Intlungu yesandla? Isenokuba yimeko apho amathambo amabini esandleni etyibilika khona (iScapholunate Dissociation)!

Ngaba ngamanye amaxesha ukhe uzive into engaqhelekanga okanye ebuhlungu esihlahleni sakho? Mhlawumbi le ntlungu yaqala xa uwe, uphakamisa into enzima, okanye udlala imidlalo. Uninzi lwexesha, sicinga, "Owu, kukukruneka nje." Kodwa ngamanye amaxesha, le inokuba yimeko efuna ingqalelo engakumbi. Yiloo nto siza kuthetha ngayo namhlanje, imeko eyenzeka esihlahleni efuna ukuvavanywa nzulu kancinci.

Yintoni le nto ibangela ukuqhekeka kwethambo lesandla? (Ukuqhekeka kweScapholunate)

Ngamafutshane, oku `(Scapholunate Dissociation)` kuxa amathambo amabini amancinci esihlahleni sethu, ithambo le-`Scaphoid` kunye nethambo le-`Lunate`, ehamba kancinci kwindawo afanele ukuba kuyo, nto leyo edala umsantsa, okanye `umsantsa`, phakathi kwawo. Ngokuchanekileyo, la mathambo mabini adityaniswe yi-ligament enamandla kakhulu, esiyibiza ngokuba yi-`Scapholunate Interosseous Ligament (SLIL). Kwingozi ethile, ingakumbi xa isandla sijijekile kwaye siwa, le 'ligament' inokukrazuka. Kulapho unxibelelwano phakathi kwamathambo amabini luba lukhulu, kwaye aqala ukuhambahamba. Xa usebenzisa isihla sakho, la mathambo mabini ayasuka komnye komnye, okanye `ahlukane`.

Oku kufana neqhina elibotshelelwe ngeentambo ezimbini. Lo gama nje iqhina liqinile, iintambo ezimbini ziyadibana, kodwa njengoko iqhina likhululekile, iintambo ezimbini ziyahlukana.

Ngubani onokuba nethuba elikhulu lokufumana le meko?

Enyanisweni, le meko ibizwa ngokuba yi-`(Scapholunate Dissociation)` inokwenzeka nakubani na, nokuba yindoda okanye ngumfazi, uhlanga, okanye unqulo. Nangona kunjalo, ingozi enkulu ikwabo bawa ngezandla nangamadolo . Khawuthelekelele, uhamba esitalatweni uze ngequbuliso utyibilike, size sizibeke phantsi ngokuzenzekelayo ukuze sizisindise. Kulapho ke kunokwenzeka ukuba le ngozi yenzeke khona.

Ixhaphake kangakanani le meko?

Njengoko sinokubona, xa sijonga ezinye izihlunu zesandla, le meko `(Scapholunate Dissociation)` inokubonwa malunga ne-5% (`5%`) yeemeko . Kwakhona, ezinye izihlunu kwindawo yesandla, ingakumbi ezo zifana nohlobo esilubiza ngokuba yi-`distal radius fractures``, oko kukuthi, xa ithambo elikhulu esandleni liqhekeka kufutshane nesandla, linokubonwa malunga ne-40% (`40%`) yeemeko ezinale meko `(SL dissociation)` . Kukho ezinye izihlunu ezikhethekileyo, ezifana ``izihlunu zemoto``, ezihlala zibonwa ngazo.

Kutheni oku kusenzeka? Zithini izizathu?

Njengoko benditshilo ngaphambili, unobangela oyintloko woku kudla ngokuba "kukuwela esandleni esoluliweyo" . Ngokuchanekileyo, xa uwela uze ubeke isandla sakho emhlabeni uze ubeke ubunzima kuso, uxinzelelo lunokukrazula "i-scapholunate interosseous ligament (SLIL)``.

Ngaphandle koko, kunokubakho ezinye izizathu ezininzi:

• Ukubamba ivili lokuqhuba ngokuqinileyo ngexesha lengozi yemoto, njengemoto: Le ligament ingonakaliswa kukubetha kwesandla ngexesha lokungqubana ngequbuliso.
• Ezinye iimeko zofuzo: Umzekelo, iimeko ezifana ne-'Hereditary Spastic Paraparesis'.
• Ukungakwazi Ukuzala: Abanye abantu bazalwa benemisipha ekhululekileyo emalungeni abo. Oku kunokwenzeka nakubo.
• I-Rheumatoid Arthritis: Esi sisifo esibangela ukudumba kwamalungu. Esi sifo sinokubangela ukuba imisipha ibe buthathaka, nto leyo enokubangela ukuba kubekho esi sifo.

Zithini iimpawu zoku? Kuvakala njani?

