Ubuhlungu besihlakala? Kungaba yisimo lapho amathambo amabili esandleni eshelela khona (i-Scapholunate Dissociation)!

Ingabe ngezinye izikhathi uzizwa into engavamile noma ebuhlungu esihlakaleni sakho? Mhlawumbe lobu buhlungu buqale lapho uwe, uphakamisa into esindayo, noma udlala imidlalo. Esikhathini esiningi, sicabanga ukuthi, "O, kumane nje kuyisihibe." Kodwa ngezinye izikhathi, lokhu kungaba yisimo esidinga ukunakwa okwengeziwe. Yilokho esizokhuluma ngakho namuhla, isimo esenzeka esihlakaleni esidinga ukuhlolwa okujulile.

Kuyini lokhu kuhlukana kwethambo lesihlakala? (Ukuhlukaniswa kwe-Scapholunate)

Kalula nje, lokhu `(Ukuhlukaniswa kwe-Scapholunate)` kwenzeka lapho amathambo amabili amancane esihlakaleni sethu, ithambo le-`Scaphoid' kanye nethambo le-`Lunate', ehamba kancane eqhelile lapho kufanele abe khona, okudala igebe, noma 'igebe', phakathi kwawo. Ukuze kube sobala, la mathambo amabili axhumene nge-ligament enamandla kakhulu, esiyibiza ngokuthi i-`Scapholunate Interosseous Ligament (SLIL). Ngengozi ethile, ikakhulukazi lapho isandla sisontekile futhi siwa, le 'ligament' ingadabuka. Yilapho ukuxhumana phakathi kwamathambo amabili kukhululeka khona, futhi aqala ukuhambahamba. Uma usebenzisa isihlakala sakho, la mathambo amabili ayasuka komunye nomunye, noma 'ahlukane'.

Lokhu kufana nefindo eliboshwe ndawonye ngezintambo ezimbili. Uma nje ifindo liqinile, izintambo ezimbili ziyahlangana, kodwa njengoba ifindo likhululeka, izintambo ezimbili ziyahlukana.

Ubani onamathuba amaningi okuthola lesi simo?

Eqinisweni, lesi simo esibizwa ngokuthi `(Scapholunate Dissociation)` singenzeka kunoma ubani, kungakhathaliseki ubulili, uhlanga, noma inkolo. Kodwa-ke, ingozi enkulu kakhulu ilabo abawa ngezandla nangamadolo . Cabanga nje, uhamba emgwaqweni bese ushelela ngokuzumayo, bese sibeka izandla zethu phansi ngokuzenzakalelayo ukuze sizisindise. Yilapho-ke le ngozi ingenzeka khona kakhulu.

Sivame kangakanani lesi simo?

Njengoba singabona, uma sibheka ezinye iziphazamiso zesihlakala, lesi simo `(Scapholunate Dissociation)` singabonakala cishe ku-5% (`5%`) wezimo . Futhi, ezinye iziphazamiso endaweni yesihlakala, ikakhulukazi lezo zohlobo esizibiza ngokuthi ``distal radius fractures``, okungukuthi, lapho ithambo elikhulu esandleni liphuka eduze kwesihlakala, lingabonakala cishe ku-40% (`40%`) wezimo ezinalesi simo `(SL dissociation)` . Kukhona ezinye iziphazamiso ezikhethekile, njenge ``chauffeur fractures``, okuvame ukubonakala ngazo lokhu.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Njengoba ngishilo ngaphambili, imbangela eyinhloko yalokhu ivame ukuba "ukuwa ngesandla eseluliwe ". Uma sikhuluma iqiniso, uma uwa bese ubeka isandla sakho phansi bese usibeka isisindo, ingcindezi ingadabula i-"scapholunate interosseous ligament (SLIL)".

Ngaphandle kwalokho, kungase kube nezinye izizathu eziningana:

• Ukubamba isiteringi ngokuqinile ngesikhathi sengozi yemoto, njengemoto: Lo msipha ungalimala ngenxa yokushaya kwesandla ngesikhathi sokushayisana okungazelelwe.
• Ezinye izimo zofuzo: Isibonelo, izimo ezifana ne-'Hereditary Spastic Paraparesis'.
• Ukuxega kwe-Congenital Ligament: Abanye abantu bazalwa benemisipha exegayo emalungeni abo. Lokhu kungenzeka kakhulu nakubo.
• I-Rheumatoid Arthritis: Lesi yisifo esibangela ukuvuvukala kwamalunga. Lesi sifo singabangela nokuba imisipha ibe buthaka, okungaholela kulesi simo.

Ziyini izimpawu zalokhu? Kuzwakala kanjani?

