Ese hari igihe wibaza niba ububabare wumva mu bice bimwe na bimwe by'umubiri wawe, cyane cyane mu mavi, mu kibuno, cyangwa mu mugongo, buterwa no kutagenda neza kw'igufwa cyangwa kuvunika? Muganga wawe ashobora kuba yarakubwiye iby'ibagwa ryitwa osteotomy. Bishobora gutera ubwoba kumva ibi. Ariko iyo uzi ibisobanuro birambuye, ubwo bwoba buragabanuka cyane. None se, uyu munsi, twavuga kuri ubu buvuzi mu buryo bworoshye?

Mu magambo make, iki ni iki (Osteotomy)?

Mu magambo make, gupima amenyo ni ukubaga. Bikubiyemo gukata igufwa, rimwe na rimwe kongeramo igufwa rishya, hanyuma ukarihindura cyangwa ukarisubiza mu mwanya waryo ukwiye. Tekereza nk'umubaji utema igice cy'igiti, akagihindura, akagiha ishusho nshya, ariko ibi bikorwa ku magufwa yo mu mubiri wacu.

Umuganga wawe ashobora gukora osteotomy ku igufwa iryo ari ryo ryose mu mubiri wawe. Urugero, mu rwasaya rwawe, mu nkokora, mu mugongo, mu rutugu, mu kibuno, mu ivi, ku kuguru, ku mano, cyangwa ku kirenge. Akenshi ikoreshwa mu kuvura ibibazo mu ngingo zawe - aho amagufwa abiri ahurira. Hariho ubwoko bwinshi butandukanye bwa osteotomy n'uburyo bwo kuyivura. Akenshi byitwa izina ry'umuganga wavumbuye ubu buryo cyangwa uburyo igufwa ricibwamo kandi rigahinduka.

Kuki ubu buryo bwo kubaga (Osteotomy) bukorwa?

Noneho ushobora kuba wibaza uti 'Kuki ugomba gukata amagufwa gutya?' Hari impamvu nyinshi.

• Kosora inguni, kunama, cyangwa kuzunguruka kw'amagufwa: Hari igihe amagufwa ashobora kuba atari ahantu heza. Uku kubagwa bifasha gukosora ibyo. Tekereza nawe, amaguru ya bamwe ashobora kuba ameze nk'inyuguti ya O (bowlegs) cyangwa nk'inyuguti ya X (knock-knees). Ibi bikoreshwa mu gukosora ibintu nk'ibyo.
• Kosora ingingo ifite ubumuga cyangwa idakora neza: Ingingo zimwe na zimwe zishobora kuvukana ubusembwa buto, cyangwa zishobora guhinduka ubumuga bitewe n'ikibazo runaka mu buzima.
• Kugabanya cyangwa kongera amagufwa: Ese ntabwo ari ibintu bitangaje? Yego, rimwe na rimwe ubu buryo bukoreshwa no guhindura uburebure bw'amagufwa.
• Sana ingingo yangiritse: Niba ingingo yangiritse bitewe n'impanuka cyangwa indi mpamvu.
• Hindura agace gafite uburemere bw'ingingo: Tekereza ko agatsi ko ku ruhande rumwe rw'ivi ryawe kamaze gusaza. Ni bwo wumva ububabare. Uku kubagwa gushobora guhindura uburyo uburemere butwarwa no koherezwa ku ruhande hamwe n'agatsiko gafite ubuzima bwiza. Ibyo bizagabanya ububabare.
• Kugabanya ububabare buterwa na osteoarthritis: Iki ni igisubizo cyiza cyo kugabanya ububabare buterwa n'iyi ndwara yo mu ngingo igenda irushaho kwangirika, cyane cyane mu mavi no mu kibuno.
• Gusubika kubagwa ingingo nshya ku bantu bakiri bato kandi bakora cyane: Kuri bamwe mu rubyiruko, kubagwa ingingo bituma bashobora gukoresha ingingo zabo igihe kirekire aho kuzisimbuza ako kanya iyo ingingo ishaje.
• Kosora ibindi bibazo byihariye by'amagufwa.

