Ukuphuka kwamadolo ukulimala kanzima okubandakanya amathambo amane abandakanyeka ekwakheni lelijoyinti. I-pathology isakazeke phakathi kwamantombazane nabesilisa abangaphezu kweminyaka engama-20. Ama-fracture amadolo abika cishe i-10% yenani eliphelele lokulimala kwemisipha.
Izinhlobo
Ukusebenza kokwelapha okunqunyiwe kuncike ekuhlolweni okulungile nasekuzimiseleni kohlobo lokulimala. Ukwahlukana yilezi:
- Vula. Zihambisana nomonakalo wobuqotho besikhumba.
- Kuvaliwe. Isikhumba asilimele.
Ukwephuka kwamadolo okuvulekile kuhlotshaniswa nengozi enkulu yokutheleleka nokulahleka kwegazi okunzima. Ukushoda kosizo lokuqala olufike ngesikhathi kungaholela ekufeni kwalowo ohlukunyeziwe.
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Ukuqhekeka kwamadolo kwe-intra-articular yilawa:
- ngokufuduswa kwezicucu;
- akukho offset.
Ngokuya ngesikhundla sezingxenye ze-patella, ukulimala kuhlukaniswa kwaba:
- Osteochondral. Ingxenye encane ye-patella ihlukanisiwe.
- Kuvundlile. Ukuphula ithambo kabili.
- Ama-splinters amaningi. Ithambo liphihlizwa laba yizicucu eziningana.
- Kuqondile. Indebe iyabhidlika.
Ngokuya ngendawo yezingcezu zamathambo eceleni kwe-eksisi, ama-fractures yilezi:
- Ngokususwa kwezingcezwana. Ukungenelela kokuhlinzwa kuyadingeka.
- Akukho ukukhetha.
- Ukucindezela. Ithambo licindezelwe phakathi.
Ubukhulu bokulimala okushiye indawo yokuhlala buxhomeke kakhulu ekuguleni. Uma isisulu singenazinkinga ngamathenda, ukufuduswa kwe-shrapnel kungagwenywa.
Ukwephuka okudala kudinga ukwelashwa nokuvuselelwa okude kunokuqhekeka okuyisisekelo.
Izizathu
Ukulimala kwamadolo kuvame kakhulu kubagijimi abangochwepheshe ngenxa yokuxineka okukhulu okuqhubekayo emadolweni. Lokhu kulimala kuvamile nakwabadala ngenxa yokuwohloka okuhlobene nobudala kwezicubu ezihlangene.
Izimbangela ezinkulu zokuphuka kwamadolo yilezi:
- ukushaya okukhulu kwe-patella noma ukucindezela ngokweqile emadolweni;
- uwe emlenzeni ongezansi ogobeke edolweni.
Ukwephulwa kobuqotho bamadolo kungenzeka ngenxa yokuqina okuqinile kwamathenda, okudala ukuqhuma kwezinsimbi zomzimba nezethambo zesifunda se-patellar.
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Izimpawu
Ukubonakaliswa okulandelayo komtholampilo kuyisici sokuqhekeka kwamadolo:
- ubuhlungu obukhulu;
- ukuvuvukala kwezicubu eziseduze;
- hematoma;
- ukusonteka kokuhlangana kwamadolo, ngenxa yokushintshwa kwamathambo;
- ukuphuka esikhunjeni;
- ukwephulwa kokusebenza kokuhlanganyela kanye nemikhawulo yokuhamba;
- ukwanda kwezinga lokushisa.
Ukuqashelwa kokulimala kusekelwe ekubambeni noma ekuhlolweni kwesithombe se-X-ray lapho kubonakale khona umonakalo. Ezinsukwini ezimbalwa ngemuva kokulimala, idolo liphenduka libe luhlaza okwesibhakabhaka, kanti i-hematoma isakazeka onyaweni.
Lesi simo sithathwa njengesijwayelekile ngedolo eliphukile, aludingi ukwelashwa okwengeziwe.
Uma kulimala idolo, kudingeka ukunakekelwa ngokushesha kwezokwelapha, ngoba ukwelashwa okungafanele kungadala izinkinga ezinkulu. Akunakwenzeka ngokuphelele ukuzelapha.
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Insiza yezimo eziphuthumayo
Isisulu esaphuke idolo sidinga usizo lwezempilo olufanele. Ngakho-ke, umsebenzi wokuqala wabantu abaseduze ukulethwa okuphuthumayo kwesiguli esikhungweni sokuhlukumezeka esiseduze.
Ukunciphisa ubungozi bezinkinga ezikhona, isiguli sidinga usizo lokuqala olusezingeni eliphezulu endaweni yesehlakalo:
- Ngokuphuka okuvulekile, ukuphuma kwegazi kumisiwe nge-aseptic bandage ne-tourniquet. Uma kunesidingo sokuhambisa isisulu isikhathi eside, i-tourniquet isuswa njalo ngemizuzu engama-40 ngenkathi yasebusika nangemva kwemizuzu engama-90 ehlobo.
- Lapho kuvaliwe: isitho esilimele asinamandla, kufakwa icompress ebandayo bese ilungiswa ngentambo.
Noma yiluphi uhlobo lokuphuka ludinga ukukhululeka kobuhlungu obuphezulu.
Ukuzinciphisa izingcezu akuvunyelwe nakancane. Isenzo esinjalo siyalimaza isiguli futhi sisenza sibe sibi isimo saso.
Ukwelashwa nokuvuselelwa
Ukwelashwa kokulimala emadolweni kungumsebenzi kadokotela ohlinzayo wamathambo. Ukwelashwa kungenziwa ngokulondolozwa noma ngokuhlinzwa, ngokuya ngobukhulu bokulimala.
