Seedaha bakhtiisto wadajir ah garabka: Calaamadaha iyo Daaweynta

Haddii aan ku eekaan aragtida ah in shaqada laga sameeyey nin daanyeer ka, talaabada ugu horeysa ee this Jidka dheer oo adag iska leh si wadajir ah garabka. Waxa ay aheyd inuu qaab-dhismeedka gaar suurto by qaybaha salka of addinka sare si ay u bartaan inta kale ee nuujiya aan caadi ahayn sifooyinka functional.

Taa baddalkeeda, si weyn u ballaarinta hawlaha ay ka taageero keliya marka la guuro, gacmaha aadanaha ayaa noqotay mid ka mid ah qaybaha ugu buuqsan ee jirka. Marka tan la eego, dhaawaca ay dhex-xidh garabka, taas oo inta badan la socda ee seedaha bakhtiisto wadajir ah garabka, oo ku yaalla aagga of fiiro gaar ah ee rugaha caafimaadka. Iyo sababta xididka of this - khasaaraha suurto galka ah ee awooda in ay ka shaqeeyaan, iyo waxa ka sii xun, qof naafo si sax ah ama aan burbur waqtigii la daaweyn.

Warbixinta Gaarka ah ee tixraaca jidh

aqonsado ee wadajirka ah garabka waxaa lagu qeexay sida cabirku yahay meelaha ay articular run. In formation of canaasiirta lafaha si toos ah lug laba lafaha, oo daab iyo humerus. Oogada articular of humerus waxaa matalaya madaxa spherical. Iyadoo la tixgelinayo dusha concave ee saabka aagga daab gadood ka glenoid waxa ay ku saabsan afar jeer ka yar aagga xiga kubada.

ka daab xiriir ka maqan waa mowjadda giraanta carjawda - dhismeedka connective cufan, u yeedhay dibinta articular. Waa this element buunshada ku, wada jir ah ula kaabsal ku hareereysan laabatada, oo u ogolaanaya inuu dadka la tiro sax ah jidh iyo waqti isku mid ah si ay u qabtaan kala duwan cajiib ah oo mooshin, taas oo suurto gal ah in stock uu diidanaa oo dhan si wadajir kale.

Xafidaada ee seedaha iyo murqaha si wadajir ah awood dhaqdhaqaaqa

Waxay ka caawisaa synovium khafiif kaabsal wadajir hayn ay qaab-dhismeedka jidh jilibka rostral-humeral awood badan. Dhinacyada waxaa la in si wadajir ah u kordhiyay hayn dheeri ah articular uu legyahay bloat kaabsal seed (legyahay) iyo muruqyada subscapularis. Saddexdan xadhig connective oo ku xanuunsado, haddii uu jiro dillaac ah seedaha wada garabka.

Subscapularis, deltoid, wareega kor iyo podkostnaya, waaweyn iyo kuwo yaryar, iyo sidoo kale Caanamareeno ugu weyn iyo latissimus dorsi siin wadajir kala duwan ee balaadhan oo ah dhaq-ku wareegsanaa oo dhan saddex faasas. Legyahay in dhaqdhaqaaqa wadajirka ah garabka uusan ka qayb qaadan.

Dhaawacyada si wadajir ah garabka iyo sababaha dhaawac

Waxaa ka mid ah dhaawacyada ugu badan ee garabka burbur si wadajir ah loo sii daayo. Macquulka ah murgacashada wadajir ah la dillaac ah qayb ahaan ama gebi ama waxa aan. si wadajir ah iyo barakacyo, Goosimo jab avulsion intra ama dheeri ah articular (ee seedaha lifaaqa) ka mid ah dhaawacyada ugu daran yihiin.

Sababaha ugu waaweyn ee dhaawaca ku wadajir ah garabka waa saamayn toos ah ama dadban ay qaab-dhismeedka farsamo. Tani waxay noqon kartaa hit si toos ah iyo dhacay fidsan gacanta weeraryahanka. Sharp kacsanaanta muruq xad-dhaaf ah, guurto si wadajir ah, ama dhaqdhaqaaq lama filaan ah tiro badan waxaa laga yaabaa keeni sida murgacashada ama bax laabatada. Sida caadiga ah oo ay la socdaan ay seeduhu bakhtiisto wadajir ah garabka (sawirka hoos ku qoran), waxay u baahan tahay ma aha oo kaliya lagu daaweeyo dhaawacyada ugu, laakiin sidoo kale soo celiyo daacadnimada qalab jilibka ah.

