Izixazululo Ezithuthukisiwe Zokubuyisela Idolo

Ukulimala kweMeniscal

Ukulimala kwe-Meniscal kwenzeka emidlalweni ehlukahlukene, ikakhulukazi imidlalo yokuxhumana, futhi kuvame kakhulu emisebenzini yansuku zonke nasemsebenzini, ngokuvamile kuhlanganiswe nokunye ukulimala kwemisipha. I-meniscus ephakathi ilimala kalula lapho umlenze ophansi ujikeleza ngaphandle ngokuphathelene ne-femur, kuyilapho i-meniscus yangasese ijwayele ukulimala ngesikhathi sokujikeleza kwangaphakathi kwe-tibia. Ukulimala kwe-Meniscal kungase kwenzeke ngenxa ye-hyperflexion noma i-hyperextension yamadolo noma umthelela oqondile phakathi kwe-femur ne-tibia. Imibiko evela phesheya ibonisa ukuthi ukulimala kwe-meniscus kwangaphakathi kuvame izikhathi ezinhlanu kunokulimala kwe-meniscus yangemuva, kuyilapho imibiko yasekhaya iphakamisa ukusabalala okuphezulu kokulimala kwe-meniscus yangemuva.

I-Medial Collateral Ligament (MCL) Ukulimala

I-MCL iqukethe izendlalelo ezikha phezulu nezijulile ngaphandle kwegebe elihlukile phakathi kwazo. Ungqimba olungaphezulu luvela eduze kwe-adductor tubercle bese lufaka ohlangothini lwangaphakathi lwengxenye engenhla ye-tibia, kuyilapho ungqimba olujulile luqala ku-epicondyle ephakathi bese lufaka ohlangothini lwangaphakathi lwengxenye engenhla ye-tibia, okufaka isandla ku-capsule ehlangene. kanye nokuxhuma ku-meniscus ephakathi. Ukulimala kwe-MCL kuvela emandleni asebenza ngaphandle, njengokuthunjwa kwe-tibial kanye nokuzungezisa kwangaphandle noma ukukhishwa kwe-femoral nokuzungezisa kwangaphakathi.

I-Lateral Collateral Ligament (LCL) Ukulimala

Ukulimala kwe-LCL akuvamile futhi ngokuvamile kubangelwa ukusetshenziswa kwamandla ngaphakathi kwamadolo ahlangene noma ezinye izimbangela eziholela ekulimazeni kwe-varus yamadolo, ngokuvamile okuhambisana nokulimala kwe-capsule ehlangene, imisipha ye-peroneal, i-biceps femoris, imisipha ye-hamstring, noma ngisho. i-peroneal nerve evamile.

I-Anterior Cruciate Ligament (ACL) Ukulimala

I-ACL iqala phakathi kwezindawo zangaphambili ze-condyle ye-tibial kanye nophondo lwangaphambili lwe-meniscus yangemuva, iphele engxenyeni engaphakathi ye-condyle ye-femoral lateral. Iqukethe inqwaba ye-lateral lateral kanye nenqwaba ye-medial yangaphambili. Ukulimala kwe-ACL kuvame kakhulu, ngokuvamile kuyingxenye yokulimala okuhlangene, kodwa kungase kwenzeke njengokulimala okukodwa.

Ukulimala Kwe-Posterior Cruciate Ligament (PCL).

I-PCL inamathela engxenyeni engemuva ye-surface ehlangene ye-tibial, idlulela ekupheleni kwe-posterior engenhla ye-tibia, igijima ngemuva kwe-posterior medial bundle ye-anterior cruciate ligament, futhi iphetha engxenyeni ye-lateral ye-condyle ye-femoral medial. I-PCL iqinile, ngakho-ke ukulimala akuvamile, ngokuvamile kubangelwa amandla angaphandle abalulekile futhi ngokuvamile kuhambisana nokunye ukulimala.

Ukuhlolwa Komtholampilo: Kuhlanganisa ukubhekwa kwezimpawu, ukuhlola ukuzinza okuhlangene, ukukalwa kobubanzi obuhlangene bokunyakaza, njll.

Izifundo Zokucabanga: I-X-ray, i-MRI, i-CT scan, njll., esetshenziselwa ukubuka izakhiwo zamathambo, izicubu ezithambile, nezinga lokulimala.

Ukuhlolwa kwe-Arthroscopic: Kubheka ngokuqondile izimo zangaphakathi zelunga, kusiza ekuxilongeni nasekwelapheni.

Ukulimala kweMeniscal

Iziguli zivame ukuba nomlando wokuhlukumezeka, ubuhlungu obusheshayo ngemva kokulimala, ukuvuvukala kwamadolo okulandelana, ubuhlungu obubuhlungu obusendaweni obungalungile, futhi kamuva, ubuhlungu besayithi elithile. Ngemuva kokulimala, ukuhlanganiswa kwe-joint effusion kwenzeka, kanye nokukhiya ngokuhlanganyela kanye nokubukeka "kwendlela enikezayo" ngesikhathi sokunyakaza kwamadolo, okuhambisana nokuchofoza, nokuzwela okuzwakalayo kwendawo endaweni ehlangene. Ukuhlolwa kukaMcMurray kuvame ukuba ne-positive futhi kuyindlela yokuhlola esetshenziswa kakhulu. I-Apply Test ingabangela ubuhlungu ohlangothini olulimele futhi ihlole isimo ngesikhathi sokusquat ngaphansi komthwalo. Abanye baphinde benze ukuhlolwa kokushwibeka, babeke isithupha endaweni ehlangene yohlangothi olulimele futhi benyakazisa umlenze kancane, bezwe i-meniscus ingena iphuma endaweni, okuyinto enhle uma ihambisana nobuhlungu.

