Ake sifunde ngqo nge-'Hill-Sachs Lesion' eyenzeka lapho ihlombe liphuma endaweni yalo!

Cishe uke wezwa othile ethi uphuke ihlombe lakhe, akakwazi ukuphakamisa ingalo yakhe, futhi usezinhlungwini ezinkulu, akunjalo? Mhlawumbe yilokho okwenzeka kuwe. Lapho ihlombe liphuke, okusho ukuthi ingxenye yehlombe efana nebhola iyaphuma, amathambo angaphakathi kwehlombe lethu nawo angonakala. Yilokho okushiwo yi-'Hill-Sachs Lesion' (ebizwa nangokuthi i-Hill-Sachs lesion). Ake sixoxe ngalokhu kalula nangokucacile.

Iyini le 'Hill-Sachs Lesion'?

Kalula nje, i-Hill-Sachs Lesion iyiqhubu elincane noma ukuphuka okwenzeka phezulu kwethambo lakho elingaphezulu lengalo (ithambo elide phezulu kwengalo elixhuma ehlombe - i-humerus), ikakhulukazi engxenyeni yalo efana nebhola (ikhanda le-humeral). Cabanga ukuthi uma uwisa ihlombe lakho, le ngxenye efana nebhola ikhuhla kanzima esokisini sejoyinti lakho lehlombe (isokisi le-glenoid). Yilapho ingxenye encane yaleli thambo ichotshozwa khona bese yakha ukugoba okuncane. Kufana nokugoba okuncane lapho i-apula liwela phansi.

Ubani onamathuba amaningi okuthuthukisa lesi 'Silonda saseHill-Sachs'?

Eqinisweni, noma ubani ongakhumuka ihlombe lakhe usengozini yokuthola lesi 'Silonda saseHill-Sachs'. Lokhu kungenxa yokuthi kwenzeka lapho ihlombe likhumuka engozini noma ekuweni. Kodwa-ke, kwabanye abantu, le ngozi iphakeme kancane.

• Kwabadlali: Ikakhulukazi labo abadlala imidlalo yokuxhumana, isibonelo i-rugby, ibhola lezinyawo, isibhakela.
• Kwabesilisa: Kuthiwa amadoda anamathuba okukhumuka kwamahlombe ngokuphindwe kabili kunabesifazane.
• Kwabancane abaneminyaka ephakathi kwengu-15 no-30: Abantu abakuleli qembu leminyaka banamathuba amaningi okubandakanyeka ezingozini ngoba bamatasa kakhulu.
• Kulabo abake bakhumuka ihlombe labo ngaphambili: Uma usukhumukile ihlombe lakho, cishe uzokhumuka futhi. Lokhu kungaholela ku-'Hill-Sachs Lesion'.

Sivame kangakanani lesi simo?

Ngokusho kwedatha yaseMelika, cishe abantu abayi-10 kwabayi-10000 bayakhumuka ihlombe labo minyaka yonke. Lokho kusho ukuthi akwenzeki kuwo wonke umuntu. Kodwa-ke, uma ukhumuka ihlombe lakho, amathuba okuba ne-'Hill-Sachs Lesion' abalulekile. Ezinye izifundo ziphakamisa ukuthi phakathi kuka-40% no-90% wabantu abakhumuka ihlombe labo bazoba nalokhu kulimala. Lokho kusho ukuthi uma ukhumuka ihlombe lakho, kufanele ucabange ngalokhu futhi.

Lesi 'Silonda saseHill-Sachs' sithinta kanjani umzimba wakho?

Esikhathini esiningi, i-`Hill-Sachs Lesion` iyodwa ayinawo umthelela omkhulu. Okusho ukuthi, ubuhlungu obuvela ekuqhekekeni kwehlombe kanye nokungakwazi ukuhambisa ingalo yizimpawu eziyinhloko. Kodwa-ke, uma le `Hill-Sachs Lesion` ikhona, lezo zimpawu zingase zibe zimbi kakhulu . Ubuhlungu bungase bube bubi kakhulu, futhi ubunzima bokuhambisa ingalo bungakhula.

