Ka tuyige buli kimu ekikwata ku kulongoosa amagumba (Osteotomy) mu ngeri ennyangu!

Oluusi weebuuza oba obulumi bw’owulira mu bitundu by’omubiri gwo ebimu naddala amaviivi, ebisambi oba omugongo, buva ku magumba amatono obutakwatagana oba okumenya? Omusawo wo ayinza okuba nga yakubuulira ku kulongoosa okuyitibwa osteotomy. Kiyinza okukutiisa katono okuwulira ku nsonga eno. Naye bw’omanya ebikwata ku nsonga eyo, okutya okwo kukendeera nnyo. Kale, leero, tunaayogera ku kulongoosa kuno mu ngeri ennyangu?

Mu ngeri ennyangu, kino (Osteotomy) kye ki?

Okay, mu ngeri ennyangu, okusala amagumba nkola ya kulongoosa. Kizingiramu okusala eggumba, oluusi n’ogattako eggumba eppya, n’oluvannyuma n’oddamu okubumba eggumba oba okulizza mu kifo kyalyo ekituufu. Kilowoozeeko ng’omubazzi bw’asala akati, n’akaddamu okubumba, n’afuna ekifaananyi ekipya, naye kino kikolebwa ku magumba agali mu mubiri gwaffe.

Omusawo akulongoosa asobola okusala amagumba gonna mu mubiri gwo. Ng’ekyokulabirako, mu bbwa, enkokola, omugongo, ekibegabega, ekisambi, okugulu, ekigere, ekigere oba ekigere. Kitera okukozesebwa okujjanjaba ebizibu mu binywa byo – amagumba abiri we gasisinkanira. Waliwo ebika bingi eby’enjawulo eby’okusala amagumba n’obukodyo. Zitera okutuumibwa amannya g’omusawo alongoosa eyayiiya enkola eno oba engeri eggumba gye lisalibwamu ne liddamu okubumba.

Lwaki okulongoosa kuno (Osteotomy) kukolebwa?

Kati oyinza okuba nga weebuuza, ‘Lwaki olina okusala amagumba bw’otyo?’ Waliwo ensonga eziwerako.

• Tereeza enkoona, okufukamira oba okuzimbulukuka kw’amagumba: Oluusi amagumba gayinza okuba nga gavudde mu kifo katono. Okulongoosa kuno kuyamba okutereeza ekyo. Lowooza ku kino, amagulu g’abantu abamu gayinza okuba nga gafaanana ng’ennukuta O (bowlegs) oba ng’ennukuta X (knock-knees). Kino kikozesebwa okutereeza ebintu ng’ebyo.
• Tereeza ekiwanga ekifuuse ekifu oba ekitali kituufu: Ennyondo ezimu ziyinza okuzaalibwa nga zirina obulemu obutonotono, oba ziyinza okulema olw’ekizibu ekimu ng’omuntu akula.
• Funza oba gawanvuya amagumba: Tekyewuunyisa? Yee, mu mbeera ezimu enkola eno era ekozesebwa okukyusa obuwanvu bw’amagumba.
• Ddabiriza ekiyungo ekyonoonese: Singa ekiyungo kiba kyonoonese olw’akabenje oba ensonga endala.
• Kyusa ekitundu ky’ekiwanga ekizitowa: Teebereza ng’amagumba agali ku ludda olumu olw’okugulu kwo kaakaddiwa. Wano w’owulira obulumi. Okulongoosa kuno kuyinza okukyusa engeri obuzito gye butambuzibwamu ne budda ku ludda nga bulina eggumba obulamu. Ekyo kijja kukendeeza ku bulumi.
• Okukendeeza ku bulumi obuva ku bulwadde bw’amagumba: Kino kirungi okukendeeza ku bulumi obuva ku bulwadde buno obw’ennyondo obuvunda naddala mu maviivi n’ebisambi.
• Okwongezaayo okulongoosa ekiwanga eri abavubuka, abakola ennyo: Ku bavubuka abamu, okusala amagumba kibasobozesa okukozesa ekiwanga kyabwe okumala ebbanga eddene okusinga okukyusa ekiwanga amangu ago ng’ekiwanga kikaddiye.
• Tereeza ebizibu ebirala ebitongole eby’amagumba.

