Ukuqhekeka kwemisipha kanye nokukhubazeka kuyizifo ezivamile, ezibangelwa kakhulu ukulimala noma ukulimala, ukuze kubuyiselwe ukusebenza kwesitho, imisipha ephukile noma enephutha kumele ilungiswe ngesikhathi. Ukuthunga imisipha kuyindlela yokuhlinzwa eyinkimbinkimbi futhi ebucayi. Ngenxa yokuthi imisipha yakhiwe kakhulu ngemicu emide, ingxenye ephukile ithambekele ekuqhekekeni noma ekunwetshweni kwemisipha ngesikhathi sokuthunga. Imisipha ingaphansi kokucindezeleka okuthile futhi ihlala kuze kube yilapho imisipha iphola, futhi ukukhetha imisipha nakho kubaluleke kakhulu. Namuhla, ngizokwabelana nani ngokulimala kwemisipha okuvamile okungu-12 kanye nezimiso, isikhathi, izindlela kanye namasu okulungisa imisipha yemisipha yemisipha yemisipha.
I. I-Cufftear
1. I-Pathogeny:
Ukulimala okungapheli kwehlombe;
Ukulimala: ukulimala ngokweqile kwe-tendon ye-rotator cuff noma ukuwa lapho umlenze ongaphezulu weluliwe futhi uboshwe phansi, okubangela ikhanda le-humeral ukuba lingene futhi lidabule ingxenye engaphambili ye-rotator cuff；
Imbangela yezokwelapha: ukulimala kwe-tendon ye-rotator cuff ngenxa yamandla amaningi ngesikhathi sokwelashwa ngesandla；
2. Isici somtholampilo:
Izimpawu: Ubuhlungu behlombe ngemva kokulimala, ubuhlungu obufana nokuklebhuka;
Izimpawu: uphawu lobuhlungu oluyi-60º～120º; ukuthunjwa kwamahlombe kanye nobuhlungu bokumelana nokujikeleza kwangaphakathi nangaphandle; ubuhlungu bokucindezela emngceleni ongaphambili we-acromion kanye nokukhula okukhulu kwe-humerus;
3. Ukuthayipha ngokwezokwelapha:
Uhlobo I: Akukho buhlungu uma usebenza ngokujwayelekile, ubuhlungu uma uphonsa noma uphendula ihlombe. Ukuhlolwa kwenzelwa ubuhlungu obungemuva kuphela;
Uhlobo II: Ngaphezu kobuhlungu lapho kuphindaphindwa ukunyakaza okulimele, kukhona ubuhlungu bokumelana ne-rotator cuff, futhi ukunyakaza okuvamile kwehlombe kuyinto evamile.
Uhlobo lwesithathu: luvame kakhulu, izimpawu zifaka phakathi ubuhlungu behlombe kanye nokulinganiselwa kokunyakaza, futhi kukhona ubuhlungu bokucindezeleka kanye nokumelana lapho kuhlolwa.
4. Ukuqhekeka komsipha we-Rotator cuff:
① Ukuqhekeka okuphelele:
Izimpawu: Ubuhlungu obukhulu obutholakala endaweni ethile ngesikhathi sokulimala, ukukhululeka kobuhlungu ngemva kokulimala, kulandelwe ukwanda kancane kancane kwezinga lobuhlungu.
Izimpawu zomzimba: Ubuhlungu obuvame kakhulu ehlombe, ubuhlungu obukhulu engxenyeni ephukile ye-tendon;
Ukuqhekeka okuvame ukuzwakala kalula kanye nomsindo ongavamile wokuhlikihla amathambo;
Ubuthakathaka noma ukungakwazi ukubamba ingalo engenhla iye kuma-degrees angu-90 ohlangothini oluthintekile.
Ama-X-ray: Izigaba zokuqala ngokuvamile azinazo izinguquko ezingavamile;
Ukubonakala kwe-humeral tuberosity osteosclerosis okubonakalayo sekwephuzile, ukuwohloka kwe-cystic noma ukuqina kwemisipha.
② Ukuqhekeka okungaphelele: i-arthrography yamahlombe ingasiza ukuqinisekisa ukuxilongwa.
5. Ukuhlonza imisipha ye-rotator cuff lapho iqhuma futhi ingaqhumanga
①1% i-procaine engu-10 ml ukuvalwa kwezindawo zobuhlungu;
② Ukuhlolwa kokuwa kwengalo engenhla.
II. Ukulimala kwemisipha yekhanda elide le-becips brachii
1. I-Pathogeny:
Ukulimala okubangelwa ukujikeleza kwamahlombe okuphindaphindiwe nokunyakaza okunamandla kwejoyinti lehlombe, okubangela ukuguguleka nokwephuka okuphindaphindiwe kwe-tendon ku-sulcus ephakathi kwe-nodal;
Ukulimala okubangelwa ukudonsa ngokweqile okungazelelwe;
Ezinye: ukuguga, ukuvuvukala kwe-rotator cuff, ukulimala kokuma kwemisipha ye-subscapularis, izimbotshana eziningi ezitholakala endaweni ethile, njll.
