Ake sifunde konke mayelana nokuhlinzwa kokuqondisa amathambo (i-Osteotomy) ngendlela elula!

Ingabe ngezinye izikhathi uyazibuza ukuthi ubuhlungu obuzwayo ezingxenyeni ezithile zomzimba wakho, ikakhulukazi amadolo akho, izinqe, noma umgogodla, bubangelwa ukungalungi kahle kwethambo noma ukuphuka? Udokotela wakho kungenzeka ukuthi ukutshelile ngokuhlinzwa okubizwa ngokuthi i-osteotomy. Kungaba yinto eyesabekayo ukuzwa ngalokhu. Kodwa uma wazi imininingwane, lokho kwesaba kunciphile kakhulu. Ngakho-ke, namuhla, sizokhuluma ngalokhu kuhlinzwa kalula?

Kalula nje, kuyini lokhu (i-Osteotomy)?

Kulungile, ukusho kalula nje, i-osteotomy inqubo yokuhlinzwa. Ihilela ukusika ithambo, ngezinye izikhathi ukwengeza ithambo elisha, bese ulishintsha noma ulibuyisele endaweni yalo efanele. Cabanga ngakho njengombazi osika ucezu lokhuni, alushintshe, futhi alunike isimo esisha, kodwa lokhu kwenziwa emathanjeni emzimbeni wethu.

Udokotela wakho ohlinzayo angenza i-osteotomy kunoma yiliphi ithambo emzimbeni wakho. Isibonelo, emhlathini wakho, endololwaneni, emgogodleni, ehlombe, esinqeni, edolweni, emlenzeni, ozwaneni, noma onyaweni. Ivame ukusetshenziselwa ukwelapha izinkinga emalungeni akho - lapho amathambo amabili ehlangana khona. Kunezinhlobo eziningi ezahlukene ze-osteotomy kanye namasu. Zivame ukuqanjwa ngodokotela ohlinzayo owasungula inqubo noma indlela ithambo elisikwa futhi libunjwe ngayo kabusha.

Kungani kwenziwa lokhu kuhlinzwa (kwe-Osteotomy)?

Manje ungase uzibuze, 'Kungani kufanele unqume amathambo kanje?' Kunezizathu eziningana.

• Lungisa i-engeli, ukugoba, noma ukujikeleza kwamathambo: Ngezinye izikhathi amathambo angaba yinto engafaneleki. Lokhu kuhlinzwa kusiza ukulungisa lokho. Cabanga ngakho, imilenze yabanye abantu ingase ifane nohlamvu u-O (bowlegs) noma uhlamvu u-X (knock-knees). Lokhu kusetshenziselwa ukulungisa izinto ezinjalo.
• Lungisa ilunga elikhubazekile noma elingahlelekile kahle: Amanye amalunga angazalwa enezinkinga ezincane, noma angakhubazeka ngenxa yenkinga ethile kamuva ekuphileni.
• Fushanisa noma welule amathambo: Akumangalisi yini? Yebo, kwezinye izimo le ndlela isetshenziswa futhi ukushintsha ubude bamathambo.
• Lungisa ilunga elilimele: Uma ilunga lonakele ngenxa yengozi noma esinye isizathu.
• Shintsha indawo ethwala isisindo yelunga: Cabanga ukuthi i-cartilage kolunye uhlangothi lwedolo lakho isigugile. Yilapho-ke uzwa khona ubuhlungu. Lokhu kuhlinzwa kungashintsha indlela esithwalwa ngayo isisindo bese kusiqondisa ohlangothini nge-cartilage enempilo. Lokho kuzonciphisa ubuhlungu.
• Nciphisa ubuhlungu obubangelwa yi-osteoarthritis: Lesi yisisombululo esihle sokunciphisa ubuhlungu obubangelwa yilesi sifo samalunga esiwohlokayo, ikakhulukazi emadolweni nasezinqeni.
• Ukuhlehlisa ukuhlinzwa kokushintsha amalunga kubantu abasebasha, abakhuthele: Kwabanye abantu abasebasha, i-osteotomy ibavumela ukuthi basebenzise amalunga abo isikhathi eside kunokuba bashintshe amalunga ngokushesha lapho amalunga eguga.
• Lungisa ezinye izinkinga ezithile zamathambo.

