Opaleshoni Yokonza Mbali Yopatulidwa
Gulu lopatulidwa ndilo vuto limene limapangitsa kuti collarbone (clavicle) ikhale yosiyana ndi chiyanjano chake kuchokera pamapewa. Kawirikawiri zimasokonezeka ndi kugawanika kwa mapewa, kupatukana kumagawo ndi zovulaza zosiyana. Kawirikawiri zimayambitsa kugwa kunja kwa dzanja lanu kapena mapewa, anthu omwe ali ndi mapewa amapezekanso ndi kupweteka pamwamba pa mapewa awo.
Kutupa kwenikweni kumayambitsa mapeto a collarbone akukankhira motsutsa khungu.
Anthu ambiri omwe ali ndi mapewa atapatulidwa amatha kupweteka ndi mankhwala osachiritsika . Ndipotu, opaleshoni ambiri a opaleshoni amavomereza kuti mtundu uliwonse ndi mtundu wa II wopatukana ukhoza kusamalidwa popanda opaleshoni. Mtundu Woyamba I ndi Wachiŵiri kugawana magawo ndiwowonjezereka kwambiri, choncho, kuchitapo opaleshoni kumawonedwa ngati kagawo kakang'ono ka kuvulala kumeneku.
Pali kutsutsana pa kayendetsedwe ka kusiyana kwa mtundu wa III, pamene mtundu waukulu wa IV, V, ndi VI ukulekanitsa kumachita bwino ndi opaleshoni. Mfundo yaikulu ndi yakuti, anthu ambiri adzachita zabwino popanda opaleshoni; Ndi mitundu yoopsa kwambiri ya mapewa olekana omwe amatha kuchitidwa opaleshoni.
Njira Yopangira Opaleshoni
Cholinga cha mankhwala onse opaleshoni ndi kupatulira mapewa ndi kubwezeretsa kusinthasintha kwa mapeto a collarbone ndi kunja kwa mapewa (acromion).
Pamapeto pake, chiyembekezo ndicho kubwezeretsa kuikidwa kwa mafupawa, kuwaika pamalo otetezeka, ndi kuchepetsa kupweteka pa mgwirizano wa acromioclavicular.
Njira zazikulu zopangira opaleshoni ndizo:
Kukonza mgwirizano wa AC: Kukonzekera mgwirizano wa acromioclavicular kumapanga nzeru zambiri. Mbali yodziwika kwambiri ya chovulala ndi kusokonezeka kwa mgwirizano, ndipo kuika ndi kugwirizanitsa malo oyenera kumapanga nzeru zambiri.
Mgwirizano wa AC umagwiritsidwa ntchito ndi zitsulo kapena zitsulo zotchedwa Kirschner waya (k-waya). Zovuta za opaleshoniyi ndizoti zimalephera kuthetsa kuwonongeka kwa ligament ku mitsempha yamphamvu yomwe imagwira mapeto a chiwombankhanga pansi. Kuonjezera apo, zida zachitsulo zomwe zimagwiritsidwa ntchito kuti zigwirizane zikhoza kupweteka, zikhoza kuchotsedwa, komanso zowonjezereka zokhudzana ndi kuthekera kuti izi zimatha kuyenda. Izi zikutanthauza kuti akhoza kuyenda mkati mwa thupi, ndipo pali malipoti owopsa a ma-wira omwe amaikidwa m'kati mwa chifuwa.
Kusunga Collarbone Down: Pali njira zingapo zothandizira kuvulala kwa mgwirizano wa AC omwe amachititsa khungu la pansi, ena pogwiritsa ntchito chitsulo, ena pogwiritsa ntchito sutures. Kaŵirikaŵiri collarbone imagwiritsidwa ntchito ku coracoid, chingwe cha fupa kutsogolo kwa phewa lomwe liri pansi pa collarbone. Mwina phokoso likhoza kuikidwa kuchokera ku collarbone kupita ku corocoid, kapena mafupa awiri akhoza kukulumikizana pamodzi mwamphamvu ndi sutures. Zovuta za njirazi ndikuti zikuluzikulu zimafunika kuchotsedwa ndipo sutures ikhoza kudula ndi kuthyola fupa.
Kubwezeretsa Zigamulo: Gawo lomaliza laziganizo ndikumanganso zida zomwe zimagwira ntchito yomaliza.
Pali njira zingapo zomwe mungachite kuti mugwiritse ntchito mankhwalawa, pogwiritsira ntchito minofu kapena minofu . Imodzi mwa njira zomwe zimachitidwa kawirikawiri, yotchedwa Opaleshoni ya Weaver-Dunn, amasintha imodzi mwazigawo zazikulu zomwe zimagwirizanitsa ndi acromion mpaka kumapeto kwa chiwongolero. Izi zimagwirizanitsa chikhalidwe chawo. Zosankha zina zimaphatikizapo kukonzanso mitsempha yowonongeka (yomwe inang'ambika pamene kuvulala kwa mapewa kunayamba kuchitika) ndi mtundu wa tendon kuchokera kumapazi anu kapena tendon kuchokera kwa wopereka. Gulu la tendon likulumikizidwa ku coracoid yolumikizidwa ndiyeno nkulowa mu chinyama.
Chithandizo changa chofunika kwambiri
Nthawi zambiri, ndimakonda kukonzanso mitsempha yowonongeka. Kuthamanga kwa magetsi kuchokera ku chiwombera kumakhudza, ndipo odwala ambiri sakufuna opaleshoni yachiwiri kuti achotsedwe kawirikawiri. Kuwonjezera apo, njira yokonzanso ndiyo yokhayo yomwe imayankhula vuto lalikulu - mitsempha yowonongeka yomwe imagwira mapeto a chiwongolero. Ndimagwiritsa ntchito minofu yothandizira yomwe imayendayenda pakhomoli ndipo imachitika mu collarbone ndi zikopa zomwe zimatengedwa ndi thupi nthawi. Ngakhale kuti n'zotheka kugwiritsa ntchito minofu ya munthu, osati minofu yopereka chithandizo, anthu ambiri safuna kuchita opaleshoni imodzi panthawi imodzi komanso pamilendo yawo. Choncho, tchutchutchu ndi njira yabwino ndipo yagwira bwino ntchito zanga.
Zonse zomwe zinanenedwa, madokotala ena opaleshoni amapindula ndi njira zina zothandizira. Chifukwa chakuti dokotala wina amafuna chithandizo china sichikutanthauza kuti ndi zabwino kwambiri. Madokotala ochita opaleshoni amatsutsana kwambiri pa nkhaniyi ndipo sangagwirizane kuti ndi njira iti yabwino. Onetsetsani kuti mwapeza dokotala wodwala amene ali ndi chithandizo chochipatala pa mapewa osiyana mukamasankha.
> Zotsatira:
> Simovitch R, Sanders B, Ozbaydar M, Lavery K, Warner JJ. "Kuvulala kwagwirizanaku: Kugwiritsidwa ntchito ndi kasamaliro" J Am Acad Orthop Surg. 2009 Apr; 17 (4): 207-19. Onaninso.