Ni iki ngomba gukora mbere yo kubagwa?

Mbere yo kubagwa osteotomy, umuganga wawe azagutegeka ibizamini byinshi kugira ngo arebe ubuzima bwawe muri rusange. Ibi bikunze kuba birimo:

• Ibipimo by'amaraso: Ibi bigenzura urwego rw'ibice bitandukanye mu maraso yawe n'uko ingingo zawe z'imbere zikora.
• Ibipimo by'inkari: Ibi bishobora gufasha kumenya ubuzima bwawe muri rusange no kumenya indwara zishobora kuba zibangamira gukira kw'amagufwa, nk'ubwandu cyangwa diyabete.
• Ikizamini cya ECG (Electrocardiogram): Kigenzura imikorere y'amashanyarazi y'umutima wawe.
• X-ray yo mu gituza: Kugira ngo umenye neza ko ibihaha byawe bikora neza mbere yo kubagwa.
• Gupima X-ray cyangwa CT scans: Ibi bikoreshwa mu gutegura kubagwa ureba neza amagufwa/ingingo zawe. Umuganga w’inzobere mu kubaga agomba kumenya neza ingano, uburebure, ubugari, n’inguni y’igufwa rigomba gukurwaho. Hari igihe hakorwa icyitegererezo cya 3D hakoreshejwe mudasobwa kugira ngo hategurwe kubagwa.

Ni iki gikunze kubaho mu gihe cyo kubaga Osteotomy?

Ubwa mbere, uzahabwa ikinya. Ibi bishobora gukorwa mu buryo butandukanye:

• Anesthesia yo mu gace ni ugutuma ahantu ho kubagwa hakorerwa gusa hadakora neza.
• Anesthesia yo mu mugongo.
• Kugusinzira burundu (anesthesia rusange).
• Anesthesia yo mu gace ikoreshwa mu gusiga ibisebe ahantu ho kubagwa gusa.

Muganga azahitamo uburyo bukubereye cyane.

Hanyuma, itsinda ry’ababaga rirasukura agace gakikije igikorwa cyo kubaga bakoresheje umuti urwanya udukoko. Hanyuma, agace gatwikirwa n’igitambaro cyo kubaga.

Umuganga ubaga agukata uruhu. Bakoresha insinga ziyobora kugira ngo bagaragaze agace k'igufwa rigomba gukurwaho (akenshi kaba gafite ishusho nk'iy'agace k'igufwa, ariko ibi biratandukanye bitewe n'uko wabaga). Udupira twihariye two kubaga dukoreshwa mu gukuraho aka gace k'igufwa karimo ikimenyetso.

Nyuma yo gukuraho igufwa ryarwaye cyangwa ryangiritse, icyuho gifungwa hifashishijwe ibice bisigaye by'igufwa ku mpande zombi. Bitewe n'ubwoko bwa osteotomy wakoze, igufwa rishobora gushyirwa aho igufwa ryakuwe. Hanyuma, udupira, imisumari, udukoresho two gupfuka, amasahani, cyangwa inkoni bikoreshwa kugira ngo igufwa rikomeze kuguma mu mwanya waryo kugeza rikize. Bimwe muri ibyo bice by'icyuma ni iby'igihe gito, mu gihe ibindi ari ibya burundu.

Ni ubuhe bwoko bw'ingenzi bw'ibagwa ry'amagufwa (osteotomy)?

Kubaga osteotomi bishobora kuvura ibibazo bitandukanye by'amagufwa n'ingingo. Reka turebe bimwe mu bwoko bw'ingenzi.

