Masifunde ngqo nge-'Hill-Sachs Lesion' eyenzeka xa igxalaba likhutshiwe!

Mhlawumbi ukhe weva umntu esithi uphumile igxalaba lakhe, akakwazi ukuphakamisa ingalo yakhe, kwaye uneentlungu ezibuhlungu, akunjalo? Mhlawumbi yiloo nto eyenzekileyo nakuwe. Xa igxalaba liphumile, oko kuthetha ukuba inxalenye yegxalaba efana nebhola iyaphuma, amathambo angaphakathi kwegxalaba lethu nawo anokonakala. Yiyo loo nto le 'Hill-Sachs Lesion' (ekwabizwa ngokuba sisilonda seHill-Sachs). Makhe sithethe ngale nto ngokulula nangokucacileyo.

Yintoni le 'Hill-Sachs Lesion'?

Ngamafutshane, iHill-Sachs Lesion sisilonda esincinci okanye umkrwelo owenzeka phezulu kwethambo lakho elingaphezulu lengalo (ithambo elide elingaphezulu kwengalo eliqhagamshela egxalabeni - ihumerus), ngakumbi kwinxalenye yalo efana nebhola (intloko ye-humeral). Khawuthelekelele ukuba xa uwisa igxala lakho, le nxalenye efana nebhola ikhuhla ngamandla kwisokethi yejoyinti yakho yehlombe (i-glenoid socket). Kulapho iqhekeza elincinci leli thambo lityumkileyo kwaye lenze i-dent encinci. Kufana nomkrwelo omncinci xa iapile iwela emhlabeni.

Ngubani onokuba nethuba elikhulu lokufumana le `Hill-Sachs Lesion`?

Enyanisweni, nabani na onokukhubeka igxalaba lakhe usemngciphekweni wokufumana esi `silonda saseHill-Sachs`. Oku kungenxa yokuba kwenzeka xa igxalaba likhubeka kwingozi okanye ekuweni. Nangona kunjalo, kwabanye abantu, le ngozi iphezulu kancinci.

• Kwabadlali: Ingakumbi abo badlala imidlalo yokudibanisa, umzekelo i-rugby, ibhola ekhatywayo, i-boxing.
• Kumadoda: Kuthiwa amadoda anamathuba aphindwe kabini okuba negxalaba elikhumkileyo kunabafazi.
• Kubantu abaselula abaphakathi kweminyaka eli-15 nengama-30 ubudala: Abantu abakweli qela leminyaka banamathuba amaninzi okubandakanyeka kwiingozi kuba bakhuthele kakhulu.
• Kwabo bakha bakhubeka igxalaba labo ngaphambili: Wakuba ukhubeke igxalaba lakho, kunokwenzeka ukuba uphinde ulikhubeke. Oku kunokukhokelela kwi-'Hill-Sachs Lesion'.

Ixhaphake kangakanani le meko?

Ngokwedatha yaseMelika, malunga nabantu abali-10 kwikhulu lamawaka bayakhubeka igxalaba labo minyaka le. Oko kuthetha ukuba akwenzeki kubo bonke abantu. Nangona kunjalo, ukuba ukhubeka igxalaba lakho, amathuba okuba ne-'Hill-Sachs Lesion' abalulekile. Ezinye izifundo zibonisa ukuba phakathi kwama-40% nama-90% abantu abakhubeka igxalaba labo baya kuba nale ngozi. Oko kuthetha ukuba ukuba ukhubeka igxalaba lakho, kuya kufuneka ucinge ngale nto.

Le `Hill-Sachs Lesion` iyichaphazela njani umzimba wakho?

Amaxesha amaninzi, i-`Hill-Sachs Lesion` yodwa ayinampembelelo ingako. Oko kukuthi, iintlungu ezivela ekuqhekekeni kwegxalaba kunye nokungakwazi ukuhambisa ingalo zezona mpawu ziphambili. Nangona kunjalo, ukuba le 'Hill-Sachs Lesion' ikhona, ezo mpawu zinokuba nzima ngakumbi . Intlungu inokuba mandundu, kwaye ubunzima bokuhambisa ingalo bunokwanda.

