Ukulimala Okuphakathi Kwe-Elbow ekuphonsa Abadlali
UTommy John angase aziwa kangcono ngabalandeli abancane be-baseball hhayi ngalokho akwenzile emgodini we-pitcher, kodwa ngenqubo yokuhlinzwa enegama lakhe. Ukwesaba amabhentshi e-baseball kanye nabanye abagijimi abaphonsa phansi bayalimala ku-lignaral colamentater of the elbow. Isibambiso se-ulnar isigamento se-elbow sisehlangothini lwangaphakathi (eliphakathi) lohlangene, futhi lisiza ukunikeza ukuzinza komhlanganiso we-elbow.
Lapho ukuphonsa, ukucindezeleka okukhulu kubeka kwi-lignar collateral ligament, futhi ukulimala kungenzeka ku-ligament.
Eminyakeni yamuva, ukulimala ku-ulnar indlondal ligament, futhi isidingo sokuhlinzwa kukaTommy John, sekuye kwavame kakhulu. Kukhona ukukhathazeka phakathi odokotela ukuthi izinga lokulimala liyanda, mhlawumbe ngenxa yemigodi yebhola yebhola ephonsa kakhulu, kaningi. Nakuba abaqeqeshi abaningi beqaphela ukubaluleka kokubala kokulinganisa, kunzima ukwazi ukuthi kuningi kangakanani. Ngaphezu kwalokho, i-baseball ehlobo iye yaqala ukusebenza emnyakeni omude wabagijimi abaningi abasha, ngokuqhubeka nokubeka ingcindezi ekucindezelekeni okuphindaphindiwe.
Izimpawu zokulimala kwe-UCL
Isibonakaliso esivame kakhulu se-ulnar ukulimala komgogodla ubuhlungu ngokuqondile phezu komgogodla ohlangothini olungaphakathi lwendonga. Kodwa-ke, akuzona zonke izinhlungu ze-elbow kumdlali ophonsa ukulimala okwe-UCL, futhi kubalulekile ukuba uhlolwe ngokucophelela ngudokotela onamakhono ekuphonsa ukulimala ukuze anqume imbangela yobuhlungu be-elbow.
Izimpawu ezivame kakhulu zokulimala kwe-ulnar izimboni zihlanganisa:
- Ubuhlungu, ngokuvamile kuvamise 'esigabeni sokugcina' sokujikijela (lapho ibhola likhuphuka, futhi ngemuva kwekhanda)
- Inzwa 'yokuphuma' lapho ubuhlungu buqala
- Ubumbulu noma ukubetha esandleni naseminwe
- Nciphisa ukuhamba kwe-pitch velocity
Njengoba kushiwo, kunezinye izimbangela zezimpawu.
Ngokuqondile, i- tendinitis yemisipha engxenyeni yangaphakathi ye-elbow (imisipha yemisipha ye-wrist) iyinkinga evame kakhulu ukudala izimpawu ezifanayo. I-tendinitis ngokuvamile iqala kancane kancane kunokulimala kwe-UCL, kodwa ngokuvamile ididekile. Izinkinga ze-ulnar zesibindi zingabangela ubuhlungu kanye nezimpawu zesibindi endaweni efanayo.
Ukuvimbela ukulimala kwe-UCL
Ukuhlinzwa kukaTommy John kungadinga isikhathi esingaphezu konyaka sokuvuselela, futhi akusona isiqinisekiso sokubuyela ezingeni elifanayo lokuphonsa, ngakho ukubaluleka kokuvimbela ukulimala kwe-UCL kuyinhloko. IKomiti Yeluleki Yama-Medical / Safety Safety yase-USA yenza izincomo ezithile mayelana nokuthi zingaki imiphakathi ehlukene nabadlali bezeminyaka kufanele zilinganiselwe ukuphonsa inkambo yomdlalo kanye neviki, nokuthi kufanele baphumule kangakanani emva kokuphonsa. Bonke abaqeqeshi kuwo wonke amazinga obudala kumele bajwayelane nale mingcele.
Noma yiziphi izibonakaliso zokuqala zenhlanhla kufanele ziphathwe ngokuphuthuma. Abaphangi abakha ubuhlungu be-elbow kufanele basuswe emncintiswaneni ngokushesha futhi bahlolwe ngumuntu oqeqeshwe ngezimbangela ezivamile zobuhlungu be-elbow. Ukuqhubekela phambili kufanele kuqhutshwe njalo ngaphambi kokubuyela emuva, ngisho noma imbangela kucatshangwa ukuthi ayihambisani nokulimala ku-UCL.
UCL Ukwelashwa Kokulimala
Abaningi abagijimi abahlala belimala kakhulu ku-UCL bazozama ukwelashwa okungekho emthethweni kuqala. Ukuphumula okusheshayo kwendwangu ebuhlungu, okulandelwa ukuhlolwa okusebenzayo ngokucophelela kwelashwa kufanele kuqhubeke. Ukwelapha ngokomzimba kufanele kufaka ukuhlolwa okucophelela kokuphonsa imishini ukuze kunqume izindlela zokunciphisa ukucindezeleka okubekwa kulo mgodi olimale.
Ukwelapha okuhlinzekwa ukwenza inqubo kaTommy John kwenziwa ngokuvuselela i-ligament entsha, hhayi ukulungisa i-ligament eyonakalisiwe (efana nokuvuselelwa kwe-ACL ). I-UCL entsha yenziwe nge-tendon engxenyeni engaphambili ebizwa ngokuthi i-palmaris longus tendon.
Iningi, kodwa hhayi sonke, lethu line-palmaris longus tendon, kodwa asiyidingi. Uma ungenayo i-palmaris longus tendon, kunezinye izintambo ezingasetshenziswa ekwenzeni i-ligament entsha.
Uma sekutholakale ukuhlanganiswa, udokotela wakho ohlinzayo uzokwenza izimbobo ezincane ezingenhla nangaphansi kwehlangothini lwe-elbow lapho i-UCL ihlanganisa khona ithambo. I-tendon graft izokhishwa ngaphakathi emigodini, futhi igqoke isitayela se-figure-of-8 futhi ibuyele emuva emuva kwayo ngokwayo ukuze idale umugqa omusha.
Ukuvuselelwa emva kokuhlinzwa kukaTommy John kuthatha cishe unyaka. Abagijimi abaningi abaqali ukuphonsa okungenani izinyanga ezingu-4 ngemuva kokuhlinzwa, futhi ukuqhubeka kuhamba kancane. Abanye abagijimi babuyela emandleni aphelele ngezinyanga ezingu-9, nakuba abaningi bathatha isikhathi esingaphezu konyaka ukuze babuyiselwe ngokugcwele.
Imithombo:
UBruce JR no-Andrews JR. "Ukulimala KwamaLigamental I-Ulnar Collateral ku-Athletic Attack" J Am Acad Orthop Surg May 2014; 22: 315-325 .; doi: 10.5435 / JAAOS-22-05-315