Uma kwenzeka ukuhlukana kwehlombe njalo, njengomsila olandelanayo njalo, ukwelashwa ngokuhlinzwa kufanelekile. Into eyinhloko ixhomeke ekuqiniseni ingalo ye-capsule yamalunga, ukuvimbela ukujikeleza kwangaphandle ngokweqile kanye nemisebenzi yokuthumba, kanye nokuqinisa ilunga ukuze kugwenywe ukuhlukana okuqhubekayo.
1, Ukusetha kabusha ngesandla
Ukuhlukaniswa kwemisipha kufanele kuqalwe kabusha ngokushesha okukhulu ngemva kokuhlukaniswa kwemisipha, futhi kufanele kukhethwe i-anesthesia efanele (i-brachial plexus anesthesia noma i-general anesthesia) ukuze kuphumule imisipha futhi kwenziwe ukuvuselelwa ngaphandle kobuhlungu. Abantu asebekhulile noma labo abanemisipha ebuthakathaka bangenziwa futhi ngaphansi kwe-analgesic (njenge-75 ~ 100 mg ye-dulcolax). Ukuhlukaniswa kwemisipha okujwayelekile kungenziwa ngaphandle kwe-anesthesia. Indlela yokubeka kabusha imisipha kufanele ibe mnene, futhi amasu aqinile awenqatshelwe ukugwema ukulimala okwengeziwe njengokuphuka noma ukulimala kwemizwa.
2. Ukushintsha indawo yokuhlinzwa
Kunezinhlobo ezimbalwa zokukhumuka kwamahlombe ezidinga ukuhlinzwa kabusha. Izinkomba yilezi: ukukhumuka kwamahlombe angaphambili kanye nokushelela ngemuva kwekhanda elide le-biceps tendon. Izinkomba yilezi: ukukhumuka kwamahlombe angaphambili kanye nokushelela ngemuva kwekhanda elide le-biceps tendon.
3. Ukwelashwa kokukhumuka kwehlombe elidala
Uma ihlombe lingashintshwanga isikhathi esingaphezu kwamasonto amathathu ngemva kokusuka, kubhekwa njengokusuka okudala. Umgodi wamalunga ugcwele izicubu ezibomvu, kukhona ukunamathelana nezicubu ezizungezile, imisipha ezungezile iyancipha, futhi uma kuhlangene ukuphuka kwamathambo, kwakheka amabala amathambo noma kwenzeka ukuphulukiswa okukhubazekile, zonke lezi zinguquko ze-pathological zivimbela ukushintshwa kwe-ikhanda elithambile.
Ukwelashwa kokuhlukana kwamahlombe amadala: Uma ukuhlukana kungakapheli izinyanga ezintathu, isiguli sisesincane futhi sinamandla, ilunga elihlukanisiwe lisenohlobo oluthile lokunyakaza, futhi akukho ukubola kwamathambo kanye nokuqina kwamathambo ngaphakathi kwe-articular noma ngaphandle kwe-articular ku-x-ray, kungazanywa ukuhlelwa kabusha ngesandla. Ngaphambi kokusetha kabusha, ithambo le-ulnar hawk elithintekile lingadonswa amasonto angu-1-2 uma isikhathi sokuhlukana sifushane futhi umsebenzi wamalunga ulula. Ukusetha kabusha kufanele kwenziwe ngaphansi kwe-anesthesia ejwayelekile, kulandelwe ukuhlikihlwa kwamahlombe kanye nemisebenzi yokunyakazisa kancane ukuze kukhishwe ukunamathelana nokunciphisa ubuhlungu bemisipha, bese kulungiswa kabusha okomile. Umsebenzi wokusetha kabusha wenziwa ngokuxhunywa nokuhlikihlwa noma ukuxutshwa kwezinyawo, futhi ukwelashwa ngemva kokusetha kabusha kufana nokwe-dislocation entsha.
4. Ukwelashwa kokukhumuka okujwayelekile kwamalunga ehlombe
Ukuqhekeka kwangaphambi kwehlombe okuvamile kubonakala kakhulu kubantu abadala abasebasha. Ngokuvamile kukholelwa ukuthi ukulimala kubangelwa ukuqhekeka kokuqala okubuhlungu, futhi nakuba kuqalwa kabusha, akulungiseki futhi akuphumuli kahle. Ilunga liyaphela ngenxa yezinguquko ze-pathological ezifana nokuklebhuka noma ukuvuvukala kwe-capsule yamalunga kanye nomonakalo we-cartilage glenoid labrum kanye nomkhawulo we-monsoon ngaphandle kokulungiswa okuhle, kanye nokuqhekeka kwekhanda elingemuva le-humeral head depression kuyalingana. Ngemva kwalokho, ukuqhekeka kungase kwenzeke ngokuphindaphindiwe ngaphansi kwamandla amancane angaphandle noma ngesikhathi sokunyakaza okuthile, njengokuthunjwa kanye nokujikeleza kwangaphandle kanye nokwandiswa kwangemuva kwe-izitho zangaphezulu. Ukuxilongwa kokuhlukana kwehlombe okuvamile kulula kakhulu. Ngesikhathi sokuhlolwa kwe-X-ray, ngaphezu kokuthatha amafilimu acacile angaphambili nangemuva ehlombe, kufanele kuthathwe ama-X-ray angaphambili nangemuva engalweni engenhla endaweni yokujikeleza kwangaphakathi engu-60-70°, okungabonisa ngokucacile isici sekhanda elingemuva le-humeral.
Uma kwenzeka ukuhlukana kwamahlombe okuvamile, kunconywa ukwelashwa ngokuhlinzwa uma ukuhlukana kwenzeka njalo. Inhloso ukuthuthukisa ukuvulwa kwangaphambi kwe-capsule yamalunga, ukuvimbela ukujikeleza kwangaphandle ngokweqile kanye nemisebenzi yokuthumba, kanye nokuqinisa ilunga ukuze kugwenywe ukuhlukana okuqhubekayo. Kunezindlela eziningi zokuhlinzwa, ezisetshenziswa kakhulu indlela kaPutti-Platt kanye nendlela kaMagnuson.
Isikhathi sokuthunyelwe: Feb-05-2023
