhlinzeka ngezindlela ezincane. Umqondo walendlela yokuhlinzwa ukukwenza inqubo efanayo ngokuphazanyiswa okuncane emisipha ezungezile kanye nezicubu ezithambile. Ngokwenza ukuhlinzeka ngemibono encane, nge-dissection encane elula, ithemba ukuthi iziguli zizozwa ubuhlungu obuncane futhi zilulame ngokushesha.
Ukuqonda ukushintshwa kwe-Hip Anterior
Ukuguqulwa kwe-hip anterior akuyona ukuhlinzwa okusha. Abahlinza abaningi abahlinzayo baye benza izinguquko zokuqhaqhaza ngokuqothulwa kwangaphambili emashumini eminyaka. Eqinisweni, umbiko okhulunywe kakhulu kule nqubo wanyatheliswa ngo-1980. Yini entsha mayelana nokufakwa esikhundleni se-hip yangaphambili ukuthi ukuhlinzwa kwenziwa ngezinkomba ezincane nge-instrumentation ekhethekile kakhulu ukusiza ukwenza lokhu kuhlinzwa kube nzima kakhulu isiguli.
Ukuhlangana kwe-hip kujulile ngaphakathi emzimbeni ekuhlanganiseni kwesikhumba futhi phezulu kwethambo lethanga. Zonke izikhundla ze-hip, kungakhathaliseki ukuthi zihlobo luni, zidinga udokotela wakho ohlinzayo ukuba athathe isikhundla esiphambili sethanga lesenzeni kanye nesokhethi sekhanda. Kunezinhlobo eziningi zezindlela zokuhlinza udokotela wakho ohlinzayo lokhu, njengoba udokotela wakho ohlinzayo angasondela ekhanda lakho ngemuva kokujoyina (indlela engezansi), ohlangothini lwendlela ehlangene (i-lateral noma i-anterolateral approach), ngaphambili kokujoyina (i-anterior indlela), noma ngokusebenzisa inhlanganisela yezindlela (indlela yokungena embili ).
Kubalulekile ukuqonda ukuthi zonke lezi zindlela zifeza umgomo ofanayo wokufaka ibhola kanye nesokhethi sohlangothini lwe-hip .
Izimo Eziyingqayizivele Zomgwaqo Ongaphambili Ukushintshwa Kwe-Hip
Indlela yokuguqulwa kwe-hip yangaphakathi yindlela yokuhlukanisa imisipha, okusho ukuthi udokotela ohlinzayo ufika ehlathini phakathi kwemisipha emibili, kunokuba asuse bese ebuyisela kabusha imisipha.
Inzuzo kucatshangwa ukuthi ukuvuselelwa kungaqhubekela phambili ngokungahambisani nemisipha ehlangene.
Njengazo ezinye izindlela ezingenasidingo ezingenasidingo, ubungako bokufakwa komshini bugcinwa bufushane ngangokunokwenzeka emzamweni wokusiza ukunciphisa ukungakhululeki kokuthutha. Ukufakwa esikhundleni se-hip kwangaphakathi kubhekwa abanye odokotela abahlinzayo ukuba babe nesilinganiso esingaphansi sokuhlukaniswa , nakuba izimpande ezintsha zisebenza abanye odokotela abahlinzayo bacabanga ukuthi lokhu akuseyona inzuzo ehlukile ye-hip replacement hip esikhundleni.
Izingqinamba eziningi ezihlobene nokuguqulwa kwe-hip esikhundleni se-anterior zifana nezinkinga ezijwayelekile zokufaka esikhundleni se-hip esikhundleni . Okunye ukucindezeleka okuqondile kuwukulimaza esikhungweni esikhulu sesikhumba esiseduze nalokho okushiwo ukuqhutshwa kwe-hip esikhundleni. Ukulimala kule nerve, i-lateral femoral cutaneous nerve, ngesikhathi sokuhlinzwa kungabangela ubuhlungu obungapheli nokuzwa okungavamile eduze nangaphambili kwethanga.
Ingabe Ukushintshwa Kwe-Hip Anterior Better?
Njengazo zonke izinguquko eziningi ekusebenziseni ukujoyina okuhlanganyelwe, akukwazi ukuthi uma ukushintshwa kwe-hip anterior kungcono kunezinye izindlela zokuhlinza ukushintshwa kwe-hip. Kukhona izinzuzo nezinsalela zezindlela ezahlukene zokuhlinza ukuqhutshwa kwe-hip.
Ngenkathi abanye bephikisa ukuthi ukuvuselela kungase kube ngokushesha noma ubuhlungu bungase bube ngaphansi, kukhona idatha ephikisanayo ukusekela le mpikiswano. Ezinye izifundo azitholanga umehluko ekubuyiseleni lapho ukushintshwa kwendlela ye-hip anterior kuqhathaniswa namanye amasu.
Isifiso sokunciphisa ubuhlungu nokubuyiselwa ngesivinini kuyaqondakala. Kodwa-ke, isici esibaluleke kunazo zonke ekuhlinzekeni kwe-hip esikhundleni sokuthi uhlinzekele ukuguqulwa kwesikhumba ukunikeza ukujoyina okungenabuhlungu futhi kuzohlala isikhathi eside . Le migomo ayikwazi ukuyekethiswa uma izinguquko zenziwa ukuze zikhishwe amasu okuguqula.
Ngenkathi ukufakelwa esikhundleni kwe-hip kwangaphakathi kungahlinzeka ezinye izinzuzo uma kuqhathaniswa nezinye izinhlobo zokufakelwa kwe-hip , aziwa ukuthi lokhu kubonisa ngempela ukuthuthukiswa kokuhlinzwa esikhundleni sokunyakaza.
Ungaxoxa ngalezi zinkinga nodokotela wakho uma usulungele ukucubungula ukufakwa esikhundleni se-hip.
Imithombo:
Klausmeier V, et al. "Ingabe kukhona ukuphumula okusheshayo nge-THA yangaphakathi noma ye-anterolateral? Ukutadisha umshayeli." Clin Orthop Relat Res. 2010 Feb; 468 (2): 533-41.
I-TR, i-Keggi KJ: Indlela yokuqala yokugubha i-arthroplasty. Clin Orthop Relat Res 1980; 152: 255-260.
I-TP ye-Vail, i-Callaghan JJ. "Ukunciphisa Okuncane Okungokoqobo I-Hip Arthroplasty" J. Am. I-Acad. I-Ortho. Ngo-Okthoba 2007; 15: 707 - 715.