Enye into kukuba le 'Hill-Sachs Lesion' ingathatha ixesha elide ukuba igxalaba lakho liphole. Kwakhona, xa inxeba lilikhulu, kokukhona kunokwenzeka ukuba igxalaba lakho liphinde liqhekeke kwixesha elizayo. Ekuhambeni kwexesha, isifo samathambo kuloo malungu egxalaba sinokuvela.Kukwakho nokwenzeka kokuba ne-arthritis yamagxa, nto leyo ethetha ukuba ilungu ligugile.

Zithini iimpawu zeHill-Sachs Lesion?

Iimpawu ze-'Hill-Sachs Lesion' ziyafana nezo zegxalaba eliphumileyo. Nangona kunjalo, njengoko benditshilo ngaphambili, ukuba unale 'lesion', iimpawu zinokuba nzima ngakumbi.

• Ndiva iintlungu eziqatha kakhulu .
• Ndiziva ndibuthathaka esandleni sam.
• Andikwazi ukuhambisa isandla sam.
• Igxalaba libukeka lahlukile , ngaphandle kwendawo elalikuyo ngaphambili (ngokungathi liphumile).
• Kuvela ukudumba .
• Usenokubona imivumbo okanye utshintsho kumbala wolusu.
• Ukuqaqamba kwemisipha.
• Usenokuziva ungenazimvakalelo, urhawuzelelo, okanye ubuthathaka esandleni sakho, entendeni yesandla, okanye kwiminwe yakho.

Kubalulekile: Ukuba ucinga ukuba igxalaba lakho likhumkile, okanye ukuba ufumene ingozi enkulu egxalabeni lakho, yiya kwigumbi likaxakeka lesibhedlele esikufutshane ngoko nangoko. Musa ukulibazisa, kuba kubaluleke kakhulu ukufumana unyango ngokukhawuleza.

Yintoni ebangela le 'Hill-Sachs Lesion'?

Isizathu esiphambili kukukhubeka kwegxalaba .

Cinga ngale ndlela: ilungu lethu lamagxa liyi-'ball-and-socket joint'. Inxalenye efana nebhola ephezu kwethambo lakho elingaphezulu lengalo ('Humerus') idla ngokuba ngaphakathi kwi-'socket' ethanjeni legxalaba ('Scapula').

Ngoku, ukuba igxalaba lakho liphuma phambili (oko kukuthi, liphuma ngaphambili emzimbeni wakho), inxalenye efana nebhola yethambo lengalo ephezulu, i-socket, inokunamathela kwi-socket ize ikhuhleke. Loo xinzelelo lubangela ukuba inxalenye efana nebhola ityumke ize yenze 'i-dete'. Oku kubizwa ngokuba yi-'Hill-Sachs Lesion'.

Izizathu eziphambili zokuxhawula amagxa zezi:

• Ukwenzakala kwezemidlalo - Cinga ngokuwa ngelixa udlala i-rugby, okanye ukuntywila ngelixa udlala ikhilikithi.
• Ukuwa - Oku kungenzeka ngokuwa phantsi okanye ezantsi kwezinyuko.
• Iingozi zeemoto - Olu hlobo lweengozi lunokubangela ukwenzakala emagxeni.

Oogqirha bayibona njani i-'Hill-Sachs Lesion'?

Xa usiya kugqirha onegxalaba eliphumileyo, baza kujonga ukuba akukho nxeba leHill-Sachs xa bekuxilonga.

Okokuqala, ugqirha uza kwenza uvavanyo lomzimba lwengalo yakho negxalaba lakho. Baza kukhangela iindawo ezibuhlungu, ukudumba, kunye nokuba ungakwazi na ukuyishukumisa ingalo yakho. Emva koko, banokwenza uvavanyo oluthile ukuze babone ukuba kwenzeka ntoni ngaphakathi.

