Izinketho zokuhlinzeka ukwelashwa kwe-Arthritic Wrist Joint
Isihlanganisi sesibindi sinhlanganiso yamathambo amabili angaphambili (i-radius kanye ne-ulna), neqembu lamathambo amancane angaphansi kwesandla (amathambo e-carpal). Njengamanye amalunga emzimbeni, isikhonkwane singathuthuka isifo samathambo, esibangela ubuhlungu obuhlangene nokuvuvukala. Izinhlobo ezihlukahlukene ze-arthritis zingathinta inhlanganisela yesandla, kuhlanganise ne- osteoarthritis ne-arthritis ye-rheumatoid.
Ukwelashwa kwesifo samathambo esibelethweni sivame ukuqala ngemithi elula, futhi uma lokhu kuhluleka ukunikeza usizo, kungase kutholakale izinketho zokuhlinzwa. Ngenhlanhla, ngokungafani nezinkophe namadolo, asihambanga ngezandla zethu, abantu abaningi bafunda ukuphatha ngokwanele izimpawu zabo zesifo samathambo ngaphandle kokuhlinzeka okukhulu. Nokho, kwezinye iziguli, izimpawu ze-arthritis zikhubaza, futhi ekugcineni ukuhlinzwa kungadingeka.
Ukwelapha Okungahlosiwe
Ukwelashwa kwe-arthritis cishe kuqala ngezinyathelo ezithile ezilula. Kubantu abane-arthritis yesihenqo, izifo ezivamile zibandakanya ice noma ukushisa kwesicelo , imithi yomlomo kanye nemilenze ye-cortisone . Ukugqama kwesibindi kanye nama-braces ngokuvamile kuwusizo kakhulu ekwelapheni isifo samathambo esikhwameni; ukwelashwa ngokomzimba kungase kuhlinzeke nokuphumula kwezibonakaliso ezibuhlungu.
Ngokuvamile, izimpawu zesifo samathambo zingakwazi ukuphathwa ngalezi zinyathelo zokwelashwa ezingenasidingo. Ngokungafani ne-hip ne-knee arthritis, lapho sihamba khona emaphethelweni akhe aphansi okubangela ubuhlungu nokukhubazeka, i-arthritis ephezulu ingaphethwe kaningi ngezokwelapha.
Ngokushintsha indlela esenza ngayo imisebenzi, futhi sizama ezinye zezokwelapha ezilula, ezingenasidingo, abantu abaningi bangakwazi ukuphatha i-arthritis yesibhamu ngaphandle kokuthi benze inqubo yokuhlinza. Kodwa-ke, uma lezi zokwelapha ezingekho emthethweni zingaphumeleli ngokwanele izimpawu, kunezinye izinketho zokwelapha.
Ukuhlinzwa kwe-Wrist Fusion
I- fusion yesisindo iyindlela ejwayelekile yokwelapha isifo samathambo esiqinile esibukweni. Kwezinye izimo, lapho i-arthritis inqunyelwe khona endaweni encane yehlangene, kungenzeka kube khona ithuba lokwenza i-fusion phakathi kwamathambo amancane esandla, okuthiwa "ukuhlanganiswa okulinganiselwe." Isibonelo, i-"fusion ekhoneni elilodwa" iyindlela yokwelapha eyenziwa uma isifo samathambo singaniselwe emathanjeni amancane esikhwameni, ngokuvamile okubangelwa ukuhlukumeza okudala noma ukuhlukumezeka kokujoyina.
Kubantu abanesifo samathambo esasakazeke kakhulu - ikakhulukazi lapho i-arthritis ihilela ukuphela kwamathambo angaphambili - ukhetho luba yingqikithi yenhlanganisela yesandla. Kulesi simo, ipuleti enkulu ne-screws zensimbi zifakwe ngaphesheya kwesihlanganiso somunwe. Isibindi ngeke siphinde siguqe, kodwa kubantu abane-arthritis enamandla, umgomo oyinhloko ukuphumula ubuhlungu. I-fusion yesihenqo ngokuvamile ihlinzeka ngokuhlanganyela okuqinile futhi okungenabuhlungu ukuze kuvunyelwe ukusebenza okuningi.
