Ukuqhekeka kwe-tendon kanye nokukhubazeka yizifo ezivamile, ikakhulukazi ezibangelwa ukulimala noma ukulimaza, ukuze kubuyiselwe umsebenzi wesitho, i-tendon ephukile noma engalungile kufanele ilungiswe ngesikhathi. I-tendon suturing iyindlela yokuhlinza eyinkimbinkimbi futhi ebucayi. Ngenxa yokuthi i-tendon ngokuyinhloko yakhiwe imicu ye-longitudinal, isiphetho esiphukile sijwayele ukuhlukana noma ukuphakama kwe-suture ngesikhathi sokuthunga. I-suture ingaphansi kokucindezeleka okuthile futhi ihlala kuze kube yilapho i-tendon iphulukisa, futhi ukukhetha kwe-suture nakho kubaluleke kakhulu. Namuhla, ngizokwabelana nawe ngokulimala kwe-tendon evamile ye-12 kanye nezimiso, isikhathi, izindlela nezindlela zokulungisa i-tendon ye-tendon sutures.
I.Cufftear
1. I-Pathogeny:
Ukulimala okungapheli kwehlombe;
I-Trauma: ukulimala ngokweqile kwe-tendon ye-cuff ye-rotator noma ukuwa ngesitho esingaphezulu sinwetshiwe futhi siboshwe phansi, okwenza ngobudlova ikhanda elithambile lingene futhi liklebhule ingxenye yangaphambili ephakeme ye-rotator cuff;
Imbangela yezokwelapha: ukulimala kwe-rotator cuff tendon ngenxa yamandla amaningi ngesikhathi sokwelashwa okwenziwa ngesandla;
2.Isici somtholampilo:
Izimpawu: Ubuhlungu behlombe ngemva kokulimala, ubuhlungu obufana nokudabula;
Izimpawu: 60º～120º i-arc enhle yophawu lobuhlungu; ukuthunjwa kwehlombe kanye nobuhlungu bokumelana nokujikeleza kwangaphakathi nangaphandle; ubuhlungu bengcindezi emngceleni wangaphambili we-acromion kanye ne-tuberosity enkulu ye-humerus;
3.Ukuthayipha komtholampilo:
Thayipha I: Abukho ubuhlungu obunomsebenzi ojwayelekile, ubuhlungu lapho uphonsa noma uphendula ihlombe. Ukuhlolwa kuphela ubuhlungu be-retro-arch;
Thayipha II: Ngaphezu kobuhlungu lapho uphinda ukunyakaza okulimele, kukhona ubuhlungu bokumelana ne-rotator cuff, futhi ukunyakaza okujwayelekile kwehlombe kuvamile.
Uhlobo lwe-III: oluvame kakhulu, izimpawu zihlanganisa ubuhlungu behlombe kanye nomkhawulo wokunyakaza, futhi kukhona ubuhlungu bengcindezi nokumelana nokuhlolwa.
4.Ukugqashuka kwe-Rotator cuff tendon:
① Ukugqashuka okuphelele :
Izimpawu : Ubuhlungu obukhulu bendawo ngesikhathi sokulimala, ukukhululeka kobuhlungu ngemva kokulimala, okulandelwa ukwanda kancane kancane kwezinga lobuhlungu.
Izimpawu ezingokomzimba:Ubuhlungu bengcindezi esabalele ehlombe, ubuhlungu obuhlabayo engxenyeni ephukile ye-tendon;
Ngokuvamile ukuqhekeka okuzwakalayo nomsindo wokuhlikihla amathambo ongavamile;
Ubuthakathaka noma ukungakwazi ukuthumba ingalo engaphezulu ibe ngu-90º ohlangothini oluthintekile.
Ama-X-ray: Izigaba zakuqala ngokuvamile azikho izinguquko ezingavamile;
Okubonakala sekwephuzile kwe-humeral tuberosity osteosclerosis ukonakala kwe-cystic noma i-tendon ossification.
② Ukuphuka okungaphelele: i- arthrography yehlombe ingasiza ukuqinisekisa ukuxilongwa.
5. Ukuhlonza izintambo ze-rotator cuff ngokuqhekeka nangaphandle kokuphuka
①1% i-procaine engu-10 ml yokuvalwa kwendawo yobuhlungu;
② Ukuhlolwa kokuwa kwengalo engenhla.
II.Injory of the becips brachii ithoni yekhanda elide
1. I-Pathogeny:
Ukulimala okubangelwa uhla oluningi oluphindaphindiwe lokujikeleza kwehlombe kanye nokunyakaza okunamandla kwejoyinti lehlombe, okubangela ukuguga okuphindaphindiwe kwe-tendon ku-sulcus inter-nodal;
Ukulimala okubangelwa ukudonsa ngokweqile ngokuzumayo;
Abanye: ukuguga, ukuvuvukala kwe-rotator cuff, ukulimala kwe-tendon ye-subscapularis, izimpawu eziningi zendawo, njll.
