Ukuphazamiseka kwehlombe kungukulimala okwenzeka ngebhola kuphuma emhlangothini wehlombe nebhokisi. Ukuhlukunyezwa kwamagundane kubangelwa ukulimala okulimazayo (ukuwa, ukushayisana kwemoto, njll) noma ukulimala kwezemidlalo. Iningi lamahlombe lahlukana lapho ibhola liphuma phambi kwehlombe - okubizwa ngokuthi i-anterior shoulder dislocation.
Amaphesenti angaba ngu-95% amahlombe ahlukaniswayo ahlukumezwa kwangaphambili.
Ihlombe lingase libuyele ngemuva kwehlombe, nakuba lokhu kulimala okungavamile nakakhulu. Lapho ibhola liphuma ngemuva kwesikhwama sehlombe, ukulimala kubizwa ngokuthi i-posterior shoulder dislocation. Ukuhlukaniswa okuthunyelwe okubalulekile kubalulekile ukuqaphela ukuthi ukwelashwa kuhluke kakhulu, futhi ngeshwa, lokhu kungalimala kalula.
Esinye sezizathu zokuthi lokhu kulimala kungaphuthelwa ukuthi ingalo ibanjwe endaweni ebonakala ijwayelekile. Ngokuvamile, ingalo engenhla ibanjwe ohlangothini, ne-forearm ephikisana nomzimba. Lokhu kufana nesimo ongase ubambe ngaso ngengalo yakho ngenhlobo yokudideka yokulimala , okwenza ukuhlukaniswa kokuhlanganyela kungabonakali kancane.
Izimbangela Zokususwa Kwangemva Kwangemva
Ngokungafani nokuhlukunyezwa kwangaphakathi okwenzeka ngemuva kokulimala okukhulu, izimbangela ezimbili ezivame kakhulu zokuxoshwa kokuhamba ngemva kokuhamba ngemuva kokungena kwezinto ziyingozi nokushona kagesi.
Imisipha ejikeleza ihlombe ngaphakathi ngaphakathi inamandla kakhulu kunemisipha ejikeleza ihlombe ngaphandle. Ngenxa yalokhu ukungalingani kwamandla, ukuphazamiseka okungazelelwe, okuphoqelekile - njengalabo abanolwazi ngesikhathi sokuthunjwa noma ukushaqeka - bangadonsela ibhola ngemuva kwehlombe.
Ngokuvamile ngemuva kokulimala okulimazayo njengokuwa noma ukulimala kwezemidlalo, abantu bafuna ukuthi kungenzeka ukuxoshwa kwehlombe.
Ngakolunye uhlangothi, lapho umuntu ehlushwa noma eshaywa ngogesi, abantu abaningi abacabangi ukuthi kungenzeka ukuxoshwa kwehlombe. Ngakho-ke, lokhu kulimala ngezinye izikhathi kunganakiwe ngoba ukunakwa kweminye imikhakha yempilo yesiguli. Kulezi zimo, ubuhlungu behlombe bungase kubangelwe ukuphazamiseka ngenxa yokuqothulwa noma ukuthuthumela.
Ukwelashwa Kwezinguquko Eziphansi
Isinyathelo esibaluleke kakhulu sokuqala ekuphulukiseni ukuthuthwa kwe-posterior, uma ukulimala kubonakala, ukubeka kabusha ibhola emhlangothini wegqoko nekhanda. Ukuhlelwa kabusha kokuhlanganiswa, okubizwa ngokuthi 'ukunciphisa' i-+ -joint , ngokuvamile akunzima, kodwa kulula kakhulu ukubekezelela nge-anesthesia ukuze unciphise ubuhlungu nokungahambi kahle.
Ukwelapha okuhlinzekwa kokuxoshwa kungacatshangelwa, ikakhulukazi uma ukulimala kwamathambo kuhambisana nokuhlukaniswa. Uma kwenzeka i-posterior shoulder dislocation, kuvamile ukuthi uma ihlombe liphuma ngaphandle, ibhola lishaya ngamandla emaphethelweni. Lokhu kungabangela ukuhlukumeza okwenzekayo okubizwa ngokuthi i-backverse Hill-Sachs defect. Ukukhubazeka kwe-Hill-Sachs kuyinto ejwayelekile yokuthola ngokuhlukaniswa kwangaphakathi. Ukulimala okunjalo, ngaphandle kwehlangothini oluhlukile kwebhola futhi ngaleyo ndlela kuthiwa yi-Hill-Sachs ehlanekezelayo, kwenzeka nge-dislocation ngemuva.
Kukhona nezinye ukulimala okungahle kwenzeke ngokubambisana ne-posterior shoulder shoulder dislocations. Lezi zihlanganisa ukuqubuzana kwe-humerus ehamba phambili , izinyembezi ze-labrum , nezinyembezi ze- rotator . Ngaphezu kokwelashwa kwe-dislocation, kubalulekile ukuqinisekisa ukwelashwa okufanele kwalokhu kulimala okuhlobene.
Isibikezelo
Njengoba kuxoxwa, ukuhanjiswa okungemva kokuvamile akuvamile. I-prognosis ibonakala sengathi ihlobene kakhulu nomonakalo wethambo ne-cartilage okwenzeka ngesikhathi sokuxoshwa. Ukukhathazeka kweziguli eziye zahlukanisa amahlombe kubandakanya amathuba okuphindaphinda okuphindaphindiwe (okuphindaphindiwe).
Ukuphazamiseka okuvamile kuyinkinga enkulu ngamathambo amakhulu amakhulu njengoba kukhona ukuzinza okuncane ehlombe uma ithambo lonakalisiwe.
Umthombo:
URouleau DM, uHebert-Davies J, uRobinson CM. "Ukuhlukunyezwa Kwamahlombe Okumnyama Okumangalisayo" UJ Am Acad Orthop Surg NgoMashi 2014; 22: 145-152.