Ukuhanjiswa kwe-patella kwenzeka D xa i-kneecap ikhutshwa ngaphandle kwe-groove ekupheleni kwethambo lesithambo. I-kneecap isoloko idonselwa ngaphandle kwe-groove. Xa kwenzeka ukutshatyalaliswa kweelabella , kunokwenzeka ukuba kuphinde kwenzeke kwakhona kwikamva.
Ukuqonda ukuba kutheni i-kneecap ichithwa yinto ebalulekileyo ekuqaliseni unyango olufanelekileyo.
Kwamanye abantu, ukulungelelanisa amathambo okanye isifo semfuyo kungabangela umba, kwabanye, kunokuthi kubekho i-ligament ephahliweyo. Ukuba kugqitywa ukuba utyando luyindlela ekhethekileyo yokonyango, ke ukugqiba utyando oluthile linyathelo elibalulekileyo kunqanda ukutshintshwa kwexesha elizayo.
Unyango Ongafunywanga
Ngokwesiko, emva kokutshatyalaliswa kwexesha lokuqala lokubambisa i-patella, unyango olungelona unyango lunconywa. Unyango olungaphelelanga luhlala lubandakanya unyango lwangokwenyama ukuqinisa imisipha emadolweni kunye nokusetyenziswa kwe-brace ukuze uncede ubambe i-kneecap kwindawo efanelekileyo. Indlela efanelekileyo yokunganyanga ukukhusela ukuxhatshazwa kwexesha elizayo kuyabonakala, kodwa oogqirha abaninzi banomuvo wokubaluleka ukufumanisa ukuba le nto yayisiganeko esisodwa, okanye ukuba kungenzeka ukuba yinkinga ephindaphindiweyo. Ukuhlinzwa ngokukhawuleza emva kokutshatyalaliswa kwexesha lokuqala akuzange kubonakale kunenzuzo.
Uninzi lwagqirha luyavuma, ukuba i-kneecap ichithe amaxesha amaninzi, ngoko utyando kufuneka kuqwalaselwe.
Xa i-kneecap ihamba, iyakwazi ukulimaza i-cartilage emadolweni, ekhokelela ekungciphekweni kwe- knee arthritis . Xa kuqhutyelwa amaninzi amaninzi, utyando lwe-patellar ukuzinza kufuneka luqwalaselwe.
Ukukhululwa kwexesha
Ukukhululwa ngokusemthethweni ngumsebenzi olula kwaye oqhelekileyo owenziwe ukutyunjwa ukujongana nokungazinzi kwe-patellar .
Ngenxa yokuba i-kneecap idonsa ngaphandle kweedolo, ukukhululwa kwe-lateral kudonsa i-capsule ye-knee ehlangene (retinaculum) ngaphandle kwendibano-idolo . Ingcamango iwukuba ukhulule ukutsala ngaphandle kwaye unethemba lokuba ubeka phambili i-kneecap ngaphakathi kwendawo yokutya ekupheleni kwethambo lethanga. Ukukhululwa ngokusemthethweni kungenziwa kunye ne-mediation or reconstruction (MP).
Uxinzelelo lwezoNyango / uReefing
Ukugqithiswa kwezokwelapha yinkqubo yokumisa izicubu kwicala langaphakathi lamadolo. Njengokuba ukukhululwa kwesikhokelo kukhulula izakhiwo ezithatha i-kneecap ngaphandle, i-intrical imbrication igxininisa izakhiwo kwicala langaphakathi lamadolo. Indlela eqhelekileyo yokuqinisa umgca wecala eguqeni iqhubela phambili isinamathiselo semisipha ye-quadriceps kwi-kneecap kwicala langaphakathi lamadolo.
Ukulungiswa kwe-MPFL / Ukwakhiwa kwakhona
Inkqubo yenkqubo yamaninzi eyenziwa kwi-patellar dislocation idilesi ebalulekileyo ebizwa ngokuba yiligamentaloral legament, okanye i-MPFL. I-MPFL yintsimbi phakathi kwephefu lesithambo lesithanga (femur) kunye necala langaphakathi le-kneecap (patella). Xa i-kneecap ihambela, i-MPFL ihlala idwengulwe.