Osteotomy y'umunwa

Ibi bikubiyemo guhuza amagufwa y'umusaya wawe wo hasi (mu mandible) cyangwa mu maxilla n'igice cyose cy'umutwe wawe cyangwa amenyo yawe. Ibi bishobora gukosora ibibazo nko kuruma, kugorwa no guhekenya cyangwa kumira, kwangirika cyane kw'amenyo, kugabanuka k'akananwa, kuruma cyane, cyangwa kuruma munsi y'amenyo. Ushobora kandi gukenera ibyuma bifasha amenyo yawe guteranya amenyo n'umusaya wawe mbere cyangwa nyuma yo kubagwa.

• Kubagwa urwasaya rwo hasi byitwa osteotomy yo mu mandibular .
• Kubagwa ku ruhago rwo hejuru byitwa kandi osteotomy yo mu maxillary .
• Hari uburyo bwihariye bwo kubaga, urugero, LeFort osteotomy ni ukubaga kugira ngo hakorwe imvune iri hagati mu maso aho urwasaya rwo hejuru ruhurira n'igufwa ry'umusaya. Sagittal split osteotomy ni ubwoko bw'uburyo bwo kubaga urwasaya kugira ngo umusaya wo hasi uhuze neza n'amenyo.

Osteotomy y'amagufwa y'urushyi rw'umunwa

Ubu buryo bwo kubaga bukorwa kugira ngo hahindurwe imiterere y'akananwa. Ubusanzwe bikorwa kugira ngo uburebure bw'akananwa bube bugufi cyane, cyangwa kugira ngo agakananwa kagufi kabe kagufi. Ibi bishobora kwimura agakananwa imbere cyangwa mu cyerekezo gitandukanye. Hari igihe ubu buryo ari bwiza kuruta gushyiramo agakanwa. Muri ubu buryo bwo kubaga, igufwa ryawe riracibwa rigakurwamo. Umuganga ubaga atera icyuho mu kanwa. Ushobora gutakaza ibyiyumvo mu minwa yawe mu gihe cy'amezi make.

Kuvura indwara yo mu gituza

Niba ibibazo ku ngingo y'inkokora bitera ibibazo ku mwanya w'ukuboko kwawe ko hasi, urugero nko kuba ukuboko kumanika hafi cyane y'umubiri (cubitus varus) cyangwa kure cyane y'umubiri (cubitus valgus), ubu buryo bwo kubaga bukorwa kugira ngo hakosorwe ibyo bibazo. Hariho ubwoko butandukanye bwo kubaga osteotomy bitewe n'ikibazo.

Gupima uruti rw'umugongo

Ubu buryo bwo kubaga bukorwa kugira ngo hakosorwe imigongo y'umugongo. Imirongo karemano y'umugongo wacu ifasha mu kuguma hagati y'umubiri w'umuntu hejuru y'ikibuno. Iyo imirongo imwe cyangwa nyinshi z'umugongo ziyongera cyangwa zikagabanuka, umugongo ntuba ugororotse. Ibi bishobora gutera ububabare, umunaniro, n'umuvuduko ku ngingo z'imbere. Intego y'ubu buryo bwo kubaga ni ukugarura uburimbane mu mugongo, kugabanya ububabare, no gukumira ko indwara ikomeza kwiyongera cyangwa ikongera.