Calaamadaha la dillaacaan soo gaaray

Dhaawaca ayaa dhici kara marka uu jiro hoos u dhacday ee loo qoondeeyay kordhiyay weerarka ama in ay gacanta dhinaca. Waxa kale oo suuragal dillaac jilibka ay sabab u tahay dhaq-af badan in ugu badnaan ilaa xad la ogolaan karo ama qiilqiil ama gacanta, tusaale ahaan marka laga height a hoos.

dhaawac la socda iyo dillaac ah kaabsal oo ka mid ah calaamadaha garabka seedaha si wadajir ah waxaa lagu gartaa xanuun af badan ee ka dambeeya waqtiga dhaawaca, iyo in si gaar ah muhiim u soconin, waayo, dhaq-cel-farsamo dhaawac. Dheeraad ah horumarinta degaanka bararka burburka wixiii qaabeynta dibadda si wadajir ah. Waxa intaa dheer in barar, barar dhismaha ka qayb geli kara huleeshay ka dhaawacmeen xididdada dhiiggu u dhow seedaha, murqaha ama dhiigga.

habab dheeraad ah ee qiimaynta darnaanta dhaawac

Waxaa ka mid ah hababka cilmi clinical, traumatologist jidaynayey si loo ogaado haddii ay jiraan waa dillaac ah qayb ka mid ah seedaha wada garabka ama dhaawac guud ahaan, waxay u taagan tahay ogaanshaha ultrasonic iyo magnetic resonance imaging. Labada hababka waxba ma aad dhashid load radial, laakiin aad u badan xal. Gaar ahaan, MRI ogolaanaya isku halaynta ugu badan si loo ogaado baaritaan iyo la doortay ee daaweynta.

Raajada ama raajito loogu xisaabiyaa la fuliyaa si looga fogaado lesions lafta: jab ah (oo ay ku jiraan vouchers), kala-baxa, conjugated la jab iyo barakacyo wada garabka. Inta badan loo isticmaalaa arthrocentesis. Arthroscopy sameeyaa looga shakisan yahay isbedel side dhismayaasha unugyo laabatada ama dillaacin kaabsulka. Xaaladaha qaarkood, loo isticmaalo arthrography.

Degree ee adkaanta dhaawac

Kala classical ee fudud, dhexdhexaad ah uu dhaawac aad u daran, iyo codsatay dhanka ah seedaha dildillaacsan. By dhaawac yar oo si wadajir ah garabka, xad seedaha, waxaa ka mid ah iskala dhaawac u eexan ee seedaha macdantaa ah, iyadoo la sii daacadnimada xididdada dhiigga, dareemayaasha iyo muruqyada. Lagu gartaa shahaado qayb celceliska jeex fiber ee seedaha ah, muruqyada ku wareegsan qaybta dhaawac ku lug leh geeddi-socodka, kaabsal wadajirka ah dhaawac ayaa laga yaabaa. Midkii kowaad wuxuu la xiriiraa murgacasho darajadii, kii labaadna wuxuu ahaa - stretchability soconin qayb ahaan.

dhaawac aad u daran ay weheliyaan daacadnimada ah seed jebinta dhamaystiran oo qaabka (jilibka) - garabka soconin seedaha wadajir dhaawac vascular maxaliga ah, iyo ka qaybgalka dareemayaasha cilladaha ee kaabsal wadajirka ah. At this xad suurto gal ah iyo avulsion intraarticular jab, hemorrhage wadajir ah (hemarthrosis).

Nidaamka daaweynta

Iyada oo ku xidhan heerka darnaanta burburka in garabka qalab jilibka wadajirka ah, daaweynta muxaafidka ah ama qalliinka waa la isticmaali karaa. Haddii uu jiro dillaac ah qayb ka mid ah seedaha wada garabka, daaweynta ku eg tahay hababka muxaafidka ah. Habka xanuun Applied iyo joojin (joojin). Waxaa laga yaabaa in rogo bintovoy ama nuuradda kabka, iyadoo ku xiran darraanta, nooca dhaawaca iyo mugga mid ah dhismayaashii saameeyeen. Bintovuyu ama orthesis immobilisation malaastaan bedeli karaan (bands) ee garabka wadajir ah ama dhexdhexaad ah u qardarin adag.

fasax A complete, gaar ahaan dhaawac u muruqyada iyo kaabsoosha wadajir ah, loo isticmaalo qalliinka. Dhibbanaha wuxuu u baahan yahay profile trauma isbitaal iyo dayactirka muddo dheer ka dib markii dheecaan ka isbitaalka.

guide kabashada qalad Hawleed

The si degdeg ah farqiga saxo oo ka mid ah howlgalka garabka seedaha wadajirka ah ee lagu saleyn doonaa, si fiican fursadaha soo kabashada buuxda oo shaqo wadajir ah oo hoos u boqolleyda dhibaatooyin dhaawac. dayactirka Qalliinka ee jilibka ah dhaawacan (seed) muruqyada ku xeeran, iyo baabi'inta ee burburay kaabsal iin vascular yaraynaysaa in ay crosslinking.

Under suuxinta guud (narcosis) helaan si toos ah waxaa laga dhigay wax ka badan dissection layerwise kaledii dhaawacan iyo kala unugyada. Cilladaha helay sutured. Dhaawacu waa la xiray ee layers. In muddo hore postoperative isticmaalaya malaastaan a joojin la daaqad for tollin postoperative tuuray.