Yini okufanele ngiyenze ngaphambi kokuhlinzwa?

Ngaphambi kokuba wenze i-osteotomy, udokotela wakho ohlinzayo uzoyala ukuhlolwa okuningana ukuze ahlole impilo yakho jikelele. Lokhu kuvame ukufaka:

• Ukuhlolwa kwegazi: Lokhu kuhlola amazinga ezingxenye ezahlukahlukene egazini lakho nokuthi izitho zakho zangaphakathi zisebenza kanjani.
• Ukuhlolwa komchamo: Lokhu kungasiza ekunqumeni impilo yakho jikelele futhi kutholakale noma yiziphi izimo ezingase ziphazamise ukuphulukiswa kwamathambo, njengokutheleleka noma isifo sikashukela.
• Ukuhlolwa kwe-ECG (i-Electrocardiogram): Kuhlola ukusebenza kukagesi kwenhliziyo yakho.
• I-X-ray yesifuba: Ukuqinisekisa ukuthi amaphaphu akho asebenza kahle ngaphambi kokuhlinzwa.
• Ama-X-ray noma ama-CT scan: Lokhu kusetshenziselwa ukuhlela ukuhlinzwa ngokubheka amathambo/amalunga akho ngokucacile. Udokotela ohlinzayo udinga ukwazi kahle ubukhulu, ubude, ububanzi, kanye ne-engeli yethambo okufanele lisuswe. Ngezinye izikhathi kwenziwa imodeli ye-3D kusetshenziswa ikhompyutha ukuhlela ukuhlinzwa.

Kwenzekani ngokuvamile ngesikhathi sokuhlinzwa kwe-Osteotomy?

Okokuqala, uzonikezwa i-anesthesia. Lokhu kungenziwa ngezindlela ezahlukene:

• I-anesthesia yesifunda iwukunciphisa kuphela indawo lapho ukuhlinzwa kuzokwenziwa khona.
• Ukubulala izinzwa komgogodla.
• Ukukwenza ulale ngokuphelele (i-anesthesia ejwayelekile).
• I-anesthesia yendawo isetshenziselwa ukubulala izinzwa kuphela indawo lapho ukuhlinzwa kuzokwenziwa khona.

Udokotela uzokhetha indlela efanele kakhulu kuwe.

Okulandelayo, ithimba lokuhlinzwa lihlanza indawo ezungeze ukuhlinzwa ngesisombululo sokulwa namagciwane. Bese, indawo imbozwa ngendwangu yokuhlinzwa.

Udokotela ohlinzayo wenza i-incision esikhumbeni sakho. Basebenzisa izintambo eziqondisayo ukuphawula indawo yethambo okufanele isuswe (ngokuvamile ngesimo se-wedge, kodwa lokhu kuyahlukahluka kuye ngokuhlinzwa). Kusetshenziswa isaha elikhethekile lokuhlinzwa ukususa le ndawo yethambo ephawuliwe.

Ngemva kokususa ithambo eligulayo noma elonakele, isikhala siyavalwa ngokujoyina izingxenye ezisele zethambo kuzo zombili izinhlangothi. Kuye ngohlobo lwe-osteotomy onayo, i-bone graft ingafakwa endaweni lapho ithambo lisusiwe khona. Ngemuva kwalokho, kusetshenziswa amaphini, izikulufo, ama-staple, amapuleti, noma izinduku ukubamba ithambo lihlale endaweni yalo kuze kube yilapho liphola. Ezinye zalezi zingcezu zensimbi zingezesikhashana, kanti ezinye zihlala unomphela.

Yiziphi izinhlobo eziyinhloko zokuhlinzwa kwe-osteotomy?

Ukuhlinzwa kwe-osteotomy kungelapha izinkinga eziningi zamathambo namalunga. Ake sibheke ezinye zezinhlobo eziyinhloko.