Nkole ki nga sinnalongoosebwa?

Nga tonnaba kulongoosa magumba, omusawo akulongoosa ajja kulagira okukeberebwa okuwerako okukebera obulamu bwo okutwalira awamu. Mu bino ebiseera ebisinga mulimu:

• Okukebera omusaayi: Bino bikebera emiwendo gy’ebitundu eby’enjawulo mu musaayi gwo n’engeri ebitundu byo eby’omunda gye bikolamu.
• Okukebera omusulo: Bino bisobola okuyamba okuzuula obulamu bwo okutwalira awamu n’okuzuula embeera yonna eyinza okuba ng’etaataaganya okuwona kw’amagumba, gamba ng’okukwatibwa yinfekisoni oba ssukaali.
• Okukebera ECG (Electrocardiogram): Kukebera amasannyalaze g’omutima gwo.
• X-ray y’ekifuba: Okukakasa nti amawuggwe go gakola bulungi nga tonnalongoosebwa.
• X-rays oba CT scans: Zino zikozesebwa okuteekateeka okulongoosa nga otunuulira bulungi amagumba go/ennyondo zo. Omusawo alongoosa alina okumanya obulungi obunene, obuwanvu, obugazi, n’enkoona y’eggumba erigenda okuggyibwamu. Oluusi ekifaananyi kya 3D kikolebwa nga bakozesa kompyuta okuteekateeka okulongoosa.

Kiki ekitera okubaawo nga balongoosebwa Osteotomy?

Okusooka, ojja kuweebwa eddagala eribudamya. Kino kiyinza okukolebwa mu ngeri ez’enjawulo:

• Regional anesthesia kwe kuzimba ekitundu kyokka awagenda okulongoosebwa.
• Okubudamya omugongo.
• Okukuteeka ddala mu tulo (general anesthesia).
• Obulwadde bw’okubudamya mu kitundu bukozesebwa okuzirika ekitundu kyokka we banaalongoosebwa.

Omusawo ajja kulonda enkola esinga okukusaanira.

Ekiddako, ttiimu y’abalongoosa eyoza ekitundu ekyetoolodde okulongoosebwa n’eddagala eritta obuwuka. Oluvannyuma, ekitundu ekyo kibikkibwako olugoye olulongoosa.

Omusawo akulongoosa akusalako mu lususu. Bakozesa waya ezikulembera okulaga ekitundu ky’eggumba erigenda okuggyibwamu (ebiseera ebisinga mu ngeri y’ekiwujjo, naye kino kyawukana okusinziira ku kulongoosebwa). Ekyuma eky’enjawulo eky’okulongoosa kikozesebwa okuggyawo ekitundu kino eky’amagumba ekiriko akabonero.

Oluvannyuma lw’okuggyawo eggumba erirwadde oba eryonoonese, ekituli kiggalwa nga bagatta ebitundu by’eggumba ebisigadde ku njuyi zombi. Okusinziira ku kika ky’amagumba g’olina, oyinza okuteekebwamu eggumba mu kifo eggumba we lyaggyibwamu. Oluvannyuma, bakozesa ppini, sikulaapu, sitayiro, obubaawo oba emiggo okukwata eggumba mu kifo kyalyo okutuusa lwe liwona. Ebimu ku bitundu by’ebyuma bino bya kaseera buseera, ate ebirala bya lubeerera.

Bika ki ebikulu eby’okulongoosa amagumba?

Okulongoosa amagumba kuyinza okujjanjaba ebizibu by’amagumba n’ennyondo eby’enjawulo. Ka tulabe ebimu ku bika ebikulu.