Enye into ukuthi lesi 'Silonda saseHill-Sachs' singathatha isikhathi eside ukuba ihlombe lakho liphole. Futhi, uma isilonda sikhulu, kulapho kungenzeka khona ukuthi ihlombe lakho liphinde liqhume esikhathini esizayo. Ngokuhamba kwesikhathi, isifo samathambo kulelo hlombe singakhula.Kukhona futhi amathuba okuba nesifo samathambo ehlombe, okusho ukuthi ilunga seligugile.

Ziyini izimpawu ze-Hill-Sachs Lesion?

Izimpawu ze-'Hill-Sachs Lesion' zifana kakhulu nezehlombe eliphumile. Kodwa-ke, njengoba ngishilo ngaphambili, uma unalesi 'silonda', izimpawu zingase zibe zimbi kakhulu.

• Ukuzwa ubuhlungu obukhulu kakhulu .
• Ngizizwa ngibuthakathaka esandleni sami.
• Angikwazi ukuhambisa isandla sami.
• Ihlombe libukeka lihlukile , ngaphandle kwalapho lalikhona ngaphambili (njengokungathi liphumile).
• Kuvuvukala .
• Ungase ubone imivimbo noma izinguquko embala wesikhumba.
• Ukuqaqamba kwemisipha.
• Ungase uzizwe ungenamizwa, ubuthakathaka, noma ubuthakathaka esandleni sakho, entendeni yesandla, noma eminweni.

Okubalulekile: Uma ucabanga ukuthi ihlombe lakho liphuke, noma uma ube nengozi enkulu ehlombe lakho, hamba uye egumbini lezimo eziphuthumayo esibhedlela esiseduze ngokushesha. Ungalibali, ngoba kubaluleke kakhulu ukuthola ukwelashwa ngokushesha.

Yini ebangela lesi 'Silonda saseHill-Sachs'?

Imbangela eyinhloko ukukhumuka kwehlombe .

Cabanga ngale ndlela: ijoyinti lethu lamahlombe liyijoyinti eliyibhola nesokhethi. Ingxenye efana nebhola ephezu kwethambo lakho elingaphezulu lengalo (`iHumerus`) ivame ukuba ngaphakathi kwe-`socket` ethanjeni lehlombe (`iScapula`).

Manje, uma ihlombe lakho liphuma phambili (okungukuthi, liphuma ngaphambili komzimba wakho), ingxenye efana nebhola yethambo lengalo elingenhla, isokhethi, ingabhajwa esokhethini bese ihlikihla. Lokho kucindezela kubangela ukuthi ingxenye efana nebhola ilimale bese yakha 'isithonto'. Lokhu kubizwa ngokuthi 'i-Hill-Sachs Lesion'.

Izizathu eziyinhloko zokukhuhla amahlombe yilezi:

• Ukulimala kwezemidlalo - Cabanga ngokuwa ngenkathi udlala i-rugby, noma ukuntywila ngenkathi udlala ikhilikithi.
• Ukuwa - Lokhu kungenzeka ngokuwela phansi noma phansi ezitebhisini.
• Izingozi zezimoto - Lezi zinhlobo zezingozi zingabangela nokulimala emahlombe.

Odokotela bayibona kanjani i-'Hill-Sachs Lesion'?

Uma uya kudokotela onehlombe eliphumile, bazohlola ukuthi une-Hill-Sachs Lesion uma bekuxilonga.

Okokuqala, udokotela uzokwenza ukuhlolwa ngokomzimba kwengalo yakho nehlombe lakho. Bazobheka izindawo ezinobuhlungu, ukuvuvukala, nokuthi ungakwazi yini ukuhambisa ingalo yakho. Ngemuva kwalokho, bangenza izivivinyo ezithile zezithombe ukuze babone ukuthi kwenzekani ngaphakathi.

