Kubwezeretsedwa kwa Ligament Ligament (UCLR)
Kubwezeretsedwa kwa Ligament Ligament, kapena UCLR, amadziwika kuti Tommy John opaleshoni. Ndi ndondomeko yomwe imakonzedweratu kukonzanso ndondomeko yowonongeka m'goli wotchedwa lignar collateral ligament (ena amagwiritsa ntchito mawu akuti medial collateral ligament). Kuvulala kumeneku kumapangitsa kuti golowelo lisamadzikeke ndipo limafuna chithandizo chamankhwala. Ngati chovulalacho sichithandizana ndi chithandizo chamankhwala, opaleshoni nthawi zambiri amachiritsidwa.
Chilumba cha Ulnar chimakhala chofala kwambiri pamathamanga "otaya" kwambiri, monga akatswiri a masewera a baseball. Kuponyera ntchito kumapangitsa kuti anthu azivutika maganizo pamlingo, kuvulaza dera lanu mochulukirapo kusiyana ndi masewera ena. Kwa othamanga ambiri, opaleshoni ya Tommy John ikhoza kubwezeretsanso ntchito, ndipo ena amatha kuchira kwathunthu.
Kwa odwala ena, opaleshoni siyikuchitidwa kuti apitirize kuchita monga wothamanga, koma kuchepetsa zizindikiro za kuvulala-makamaka kupweteka kwa mphuno ndi kufooka m'manja mwa mkono wokhudzidwa.
Ligament ya Ulnar
Nthenda yotchedwa ulnar igament ndi gulu lakuda la minofu yofanana ndi gulu lamphamvu kwambiri la mphira. Zimagwira ntchito yothandizira pothandizira kuti zikhazikike ndi kulimbikitsa chigoba. Mitsempha imatha kuvulazidwa, kutambasula ndi kusokonezeka. Kuvulala koopsa, kumene mitsempha imakhala yoonongeka ndi kubwereza kubwereza, ili pakati pa mitundu yowonjezereka ya mavuto a ulnar collateral ligament issues.
N'chifukwa chiyani amatchedwa Tommy John Surgery?
Tommy John anali katswiri wodziwa ntchito ku Los Angeles Dodgers. Mu 1974 anawononga chigamba chake, chomwe chinkaonedwa ngati chovulaza chogwira ntchito kwa katswiri wamapeni. John, komabe anasankha kupanga njira yomwe inali kuyesera panthawiyo, kuchotsa mimba yowonongeka ndi tendon ku dzanja lake lina.
Tommy John anavomera kuti Dr. Frank Jobe azitsatira ndondomeko zochepa zomwe akanatha kuti adziwe. Kenako anatenga 1974 ndiyeno 1975 baseball nthawi kuti akonzere mkono wake. Chotsatira chake chinali chosinthika-John adagwira ntchito mwakhama kufikira 1989-ndipo njirayi tsopano ikudziwika kuti Tommy John opaleshoni.
Ndondomeko
Kuchita opaleshoni ya Tommy John kumachitidwa pansi pa anesthesia ndi dotolo wamatumbo. Mmodzi wodwala atayamba kuvulala ndipo anesthesia yayamba kugwira bwino ntchito, njirayi imayambira ndi kutengeka mkati mkati mwa chigoba chomwe chimachotsedwa mzerewu. Ndondomekoyi ndi yochepa kwambiri , choncho, kukopa ndi kochepa, momwe ndondomeko ikugwiritsidwira ntchito pogwiritsa ntchito laparoscope.
Ngati kukonzanso kumafunika, kutengeka kochepaku kumagwiritsidwa ntchito poika zida mu malo ophatikizana ndikukonzekera ndondomeko yotsekemera. Ngati kumangidwanso kumakhala kofunika, nthawi zambiri pamakhala phokoso linalake, makamaka pambali ya mkono, kuti mutenge kachilombo ka malo omwe simunavulaze. Ngakhale choponderezeka ndi chisankho chofala kwambiri, malo ena omwe angathe kukhalapo amakhala ndi phazi lakumtunda ndi lamanzere. Kawirikawiri, tendon yopereka ndalama zingagwiritsidwe ntchito m'malo mwa tchupi la wodwalayo.
Kamodzi kowonjezereka kameneka kamapezeka, kamasulidwa m'malo ngati malo amtundu wa ulnar. Kwa odwala ena omwe ali ndi zizindikiro za kufooka ndi kukwapula m'manja, mitsempha ya ulnar ingasunthidwe pang'ono kuti ikathandize kubwerera kwathunthu.
Ngozi
Kuphatikiza pa zoopsa zomwe zimachitika pa opaleshoni komanso kuopsa kwa anesthesia , opaleshoni ya Tommy John ili ndi zovuta zenizeni kwa wodwalayo. Kwa ena, matenda okhudza ubongo, kapena kusowa kwa ziwalo za mitsempha, amatha kuchoka dzanja lomwe lakhudzidwa, lopanda mphamvu, kapena lofooka. Matendawa angapite patsogolo pakapita nthawi kapena angakhale chidziwitso chosatha cha kuvulala koyambirira.
Kwa odwala ena, kusasinthasintha kumawoneka pambuyo pakuchita opaleshoni, pamene ena nthawi zonse amatha kukhala ndi maganizo osasinthasintha pakhomo. Ngakhale zachilendo pambuyo pochita opaleshoni kuti zikhale zovuta kuwongolera kwathunthu, kusuntha kumeneku sikungabwerere kuzinthu zambiri zomwe zinkachitika musanavulaze.
Kubwezeretsa
Kubwezeretsa opaleshoni ya mtundu uwu wavulala ndi wowongoka. Kuchita opaleshoni ya Tommy John kumafuna kuti munthu azikhala m'chipatala usiku wonse, kenako amachiritsidwa kwambiri. Kwa masabata angapo oyambirira, golidiyo ikhoza kukhala yosasinthika, kusunga mkono wa golidi ndikugwiritsidwa ntchito. Mzere watsopanowu ndi wofooka kwambiri pamasabata oyambirira pambuyo pa opaleshoni, kotero ndikofunika kutsatira malangizo a dokotala kuti ateteze malo opaleshoni.
Mutha kupatsidwa mankhwala opweteka m'masiku oyambirira a kuchira, pambuyo pake kutentha ndi ayezi zimagwiritsidwa ntchito kuchepetsa ululu. Pomwe mankhwalawa sakufunikanso, mankhwala amayamba kuyambiranso mphamvu. Kwa ena, maulendo ambiri amabwerera m'masabata asanu ndi limodzi ndi asanu ndi limodzi (6-8), komabe, kwa othamanga mpikisano, kukonzanso kwakukulu kumatha kumatha chaka chimodzi kubwerera kuntchito yonse.
Ochita maseĊµera ambiri okondwerera amamva kuti ali amphamvu kuposa iwo asanayambe opaleshoni, popeza anali "akunyamula" mkono poyankha ululu. Ambiri amachira kwathunthu ndipo amatha kubwerera kuntchito zawo zachizolowezi.
Zotsatira
Ntchito yomangidwanso ya Ulnar. CA Bush Joseph, MD. Yapezeka April, 2012. http://www.rushortho.com/forms/Ulnar_Collateral_Ligament_Reconstruction_Protocol.pdf