• Urugero, mu ndwara nka Ankylosing Spondylitis , umugongo ushobora kunama burundu imbere kandi akananwa gashobora gukora ku gituza. Ubu buryo bwo kubaga bushobora gufatwa nk'aho bukemura ibibazo nk'ibi by'inguni.
• Hari ubwoko bwinshi bw'ingenzi:
• Gupima amenyo y'inkingo y'inyuma: Ibi bitera indwara ya lordosis mu mugongo wo hasi n'indwara ya kyphosis mu mugongo wo hejuru. Ponte osteotomy ni uburyo bwihariye bukoreshwa mu gukosora kyphosis.
• (Gupima amagufwa ya Smith-Petersen):Ubu ni uburyo bwihariye bukoreshwa mu gukosora indwara ya lordosis. Igice cy'igufwa gikurwa inyuma y'umugongo hanyuma umugongo ugasubira inyuma.
• Osteotomy yo gukuramo ibice bya pedicle: Ibi bituma habaho umugongo ukomeye (lordosis) mu gice cyo hasi cy'umugongo.
• (Gupima igufwa mu magufwa: Ibi bikubiyemo gukora igufwa riri hejuru no munsi y’igufwa riri hagati y’amagufwa yo mu mugongo. Mu gihe cyo kubagwa, igufwa n’ibice byaryo biri hafi birakurwaho.
• (Gukuraho inkingi y'umugongo): Muri ibi, umugongo umwe cyangwa myinshi irakurwaho burundu. Ibi bishobora gukosora cyane. Kubera ko igufwa rinini rikurwaho, umuganga wuzuza aka gace akoresheje agace k'amagufwa cyangwa akazu k'icyuma.

Osteotomy yo mu kibuno

Ibi bikubiyemo kuvugurura umutwe wawe wa acetabulum cyangwa femur. Uyu ni umugozi w'ikibuno uri mu kibuno cyawe. Umuganga ubaga, agakata, cyangwa agakuraho igice cy'igufwa kugira ngo ahuze ubuso bw'ingingo buremereye.

• Ubwoko bw'ingenzi:
• Osteotomy ya Periacetabular: Ibi bikorwa kugira ngo hakosorwe dysplasia yo mu kibuno, ikibazo aho umuyoboro w'ikibuno udapfuka neza umupira w'igufwa ry'ikibero. Mu gihe cyo kubagwa, igice cy'igufwa ry'ikibuno kiracibwa, kigashyirwa mu mwanya wacyo, hanyuma kigafatwa n'udupira.
• Gupima amenyo y'abagore: Ibi bikubiyemo gukata no kuvugurura igufwa ryo hejuru ry'ikibero (femur) kugira ngo bifashe kugarura imikorere y'ikibuno.

Kubaga amagufwa mu ivi

Guca amagufwa y'amagufwa bikubiyemo gukata no kuvugurura igufwa rimwe mu magufwa abiri aboneka munsi y'ivi - yaba igituza cyangwa igituza cy'ivi. Ibi bikunze gukorwa kugira ngo hakorwe ibyangiritse biterwa na rubagimpande. Ubu buryo bwo kubaga buhindura ingingo y'ivi, bugahindura uburemere n'umuvuduko uva ku ruhande rwangiritse rw'ivi ukajya ku ruhande ruzima. Guca amagufwa y'ama ...

• Aho osteotomy iherereye biterwa n'aho yangiritse. Urugero, muri osteotomy yo mu gice cyo hejuru cy'ikirenge , iyo icyangiritse cy'igufwa kiri imbere mu ivi, igice cy'igufwa gikozwe nk'uruti gikurwa inyuma mu ivi, cyangwa igufwa rigafungurwa mu buryo bumeze nk'uruti imbere mu ivi. Ibi bigorora ukuguru kandi bikarinda indwara ya rubagimpande kwiyongera.
• Amoko amwe n'amwe y'ivi (Osteotomy):
• Gupima amaguru mu gice cy'amavi: Ibi bituma amaguru ahagarara neza bigashyira igitutu kinini imbere mu ivi.
• Guca amagufwa yo mu mavi mu buryo bwa "high tibial osteotomy": Ibi bikoreshwa mu guhuza ingingo y'ivi ku bantu bafite rubagimpande y'ivi. Uku kubagwa gushobora gukumira cyangwa gutinza gukenera gusimbuza igice cy'ivi cyangwa ryose.
• (Kuvura indwara ya Fulkerson osteotomy):Ubu ni uburyo bwihariye. Igice cy'agace runaka ka tibia (tibial tubercle) kirakurwaho. Ibi bihindura aho umutsi w'ivi ufata kuri tibia, bigabanya umuvuduko ku ivi kandi bikarinda kwimuka.

