Kuchita opaleshoni kungakhale njira yabwino yothetsera mavuto ambiri . Ngakhale kuti choyamba chithandizo cha mankhwala ndi kawirikawiri njira yopaleshoni, nthawi zambiri anthu amafika pamene opaleshoni imakhala njira yabwino yothetsera vuto lawo. Phunzirani za njira zamakono zomwe zimachitika pofuna kuthana ndi mavuto, ndipo ngati chimodzi mwa izi chingakuthandizeni kuthetsa vuto lanu. Zina mwa opaleshoni imeneyi ndi opaleshoni yochepa kwambiri , pomwe ena ndi opaleshoni yotseguka. Ndondomeko iliyonse imakhala yowonjezereka, yowonongeka, komanso yoopsa yomwe imachitika pamodzi ndi chithandizo. Pano mungaphunzire za nkhani izi ndi zodetsa nkhawa.
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Kujambula Kwambiri: Bursitis / Impingement TreatmentChimodzi mwa zifukwa zomwe zimachitika kachitidwe ka opaleshoni ndizochithandizo cha kutupa kuzungulira chikho cha rotator. Anthu nthawi zambiri amagwiritsa ntchito mawu osiyana pofotokoza izi. Ambiri amachipatala amatanthawuza ' matenda a impingement ,' omwe amachititsa kutupa pakati pa mpira pamapewa ndi pamwamba pa mapewa pamwamba pake. Mu danga ili ndi mitsempha ya zowonongeka ndi zobiriwira zomwe zimapangitsa kuti tizilombo tiziyenda. Mayina ena omwe anthu angagwiritse ntchito pofotokozera matenda a impingement amachititsa kuti tizilombo toyambitsa matenda ndi bursitis.
Pamene kugwiritsira ntchito nyamakazi kumagwiritsidwa ntchito pofuna kuthana ndi matenda a impingement, anthu amachitcha kuti kukhumudwa kosasokonezeka. The acromion ndi dzina la pamwamba pa mapewa, ndipo malo pansi ndi kumene kusindikiza kumachitika. Chifukwa chake kusokonezeka maganizo kumatsegula malo osamalitsa.
Mukamagwiritsa ntchito mankhwala osokoneza bongo, dotolo wanu akhoza kuchotsa bursa yekha, kapena akhoza kuchotsa zina mwazithunzi za acromion. Cholinga ndicho kuchotsa kutupa ndikupanga malo kuti chingwe cha rotator chizikhala popanda kugwedezeka pakati pa fupa. Njira yopaleshoniyi ikhoza kuchitidwa padera, kapena ngati gawo la opaleshoni yophimba. Ngakhale kuti izi zinachitika kale m'mabuku monga opaleshoni yotseguka, kuponderezedwa kosautsa kumakhala nthawi zonse ngati opaleshoni yamakono masiku ano.
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Kujambula Kwambiri: Kukonzekera kwa SLAPMisozi yosalala ya paphewa ndi kuvulaza khungu la karotila kamene kamakwera ndikulitsa chingwe chokwanira chotchedwa labrum. Misozi ya SLAP imapezeka pamwamba pa labhu, yotchedwa gawo lapamwamba la labhu. Dzina lakuti SLAP limachokera ku chithunzi chapamwamba chotchulidwa pamwamba kuchokera ku anterior mpaka posterior. Gawo ili labramu ndilofunika chifukwa ndi malo omwe amamangiriza mutu wautali wa biceps tendon, ndipo amatha kukhala ndi zovuta zosiyana.
Kwa anthu omwe amasautsika ndi misozi ya SLAP, njira imodzi ndiyokonzanso labrum . Kuchita zimenezi kumaphatikizapo opaleshoni yong'onoting'ono kuti akonze kansalu kakang'ono kameneka kubwerera kumapeto kwa thumba la phewa. Mankhusu amamangirizidwa ku fupa la mthunzi wa paphewa, ndipo labrum imakhala yokonzedweratu ku fupa. Ngati zowonongekazo zikulowa m'kati mwa biceps, osati pa labrum, ndiye kuti njira zina zopaleshoni zothetsera biceps tendon (onani m'munsimu) zingaganizidwe.
