Nemisipha yento kwegxalaba: Iimpawu and Treatment

Ukuba asigungqi kwithiyori nibulalekayo yenziwa monkey umntu, inyathelo lokuqala le ndlela elide kwaye kunzima bobabo kwegxalaba. Yaba nesakhiwo yakhe ekhethekileyo kwenzeka yi inxalenye yenkqubo-nemilenze ukuze ufumane ezinye ezanyisayo ezingaqhelekanga iimpawu ezisebenzayo.

Kwelinye icala, ukwandisa kakhulu nemisebenzi yayo ukusuka inkxaso nje xa uhambisa, izandla zabantu ziye zaba enye kwezona ndawo ngokwasemphefumlweni omzimba. Kulo mba, yokwenzakala ye umbhinqo igxalaba, nto leyo edla ihamba kunye nemisipha yento kwegxalaba, ibekwe kummandla ingqalelo ekhethekileyo oonoklinikhi. Kwaye ingcambu unobangela wale - Ukungakwazi ukusebenza kunokwenzeka, yaye yintoni na mbi, umntu okhubazeke ngokufanelekileyo okanye hayi umonakalo ngexesha asinyangeki.

reference Brief yokwakheka

Ukohluka kwegxalaba ichazwa njenge umlinganiselo kwemiphezulu yayo articular lokwenyaniso. Ekubunjweni eziqalelo amathambo abanenxaxheba ngokuthe ngqo amathambo ezimbini: ikhaba kunye ihumerus. Le articular ebusweni ihumerus umelwe intloko ukulenza. Ngokubhekiselele kumphezulu phakathi kwe lweHo- indawo blade elimbhoxo glenoid ngayo malunga kane incinane nobakhe ibhola.

Ukulahleka evela blade zomfowunelwa lisisiqalo ring intlala - isakhiwo ashinyeneyo nokuqina, ekuthiwa lip articular. Yiyo le into ezinezikhondo, kunye philisi olungqonge edibeneyo, kwaye ivumela ukuba ngokwesahlulo echanekileyo yokwakheka kwaye ngaxeshanye ukwenza uluhlu engakholelekiyo sesindululo, apho kunokwenzeka kaloliwe ezinye lonke ilunga.

Nokubuyisa nemisipha edibeneyo kunye nezihlunu evumela intshukumo

Kuyanceda synovium obhityileyo capsule joint ukugcina isakhiwo yokwakheka enamandla rostral-humeral lungu layo. Kunye nayo ekwenzeni ngokwandisa nokugcina extra-articular philisi ezidala izo- imicu (izo-) kunye nezihlunu subscapularis. Aba bathathu ntambo nokuqina kwaye ubunzima xa kukho uqhekeko kwemisipha kwegxalaba.

Subscapularis, deltoid, zokumaketha kunye podkostnaya, ezinkulu nezincinci ngeenxa zonke, kwakunye pectoralis ezinkulu latissimus dorsi anike joint uluhlu olubanzi iintshukumo ngeenxa zonke zontathu nangeempahla ezibukhali zesinyithi. Zomfana kwi iintshukumo kwegxalaba ongathathi nxaxheba.

Nokwenzakala kwegxalaba noonobangela yokwenzakala

Phakathi ukulimala uqhelekileyo emagxeni ezidityanelweyo ukukhululwa ukugruzuka. Kunokwenzeka komsipha kunye uqhekeko buso okanye epheleleyo okanye ngaphandle kwayo. Dislocation joint, amaqhekeza avulsion ngokwaphulwa lwangaphakathi okanye extra-articular (kwi nemisipha isihlomelo) ziphakathi ukulimala ezinzulu.

Iimbangi ezingundoqo umonakalo kwegxalaba kuba nomphumela ngqo okanye ezingathanga ngqo kwi kwisakhiwo yayo mechanical. Oku kuba hit ngqo kunye esiwa phantsi ndinabile ingalo phambili. Elibukhali kakhulu ingxabano kwezihlunu, hambisa edibeneyo, okanye intshukumo ngesiquphe ininzi kakhulu kunokubangela njenge enyelisa okanye dislocation welungu. Ngokuqhelekileyo kunye nemisipha zabo kwegxalaba (umfanekiso eboniswe ngezantsi), oko kufuna kuphela aphathe iingozi ezininzi, kodwa ukubuyisela isidima izixhobo lungu.

