Masifunde yonke into malunga notyando lwamathambo (i-Osteotomy) ngendlela elula!

Ngaba ngamanye amaxesha ukhe uzibuze ukuba intlungu oyivayo kwiindawo ezithile zomzimba wakho, ingakumbi amadolo akho, izinqe, okanye umqolo, ibangelwa kukungahambi kakuhle kwethambo okanye ukwaphuka? Ugqirha wakho usenokuba ukuxelele ngotyando olubizwa ngokuba yi-osteotomy. Kunokuba yinto eyoyikisayo ukuva ngale nto. Kodwa xa usazi iinkcukacha, olo loyiko luyancipha kakhulu. Ngoko ke, namhlanje, masithethe ngolu tyando ngokulula?

Kalula nje, yintoni le (i-Osteotomy)?

Kulungile, ukuyibeka ngokulula, i-osteotomy yinkqubo yotyando. Ibandakanya ukusika ithambo, ngamanye amaxesha ukongeza ithambo elitsha, uze ulitshintshe ithambo okanye ulibuyisele kwindawo yalo efanelekileyo. Cinga ngayo njengomchweli osika isiqwenga somthi, asitshintshe, aze asinike imo entsha, kodwa oku kwenziwa emathanjeni emzimbeni wethu.

Ugqirha wakho angenza i-osteotomy kuyo nayiphi na ithambo emzimbeni wakho. Umzekelo, kumhlathi wakho, engqinibeni, emqolweni, egxalabeni, esinqeni, edolweni, emlenzeni, ezinzwaneni, okanye enyaweni. Idla ngokusetyenziselwa ukunyanga iingxaki ezimalunga akho - apho amathambo amabini adibana khona. Kukho iintlobo ezahlukeneyo ze-osteotomy kunye neendlela. Zihlala zithiywa ngegama logqirha owasungula le nkqubo okanye indlela ithambo elisikwa nelibunjwe ngayo ngokutsha.

Kutheni le nto kwenziwa olu tyando (lwe-Osteotomy)?

Ngoku usenokuba uzibuza, 'Kutheni kufuneka unqumle amathambo ngolu hlobo?' Kukho izizathu ezahlukeneyo.

• Lungisa i-engile, ukugoba, okanye ukujikeleza kwamathambo: Ngamanye amaxesha amathambo anokuba yinto engafanelekanga. Olu tyando lunceda ukulungisa loo nto. Cinga ngayo, imilenze yabanye abantu inokuba nomfanekiso woonobumba u-O (bowlegs) okanye njengonobumba u-X (knock-knees). Oku kusetyenziswa ukulungisa izinto ezinjalo.
• Lungisa ilungu elinokukhubazeka okanye elingahambanga kakuhle: Amanye amalungu anokuzalwa eneziphene ezincinci, okanye anokukhubazeka ngenxa yengxaki ethile kamva ebomini.
• Nciphisa okanye wolule amathambo: Ayimangalisi na le nto? Ewe, kwezinye iimeko le ndlela ikwasetyenziswa ukutshintsha ubude bamathambo.
• Lungisa ilungu elonakeleyo: Ukuba ilungu lonakele ngenxa yengozi okanye esinye isizathu.
• Tshintsha indawo ethwele ubunzima belungu: Khawuthelekelele ukuba i-cartilage kwelinye icala ledolo lakho igugile. Kulapho uziva khona iintlungu. Olu tyando lunokutshintsha indlela obuthwalwa ngayo ubunzima kwaye lubuthumele ecaleni nge-cartilage ephilileyo. Oko kuya kunciphisa iintlungu.
• Nciphisa iintlungu ezibangelwa yi-osteoarthritis: Esi sisisombululo esilungileyo sokunciphisa iintlungu ezibangelwa sesi sifo samalungu esiwohlokayo, ingakumbi emadolweni nasezinqeni.
• Utyando lokutshintshwa kwamalungu olutsha olusebenzayo: Kwabanye abantu abaselula, i-osteotomy ibavumela ukuba basebenzise amalungu abo ixesha elide kunokuba batshintshe amalungu abo ngoko nangoko xa amalungu ephela.
• Lungisa ezinye iingxaki ezithile zamathambo.