Ngokuphuka okuvaliwe, usimende usetshenziswa isikhathi esiyizinyanga eziyi-1.5 kuya kwezi-2. Uma kukhona ukulimala kwe-condyle, kwenziwa ukubhoboza ngaphambi kokuphonsa ukukhipha uketshezi emgodini we-articular of the joint. Ngesikhathi esifanayo, kwenziwa i-anesthesia. Ukuhlanganiswa kwedolo kusetshenziswa njengenye indlela yokufaka ukhonkolo.
Umlenze uphonswa esimweni lapho idolo ligobele ngaphakathi, cishe ama-5-7 degrees. Ungafaki ukhonkolo engxenyeni engezansi enwetshiwe ngokugcwele.
Uma kutholakala ukuphuka kwendawo, amathambo agudluliwe ayancishiswa ngaphansi kwe-anesthesia ejwayelekile. Ngemuva kwalokho, kufakwa ukhonkolo.
Uma ukulimala kukhuliswa ukuqhuma kwezicubu ezithambile nokuhlukaniswa kwezicucu ezisethanjeni, isiguli sidinga ukuhlinzwa.
Odokotela babuyisa amathambo ngezicucu, bawaqoqa endaweni yabo yokuqala. Izingxenye zamathambo ziboshelwe ndawonye namadivayisi akhethekile okuhlinza: izikrini, izinaliti zokunitha, amabhawodi, izikhonkwane zensimbi kanye namapuleti.
Ukhonkolo usetshenziswa ngemuva kokusebenza ngempumelelo. Inqubo yokubuyiselwa ngokuhlanganyela incike kuzimpawu zomuntu ngamunye zomzimba womuntu. Ukuphulukiswa kokuhlangana kwamadolo okuhambisana nokuqhekeka kwezicubu ezithambile kuthatha isikhathi eside kakhulu kunezinye izinhlobo zokuphuka.
Ukudonsa amathambo kuyindlela yokwelapha ephumelelayo. Kulokhu, kufakwa isondo engalweni elimele, isikhulumi siqhutshwa ngesithende, futhi umthwalo umiswa ekugcineni kwaso. Ngemuva kwezinsuku ezimbalwa, ukwelashwa kuyenezelwa ngokungezwani okulandelayo ngokusebenzisa izinsimbi eziseceleni, ezisetshenziswa ku-condyle nasemlenzeni ophansi.
Ukwelashwa kwezidakamizwa kuhloswe ngakho ukunciphisa isimo sesisulu nokuvikela izinkinga ezingaba khona. Ngokomyalelo kadokotela, kusetshenziswa la maqembu emithi alandelayo:
- Izinzwa zokubulala izinzwa. Ukudambisa izinhlungu.
- Imithi elwa namagciwane. Basiza ukuvimbela ukutheleleka kwezicubu ezilimele ngokulimala okuvulekile.
- Ama-analgesics. Isetshenziswa njengemithi ehambisanayo kuze kutholakale ubuhlungu.
- Ama-NSAID. Bayamisa inqubo yokuvuvukala.
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Ukuguqa kwamadolo
Kuyindlela ephumelelayo yokwenza ukhonkolo wendabuko. Ukuqhekeka kwamadolo kunezinzuzo eziningi:
- ukulungiswa okuthembekile kokuhlanganiswa kwamadolo;
- ukuhamba ngokunethezeka;
- impahla yokulungisa ukuguqulwa kwesitho;
- ukunciphisa umthwalo emlenzeni nokuqinisekisa isimo esizolile.
Lolu hlobo lwe-orthosis lungasetshenziselwa izinhloso ezahlukahlukene:
- ukulungisa umlenze;
- ukususa umthwalo;
- ukulungiswa kokushintshwa kokuma komlenze.
Ukuvuselelwa
Isikhathi sokululama singahluka kumuntu nomuntu. Ngokuphuka okuncane, umuntu uyalulama ezinyangeni ezingu-2-3. Ngemuva kokulimala kanzima, ukuvuselelwa kungathatha izinyanga eziyi-10 kuye kwezingu-12.
Ukuze kusheshiswe ukuphulukiswa, isiguli sinqunyelwe izinqubo:
- ukubhucungwa umzimba;
- ukwelashwa ngemagnet;
- UHF;
- izicelo zodaka;
- okugeza usawoti;
- i-electrophoresis;
- Ukuzivocavoca umzimba.
Lapho uthuthukisa idolo, umthwalo kufanele ukhuliswe kancane kancane ukuze ungaphazamisi ukulimala okuphindaphindiwe.
Kunconywa ukuzijwayeza ukuhamba ngokukhululeka futhi usebenzise ibhayisikili lokuzivocavoca.
Izinkinga nemiphumela
Ngemuva kokuhlinzwa, izinkinga zasendaweni kanye nezejwayelekile kungenzeka.
Izinkinga zasendaweni zifaka:
- Isilonda esithathelwanayo.
- Ukuvuselelwa.
Ngokwelashwa okufika ngesikhathi kosizo lwezokwelapha, akulona usongo empilweni yomuntu.
Inqubo yokuphulukisa yokulimala ihlolwe yi-radiography, engadala:
- i-bursitis;
- isifo samathambo;
- i-syndrome ebuhlungu engapheli emadolweni;
- ukuqina;
- kunciphise ukuqina kwezinto ezisetshenziswayo;
- imisipha yoma.
Izinkinga ezijwayelekile zingaholela esifo senhliziyo.
Ukuqapha kwezokwelapha kanye nezindlela eziyinkimbinkimbi zokwelashwa kanye nokuvuselelwa kunganciphisa ubungozi bezinkinga ezikhona futhi kusize ukubuyisa imisebenzi yamadolo.
