Ukulimala kwesigxina seLigament ye-Ligament I-Knee
I-posterior cruciate ligament, okanye i-PCL, yenye yezinto ezine ezibalulekileyo ekuzinzileni kwamadolo . I -stress cruciate ligament , okanye i-ACL, ihleli phambi kwe-PCL. I-ACL iyaziwa kakuhle, inxenye kuba iinyembezi ze-ACL zixhaphake ngokuqhelekileyo kunokuxhatshazwa kwezinto ezinokulimala kwi-PCL. Kuyathakazelisa ukuba kucatshangelwa ukuba ukulimala kwe-PCL kubangelwa kuma-20 ekhulwini lokulimala kwamadolo, nangona kunjalo, i-PCL ayinakuthetha ngokuthe ngantoni ngenxa yokuba le nxeba ihlala ishiywanga.
I-PCL yi-ligament evimbela i-tibia (ithambo lesifuba) ukusuka kwi-sliding kakhulu. Ngokubambisana ne- ACL egcina i-tibia isuka kwi-slide phambili, iPCL inceda ukugcina i-tibia kwisithuba esingezantsi kwe-femur (ithambo lesithambo).
Izinyembezi zePCL
Indlela eqhelekileyo yokulimala kwe-PCL yinto ebizwa ngokuthi "yingozi yedashboard." Oku kwenzeka xa idolo ligobile, kwaye into enamandla ixabela i-back back. Kubizwa ngokuba 'yingozi yedashbhodi' kuba oku kubonakala kwimibhobho yemoto xa i-shin ihlasela ideshibhodi ngamandla. Olunye uhlobo oluqhelekileyo lokulimala luyingozi yezemidlalo xa umgijimi ewela phambi kwamadolo. Kule nzakalo, idolo liyi-hyper flexed (ibambe yonke indlela), kunye nonyawo olubhekise phambili. Ezi ntlobo zokulimala zixinzelele i-PCL, kwaye ukuba amandla aphakamileyo ngokwaneleyo, inyembezi ye-PCL ingaba ngumphumo.
Ukulimala kwe-PCL kudla ngokubonakala ngengozi enkulu engabangela ukulimala kwiindawo ezininzi zamadolo.
Iinyembezi ze-PCL zinokudityaniswa namanye amanxeba emilenze, kuquka iinyembezi ze-ACL, iinyembezi ze- MCL kunye neenyembezi ze- LCL . Banokufumaneka kunye neendlela eziyinkimbinkimbi zokulimala ezinjenge- posterolateral rotatory instability . Ukongeza, ukulimala kwe-PCL kunokudibaniswa ne- meniscusmbezi kunye nomonakalo we-cartilage .
Ngokuqhelekileyo la maphepha anzima kakhulu okwenzakalo ayenzeka ngokuguqulwa kwamadolo .
Iimpawu zee-PCL Izinyembezi
Iimpawu eziqhelekileyo zezinyembezi ze-PCL zifana neempawu zeendlebe ze-ACL. Ubunzima be-Knee , ukuvuvukala kunye nokunciphisa ukunyuswa okuqhelekileyo kuyaqhelekileyo nakubonakele. Izigulane zinokuvakalelwa kukuba idolo "lidlulile" okanye linikezela. Iingxaki zokungazinzi kwamadolo kwiiveki kunye neenyanga emva kokulimala kwe-PCL aziqhelekanga njengokungazinzi ngokulandela i- ACL izinyembezi. Xa izigulane zizinzile emva kokulimala kwe-PCL zidla ukuba zikwazi "ukuzithemba" ngamadolo, okanye zivakalelwa ngathi idolo liyakunika. Ukuba le sikhalazo sokungazinzi kuyinkathazo emva kokulimala kwe-PCL, kunokubonisa ukuba uqhubeke nokuhlinzwa.