Okusala amagumba mu bbwa

Kino kizingiramu okukwataganya amagumba g’akawanga ko aka wansi (manible) oba akawanga aka waggulu (maxilla) n’omutwe gwo gwonna ne/oba amannyo go. Kino kiyinza okutereeza ebizibu ng’okuluma okuggule, okukaluubirirwa okukamula oba okumira, okwambala ennyo amannyo, ekirevu ekidda emabega, okuluma ekisusse oba okuluma wansi. Oyinza n’okwetaaga okusiba amannyo nga tonnalongoosebwa oba ng’omaze okulongoosebwa okusobola okukwataganya amannyo go n’akawanga.

• Okulongoosa okukolebwa ku bbwa erya wansi kuyitibwa mandibular osteotomy .
• Okulongoosa okukolebwa ku bbwa erya waggulu era kuyitibwa maxillary osteotomy .
• Waliwo enkola ezimu ezenjawulo, okugeza, okusala amagumba mu LeFort kwe kulongoosa okuddaabiriza okumenya wakati mu ffeesi ng’akawanga aka waggulu kasisinkanye n’eggumba ly’akawanga. Sagittal split osteotomy kika kya kulongoosa bbwa okutambuza akawanga aka wansi okusobola okukwatagana obulungi n’amannyo.

Okusala amagumba mu kalevu

Okulongoosa kuno kukolebwa okukyusa enkula y’akalevu. Kitera okukolebwa okuwanvuya ekirevu singa kiba wansi nnyo, oba okufuula ekirevu ekifunda ekimpi. Kino kiyinza okutambuza ekirevu mu maaso oba mu kkubo ery’enjawulo. Oluusi kino kiba kirungi okusinga okuteekebwamu ekirevu. Mu kulongoosa kuno, eggumba lyo ery’akawanga lisalibwa ne litambuzibwa. Omusawo alongoosa asala munda mu kamwa. Oyinza okubulwa okuwulira mu mimwa gyo okumala emyezi mitono.

Okusala amagumba g’enkokola

Singa obuzibu ku kinywa ky’enkokola buba buleeta obuzibu mu kifo omukono gwo ogwa wansi we gubeera, gamba ng’omukono bwe guwanirira nnyo okumpi n’omubiri (cubitus varus) oba wala nnyo n’omubiri (cubitus valgus), okulongoosa kuno kukolebwa okutereeza ebizibu ng’ebyo. Waliwo ebika by’okusala amagumba eby’enjawulo okusinziira ku buzibu.

Okusala amagumba mu mugongo

Okulongoosa kuno kukolebwa okutereeza enkokola z’omugongo. Enkokola ez’obutonde ez’omugongo gwaffe ziyamba okukuuma ekifo ky’omubiri ekiyitibwa center of gravity waggulu w’ekisambi. Singa okukoona mu kitundu kimu oba ebisingawo ku mugongo kweyongera oba okukendeera, omugongo tegugolokofu. Kino kiyinza okuleeta obulumi, obukoowu, n’okunyigirizibwa ku bitundu by’omubiri eby’omunda. Ekigendererwa ky’okulongoosa kuno kwe kuzzaawo bbalansi mu mugongo, okukendeeza ku bulumi, n’okutangira obuzibu buno okuddamu oba okweyongera.