Bazi:

• Uvavanyo lwe-X-ray(`Ii-X-reyi`): Oku kunokunceda ukujonga indawo amathambo, ukwaphuka kwamathambo, njl. Nokuba `Isilonda saseHill-Sachs` sinokubonwa ngamanye amaxesha kwi`X-reyi`.
• Iskeni ye-MRI (Magnetic Resonance Imaging): Oku kunokubonelela ngombono ocacileyo wezicubu ezithambileyo, ezifana nezihlunu, ii-ligaments, imisipha, kunye namathambo. I-MRI ibaluleke kakhulu ekumiseleni ubungakanani obuchanekileyo kunye nobunzulu be-Hill-Sachs Lesion.
• Iskeni ye-CT (Computed Tomography): Oku kunokubonelela ngolwazi oluneenkcukacha ezininzi malunga namathambo. Iskeni ye-CT ngamanye amaxesha isetyenziswa xa kucwangciswa utyando.

Ezi scans zinokubona ngokucacileyo indawo kunye nobukhulu benxeba lethambo, nto leyo eluncedo kakhulu ekucwangciseni unyango.

Inyangwa njani iHill-Sachs Lesion?

Uhlobo lonyango olufunekayo luxhomekeke kubungakanani beHill-Sachs Lesion, oko kukuthi, umonakalo ethanjeni.

Ngokwesiqhelo, ukuba intloko ye-humeral ingaphantsi kwama-20% yaphukile, akukho nyango lukhethekileyo lufunekayo. Unyango oluqhelekileyo lwegxalaba eliphumileyo luyasetyenziswa.

Unyango olungelulo utyando

1. Ukunciphisa okuvaliweyo:

Le yeyona nto ibalulekileyo. Kuthetha ukubuyisela igxalaba lakho apho belikhona, kwisokethi. Olu asilotyando. Ugqirha uza kubamba igxalaba lakho ngaphandle, alitsale ngendlela efanelekileyo, aze alibuyisele ngaphakathi. Ngelixa esenza oku, unganikwa i-anesthetic yendawo (iyeza elithomalalisa kuphela indawo) ukunciphisa iintlungu, okanye unganikwa amayeza okuthomalalisa (amayeza akwenza uzive uzolile kancinci).

2. Ukungakwazi ukuhambahamba:

Emva kokuba igxalaba libuyiselwe endaweni yalo, kunokufuneka unxibe i-splint okanye i-sling ukuze lihlale lisendaweni yalo. Oku kubizwa ngokuba yi-immobilization. Oku kuvumela igxalaba elonzakeleyo ukuba liphumle kwaye lincede liphile.

Ugqirha angakuxelela ukuba ufake umkhenkce izihlandlo ezininzi ngemini. Angakuxelela nokuba wenze ezinye iindlela zokuzilolonga ukuze igxalaba lakho lingaqini okanye liqandiswe (liqandiswe). Buza ugqirha wakho ukuba kufuneka unxibe isilingi ixesha elingakanani kwaye kufuneka wenze umthambo ongakanani. Uninzi lwabantu kufuneka bagcine igxalaba labo lingashukumi kangangeeveki ezimbalwa.

3. Unyango lomzimba:

Njengoko igxalaba lakho liphola kancinci kancinci, phinda ufumane amandla alo kwaye ukwazi ukulishukumisa kakuhle.Unyango lomzimba luya kuqala. Okokuqala, uza kolula kancinci ukuze igxalaba lakho likhululeke kwaye lingabi nakuqina. Emva koko, ugqirha wakho okanye ingcali yezonyango zomzimba iza kongeza umthambo wokuqinisa izihlunu zakho kunye nemisipha. Oku kuya kunceda ekunciphiseni umngcipheko wokukhubeka kwixesha elizayo. Abantu abaninzi kuya kufuneka benze unyango lomzimba kangangeenyanga ezimbalwa emva kokukhubeka.

Utyando lweHill-Sachs Lesion

Ukuba i-`Hill-Sachs Lesion`, oko kukuthi, inxeba lethambo, ligubungela ngaphezulu kwe-20% yenxalenye efana nebhola yethambo lengalo ephezulu (`intloko yehumerus`), oko kuthetha ukuba inxeba likhulu, kunokufuneka utyando ukuze lilungiswe.