Kunjalo:

• Ukuhlolwa kwe-X-ray(`I-X-ray`): Lokhu kungasiza ekuhloleni indawo yamathambo, ukwaphuka, njll. Ngisho ne-`Hill-Sachs Lesion` ngezinye izikhathi ingabonakala ku-`X-ray`.
• Iskeni se-MRI (Magnetic Resonance Imaging): Lokhu kunganikeza umbono ocacile wezicubu ezithambile, njengemisipha, imisipha, imisipha, namathambo. I-MRI ibaluleke kakhulu ukuthola ubukhulu obuqondile kanye nokujula kwe-Hill-Sachs Lesion.
• Ukuskena kwe-CT (Computed Tomography): Lokhu kunganikeza nolwazi olunemininingwane eminingi ngamathambo. Ukuskena kwe-CT ngezinye izikhathi kusetshenziswa lapho kuhlelwe ukuhlinzwa.

Lezi ziskeni zingabona kahle indawo kanye nosayizi wokulimala kwethambo, okuwusizo olukhulu ekuhleleni ukwelashwa.

Ilashwa kanjani i-Hill-Sachs Lesion?

Uhlobo lokwelashwa oludingayo luncike ebangeni le-Hill-Sachs Lesion, okungukuthi, umonakalo ethanjeni.

Ngokuvamile, uma ikhanda le-humeral elingaphansi kuka-20% liphukile, akukho ukwelashwa okukhethekile okudingekayo. Kusetshenziswa ukwelashwa okuvamile kwehlombe eliphumile.

Ukwelashwa okungekona ukuhlinzwa

1. Ukunciphisa okuvaliwe:

Lokhu kuyinto ebaluleke kakhulu. Kusho ukubuyisela ihlombe lakho lapho lalikhona, esokhethini. Lokhu akusikho ukuhlinzwa. Udokotela uzobamba ihlombe lakho ngaphandle, alidonsele ngendlela efanele, bese elibuyisela ngaphakathi. Ngesikhathi wenza lokhu, ungase unikezwe umuthi wokubulala izinzwa wendawo (umuthi oqeda ubuhlungu endaweni kuphela) ukuze unciphise ubuhlungu, noma ungase unikezwe imithi yokudambisa (imithi ekwenza uzizwe uzolile kancane).

2. Ukungakwazi ukuhamba:

Ngemva kokuba ihlombe selibuyiselwe endaweni yalo, kungadingeka ukuthi ugqoke i-splint noma i-sling ukuze uligcine lisendaweni yalo. Lokhu kubizwa ngokuthi ukungasebenzi. Lokhu kuvumela ihlombe elilimele ukuthi liphumule futhi lisize liphole.

Udokotela angase akutshele ukuthi ufake iqhwa izikhathi eziningana ngosuku. Angase akutshele nokuthi wenze ezinye izivivinyo ukuze ihlombe lakho lingaqini noma liqandiswe (liqandiswe). Buza udokotela wakho ukuthi kufanele ugqoke i-sling isikhathi esingakanani nokuthi kufanele uvivinye umzimba ongakanani. Iningi labantu lidinga ukugcina ihlombe labo lingashukumi amasonto ambalwa.

3. Ukwelashwa ngokomzimba:

Njengoba ihlombe lakho liphola kancane kancane, thola amandla alo futhi ukwazi ukulihambisa kahle.Ukwelashwa ngokomzimba kuzoqala. Okokuqala, uzokwenza ukwelula okuncane ukuze ihlombe lakho likhululeke futhi lingabi nokuqina. Ngemuva kwalokho, udokotela wakho noma uchwepheshe wezokwelapha ngokomzimba uzokwengeza izivivinyo zamandla ukuze aqinise imisipha yakho kanye nemisipha. Lokhu kuzosiza futhi ukunciphisa ingozi yokukhumuka esikhathini esizayo. Abantu abaningi kuzodingeka benze ukwelashwa ngokomzimba izinyanga eziningana ngemva kokukhumuka.

Ukuhlinzwa Kwe-Hill-Sachs Lesion

Uma i-'Hill-Sachs Lesion', okungukuthi, inxeba lethambo, limboza ingxenye engaphezu kuka-20% yethambo lengalo engenhla ('ikhanda le-humerus'), okusho ukuthi inxeba likhulu, kungadingeka ukuhlinzwa ukuze lilungiswe.

