Mafambi asina kujeka Anotapira muzvigaro zvavo
Majoka akabatanidzwa ishamwari yakaoma inobvumira kufamba kuno kupfuura chero imwe nhengo muviri. Nokuti hubatanidzwa hune foni, hunogona kuva nemafungiro ekufambisa zvakare uye inowanzosunungurwa. Vanhu vane mafudzi avo vasingagari zvakasimba mukati memubatanidzwa vanonzi vane hutende husina kusimba.
Akabatanidzwa kusagadzikana ndiwo mamiriro apo bhora rebhokisi-ne-rakagadzikana mazamu rinobatanidzwa rinogona kubuda muhomwe.
Dzimwe nguva bhora rinouya chikamu chekubuda kunze kwechekeri, inonzi mapepa subluxation . Dzimwe nguva, bhora rinouya zvachose kunze kwechekeri, rinonzi mapepa dislocation .
Iko kune maviri maviri maitiro ehufudzi kusagadzikana:
- Kushungurudzika Kunetseka: Kusagadzikana kunetseka kunenge kuchiitika kana pane kukuvadzwa kwakanyanya pamapfudzi, zvakadai sokuwa kana mitambo yekuvaraidza. Mafudzi acho anobviswa zvakasimba kubva pachigadziko chawo, uye kazhinji anofanira kudzorerwa muchigaro nekugadzirisa zvakananga, dzimwe nguva achida anesthesia. Kushungurudzika kunoshungurudza kunowanzokonzera mitsetse iyo inobata bhora muhomwe uye inoita kuti fudzi riwedzere kubuda zvakare mune ramangwana.
- Multi-Directional Instability: Multi-directional instability (dzimwe nguva yakadhindurwa seMMI) inowanikwa apo musangano wepafudzi uri wakasununguka mukati mekona. Hapana chakaipa chinowanzokonzera kusagadzikana, asi pane iyo ffudzi ine chido chekuchinja zvakanyanya, zvichikonzera marwadzo mubato. Kakawanda, vanhu vane zviratidzo zvekunyengedza kwema-multi-direction kushungurudzika kwekuvhara, kana kushanduka, kwepafudzi nepamusoro-soro.
Zvinhu Zvitanhatu Zvokubatana Zvakagadzikana Kubatsira kune MDI
Pane zvinhu zvitatu zvinoita kuti ugadzikane hupi hupi huri mumuviri. Izvi zvinosanganisira:
- Bony Anatomy: Mapfupa epafudzi anobatsira zvikuru kuderera kwechibatanidzwa ichi. Ichekete iri isina kudzika, uye pasina dzimwe zvivako zvekubata mafudzi panzvimbo, bhora haringagari munzvimbo. Enzanisa izvi nekubatanidzwa kwechikafu, icho chine tambo yakadzika uye apo zvakaoma kubvisa bhora kubva mucheka.
- Staticzers Staticzers: Izvo zvakasimba zvinodzivirira ndiyo mitsipa inopoteredza sangano. Ligamende rinobatanidza mapfupa maviri pamwechete. Ligamende inoshanduka (vanogona kukotama), asi kwete elastic (havatauriri). Vanhu vane dambudziko rekunyanya kushungurudzika vanowanzobvarura mitsipa yejovo rwepafudzi. Vanhu vane mitemo yakasiyana-siyana vanowanzova vasina kusimba. Muzvokwadi, pane mararamiro emamiriro ezvinhu anogona kukonzera kusagadzikana kwakawanda kwekutenderera.
- Dynamic Stabilizers: Iyo inogadzirisa inoshandiswa ndiyo mitsipa nematoni zvakapoteredza fudzi. Tsvina idzi dzinosanganisira chikwata chinotenderera , boka remiviri yakakomberedza bhora refudzi. Dynamic stabilizers dzinogadziriswa, uye dzinodzikawo. Vanhu vazhinji vane hutsika hwakasiyana-siyana hunogona kusimbisa kusimba kwakasimba kunokonzera kusagadzikana kwemasimba.