Uma unesifo esibizwa ngokuthi "i-Scapholunate Dissociation", ngokuvamile uzobhekana nalokhu okulandelayo:

• Ubuhlungu ngemuva kwesihlakala, ikakhulukazi uma ubamba into ngokuqinile (`ukunyakaza okunamandla kokubamba`) : isibonelo, lapho uvula isivalo sebhodlela noma ubamba isibambo somnyango.
• Ubuthakathaka emandleni okubamba: Ukungakwazi ukubamba izinto ngokuqinile njengakuqala.
• Ukuvuvukala nobuhlungu obuzungeze isihlakala: Indawo ezungeze isihlakala iyavuvukala futhi ibuhlungu ukuyithinta.
• Ubuhlungu lapho welula isihlakala sakho: Kubuhlungu uma uphendula isandla sakho.
• Ngezinye izikhathi ungase uzwe umsindo "wokuchofoza" uvela esihlakaleni sakho.

Khumbula, lezi zimpawu azibonakali ngokufanayo kuwo wonke umuntu. Abanye abantu bazwa ubuhlungu obukhulu, abanye bazwa ubuhlungu obuncane. Ngakho-ke, uma uzwa into engavamile esihlakaleni sakho, kungcono ukubona udokotela.

Udokotela uhlonza kanjani lokhu?

Uma uya kudokotela, bazoqala bakubuze ngezimpawu zakho. Ube nobuhlungu isikhathi esingakanani, buqale kanjani, futhi buqala nini ukuba bubi kakhulu? Ngemuva kwalokho bazohlola isihlakala sakho ukuze babone ukuthi kukhona yini ubuhlungu, ukuvuvukala, noma ukuthamba.

Ngaphezu kwalokho, udokotela angenza izivivinyo ezifana nalezi:

• Ukuhlolwa Kokushintsha Kwe-Scaphoid: Kulokhu kuhlolwa, udokotela ubeka isandla sakhe phezu kwethambo lakho le-scaphoid bese enyakazisa isihlakala sakho. Lokhu kuhlolwa kuhlola ukuqina kwethambo le-scaphoid.
• I-X-ray: Lokhu kungabonisa ukuthi igebe lingakanani phakathi kwamathambo e-scaphoid kanye ne-lunate (igebe le-scapholunate). Ngokuvamile, leli gebe lingamamilimitha amabili (2 mm) noma ngaphansi. Kodwa-ke, uma kwenzeka ukuhlukana kwe-SL, leli gebe lingaba ngamamilimitha amahlanu (5 mm) noma ngaphezulu. Ngezinye izikhathi, ungabona into ebizwa ngokuthi "uphawu lwendandatho" ku-X-ray. Lokhu kungukungahleleki kahle kwethambo le-scaphoid.
• Ukuhlolwa kwe-MRI (Magnetic Resonance Imaging):I-MRI ingabonisa ngokucacile ukuthi i-scapholunate interosseous ligament (SLIL) idabukile yini. Ingathola isithombe esihle sezicubu ezithambile ezizungeze ithambo.
• I-Arthroscopy: Lokhu kuhilela ukwenza ukusika okuncane kakhulu nokufaka ikhamera (isikophu) kuyo ukuze ubheke ngaphakathi kwejoyinti. Lokhu kukuvumela ukuthi ubone umonakalo wemisipha ngokuqondile. Ngezinye izikhathi, ukwelashwa kungenziwa ngesikhathi esifanayo ne-arthroscopy.

Kuphathwa kanjani lokhu? (Ukwelashwa)

Uma welapha isimo esibizwa ngokuthi 'i-Scapholunate Dissociation', izinto zokuqala okufanele uzenze yilezi:

• Ama-analgesics: Imithi inikezwa ukunciphisa ubuhlungu.
• Ukugoba: I-splint ekhethekile isetshenziselwa ukuvimba isihlakala nesithupha. Lokhu kusiza imisipha eyonakele ukuthi iphole.

Ngemuva kwalokho, udokotela wakho cishe uzokudlulisela kuchwepheshe wezandla. Lesi simo sivame ukudinga ukuhlinzwa kwezandla zingakapheli amasonto ayisithupha ngemuva kokulimala.

Ngesikhathi sokuhlinzwa, uzonikezwa i-anesthesia ejwayelekile (okusho ukuthi uzobe ulele ngokuphelele), noma uzonikezwa i-anesthesia yesifunda (okusho ukuthi uzophelelwa amandla kuphela). Ngesikhathi sokuhlinzwa, udokotela uzokwenza okulandelayo:

• Kwenziwa ukusika okuncane ngemuva kwesihlakala.
• Izicubu ezonakele ziyasuswa futhi zihlanzwe.
• Bese, ukuze uvale igebe phakathi kwamathambo e-scaphoid namathambo e-lunate, okungukuthi, ukuhlanganisa amathambo amabili, usebenzisa into efana nomsipha othathwe kwenye indawo emzimbeni wakho, umthungo, noma isikulufu sensimbi.
• Ekugcineni, ukusikwa kuthungwa ndawonye.