Ndingenza ntoni ngaphambi kotyando?

Ngaphambi kokuba wenze i-osteotomy, ugqirha wakho uza kuyalela iimvavanyo ezininzi ukujonga impilo yakho ngokubanzi. Ezi zihlala ziquka:

• Uvavanyo lwegazi: Olu vavanyo lujonga amanqanaba eenxalenye ezahlukeneyo egazini lakho kunye nendlela amalungu akho angaphakathi asebenza ngayo.
• Uvavanyo lomchamo: Olu vavanyo lunokunceda ekuqinisekiseni impilo yakho ngokubanzi kwaye lufumanise naziphi na iimeko ezinokuthi ziphazamise ukuphiliswa kwamathambo, njengosulelo okanye isifo seswekile.
• Uvavanyo lwe-ECG (i-Electrocardiogram): Lujonga ukusebenza kombane kwentliziyo yakho.
• I-X-ray yesifuba: Ukuqinisekisa ukuba imiphunga yakho isebenza kakuhle ngaphambi kotyando.
• Ii-X-reyi okanye ii-CT scans: Ezi zisetyenziselwa ukucwangcisa utyando ngokujonga amathambo/amalungu akho ngokucacileyo. Ugqirha kufuneka azi kakuhle ubungakanani, ubude, ububanzi, kunye ne-engile yethambo eliza kususwa. Ngamanye amaxesha kwenziwa imodeli ye-3D kusetyenziswa ikhompyutha ukucwangcisa utyando.

Yintoni edla ngokwenzeka ngexesha lotyando lwe-Osteotomy?

Okokuqala, uza kunikwa i-anesthesia. Oku kungenziwa ngeendlela ezahlukeneyo:

• I-anesthesia yengingqi kukunciphisa kuphela indawo apho utyando luza kwenziwa khona.
• I-anesthesia yomqolo.
• Ukukwenza ulale ngokupheleleyo (i-anesthesia eqhelekileyo).
• I-anesthesia yendawo isetyenziselwa ukubulala iintlungu kuphela kwindawo apho utyando luza kwenziwa khona.

Ugqirha uza kukhetha indlela efanelekileyo kuwe.

Emva koko, iqela lotyando licoca indawo ejikeleze utyando ngesisombululo sokulwa neentsholongwane. Emva koko, indawo igqunywe ngelaphu lotyando.

Ugqirha wenza utyando eluswini lwakho. Basebenzisa iingcingo ezikhokelayo ukuphawula indawo yethambo ekufuneka isuswe (idla ngokuba yi-wedge, kodwa oku kuyahluka ngokuxhomekeke kutyando). Kusetyenziswa isarha ekhethekileyo yotyando ukususa le ndawo iphawulweyo yethambo.

Emva kokususa ithambo eligulayo okanye elonakeleyo, umsantsa uvalwa ngokudibanisa iindawo eziseleyo zethambo kumacala omabini. Ngokuxhomekeke kuhlobo lwe-osteotomy onayo, i-bone graft ingafakwa kwindawo apho ithambo lisusiwe khona. Emva koko, iiphini, izikrufu, ii-staples, iipleyiti, okanye iintonga zisetyenziselwa ukubamba ithambo lihlale endaweni yalo de liphole. Ezinye zezi ziqwenga zesinyithi zezexeshana, ngelixa ezinye zihlala zihleli.

Ziziphi iintlobo eziphambili zotyando lwe-osteotomy?

Utyando lwe-osteotomy lunokuphelisa iingxaki ezahlukeneyo zamathambo namalungu. Makhe sijonge ezinye zezona ntlobo ziphambili.