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Kujambula Kwambiri Kwambiri: Chithandizo cha DislocationNgati chovulala cha paphewa chimachitika, chinachake chawonongeka chomwe chimalola kuti mpira utuluke mudothi la mapewa. Kawirikawiri, kuwonongeka ndi chimodzi mwa zigawo zingapo, ndipo cholinga cha kupaleshoni kwapadera ndi kukonzanso zochitikazo.
Achinyamata othamanga, mbali yovulazidwayo imatchedwa labamu, ndipo kuwonongeka kumachitika kumbali yeniyeni ya lala. Kuti athetse batawa, anthuwa adzachita opaleshoni yotchedwa Bankart kukonza . Kuchita opaleshoniyi kungakhoze kuchitidwa ngati opaleshoni yotseguka koma nthawi zambiri amachitidwa ngati njira yowonongeka.
Pa anthu 30 kapena kuposerapo, kuwonongeka kumeneku kumafala kwambiri ku khola lozungulira la mapewa. Izi zikachitika, njira yowonongeka ndi yokonzanso katemera, monga momwe tafotokozera pansipa.
Palinso anthu ena omwe ali ndi chikhomodzinso cha mitsempha ya m'mapewa omwe amachititsa kuti zikhale zovuta kwambiri pamapapu. Anthuwa ali ndi phewa lomwe lingalowe mkati mwamsanga ndipo limasowa khungu lonse la mapewa lokhazikika kuti liwathetse vuto lawo.
Pomalizira pake, anthu omwe amawonongeka kwambiri pamapewa, omwe amachokera kumabwereza ambiri, akhoza kuchitidwa opaleshoni yowonjezera kuti aike mpirawo muzitsulo. Pali njira zambiri zosiyana, koma izi zimaphatikizapo kusuntha fupa paphewa pang'onopang'ono kuti agwire mpira molimba kwambiri mkati mwa chingwe cha mgwirizano.
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Kujambula Kwambiri Kwambiri: Kutsekedwa Pamodzi KwambiriMapewa ofiira ndi ofanana kwambiri. Ndipotu, kachiwiri ndi mavuto a zikhotakhota okha omwe amachititsa kuti ululu ukhale wambiri. Mwamwayi, mapewa osungunuka nthawi zambiri amakhala osadziwika bwino omwe amachititsa kuchedwa pozindikira ndi kuchiza. Kawirikawiri chithandizo chamtundu wambiri chikhoza kuchitika ndi mankhwala osamalidwa, komabe, nthawi zina zosavuta, chithandizo cha opaleshoni chimakhala chosankha.
Pamene phokoso lachisanu ndi chida likupezeka, kapule yomwe imayandikana paphewa imakhala yolimba ndikugwirizanitsa. Cholinga cha opaleshoni ndichotsegula minofuyi yomwe imagwiritsidwa ntchito kuti zitheke mosavuta. Lingaliro la opaleshoni ndi lolunjika bwino: dulani mutu wa phewa ponseponse pozungulira mapewa kuti asunthire momasuka. Gawo lovuta ndilo chifukwa mapewa ndi olimba kwambiri, kuyendayenda mkati mwa phewa kudula kapsule mosamala ndi vuto la opaleshoni.
Vuto lina la opaleshoni yofiira ndiloti akadula mutuwo, thupi lifuna kupanga minofu yatsopano. Matenda oyambirira, opweteketsa thupi ndi ma rehab ndi ofunikira kuti mapewa aziyenda bwino.
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Zokonzanso za RotatorChimodzi mwa njira zamakono zochitira opaleshoni pa mapewa ndi kukonza kabokosi ka zitsulo. Pali njira zambiri zomwe mungasankhire chophimba chovunda , ndipo dokotala wina aliyense akhoza kukhala ndi njira zawo zokha. Cholinga cha opaleshoni iliyonse yokonza opaleshoni ndikutulukira mbali yowonongeka, kenako kuyeretsa ndi kuyambitsa thambo lozungulira. Pamene minofu yathanzi imadziwika, cholinga chake ndi kukonzanso vutolo mu tendon popanda kutambasulira kwambiri tchuthi. Nthaŵi zambiri, izi zingatheke.