I-arthrografia ehlangene yamadolo iyithuluzi lokuxilonga elisetshenziswa njalo, elisiza ekulimaleni kwasendaweni. Nakuba isasetshenziswa kwezinye izimo, kancane kancane ithathelwe indawo nezindlela ezintsha zokuhlola. Ukuhlolwa kwe-arthroscopic kunesilinganiso sokuqinisekisa esifinyelela ku-90% futhi singasetshenziselwa ukuhlinzwa kodwa kunemikhawulo ekubhekeni uphondo lwangemuva lwe-meniscus ephakathi. I-MRI ibalulekile ekuxilongeni ukulimala kwezicubu ezithambile ezihlangene.

I-Medial Collateral Ligament (MCL) Ukulimala

Ngemuva kokulimala, ubuhlungu obukhulu buvela ohlangothini oluphakathi kwedolo elihlangene, likhululiwe bese landa, okuholela ekuvuvukeni okuphakathi kanye ne-ecchymosis. Ku-30 ° we-flexion yamadolo, ukuzwa okungavamile kokuvula indawo ehlangene kungase kuzwakale, kuncishiswe ukungezwani kwe-MCL, nokuhlolwa kokucindezeleka kwe-valgus. Ukwenza ukucindezeleka kwe-valgus i-X-rays yokuqhathanisa kwamazwe amabili kubonisa ukwanda kwesikhala esihlangene ohlangothini oluthintekile ngaphezu kwe-10 °, okubonisa ukuphuka okuphelele kwe-MCL, kanye nokulimala okungase kube khona kwe-anterior cruciate ligament. I-MRI inikeza ukuxilongwa okucacile.

I-Lateral Collateral Ligament (LCL) Ukulimala

Iziguli zivame ukuba nomlando wamandla angaphakathi emadolweni ahlangene, ubuhlungu bamadolo obungemuva kokulimala ngemuva kokulimala, ukuvuvukala, nokuzwela okuphawulekayo kwendawo, okuvame ukuphuka kwekhanda le-fibular. Uma kuhambisana nokulimala ezakhiweni eziseduze, izimpawu ezihambisanayo zenzeka. Ukucindezeleka kwe-Valgus kuhle, kunciphise ukungezwani kwe-LCL, nokuzwela okuphathekayo kanye nomuzwa wokuvula ongajwayelekile. I-X-ray yokucindezeleka kwe-Valgus ibonisa ukwanda kwesikhala esihlangene ohlangothini oluthintekile.

I-Anterior Cruciate Ligament (ACL) Ukulimala

Ukulimala kwe-ACL kuvame ukwenzeka ngenxa yokuhlukumezeka okukhulu kwamadolo, ukuzwa ukuzwa okudabukisayo, ubuhlungu obuhlangene emadolweni, ukungazinzi, ukungakwazi ukuphinda ukunyakaza, noma ukuqhubeka nokuzivocavoca. Ukuvuvukala kwamalunga okulandelayo kanye ne-hemarthrosis kwenzeka, futhi ukuhlolwa kwedrowa kuhle. Ubuhlungu obukhulu obunzima buvame ukwenza ukuhlolwa okuningiliziwe kube inselele, kodwa ukuhlolwa kungenziwa ngemva kwe-anesthesia noma esikhathini se-post-acute. Ukuhlolwa kwedrowa langaphambili elihle, ukuhlolwa kwe-Lachman, ukuhlolwa kwe-pivot shift, nokuhlolwa kwe-jerk kubonisa ukulimala kwe-ACL. Ukuhlolwa kwe-Lachman okwenziwa ngokulenga komlenze wesiguli kuhle, okubonisa ukulimala kwe-ACL. Ama-X-ray ukuze kutholwe ukuphuka kwe-avulsion abalulekile ngokuxilonga. Ukuhlolwa kwe-drawer yangaphakathi ngesikhathi esisodwa ama-X-ray abonisa ukufuduka kwe-tibial yangaphambili, okubonisa ukulimala kwe-ACL. I-MRI inikeza ukuxilongwa okunembile.

Ukulimala Kwe-Posterior Cruciate Ligament (PCL).

Izimpawu zokulimala kwe-PCL zifana nalezo zokulimala kwe-ACL futhi zinomlando ocacile wokuhlukumezeka okukhulu. Ukuhlolwa kwedrowa elingemuva kuhle, futhi ama-X-ray angenziwa ukuze axilongwe. Iziguli ezilele phansi ngezinyawo zombili izinyawo etafuleni lokuhlola cishe i-90 ° ye-knee flexion zingase zithole i-posterior tibial sag; lapho umhloli ebamba i-femur yesiguli kude futhi eguquguquka i-hip namadolo, ukunyakaza kwangemuva kwe-tibia ehamba phambili kubonakala kakhulu, okubonisa ukuphuka kwe-PCL. Ama-X-ray abonisa ukuphuka kwe-PCL avulsion. I-MRI inemba uma kuqhathaniswa ukuze kuhlonzwe ukulimala kwe-PCL.