Utyando lwe-osteotomy yomhlathi

Oku kubandakanya ukulungelelanisa amathambo omhlathi wakho ongezantsi (umhlathi ongasentla) okanye umhlathi ongaphezulu (umhlathi ongasentla) kunye nentloko yakho yonke kunye/okanye amazinyo. Oku kunokulungisa iingxaki ezinje ngokuluma okuvulekileyo, ubunzima bokuhlafuna okanye ukuginya, ukuguguleka kwamazinyo kakhulu, isilevu esibuyela umva, ukuluma kakhulu, okanye ukuluma ngaphantsi. Ungadinga neebraces ngaphambi okanye emva kotyando ukuze ulungelelanise amazinyo akho nomhlathi wakho.

• Utyando olwenziwa kumhlathi ongezantsi lubizwa ngokuba yi-mandibular osteotomy .
• Utyando olwenziwa kumhlathi ongaphezulu lukwabizwa ngokuba yi-maxillary osteotomy .
• Kukho iinkqubo ezithile, umzekelo, i-LeFort osteotomy lutyando lokulungisa ukwaphuka embindini wobuso apho umhlathi ongaphezulu udibana khona nomhlathi. I-sagittal split osteotomy luhlobo lotyando lomhlathi oluhambisa umhlathi ongezantsi ukuze ulungelelane namazinyo.

Utyando lwe-osteotomy yesilevu

Olu tyando lwenziwa ukutshintsha imo yesilevu. Ludla ngokwenziwa ukuze kwandiswe isilevu ukuba sisezantsi kakhulu, okanye ukwenza isilevu esincinci sibe mfutshane. Oku kungayishukumisa isilevu phambili okanye kwicala elahlukileyo. Ngamanye amaxesha olu khetho lungcono kunokufakelwa isilevu. Ngexesha lotyando, umhlathi wakho uyasikwa uze ushukunyiswe. Ugqirha wenza umsi ngaphakathi emlonyeni. Ungalahlekelwa yimvakalelo emilebeni yakho kangangeenyanga ezimbalwa.

Utyando lwe-elbow osteotomy

Ukuba iingxaki zelungu lengqiniba zibangela iingxaki kwindawo yengalo yakho esezantsi, njengokuba ingalo ixhomekeke kakhulu emzimbeni (cubitus varus) okanye ikude kakhulu nomzimba (cubitus valgus), olu tyando lwenziwa ukulungisa ezo ngxaki. Kukho iintlobo ezahlukeneyo ze-osteotomy kuxhomekeke kwingxaki.

Utyando lomqolo

Olu tyando lwenziwa ukuze kulungiswe amagophe omqolo. Amagophe endalo omqolo wethu anceda ukugcina umbindi womxhuzulane womzimba phezu kwe-pelvis. Ukuba igophe kwinxalenye enye okanye ezingaphezulu zomqolo liyanda okanye liyancipha, umqolo awuthe tye. Oku kunokubangela iintlungu, ukudinwa, kunye noxinzelelo kwizitho zangaphakathi. Injongo yolu tyando kukubuyisela ibhalansi kumqolo, ukunciphisa iintlungu, kunye nokuthintela ukuphazamiseka ukuba kuphinde kwenzeke okanye kube mandundu.