Zviratidzo zvemafudzi akawanda anogadzikana zvinosanganisira kurwadziwa uye kuoma nemabasa ekumusoro. Vanhu vazhinji vane zviratidzo zvine chokuita nehutungamiri hwehutungamiri huzhinji hunobatanidzwa mumitambo inosanganisira kuwedzera kwekufamba, kusanganisira kushambira, gymnastics, uye softball. Vasikana vaduku ndivo vanowanzobatwa nehutano hwakasiyana-siyana.
Kurapa
Kurapa kweMMI kwakasiyana nekurapa kwekushungurudzika kunetseka kwefudzi.
Kazhinji kazhinji, vanhu vanogona kudzoka kubva pakusagadzikana kwakasiyana-siyana nekurapa kusina kurapa ; izvi zvinosanganisira vakwikwidzi-vhesi, vakwikwidzikwi.
Mishonga inofanirwa kuiswa pakusimbisa kusimba kwakasimba kwekubatana kwepafudzi. Mukuwedzera, vanhu vazhinji vane unhu hwakasiyana-siyana hunofungidzirwa vanofungidzirwa kuti vane mafungiro ane mafudzi-akangwara-kunyanya, mafambiro avo emapfudzi (mapepa) haatongorongedzwi nemafudzi avo. Nokudzokorora kugadzirwa kwemazuva ose, uye kusimbisa hutsika hunosimbisa kusanganisira hurumende yehutori, basa rekubatanidzwa pamwe chete rinowanzovandudza.
Kuongorora kwakasiyana-siyana kwakaratidza kuti huwandu hwevarwere hunosimbiswa hunokwanisa kupora kubva kune hutungamiri huzhinji husina kusimba nehurongwa hwekugadzirisa mapepa. Inenge 85% yevarwere vanoenda purogiramu yakadaro vachapa mhinduro yakanaka. Kune vamwe vanhu vanokundikana kuvandudza uye vanogona kuguma vachivhiyiwa.
Surgery
Kugadziriswa kweMMI kunofungidzirwa kune varwere vane zviratidzo zvinoramba zvichiitika zvepfudzi rinobuda muchigadziko, pasinei nekurapa kwenguva refu isiri kurapwa. Kazhinji kazhinji, kuvhiyiwa kunosanganisira kusimbisa miviri inopoteredza fudzi. Vamwe vanachiremba vanosarudza kuita izvi arthroscopically, uye vamwe kuburikidza nehutano hunoshandiswa hwekuvhiya .
Pasina nguva refu yapfuura, yakange yakakurumbira kuita chirongwa chinonzi thermal shrinkage, uchishandisa kupisa kwemafuti kuti zvive nehutu-tissue mufudzi kuti usimbise joko capsule. Iyi nzira yekupisa inopisa yakaratidza kuva nemigumisiro yakaipa kwazvo, uye kazhinji yaida kurapwa kwakanyanya.
Kuvhiya kwakanakisisa kwekutenderera kwemashoko akawanda kune maitiro e capsular shift kana capsular plication, iyo ndiyo nzira mbiri iyo inomisa sopule yepafudzi. Mukuwedzera, vamwe vanachiremba vanoita chiratidzo chekuvhara nguva, iyo nzira inovhara kusiyana pakati pematanda emutambo we rotator.
Rehab mushure mekuvhiyiwa kwehutano hwakasiyana-siyana hunowanzotora mwedzi yakawanda. Pakutanga, mushure mekuvhiyiwa, mafudzi haakwanisi kubvumira mishonga yakasimbiswa kuti iporeswe, uye zvino basa rinotanga kudzoka zvakare, rinotevera nekusimbiswa. Vatambi vakawanda vanobvumirwa kudzokerazve mabasa ose mukati memwedzi mitanhatu.
Kunobva:
Gaskill TR, et al. "Kutungamirirwa Kwemazuva Akasiyana-siyana Edzimba" J Am Acad Orthop Surg December 2011; 19: 758-767.