Ukubuyiswa kwe-Wrist
Ukuhlanganiswa kwesibindi kungashintshwa, kufana nendlela ukuguqulwa kwamadolo noma ukukhishwa kwe- hip kwenziwa ngayo: ukujoyina kufakwe esikhundleni sezinto zensimbi neziplastiki ezivumela ukunyakaza kokubambisana phakathi kwesandla nangaphambili.
Inzuzo yendawo yokukhishwa kwesigqila ukuthi, ngokungafani ne-fusion, iziguli ezine-joint joint zizoba nokuhamba kwesandla.
Okungalungile ukuthi lokhu ngokuvamile akuyona inqubo enhle yeziguli ezisebenzayo nezincane, njengoba izimpande aziklanyelwe ukulwa namandla amakhulu. Ngaphezu kwalokho, ukuhlinzekwa kwesandla kwesikhumba kungavamile, ngakho-ke ngokungafani nokuqothulwa kwamagqabha namadolo, kunabaningi abahlinzayo abenza le nqubo eyinkimbinkimbi.
I-Carpectomy
I-carpectomy iyindlela yokuhlinzwa yokukhipha amathambo amancane esihlangene somunwe. Uhlobo oluvame kakhulu lwe-carpectomy lususa ithambo elincane phansi kwesithupha, okuthiwa i-trapezium, kubantu abane- arthritis yesisekelo sesithupha .
Uma i-arthritis isakazeke kakhulu esihlakaleni, ukuhlinzwa okubizwa ngokuthi i-proximal row carpectomy (noma i-PRC) isusa amathambo amathathu amancane ukuze kukhishwe amalunga agqamile wesandla.
I-carpectomy yemigqa ehamba phambili ingaba yindlela abantu abakudinga ukuhamba kwekhanda futhi ngakho-ke abafuni ukuhlanganiswa, okwamanje bayasebenza kakhulu. Ngaphezu kwalokho, i-carpectomy ingase ibe yindlela engcono kakhulu kubantu abangewona abakhethiweyo abalungile bokuncintisana, njengababhemayo abanethuba eliphezulu lokubhekana nezinkinga , njengokungabambisani, nokuhlinzeka nge-fusion.
Imiphumela Ngemva Kokuhlinzwa
Imiphumela yokwelashwa kwesifo samathambo ngokuhlinzwa ngokuyinhloko kuncike ekuqhathaniseni ukwelashwa okungcono kakhulu kwesiguli ngasinye. Akuyona ngayinye yalezi zindlela zokuhlinzwa ezifanelekayo wonke umuntu onesifo samathambo, ngakho-ke kubalulekile ukuba uhlolwe udokotela onolwazi ngalunye lwalezi zindlela.
Ezigulini ezitholwa ukuhlinzeka nge-arthritis yesibindi, abaningi bayothola ukukhululeka kokunye noma ubuhlungu babo bonke. Nakuba umsebenzi ungajwayelekile emva kokuhlinzwa kwamathambo e-arthritis, ngokuvamile kuvame ukwedlula isiguli esitholile ngaphambi kokuhlinzwa. Ukuhamba kwesibindi kuyashintsha, kuye ngokuthi yikuphi ukukhetha okukhethiwe okukhethiwe.
Imithombo:
I-Weiss AC, et al. "Isamba se-Arthroplasty" J Am Acad Orthop Surg ngoMashi 2013 vol. 21 cha. 3 140-148
Wyrick JD. "I-Carpectomy kanye ne-Intercarpal Arthrodesis Rout Proximal for the Management of Arthritis Wrist" UJ Am Acad Orthop Surg July / Agasti 2003; 11: 277-281.