Ukwelashwa Ukulungisa Uhlu Oluhlukene
Ihlombe elihlukanisiwe liyisimo esibangela i-collarbone (clavicle) ukuba ihlukaniswe nokunamathiselwe kwayo okujwayelekile kusuka ehlombe lehlombe. Ngokuvame ukudideka nge- shoulder dislocation , ukwehlukaniswa kwamapulangwe kuyingozi ehlukile. Ngokuvamile kubangelwa ukuwela ngaphandle kwengalo yakho noma ihlombe, abantu abanokuhlukaniswa kwehlombe bayobona i-bump nobuhlungu phezulu kwehlombe.
I-bump empeleni ibangelwa ukuphela kwe-collarbone ephikisana nesikhumba.
Abantu abaningi abanamahlombe ahlukanisiwe bangaphatha ukulimala ngezokwelapha ezingenasidingo . Eqinisweni, odokotela abaningi bamazinyo bayavuma ukuthi yonke uhlobo I futhi uthayiphe ukuhlukana II kungenziwa ngaphandle kokuhlinzwa. Thayipha i-I no-II ukuhlukaniswa kwamaphethelo yiyona ejwayelekile kunazo zonke, ngakho-ke ukungenelela kokuhlinzwa kubhekwa kuphela engxenyeni encane yalezi zingozi.
Kukhona ukungqubuzana mayelana nokuphathwa kohlobo lwe-III ukuhlukaniswa kwehlombe, kuyilapho iningi le-IV, i-V, ne-VI lehlukaniswe ukuhlukana kwenza ngcono ngokuhlinzwa. Okubalulekile, abantu abaningi bazokwenza kahle ngaphandle kokuhlinzwa; yizinhlobo kuphela ezinzima kakhulu zamahlombe ahlukanisiwe eziphelela ekudleni ukwelashwa.
Izinketho zokuhlinza zokwelapha
Umgomo wawo wonke ukwelashwa okuhlinzekwa ukuhlukaniswa kwehlombe ukubuyisela ukulungiswa okujwayelekile kokuphela kwe-collarbone nomngcele ongaphandle we-shoulder blade (i-acromion).
Ekugcineni, ithemba liwukubuyisela ukulungiswa kwala mathambo, bawabeke endaweni ezinzile, futhi banciphise ubuhlungu ekuhlanganyeleni kwe-acromioclavicular.
Izinketho eziyinhloko zokuhlinza zihlanganisa:
Ukulungisa i-AC Joint: Ukulungiswa kokuhlanganiswa kwe-acromioclavicular kwenza umqondo omkhulu. Isici esivelele kakhulu salokhu ukulimala ukuphazanyiswa kokujoyina, nokuguqula nokubamba iqhaza endaweni efanele kwenza umqondo omkhulu.
Ukuhlanganyela kwe-AC kuvame ukuqhutshwa ngezinsimbi zamapulangwe noma izikhonkwane ezibizwa ngokuthi yi- Kirschner wires (k-wires). Ukuphazamiseka kwalokhu kuhlinzwa kungukuthi ukuhluleka ukulungisa umonakalo wegamenteni emigqeni enamandla ebambe ukuphela kwe-clavicle phansi. Ngaphezu kwalokho, lezi zimila zensimbi ezisetshenziselwa ukubamba iqhaza endaweni zingabangela ubuhlungu, kungase kudingeke zisuswe, nokunye okuningi mayelana nokuthi kungenzeka ukuthi lezi zimila zingahamba. Lokhu kusho ukuthi bangakwazi ukuhamba ngaphakathi komzimba, futhi kukhona imibiko esesabekayo ye-k-wires efakwe ku-clavicle ephela ngaphakathi kwesikhumba esifubeni ngokuhamba kwesikhathi.
Ukubamba i-Collarbone Down: Kukhona amasu amaningana okubhekana nokulimala okuhlangene kwe-AC okubamba ikollarbone phansi, abanye basebenzise insimbi, abanye basebenzisa ama-sutures anzima. Ngokuvame ukwenziwa kwe-collarbone kubanjwe inqubo ye-coracoid, i-hook of bone ngaphambili kwehlombe elingaphansi kwe-collarbone. Kungakhathaliseki ukuthi i-screwbone ingafakwa ku-corocoid, noma amathambo amabili angahlanganiswa ngokuqinile nge-sutures. Ukuphazamiseka kwalezi zindlela ukuthi izikrini ngokuvamile kufanele zisuswe futhi ama-sutures angadlula futhi aphule ithambo.
Ukuvuselela iziLigamente: Isigaba sokugcina sokhetho ukulungisa kabusha imigqa ebambe ukuphela kwe-clavicle endaweni efanele.
Kunezinhlobo eziningi zokhetho kule nqubo, noma usebenzisa izicubu zesiguli noma izicubu zomnikelo . Enye yezinqubo ezivame ukuqhutshwa, okuthiwa i-Weaver-Dunn ukuhlinzwa, ishintsha enye yemigqa emikhulu ehlangene ne-acromion kuze kube sekupheleni kwe-clavicle. Lokhu kugcina i-clavicle endaweni yayo evamile. Okunye okukhethwa kukho kubandakanya ukuvuselelwa kwemigudu ye-coracoclavicular (eyadwengulwa lapho ukulimala kokuhlwithwa kwehlombe kwenzeka) noma i-tendon emlenzeni wakho noma ithenda evela kumnikeli. I-tendon graft ihlanganiswe i-coracoid enezinyosi bese ingena ku-clavicle.
Ukwelashwa Kwami Okuthandwayo
Ezimweni eziningi, ngithanda ukubuyisela kabusha imilayezo ewonakele. Ukufuduka kwe-Metal ukuhamba (ukunyakaza) kusuka ku-clavicle kuhlobene, futhi iziguli eziningi azifuni ukuhlinzekwa okwesibili ukukhishwa kwesikhashana kwesimiso. Ngaphezu kwalokho, inqubo yokuvuselela iyona kuphela ekhuluma nenkinga eyinhloko - imigqa ephukile egcina ukuphela kwe-clavicle. Ngisebenzisa izicubu ezinikela nge-coracoid futhi zigcinwe ku-collarbone enezigcawu ezitholwa ngumzimba ngokuhamba kwesikhathi. Nakuba kungenzeka futhi ukusebenzisa izicubu zomuntu siqu, kunokuba izicubu zinikele, abantu abaningi abafuni ukuhlinzwa ngokufanayo ngesikhathi esifanayo nasemilenzeni yabo! Ngakho-ke, i-tendon ye-donor iyindlela enhle futhi isebenze kahle ekuhlangeneni kwami.
Konke okushiwo, abanye odokotela abahlinzayo baphumelela ngezinye izindlela zokwelapha. Kungenxa yokuthi udokotela oyedwa ohlinzayo ukwelashwa okuthile akusho ukuthi yiyona engcono kakhulu. Abahlinzayo abahlinzeka kahle kakhulu baphikisana ngalezi zinkinga futhi bangavumelani ngokuthi iyiphi inketho engcono kakhulu. Qinisekisa ukuthi uthola udokotela ohlinzayo onokuhlangenwe nakho nokuphathwa kokwelashwa kwehlombe elihlukanisiwe uma wenza isinqumo sakho.
> Imithombo:
> Simovitch R, Sanders B, Ozbaydar M, Lavery K, Warner JJ. "Ukulimala okuhlanganyelwe kwe-Acromioclavicular: ukuxilongwa nokuphathwa" J Am Acad Orthop Surg. 2009 Ngo-Apr; 17 (4): 207-19. Buyekeza.