Into ebalulekileyo ekwenzeni ukuxilongwa kwe-PCL izinyembezi kukungazi ukuba kwenzeka ntoni ukulimala. Ukwazi ibali lokulimala (umzekelo, isikhundla somlenze kunye nento eyenzekayo) kuya kunceda ekwenzeni ukuxilongwa. Ukuhamba ngokucacileyo kunokuvavanya umsebenzi we-PCL. Eyona inokuthenjelwa yile vavanyo yecrosoft yangaphambili . Xa uguqa ngamadolo, ugqirha wakho uya kuphelisa i-tibia ngasemva; oku kugxininisa i-PCL. Ukuba i-PCL ayinanto okanye idwenguliwe, i-tibia iya kuguqa ngokukhawuleza, kwaye ibonise ukulimala kwi-PCL.
I-ray-ray kunye nee-MRIs nazo zinceda ekucaciseni ukuxilongwa nokufumanisa naziphi na ezinye izakhiwo zamadolo ezinokulimala. Kuqhelekile ukufumana ezinye ukulimala kwegamentala okanye umonakalo we- cartilage xa kufunwa i-PCL.
Iinyembezi ze-PCL zixhaswe ngokukhawuleza kokulimala, ibanga lokuqala ukuya kwibanga lesi-III. Ibakala lithatyathwa ngokwezinga lokuxiliswa kwendlela yokulinganisa ngexesha lokuhlolwa kwakho. Ngokubanzi, ukufakwa kwemazi kubangelwa oku kulandelayo:
- Bakala I: Iinyembezi ezikhethekileyo ze-PCL.
- IBanga lesi-II: I- isolated, iphelele kwiingcingo kwi-PCL.
- IBanga III: Iinyembezi ze-PCL kunye nezinye izinto ezinobungozi begament.
Unyango lwe-PCL Tear
Ukunyanga kwezinyembezi ze-PCL kuyimpikiswano, kwaye, ngokungafani nokunyangwa kwe-ACL izinyembezi, akukho mvumelwano esincinci malunga nokunyanga okufanelekileyo kuzo zonke izigulane.
Ulwaphulo lokuqala lweentlungu kunye nokuvuvukala luquka ukusetyenziswa kweentonga , iqhwa kunye nokuphakama. Emva kokuba ezi ziimpawu zizinzile, unyango lomzimba luncedo ekuphuculeni ukunyuka kwamadolo kunye namandla. Unyango olungenalo unyango lucetyiswa kumabanga amaninzi I-grade II kunye ne-II II yezinyembezi.
Ukuphinda kwakhiwe uphando lwe-PCL kuxabana, kwaye ngokuqhelekileyo kukhuthazwa kuphela kwiinyembezi ze-PCL zeBakala III. Ngenxa yobunzima bezobuchwepheshe, oogqirha abathile bama-orthopedic abayiboni inzuzo yokwakhiwa kwe-PCL. Abanye, nangona kunjalo, bakholelwa ukuvuselelwa kwe-PCL kunokukhokelela ekuzinzileni kwamadolo nokuphucula ubunzima beengxaki ezantsi kwendlela.
Ukwakhiwa kwe-PCL yokugada kunzima kunxenye ngenxa yendawo yePCL emadolweni. Ukuzama ukubeka igraft entsha ye-PCL kule ndawo kunzima, kwaye ngokugqithiseleyo ixesha lezi ziqhelaniso ziyaziwayo ngokulula kwaye zisebenzise ngaphantsi. Ngokuqhelekileyo, ukulungiswa kwakhona kwePCL kugcinwe kwizigulana ezenzakalise amaninzi emidolo , okanye abo bangenako ukwenza imisebenzi yabo eqhelekileyo ngenxa yokungazinzi kwamadolo.
Imithombo:
I-Cosgarea AJ, Jay PR "Ukulimala kweLigament yokuLungulwa kweLigament: UkuHlola noLawulo" J Am Acad Orthop Surg, Vol 9, no-5, Septemba / Oktobha 2001, 297-307.