Iimpawu ze lungu komsipha

Ukwenzakala kungenzeka xa kukho ziyakweyela esabiwe waphuma phambili okanye ngengalo ecaleni. Kwakhona lungu kunokwenzeka komsipha ngenxa intshukumo elibukhali kwi ubuninzi Ubungakanani obuvunyiweyo okanye ulenga okanye ngengalo, umzekelo xa lehla ukusuka ephakamileyo.

umonakalo ehamba kunye komsipha le philisi iimpawu zamagxa nemisipha ezingamadlelane luphawulwa iintlungu elibukhali ngexesha kukwenzakala, yaye zibaluleke ngokukhethekileyo ukuba discontinuity, kuba intshukumo abaphinda indlela yokwenzakala. Ngakumbi ekuphuhliseni nokudumba kwindawo umonakalo liyitshintshe uqwalaselo olungaphandle ehlangeneyo. Ukongezelela nokudumba, ukudumba ukwakheka bangathabatha inxaxheba kusukela imithambo yegazi eyonakeleyo kufutshane imisipha, izihlunu okanye igazi.

iindlela ezongezelelweyo ekuhloleni ubuzaza yokulimala

Phakathi yenze uphando lwezonyango, traumatologist ukuvumela ukufumanisa ukuba ingaba kukho komsipha kwenxenye nemisipha kwegxalaba okanye umonakalo iyonke, umi uxilongo cuke kunye nemagnethi ekuvakaleni kwelizwi umfanekiso. Zombini ezi ndlela musa ukungqinela umthwalo iphiramidi, kodwa ube elikhulu kakhulu isisombululo. Ngokukodwa, MRI ivumela ukuthembeka ubuninzi ukufumanisa isifo kwaye ukhetho konyango.

Ray okanye Itomography ayifum kwenziwa ukuze uphephe izibhaxu bone: Ukophuka (kuquka iivawutsha), dislocations, conjugated kunye ukwaphuka kunye dislocation kwegxalaba. Kudla wasebenzisa arthrocentesis. Arthroscopy lwenziwa ngo kuyakrokreleka utshintsho sisiba mandundu kwezakhiwo zeethishu nokuqina welungu okanye breakage le philisi. Kwezinye iimeko, wasebenzisa arthrography.

Ubungakanani sandla yokulimala

Ukwahlulwa classical ezilula, ngcathu kukwenzakala kakhulu, ndayinikela nxamnye nemisipha eqwengiweyo. Ngu njengokonzakala kancinane kwegxalaba, noko nemisipha, aquka ndisolulela nomonakalo nomntu kwemisipha imicu, lo gama kugcinwe ukuthembeka imithambo yegazi, imizwa kunye nezihlunu. Lubonakala ngokuba avareji iqondo kwenxenye ifayibha iinyembezi le imisipha, izihlunu ezingqonge isahlulo owenzakeleyo inxaxheba kule nkqubo, i-philisi edibeneyo nako nokuba yonakele. Eyokuqala iphathelene ukuya enyelisa idigri, yesibini - stretchability discontinuity buso.

umonakalo ezimandundu sikhatshwe epheleleyo ingqibelelo ukophulwa imicu ngesakhiwo (lungu) - discontinuity igxalaba nemisipha ngokudibeneyo umonakalo semithambo lwasekuhlaleni, nemithambo ukubandakanyeka ziintsilelo philisi ngokuhlangeneyo. Kule kangangoko kunokwenzeka kwaye avulsion intraarticular kwizaphuko, Ukopha ngokudibeneyo (hemarthrosis).

Inkqubo unyango

Kuxhomekeka kwinqanaba ubuzaza umonakalo egxalabeni ngokudibeneyo lungu izixhobo, ingasetyenziswa unyango angqingqwa okanye operative. Ukuba kukho komsipha kwenxenye nemisipha kwegxalaba, unyango silinganiselwe iindlela angqingqwa. analgesia Applied kunye immobilization (immobilization). Mhlawumbi tell bintovoy okanye udaka alahle, ngokuxhomekeke ebukhulwini, ubume ukonzakala kunye nomthamo izakhiwo abachaphazelekayo. Bintovuyu okanye ukutyabeka immobilisation orthesis buyisela (bands) of nomlenze ezidityanelweyo okanye ziqinile nitrogen esiphakathi.

A ikhefu epheleleyo, ingakumbi umonakalo imisipha njengezingxobo ezidibeneyo, wasebenzisa utyando. Ixhoba kufuneka iprofayili esibhedlele umothuko kunye kwimo ixesha elide emva kokuba bekhululwe esibhedlele.

guide alulame fault Operational

I msinyane umsantsa ulungiso umsebenzi igxalaba nemisipha ziza kusetyenziswa, ngcono amathuba sokubuyisela ngokupheleleyo umsebenzi ngokudibeneyo kwaye sehlise ipesenti kubunzima yokwenzakala. ukulungiswa zoqhaqho a lungu eyonakeleyo (imicu) izihlunu ezikufutshane, kunye nokupheliswa ezonakeleyo ezinemigca isiphako philisi kunciphisa ukuya crosslinking zabo.

Phantsi zomzimba jikelele (narcosis) ufikelelo ngqo senziwe phezu ezimashakeleyo asike kuwela layerwise kunye nokwahlukana kwithishyu. Iziphene kwafunyanwa sutured. Inxeba ivaliwe ngokwemaleko. Kweli xesha lokuqala postoperative usebenzisa udaka waphosa immobilization kunye window ukuba suture postoperative.

