Ukushintshwa kwamahlombe

Ukufakwa esikhundleni kwamahlombe kungukuhlinzwa ukuze kufakwe esikhundleni samathambo ehlanganiso lehlombe ngezitho ezihlangene zokufakelwa.

Uzothola i-anesthesia ngaphambi kwalokhu kuhlinzwa. Izinhlobo ezimbili ze-anesthesia zingasetshenziswa:

• I-anesthesia ejwayelekile, okusho ukuthi uzobe uqulekile futhi ungakwazi ukuzwa ubuhlungu.
• I-anesthesia yesifunda yokundikaza ingalo nehlombe lakho ukuze ungezwa buhlungu kule ndawo. Uma uthola i-anesthesia yesifunda kuphela, uzophinde unikezwe umuthi ozokusiza uphumule ngesikhathi sokuhlinzwa.

Ihlombe liyibhola nesokhethi elihlangene. Umphetho oyindilinga wethambo lengalo ungena embobeni esekugcineni kwenkaba yehlombe, ebizwa ngesokhethi. Lolu hlobo lwesihlanganisi likuvumela ukuthi uhambise ingalo yakho ezinkomba eziningi.

Ekushintsheni okuphelele kwehlombe, ukuphela okuyindilinga kwethambo lengalo lakho kuzothathelwa indawo isiqu sokufakelwa esinekhanda lensimbi eliyindilinga (ibhola). Ingxenye yesokhethi (glenoid) yebhande lakho lehlombe izothathelwa indawo ulwelwesi (isokhethi) olubushelelezi oluzobanjelwa usimende okhethekile.Uma kuphela i-1 kulawa mathambo ama-2 adinga ukufakwa esikhundleni, ukuhlinzwa kubizwa ngokushintshwa kwehlombe okuyingxenye, noma i-hemiarthroplasty.

Olunye uhlobo lwenqubo lubizwa ngokuthi yi-reverse total shoulder replacement. Kulesi ukuhlinzwa, izikhundla zebhola lensimbi nesokhethi zishintshiwe. Ibhola lensimbi linamathele ehlombe. Isokhethi linamathele ethanjeni lengalo. Lokhu kuhlinzwa kungenziwa lapho imisipha yamakhokho e-rotator ilimale kabi noma kukhona ukuphuka kwehlombe.

Ngokushintshwa okuhlangene kwehlombe, udokotela wakho ohlinzayo uzokwenza imbobo (usike) phezu kwehlangothini lakho lehlombe ukuvula indawo. Lapho-ke udokotela wakho ohlinzayo uzokwenza lokhu:

• Susa ikhanda (phezulu) lamathambo engalo yakho ephezulu (i-humerus)
• Misa ikhanda lensimbi elisha bese ungena endaweni
• Smooth surface yesokhethi endala bese usimende entsha isendaweni
• Vala imbobo yakho ngeziqeshana eziyinhloko noma ama-sutures
• Faka okokugqoka (ibhandishi) enxebeni lakho

Udokotela wakho ohlinzayo angafaka ithubhu kule ndawo ukukhipha uketshezi olungase lukhule ngokuhlanganyela. Idreyini izosuswa lapho ungasayidingi.

Lokhu kuhlinzwa kuvamise ukuthatha ihora eli-1 ukuya kwele-3.

Ukuhlinzwa okufaka ihlombe kuvame ukwenziwa lapho unezinhlungu ezinzima endaweni yehlombe, okunciphisa amandla akho okuhambisa ingalo. Izimbangela zobuhlungu behlombe zifaka:

• I-osteoarthritis
• Umphumela ompofu wokuhlinzwa kwangaphambilini kwehlombe
• Isifo samathambo
• Ithambo eliphukile kabi engalweni eduze kwehlombe
• Izicubu ezilimele kabi noma ezidabukile ehlombe
• Isimila ngaphakathi noma nxazonke kwehlombe

Udokotela wakho kungenzeka angakutusi lokhu kuhlinzwa uma une:

• Umlando wokutheleleka, ongasakazeka kujoyini elithathelwe indawo
• Ukungasebenzi kahle kwengqondo
• Isikhumba esingenampilo esizungeze indawo yehlombe
• Imisipha ebuthakathaka kakhulu (i-rotator cuff) ezungeze ihlombe engakwazi ukulungiswa ngesikhathi sokuhlinzwa

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukusabela emithini noma ezinkingeni zokuphefumula
• Ukopha, ukunqamuka kwegazi, noma ukutheleleka

Izingozi zokuhlinzwa esikhundleni sehlombe yilezi:

• Ukusabela okweqile kujoyini lokufakelwa
• Ukulimala komthambo wegazi ngesikhathi sokuhlinzwa
• Ukuphuka kwamathambo ngesikhathi sokuhlinzwa
• Ukulimala kwemithambo ngesikhathi sokuhlinzwa
• Ukususwa kwejoyinti lokufakelwa
• Ukuxega kokufakwa ngokuhamba kwesikhathi

Tshela umhlinzeki wakho wezempilo ukuthi yimiphi imithi oyiphuzayo. Lokhu kufaka phakathi imithi, izithasiselo, noma amakhambi owathengile ngaphandle kwemithi kadokotela.