Ukuhlinzwa kwe-Jaw osteotomy

Lokhu kuhilela ukuhlanganisa amathambo omhlathi wakho ongezansi (i-mandible) noma umhlathi ongaphezulu (i-maxilla) nekhanda lakho lonke kanye/noma amazinyo. Lokhu kungalungisa izinkinga ezifana nokuluma okuvulekile, ubunzima bokuhlafuna noma ukugwinya, ukuguguleka kwamazinyo ngokweqile, isilevu esibuyela emuva, ukulunywa ngokweqile, noma ukulunywa ngaphansi. Ungase udinge nezinsimbi zokubopha ngaphambi noma ngemva kokuhlinzwa ukuze uhlanganise amazinyo akho nomhlathi wakho.

• Ukuhlinzwa okwenziwa emhlathini ongezansi kubizwa ngokuthi i-mandibular osteotomy .
• Ukuhlinzwa okwenziwa emhlathini ongaphezulu kubizwa nangokuthi i-maxillary osteotomy .
• Kunezinqubo ezithile ezithile, isibonelo, i-LeFort osteotomy iwukuhlinzwa kokulungisa ukuphuka phakathi kobuso lapho umhlathi ongaphezulu uhlangana khona nethambo lomhlathi. I-sagittal split osteotomy uhlobo lokuhlinzwa komhlathi ukuhambisa umhlathi ongezansi ukuze uvumelane kangcono namazinyo.

Ukuhlinzwa kwesilevu

Lokhu kuhlinzwa kwenziwa ukushintsha ukuma kwesilevu. Ngokuvamile kwenziwa ukuze kwelulwe isilevu uma siphansi kakhulu, noma ukwenza isilevu esincane sibe sifushane. Lokhu kungashukumisa isilevu phambili noma ngendlela ehlukile. Ngezinye izikhathi lokhu kuyindlela engcono kunokufakelwa isilevu. Phakathi nalokhu kuhlinzwa, umhlathi wakho uyasikwa bese ushukunyiswa. Udokotela ohlinzayo wenza i-incision ngaphakathi komlomo. Ungase ulahlekelwe umuzwa ezindebeni zakho izinyanga ezimbalwa.

Ukuhlinzwa kwe-elbow osteotomy

Uma izinkinga nge-elbow joint zibangela izinkinga ngokuma kwengalo yakho engezansi, njengokuthi ingalo ilenga kakhulu emzimbeni (cubitus varus) noma ikude kakhulu nomzimba (cubitus valgus), lokhu kuhlinzwa kwenziwa ukuze kulungiswe izinkinga ezinjalo. Kunezinhlobo ezahlukene ze-osteotomy kuye ngenkinga.

Ukuhlinzwa kwe-osteotomy yomgogodla

Lokhu kuhlinzwa kwenzelwa ukulungisa amajika omgogodla. Amajika emvelo omgogodla wethu asiza ukugcina isikhungo somzimba samandla adonsela phansi phezu kwe-pelvis. Uma ijika engxenyeni eyodwa noma ngaphezulu yomgogodla likhula noma lincipha, umgogodla awuqondile. Lokhu kungabangela ubuhlungu, ukukhathala, kanye nengcindezi ezithweni zangaphakathi. Umgomo walokhu kuhlinzwa ukubuyisela ibhalansi emgogodleni, ukunciphisa ubuhlungu, nokuvimbela lesi sifo ukuthi singaphinde sibuye noma sibe sibi kakhulu.