Kukonza katatu kwa Rotator kungapangidwe m'njira zosiyanasiyana. Njira yachizolowezi yopanga opaleshoni ndiyo kupanga makina aakulu, kusokoneza minofu yoyandikana nayo, ndi kukonzanso chikho cha rotator powona bwinobwino vutoli. Izi zimatchedwa kukonzanso katatu kotseguka. Njira yatsopano ndiyo kuchita opaleshoniyi. Mu njirayi, amagwiritsidwa ntchito pang'ono poyika kamera ndi zipangizo zing'onozing'ono. Kukonzekera kumachitika mwachindunji, mwa kuyang'ana pa chinsalu m'malo moyang'ana molunjika pa vutoli.
Palinso njira yosakanizidwa, yomwe imatchedwa kukonza katemera wotsegula mini, yomwe imapereka ubwino wina wa opaleshoni yamakono pamene ikuloleza kukonza molunjika kwa matenda. Palibe njira imodzi yokha yomwe ili yabwino kwambiri. Madokotala ena opaleshoni ali ndi luso lokonzekera kuposa lina, ndipo misozi imatha kuyendetsedwa bwino ndi njira imodzi kapena ina.
Palinso zinthu zina zomwe simungathe kukonza. Panthawiyi misozi ikuluikulu, yomwe imatchedwa misozi yozungulira , kuyesa kutsekera pakhomo la rotator sizothandiza pamene matendawa amatsitsimutsidwa kwambiri ndipo amawombera. Pali njira zothetsera vutoli, koma misonzi imeneyi silingathe kukonzedwa.
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Mavuto Ogwirizanitsa AmagetsiMgwirizano wa acromioclavicular (womwe nthawi zambiri umatchedwa AC mgwirizano) umagwirizanitsa mapeto a khungu (collarbone) ndi pamwamba pa mapewa (acromion). Mgwirizano umenewu ndi mbali yofunika kwambiri ya mapewa, ngakhale kuti amayenda pang'ono pang'onopang'ono ndi mpira ndi phokoso la mapewa.
Pali mavuto angapo omwe angakhoze kuchitika palimodzi la acromioclavicular. Choyamba ndichoti chikhoza kutha. Nthawi zina izi zimachitika chifukwa cha nyamakazi ya mgwirizano wa AC , nthawi zina ndi chifukwa cha kupsinjika kwanthawi yayitali. Mgwirizano wa AC ungathe kuwonongeka chifukwa cha ntchito zina zomwe zimayambitsa kupanikizana, monga weightlifting. Matendawa amatchedwa osoolysis a distal omwe amachititsa kuti mafupa azifooka. Pamene mavutowa akuchitika, chithandizochi ndichochotsa mapeto a collarbone kuti afutukule danga la mgwirizano wa AC.
Vuto lina lofala lomwe limapezeka pa mgwirizano wa AC ndi kusakhazikika, kutchedwa kupatukana kwa mapewa . Izi zimachitika kawirikawiri chifukwa cha kuvulala kumadera a m'mphepete omwe amachititsa kuwonongeka kwa mitsempha yomwe imagwirizanitsa mapeto a chiguduli ku mapewa. Kusiyana kumagazi kawiri kaŵirikaŵiri kumatha kuchiritsidwa mwachipatala, koma pamene opaleshoni ikuchitidwa, njira yowonongeka ndiyo kukonzanso kapena kukonzanso mitsempha yomwe imathandizira mapeto a chiwongolero .
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Kusintha KwambiriKuchita opaleshoni kumodzi ndi njira yothetsera yomwe imakhala yosungirako nyamakazi yapamwamba ya paphewa, ingathenso kugwiritsidwanso ntchito kwa fractures zovuta za pamapewa ndi mavuto ena omwe sangathe kukonzedwa mokwanira. Bwalo loponyedwa m'malo mwake lidzachotsa mpira wotayika ndi paphetechete yokhala pamodzi ndi mpira wopangira wopangidwa ndi chitsulo, ndi chingwe chopangidwa ndi pulasitiki. Kuyika mapepala kumapangidwira kuti azigwira ntchito mofanana.
Nthawi zina, mpira wonse ndi phokoso lazitsulo sizingafunikirenso. Izi zikhoza kukhala choncho ndi matenda a nyamakazi akale kapena pamatumbo a pamwamba pa mkono. Muzochitika izi, kusamalidwa pang'ono kungakhale njira yabwino yothetsera vuto lanu. Njirayi, yotchedwa hemiarthroplasty , imangobweretsa mpira pamapewa, ndipo zitsulo zatsala zokha.