Xa kunokulimala kanzima , kunokunokwenzeka ukulungisa i-MPFL.
Oku kuyinyaniso kwixesha lokuqala lokuchithwa okujongene nokuhlinzwa ngokukhawuleza. Ngoko ke, abanye oogqirha baxhasa ukuhlinzwa ngokukhawuleza emva kokuba i-patella yokuqala ichithe ukulungiswa kwe-MPFL, nangona le nto ingazange iboniswe ukunciphisa ukuphindaphinda kwakhona.
Emva kokuphindaphinda, ukulungiswa kwe-MPFL, iligament entsha kufuneka yenziwe. Oku kunokukwenziwa ngokusebenzisa i-ligament okanye ithethoni ukusuka kwenye indawo emzimbeni wakho, okanye kwi-donor (cadaver). I-ligel entsha ye-MPFL idalwe kwaye ifakwe kwinqaba le-kneecap. Le MPFL esanda kuphinda iphinde ibuye ibeke i-kneecap kwindawo efanelekileyo.
I-Bone Realignment / Fulkerson Inkqubo
Kwezinye izigulane, i-anatomy yabo ayiqhelekanga kwaye igalelo kwi-kneecap ephuma ngaphandle. Ingxaki ingaba yindawo engacacanga ekupheleni kwethambo lethanga okanye ukulungelelaniswa okungavumelekanga komgca ongaphantsi .
Kule meko, utyando oluqhelekileyo lulungelelanisa umgca ngokubeka i-tubercle ye-tibial kwi bone bone. I-tubercle ye-tibial, i-bump phezulu kwisithambo shin, ifake i- tendel patonlar . Ngokumiswa kwe-tubercle ye-tibial, i-patella ithonywa ngaphezulu ukuya kwicala langaphakathi lamadolo.
Kukho iintlobo ezahlukeneyo zokuhlinzwa okufezekisa lo msebenzi. Inkqubo yeFulkerson yinto eqhelekileyo kwaye ibizwa ngamagqirha achaza le ndlela. Kukho ezinye iinkqubo ezifanayo ezikwazisa i-tubercle ye-tibial.
Rehab Emva koPilisi
I-Rehab emva kokuhlinzwa ukuba iguqulwe i-patella iyatshintsha. Ubuncinane bokubuyiswa kwakhona kunokukhishwa kwesikhashana, kwaye i-rehab ende kakhulu inenkqubo yokuguqula amathambo. Kungakhathaliseki ukuba yintoni eyenziwa yinkqubo, inkcenkcesha eqhelekileyo emva kokuhlinzwa kukuba lukhuni lwamadolo . Ukufumana amandla oqhelekileyo kunye nokuhamba okufunyenweyo emva kokuhlinzwa kunokuthatha inyanga okanye ngaphezulu.
Njengoko kuthethwe ekuqaleni kwinqaku, ibalulekileyo le nyathelo kukuqinisekisa ukuba utyando olulungileyo luyenzeka ngokusekelwe kwimeko nganye. Akuyiyo yonke i-kneecap yokutshatyalaliswa eyenzeka ngesizathu esifanayo, kwaye ngoko ke akukho zonyango zonke zifana. Ukubona udokotela ogqirha oqhelana nezizathu kunye neyeza zokwelapha i-kneecap kubalulekile.
Nangona ukutshatyalaliswa kwe patella kungenzeka emva kokuhlinzwa, aphantsi kakhulu. Uninzi lwezigulana lunokuphinda luqalise phambili izinga lokulimala komsebenzi ngaphandle kokuba nomngcipheko wokususa i-kneecap yabo.
Imithombo:
I-Hing CB, kunye ne-al. "Ukutshintshwa kokungenelelekanga kokungenelelo kokuphatha i-patellar dislocation" I-Cochrane Database Syst Rev. 2011 Nov 9; 11: CD008106.
I-Andrish J. "Ulawulo lwe-patellar dislocation" ngokuphindaphindiweyo "i-Orthop Clin North Am. 2008 Julayi; 39 (3): 313-27.