• Isibonelo, esimweni esifana ne -Ankylosing Spondylitis , umgogodla ungagoba unomphela phambili futhi isilevu singathinta isifuba. Lokhu kuhlinzwa kungabhekwa njengokulungisa izinkinga ezinjalo ze-angular.
• Kunezinhlobo eziningana eziyinhloko:
• I-osteotomy yekholomu engemuva: Lokhu kudala i-lordosis emhlane ongezansi kanye ne-kyphosis emhlane ongaphezulu. I-Ponte osteotomy iyindlela ekhethekile esetshenziselwa ukulungisa i-kyphosis.
• (Ukuhlinzwa kwamathambo kukaSmith-Petersen):Lena inqubo ekhethekile esetshenziselwa ukulungisa i-lordosis. Ingcezu yethambo isuswa ngemuva komgogodla bese umgogodla uthambekela emuva.
• Ukuhlinzwa kwe-Pedicle subtraction osteotomy: Lokhu kudala i-inner curve eqinile (i-lordosis) emhlane ongezansi.
• (Ukuhlinzwa kwethambo-idiski-ithambo): Lokhu kuhilela ukudala ithambo ngaphezulu nangaphansi kwediski phakathi kwamathambo omgogodla. Ngesikhathi sokuhlinzwa, idiski kanye nama-endplate ayo aseduze kuyasuswa.
• (Ukususwa kwekholomu yomgogodla): Kulokhu, i-vertebrae eyodwa noma ngaphezulu isuswa ngokuphelele. Lokhu kungenza ukulungiswa okubaluleke kakhulu. Ngenxa yokuthi inani elikhulu lamathambo liyasuswa, udokotela ohlinzayo ugcwalisa le ndawo nge-bone graft noma ikheji lensimbi.

Ukuhlinzwa kwe-hip osteotomy

Lokhu kuhilela ukubumba kabusha ikhanda lakho le-acetabulum noma le-femur. Leli yilungu lesinqe eliyi-ball-and-socket esinqeni sakho. Udokotela ohlinzayo usika, abumbe, noma asuse ithambo kancane ukuze alungise izindawo ezithwala isisindo selungu.

• Izinhlobo eziyinhloko:
• Ukuhlinzwa kwe-Periacetabular osteotomy: Lokhu kwenzelwa ukulungisa i-hip dysplasia, isimo lapho i-hip socket ingambozi ngokuphelele ibhola lethambo lethanga. Ngesikhathi sokuhlinzwa, ingxenye yethambo lethanga iyasikwa, ibekwe kabusha, futhi iboshwe ngezikulufo.
• Ukuhlinzwa kwe-Femoral osteotomy: Lokhu kuhilela ukusika nokubumba kabusha ithambo lethanga elingaphezulu (i-femur) ukusiza ukubuyisela ukusebenza kwe-hip.

Ukuhlinzwa kwamadolo

Ukuhlinzwa kwe-osteotomy kuhilela ukusika nokushintsha elinye lamathambo amabili atholakala ngaphansi kwe-kneecap - kungaba yi-tibia noma i-femur. Lokhu kuvame ukwenziwa ukulungisa umonakalo obangelwe yi-arthritis. Lokhu kuhlinzwa kulungisa kabusha ijoyinti ledolo, kushintsha isisindo kanye nokucindezela kusuka ohlangothini olulimele lwedolo kuye ohlangothini oluphilile. Ukuhlinzwa kwe-osteotomy yedolo kuvame ukwenziwa ezigabeni zokuqala ze-osteoarthritis, lapho umonakalo ungohlangothi olulodwa lwedolo.

• Indawo yokuhlinzwa kwe-osteotomy incike endaweni yomonakalo. Isibonelo, ku -osteotomy ephezulu ye-tibial , uma umonakalo we-cartilage ungaphakathi kwedolo, ucezu lwethambo olufana ne-wedge luyasuswa ngaphandle kwedolo, noma ithambo livuleke ngendlela efana ne-wedge ngaphakathi kwedolo. Lokhu kuqondisa umlenze futhi kuvimbele i-arthritis ukuthi ibe yimbi kakhulu.
• Ezinye izinhlobo zedolo (i-Osteotomy):
• Ukuhlinzwa kwe-Tibial osteotomy: Lokhu kudala ukuhlangana kwe-bowlegged okubeka ingcindezi enkulu ngaphakathi kwedolo.
• Ukuhlinzwa kwe-high tibial osteotomy: Lokhu kusetshenziselwa ukulungisa idolo kubantu abane-arthritis yamadolo. Lokhu kuhlinzwa kungavimbela noma kubambezele isidingo sokufakwa kwedolo eliyingxenye noma eliphelele.
• (Ukuhlinzwa kwe-Fulkerson osteotomy):Lena inqubo ekhethekile. Ingxenye yendawo ethile ye-tibia (tibial tubercle) iyasuswa. Lokhu kushintsha indawo ye-kneecap tendon lapho inamathela khona kwi-tibia, kunciphisa ingcindezi ku-kneecap futhi kuvimbele ukuhlukana.