Kunezinqubo eziningana zokuhlinzwa ezivame ukwenziwa:

• Inqubo yokubuyisela: Lokhu kuhilela ukugcwalisa isikhala esifana nomgodi esishiywe yi-Hill-Sachs lesion ngezicubu ezithambile eziseduze. Ngokuvamile, i-capsule kanye ne-tendon eduze kokulimala kwehlombe kuyasetshenziswa kulokhu.
• Ukufakelwa Kwamathambo: Kule nqubo, udokotela uthatha izicubu zethambo ezengeziwe azifake endaweni eyonakele ye-humerus ukuze azilungise. Lokhu ngezinye izikhathi kubizwa ngokuthi ukwandiswa kwamathambo.
• Ukufakwa esikhundleni samahlombe: Uma kunomonakalo omkhulu ku-humerus, i-scapula (i-shoulder blade), kanye nezinye izicubu ehlombe, kungase kudingeke ukufakwa esikhundleni samahlombe. Kulesi simo, udokotela ohlinzayo ususa izingxenye zehlombe ezonakele bese ezifaka izingcezu zokufakelwa esikhundleni sazo.

Kuthatha isikhathi esingakanani ukuphulukiswa?

Ngokuvamile kuthatha izinyanga eziningana ukululama ekulimaleni kwe-Hill-Sachs. Ihlombe lakho kuzodingeka lingasebenzi amasonto amaningana, kulandele izinyanga zokwelapha ngokomzimba.

Ukuthi kuthatha isikhathi esingakanani ukuthi inxeba lakho liphole kuncike ezintweni eziningana:

• Indlela ukulimala okwenzeke ngayo (njengokuwa noma ingozi yezemidlalo).
• Kungakhathaliseki ukuthi kukhona okunye ukulimala noma umonakalo ngaphakathi kwehlombe (njengokuqhekeka kwemisipha noma umonakalo we-labrum).
• Uhlobo luni lokwelashwa obeludinga, noma uma kwadingeka uhlinzwe ?

Udokotela wakho noma udokotela ohlinzayo uzokunikeza isikhathi esithile sokululama ngenxa yokulimala kwakho, ngakho ungakhathazeki.

Ingabe lesi 'silonda saseHill-Sachs' singavinjelwa?

Njengoba ukukhumuka kwamahlombe amaningi kubangelwa izehlakalo ezizumayo njengokuwa kanye nezingozi zemidlalo, akukho lutho olungenziwa ngqo ukuvimbela lesi 'Silonda saseHill-Sachs'.

Kodwa-ke, kuwumqondo omuhle ukulandela lawa macebiso okuphepha ukuze unciphise ingozi yezingozi:

• Gqoka ibhande lesihlalo njalo uma ugibele imoto.
• Gqoka imishini yokuphepha efanele ngesikhathi somsebenzi kanye nemidlalo.(isib. isigqoko sokuzivikela, amahlombe).
• Gcina ikhaya lakho nendawo yakho yokusebenza icocekile futhi ingenazo izinto ezingabangela ukuthi wena noma abanye bawe. Qaphela izindawo ezishelelayo.
• Uma uthatha okuthile okuvela phezulu, sebenzisa njalo ithuluzi noma ithuluzi elenzelwe le njongo. Ungalokothi ukhwele ezihlalweni noma ematafuleni.
• Uma unenkinga yokuhamba noma usengozini enkulu yokuwa, sebenzisa induku noma i-walker.

Yini ongayilindela nge-'Hill-Sachs Lesion'?

Iningi labantu liyalulama ngokuphelele ekulimaleni. Ngisho noma uhlinzwa, kufanele ukwazi ukubuyela emisebenzini yakho eminingi evamile kanye nezemidlalo uma ihlombe lakho selipholile.

Kodwa-ke, uma usuphumile ehlombe lakho, unamathuba amaningi okulimala futhi. Ezinye izifundo zithole ukuthi abangaphezu kuka-90% babadlali abangaphansi kweminyaka engu-25 abaphumile ehlombe labo emdlalweni wokuxhumana bazophinde balimaze ihlombe elifanayo esikhathini esizayo.