Kukho iinkqubo ezininzi zotyando ezenziwa rhoqo:

• Inkqubo yokubuyisela: Oku kuquka ukuzalisa indawo efana nomngxuma eshiywe sisilonda seHill-Sachs ngezicubu ezithambileyo ezikufutshane. Ngokwesiqhelo, i-capsule kunye ne-tendon ekufutshane nokwenzakala kwegxalaba ziyasetyenziselwa oku.
• Ukufakelwa kwamathambo: Kule nkqubo, ugqirha uthatha izicubu zethambo ezongezelelweyo aze azifake kwindawo eyonakeleyo ye-humerus ukuze ayilungise. Oku ngamanye amaxesha kubizwa ngokuba kukwandiswa kwamathambo.
• Ukutshintshwa kwamagxa: Ukuba kukho umonakalo omkhulu kwi-humerus, i-scapula (i-shoulder blade), kunye nezinye izicubu egxalabeni, kunokufuneka ukutshintshwa kwamagxa. Kwimeko enjalo, ugqirha otyandayo ususa iindawo ezonakeleyo zegxala aze azifake iziqwenga zokufakelwa.

Kuthatha ixesha elingakanani ukuphiliswa?

Kudla ngokuthatha iinyanga ezininzi ukuze uphile emva kweHill-Sachs Lesion. Igxalaba lakho kuya kufuneka lingasebenzi kangangeeveki ezimbalwa, kulandele iinyanga zonyango lomzimba.

Ixesha elithathayo ukuba inxeba lakho liphole lixhomekeke kwizinto ezininzi:

• Indlela eyenzeke ngayo ingozi (njengokuwa okanye ingozi yezemidlalo).
• Nokuba kukho ezinye iingozi okanye umonakalo ngaphakathi egxalabeni (ezifana nemisipha ekrazukileyo okanye umonakalo kwi-labrum).
• Luhlobo luni lonyango obuludinga, okanye ukuba bekufuneka utyando ?

Ugqirha wakho okanye ugqirha uza kukunika ixesha elithile lokuchacha ngenxa yokwenzakala kwakho, ngoko ungakhathazeki.

Ngaba le 'Lesion yaseHill-Sachs' ingathintelwa?

Ekubeni uninzi lokukhubeka kwamagxa kubangelwa ziziganeko ezingalindelekanga ezifana nokuwa kunye neengozi zemidlalo, akukho nto inokwenziwa ngokukodwa ukuthintela le 'Hill-Sachs Lesion'.

Nangona kunjalo, licebo elihle ukulandela la macebiso okhuseleko ngokubanzi ukuze unciphise umngcipheko weengozi:

• Soloko unxibe ibhanti xa ukhwela imoto.
• Nxiba izixhobo zokhuseleko ezifanelekileyo ngexesha lomsebenzi nomdlalo.(umz. isigcina-ntloko, ii-earpad).
• Gcina ikhaya lakho nendawo osebenza kuyo icocekile kwaye ingenazo izinto ezinokubangela ukuba wena okanye abanye bawe. Lumka kwiindawo ezityibilikayo.
• Xa uthatha into evela phezulu, soloko usebenzisa isixhobo okanye isixhobo esenzelwe loo njongo. Ungaze ukhwele ezitulweni okanye etafileni.
• Ukuba unengxaki yokuhamba okanye usemngciphekweni omkhulu wokuwa, sebenzisa induku okanye i-walker.

Yintoni onokuyilindela nge-'Hill-Sachs Lesion'?

Uninzi lwabantu luyaphola ngokupheleleyo emva kokwenzakala. Nokuba utyando, kufuneka ukwazi ukubuyela kwimisebenzi yakho yesiqhelo kunye nemidlalo emva kokuba igxalaba lakho lipholile.

Nangona kunjalo, wakuba ukhubeke igxalaba lakho, unamathuba amaninzi okuphinda wonzakale. Ezinye izifundo zifumanise ukuba ngaphezulu kwama-90% abadlali abangaphantsi kweminyaka engama-25 ubudala abakhubeke igxalaba labo kumdlalo wokudibanisa baya kuphinda balimaze igxalaba elifanayo kwixesha elizayo.

Ngoko ke, ngaphambi kokuba uqalise nayiphi na imisebenzi yomzimba - ingakumbi imidlalo - thetha nogqirha wakho okanye ugqirha wakho. Banokukuchazela into omawuyilindele kunye nendlela yokuthintela ukukhubeka kwixesha elizayo. Unyango olufanelekileyo lomzimba lunokunciphisa le ngozi.

