Ukuhlinzwa ukuvimbela ukuhlukaniswa kwehlombe okuphindaphindiwe
Ukuhlukunyezwa kwamaphutha kukhona ukulimala okuvamile, ikakhulukazi kubantu abasha, abakhuthele. Ukuhlinzwa oku-Latarjet kungenziwa ukuvimbela ukudluliswa okuphindaphindiwe. Uma ngabe omunye usule ihlombe lawo kanye, ukuphindaphinda okuphindaphindiwe (noma ukuphinda) kungase kube ngokwengeziwe. Abanye abantu bathuthuka ukungazinzi okunzima kwesigxobo sebhegi ne-socket ukuthi ukuhlukaniswa kungenziwa ngemisebenzi elula noma ngenkathi ulele.
Ngaso sonke isikhathi lapho ihlombe liphazamiseka, umonakalo owengeziwe ungenzeka kuhlangene. Ngenxa yalesi sizathu, abantu abaphindaphindiwe ukuxoshwa kuzovame ukuhlinzwa ngokuzama ukuqinisa ukujoyina nokuvimbela ukuhanjiswa okuzayo.
Ukulimala Kwamahlombe Kusuka Kwezinguquko
Umonakalo ongokomfanekiso ohlangothini lwehlombe uqala njengomgogodla oqhekekile okokuqala lapho ihlombe liphuma ekhoneni. Lokhu ukulimala kubizwa ngokuthi yi- Bankart izinyembezi futhi kubonakala ngokujwayelekile kakhulu, ikakhulukazi ezigulini ezincane (ezingaphansi kweminyaka engama-35) ezisekela i-shoulder initial dislocation. Phakathi naleso sikhathi sokuqala, noma ukuhlukaniswa okulandelayo, umonakalo owengeziwe kwezinye izakhiwo kungenzeka. Ngokuvamile ugqozi noma ithambo mayelana nesokhethi lonakalisiwe, futhi lokhu kunzima kakhulu ukulungisa.
Glenoid Bone Loss
Uma ukulimala kwethambo kwenzeka, umonakalo ungase ubonakale ebhola noma isikhwama sehlombe. Ukulimala ibhola kubizwa ngokuthi i- Hill-Sachs lesion .
Ukulimala kwesikhwama kubangela ukuhlukana nokulahleka kwethambo ku-glenoid (isikhwama sehlombe).
Lapho isikhwama sehlombe sonakalisiwe, isokhethi singase sigqoke kancane kancane. Njengoba lokhu kwenzeka, ithuba lokuhlukaniswa okuphindaphindiwe likhuphuka. Eqinisweni, ukulahlekelwa kwethambo le-glenoid kungafika ekugcineni lapho iziguli zinenkinga yokugcina ihlombe kulesi sikhwama nhlobo.
Enye yokwelashwa kwe-glenoid bone ukubizwa ngokuthi i-Latarjet ukuhlinzwa.
I-Latarjet Surgery
Inqubo ye-Latarjet yenzelwe ukwandisa i-glenoid ngethambo elengeziwe. Ithambo livela ku-scapula (i- shoulder blade ) futhi liyi-hook ye-bone okuthiwa i-coracoid. I-coracoid iyinkokhelo yethambo phambi kwehlombe lehlombe futhi liyisibopho semisipha eminingana. Phakathi nokuhlinza kwe-Latarjet, udokotela ohlinzayo ususa i-coracoid kusukela ekunamathiselwe kwayo kuya kwisiqephu futhi uhambisa i-coracoid, kanye nezinamathiselo zomzimba, amamitha ambalwa ambalwa ngaphambili kwesikhwama sehlombe. Uma isesimweni, i-coracoid ishaywa ehlathini lehlombe.
Inqubo ye-Latarjet ifeza imisebenzi emibili ebalulekile: Okokuqala, yandisa inani lamathambo ejokeni lehlombe lokubuyisela ithambo elahlekile. Okwesibili, imisipha ehlanganiswe ne-coracoid yenza i-sling, ukusiza ukusekela ihlombe phambi kwe-joint.
I-Latarjet iyinkambiso ephumelela kakhulu ekubuyiseleni ukuzinza ekuhlanganyeleni kwehlombe. Eqinisweni, ngokomlando, lokhu kuhlinzekwa kwasetshenziselwa ukwelashwa okujwayelekile kubantu abanamahlombe okuhlukana . Njengoba izindlela ezintsha zokuhlinzwa zithuthukisiwe , i-Latarjet manje ayisetshenziselwa ukulungiswa okujwayelekile.
Esikhundleni salokho, inqubo yeLatarjet ikhethwa kulabo abagulayo abaye bagqoke okungenani u-25% wesikhwama sehlombe.
Ukuvuselelwa ngokulandela ukuhlinzwa kwe-Latarjet kubandakanya okungenani izinyanga ezingu-4-6. Izigaba zokuqala zokuvuselelwa ziyadingeka ukuze kuvikelwe ihlombe ngokwanele ukuvumela ukuphulukiswa kwamathambo okugcwele. Ngakho-ke, ukuhamba kuvinjelwe ezinyangeni ezimbalwa zokuqala ngenkathi ukuphulukiswa kwethambo kwenzeka. Ngaleso sikhathi, kancane kancane ukunyakaza kwehlombe kungakhula, kulandelwe ukuqiniswa okuqhubekayo .
Izinkinga
Izinkinga zingavamile emva kokuhlinzwa kwe-Laterjet, kodwa kukhona okunye okukhathazayo okubalulekile.
Lokhu akuyona inqubo yokuhlinzwa encane, futhi ukuvuselelwa ngemuva kokuhlinzwa kungase kube yinde. Okunye okukhathazayo okuyingqayizivele kuhlanganisa ukungaboni kahle kwethambo elidluliselwa esikhwameni sehlombe. Ukuze ukuhlinzwa kuphuluke ngokugcwele, ithambo kufanele lifake phambi kwesikhethi; ku-3% weziguli, ukungaboni ngaso sonke isikhathi kwalesi sithambo kungenzeka. Izinzwa eziningi eziningi zizungezile i-coracoid ngaphambili kwehlombe. Ukulimala kulezi zinzwa kungenzeka ngesikhathi senqubo yokuhlinzwa. Okokugcina, iziguli ezinokuhlinzwa kufanele ziqonde ukuthi abantu abaningi abanokuhlinza kamuva kwe-Laterjet abanalo ukuhamba okuvamile kokujoyina ngemva kokuhlinzwa. Lokhu kuvamise ukwamukeleka kunikezwe ngcono ekuqineni kokujoyina.
Imithombo:
I-Sahajpal DT noZuckerman JD "Ukuchithwa kwe-Glenohumeral Chronic" uJ Am Acad Orthop Surg ngoJulayi 2008; 16: 385-398.