Amagufwa y'amagufwa y'ikirenge kinini n'amaboko manini

Uburyo bwo gukata ikirenge hakoreshejwe uburyo bwa hallux osteotomy bukubiyemo gukuramo igufwa ku mano manini no kurigorora. Uburyo bwo gukata ikirenge hakoreshejwe uburyo bwa calcaneus osteotomy buhindura imiterere y'ikirenge kugira ngo gikosore ibirenge birambuye cyangwa ibirenge bifite umugongo urenze usanzwe.

• Uburyo butandukanye bwihariye (Osteotomy) bwo kuvura ibibazo by'ibirenge:
• Ubu buvuzi bw'amagufwa bwa Chevron na Akin: Ubu buvuzi bukosora ubumuga bworoshye kugeza ku buringaniye bw'ikirenge kinini buterwa n'uburibwe bw'amenyo (hallux valgus).
• (Dwyer osteotomy): Ibi bihindura ishusho y'ikirenge kugira ngo bigabanye umugongo muremure udasanzwe.
• (Weil osteotomy): Ibi bikosora inzara n'ububabare munsi y'umupira w'ikirenge cyawe.
• (Cotton osteotomy): Ibi bifasha gukora umugongo mu kirenge.

Ni izihe ngaruka mbi zishobora guterwa n'ubu buvuzi?

Nk’uko bigenda mu kubaga kose, gukorerwa osteotomy bishobora kugira ingaruka zimwe na zimwe. Ariko ntugahangayike, abaganga bakora uko bashoboye kugira ngo bagabanye izo ngaruka. Ingaruka nyamukuru ni izi:

• Ibibazo bijyanye n'ikinya.
• Kwandura indwara.
• Amaraso apfutse.
• Gukomereka kw'imitsi cyangwa imitsi.
• Nta kibazo amagufwa adakomeza gukora neza cyangwa ngo akire neza iyo akize.
• Kubyimba no gukomera kw'ingingo.
• Ububabare bw'igihe kirekire.
• Imiterere y'inkovu.

Ni ingenzi cyane kuganira na muganga wawe kuri izi ngaruka no kubaza ibibazo byose ufite.

Bizatwara igihe kingana iki kugira ngo kire? Nkore iki?

Igihe cyo gukira gishobora gutandukana bitewe n'umuntu ku giti cye. Biterwa n'ibintu byinshi, harimo ubwoko bwa osteotomy wakorewe, uburyo bwo kubaga, ingano n'uburemere bw'ibyangiritse ku magufwa yawe, imbaraga zawe, ndetse n'ubushake bwawe bwo gukira.

Bifata igihe kugira ngo igufwa rire. Hazabaho ububabare aho bakorewe, kandi hazabaho ububabare kugeza igihe igikomere kizakira.

• Ushobora kuba ukeneye kwambara icyuma gikingira igituza, icyuma gikingira igituza, cyangwa imbago. Ibi bizafasha kugabanya urujya n'uruza rw'amagufwa n'ingingo, kugabanya ibiro by'igufwa ryakoreweho, no gutuma amagufwa akira neza. Ibi akenshi bimara ibyumweru bike kugeza ku mezi abiri.
• Nubwo waba wambaye icyuma cyangwa agapira, uzakenera ubuvuzi bw'umubiri mu minsi mike nyuma yo kubagwa.Ubuvuzi bw'umubiri bwongera imbaraga n'imikorere y'ingingo zawe.
• Niba wabazwe ivi cyangwa ikibuno, ushobora gukenera gukoresha inkoni mu gihe cy'amezi make. Uzakenera gukomeza gukoresha physiotherapy kugira ngo wongere kugira imbaraga n'uburinganire.
• Niba warabazwe urwasaya (gukorerwa osteotomy), urwasaya rwawe ruzafungwa neza kandi uzamara ibyumweru bitandatu urya indyo y'amazi. Niba wabazwe ku mano yawe manini, ntuzashobora kwambara inkweto cyangwa gutwara imodoka mu gihe cy'ibyumweru bibiri kugeza kuri bitandatu.

