E pāorooro tonu ana tō pakihiwi? Me ako tātou mō tēnei Lesion Bankart!

Kua hē te pokohiwi i a koe? Kua hinga rānei koe i a koe e takaro ana i ngā hākinakina, ā, kua pāngia koe e te mamae nui i roto i tō pokohiwi, ā, kāore e taea te neke i tō ringa? Tērā pea kei te hiahia koe ki te mōhio mō tētahi āhuatanga e kiia nei ko te Lesion Bankart. Me kōrero tātou mō tēnei mea me te ngāwari, me te ngākau māhaki hoki.

He aha tēnei Lesion Bankart?

He whakarāpopototanga noa iho, ko te haehae o Bankart he whara ki te kiko honohono e āwhina ana ki te pupuri i tō pakihiwi kia mau tonu, arā, te pūnga, i te hononga o tō pakihiwi. Ka puta tēnei ina panaia tō pakihiwi ki mua, ki tahaki hoki i waho o tōna pūnga, ka pakaru taua kiko.

Me titiro tātou ki te āhua o te pakihiwi?

He hononga tō pakihiwi i hangaia e te wāhanga porowhita o runga o te wheua nui i tō ringa o runga (te humerus) e uru ana ki roto i te kōhao i roto i tō pakihiwi (te scapula). Kei roto i tēnei kōhao he mowhiti kiriuhi. Koinei te mea e tautoko pai ana, e pumau ana hoki te hononga pakihiwi.

Ko tēnei mowhiti kiriuhi te mea e kiia nei e tātou ko te 'Glenoid Labrum' . Whakaarohia, he aha te mea ka tupu mēnā ka puta tō wheua pakihiwi i taua pūnga ka pā ki tēnei glenoid labrum? Kātahi ka pakaru pea tēnei labrum, ka marere atu rānei i te wheua. Koinei te mea e kiia nei e tātou ko te Bankart Lesion.

Ka taea e te tākuta te whakahoki i tō pakihiwi kua motumotu ki tōna tūranga. Heoi, e kore tēnei e whakaora i te whara o Bankart. He whara roa tēnei e kore ai e pumau te hononga o tō pakihiwi, ko te tikanga he nui ake te tūponotanga ka motumotu anō tō pakihiwi.

He pēhea te auau o tēnei whara?

He whara pakihiwi tino noa te piko o te pokohiwi. E pāngia ana e te tata ki te 1% o te taupori. Tata ki te 90% o ngā piko o te pakihiwi he piko o mua, arā, ka panaia te wheua ki mua mā roto i te pūwero.

Koinei te wāhi e tino tūpono ai te pakaru o te glenoid labrum ina whiua whakamua te pakihiwi. Inaa, i waenga i te 87% me te 100% o aua whiunga ka hua ake he pakaru ki tēnei labrum. Nō reira, ki te mea kua he tō pakihiwi, he tino tūponotanga ka pakaru koe i te Bankart.

He aha te whara Bony Bankart?

Tērā pea ka kī mai tō tākuta he 'raruraru wheua Bankart' tōu. Ko te tikanga o tēnei kua pakaru tō glenoid labrum me te wheua i te poka pakihiwi (te glenoid). Ko te tikanga o tēnei kua haehae te kiko, kua whati te wheua, kua tangohia rānei tētahi wahi iti.

He iti ake te kitea o ēnei whara Bankart he wheua i ngā whara Bankart muka, e kino ana ki te labrum anake. Heoi, e kitea ana i roto i te 73% o ngā take o te nekehanga o te pakihiwi o mua.

He aha te take o tēnei?

Ko te pakaru o te pakihiwi, arā, ko te pakaru o te Bankart, ko te pakaru rānei o te glenoid labrum, ko te pakaru o te wheua i roto i tō pakihiwi, ā, ko te pakaru hoki o te kiko tautoko e karapoti ana. Ko te pakaru o te pakihiwi he whara whara i puta mai i te kaha nui.

He maha ngā take matua mō tēnei:

• Ngā aituā motuka: Pērā i te wā ka pāngia koe e te motuka.
• Ngā aituā hākinakina: Ka pā pea ki te pakihiwi ina ruku koe, ka hinga i a koe e tākaro kirikiti ana, ina tākaro whutupōro, poipapa rānei koe.
• Te hinganga: Ki te hinga koe i te teitei, ki te paheke rānei, ka whara pea tō pakihiwi.

Whakaarohia, i a koe e eke pahikara ana, ka pēhi ohorere koe, ka hinga, ka pā ki tō pakihiwi, ā, ka taea e koe te hinga. Mēnā rānei ka paheke koe i te tūru i a koe e mahi ana i ngā mahi o te whare, ka pā ki tō pakihiwi? Ka taea e ngā mea pēnei te whara.

He aha ngā tohu?