2. Isici somtholampilo:
I-Tendonitis kanye/noma i-tenosynovitis yomsipha wekhanda elide we-biceps:
Izimpawu: ubuhlungu kanye nokungakhululeki ngaphambili kwehlombe, okuphuma phezulu naphansi kwe-deltoid noma i-biceps.
Izimpawu zomzimba:
Ukuqina kwemisipha yekhanda elide phakathi kwama-nodal kanye ne-biceps;
Ama-striae asendaweni angase azwakale kalula;
Ubuhlungu bokubanjwa kwengalo engenhla kanye nobuhlungu bokunwetshwa ngemuva;
Isibonakaliso esihle sikaYergason;
Ukunyakaza okulinganiselwe kwejoyinti lehlombe.
Ukuqhekeka komsipha wekhanda elide le-biceps:
Izimpawu:
Labo abaphula umsipha ngokuwohloka okukhulu: ngokuvamile akukho mlando ocacile wokulimala noma ukulimala okuncane kuphela, futhi izimpawu azibonakali;
Labo abanokuqhuma okubangelwa ukufinyela okunamandla kwe-biceps ngokumelene nokumelana: isiguli sinomuzwa wokudabula noma sizwa umsindo wokudabula ehlombe, futhi ubuhlungu behlombe busobala futhi busakazeka ngaphambili kwengalo engenhla.
Izimpawu zomzimba:
Ukuvuvukala, i-ecchymosis kanye nobuhlungu ku-sulcus ye-inter-nodal;
Ukungakwazi ukugoba indololwane noma ukuncipha kokugoba kwendololwane;
Ukungalingani ngesimo semisipha ye-biceps ezinhlangothini zombili ngesikhathi sokuqiniswa okunamandla;
Indawo engajwayelekile yesisu semisipha ye-biceps ohlangothini oluthintekile, olungase ludlulele phansi engxenyeni engezansi yengalo engenhla;
Uhlangothi oluthintekile lunemisipha ephansi kunehlangothi eliphilile, kanti isisu semisipha sivuvukele kakhulu kunehlangothi eliphambene ngesikhathi sokufinyela ngamandla.
Ifilimu ye-X-ray: ngokuvamile azikho izinguquko ezingavamile.
III.Iinjabulo kai-becips brachii tendon
1. Imvelaphi:
I-enthesiopathy ye-triceps brachii tendon (i-enthesiopathy ye-triceps brachii tendon): i-triceps brachii tendon idonswa ngokuphindaphindiwe.
Ukuqhekeka kwe-tendon ye-triceps brachii (ukuqhekeka kwe-tendon ye-triceps brachii): i-tendon ye-triceps brachii idwengulwa amandla angaphandle angaqondile angazelelwe futhi anobudlova.
2. Izimpawu zomtholampilo:
I-endopathy ye-tendon ye-triceps:
Izimpawu: ubuhlungu ngemuva kwehlombe obungase buvele e-deltoid, ukungazweli kwendawo noma ezinye izinkinga zemizwa;
Izimpawu:
Ubuhlungu obucindezelayo emsipha wekhanda elide we-triceps brachii ekuqaleni komngcele ongaphansi we-scapular glenoid etafuleni langaphandle lengalo engenhla;
Ubuhlungu obuhle bokumelana nokwelulwa kwendololwane; ubuhlungu be-triceps obubangelwa ukuphinyiselwa ngokweqile kwengalo engenhla.
I-X-ray: ngezinye izikhathi kuba nomthunzi oqinile ekuqaleni kwemisipha ye-triceps.
Ukuqhekeka kwemisipha ye-triceps:
Izimpawu:
Ukuguguleka okukhulu ngemuva kwendololwane ngesikhathi sokulimala;
Ubuhlungu nokuvuvukala endaweni yokulimala;
Ubuthakathaka ekunwetshweni kwendololwane noma ukungakwazi ukwelula indololwane ngokugcwele;
Ubuhlungu buqiniswa ukumelana nokwelulwa kwendololwane.
Izimpawu zomzimba:
Ukucindezeleka noma ngisho nokukhubazeka kungazwakala ngaphezu kwe-ulnar humerus, futhi ingxenye enqunyiwe ye-triceps tendon ingaphathwa ngesandla;
Ubuhlungu obukhulu e-ulnar humerus node;
Ukuhlolwa kokwelulwa kwendololwane okuhle ngokumelene nokudonsa phansi.
Ifilimu ye-X-ray:
Ukuphuka kwe-avulsion okuqondile kubonakala cishe nge-1 cm ngaphezu kwe-ulnar humerus;
Ukukhubazeka kwamathambo kubonakala ku-ulnar tuberosity.
Isikhathi sokuthunyelwe: Julayi-08-2024