• Umzekelo, kwimeko efana ne -Ankylosing Spondylitis , umqolo unokugoba unaphakade kwaye isilevu sinokuchukumisa isifuba. Olu tyando lunokuthathwa njengokulungisa iingxaki ezinjalo ze-angular.
• Kukho iintlobo ezininzi eziphambili:
• I-Posterior column osteotomy: Oku kudala i-lordosis kumqolo ongezantsi kunye ne-kyphosis kumqolo ongaphezulu. I-Ponte osteotomy yindlela ekhethekileyo esetyenziselwa ukulungisa i-kyphosis.
• (Unyango lwe-osteotomy lukaSmith-Petersen):Le yinkqubo ekhethekileyo esetyenziselwa ukulungisa i-lordosis. Iqhekeza lethambo liyasuswa ngasemva komqolo ukuze umqolo uthambekele ngasemva.
• Utyando lokususa i-pedicle osteotomy: Oku kudala i-inner curve enamandla (i-lordosis) kumqolo ongezantsi.
• (I-Bone-disk-bone osteotomy): Oku kuquka ukudala ithambo elingaphezulu nangaphantsi kwediski phakathi kwamathambo omqolo. Ngexesha lotyando, idiski kunye neepleyiti zayo ezikufutshane ziyasuswa.
• (Ukususwa kwekholamu yomqolo): Kule meko, ithambo elinye okanye ngaphezulu lisuswa ngokupheleleyo. Oku kunokwenza ulungiso olubaluleke kakhulu. Ngenxa yokuba ithambo elininzi lisuswa, ugqirha uzalisa le ndawo ngethambo okanye ikheyiji yesinyithi.

Utyando lwe-hip osteotomy

Oku kuquka ukubumba ngokutsha intloko yakho ye-acetabulum okanye ye-femur. Le yi-ball-and-socket hip joint esesinqeni sakho. Ugqirha uyasika, abumbe, okanye asuse ithambo kancinci ukuze alungelelanise iindawo ezithwele ubunzima belungu.

• Iintlobo eziphambili:
• Utyando lwe-Periacetabular osteotomy: Oku kwenzelwa ukulungisa i-hip dysplasia, imeko apho i-hip socket ingagqumi ngokupheleleyo ibhola lethambo lethanga. Ngexesha lotyando, inxalenye yethambo le-hip iyanqunyulwa, ibekwe endaweni yayo, ize iqiniswe ngezikrufu.
• Utyando lwe-Femoral osteotomy: Oku kubandakanya ukusika nokutshintsha ithambo lethanga elingaphezulu (i-femur) ukunceda ukubuyisela ukusebenza kwesinqe.

Utyando lwedolo lwe-osteotomy

Utyando lwe-osteotomy lubandakanya ukusika nokutshintsha elinye lamathambo amabini afumaneka phantsi kwe-kneecap - nokuba yi-tibia okanye i-femur. Oku kudla ngokwenziwa ukulungisa umonakalo obangelwe yi-arthritis. Olu tyando luguqula i-knee joint, lutshintshe ubunzima kunye noxinzelelo ukusuka kwicala elonakeleyo ledolo ukuya kwicala eliphilileyo. Utyando lwe-knee osteotomy ludla ngokwenziwa kwizigaba zokuqala ze-osteoarthritis, xa umonakalo ukwicala elinye kuphela ledolo.

• Indawo yotyando lwe-osteotomy ixhomekeke kwindawo yomonakalo. Umzekelo, kwi- osteotomy ephezulu ye-tibial , ukuba umonakalo we-cartilage ungaphakathi kwedolo, iqhekeza lethambo elimile okwe-wedge liyasuswa ngaphandle kwedolo, okanye ithambo livuleke ngendlela efana neye-wedge ngaphakathi kwedolo. Oku kulungisa umlenze kwaye kuthintele ukuba isifo samathambo singabi sibi.
• Ezinye iintlobo zedolo (i-Osteotomy):
• Utyando lwe-Tibial osteotomy: Oku kudala ulungelelwaniso lwe-bowlegged olubeka uxinzelelo olugqithisileyo ngaphakathi kwedolo.
• Utyando lwe-high tibial osteotomy: Olu tyando lusetyenziselwa ukulungisa idolo kubantu abane-arthritis yedolo. Olu tyando lunokuthintela okanye lulibazise isidingo sokutshintshwa kwedolo ngokupheleleyo okanye inxalenye yalo.
• (Utyando lwe-osteotomy eFulkerson):Le yinkqubo ekhethekileyo. Inxalenye yendawo ethile ye-tibia (tibial tubercle) iyasuswa. Oku kutshintsha indawo apho i-kneecap tendon inamathela khona kwi-tibia, kunciphisa uxinzelelo kwi-kneecap kwaye kuthintele ukukhubeka.

