Ukuqhekeka kwemisipha kunye nesiphene zizifo eziqhelekileyo, ezibangelwa kakhulu kukwenzakala okanye ukudumba, ukuze kubuyiselwe ukusebenza kwelungu, imisipha eqhekekileyo okanye enesiphene kufuneka ilungiswe ngexesha. Ukuthungwa kwemisipha yindlela yotyando eyinkimbinkimbi nethambileyo. Ngenxa yokuba imisipha yenziwe kakhulu ngemicu emide, isiphelo esiqhekekileyo sithambekele ekuqhekekeni okanye ekukhuleni kwemisipha ngexesha lokuthungwa. Imisipha iphantsi koxinzelelo oluthile kwaye ihlala ide imisipha iphole, kwaye ukukhetha imisipha kubaluleke kakhulu. Namhlanje, ndiza kwabelana nani nge-tendon ezili-12 eziqhelekileyo kunye nemigaqo, ixesha, iindlela kunye neendlela zokulungisa imisipha kwimisipha yemisipha yemisipha.
I. I-Cufftear
1. I-Pathogeny:
Ukulimala okungapheliyo kwegxalaba;
Ukonzakala: ukwenzakala okugqithisileyo kwi-tendon ye-rotator cuff okanye ukuwa kunye nomlenze ongasentla owandisiweyo kwaye uxhaswe emhlabeni, okubangela ukuba intloko ye-humeral ingene kwaye ikrazule inxalenye engaphambili ye-rotator cuff;
Isizathu sezonyango: ukwenzakala kwi-tendon ye-rotator cuff ngenxa yamandla amaninzi ngexesha lonyango lwesandla；
2. Uphawu lwezonyango:
Iimpawu: Intlungu yamagxa emva kokwenzakala, intlungu efana nokukrazuka;
Iimpawu: uphawu lwentlungu oluyi-60º～120º; ukuxhwilwa kwamagxa kunye nentlungu yokumelana nokujikeleza kwangaphakathi nangaphandle; intlungu yoxinzelelo kumda ongaphambili we-acromion kunye nobunzima obukhulu be-humerus;
3. Ukuthayipha ngokwezonyango:
Uhlobo I: Akukho ntlungu xa usebenza ngokubanzi, akukho ntlungu xa uphosa okanye ujika igxalaba. Uvavanyo lwenzelwe kuphela intlungu yangasemva;
Uhlobo lwesiBini: Ukongeza kwintlungu xa kuphindaphindwa intshukumo eyenzekileyo, kukho intlungu yokumelana ne-rotator cuff, kwaye intshukumo yegxalaba iyonke iqhelekile.
Uhlobo lwesithathu: luxhaphake kakhulu, iimpawu ziquka iintlungu zamagxa kunye nokunqongophala kokunyakaza, kwaye kukho uxinzelelo kunye nentlungu yokumelana xa kuhlolwa.
4. Ukuqhambuka komsipha we-Rotator cuff:
① Ukuqhekeka okupheleleyo:
Iimpawu: Intlungu ebuhlungu kakhulu ngexesha lokwenzakala, ukukhululeka kwentlungu emva kokwenzakala, kulandele ukunyuka kancinci kwinqanaba lentlungu.
Iimpawu zomzimba: Intlungu yoxinzelelo exhaphakileyo egxalabeni, intlungu ebukhali kwindawo eqhekekileyo ye-tendon;
Ukuqhekeka okuvakalayo rhoqo kunye nesandi esingaqhelekanga sokukhuhla amathambo;
Ubuthathaka okanye ukungakwazi ukutsala ingalo engasentla iye kuma-90º kwicala elichaphazelekayo.
Ii-X-reyi: Amanqanaba okuqala adla ngokungabi natshintsho lungaqhelekanga;
Ukubonakala kade kwe-humeral tuberosity osteosclerosis i-cystic degeneration okanye i-tendon ossification.
② Ukuqhekeka okungaphelelanga: i-arthrography yamagxa inokunceda ukuqinisekisa ukuxilongwa.
5. Ukuchongwa kwemisipha ye-rotator cuff enokuqhekeka nengenako ukuqhekeka
①1% yeprocaine 10 ml ukuvalwa kweendawo ezibuhlungu;
② Uvavanyo lokuwisa ingalo engentla.
II. Ukulimala kwemisipha yentloko ende ye-becips brachii
1. I-Pathogeny:
Ukwenzakala okubangelwa kukujikeleza kwamagxa ngokuphindaphindiweyo kunye nokunyakaza ngamandla kwelungu legxa, okubangela ukuguguleka nokukrazuka kwemisipha kwi-inter-nodal sulcus;
Ukwenzakala okubangelwa kukutsalwa ngokugqithisileyo ngequbuliso;
Ezinye: ukwaluphala, ukudumba kwe-rotator cuff, ukwenzakala kwe-subscapularis tendon stop, izitywina ezininzi ezikwindawo ethile, njl.
