Ukulimala Okuqhelekileyo Kwama-Tissue Tissue Okubangelwa yi-Trauma

Ngokutsho kweAmerican Academy of Orthopedic Surgery �Ezona zicubu zithambileyo zixhaphakileyo zonzakeleyo zizihlunu, imisipha, kunye nemithambo.

Ukwenzakala okumandundu kubangelwa kukwenzakala ngesiquphe, njengokuwa, ukujijeka, okanye ukuvuthela emzimbeni. Imizekelo yokwenzakala okumanyumnyezi ibandakanya i-sprains, i-sprains, kunye ne-contusions.�� (orthoinfo.aaos.org/topic.cfm?topic=A00111) Kwakhona akufanele sikhohlwe ukuba kukho ezinye izicubu ezithambileyo ezinokulimala kunye nenkcazo eyinyani yezicubu ezithambileyo, nantoni na into engekho ithambo izicubu ezithambileyo.

Oku kubandakanya ingqondo, imiphunga, intliziyo kunye nalo naliphi na elinye ilungu lomzimba. Nangona kunjalo, kunyango ukwenzakala kwezicubu ezithambileyo kuqhelekile ukuba kukhawulelwe kwizihlunu, iiligaments kunye neetendon.

Ulwahlulo loLwahlulo lweTissue ethambileyo

Xa thina jonga uhlobo lwezakhiwo eziqulunqwe yimisipha, i-tendon kunye ne-ligament, siya kuqonda ukuba ziyizicubu ezidibeneyo. NgokweZiko leSizwe lezeMpilo �Iithishu ezinxibelelanayo yimathiriyeli engaphakathi emzimbeni wakho exhasa uninzi lwamalungu ayo. Yeyona "glue yeselula" enika izicubu zakho ukumila kwazo kwaye inceda ukubagcina bomelele. Ikwanceda ezinye zezicubu zakho zenze umsebenzi wazo (www.nlm.nih.gov/medlineplus/connectivetissuedisorders.html). Ngokungafani nokulungiswa kwe-fracture apho ithambo litshintshwa kwaye ngokuqhelekileyo liphilisa ngokufanelekileyo xa lilungelelaniswa kwaye liphumle, ukuphazamiseka kwezicubu ezixhamlayo zifumana uhlobo olwahlukileyo lokulungiswa kwesilonda esinokutshintshwa kwezicubu eziphambukayo njenge-sequella yokulimala komzimba kwaye kunomsebenzi ongapheliyo ongapheliyo.

Ukuba sigxininisa kwi-sprains okanye ukulimala kwe-ligamentous, ngokutsho kwe-American Academy of Orthopedic Surgery kukho iintlobo ezintathu ze-sprains:

I-sprains ihlelwa ngokobunzima:₁

• IBanga loku-1 i-sprain (ephakathi):�Ukolula kancinci kunye nomonakalo othile kwimicu (fibrils) yeligament.
• IBanga lesi-2 i-sprain (ephakathi):�Ukukrazuka komthambo. Kukho ukukhululeka okungaqhelekanga (ukuyekelela) kwilungu xa lishukunyiswa ngeendlela ezithile.
• IBanga lesi-3 i-sprain (kakhulu):�Ukukrazuka ngokupheleleyo kwethambo. Oku kubangela ukungazinzi okuphawulekayo kwaye kwenza i-joint ingasebenzi.

Kungakhathaliseki ukuba ubunzima be-sprain, kukho umonakalo wezicubu okanye ukulimala komzimba kwaye isinyathelo esilandelayo kukufumanisa ukuba kukho ukuphilisa okanye ukulungiswa kwesilonda. NgokukaWoo, uHildebrand, uWatanabe, uFenwick, uPapageorgiou kunye noWang (1999) � ngenxa yoko indibaniselwano yonyango lweeseli kunye nonyango lokukhula kunokubonelela ngeendlela ezintsha zokuphucula ukuphiliswa kwethambo kunye nethambo. Ngokuqinisekileyo, iingcebiso ezithile malunga nokukhethwa kwezinto zokukhula, kunye nexesha kunye nendlela yokusetyenziswa ayinakwenziwa ngeli xesha.