Chinthu china chimene chimatchedwa kuti kutsogolo kwa mapewa . Kuchita opaleshoniyi, monga kumveka kuchokera ku dzina lake, kumasintha malo a mpira ndi chingwe kuti bwalo lolowera lipite kumalo kumene chingwecho chili, ndipo chingwe cholowera m'malo chimapita kumene mpira wa phewa unali. Chifukwa chochita izi ndikuti zimapereka mwayi kwa anthu omwe amawononga kwambiri chikhoto. Ili ndi njira yabwino kwambiri kwa anthu omwe ali ndi vuto lotchedwa rotator chikhomodzinso chiwonongeko , kuphatikizapo kuwonongeka kwa mapepala a mapepala ndi mapepala a rotator.
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Kupanga Opaleshoni Yopangira BicepsBiceps tendon ndi minofu kutsogolo kwa mkono wanu. Minofu imagwirizanitsidwa ndi fupa ndi tendons, ndipo pamwamba pa minofu, pali zojambula ziwiri zamatoni. Imodzi ili kutsogolo kwa phewa, yotchedwa mutu wamfupi wa biceps. Mtedza wina, womwe umatchedwa mutu wautali wa mapiritsi, uli mkati mwa phewa. Mutu wautali wa tizilomboti timayendayenda m'khola la rotator, timadutsa mkati mwa phewa, ndipo timakafika pamwamba pa thabwa la phewa. Kuphatikizika kovuta kumeneku kumapangitsa kuti mutu wautali wa biceps isokonezeke kwambiri .
Kuchita opaleshoni pamatope a biceps kungakhale kochitidwa padera, kapena kungapangidwe ngati mbali ya opaleshoni ina monga opanga katoto. Kawirikawiri pali njira ziwiri zomwe mungapangire opaleshoni. Imodzi ndiyo kudula tendon mkati mwa phewa ndikugwirizanitsa thambo kunja kwa mgwirizano. Njira ina ndi kungodula tendon ndi kuichotsa pansi.
Pali ubwino ndi zoipa za njira iliyonse, ndipo zosankha zonsezi zingakhale ndi zotsatira zabwino kwambiri. Ngakhale anthu ambiri amaganiza kuti kudula tchuthi kungachititse kuchepetsa mphamvu ndi ntchito, pali mauthenga ambiri a akatswiri a maseŵera omwe ali ndi tenotomy ndipo akufulumira kupikisana pa mpikisano wothamanga!
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Kukonza Zokhazikika Padziko LonseMphuno yozungulira paphewa ikhoza kuchitidwa opaleshoni malingana ndi kuopsa kwa chovulala ndi kuyembekezera kwa wodwalayo. Zina mwaziphuphu zomwe zimafala kwambiri pambali pake ndi izi:
Kusankha chithandizo chabwino kungaphatikizepo zinthu zosiyanasiyana, koma opaleshoni nthawi zambiri amagwiritsidwa ntchito pochiza mavulalawa.
Mavuto ndi Zovuta za Opaleshoni
Zonsezi zogwiritsidwa ntchito zapaleshoni zingathe kuchitidwa mosamala komanso mogwira mtima, koma sizingatheke kuti zikhale zovuta . Ngakhale mavuto ali osadabwitsa pambuyo pa mitundu yambiri ya opaleshoni ya m'mapewa, akhoza kuchitika.
Musanachite opaleshoni iliyonse, muyenera kuyankhula ndi dokotala wanu opaleshoni zokhudzana ndi zomwe zingatheke kuti mumvetsetse ndi kuti ndi mankhwala ati ndi zotsatira zomwe mungayembekezere ngati vutoli likuchitika. Kuphatikiza apo, mapewa ambiri opaleshoni amawasankha-payenera kukhala ndi mwayi wokambirana za ubwino ndi kupweteka kwa chithandizo cha opaleshoni ndi chopanda chithandizo ndi dokotala kuti mudziwe zomwe mukulowa.
> Chitsime:
> Tonino PM, ndi al. "Mavuto Ovuta Kumodzi: Kufufuza ndi Chithandizo" J Am Acad Orthop Surgery March 2009; 17: 125-136.