• Okugeza, mu mbeera nga Ankylosing Spondylitis , omugongo guyinza okufukamira enkalakkalira mu maaso era ekirevu ne kikwata ku kifuba. Okulongoosa kuno kuyinza okulowoozebwako okutereeza ebizibu ng’ebyo eby’enkoona.
• Waliwo ebika ebikulu ebiwerako:
• Posterior column osteotomy: Kino kireeta lordosis mu mugongo ogwa wansi ate kyphosis mu mugongo ogwa waggulu. Ponte osteotomy nkola ya njawulo ekozesebwa okutereeza kyphosis.
• (Smith-Petersen okusala amagumba):Eno nkola ya njawulo ekozesebwa okutereeza obulwadde bwa lordosis. Ekitundu ky’eggumba kiggyibwa emabega w’omugongo okusobola okulengejja omugongo emabega.
• Pedicle subtraction osteotomy: Kino kireeta okukoona okw’amaanyi okw’omunda (lordosis) mu mugongo ogwa wansi.
• (Bone-disk-bone osteotomy): Kino kizingiramu okukola eggumba waggulu ne wansi wa disiki wakati w’omugongo. Mu kiseera ky’okulongoosebwa, disiki n’enkomerero zaayo eziriraanye ziggyibwamu.
• (Vertebral column resection): Mu kino, omugongo gumu oba okusingawo guggyibwawo ddala. Kino kiyinza okukola okutereeza okusinga obukulu. Olw’okuba amagumba mangi gaggyibwamu, omusawo alongoosa ekitundu kino ajjuzaamu amagumba agasimbiddwa oba ekiyumba eky’ekyuma.

Okusala amagumba mu kiwato

Kino kizingiramu okuddamu okubumba omutwe gwo ogwa acetabulum oba femur. Kino kye kiyungo ky’ekisambi ekiyitibwa ball-and-socket hip joint mu kiwato kyo. Omusawo alongoosa asala, abumba oba aggyamu ekitundu ku ggumba okusobola okuddamu okutereeza ebitundu by’ekiwanga ebizitowa.

• Ebika ebikulu:
• Periacetabular osteotomy: Kino kikolebwa okutereeza hip dysplasia, embeera nga hip socket tebikka ddala mupiira gwa ggumba ly’ekisambi. Mu kiseera ky’okulongoosebwa, ekitundu ky’eggumba ly’ekisambi kisalibwa, ne kiddamu okuteekebwa mu kifo, ne kinyweza ne sikulaapu.
• Femoral osteotomy: Kino kizingiramu okusala n’okuddamu okubumba eggumba ly’ekisambi erya waggulu (femur) okuyamba okuddamu okukola kw’ekisambi.

Okusala amagumba g’okugulu

Okusala amagumba kizingiramu okusala n’okuddamu okubumba emu ku magumba abiri agasangibwa wansi w’okugulu – oba ekisambi oba ekisambi. Kino kitera okukolebwa okuddaabiriza ebyonoonese olw’endwadde z’enkizi. Okulongoosa kuno kuddamu okutereeza ekinywa ky’okugulu, ne kikyusa obuzito ne puleesa okuva ku ludda lw’okugulu olwonooneddwa okudda ku ludda olulamu. Okusala amagumba mu kugulu kutera kukolebwa mu biseera ebisooka eby’obulwadde bw’amagumba, ng’okwonooneka kuli ku ludda lumu lwokka olw’okugulu.

• Ekifo we balongoosebwa amagumba kisinziira ku kifo awaali okwonooneka. Okugeza, mu high tibial osteotomy , singa obuwanga obwonooneddwa buba munda mu kugulu, ekitundu ky’eggumba eriringa ekiwujjo kiggyibwa ebweru w’okugulu, oba eggumba ne liggulwawo mu ngeri eringa ekiwujjo munda mu kugulu. Kino kigolola ekigere ne kiziyiza endwadde z’enkizi okweyongera.
• Ebika by’okugulu ebimu (Osteotomy):
• Tibial osteotomy: Kino kikola okukwatagana kw’amagulu g’ebbakuli nga kuteeka puleesa esukkiridde ku munda mu kugulu.
• High tibial osteotomy: Kino kikozesebwa okuddamu okutereeza ekinywa ky’okugulu mu bantu abalina obulwadde bw’enkizi. Okulongoosa kuno kuyinza okuziyiza oba okulwawo obwetaavu bw’okukyusa okugulu ekitundu oba kwonna.
• (Okulongoosa amagumba mu Fulkerson):Eno nkola ya njawulo. Ekitundu ky’ekitundu ekigere eky’omugongo (tibial tubercle) kiggyibwamu. Kino kikyusa ekifo omusuwa gw’okugulu we gukwata ku kisambi, ne kikendeeza ku puleesa ku kifuba n’okuziyiza okusengulwa.