Ukulimala kwamathambo ezinzwane ezinkulu nezinyawo

I-hallux osteotomy inqubo ehilela ukususa ithambo kuzwane olukhulu bese liqondiswa. I-calcaneus osteotomy inqubo eshintsha unyawo ukuze lulungise izinyawo ezisicaba noma izinyawo nge-arch ephakeme kunokuvamile.

• Izindlela eziningana ezithile (i-Osteotomy) zokwelapha izinkinga zezinyawo:
• Ukuhlinzwa kwe-Chevron ne-Akin: Lokhu kuhlinzwa kulungisa ukukhubazeka okuncane kuya kokuphakathi kozwane olukhulu okubangelwa ama-bunion (i-hallux valgus).
• (Dwyer osteotomy): Lokhu kubumba kabusha unyawo ukuze kuncishiswe i-arch ephezulu ngendlela engavamile.
• (Weil osteotomy): Lokhu kulungisa izinzwane zezinzipho kanye nobuhlungu ngaphansi kwebhola lonyawo lwakho.
• (Ukuhlinzwa kwe-Cotton osteotomy): Lokhu kusiza ekwakheni i-arch onyaweni.

Ziyini izingozi zalokhu kuhlinzwa?

Njenganoma yikuphi ukuhlinzwa, i-osteotomy ingaba nezingozi ezithile. Kodwa ungakhathazeki, odokotela benza konke okusemandleni abo ukunciphisa lezi zingozi. Izingozi eziyinhloko yilezi:

• Izinkinga nge-anesthesia.
• Ukutheleleka.
• Amahlule egazi.
• Ukulimala kwemizwa noma kwemithambo yegazi.
• Kulungile ukuthi amathambo angahlali kahle noma angapholi kahle uma ephola.
• Ukuvuvukala nokuqina kwamalunga.
• Ubuhlungu besikhathi eside.
• Ukwakheka kwezicubu zesilonda.

Kubaluleke kakhulu ukukhuluma nodokotela wakho ngalezi zingozi bese ubuza yonke imibuzo onayo.

Kuzothatha isikhathi esingakanani ukuphulukiswa? Kufanele ngenzeni?

Isikhathi sokululama singahluka kumuntu nomuntu. Kuncike ezintweni eziningi, okuhlanganisa uhlobo lwe-osteotomy owake wayenza, indlela yokuhlinzwa, ubukhulu kanye nobukhulu bomonakalo emathanjeni akho, amandla akho, kanye nokuzimisela kwakho ukuphulukiswa.

Kuthatha isikhathi ukuthi ithambo liphole. Kuzoba nobuhlungu endaweni yokuhlinzwa, futhi kuzoba nobuhlungu kuze kube yilapho inxeba liphola.

• Kungadingeka ugqoke i-cast, i-splint, noma izinduku zokusibekela. Lokhu kuzosiza ekunciphiseni ukunyakaza kwamathambo namalunga, kunciphise isisindo ethanjeni elihlinzwe, futhi kuvumele amathambo ukuba alulame kahle. Lokhu kuvame ukuhlala kusukela emavikini ambalwa kuya cishe ezinyangeni ezimbili.
• Ngisho noma ufakwe i-cast noma i-splint, uzodinga ukwelashwa ngokomzimba zingakapheli izinsuku ezimbalwa uhlinzwe.Ukwelashwa ngokomzimba kwandisa amandla nokuhamba kwamalunga akho.
• Uma uhlinzwe edolweni noma esinqeni, kungase kudingeke usebenzise izinduku zokusibekela izinyanga ezimbalwa. Kuzodingeka uqhubeke nokwelashwa ngokomzimba ukuze ubuyisele amandla akho nokulinganisela.
• Uma uke wahlinzwa umhlathi (i-jaw osteotomy), umhlathi wakho uzovalwa ngentambo futhi uzohlala udla ukudla okumanzi cishe amasonto ayisithupha. Uma uke wahlinzwa ozwaneni lwakho olukhulu, ngeke ukwazi ukugqoka izicathulo noma ukushayela cishe amasonto amabili kuya kwayisithupha.