Taariikhaha joojin nuurad iyo daaweynta isbitaalka waxaa go'aamiya mugga mid ah dhismayaashii ay dhibaatadu saameysey. factor muhiim u ah tirada sariir-maalmood waa da'da bukaanka, dabeecadda ee uu shaqada, iyo wada-aadamenimo.

Burburka u seedaha suxulka

Waa dhif iyo naadir in xaaladaha qoyska, dhaawac waa ka caadiga ah ee ciyaartooyda xirfadleyda ah, marka la isticmaalayo firfircoon oo af badan gacanta ku ruxruxo, qaloocsan tahay xagasha. kooxda halista ku jira, ugu horreeya oo dhan, ciyaaryahan tennis, golfers, kubadda gacanta, baseball, iyo Polo biyaha.

Inta badan dhaawac jilibka annular ee gacan, ulna jilibka, ama radial ah. Waa calaamad burburka xanuunka, inta lagu guda jiro kordhaya dhaqdhaqaaqa. Lagu gartaa barar, hemorrhage galay nudaha ku hareereysan. Fursada hemarthrosis. Haddii uu jiro dillaac dhamaystiran seedaha, waxaa laga yaabaa in wax yar la mowjadda lafaha dhudhun ee wadajirka ah.

Raajada ogolaanaya in la kala jabka of bax. MRI tusi doonaa meesha ay ku kooban dillaac seedaha suxulka. Daaweynta dillaac qayb oo aan dhamaystirnayn oo muxaafid ah. Khuseysaa joojin muddo dhowr toddobaad ah. fasax A complete la sameeyo seedaha qalliinka caag burburay.

anatomy kooban oo si wadajir ah gacanta

Complex in qaab-dhismeedka sameeyay si wadajir ah dusha carjawda articular of saxan shucaaca iyo ulna by ah dhudhun iyo scaphoid ah, lunate iyo kooxda xagalka burush. Pisiform lafta waxa uu ku yaalaa gudaha oo ka mid ah soo gaaray iyo ka qaybgalka tooska ah ee formation of wadajirka ah ma aqbasho.

Xoojinta shan seedaha wadajir ah. timireed waa jilibka suxulka iyo curcurtaka ka dusha dhabarka - dambe ee farabadan ee burushka. On dhinac waa palmar ah lateral (dhinaca suulka) iyo ulnar (dhinaca farta yar) seedaha.

Burburka u seedaha ah curcurka waa yara naadir badan seedaha bakhtiisto wadajir ah garabka. Laakiin in ka badan seedaha xusulka.

Jebi seedaha curcurka

hab ay of dhacdo dhaawacyo la xiriira hoos u dhacday gacanta weeraryahanka qaawan ama dharbaaxo ku burushka laaban yihiin ama toosan. Xilkaasi waxa uu gacanta ugu dambeeya waqtiga dhaawaca waa si toos ah ay khusayso si loo ogaado taas oo ka mid ah garoomada dhaawac soo gaaray laga yaabaa. Inta badan oo dhan dhaawac soo horjeeda connective in qaab dhismeedka laab ah burushka.

Tilmaamo Top of dhaawac, xanuun, barar, shaqo wadajir ah oo yaraada iyo hematoma unug jilicsan. Haddii uu jiro xanuun dhaqdhaqaaqa faraha ama gacanta u soo maratay kordhiyaa at Warega in si wadajir ah, waxaa lagu tuhunsan yahay waxaa laga yaabaa in seedaha bakhtiisto si wadajir ah gacanta. Calaamadaha waxaa kaabaya cilmi cudurka of hardware: X-ray - in laga saaro jab lafta, ultrasound iyo / ama MRI. Waxay lagama maarmaan ah si loo ogaado nooca dhaawaca seedaha iyo unugyada kale ee jilicsan hareereysan laabatada yihiin.

Sida ay dhacdo in kasta oo kale, haddii ay jirto a seedaha farqiga laabatada gacanta, daaweynta ku xirnaan doontaa darnaanta dhaawaca. In darnaanta fudud iyo kuwa dhexdhexaadka khuseysaa muxaafidka hoos culus - istaraatijiyad hawl.

Marka laga nooca waxyeellada dhacday, waxa dabiiciga ah ee ku xad daacadnimada dhismeedka wadajir ah, si wadajir ah la dhaawacay, curcurka, xusulka, ama jiro dillaac ah qayb ahaan ama gebi ah seedaha wada garabka, daaweynta waa in had iyo jeer la maamula takhasus u leh. tashi qasabka ah in qol profile ah (rugta jab leeyihiin trauma ee rugta caafimaadka ama waaxda aqbaliddoodii of traumatological isbitaalka). Tani waa run gaar ah dhaawacyada carruurnimada, sida in bukaanka ka yar, waxaa jira tiro ka mid ah muuqaalada da'da la xiriira in qarin kartaa dhaawac halis ah. Iyo dib u raadinaya gargaar caafimaad u lihi waxay keeni kartaa cawaaqib muddo dheer xun.