Ukuqhekeka kwe-tendon kunye nesiphene zizifo eziqhelekileyo, ezibangelwa kakhulu kukulimala okanye ukutshatyalaliswa, ukwenzela ukubuyisela umsebenzi welungu, i-tendon ephukileyo okanye ephosakeleyo kufuneka ilungiswe ngexesha. I-Tendon suturing yindlela entsonkothileyo kunye nethambileyo yotyando. Ngenxa yokuba i-tendon ubukhulu becala iqulunqwe yimicu ye-longitudinal, isiphelo esaphukileyo sithambekele ekuqhekekeni okanye e-suture elongation ngexesha le-suture. I-suture iphantsi koxinzelelo kwaye ihlala de i-tendon iphilise, kwaye ukhetho lwe-suture lubaluleke kakhulu. Namhlanje, ndiya kukwabelana nawe i-12 yokulimala kwe-tendon eqhelekileyo kunye nemigaqo, ixesha, iindlela kunye nobuchule bokulungisa i-tendon ye-tendon sutures.
I.Cufftear
1. Ipathojeni:
Ukwenzakala okungapheliyo egxalabeni;
I-Trauma: Ukulimala ngokugqithiseleyo kwi-tendon ye-rotator cuff okanye ukuwa kunye nomlenze ophezulu owandisiweyo kwaye uqiniswe emhlabeni, ngobudlova obangela ukuba intloko ye-humeral ingene kwaye ikrazule inxalenye yangaphambili ephezulu ye-rotator cuff;
Isizathu sonyango: ukwenzakala kwi-tendon ye-rotator cuff ngenxa yamandla amaninzi ngexesha lonyango lwezandla;
2. Uphawu lwezonyango:
Iimpawu: Intlungu yegxalaba emva kokulimala, intlungu efana nokukrazula;
Iimpawu: 60º～120º i-arc entle yophawu lweentlungu; ukuhluthwa kwamagxa kunye neentlungu zangaphakathi kunye nangaphandle zokujikeleza ukujikeleza; intlungu yoxinzelelo kumda wangaphambili we-acromion kunye ne-tuberosity enkulu ye-humerus;
3.Ukuchwetheza kwezonyango:
Uhlobo I: Akukho ntlungu kunye nomsebenzi jikelele, intlungu xa iphosa okanye ijika ihlombe. Uvavanyo kuphela kwiintlungu ze-retro-arch;
Uhlobo lwe-II: Ukongeza kwintlungu xa uphinda intshukumo yokulimala, kukho intlungu yokumelana ne-rotator cuff, kunye nokuhamba ngokubanzi kwegxalaba kuqhelekile.
Uhlobo lwe-III: oluqhelekileyo, iimpawu zibandakanya intlungu yegxalaba kunye nokunciphisa ukunyakaza, kwaye kukho uxinzelelo kunye nokuxhatshazwa kweentlungu ekuhlolweni.
4.Ukugqabhuka komthambo we-Rotator cuff:
① Ukugqabhuka ngokupheleleyo :
Iimpawu : Intlungu ebuhlungu yendawo ngexesha lokulimala, ukukhululeka kwentlungu emva kokulimala, kulandelwa ukunyuka ngokuthe ngcembe kwinqanaba leentlungu.
Iimpawu zomzimba:Intlungu exhaphakileyo yoxinzelelo egxalabeni, iintlungu ezibukhali kwindawo eqhekekileyo ye-tendon;
Ngokufuthi ukuqhekeka okubonakalayo kunye nesandi esingaqhelekanga sokuhlikihla amathambo;
Ubuthathaka okanye ukungakwazi ukuxhwila ingalo ephezulu ukuya kuma-90º kwicala elichaphazelekayo.
I-X-reyi: Amanqanaba okuqala adla ngokungabi natshintsho olungaqhelekanga;
I-humeral tuberosity osteosclerosis ebonakalayo kade i-cystic degeneration okanye i-tendon ossification.
② Ukuqhawula okungaphelelanga: i-arthrografia yamagxa inokunceda ukuqinisekisa ukuxilongwa.
5. Ukuchongwa kwee-tendon ze-rotator cuff kunye nangaphandle kokuphuka
①1% procaine 10 ml indawo yokuvalwa kwendawo yeentlungu;
② Uvavanyo lokuwisa ingalo ephezulu.
II.Injory ye-becips brachii intambo yentloko ende
1. Ipathojeni:
Ukulimala okubangelwa ukuphindaphinda ngokuphindaphindiweyo ukujikeleza kwamagxa kunye nokunyakaza okunamandla kwegxalaba, okubangela ukugqoka ngokuphindaphindiweyo kunye nokukrazula kwe-tendon kwi-inter-nodal sulcus;
Ukwenzakala okubangelwa kukutsalwa ngokugqithisileyo ngesiquphe;
Abanye: ukuguga, ukuvuvukala kwe-rotator cuff, i-subscapularis tendon yokuyeka ukulimala, izitywina ezininzi zendawo, njl.