Ngakho-ke, ngaphambi kokuthi uqale kabusha noma yimuphi umsebenzi womzimba - ikakhulukazi xhumana nezemidlalo - khuluma nodokotela wakho noma udokotela ohlinzayo. Bangachaza ukuthi yini ongayilindela nokuthi ungakuvimbela kanjani ukukhumuka kwemisipha esikhathini esizayo. Ukwelashwa ngokomzimba okufanele nakho kunganciphisa le ngozi.

Ingabe ngeke ngikwazi ukuya emsebenzini noma esikoleni ngize ngilulame?

Uma ungakwazi ukwenza umsebenzi wakho noma umsebenzi wesikole ngaphandle kokuhambisa ingalo yakho ngenkathi ihlombe lakho lingasebenzi, ungase ungakwazi ukuya emsebenzini noma esikoleni. Udokotela wakho uzokutshela ukuthi yiziphi izinyathelo nezikhundla okufanele uzigweme uze ululame. Landela leyo miyalelo ngokucophelela.

Kufanele ngiye nini egumbini lezimo eziphuthumayo?

Uma uke waba nengozi enkulu (ukulimala) , hamba uye egumbini lezimo eziphuthumayo ngokushesha.

Uma ucabanga ukuthi ihlombe lakho liphumile:

• Iya ekamelweni lezimo eziphuthumayo noma ushayele ucingo ku-1990.
• Ungasishukumisi isandla sakho. Sigcine siseduze nomzimba wakho.
• Ungazami ukuhlela kabusha ihlombe lakho wena ngokwakho. Ungavumeli muntu ngaphandle kukadokotela ukuthi akwenze. Uma umuntu ongeyena uchwepheshe ezama ukuhlela kabusha ihlombe lakho, ungase ulimaze imithambo yegazi, imisipha, imisipha kanye nemizwa.
• Beka iphakethe leqhwa endaweni elimele. Lokhu kuzonciphisa ukuvuvukala nobuhlungu.
• Ama-painkiller (isib. i-paracetamol, noma ama-'NSAID' - Imithi engeyona eye-steroidal yokulwa nokuvuvukala, njengoba kunqunywe udokotela wakho) ingasiza ekunciphiseni ubuhlungu nezinye izimpawu. Kodwa-ke, ungaphuzi ngaphezu komthamo onconywayo.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma ubhekene nesimo esifana nalesi, kuwumqondo omuhle ukubuza udokotela wakho ngalokhu okulandelayo:

• Ingabe ngidinga ukuhlinzwa ukuze ngilungise i-Hill-Sachs Lesion yami? Uma kunjalo, hlobo luni?
• Kudingeka ngigcine ingalo yami ingasebenzi isikhathi esingakanani?
• Kufanele ngiqale nini ukwelashwa ngokomzimba? Kuzothatha isikhathi esingakanani?
• Ngizokwazi nini ukudlala imidlalo noma ukuzivocavoca futhi? Yiziphi izinto engingaziqala ngokuzenza?
• Yini engingayenza ukuze ngivimbele ihlombe lami ukuthi lingaphinde liqhume?

Uyini umehluko phakathi kwe-'Hill-Sachs Lesion' kanye ne-'Reverse Hill-Sachs Lesion'?

I-`Hill-Sachs Lesion` kanye ne-`Reverse Hill-Sachs Lesion` ziyizinhlobo ezifanayo zokulimala. Umehluko kuphela ukuthi ukulimala kukuluphi uhlangothi lwengxenye efana nebhola yethambo lakho elingaphezulu lengalo (`Humerus`) .

• I-'Hill-Sachs Lesion' iyiqhubu elivela ngemuva (ngokwezokwelapha, 'isici se-posterolateral') sengxenye efana nebhola yehlombe uma isunduzelwa phambili kusukela 'ohlangothini olungaphambili'.
• I-'Reverse Hill-Sachs Lesion' iyiqhubu elivela ohlangothini olungaphambili (ngokwezokwelapha, 'isici se-anteromedial') sengxenye efana nebhola yehlombe lapho iphonswa kusukela 'ohlangothini olungemuva'.

Zombili zixilongwa futhi zelashwa ngendlela efanayo.

Uyini umehluko phakathi kwe-'Hill-Sachs Lesion' kanye ne-'Bankart Lesion'?