2.Isici somtholampilo:
I-tendonitis kanye/noma i-tenosynovitis yemisipha yekhanda elide lama-biceps:
Izimpawu: ubuhlungu nokungakhululeki phambi kwehlombe , ukukhazimula phezulu naphansi kwe-deltoid noma i-biceps.
Izimpawu ezibonakalayo:
I-Inter-nodal sulcus kanye ne-biceps yethenda yekhanda elide;
I-striae yasendaweni ingase izwakale;
Ukuthunjwa kwengalo engenhla okuhle kanye nobuhlungu bokwelulwa kwangemuva;
Isibonakaliso esihle sikaYergason;
Ibanga elilinganiselwe lokunyakaza kwelunga lehlombe.
Ukuqhekeka kwe-tendon yekhanda elide le-biceps:
Izimpawu:
Labo abaphula i-tendon ngokuwohloka okukhulu: ngokuvamile akukho mlando ocacile wokuhlukumezeka noma ukulimala okuncane kuphela, futhi izimpawu azibonakali;
Labo abadabukile okubangelwa ukufinyela okuqinile kwama-biceps ngokumelene nokuphikiswa: isiguli sinomuzwa wokudabuka noma sizwa umsindo oklebhuka ehlombe, nobuhlungu behlombe busobala futhi buphumela ngaphambili kwengalo engenhla.
Izimpawu ezibonakalayo:
Ukuvuvukala, i-ecchymosis kanye nesisa ku-sulcus inter-nodal;
Ukungakwazi ukugoba indololwane noma ukunciphisa ukugoba kwendololwane;
I-asymmetry ekubunjweni kwemisipha ye-biceps ezinhlangothini zombili ngesikhathi sokufinyela okunamandla;
Ukuma okungavamile kwe-biceps muscle belly ohlangothini oluthintekile, olungase lwehle lube ngaphansi kwe-1/3 yengalo engenhla;
Uhlangothi oluthintekile lunethoni yemisipha ephansi kunohlangothi olunempilo, futhi isisu semisipha siphefumulelwe kakhulu kunohlangothi oluphambene phakathi nokufinyela okunamandla.
Ifilimu ye-X-ray: ngokuvamile azikho izinguquko ezingavamile.
III.Injory kwei-becips brachii tendon
1.I-Etiology:
I-Enthesiopathy ye-triceps brachii tendon (i-enthesiopathy ye-triceps brachii tendon ): i-triceps brachii tendon idonswa ngokuphindaphindiwe.
Ukuphuka kwethenda ye-triceps brachii (ukuphuka kwethenda ye-triceps brachii): i-triceps brachii tendon inqanyulwa ngamandla angaphandle angaqondile angazelele futhi anobudlova.
2.Ukubonakaliswa komtholampilo:
I-Triceps tendon endopathy:
Izimpawu: ubuhlungu ngemuva kwehlombe elingase liphume ku-deltoid, ukuphazamiseka kwendawo noma okunye okungavamile kwezinzwa;
Izimpawu:
Ubuhlungu bokucindezela ku-tendon yekhanda elide le-triceps brachii ekuqaleni komngcele ophansi we-scapular glenoid etafuleni elingaphandle lengalo engenhla;
I-Positive elbow extension ubuhlungu obuphikisayo; ubuhlungu be-triceps obubangelwa ukubizelwa okwedlulele kwengalo engenhla.
I-X-ray: ngezinye izikhathi kuba nesithunzi se-hyperdense ekuqaleni kwemisipha ye-triceps.
Ukuphuka kwe-Triceps tendon:
Izimpawu:
Ukugedlezela okuningi ngemuva kwendololwane ngesikhathi sokulimala;
Ubuhlungu nokuvuvukala endaweni yokulimala;
Ubuthakathaka esandisweni sendololwane noma ukungakwazi ukunweba indololwane ngokugcwele;
Ubuhlungu bubhebhetheka ngenxa yokumelana nokunwetshwa kwendololwane.
Izimpawu ezibonakalayo:
Ukucindezeleka noma ngisho nokukhubazeka kungazwakala ngaphezu kwe-humerus ye-ulnar, futhi isiphetho esinqunyiwe se-triceps tendon singashaywa;
Ukuzwela okubukhali ku-humer node ye-ulnar;
Ukuhlolwa kokunwetshwa kwendololwane okuhle ngokumelene namandla adonsela phansi.
Ifilimu ye-X-ray:
Ukuphuka kwe-avulsion fracture kubonakala cishe ngo-1 cm ngaphezu kwe-humer ulnar;
Ukukhubazeka kwamathambo kubonakala ku-tuberosity ye-ulnar.
Isikhathi sokuthumela: Jul-08-2024