Ii-osteotomies zeenzwane ezinkulu kunye neenyawo

I-hallux osteotomy yinkqubo equka ukususwa kwethambo kubhontsi omkhulu nokulilungisa. I-calcaneus osteotomy yinkqubo etshintsha unyawo ukuze lulungise iinyawo ezisicaba okanye iinyawo nge-arch ephezulu kunesiqhelo.

• Iindlela ezahlukeneyo ezithile (i-Osteotomy) zokunyanga iingxaki zeenyawo:
• IiChevron kunye neAkin osteotomies: Olu tyando lulungisa ukukhubazeka okuncinci ukuya kokuphakathi konyawo olukhulu olubangelwa ziibunions (hallux valgus).
• (Dwyer osteotomy): Oku kutshintsha unyawo ukuze kuncitshiswe i-arch ephezulu ngendlela engaqhelekanga.
• (Weil osteotomy): Oku kulungisa iinzwane zeenzipho kunye nentlungu phantsi kwebhola yonyawo lwakho.
• (I-Cotton osteotomy): Oku kunceda ekudaleni igophe enyaweni.

Zithini iingozi zolu tyando?

Njengalo naluphi na utyando, i-osteotomy inokuba neengozi ezithile. Kodwa ungakhathazeki, oogqirha benza konke okusemandleni abo ukunciphisa ezi ngozi. Iingozi eziphambili zezi:

• Iingxaki nge-anesthesia.
• Usulelo.
• Amahlwili egazi.
• Ukulimala kwemithambo-luvo okanye kwemithambo yegazi.
• Kulungile ukuba amathambo angahlali kakuhle okanye angaphili kakuhle xa ephiliswa.
• Ukudumba kwamalungu kunye nokuqina kwawo.
• Intlungu yexesha elide.
• Ukwakheka kwezicubu ezibomvu.

Kubaluleke kakhulu ukuthetha nogqirha wakho ngale mingcipheko uze ubuze yonke imibuzo onayo.

Kuza kuthatha ixesha elingakanani ukuphola? Ndingenza ntoni?

Ixesha lokuchacha linokwahluka kumntu nomntu. Kuxhomekeke kwizinto ezininzi, kuquka uhlobo lwe-osteotomy oye wayenza, indlela yotyando, ubungakanani kunye nobunzima bomonakalo emathanjeni akho, amandla akho, kunye nokuzimisela kwakho ukuphiliswa.

Kuthatha ixesha ukuba ithambo liphole. Kuza kubakho iintlungu kwindawo yotyando, kwaye kuza kubakho ubuhlungu de inxeba liphole.

• Kusenokufuneka unxibe isamente, i-splint, okanye ii-crutches. Ezi ziya kunceda ekunciphiseni intshukumo yamathambo kunye namalungu, zinciphise ubunzima kwithambo elihlinzweyo, kwaye zivumele amathambo ukuba aphile kakuhle. Ezi zihlala zithatha iiveki ezimbalwa ukuya kwiinyanga ezimbini.
• Nokuba ufakwe isamente okanye i-splint, uya kufuna unyango lomzimba kwiintsuku ezimbalwa emva kotyando.Unyango lomzimba lonyusa amandla kunye nokuhambahamba kwamalungu akho.
• Ukuba wenze utyando edolweni okanye esinqeni, kusenokufuneka usebenzise iintonga kangangeenyanga ezimbalwa. Kuya kufuneka uqhubeke nonyango lomzimba ukuze ufumane amandla nokulinganisela.
• Ukuba ukhe wenziwa utyando lwemihlathi (i-jaw osteotomy), umhlathi wakho uya kuvalwa ngentambo kwaye uya kuhlala utya ukutya okumanzi kangangeeveki ezintandathu. Ukuba ukhe wenziwa utyando kubhontsi wakho omkhulu, awuyi kukwazi ukunxiba izihlangu okanye ukuqhuba imoto kangangeeveki ezimbini ukuya kwezintandathu.