2. Uphawu lwezonyango:
I-Tendonitis kunye/okanye i-tenosynovitis yemisipha yentloko ende ye-biceps:
Iimpawu: ukuqaqamba kunye nokungonwabi ngaphambili kwegxalaba, okuphuma phezulu nasezantsi kwi-deltoid okanye kwi-biceps.
Iimpawu zomzimba:
Ukuthamba kwemisipha yentloko ende phakathi kwe-sulcus kunye ne-biceps;
Ii-striae ezikwindawo ethile zinokuqondakala;
Ukuhluthwa kwengalo engentla kunye nentlungu yokwandiswa ngasemva;
Uphawu oluhle lukaYergason;
Umgama omncinci wokuhamba kwegxalaba.
Ukuqhekeka komsipha wentloko ende ye-biceps:
Iimpawu:
Abo baqhawula i-tendon ngokuwohloka okukhulu: amaxesha amaninzi akukho mbali icacileyo yokwenzakala okanye ukwenzakala okuncinci, kwaye iimpawu azibonakali;
Abo baqhekekileyo ngenxa yokuxinana okukhulu kwe-biceps ngokuchasene nokuxhathisa: isigulana siva isandi sokukrazuka okanye siva isandi sokukrazuka egxalabeni, kwaye intlungu yegxala iyabonakala kwaye iphuma ngaphambili kwengalo engentla.
Iimpawu zomzimba:
Ukudumba, i-ecchymosis kunye nokuthamba kwi-sulcus ye-inter-nodal;
Ukungakwazi ukugoba ingqiniba okanye ukunciphisa ukugoba kwengqiniba;
Ukungalingani kwimo yemisipha ye-biceps kumacala omabini ngexesha lokuqiniswa ngamandla;
Indawo engaqhelekanga yesisu semisipha ye-biceps kwicala elichaphazelekayo, elinokuthi liye ezantsi kwi-1/3 yengalo ephezulu;
Icala elichaphazelekileyo linemisipha ephantsi kunecala eliphilileyo, kwaye isisu semisipha sivuvukele ngakumbi kunecala elichaseneyo xa kucuthwa ngamandla.
Ifilimu ye-X-ray: ngokubanzi akukho tshintsho lungaqhelekanga.
III.Iuvuyo lwei-becips brachii tendon
1. Imvelaphi:
I-enthesiopathy ye-triceps brachii tendon (i-enthesiopathy ye-triceps brachii tendon): i-triceps brachii tendon itsalwa ngokuphindaphindiweyo.
Ukuqhekeka kwe-triceps brachii tendon (ukuqhekeka kwe-triceps brachii tendon): i-triceps brachii tendon ikrazulwa ngamandla angaphandle angangqalanga nangobundlobongela.
2. Iimpawu zonyango:
I-endopathy ye-tendon ye-Triceps:
Iimpawu: iintlungu ngasemva kwegxalaba ezinokusasazeka ziye kwi-deltoid, ukungaziva kakuhle kwendawo okanye ezinye iingxaki zeemvakalelo;
Iimpawu:
Intlungu yoxinzelelo kwi-tendon yentloko ende ye-triceps brachii ekuqaleni komda ongaphantsi we-scapular glenoid kwitafile engaphandle yengalo ephezulu;
Intlungu yokumelana nengqiniba; iintlungu ze-triceps ezibangelwa kukuphinyiselwa okugqithisileyo kwengalo engasentla.
I-X-reyi: ngamanye amaxesha kukho isithunzi esixineneyo ekuqaleni kwemisipha ye-triceps.
Ukuqhambuka kwemisipha ye-triceps:
Iimpawu:
Ukurhawuzelela okukhulu emva kwengqiniba ngexesha lokwenzakala;
Intlungu kunye nokudumba kwindawo yokwenzakala;
Ubuthathaka ekwandiseni ingqiniba okanye ukungakwazi ukwandisa ingqiniba ngokupheleleyo;
Intlungu iyanda ngenxa yokumelana nokwandiswa kwengqiniba.
Iimpawu zomzimba:
Ukudakumba okanye nokuba sisiphene kunokuvakala ngaphezulu kwe-ulnar humerus, kwaye isiphelo esinqumkileyo se-triceps tendon sinokuphathwa ngendlebe;
Ubuhlungu obubukhali kwi-ulnar humerus node;
Uvavanyo lokwandisa ingqiniba oluchanekileyo ngokuchasene nomxhuzulane.
Ifilimu ye-X-ray:
Ukuqhekeka kwe-linear avulsion kubonakala malunga ne-1 cm ngaphezulu kwe-ulnar humerus;
Iziphene zamathambo zibonakala kwi-ulnar tuberosity.
Ixesha leposi: Julayi-08-2024