Yini engingayenza ukuze nginciphise le ngozi?

Ukuze unciphise ingozi ye-`(Scapholunate Dissociation)`, into ebaluleke kakhulu ukuthatha izinyathelo zokuzivikela ekuweni. Ungenza izinto ezinjengalezi:

• Ukuzibandakanya ekuzivocavoceni okuthuthukisa ibhalansi, ukuxhumanisa, kanye namandla.
• Ukususa izingozi zokukhubeka ekhaya. Isibonelo, hlola izintambo ezikhululekile, ukukhanya okungekho kahle, kanye nokhaphethi.
• Uma kudingeka, sebenzisa ithuluzi lokusiza njengenduku noma i-walker.
• Ukugqoka izicathulo ezisicaba, eziqinile, nezibamba kahle.

Yini engingayilindela uma nginalesi simo? (Izinkinga)

Uma ungatholi ukwelashwa kokuhlukana kwe-SL ngokushesha, izinkinga ezinjengalezi zingavela:

• Ubuhlungu obungapheli: Ungase ube nobuhlungu obuqhubekayo esihlakaleni.
• I-arthritis yokuvuvukala: I-arthritis ingakhula ngokuvuvukala kwamalunga.
• Ukungazinzi kwamalunga: Ingalo ingase izwakale sengathi inyakaza ngokungalawuleki.
• Amandla okubamba anciphile: Ungase ungakwazi ukubamba izinto kahle.
• Iqakala le-Scapholunate Advanced Collapse (SLAC): Lesi yisimo se-arthritis esiwohlokayo esibangela ukuthi ilunga lesihlakala liguge. Lokhu kungaba buhlungu kakhulu.

Kuzongithatha isikhathi esingakanani ukuthi ngilulame uma nginayo (i-Scapholunate Dissociation)? (Outlook)

Uma uhlinzwa ngenxa yokuhlukana kwe-SL, kuzodingeka ufake i-cast amasonto ambalwa ngemva kwalokho. Ngemva kokuba udokotela eyisusile, ukwelashwa ngokomzimba kuzosiza isihlakala sakho ukuthi siphinde sithole amandla. Ngokwelashwa okufanele kanye nokwelashwa ngokomzimba, kufanele ukwazi ukubuyela emisebenzini yakho evamile zingakapheli izinyanga ezimbalwa.

Ngingazinakekela kanjani nge-Scapholunate Dissociation?

Ngemva kokwelashwa kokuhlukana kwe-SL, khuluma nodokotela wakho mayelana nezinhlobo zemisebenzi nokuzivocavoca ongazenza ngokuphephile. Kunezinhlelo ezithile zokuzivocavoca ezingakusiza ukuthi uthole amandla nobubanzi bokunyakaza esihlakaleni sakho. Ungalokothi weqe lokho udokotela wakho akutshela ukuthi ukwenze futhi wenze izinto ezinzima kakhulu esihlakaleni sakho.

Umlayezo Wokuya Nawe Ekhaya

Kulungile, ngakho-ke i-'Scapholunate Dissociation' esikhulume ngayo yilapho amathambo amabili amancane esihlakaleni, i-'Scaphoid' kanye ne-'Lunate', ephuma endaweni yawo, okwenza kube negebe phakathi kwawo. Imbangela enkulu yalokhu ukulimala kwe-'Ligament' exhumanisa la mathambo amabili. Lokhu kuvame ukwenzeka uma uwe nengalo yakho yeluliwe.

Izimpawu eziyinhloko ubuhlungu esihlakaleni, ukuvuvukala, ukuthamba, kanye nokuncipha kwamandla okubamba. Udokotela usebenzisa izivivinyo ezifana nokuhlolwa kwe-scaphoid shift, ama-X-ray, ama-MRI, kanye ne-arthroscopy ukuze athole lokhu.

Ukuhlinzwa kuvame ukuba yindlela engcono kakhulu yokwelapha. Ngokwelashwa okufanele kanye nokwelashwa ngokomzimba, abantu abaningi bangabuyela emisebenzini yabo evamile zingakapheli izinyanga ezimbalwa. Ngakho-ke, uma unobuhlungu obuqhubekayo noma ukungakhululeki esihlakaleni sakho, kubalulekile ukubona udokotela futhi uthole iseluleko kunokucabanga ukuthi kumane nje kuwukuklwebheka.

` Isandla, Ubuhlungu Besandla, Amathambo Esandla, Ama-Ligaments, Ukuhlukaniswa Kwe-Scapholunate, Ukuphuka, Ukuhlinzwa