Tērā pea ka pāngia koe e ēnei tohu me te whara o Bankart:

• Mamae pakihiwi: Tērā pea ka mamae tō pakihiwi katoa, ka mamae rānei te mua me te raro o te pona o tō pakihiwi. Tirohia mēnā ka mau tonu tēnei mamae, ā, kāore e memeha ina okioki.
• Te whānuitanga o te nekehanga iti: Ko ētahi nekehanga pakihiwi, pērā i te hiki i tō ringa, te whiu i tētahi mea, te toro atu rānei ki tētahi mea i runga ake i a ia, he uaua pea. Tērā pea ka uaua ki ētahi tāngata te mau kākahu, te here rānei i ō rātou whitiki nohoanga waka.
• Ngā tohu ā-ringa: Ina nekehia te hononga pakihiwi i tētahi ara, ka puta pea he tangi "pakaru" he tangi huri rānei . I ētahi wā, ka rite te wheua ki te mea kua mau, kātahi ka mamae.
• Te kore pumau o te pakihiwi: Tērā pea ka rongo koe he ngoikore te hononga o tō pakihiwi, he nui rawa rānei te nekeneke o te wheua ina hurihia tō pakihiwi. Tērā pea ka motumotu tō pakihiwi.

"I haere tētahi o ōku hoa ki te tākaro kirikiti, ā, i taraiwa ia, ā, i whati tōna pakihiwi. I whakahokia te pakihiwi e te tākuta, engari mō tētahi wā i muri mai kāore i taea e ia te pōro, te hapai rānei i tetahi mea. I kīia he pakihiwi ngoikore noa iho. Nō muri mai ka mōhio ahau he whara nā Bankart."

Me pēhea koe e tino mōhio ai ki tēnei?

Ka pātai tuatahi te tākuta ki a koe mō te whara o te pakihiwi – nōnahea i puta ai, me pēhea i puta ai, mēnā kua puta kē i mua, me ētahi atu. Kātahi ka tirotirohia te hononga pakihiwi kia kite mēnā he āhua kore pumau.

Kātahi ka mahia ngā whakamātautau whakaahua hei tirotiro i te whara. Ko te tikanga, ka uru atu ki tēnei he matawai X-ray me te MRI (Magnetic Resonance Imaging). E hiahia ana te tākuta ki te kite i te nui o te kino kua pā ki te glenoid labrum, me te kite mēnā he whara kē atu. Ka taea e te matawai MRI te kite mārama i tēnei momo kino o ngā kiko ngohengohe.

Me mahi pokanga tonu ngā whara o Bankart?

Ehara i te mea me pokanga ngā roimata katoa o te glenoid labrum. Engari ko ētahi e hiahia ana. Ka taea e ngā roimata Bankart te whakaora i a rātou anō i ētahi wā, engari kāore pea e ora pērā i te pokanga. Ka tūtohu pea tō tākuta i te pokanga mēnā:

• Mena kua motu katoa tō glenoid labrum i te wheua, me pokanga hei hono anō ki te wheua.
• Mena he whara wheua tōu i te taha o Bankart, ā, kua tangohia tetahi wāhanga o te wheua.
• Mena kei te koretake tonu tō pakihiwi nā te whara o mua, ā, he maha tonu ō pekepeke.
• Mena he mea tino nui te hononga pakihiwi ki ō mahi o ia rā, ki te mahi rānei e mahia ana e koe (hei tauira, hei kaitākaro, hei kāmura rānei).

Ka aha mēnā ka kore e rongoatia?

Ka taea e ngā whara o te pēkana te ora me te kore rongoā, engari kāore e ora tika i ngā wā katoa. I ētahi wā ka noho pūmau te hononga pakihiwi. Ka piki ake te tūponotanga o te heke anō me te pakaru anō o te uaua o te ringa.

Mā tō tākuta koe e mōhio ai mēnā ka ora pai tō whara. Ahakoa kāore koe e pokangahia, me tiaki pai tō hononga pakihiwi kia ora pai ai.

Me pēhea te whakaora i tēnei patunga mā te pokanga?

I te wā o te pokanga whati Bankart, ka tangohia te kiko mate, pakaru rānei, ā, ka whakatikatikaina te haehae ki te kiko hauora. Mēnā e tika ana, ka tāpirihia anō e te taote pokanga tō glenoid labrum ki te wheua glenoid.

Hei mahi i tēnei, ka tāpirihia e ngā taote pokanga he punga iti ki te wheua i roto i te pūnga, ā, ka tuituia te kiko glenoid labrum ki ngā punga. Kātahi ka āta whakakīia ngā tuitui kia pumau ai te hononga. I ētahi wā ka kiia tēnei he Whakatikatika Bankart .

Tikanga tirotiro wheua

I te nuinga o te wā, ka taea e ngā taote pokanga te mahi i tēnei whakatikatika Bankart mā te whakamahi i te arthroscopy pakihiwi . Ko te tikanga o tēnei ko te tapahi i tētahi wahi iti, te whakauru i tētahi ngongo iti me tētahi kāmera (he 'arthroscope') mā roto, me te mahi i te pokanga mā roto i taua ngongo.

