Ukuguquguquka kweCapsula okanye ukunyanzela kukuzinzisa ihlombe
Ukungazinzi kwintamo yimeko ekhokelela ekuhambeni okanye ekuxhasweni kwegxalaba. Oku kwenzekayo xa kukho ukuhamba okukhulu kakhulu kwimixhelo yegxala, kwaye ibhola lingaphuma kwisiseko.
Ngokubanzi, kukho iintlobo ezimbini zokungazinzi kwamagxa:
- Ukuxhamla kobuhlungu
Ukungazinzi kwamagxa kwenzeka ngokuqhelekileyo kwimidlalo okanye kwingozi, njengalapho uswele okanye ukuqhuma kwemoto. Xa igxalaba lichithwa ngamandla kwi-joint, iigaments okanye i-tendon zinokudiliza; Iprojekthi yokulimala eqhelekileyo emva kokugxothwa kwamagxa kuthiwa yi-Bankart inyembezi. Ukungazinzi kokuxhamla kwintlungu kubonakala kubantu abanobudlelwane obuqhelekileyo bemigxala eqhutywe kakhulu, bangela umonakalo xa igalelo liphuma ngaphandle.
- Ukuxhomekeka kweMidididididi (MDI)
Ukungazinzi kwamanqanaba ahlukeneyo ahlukileyo ngenxa yokuba umxhelo wegxala awukhululekile, obangela iimpawu kunye nemisebenzi eqhelekileyo. Igxalaba lakho lingashenxisa okanye lidibanise (ukuphuma ngaphandle kokudibanisa) kunye nokunyakaza okulula, kungekhona iziganeko eziphazamisayo. Kule meko, ukungazinzi yinkxalabo engundoqo, kungekhona ingozi okanye ukulimala.
Xa ufumanisa ukuba unokungazinzi kwamanqanaba amaninzi, uya kuqala ukuzama unyango lwezonyango. Ngokuqhelekileyo, ezi zonyango ziya kunceda ukukhusela ezinye iziqendu zokungazinzi ngokuqinisa imisipha ejikeleze ihlombe ukuphucula kangcono ukudibanisa. Kodwa ngamanye amaxesha iinzame ezininzi zokwenza unyango zingabonakala zingaphumeleli. Kulezi gulane, ukuhlinzwa kwegulane kunokunconywa.
Uphulo lwe-Capsule Surgery
I-capsule yamagxa iyimvulophu ejikeleze umxhelo wegxala . Iqulethe amanani amaninzi athile, okanye iigaments, ezizinzileyo.
Ngokuqhelekileyo, izigulane ezinokungazinzi kwamanyathelo ezininzi zilahla iigaments kunye nokunyaniseka kwe-capsule. I-capsule yamagxa kulezi zigulane ichazwa ngokuba neengxowa.
Ugqirha ukulungisa ukungazinzi kwamanqanaba amaninzi kugxininiswe ekuqiniseni iigaments nokunciphisa ubukhulu becala le-capsule yamagxa.
Ngokubanzi, kukho iindlela ezimbini zokupasa ukufeza oku. Utyando lwendabuko lwenzeka nge-incision phambi kwegxala, elibizwa ngokuba yi-capsular shift. Indlela yakutshanje yakwenziwa yenziwa i- arthroscopically , ngokubambisana okuncinci ngokuncedisa ikhamera efakwa kwidibeneyo.
Vula iCapsular Shift
Ukutshintshwa kwe-capsular evulekile yindlela yokuhlinzwa yendabuko eyenziwa ukuqinisa intsebenziswano. Kule nkqubo, inkohlakalo isenziwa ngaphambi komxube, kunye ne-muscle phambi kwegxala, ebizwa ngokuba yi-subscapularis ( inxalenye yesikhombi se-rotator ), igcinwe ukuvumela ukuba ugqirha wakho abone ngaphakathi ngaphakathi. I-capsule yamagxa iyabonwa kwaye ihlukaniswe; Ingxenyana engezantsi ye capsule yamagxa iyakhutshwa, kwaye emva koko umphezulu uphononwe ukuze unciphise umthamo womxube wegxala.
Ubuncedo beli qhinga kukuba lilingwa kwaye liyinyaniso. Abagqirha banokukwazi ukucinga ngendlela abaye baqinisa ngayo, kwaye banokunciphisa kakhulu umthamo we-capsule yamagxa. Ingcipheko kukuba ukubuyiswa kusele ixesha elide, ngenxa yecandelo lomgca wenxalenye yecube yomqhubi .
I-Capsular Plication
I-capsular plication yindlela yokuhlinzwa eyenziwa i-arthroscopically.
Udokotela ogqirha ufaka ikhamera kwidibene , kunye nezinye izinto ezincinci zisebenzisa i-sutures ukuba "zibambe" inxalenye yesikhwama segxeni kwaye uyigwebe phezu kwayo ukuze uqinise izicubu ze-capsular. Abanye oogqirha baziva bekwazi ukubona iziphumo zomsebenzi wabo bhetele ngokubukela oku ngekhamera, kwaye banakho ukubeka ngokuthe ngqo i-sutures esetyenziselwa ukuqinisa intloko.
Yiyiphi Intlekele Eyona Ngcono?
Akwacaca ukuba enye yezi ndlela zingcono kunezinye; ukhetho oluxhomekeke ngokuyinhloko kwindlela yokugqirha, kuba oogqirha abaninzi baya kuziva ukuba banokwenza enye yeenkqubo ngokunyaniseka.
Oku akuthethi ukuba ukhetho lwakhe lungcono - lithetha nje ukuba nguyena ogqirha wakho okhululekile owenzayo.
Siyazi ukuba enye inkqubo, ebizwa ngokuba yi-thermal capsular shrinkage - okanye i-capsulorrhaphy ye-thermal - ayifanele yenziwe. Le nkqubo, eyaziwayo kwiminyaka ye-1990 kunye nakuma-2000, isebenzisa ukutshintsha kwe-heat to cauterize kwaye iyanciphisa i-capsule yeli gxalaba. Iziphumo ezimbi ezibangelwa kulo msebenzi, ngoko ke ukutshitshiswa kwe-capsular shs
Imithombo:
Gaskill TR, et al. "Ulawulo lweZakhono eziManyeneyo kwiJolthi" J Am Acad Orthop Surg ngoDisemba 2011; 19: 758-767.