Phakathi namasonto ama-2 ngaphambi kokuhlinzwa kwakho:

• Ungacelwa ukuthi uyeke ukuthatha izinciphisi zegazi. Lokhu kufaka phakathi i-aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban powder (Xarelto), apixaban (Eliquis), kanye ne-clopidogrel (Plavix).
• Buza udokotela wakho ukuthi yimiphi imithi okufanele uyithathe ngosuku lokuhlinzwa kwakho.
• Uma unesifo sikashukela, isifo senhliziyo, noma ezinye izimo zezokwelapha, udokotela wakho ohlinzayo uzokucela ukuthi ubone udokotela wakho okuphatha ngalezi zimo.
• Tshela udokotela wakho uma uphuze kakhulu utshwala, ngaphezu kweziphuzo ezi-1 noma ezi-2 ngosuku.
• Uma ubhema, zama ukuyeka. Cela usizo kumhlinzeki wakho. Ukubhema kunganciphisa ukuphulukiswa kwamanxeba namathambo.
• Vumela udokotela wakho azi ngokushesha uma uthola umkhuhlane, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma okunye ukugula ngaphambi kokuhlinzwa kwakho.

Ngosuku lokuhlinzwa kwakho:

• Cishe uzocelwa ukuthi ungaphuzi noma ungadli lutho amahora ayisithupha kuya kwayishumi nambili ngaphambi kwenqubo.
• Thatha imithi udokotela wakho akutshele ukuthi uyiphuze ngesiphuzo esincane samanzi.
• Qiniseka ukuthi ufika esibhedlela ngesikhathi.

Ngemuva kwenqubo:

• Ungahlala esibhedlela izinsuku ezi-1 kuya kwezi-3 ngemuva kokuhlinzwa kwakho.
• Ngenkathi ulapho, ungathola ukwelashwa ngokomzimba ukusiza ukugcina imisipha ezungeze ihlombe lakho ekubeni lukhuni.
• Ngaphambi kokuba uye ekhaya, owelapha ngokomzimba uzokufundisa ukuthi uhambisa kanjani ingalo yakho ngokusebenzisa enye (enhle) ingalo yakho ukusiza.
• Ingalo yakho izodinga ukuba sendwayingini amasonto amabili kuya kwayisithupha ngaphandle kokunyakaza okusebenzayo nezinyanga ezintathu ngaphambi kokuqiniswa. Kuzoba izinyanga ezi-4 kuya kwezi-6 zokululama.
• Landela noma imiphi imiyalo oyinikezwayo mayelana nokuthi ungalinakekela kanjani ihlombe lakho ekhaya. Lokhu kufaka phakathi imisebenzi okungafanele uyenze.
• Uzonikezwa imiyalo ngokuzivocavoca kwamahlombe okufanele ukwenze ekhaya. Landela le miyalo ngqo. Ukwenza izivivinyo ngendlela engafanele kungalimaza ihlombe lakho elisha.

Ukuhlinzwa okwenziwe ngamahlombe kudambisa izinhlungu nokuqina kwabantu abaningi. Kufanele ukwazi ukuqala kabusha imisebenzi yakho ejwayelekile yansuku zonke ngaphandle kwenkinga enkulu. Abantu abaningi bayakwazi ukubuyela emidlalweni efana negalofu, ukubhukuda, ingadi, i-bowling neminye.

Ijoyini lakho elisha lehlombe lizohlala isikhathi eside uma kufakwa ukucindezela okuncane kulo. Ngokusetshenziswa okujwayelekile, ilunga elisha lamahlombe lingahlala okungenani iminyaka eyi-10.

Ingqikithi ye-arthroplasty yamahlombe; Ukufakwa esikhundleni kwehlombe le-Endoprosthetic; Ukushintshwa kwehlombe ngokwengxenye; I-arthroplasty ehlombe; Ukufaka esikhundleni - ihlombe; I-arthroplasty - ihlombe

• Ukushintshwa kwamahlombe - ukukhishwa
• Usebenzisa ihlombe lakho ngemuva kokuhlinzwa kabusha

Iwebhusayithi yeAmerican Academy of Orthopedic Surgeons. Buyisela emuva ukushintshwa kwamahlombe okuphelele. orthoinfo.aaos.org/en/treatment/reverse-total-shoulder-replacement Kubuyekezwe uMashi 2017. Kufinyelelwe kuDisemba 10, 2018.

Matsen FA, Lippitt SB, Rockwood CA, Wirth MA. I-Glenohumeral arthritis nokuphathwa kwayo. Ku: Rockwood CA, Matsen FA, Wirth MA, Lippitt SB, Fehringer EV, Sperling JW, ama-eds. I-Rockwood neMatsen’s The Shoulder. Umhlaka 5. IPhiladelphia, PA: Elsevier; I-2017: isahluko 16.

I-Throckmorton TW. Amahlombe ne-elbow arthroplasty. Ku: Azar FM, Beaty JH, Kanale ST, ama-eds. I-Operational Orthopedics yaseCampbell. Umhlaka 13. IPhiladelphia, PA: Elsevier; I-2017: isahluko 12.