Okusala amagumba g’engalo ennene n’ebigere

Hallux osteotomy nkola erimu okuggya eggumba ku kigere ekinene n’okuligolola. Okusala amagumba g’omugongo (calcaneus osteotomy) nkola eddaamu okubumba ekigere okutereeza ebigere ebipapajjo oba ebigere ebirina ekisenge ekiwanvu okusinga ekya bulijjo.

• Enkola eziwerako ezenjawulo (Osteotomy) ez’okujjanjaba ebizibu by’ebigere:
• Chevron ne Akin osteotomies: Okulongoosa kuno kulongoosa obulema obutono oba obw’ekigero obw’ekigere ekinene obuva ku bunions (hallux valgus).
• (Dwyer osteotomy): Kino kiddamu okubumba ekigere okukendeeza ku kigere ekiwanvu mu ngeri etaali ya bulijjo.
• (Weil osteotomy): Kino kitereeza engalo z’engalo n’obulumi wansi w’omupiira gw’ekigere kyo.
• (Cotton osteotomy): Kino kiyamba okukola ekisenge ekiwanvu mu kigere.

Obulabe ki obuli mu kulongoosebwa kuno?

Okufaananako n’okulongoosa kwonna, okusala amagumba kuyinza okuleeta akabi akamu. Naye teweeraliikiriranga, abasawo bakola kyonna ekisoboka okukendeeza ku bulabe buno. Obulabe obukulu bwe buno:

• Ebizibu by’okubudamya.
• Ekirwadde.
• Okuzimba omusaayi.
• Obuvune mu busimu oba emisuwa.
• Si kibi amagumba obutatereera bulungi oba obutawona bulungi nga gawonye.
• Okuzimba kw’ennyondo n’okukaluba.
• Obulumi obw’ekiseera ekiwanvu.
• Okutondebwa kw’ebitundu by’enkovu.

Kikulu nnyo okwogera n’omusawo wo ku bulabe buno n’okubuuza ebibuuzo byonna by’olina.

Kinatwala bbanga ki okuwona? Nkole ntya?

Ebiseera by’okuwona bisobola okwawukana okusinziira ku muntu. Kisinziira ku bintu bingi, omuli ekika ky’amagumba kye wakola, enkola y’okulongoosa, obunene n’obuzibu bw’okwonooneka kw’amagumba go, amaanyi go, n’okwagala kwo okuwona.

Kitwala ekiseera eggumba okuwona. Wajja kubaawo obulumi mu kifo we balongoosezza, era wajja kubaawo okulumwa okutuusa ng’ekiwundu kiwonye.

• Oyinza okwetaaga okwambala ekyuma ekikuba engoye, eky’okusiba oba emiggo. Bino bijja kuyamba okukendeeza ku ntambula y’amagumba n’ennyondo, okukendeeza ku buzito ku ggumba erilongooseddwa, n’okusobozesa amagumba okuwona obulungi. Bino bitera okumala okuva ku wiiki ntono okutuuka ku myezi nga ebiri.
• Ne bw’oba ​​oli mu cast oba splint, ojja kwetaaga obujjanjabi obw’omubiri mu nnaku ntono ng’omaze okulongoosebwa.Obujjanjabi bw’omubiri byongera amaanyi n’okutambula kw’ennyondo zo.
• Bw’oba ​​walongoosebwa okugulu oba ekisambi, kiyinza okwetaagisa okukozesa emiggo okumala emyezi mitono. Ojja kwetaaga okugenda mu maaso n’okujjanjaba omubiri okusobola okuddamu okufuna amaanyi n’okutebenkera.
• Bw’oba ​​olongooseddwa akawanga (jaw osteotomy), akawanga ko kajja kuba ka waya nga kaggaddwa era ojja kuba ku mmere ey’amazzi okumala wiiki nga mukaaga. Bw’oba ​​olongooseddwa ekigere ekinene, tojja kusobola kwambala ngatto wadde okuvuga okumala wiiki nga bbiri oba mukaaga.