Iinzame zangaphambili zokumisela iidosi ezona zilungileyo zezinto zokukhula zibonelele ngeziphumo eziphikisanayo. Nangona unyango lwemeko yokukhula lubonakaliswe ukuphucula iimpawu zokuphulukisa iigaments kunye nee-tendon, ezi zakhiwo azifikeleli kwinqanaba lezicubu ezingenakulimala.� (iphe. s320)

�Akukho nyango lukhoyo ngoku lokubuyisela i-tendon okanye i-ligament eyenzakeleyo kwimeko yayo yesiqhelo.�, utshilo uDozer noDupree (2005). (iphepha 231).

Inkqubo yoBuyiselo lwezicubu ezithambileyo

NgokukaHauser, uDolan, uPhillips, uNewlin, uMoore kunye noWoldin (2013) �isakhiwo somlenze owonzakeleyo sithatyathelwa indawo sisihlunu esimanyumnyezi, ngokwembali, ngokwesayensi yezinto eziphilayo kunye ne-biomechanically efana nezicubu ezibomvu. Ukulungiswa ngokupheleleyo kwezicubu ezibomvu zihlala zibuhlungu, i-microscopically kunye nokusebenza ngokwahlukileyo kwiithishu eziqhelekileyo� (iphe. 6) �izinto ezingaqhelekanga eziqhubekayo ezikhoyo kwi-matrix ye-ligament ehlaziyiweyo ingaba nefuthe elinzulu kwi-biomechanics edibeneyo, ngokuxhomekeke kwiimfuno zokusebenza ezibekwe kwithishu.

Ekubeni i-tissue ye-remodel ligament i-morphologically kunye noomatshini abangaphantsi kwezicubu eziqhelekileyo ze-ligament, iziphumo ze-ligament laxity, ezibangela ukukhubazeka okusebenzayo kwamalungu achaphazelekayo kunye nokubeka kwangaphambili ezinye izicubu ezithambileyo ngaphakathi nangaphandle kwamalungu umonakalo ongakumbi.� (p.7) � (iphe. ngokuqhubekayo kuboniswa ukuba iiligamente ezithile aziphili ngokuzimeleyo emva kokuqhekeka, kwaye ezo zingazivanga, zenza oko ngokweempawu ezisezantsi zokubumba xa kuthelekiswa nezicubu eziqhelekileyo. Akuqhelekanga ukuba i-ligament engaphezulu kweyodwa yenzakala ngexesha lesiganeko esisodwa esibuhlungu.� (p.8) � i-osteoarthritis yokuguqulwa kwamalungu yenye yezona ziphumo eziqhelekileyo ze-ligament laxity.

Ngokuqhelekileyo, i-pathophysiology ye-osteoarthritis kwakucingelwa ukuba ibangelwa ukuguga kunye nokunxiba kunye nokukrazula kwi-joint, kodwa uphando olutshanje luye lwabonisa ukuba iigaments zidlala indima ebalulekileyo ekuphuhliseni i-osteoarthritis. I-osteoarthritis iqala xa enye okanye ngaphezulu kwemigqa ingazinzi okanye iyancipha, kwaye amathambo aqala ukulandelela ngokungafanelekanga kwaye abeke uxinzelelo kwiindawo ezahlukeneyo, okubangelwa ukuxutywa kwethambo kwi-cartilage. Oku kubangela ukuphuka kwe-cartilage kwaye ekugqibeleni kukhokelela ekuwohlokeni, apho i-joint iyancipha ibe yithambo ethanjeni, ingxaki yomatshini wejoyinti ekhokelela ekungaqhelekanga kwi-joint mechanics. I-Hypomobility kunye ne-ligament laxity ibe yimiba ecacileyo yomngcipheko wokuxhaphaka kwe-osteoarthritis.� (p.9)

Ukujonga umhlaba jikelele kuphando kwiminyaka eyi-16 yokugqibela, kwi-1999 kwagqitywa ukuba unyango olukhoyo ngoku ukulungisa okanye ukuphilisa i-ligament eyonzakeleyo ayifikeleli kwinqanaba lezicubu ezingenakulimala. Kwi-2005 kwagqitywa ukuba akukho unyango olukhoyo ngoku ukubuyisela i-tendon okanye i-ligaments eyenzakeleyo kwimeko yayo eqhelekileyo. Ukongezelela umgangatho wangoku wophando lwe-ligament kwi-2013 wagqiba ukuba i-ligaments ayiziva ngokuzimeleyo, kodwa i-ligaments yomonakalo yimbangela ethe ngqo ye-osteoarthritis kunye ne-biomechanical dysfunction (ukungaqhelekanga komatshini odibeneyo). Uphando lwamva nje luye lwagqiba ukuba umonakalo we-ligament okanye i-sprains yinto ephambili kwi-osteoarthritis kwaye kungekhona nje ukuguga okanye ukugqoka kunye nokukrazula kwi-joint.

