Umonakalo kwiNyathelo eliHlangeneyo njengeSiphumo sokuHlukana
Ukulimala kwe-Hill-Sachs kwiphepha kwenzeka njengomphumo wokugxothwa kwamagxa . Ukuxhatshazwa kwamagxa kudla ukudideka kunye nomxhelo ohlukeneyo , kodwa oku kwahluke kakhulu. Xa kugxothwa ihlombe, ibhola yomxube webhola kunye ne-socket iphuma kwindawo. Ngokuqhelekileyo, xa le nzakalo yenzeka okokuqala, umntu kufuneka agxininise umxhelo wegxa , rhoqo kwisibhedlele okanye kwisebe lexakeka.
Umxhelo wegxala lenziwe ibhola phezulu kwethambo lesangqa (i-humerus), ebizwa ngokuba yintloko. Isiseko segxala liyingxenye yesi-scapula (umgca wecala) obizwa ngokuba yi-glenoid. Ukunceda ukubamba ibhola kwi-socket yimizila, i-cartilage, kunye neeton.
Xa kuqhutywe ihlombe, izakhiwo eziqhelekileyo ezibamba ibhola ngaphakathi kwesikhoxana soxinzelelo. Ukulimala kwiphepha kuxhomekeke kwixesha lomgulana oye walondoloza ukulimala. Umonakalo oqhelekileyo kungakhathaliseki ukuba umlenze wegxeni , obizwa ngokuba yi- Bankart, i- tearsart , eyenzeka kwizigulane ezincinci. Kubantu abadala abakhupha iigxalaba zabo, ukulimala ngokuqhelekileyo kukuthi i- rotator cuff tendons . Ukongezelela umonakalo wegilament okanye isithon , ithambo kunye ne-cartilage nazo zingonakaliswa; uhlobo oluqhelekileyo lomonakalo lubhekiswa njengesiphene se-Hill-Sachs.
Hill Sachs Defect
Ukukhubazeka kwe-Hill-Sachs kwenzeka xa kukho ukulimala kwithambo kunye ne-cartilage yekhanda elimnyama.
Njengoko intloko ekhukhulayo isuka kwisiseko sehlangeneyo, intloko ejikelezayo iyabetha umgca wesiseko ngokusebenza. Oku kudala i-divot kwintloko ehambelana nokubizwa ngokuthi i-compression fracture. Le divot ibonakala ibonakala kwi-MRI, kwaye ukulimala kwe-Hill-Sachs kukwabonakala kwakhona kwi-x-ray.
Ukukhubazeka kwe-Hill-Sachs akuveli kwedwa, oku kuthetha ukuba kukho umonakalo oye wavumela ukuba igxalaba lisuke. Isiqhelo se-Hill-Sachs sisoloko sisetyenziselwa ukuqinisekisa ukuba igxalaba laphuma ngaphandle kwesikhokelo, kungekhona nje ukutshatyalaliswa ngokukodwa, njengokuba kwenzeka kwi- subluxation . Ukukhubazeka kwe-Hill-Sachs kubonakala malunga nesiqingatha sexesha lokuqala lokuxhatshazwa kwamagxa kwaye kubonakala kubonakala kubantu abaye bahlala bexakeke kwiimeko ezidlulileyo.
Isizathu sokukhangela ukukhubazeka kwe-Hill-Sachs akukuphela nje ukuqinisekisa ukulimala kokuxhatshazwa kwamagxa, kodwa ukuchonga ukulimala kwe-Hill-Sachs kubaluleke kakhulu ukuqinisekisa ukuba unyango olulungileyo lwenkunkuma .
Uphulo lokuLawula
Njengoko kubonisiwe, kubalulekile ukuba ugqirha wakho ukuba aqaphele ukuba khona kwe-Hill-Sachs lesion ngaphambi kokuzama ukunyanga ukuphazamisa ihlombe . Ukuba isalathiso se-Hill-Sachs sikhulu kwaye sishiywa singakhange siphendulwe, ukulungiswa kungaphumeleka, kwaye ukungazinzi kwamagxa okuphindaphindiweyo kunokwenzeka.