Oyinza otya okuyamba enkola y’okuwona?

Naawe osobola okuyamba mu kiseera kino eky’okuwona.

• Tonywa ssigala: Nicotine akendeeza ku kuwona era asobola n’okutaataaganya amagumba okuwona obulungi. N’olwekyo, weewale ddala okunywa sigala .
• Lya emmere ennungi: Lya emmere ennungi, gamba ng’emmere ey’omu Mediterranean, ng’olina enva endiirwa n’ebibala bingi.
• Goberera ddala ebiragiro by’omusawo wo.
• Kuuma omugejjo omulungi.

Biki ebiyinza okusuubirwa okuvaamu?

Ebinaavaamu bijja kusinziira ku bintu gamba ng’obulamu bwo okutwalira awamu, obuzibu bw’amagumba go, obuzibu obw’enjawulo bwe walongoosebwa, n’obukugu bw’omusawo akulongoosa. Omusawo ajja kwogera naawe ku kulongoosebwa kw’ogenda okulongoosebwa n’ebyo by’osuubira ng’omaze okulongoosebwa. Tolonzalonza kubuuza musawo bibuuzo oba okugabana ebikweraliikiriza oba okutya kwonna kw’olina.

Waliwo ebika bingi eby’enjawulo eby’okusala amagumba n’okulongoosa ebirala okuddamu okutereeza n’okuddamu okubumba amagumba n’ennyondo. Omusawo ajja kwogera naawe ku kizibu kyo ekigere eky’amagumba oba ekinywa n’engeri gy’oyinza okulondamu. Okusinziira ku ngeri y’ekizibu ky’amagumba go, oyinza okusooka okujjanjabibwa n’obujjanjabi obutali bwa kulongoosa (obujjanjabi obukuuma). Mu bino biyinza okuli okuwummula, ice, eddagala eriweweeza ku kuzimba n’obulumi, n’empiso z’ekirungo kya corticosteroid. Bw’oba ​​obujjanjabi buno tebufuga buzibu bwa binywa byo, oba bw’oba ​​olina embeera etasobola kujjanjabibwa, jjukira nti omusawo w’amagumba aliwo okukuyamba. Balina engeri y’okulongoosaamu okulongoosa entambula yo n’okukendeeza ku bulumi n’obutabeera bulungi.

Ebintu ebikulu bye tulina okujjukira mu kitundu kino

Kale, kya bulijjo okuwulira ng’otya katono ng’olowooza ku ky’okusala amagumba. Wabula eno nkola ya bujjanjabi nkulu esobola okutumbula omutindo gw’obulamu bwo, okukendeeza ku bulumi, n’okuwa amagumba go n’ennyondo obulamu obupya.

• Beera mumanyi bulungi: Yogerako n’omusawo wo ku mbeera yo, okulongoosebwa kw’ogenda okulongoosebwa, ebirungi n’ebibi by’olina, n’obudde bw’okuwona.
• Goberera ebiragiro by’omusawo: Kikulu nnyo omuntu okuwona amangu okugoberera obulungi ebiragiro by’omusawo, nga tonnalongoosebwa n’oluvannyuma lw’okulongoosebwa.
• Mugumiikiriza: Kitwala ekiseera amagumba okuwona. Mu kiseera ekyo, kola bulungi ebintu ng’okujjanjaba omubiri era sigala ng’oli mugumu.
• Weewale okunywa sigala: Kino mazima ddala kintu ky’osaanidde okukola.

Bw’oba ​​olina ekibuuzo ekirala kyonna ku nsonga eno, totya kubuuza musawo wo. Baliwo okukuyamba.

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