Ngaba andizukukwazi ukuya emsebenzini okanye esikolweni de ndibe ndiphilile?

Ukuba awukwazi ukwenza umsebenzi wakho okanye umsebenzi wesikolo ngaphandle kokuhambisa ingalo yakho ngelixa igxalaba lakho lingasebenzi, usenokungakwazi ukuya emsebenzini okanye esikolweni. Ugqirha wakho uza kukuxelela ukuba zeziphi iintshukumo kunye neendawo omele uziphephe de uphile. Landela loo miyalelo ngononophelo.

Ndingaya nini kwigumbi likaxakeka?

Ukuba ukhe waba nengozi enkulu (ukwenzakala) , yiya kwigumbi likaxakeka ngokukhawuleza.

Ukuba ucinga ukuba igxalaba lakho likhutshiwe:

• Yiya kwigumbi likaxakeka okanye utsalele umnxeba ku-1990.
• Musa ukushukumisa isandla sakho. Sigcine kufutshane nomzimba wakho.
• Musa ukuzama ukuphinda ubeke igxalaba lakho endaweni yalo ngokwakho. Musa ukuvumela nabani na ngaphandle kogqirha ukuba akwenze oko. Ukuba umntu ongengogqirha uzama ukuphinda ubeke igxalaba lakho endaweni yalo, ungonakalisa imithambo yegazi, izihlunu, imisipha kunye nemithambo-luvo.
• Beka ipakethe yomkhenkce kwindawo eyonzakeleyo. Oku kuya kunciphisa ukudumba kunye nentlungu.
• Iipilisi zokunciphisa iintlungu (umz. i-paracetamol, okanye i-'NSAIDs' - Amayeza angengowe-steroidal anti-inflammatory, njengoko echazwe ngugqirha wakho) anokunceda ukunciphisa iintlungu kunye nezinye iimpawu. Nangona kunjalo, musa ukuthatha ngaphezu kwedosi ecetyiswayo.

Ndingayibuza yiphi imibuzo ugqirha wam?

Xa unemeko efana nale, kungcono ukubuza ugqirha wakho ngale nto ilandelayo:

• Ngaba kufuneka ndityandwe ukuze ndilungise isilonda sam saseHill-Sachs? Ukuba kunjalo, loluphi uhlobo?
• Kufuneka ndigcine ingalo yam ingasebenzi ixesha elingakanani?
• Ndingaqala nini unyango lomzimba? Kuza kuthatha ixesha elingakanani?
• Ndiza kukwazi nini ukudlala imidlalo okanye ukuzilolonga kwakhona? Zeziphi izinto endinokuzenza kuqala?
• Ndingenza ntoni ukuze ndithintele igxalaba lam ukuba lingaphumi kwakhona?

Yintoni umahluko phakathi kwe-'Hill-Sachs Lesion' kunye ne-'Reverse Hill-Sachs Lesion'?

I-`Hill-Sachs Lesion` kunye ne-`Reverse Hill-Sachs Lesion` ziluhlobo olufanayo lokulimala. Umahluko kuphela kukuba leliphi icala lenxalenye efana nebhola yethambo lakho elingaphezulu lengalo (`Humerus`) apho ukwenzakala kukwicala .

• I-`Hill-Sachs Lesion` sisiqhuma esenzeka ngasemva (ngokwezonyango, `umbono we-posterolateral`) wenxalenye efana nebhola yegxalaba xa ityhalelwa phambili ukusuka `kwicala elingaphambili`.
• I-'Reverse Hill-Sachs Lesion' sisiqhuma esenzeka kwicala langaphambili (ngokwezonyango, 'i-anteromedial aspect') yenxalenye efana nebhola yegxalaba xa iphoswa ukusuka 'kwicala elingasemva'.

Zombini zifunyaniswa kwaye zinyangwa ngendlela efanayo.

Yintoni umahluko phakathi kwe-'Hill-Sachs Lesion' kunye ne-'Bankart Lesion'?