I-criteria eqhelekileyo esetyenzisiweyo ukuchonga ukuba ukulimala kwe-Hill-Sachs kudinga unyango olongezelelweyo ngexesha lotyando lubukhulu besilonda. Ukulimala okubandakanya ngaphantsi kwe-20% yekhanda elixubileyo kunokuhlala kushiywe yedwa ngaphandle kokufuna unyango olungaphezulu.
Oko kuthetha ukuba unyango oluqhelekileyo lwe-shoulder dislocation (olunokuba lunokuthi lugqithise ukuhlinzwa) lunokuqhubeka ngaphandle kokufaka ingxaki kwi-Hill-Sachs.
Ukulimala okubandakanya ngaphezu kwe-40% yekhanda elixubileyo phantse njalo ludinga unyango olongezelelweyo. Kwiimeko apho ukukhubazeka kwe-Hill-Sachs kufaka phakathi kwe-20-40% yekhanda elixubileyo, ugqirha kufuneka uqikelele ukuba isiphoso sinegalelo ekuzinzeni ukungazinzi. Ukukhubazeka kwe-Hill-Sachs ebangela ibhola ukuba ihambe ngokungavumelekanga ngaphakathi kwesikhotshi kuthiwa "ukubandakanya," kwaye ukuxhatshazwa kwe-Hill-Sachs kufuna ukuba unyango olongezelelweyo lugqirha.
Izinyathelo zokwelapha ukulawula i-defect Hill-Sachs ziquka:
- Ukwenza nto
Ukuqwalasela yonyango oluqhelekileyo, kwaye ngokuqhelekileyo liphumelele. Ngokukodwa xa ukulimala kwe-Hill-Sachs kubandakanya ngaphantsi kwe-20% yintloko yentloko, akukho nto iyenzayo yonyango. - Capsular Shift
Ukutshintshela i-capsule yamagxa ngokukhethekileyo kukutyunjwa ukuqinisa izicubu endaweni ye-Hill-Sachs ukukhubazeka ukukhusela ukujikeleza ngokubanzi kwegxala. Ngokunciphisa ukujikeleza, i-defect Hill-Sachs ayikwazi ukuba yintsilelo echaphazelekayo. - I-Bone Grafting / i-Tissue Filling
Xa isikhombiso sikhulu, kwaye ngokumisa nje umxhelo awunelisekile, into kufuneka isetyenziswe ukuzalisa isiphako kwintloko yentloko. Abanye oogqirha basebenzisa ithambo, ngokusoloko bevela kwintlaka, okanye ezinye izicubu ezithambileyo ukuze bazalise. - Ukungabikho kwemali
Ukungaphumeleli kuyinkqubo yokucwangcisa ephakamisa ithambo elixinyiweyo ukuzama ukuseka kwakhona isimo esifanelekileyo sekhanda elixhamlayo. - Ukutshintshwa kwamagxa
Kwezinye iimeko ezinqabileyo, ngokukodwa kakhulu iziphene ezikhudlwana kwizigulane ezidlulileyo, ukhetho oluhle lunokuba ngumsebenzi wokuguqulwa kwamagxa . Le nkqubo isoloko igcinwe kwisigqibo sokugqibela kwizigulane ezincinci.
Ukuqwala unyango olungcono kunokuxhomekeka kumanani amaninzi kubandakanya ukubonakala kokulimala kwizifundo zokucinga, ukufundwa kweemviwo, ukulindela ukuthatha inxaxheba kwezemidlalo, kunye nokukhethwa kwabagqithisi.
Imithombo:
Provencher MT, et al. "I-Hill-Sachs Lesion: Ukuxilongwa, UkuHlulwa, kunye noLawulo" J Am Acad Orthop Surg u-Apreli 2012 vol. 20 ayi. 4 242-252