2. Uphawu lwezonyango:
I-Tendonitis kunye / okanye i-tenosynovitis yesihlunu sentloko ende ye-biceps:
Iimpawu: intlungu kunye nokungahambi kakuhle phambi kwegxalaba, ukukhupha phezulu nangaphantsi kwe-deltoid okanye i-biceps.
Iimpawu ezibonakalayo:
I-Inter-nodal sulcus kunye ne-biceps ye-tendon yentloko ende ithenda;
I-striae yendawo isenokuvakala;
Ukuxhwilwa kwengalo ephezulu kunye neentlungu zangasemva;
Uphawu oluhle lweYergason;
Uluhlu olulinganiselweyo lwentshukumo yegxalaba.
Ukuqhekeka komthambo wentloko ende ye-biceps:
Iimpawu:
Abo baqhekeza i-tendon ngokunciphisa kakhulu: ngokuphindaphindiweyo akukho mlando ocacileyo wokulimala okanye ukulimala okuncinci kuphela, kwaye iimpawu azibonakali;
Abo baqhekezayo okubangelwa ukunyanzeliswa okunamandla kwe-biceps ngokuchasene nokuchasana: isigulane sinovakalelo olukralayo okanye siva isandi esiqhekezayo egxalabeni, kunye neentlungu zegxalaba ziyabonakala kwaye ziphuma phambi kwengalo ephezulu.
Iimpawu ezibonakalayo:
Ukuvuvukala, i-ecchymosis kunye nokuthamba kwi-inter-nodal sulcus;
Ukungakwazi ukuguqula i-elbow okanye ukunciphisa i-elbow flexion;
I-Asymmetry ekubunjweni kwe-biceps muscle kumacala omabini ngexesha lokuqhawula okunamandla;
Isikhundla esingaqhelekanga se-biceps muscle belly kwicala elichaphazelekayo, elinokuthi lihle liye phantsi kwe-1/3 yengalo ephezulu;
Icala elichaphazelekayo linethoni ye-muscle ephantsi kunecala eliphilileyo, kwaye isisu se-muscle sigxininiswe kakhulu kunecala elichaseneyo ngexesha lokuqhawula okunamandla.
Ifilimu yeX-reyi: ngokubanzi akukho tshintsho lungaqhelekanga.
III.Injory yei-becips brachii tendon
1.Etiology:
I-Enthesiopathy ye-triceps brachii tendon (i-enthesiopathy ye-triceps brachii tendon): i-tendon ye-triceps brachii itsalwa ngokuphindaphindiweyo.
Ukuqhekeka kwe-tendon ye-triceps brachii (ukuphuka kwe-triceps brachii tendon): i-triceps brachii tendon ichithwa ngokukhawuleza kunye nobudlova obungathanga ngqo obungaphandle.
2.Iimpawu zeklinikhi:
I-Triceps tendon endopathy:
Iimpawu: intlungu emva kwegxalaba enokuthi ikhuphe kwi-deltoid, i-numbness yendawo okanye ezinye izinto ezingaqhelekanga;
Iimpawu:
Intlungu yoxinzelelo kwi-tendon yentloko ende ye-triceps brachii ekuqaleni komda ongaphantsi kwe-scapular glenoid kwitafile yangaphandle yengalo ephezulu;
Ukwandiswa kwe-elbow e-Positive pain resistive; iintlungu ze-triceps ezibangelwa kukubizelwa ngokugqithisileyo kwengalo engaphezulu.
X-reyi: ngamanye amaxesha kukho isithunzi hyperdense ekuqaleni kwemisipha triceps.
Ukuqhekeka kwethenda ye-Triceps:
Iimpawu:
Ukubetha kakhulu emva kwengqiniba ngexesha lokwenzakala;
Intlungu kunye nokuvuvukala kwindawo yokulimala;
Ubuthathaka ekwandisweni kwe-elbow okanye ukungakwazi ukwandisa ngokusebenzayo i-elbow ngokupheleleyo;
Intlungu eyongeziweyo kukuchasa ukwandiswa kwengqiniba.
Iimpawu ezibonakalayo:
Ukuxinezeleka okanye isiphene sinokuvakala ngaphezu kwe-humerus ye-ulnar, kwaye isiphelo esinqunyiweyo se-triceps tendon sinokucolwa;
Ububele obubukhali kwi-humerus node ye-ulnar;
Uvavanyo olulungileyo lolwandiso lwengqiniba ngokuchasene nomxhuzulane.
Ifilimu yeX-reyi:
Ukuqhekeka kwe-avulsion fracture kubonakala malunga ne-1 cm ngaphezu kwe-humerus ye-ulnar;
Iziphene zamathambo zibonwa kwi-tuberosity ye-ulnar.
Ixesha lokuposa: Jul-08-2024