I-`Hill-Sachs Lesion` kunye ne-`Bankart Lesion` ziintlobo ezimbini zokwenzakala okunxulunyaniswa nokukhubeka kwegxalaba. Nangona kunjalo, zahlukile.

• I-'Hill-Sachs Lesion' yi -bone spur eyenzeka xa igxalaba lakho lityibilika lisuka kwelinye icala ukuya kwelinye (i-anterior glenohumeral dislocation), nto leyo ebangela ukuba intloko yethambo lengalo ephezulu ('humerus') icinezelwe, nto leyo ebangela ukuba kubekho iqhubu kwi-socket yegxalaba. Oku kuthetha ukuba oku kukonakalisa ithambo.
• I-'Bankart Lesion' kukwenzakala kweringi ye-cartilage ekhuselayo ejikeleze ijoyinti yegxalaba (ebizwa ngokuba yi-'Labrum'). I-'Bankart Lesion' kukukrazuka kule 'Labrum'. Oku kungenzeka ngokukhubeka okanye intshukumo encinci ('subluxation'). Xa igxalaba likhutshiwe, kusenokwenzeka ukuba liphinde lenzeke. Ukuba igxalaba liyaqhubeka nokukhubeka okanye 'subluxate', i-'Labrum' inokonakala ngakumbi (njengokukrazuka kwe-SLAP`).

Igxalaba eliphumileyo linokuba ngamava abuhlungu kakhulu kwaye othusayo. Ukungakwazi ukuhambisa ingalo yakho ngequbuliso, uzive ngathi igxalaba lakho alisekho apho lalikhona ngaphambili, kukwenza wothuke kakhulu. Ungaze uzame "ukulibopha" igxalaba lakho ulibuyisele ndawonye. Yiya kwigumbi likaxakeka ngokukhawuleza kwaye ufumane uncedo lwezonyango ngokukhawuleza.

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Ukuba ukhe waphuma igxalaba lakho kanye, nokuba uneHill-Sachs Lesion okanye akunjalo, usemngciphekweni omkhulu wokuphinda ulilimaze kwixesha elizayo. Ngoko ke, thetha nogqirha wakho ngexesha lokuchacha kwakho. Ngale ndlela, unokufumana umbono ongcono wento omawuyilindele kunye nendlela yokukhusela igxalaba lakho.

Umyalezo Wokuya Ekhaya

Kulungile, masiphinde sichaze ezona zinto zibalulekileyo esithethe ngazo kweli `Lesion yaseHill-Sachs`:

• Oku kwenzeka xa igxalaba likhutshiwe , kwaye inxalenye efana nebhola yethambo lengalo ephezulu (i-'humerus') ibetha umngxuma webheyile yegxalaba, nto leyo ebangela ukuba kubekho umkrwelo omncinci ofana nokuqhekeka kwethambo.
• Ineempawu ezifanayo nezokuphuma kwegxalaba, njengentlungu eqatha, ukungakwazi ukuhambisa ingalo, kunye nokudumba , kodwa inokuba qatha ngakumbi.
• Kwiimeko ezininzi, igxalaba linokutshintshwa, lingasebenzi, kwaye linyangwe ngonyango lomzimba ngaphandle kotyando .
• Ukuba inxeba likhulu (ngaphezu kwe-20% yethambo), utyando lunokufuneka.
• Eyona nto ibalulekileyo kukufuna ingcebiso kagqirha ngoko nangoko ukuba igxalaba lakho liyaphuka. Musa ukuzama ukuzilungisa ngokwakho.
• Ukuba uqhuzuka igxalaba lakho kube kanye, unethuba elingcono lokuphinda uliqhuzule. Ngoko ke, kubaluleke kakhulu ukulandela iingcebiso zonyango kwaye ugcine igxalaba lakho lomelele.

Ukuba uneminye imibuzo malunga noku, ungoyiki ukubuza ugqirha wakho okanye umbelethisi. Hlala usempilweni!

Ukuqhekeka kwegxalaba , Isilonda saseHill-Sachs, Isilonda saseHill-Sachs, iintlungu zegxalaba, ukudumba kwamathambo, unyango lwegxalaba, unyango lomzimba