Ungayisiza kanjani inqubo yokuphulukiswa?

Nawe ungasiza ngalesi sikhathi sokuphulukiswa.

• Ungabhemi: I-Nicotine inciphisa inqubo yokuphulukiswa futhi ingaphazamisa nokuphulukiswa kwamathambo ngendlela efanele. Ngakho-ke, gwema ukubhema ngokuphelele .
• Yidla ukudla okuhle nokunempilo: Yidla ukudla okulinganiselayo, njengokudla kwaseMedithera, okunemifino nezithelo eziningi.
• Landela imiyalelo kadokotela wakho ngqo.
• Gcina isisindo esinempilo.

Yimiphi imiphumela engalindelwa?

Imiphumela oyitholayo izoncika ezintweni ezifana nempilo yakho iyonke, ubucayi benkinga yakho yamathambo, ukuhlinzwa okuqondile okwenzile, kanye nekhono likadokotela wakho ohlinzayo. Udokotela wakho uzokhuluma nawe ngokuhlinzwa ozokwenza nokuthi yini ongayilindela ngemva kokuhlinzwa. Ungalokothi unqikaze ukubuza udokotela wakho imibuzo noma ukwabelana nganoma yiziphi izinto ezikukhathazayo noma okwesabayo.

Kunezinhlobo eziningi ezahlukene zokuhlinzwa kwe-osteotomy kanye nezinye izinqubo zokuhlinzwa ukuze kulungiswe futhi kulungiswe kabusha amathambo namalunga. Udokotela wakho uzokhuluma nawe ngenkinga yakho ethile yamathambo noma yamalunga kanye nezinketho ezitholakalayo. Kuye ngohlobo lwenkinga yakho yamathambo, ungase uqale welashwe ngokwelashwa okungewona ukuhlinzwa (ukwelashwa okulondolozayo). Lokhu kungafaka phakathi ukuphumula, iqhwa, imithi yokulwa nokuvuvukala kanye nobuhlungu, kanye nemijovo ye-corticosteroid. Uma lokhu kwelashwa kungalawuli izinkinga zamalunga akho, noma uma unesifo esingelapheki, khumbula ukuthi udokotela wakho wamathambo ukhona ukukusiza. Banezinketho zokuhlinzwa zokuthuthukisa ukuhamba kwakho nokunciphisa ubuhlungu nokungakhululeki kwakho.

Izinto ezibaluleke kakhulu okufanele uzikhumbule kulesi sihloko

Ngakho-ke, kuvamile ukuzizwa wesaba kancane lapho ucabanga ngokuhlinzwa kwe-osteotomy. Kodwa-ke, lena inqubo ebalulekile yezokwelapha engathuthukisa ikhwalithi yempilo yakho, inciphise ubuhlungu, futhi inikeze amathambo namalunga akho impilo entsha.

• Yiba nolwazi oluphelele: Khuluma nodokotela wakho ngesimo sakho, ukuhlinzwa ozokwenziwa, izinzuzo nezinkinga zako, kanye nesikhathi sokululama.
• Landela imiyalelo kadokotela wakho: Kubaluleke kakhulu ukuze ululame ngokushesha ukulandela imiyalelo kadokotela wakho ngokucophelela, kokubili ngaphambi nangemva kokuhlinzwa.
• Bekezela: Kuthatha isikhathi ukuthi amathambo alulame. Phakathi naleso sikhathi, yenza izinto ezifana nokwelashwa ngokomzimba ngendlela efanele futhi uhlale uqinile.
• Gwema ukubhema: Lokhu kuyinto okufanele uyenze nakanjani.

Uma uneminye imibuzo mayelana nalokhu, ungesabi ukubuza udokotela wakho. Bakhona ukuzokusiza.

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