Ulnar Collateral Ligament Reconstruction (UCLR)
Ulnar Collateral Ligament Ukuvuselelwa, okanye i-UCLR, iyaziwa ngokuba nguTommy John ukuhlinzwa. Yinkqubo eyenziwa ukulungisa umlenze owonakele kwi-elbow ebizwa ngokuba yi-ulnar collateral ligament (abanye basebenzisa i-term colalateral ligament). Le nzakala yenza ukuba i-elbow ibonakale ingaqiniseki kwaye idinga unyango lomzimba. Ukuba ukulimala akuphenduli unyango lomzimba, utyando lusetyenziswe unyango olulandelayo.
Imiba ye-Ulnar yokugulisa i-ligament imiba eqhelekileyo kwibalasethi "ukuphosa" abadlali, njengama-pitcher e-baseball. Ukuphosa imisebenzi kubeka amanqanaba angabonakaliyo oxinzelelo kwi-elbow, eyenza ukulimala kwindawo leyo kunokuba kunamanye emidlalo. Kwabadlali abaninzi, u-Tommy John utyando unokubuyisela umsebenzi opheleleyo kunye nabanye, ukuphinda kuhlaziywe ngokupheleleyo.
Kwezinye izigulane, utyando aluqhutyelwa ukuba luvumeleke ukuba baqhubeke benza njengomgijimi, kodwa ukunciphisa iimpawu zolwaphulo-ubuninzi bobuhlungu kunye ne-numbness esandleni sengalo echaphazelekayo.
ILigament ye-Ulnar
I-ulnar collateral ligament yiqela elixubile leethambo ezinjengeqela elinesibhakabhaka elinamandla. Isebenza kunye ne-lateral collateral ligament ukuzinzisa nokuqinisa i-elbow. I-ligament inokulimala ngokukrazula, ukulula kunye nokuchithwa. Ukuxhatshazwa ngokugqithiseleyo, apho i-ligament ibonakaliswe ukunyakaza ngokuphindaphindiweyo, ziphakathi kweentlobo eziqhelekileyo zemiba ye-lign collateral ligament.
Kutheni Kubizwa ngokuba nguTommy John Surgery?
U-Tommy John wayengumngxube weengcali kwiLos Angeles Dodgers. Ngomnyaka we-1974 wonakalisa i-ulnar ye-collateral ligament, eyayicatshulwa njengengozi yokuphela komsebenzi kwi-pitcher. UJohn, nangona kunjalo, ukhethwa ukuba abe nenkqubo eyayimvavanyo ngeli xesha, etshintshela ligament elenzakaliswe ngethoni kwisinye ingalo yakhe.
Ngenxa yokulindela okuncinci ukuba uya kuphinda akwazi ukumisa kwakhona, uTommy John wavuma ukuba uDkt Frank Jobe enze inkqubo. Emva koko wathatha intsalela ye-1974 kwaye emva kwexesha le-1975 lebhola yebhola ye-baseball eya kuvuselela ingalo yakhe. Isiphumo sokugqibela sasingu-revolutionary-uJohn wamisa ngo-1989-kwaye inkqubo iyaziwa ngokuba nguTommy John.
Inkqubo
Utyando lukaTommy John lwenziwa phantsi kwe-anesthesia jikelele ngabagqirha bamazinyo. Xa isigulane sithotywe kwaye i-anesthesia ithathe isiphumo esipheleleyo, inqubo iqala ngokukwenziwa ngaphakathi komgca, apho isalathisi esonakalisiweyo isuswe. Inkqubo yinto encinci ye-invasive , ngoko ke, ukuchithwa kukuncinci, njengoko inkqubo yenziwa ngokusebenzisa i-laparoscope.
Ukuba ukulungiswa kuyadingeka, esi sixhobo esincinci sisetyenziselwa ukufaka izixhobo kwindawo edibeneyo kunye nokulungisa i-ligament ephuthiweyo. Ukuba kufuneka kwakhiwa kabusha, kukho ukuqhutyelwa okongezelelweyo, ngokuphindaphindiweyo kwisalathisi sesandla esithile, ukubuyisela i-tendon kwindawo engaphazamanga yomzimba. Nangona i-forearm yinto ekhethekileyo, ezinye iindawo ezinokuthi zibandakanya umlenze ophezulu nangaphantsi. Ngokuqhelekanga, ithenda yesibonelelo ingasetyenziselwa endaweni yesithinteli somguli.
Emva kokuba kufakwe i-tendon graft, ityunyiwe ibe yindawo njengendawo yokutshintshela i-ulnar collateral ligament. Kwezinye izigulane ezifumana iimpawu zokugada nokugubungela esandleni, isilonda se-ulnar sinokufuduswa kancinci ukukunceda ukubuyisela ukuva.
Mngcipheko
Ukongeza kwimingcipheko eqhelekileyo yokuhlinzwa kunye neengozi ze-anesthesia , utyando lukaTommy John luneengxaki ezikhethekileyo kwisigulane. Kweminye, i-neuropathy, okanye ukungabikho kwempembelelo yesibindi, kunokushiya isandla esichaphazelekayo, esichukumisayo kunye / okanye ebuthathaka. Le meko inokuphucula emva kwexesha okanye ibe yinkxalabo engunaphakade yengozi yangaphambili.
Kwezinye izigulane, ukungabikho kokuguquguquka kuyaphawuleka emva kokuhlinzwa, ngelixa abanye banokuhlala bevakalelwa ukungazinzi kwi-elbow. Nangona kuqhelekile emva kokuhlinzwa ukuba kunzima ukulungisa ingalo ngokupheleleyo, le ntshukumo ayiyi kubuya kwinqanaba leendwendwe ebekho phambi kokulimala.
Ukubuyisela
Ukufumana emva kokuhlinzwa okwenziwa ngolu hlobo lokulimala lucacile. Utyando lukaTommy John ludinga ukuhlala ubusuku besikhala esibhedlele, kulandelwa unyango olubanzi lokuvuselela. Kwiiveki ezimbalwa zokuqala, i-elbow ingaba yinto engagqibekanga, igcina i-elbow esekelwe kwaye ifakwe endaweni. I-graft entsha ibuhlungu kakhulu kwiiveki zokuqala emva kokuhlinzwa, ngoko kubalulekile ukulandela imiyalelo yesigqirha yokukhusela indawo yokuhlinzwa.
Unokunikezelwa ngamachiza enzantlungu ngexesha lokuqala lokuphucula, emva koko ukushisa kunye neqhwa kusetyenziselwa ukunciphisa intlungu. Xa i-immobilizer ingasadingeki, unyango lomzimba luqala ukufumana amandla kunye nobuninzi bezityalo. Kweminye, uluhlu lwempembelelo lubuyela kwiiveki ezingama-6 ukuya kwe-8, nangona kunjalo, kumdlali okhuphisanayo, ukulungiswa okubanzi kunokudlulela ngaphezu konyaka ukubuyela emsebenzini opheleleyo.
Uninzi lwabadlali abanonophelo lokuzonwabisa bavakalelwa kukuba banamandla kunokuba babekho ngaphambi kokuhlinzwa, njengoko "babethwa" ingalo ekuphenduleni intlungu. Uninzi lwabantu luyifumana ngokupheleleyo kwaye luyakwazi ukubuyela kwimisebenzi yabo eqhelekileyo.
Imithombo
Ulnar Collateral Ligament Ukwakhiwa kabusha. UKs Bush Joseph, MD. Kufumaneka ngo-Ephreli, 2012. http://www.rushortho.com/forms/Ulnar_Collateral_Ligament_Reconstruction_Protocol.pdf