Ungayinceda njani inkqubo yokuphiliswa?

Nawe unokunceda ngeli xesha lokuphiliswa.

• Musa ukutshaya: I-Nicotine iyayicothisa inkqubo yokuphiliswa kwaye inokuphazamisana nokuphiliswa kwamathambo ngendlela efanelekileyo. Ngoko ke, kuphephe ukutshaya ngokupheleleyo .
• Yitya ukutya okunempilo nokulungileyo: Yitya ukutya okunesondlo, okufana nokutya kwaseMeditera, kunye nemifuno neziqhamo ezininzi.
• Landela imiyalelo kagqirha wakho ngokuchanekileyo.
• Gcina ubunzima bakho busempilweni.

Zeziphi iziphumo ezinokulindelwa?

Iziphumo ozifumanayo ziya kuxhomekeka kwizinto ezifana nempilo yakho ngokubanzi, ubunzima bengxaki yakho yamathambo, utyando oluthile olwenzileyo, kunye nobuchule bogqirha wakho. Ugqirha wakho uza kuthetha nawe ngotyando oza kulufumana kunye nento omawuyilindele emva kotyando. Ungaze ungathandabuzi ukubuza ugqirha wakho imibuzo okanye wabelane naye ngayo nayiphi na inkxalabo okanye uloyiko onalo.

Kukho iintlobo ezininzi ezahlukeneyo ze-osteotomy kunye nezinye iinkqubo zotyando zokulungisa nokulungisa amathambo kunye namalungu. Ugqirha wakho uza kuthetha nawe ngengxaki yakho ethile yethambo okanye amalungu kunye neendlela ezikhoyo. Ngokuxhomekeke kuhlobo lwengxaki yakho yethambo, ungaqale unyangwe ngonyango olungelulo utyando (unyango olulondolozayo). Ezi zinokubandakanya ukuphumla, umkhenkce, amayeza okulwa nokuvuvukala kunye neentlungu, kunye neenaliti ze-corticosteroid. Ukuba olu nyango aluzilawuli iingxaki zakho zamalungu, okanye ukuba unesifo esingenakunyangwa, khumbula ukuba ugqirha wakho wamathambo ukhona ukukunceda. Baneendlela zotyando zokuphucula ukuhamba kwakho kunye nokunciphisa iintlungu kunye nokungonwabi kwakho.

Ezona zinto zibalulekileyo ekufuneka uzikhumbule kweli nqaku

Ngoko ke, kuqhelekile ukuziva usoyika kancinci xa ucinga ngotyando lwe-osteotomy. Nangona kunjalo, le yinkqubo ebalulekileyo yezonyango enokuphucula umgangatho wobomi bakho, inciphise iintlungu, kwaye inike amathambo namalungu akho ubomi obutsha.

• Yiba nolwazi olupheleleyo: Thetha nogqirha wakho ngemeko yakho, utyando oza kulutyanda, izinto ezilungileyo nezingalunganga, kunye nexesha lokuchacha.
• Landela imiyalelo kagqirha wakho: Kubaluleke kakhulu ukuze uphile ngokukhawuleza ukulandela imiyalelo kagqirha wakho ngononophelo, ngaphambi nasemva kotyando.
• Yiba nomonde: Kuthatha ixesha ukuba amathambo aphile. Ngeli xesha, yenza izinto ezifana nonyango lomzimba ngokufanelekileyo kwaye uhlale uqinile.
• Kuphephe ukutshaya: Le yinto omele uyenze ngokuqinisekileyo.

Ukuba uneminye imibuzo malunga noku, ungoyiki ukubuza ugqirha wakho. Bakhona ukukunceda.

I- Osteotomy, utyando lwamathambo, utyando lwamathambo, utyando lwamalungu, utyando, ukukhubazeka kwamathambo, iintlungu zamalungu