Ukuba unesifo esibizwa ngokuba yi-"Scapholunate Dissociation", uza kuba nezi ngxaki zilandelayo:

• Intlungu emqolo wesandla, ingakumbi xa ubamba into ngokuqinileyo ('intshukumo yokubamba enamandla') : umzekelo, xa uvula isiciko sebhotile okanye ubamba isitshixo socango.
• Ubuthathaka ekubambeni: Ukungakwazi ukubamba izinto ngokuqinileyo njengangaphambili.
• Ukudumba nokuthamba okujikeleze isihlahla: Indawo ejikeleze isihlahla idumbile kwaye ibuhlungu ukuyichukumisa.
• Intlungu xa wolula isandla sakho: Ibuhlungu xa ujika isandla sakho.
• Ngamanye amaxesha unokuva isandi esithi "cofa" siphuma esihlahleni sakho.

Khumbula, ezi mpawu azibonakali zifana kuye wonke umntu. Abanye abantu bafumana iintlungu ezingaphezulu, abanye baziva zincinci. Ngoko ke, ukuba uziva into engaqhelekanga esihlahleni sakho, kungcono ukubona ugqirha.

Ugqirha uyixilonga njani le nto?

Xa usiya kugqirha, baza kuqala bakubuze ngeempawu zakho. Unexesha elingakanani unentlungu, iqale njani, kwaye iba mandundu nini? Emva koko baza kuhlola isihlathi sakho ukuze babone ukuba akukho ntlungu, ukudumba, okanye ukuthamba.

Ukongeza, ugqirha angenza iimvavanyo ezifana nezi:

• Uvavanyo lokuShintsha kweScaphoid: Kolu vavanyo, ugqirha ubeka isandla sakhe phezu kwethambo lakho le-scaphoid aze ashukumise isandla sakho. Olu vavanyo lujonga ukuqina kwethambo le-scaphoid.
• I-X-reyi: Oku kungabonisa ukuba likhulu kangakanani isithuba esiphakathi kwamathambo e-scaphoid kunye ne-lunate (isithuba se-scapholunate). Ngokwesiqhelo, esi sithuba simalunga neemilimitha ezi-2 (2 mm) okanye ngaphantsi. Nangona kunjalo, kwimeko yokuqhekeka kwe-SL, esi sithuba sinokuba ziimilimitha ezi-5 (5 mm) okanye ngaphezulu. Ngamanye amaxesha, ungabona into ebizwa ngokuba "luphawu lwendandatho" kwi-X-reyi. Oku kukungalungelelani kakuhle kwethambo le-scaphoid.
• Uvavanyo lwe-MRI (Magnetic Resonance Imaging):I-MRI ingabonisa ngokucacileyo ukuba i-scapholunate interosseous ligament (SLIL) ikrazukile na. Inokufumana umfanekiso olungileyo wezicubu ezithambileyo ezijikeleze ithambo.
• I-Arthroscopy: Oku kuquka ukwenza umngxuma omncinci kakhulu nokufaka ikhamera (i-scope) kuyo ukuze ijonge ngaphakathi kwilungu. Oku kukuvumela ukuba ubone umonakalo kwimisipha ngokuthe ngqo. Ngamanye amaxesha, unyango lunokwenziwa ngaxeshanye ne-arthroscopy.

Iphathwa njani le nto? (Unyango)

Xa unyanga imeko ebizwa ngokuba yi-'Scapholunate Dissociation', izinto zokuqala ekufuneka uzenze zezi:

• Ii-analgesics: Amayeza anikwa ukunciphisa iintlungu.
• Ukuqhawula: I-splint ekhethekileyo isetyenziselwa ukuthintela ukushukuma kwesandla nobhontsi. Oku kunceda imisipha eyonakeleyo ukuba iphilise.

Emva koko, ugqirha wakho usenokukuthumela kwingcali yezandla. Le meko idla ngokufuna utyando lwezandla zingadlulanga iiveki ezintandathu emva kokwenzakala.

Ngexesha lotyando, uya kunikwa i-anesthesia eqhelekileyo (oko kuthetha ukuba uza kube ulele ngokupheleleyo), okanye uya kunikwa i-anesthesia yengingqi (oko kuthetha ukuba uza kuba ne-namsi kuphela). Ngexesha lotyando, ugqirha uya:

• Kwenziwa umsikelo omncinci ngasemva kwesandla.
• Izicubu ezonakeleyo ziyasuswa zize zicocwe.
• Emva koko, ukuze uvale umsantsa phakathi kwamathambo e-scaphoid kunye ne-lunate, oko kukuthi, ukubuyisela amathambo amabini ndawonye, ​​usebenzisa into efana nomsipha othathwe kwenye indawo emzimbeni wakho, umthungo, okanye isikrufu sesinyithi.
• Ekugqibeleni, i-incision ithungwa kwakhona.

