Capsular shift kana plication inotsigira fudzi
Akabatanidzwa kusagadzikana ndechiitiko chinogona kutungamirira kuendesa kana kuiswa pasi kwekubatana kwepafudzi. Izvi zvinoitika kana paine huwandu hwakawanda hwekubatana kwepafudzi, uye bhora rinogona kubuda muhomwe.
Pakati pese, kune zvikamu zviviri zvemafudzi kusagadzikana:
- Dambudziko Rakaomarara
Kushungurudzika kusagadzikana kwemafambi kunowanzoitika kakawanda mumitambo kana kukuvadzwa, zvakadai sokunge iwe wawa kana kuparara kwemotokari. Apo mafudzi acho akasunungurwa zvakasimba kubva pamubatanidzwa, mitsipa kana tete zvinogona kubvarura; iyo yakawanda inowanzovhiringidza muenzaniso mushure mekuparadzaniswa kwepafudzi kunonzi Bankart kuchema. Kushungurudzika kusagadzikana kwemafudzi kunowanikwa kune vanhu vane mararamiro akazara epamapfudzi ayo anosundirwa kure, achikonzera kukuvadza apo pfudzi inobva kunze.
- Multidirectional Instability (MDI)
Kuoma kwehuwandu hwehuwandu hwemashoko kune zvakasiyana nokuti hubatanidzwa hwepafudzi hwakasununguka, zvichiita zviratidzo pamwe nemabasa ezvisikwa. Bhabhi rako rinogona kusunungura kana kuisa pasi (pinda zvishoma kunze kwekubatana) uye kunyange mafambiro akareruka, kwete zviitiko zvinotyisa. Mumamiriro ezvinhu aya, kusagadzikana ndiro dambudziko guru, kwete kushungurudzika kana kukuvara.
Apo iwe unorwara uine unhu hwakasiyana-siyana hwemafudzi, iwe unowanzotanga kuedza kurapwa kwemashure. Kazhinji kacho, kurapa uku kunobatsira kudzivirira zvimwe zvikamu zvekusagadzikana kuburikidza nekusimbisa mitsipa yakakomberedza fudzi kuti iwedzere kubatanidzwa. Asi dzimwe nguva kuedza kwenguva yakareba kurapwa kungaramba kuchikundikana. Mune varwere, chirwere chepfudzi chinogona kukurudzirwa.
Rimwe Capsule Surgery
Iyo kapupa yepafudzi ndiyo envelopu inopoteredza musangano wepafudzi . Iine mamiriyoni akaenzana akareba zvikamu, kana ligaments, iyo inogadzirisa pfudzi.
Kazhinji, varwere vane unyanzvi hwakasiyana-siyana hwekutungamira hunova nehutano hwemitsipa uye kusununguka kwe capsule. Muchifupa chefudzi muvarwere ava chinorondedzerwa seine mapegi.
Kuvhiya kunogadzirisa kusagadzikana kwezvizhinji-chinangwa kunosungirirwa kusimbisa mitsipa uye kuderedza huwandu huwandu hwesapule yepafudzi.
Pakati pese, kune nzira mbiri dzokuvhiya nadzo dzinoita izvi. Kuvhiya kwechimiro kunowanikwa kuburikidza nekukanganiswa pamusoro pepamberi pefudzi, inonzi capsular shift. Imwe nzira yazvino ichangobva kushandiswa inoitwa arthroscopically , kuburikidza nekufungidzirwa zviduku nekubatsira kwekhamera inopindirwa muchibatanidzwa.
Vhura Capsular Shift
Chimwe chivharo chakasununguka ndechekuvhiya kwechirongwa chekare kunowanikwa kuti usimbise kubatana kwepafudzi. Muchiitiko ichi, kusungirirwa kunoitwa pamwe nechepamberi kwemajoini, uye musuru pamberi pefudzi, inonzi subscapularis ( chikamu chechikwata chinotenderera ), yakasununguka kuti chiregai chiremba wako aone mukati memubatanidzwa. Iyo capsule yefudzi ndiyo inowanikwa uye inoparadzaniswa; chikamu chepasi memapapule epafudzi chinogumburwa, uye ipapo kumusoro kunobviswa pasi kuti kuderedze ivhu rekubatanidzwa kwepafudzi.
Kubatsira kwemuitiro uyu ndeyekuti yakaedzwa uye ndeyechokwadi. Vanachiremba vane unyanzvi hwakanaka hwokufungidzira kuti vanosimbisa sei kubatana, uye vanogona kuderedza zvakanyanya ivhu remapapule epfudzi. Izvo zvakaderera ndezvokuti kupora ndeye kwenguva refu, muchidimbu nekuda kwechikwata chechikamu chemutambo we rotator .
Capsular Plication
Chinhu chikuru chinonzi chirwere chinoshandiswa arthroscopically.
Chiremba anovhiya akaisa kamera mubatanidzwa wepafudzi , uye kuburikidza nedzimwe zviduku zviduku zvinoshandisa sutures kuti "kubata" chikamu chepfudzi yepafudzi uye kuchichera icho pachako kuti chisimbise capsular tissue. Vamwe vanachiremba vanofunga kuti vanogona kuona migumisiro yebasa ravo zviri nani nekuona izvi kuburikidza nekamera, uye vanogona kunyanya kuisa sutures iyo inoshandiswa kusimbisa fudzi.
Ndeipi Yakanakisisa Yakapoteredza Kuvhiya?
Hazvisi pachena kana imwe yenzira idzi dzakanaka pane imwe; chisarudzo chingangodaro chinonyanya kuenderana nechinangwa chako chechiremba, sezvo vanachiremba vazhinji vachanzwa kuti vanogona kuita imwe yemitemo zvakanyanya kuvimbika.
Izvi hazvirevi kuti zvaanoda ndezvimwe zviri nani - zvinongoreva kuti ndiyo iyo chiremba wako anonyatsokwanisa kuita.
Tinoziva kuti imwe nzira, inonzi thermal capsular shrinkage - kana thermal capsulorrhaphy - haifaniri kuitwa. Iyi nzira, yakakurumbira muma1990 uye kunyange kusvika kuma2000, inoshandisa kupisa kwemafuro kuti iite cauterize uye inopisa capsule yefudzi. Zvimwe zvinokonzera zvakaipa zvakaguma nekuvhiyiwa uku, saka thermal capsular shrinkage haisati yakurudzirwa.
Sources:
Gaskill TR, et al. "Kutungamirirwa Kwemazuva Akasiyana-siyana Edzimba" J Am Acad Orthop Surg December 2011; 19: 758-767.