I-`Hill-Sachs Lesion` kanye ne-`Bankart Lesion` ziyizinhlobo ezimbili zokulimala okuhlobene nokukhumuka kwehlombe. Kodwa-ke, zihlukile.

• I-`Hill-Sachs Lesion` iyisilonda sethambo esenzeka lapho ihlombe lakho lishelela phambili lisuka kolunye uhlangothi liya kolunye (ukuhlukana kwe-anterior glenohumeral), okubangela ukuba ikhanda lethambo lengalo engenhla (`humerus`) licindezelwe, okubangela iqhubu engosini yehlombe. Lokhu kusho ukuthi lokhu kuwukulimala kwethambo.
• I-'Bankart Lesion' iwukulimala kwendandatho ye-cartilage evikelayo ezungeze ijoyinti lehlombe (elibizwa ngokuthi i-'Labrum'). I-'Bankart Lesion' iwukudabuka kule 'Labrum'. Lokhu kungenzeka ngokuphuma noma ukunyakaza okuncane ('subluxation'). Uma ihlombe seliphumile, kungenzeka ukuthi liphinde lenzeke. Uma ihlombe liqhubeka nokuphuma noma 'subluxate', i-'Labrum' ingalimala kakhulu (njengokuphuma kwe-SLAP').

Ihlombe eliphumile lingaba yinto ebuhlungu kakhulu futhi eyesabekayo. Ukungakwazi ukuhambisa ingalo yakho ngokuzumayo, uzizwa sengathi ihlombe lakho alisekho lapho lalikhona, kuyinto eshaqisayo kakhulu. Ungalokothi uzame "ukulibopha" ihlombe lakho bese ulibuyisela ndawonye. Yiya ekamelweni lezimo eziphuthumayo ngokushesha bese ucela usizo lwezokwelapha ngokushesha okukhulu.

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Uma wake wahlukana nehlombe lakho kanye, kungakhathaliseki ukuthi une-Hill-Sachs Lesion noma cha, usengozini enkulu yokulilimaza kabusha esikhathini esizayo. Ngakho-ke, khuluma nodokotela wakho ngesikhathi sokululama kwakho. Ngaleyo ndlela, ungathola umbono ongcono wokuthi yini ongayilindela nokuthi ungayivikela kanjani ihlombe lakho.

Umlayezo Wokuya Nawe Ekhaya

Kulungile, ake siphinde sixoxe ngezinto ezibaluleke kakhulu esikhulume ngazo kule 'Hill-Sachs Lesion':

• Lokhu kwenzeka lapho ihlombe liphuma endaweni yalo , futhi ingxenye efana nebhola yethambo lengalo elingenhla (i-'humerus') ishaya i-socket ye-blade yehlombe, okubangela ukuba kwakheke ukuphuka okuncane okufana nokugoba ethanjeni.
• Inezimpawu ezifanayo nezokuphuma kwehlombe, njengobuhlungu obukhulu, ukungakwazi ukuhambisa ingalo, nokuvuvukala , kodwa ingaba nzima kakhulu.
• Ezimweni eziningi, ihlombe lingashintshwa, lingasebenzi, futhi liphathwe ngokwelashwa ngokomzimba ngaphandle kokuhlinzwa .
• Uma inxeba likhulu (ngaphezu kuka-20% wethambo), kungase kudingeke ukuhlinzwa .
• Into ebaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha uma ukhumuka ihlombe. Ungazami ukuzilungisa wena.
• Uma uqhuzuka ihlombe lakho kanye, cishe uzoqhuzuka futhi. Ngakho-ke, kubaluleke kakhulu ukulandela iseluleko sezokwelapha nokugcina ihlombe lakho liqinile.

Uma uneminye imibuzo mayelana nalokhu, ungesabi ukubuza udokotela wakho noma umbelethisi. Hlala uphilile!

Ukuqhekeka kwehlombe , Isilonda saseHill-Sachs, Isilonda saseHill-Sachs, ubuhlungu behlombe, ukuphuka kwamathambo, ukwelashwa kwehlombe, ukwelashwa ngokomzimba