Ndingenza ntoni ukunciphisa lo mngcipheko?

Ukunciphisa umngcipheko we-`(Scapholunate Dissociation)`, eyona nto ibalulekileyo kukuthatha amanyathelo okuzikhusela ekuweni. Ungenza izinto ezinje:

• Ukuzibandakanya kwimithambo ephucula ulungelelwano, ulungelelwaniso, kunye namandla.
• Ukususa iingozi zokukhubeka ekhaya. Umzekelo, khangela ukuba akukho zintambo zikhululekileyo, ukukhanya okungekho kakuhle, kunye neekhaphethi.
• Ukuba kuyimfuneko, sebenzisa isixhobo sokuncedisa esifana nomsimelelo okanye isixhobo sokuhamba.
• Ndinxibe izihlangu ezithe tyaba, eziqinileyo nezibamba kakuhle.

Ndingalindela ntoni ukuba ndinayo le meko? (Iingxaki)

Ukuba awufumani unyango lokuqhekeka kwe-SL ngokukhawuleza, iingxaki ezinje ngezi zinokwenzeka:

• Intlungu engapheliyo: Usenokuba neentlungu ezingapheliyo esihlahleni.
• I-arthritis evuthayo: I-arthritis inokukhula ngokudumba kwamalungu.
• Ukungazinzi kwamalungu: Isandla singavakala ngathi sishukuma ngokungalawulekiyo.
• Amandla okubamba anciphile: Usenokungakwazi ukubamba izinto kakuhle.
• Iqatha le-Scapholunate Advanced Collapse (SLAC): Le yimeko ye-arthritis ewohlokayo ebangela ukuba ilungu lesihlakala liguge. Oku kunokuba buhlungu kakhulu.

Kuza kuthatha ixesha elingakanani ukuba ndiphinde ndiphile ukuba ndine (Scapholunate Dissociation)? (Outlook)

Ukuba utyando lokwahlukanisa i-SL, kuya kufuneka unxibe isamente iiveki ezimbalwa emva koko. Emva kokuba ugqirha eyisusile, unyango lomzimba luya kunceda isandla sakho siphinde sifumane amandla. Ngonyango olufanelekileyo kunye nonyango lomzimba, kuya kufuneka ukwazi ukubuyela kwimisebenzi yakho yesiqhelo kwiinyanga ezimbalwa.

Ndingazinyamekela njani nge-Scapholunate Dissociation?

Emva konyango lokuqhekeka kwe-SL, thetha nogqirha wakho malunga neentlobo zemisebenzi kunye nemithambo onokuyenza ngokukhuselekileyo. Kukho iinkqubo ezithile zokuzilolonga ezinokukunceda ufumane amandla kunye nomgama wokunyakaza esihlahleni sakho. Ungaze udlule koko ugqirha wakho akuxelele ukuba ukwenze kwaye wenze izinto ezinzima kakhulu esihlahleni sakho.

Umyalezo Wokuya Ekhaya

Kulungile, ngoko ke i-'Scapholunate Dissociation' esithethe ngayo kuxa amathambo amabini amancinci esihlahleni, i-'Scaphoid' kunye ne-'Lunate', ephuma endaweni yawo, nto leyo edala umsantsa phakathi kwawo. Eyona nto ibangela oku kukonakala kwe-'Ligament' edibanisa la mathambo mabini. Oku kwenzeka rhoqo xa uwe ngengalo yakho yoluliwe.

Iimpawu eziphambili ziintlungu zesandla, ukudumba, ukuthamba, kunye nokuncipha kwamandla okubamba. Ugqirha usebenzisa iimvavanyo ezifana novavanyo lwe-scaphoid shift, ii-X-ray, ii-MRI, kunye ne-arthroscopy ukufumanisa oku.

Utyando ludla ngokuba lolona nyango lubalaseleyo. Ngonyango olufanelekileyo kunye nonyango lomzimba, uninzi lwabantu lunokubuyela kwimisebenzi yabo yesiqhelo kwiinyanga ezimbalwa. Ke ngoko, ukuba unentlungu engapheliyo okanye ukungakhululeki esihlahleni sakho, kubalulekile ukubona ugqirha kwaye ufumane ingcebiso kunokuba ucinge ukuba kukukruneka nje.

Isandla , Intlungu Yesandla, Amathambo Esandla, Imisipha, Ukwahlukana Kwe-Scapholunate, Ukwaphuka Kwamathambo, Utyando