Ni gute wafasha mu nzira yo gukira?

Nawe ushobora gufasha muri iki gihe cyo gukira.

• Ntukanywe itabi: Nikotine igabanya umuvuduko wo gukira kandi ishobora no kubangamira gukira neza kw'amagufwa. Rero, irinde kunywa itabi burundu .
• Kurya indyo nziza kandi ijyanye n'ubuzima bwiza: Kurya indyo yuzuye, nk'indyo yo mu karere ka Mediterane, irimo imboga n'imbuto byinshi.
• Kurikiza amabwiriza ya muganga wawe neza.
• Komeza kugira ibiro bizima.

Ni ibihe bisubizo byitezwe?

Ibisubizo uzabona bizaterwa n'ibintu nk'ubuzima bwawe muri rusange, uburemere bw'ikibazo cy'amagufwa yawe, uburyo wakorewe ubuvuzi bwihariye, n'ubuhanga bw'umuganga wawe. Muganga wawe azakubwira ibijyanye n'ubuvuzi ugiye kubagwa n'icyo witeze nyuma yo kubagwa. Ntugatinye kubaza muganga wawe ibibazo cyangwa gusangira impungenge cyangwa ubwoba ufite.

Hari ubwoko bwinshi butandukanye bwo kubaga amagufwa n'ubundi buryo bwo kubaga kugira ngo amagufwa n'ingingo bihindurwe kandi bihindurwe. Muganga wawe azakubwira ikibazo cyawe cyihariye cy'amagufwa cyangwa ingingo hamwe n'uburyo buhari. Bitewe n'imiterere y'ikibazo cy'amagufwa yawe, ushobora kubanza kuvurwa hakoreshejwe uburyo butarimo kubagwa (ubuvuzi busanzwe). Ibi bishobora kuba birimo kuruhuka, barafu, imiti igabanya ububabare n'ububabare, hamwe n'inshinge za corticosteroid. Niba ubu buryo bwo kuvura budacunga ibibazo by'ingingo zawe, cyangwa niba ufite ikibazo kidashobora kuvurwa, ibuka ko umuganga wawe w'amagufwa ariho kugira ngo agufashe. Bafite uburyo bwo kubaga kugira ngo bongere ubushobozi bwo kugenda no kugabanya ububabare n'imibabaro yawe.

Ibintu by'ingenzi cyane ugomba kwibuka muri iyi nkuru

Rero, ni ibisanzwe kumva ufite ubwoba gato iyo utekereza ku gikorwa cyo kubaga amagufwa. Ariko, iki ni igikorwa cy'ingenzi mu buvuzi gishobora kunoza ubuzima bwawe, kikagabanya ububabare, kandi kigaha amagufwa n'ingingo zawe ubuzima bushya.

• Menya neza: Vugana na muganga wawe ibyerekeye indwara yawe, uburyo ugiye kubagwa, ibyiza n'ibibi byayo, hamwe n'igihe cyo gukira.
• Kurikiza amabwiriza ya muganga wawe: Ni ngombwa cyane kugira ngo ukire vuba gukurikiza amabwiriza ya muganga wawe witonze, haba mbere na nyuma yo kubagwa.
• Ihangane: Bifata igihe kugira ngo amagufwa akire. Muri icyo gihe, kora ibintu nk'ubuvuzi bw'umubiri neza kandi ukomeze gukomera.
• Irinde kunywa itabi: Iki ni ikintu ugomba gukora rwose.

Niba ufite ikindi kibazo kuri ibi, ntutinye kubaza muganga wawe. Barahari kugira ngo bagufashe.

Osteotomy, kubaga amagufwa, kubaga amagufwa, kubaga ingingo, kubaga , ubumuga bw'amagufwa, ububabare bw'ingingo