Imihla ukutyabeka immobilization kunye nonyango esibhedlele zigqitywa umthamo izakhiwo ezichaphazelekayo. Into ebalulekileyo ukuba inani ebhedini-ntsuku ubudala kwisigulana, uhlobo lomsebenzi wakhe, kunye nentsebenziswano morbidities.

Umonakalo kwemisipha engqinibeni

Inqabile kakhulu iimeko ekhaya, ukonzakala ekuso ngakumbi midlalo, xa usebenzisa isandla esebenzayo ezibukhali yomtshangatshangiso, igotywe engqinibeni. iqela Risk kuquka, kuqala kwiinto zonke, abadlali intenetya, Galufa, ibhola, kwibheyisbholi, kunye uMbala-manzi.

Amaninzi elimele lungu thunzi le radius, ulna akananto lungu, okanye ziqu. Kuyinto uphawu lomonakalo intlungu, ukwanda ngexesha intshukumo. Luphawulwa nokudumba, legazi kwi esikule ejikelezileyo. Amathuba hemarthrosis. Ukuba kukho komsipha epheleleyo nemisipha, ukuze neyalo kancinane amathambo ngesa- kwi entlanganweni.

Ray ivumela ukuba ezohlula ukwaphuka dislocation. MRI iza kubonisa apho localized komsipha kwemisipha ze engqinibeni. Unyango lwe komsipha kwenxalenye kwaye azigqibeleli i ngokonga. Sebenzisa immobilization kangangeeveki eziliqela. A ikhefu epheleleyo yenziwe nemisipha zeplastikhi ngotyando yonakele.

komzimba emfutshane welungu izihlahla

Complex kubume kuyilwa ngokudibeneyo articular intlala ubuso ipleyiti radiation kunye ulna yi zengalo kunye scaphoid, lunate kunye ibhrashi icala elingunxantathu. bone Pisiform ise embindini umsipha inxaxheba ngqo ekubunjweni welungu ababamkeli.

Ukomeleza nemisipha ezintlanu ezimanyeneyo. Entendeni le ngengqiniba kunye kwisihlahla lungu ukusuka kumphezulu umva - emva ligquba ibrashi. Emacaleni ke palmar osisi (ecaleni ubhontsi) kunye ulnar (kwicala encinane umnwe) nemisipha.

Umonakalo nemisipha izihlahla na anqabe kakhulu nemisipha yento kwegxalaba. Kodwa ngaphezu nemisipha ingqiniba.

Yaphula i nemisipha kwisihlahla

Indlela ingenzeka zokwenzakala ezinxulumene kukuhla phambili bako ingalo okanye ngesibetho brush bent okanye ayinakolulwa. Indawo esandleni ngexesha nenxeba efanelekileyo ngqo ukuba ngawaphi na lungu ukuze yonakele. Uninzi bonke abalimele malunga nokuqina kubume ngesondo brush.

iimpawu Top of umonakalo lungu: intlungu, nokudumba, umsebenzi kakuhle ngokudibeneyo soft ijwabu hematoma. Ukuba kukho intlungu kwi intshukumo kwi ngeminwe okanye ngesandla oko konyusa kakhulu kwi Ekuveleni kwi joint, mhlawumbi ingakrokreleka nemisipha yento entlanganweni esihlahleni. Mpawu zincediswe uphando lokufunyaniswa iintsimbi: X-ray - ngaphandle kwamathambo, ultrasound kunye / okanye MRI. Ukuba ziyimfuneko kucacisa uhlobo umonakalo nemisipha kunye nezinye kwizihlunu ezithambileyo ezingqonge entlanganweni.

Njengoko nayiphi na enye imeko, ukuba kukho nemisipha umsantsa welungu kunene, unyango iya kuxhomekeka ubungqongqo yokwenzakala. Xa aqine olulamileyo ngcathu kuyasebenza ngendeb phantsi enzima - qhinga zokusebenza.

Nokuba uhlobo umonakalo kwenzeka ntoni, yintoni na uhlobo phula ingqibelelo kwezakhiwo ngokudibeneyo, kukho edibeneyo lonzakele, iwotshi, engqinibeni, okanye kukho komsipha buso okanye epheleleyo nemisipha kwegxalaba, unyango kufuneka usoloko zilawulwa yincutshe. thethwano olugunyazisiweyo kwi profile gumbi (ikliniki ngokwaphulwa babe trauma kwi ekliniki okanye kwisebe ukwamkelwa kule traumatological esibhedlele). Oku kuyinyaniso ngokukodwa trauma ebuntwaneni, njengokuba izigulane abancinane, kukho inani lweempawu ezinxulumene-ubudala ukuba uzenze mntu wumbi ukulimala kakhulu. Zila ukufuna uncedo lonyango abanobuchule kunokubangela imiphumo ixesha elide negative.