Ngenxa yoko ngoku kucacile ngokusekelwe kubungqina besayensi bokuba ukulimala kwezicubu ezithambileyo kukuphazamiseka kwezicubu ezidibeneyo ezine-sequela engapheliyo engapheliyo kwaye yimbangela ye-arthritis yexesha elizayo. Lo ayisengomcimbi ekunokuxoxwa ngawo kwaye abo bakwiforam yezomthetho yezonyango abasaxoxa �ukwenzakala okwethutyana kwezicubu ezithambileyo� banikela intetho nje ngokungazi kunye nesizathu esinokubakho ngenxa yokuba iinyani zichaza ngokucacileyo ulandelelwano olubi olusekwe kumashumi eminyaka yenzululwazi ezininzi. izigqibo.

I-caveat kule ngxabano kukuba nangona kukho ukulimala komzimba okungenakuphikiswa kunye ne-sequella esisigxina ecacileyo, ingaba ibangela ukulahleka komsebenzi osisigxina kuyo yonke imeko? Leyo yimiba emibini ehlukeneyo kwaye ngenxa yomsebenzi we-ligaments, okukukudibanisa amathambo kumathambo i-arbiter ye-normal vs. Oko kunokufezekiswa nokuba yi-inclinometer yamacandelo amabini omqolo, ngokwe-American Medical Association Guides to Evaluation of Permanent Impairment, 5^th Uhlelo (iphe. 400) ngumgangatho (kwaye isengumgangatho wezonyango njengo-6^th Uhlelo lubhekiselele kwi-5^th kuluhlu lwezindululo).

Obunye ubungqina obunokubonwa bokuqukumbela umsebenzi ogwenxa kuqukumbela ukuyekelela kwemigqa nge-x-reyi yedijithali. Zombini izixhobo zokuxilonga ziqinisekisa ukulahleka okubonakalayo kokusebenza kwamalungu omgogodla. ��

Ubungakanani beenkcukacha zethu zikhawulelwe kwi-chiropractic kunye nokulimala kwemigudu nemiqathango. Ukuze uxoxe ngokukhetha kwimiba, nceda ukhululeke ukucela uDkt Jimenez okanye uqhagamshelane nathi 915-850-0900 .
 

Iingxelo:

1. I-Sprains, i-Strains kunye nezinye i-Soft Tissue Injuries (2015) i-American Academy ye-Orthopedic Surgery, ifunyenwe kwi-: orthoinfo.aaos.org/topic.cfm?topic=A00111
2. I-Connective Tissue Disorders (2015) Iziko leSizwe lezeMpilo, lifunyenwe kwi: www.nlm.nih.gov/medlineplus/connectivetissuedisorders.html
3. Woo S, Hildebrand K., Watanabe N., Fenwick J., Papageorgiou C., Wang J. (1999) Ubunjineli beTissue ye-Ligament kunye ne-Tendon Healing, i-Clinical Orthopedics kunye noPhando oluNxulumeneyo 367S pgs. S312-S323
4. Tozer S., Duprez D. (2005) I-Tendon kunye neLigament: Uphuhliso, ukulungiswa kunye nezifo, uPhando lweZiphene zokuZalwa (icandelo C) 75: 226-236
5. Hauser R., Dolan E., Phillips H., Newlin A., Moore R. kunye no-B. Woldin (2013) �I-Ligament Injury and Healing: Uphononongo lwe-Clinical Diagnostics yangoku kunye neTherapeutics, i-Open Rehabilitation Journal (6) 1- 20
6. Cocchiarella L., Anderson G., (2001) Izikhokelo zokuVavanywa koMonakalo ongunaphakade, i-5th Edition, i-Chicago IL, i-AMA Press

 

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