Mā ngā tikanga pokanga iti rawa te whakaekenga pēnei ka taea te whakapoto i te wā whakaora, ā, ka māmā ake te whakaora. Heoi, mō ētahi whara kino, me pokanga pea te pakihiwi tuwhera kia pai ai te ora.

He pēhea te tukanga whakaora?

Ahakoa he pokanga tōu, kāore rānei, me okioki, me whakaora anō hoki tō pakihiwi kia ora ai. Ko te tikanga me mau koe i tētahi whitiki hei ārai i tō pakihiwi mō ētahi wiki. Whai muri i tēnā, me whakaora tinana koe.

Ka hoatu e te kaiwhakaora tinana he raupapa o ngā mahi whakakori tinana ki a koe. Mā ēnei ka āwhina mārire koe ki te whakahoki mai i te kaha o te uaua me te whānuitanga o te nekehanga. Mā tēnei ka āwhina i te whakau i te hononga, ka whakaiti hoki i te tūponotanga o te whara anō.He mea tino nui kia mahia ēnei mahi whakapakari tinana kia rite ki ngā tohutohu.

He aha te tirohanga mō tēnei whara?

Tērā pea ka hiahiatia he pokanga mō te whara o Bankart. Heoi, he pai te āhua o te nuinga o te wā. Ka ora pai te nuinga o te tangata i te whara o Bankart. Heoi, ka roa pea te ono marama ka ora katoa.

Ko te mōrearea nui rawa atu i muri i te whakaoranga ko te haere tonu o te kore pumau o te pakihiwi, ka pakaru anō te pakihiwi, ka haehae hoki te labrum. Ka whakaitihia tēnei mōrearea mēnā ka pokangahia koe, ā, ka tika te mahi whakaora tinana.

He aha te rerekētanga i waenga i te whara Bankart me te whara Hill-Sachs?

Ka taea e te whara o Hill-Sachs me te whara o Bankart te puta mō te take kotahi, he maha ngā wā i te wā kotahi. Ina whati kaha te wheua o tō pakihiwi, ka pā ki te taha o te pona pakihiwi.

Ka taea e tēnei te haehae i te kiriuhi huri noa i te pūnga (tō glenoid labrum). Ka kiia tēnei he whara Bankart. Ka taea hoki e tēnei whara te kino i te wheua pakihiwi tonu, ka puta he koha ki roto. Ka kiia tēnei he koha Hill-Sachs, he whara rānei.

He aha te rerekētanga i waenga i te whara Bankart me te roimata SLAP?

Ko te haehae SLAP tētahi atu momo haehae i roto i te labrum glenoid. Ka puta tēnei i te wāhanga o runga o te labrum, mai i mua ki muri. Ko te kupu SLAP i ahu mai i te kupu whakarāpopototanga Superior Labrum Anterior to Posterior .

Kāore pea tēnei momo haehae e puta mai i te whara o te pakihiwi. Engari, ko te nuinga o te wā ka puta mai i te nekehanga kaha o te pakihiwi. Ka taea te puta ohorere, ka taea rānei te puta mārire i roto i te wā roa hei hua o te taumahatanga auau. Whakaarohia he rite ki te kaitākaro poipapa e pekepeke ana, e patu ana.

He tino ōrite ngā tohu me ngā raruraru pea o ngā whara Bankart me ngā roimata papaki. Ka taea e ēnei te whakararu i te hononga pakihiwi, ka mamae, ka nui ake te tūponotanga o te nekenekehanga o te hononga. Tērā pea me pokanga ēnei e rua.

Ki te kore koe e mahara i te he o tō pakihiwi, ā, ka mamae koe i runga ake i te pona o tō pakihiwi, he pakaru pea tōu. Ki te mea kei mua, kei raro hoki te mamae, he pakaru pea nō Bankart.

Hei whakamutunga, ngā mea hei maumahara

Ki te motu tō pakihiwi, tera pea kua motu anō hoki tō glenoid labrum. Ka pāngia pea koe e tēnei whara, ehara i te motu o te pakihiwi anake. I ētahi wā, me pokanga pea koe hei whakatika.

He nui te wā me te kaha e hiahiatia ana mō te whakaora i te whara o Bankart. Tērā pea ka roa te whakaora tinana mō ngā marama. Heoi, he tokomaha ngā tāngata, tae atu ki ngā kaitākaro, kua oti i a rātou tēnei kaupapa, ka hoki anō ki te mahi pai o ō rātou pakihiwi. Nō reira, kaua e mataku, engari me whai i ngā tohutohu a tō tākuta.Kia tere tō ora!

` Te hē o te pakihiwi, te whara o te Bankart, te labrum glenoid, te mamae o te pakihiwi, te pokanga pakihiwi, te whakaora tinana, ngā whara hākinakina