Abvarura nemarunda pakati pamafudzi muhudyu: Zviratidzo neMarapirwo

Kana tikaramba tiri pedyo dzidziso kuti basa iri rakaitwa kubva Tsoko murume, danho rokutanga munzira refu uye zvakaoma izvi ndezvako pamapfudzi rwakashodoka. Zvakanga rakasiyana nechivako chake kunounzwa dambudziko zvikamu yokumusoro muzvidimbu kuwana mamwe kujairika mhuka dzichipfekeka zvinhu.

Uyewo, yekudyidzana kuwedzera mabasa ayo kubva munhuwo rutsigiro kana uchifamba, maoko evanhu vava mumwe kupfuura vakavhiringidzwa nhengo dzomuviri. Panyaya iyi, zvinokuvadza pamusoro pamafudzi bhanhire, izvo kazhinji kuitwawo nemarunda nehondo pamafudzi muhudyu, riri munzvimbo chaiyo pfungwa vanachiremba. Uye honzeri ichi - zvikwanisike kurasikirwa kugona kushanda, uye chii ndechekuti munhu akaremara zvakanaka kana kwete rakakodzera akarapwa kukuvara.

Brief anatomical bhuku

Kusiyana pamafudzi muhudyu chinoratidzwa kuva nhamba yaro vechokwadi articular hukawanika. In paumbwe marangwanda zvinhu zviri zvakananga kwaisanganisira mapfupa maviri: chipande uye humerus. The articular pose humerus anomiririrwa idenderedzwa musoro. Panyaya concave penyika glenoid mhango denderedzwa chipande nzvimbo zviri mana nguva duku pane nzvimbo pedyo bhora.

Mboshayikwi kuonana chipande iri zvaizopedza shwashwa mhete - connective gobvu yakarongeka, inonzi articular muromo. Ndicho ichi fibrous maatomu akafanana, pamwe Kamudzira yakapoteredza vadyi, uye anobvumira iye kuva zvakarurama anatomical kuenderana uye panguva imwecheteyo kuita incredible-siyana inofamba, riri zvinobvira muna tikaisa wemari vose mumwe rwakashodoka.

Decorations vagari nemarunda uye tsandanyama kugonesa sangano

Zvinobatsira dzakaonda synovium kwemajoini Kamudzira ngaunyatsobata ayo anatomical mamiriro simba rostral-humeral shwashwa. Pamwe nawo vadyi pakukoka ngaunyatsobata mamwe-articular Kamudzira bloat biceps mudzira (biceps) uye subscapularis tsandanyama. Ava vatatu connective tambo uye vanotambura kana pane atsamwira pakati nemarunda pamusoro pamafudzi rwakashodoka.

Subscapularis, deltoid, above- uye podkostnaya, guru uye duku reraundi, uyewo pectoralis chikuru uye latissimus dorsi kupa vagari zvakawanda kufamba kumativi ose matatu namasanhu. Biceps vari kufamba pamapfudzi muhudyu haabatanidzwi.

Kukuvara fudzi vadyi uye zvinokonzera akuvara

Pakati vakawanda kukuvara pakati pamafudzi kwemajoini kusunungurwa mavanga. Possible sprains vagari pamwe zvishomanana kana kwakakwana atsamwira kana pasina izvozvo. Dislocation vadyi, intra kana nemamwe-articular avulsion kutsemuka zvimedu (ari kuda nemarunda) vari pakati zvakakura makuvaro.

The kukonzera kuvadza fudzi mapfundo iri zvakananga kana zvisina kunanga sei ayo zvokuimba marongerwo. Izvi zvinogona kuva zvakananga raparadza akawa rwakatambanudzwa mberi. Sharp kunyanya tsandanyama makakatanwa, kufambisa vadyi, kana pakarepo kufamba yemavhoriyamu huru zvingakonzera sezvinoita kuminyuka kana dislocation ari muhudyu. Kazhinji achiperekedzwa nemarunda dzavo dzakabvaruka pakati pamafudzi muhudyu (mufananidzo pasi apa), zvinoda kwete chete kubata kukuvara vakawanda, asi nokudzosa kuvimbika shwashwa midziyo.

Zviratidzo shwashwa atsamwira

Kukuvara zvingaitika kana pane kuwa muna yakagoverwa unoratidzwa mberi kana kuti kudivi ruoko. Zvinogonekawo shwashwa atsamwira nokuda unopinza sangano iri vaifanira bvumidzwa papi kana rakaturikwa kana ruoko, somuenzaniso kana akadonha kubva kumusoro.

Apa zvakakanganisika atsamwira pamusoro Kamudzira iri pamapfudzi pamwe nemarunda zviratidzo vanoonekwa ne marwadzo panguva kukuvara, uye kuti zviri kunyanya kukosha kuti discontinuity, nokuti kufamba achidzokorora mashandiro kukuvara. Uyezve dzichiri edema nharaunda kukuvara alters dzokunze pamwe configuration. Kuwedzera edema, kuzvimba pakugadzirwa anogona kuitawo vakamhanyira kubva tagovera ropa midziyo pedyo nemarunda, tsandanyama kana ropa.

Zvimwe nzira dzinoongorora kwokuomerwa zvinokuvadza

Pakati kunotoda tsvakurudzo nzira, vachibvumira traumatologist kuziva kana pane zvishomanana kuparara pakati nemarunda pakati pamafudzi muhudyu kana zvachose kukuvara, inomira ultrasonic chirwere uye rinobva resonance kuri. Nzira Dzose regai kutakura TOUR mutoro, asi kuva huru kwazvo chisarudzo. Zvikurukuru, MRI anobvumira kunonyanyisa rakavimbika kuziva chirwere uye kusarudza kurapwa.

Radiography kana computed tomography zviri kuitwa kuitira kuti vadzivise pfupa maronda: mitswe (kusanganisira vouchers), dislocations, conjugated aine kutsemuka uye dislocation pamusoro pamafudzi rwakashodoka. Aiwanzoshandisa arthrocentesis. Arthroscopy zvaitwa vanofungidzirwa chinopedza rokuchinja connective zvinyama Zvivako pejoinhi kana breakage yacho Kamudzira. Mune zvimwe zviitiko, vakashandisa arthrography.

The mwero nekuomarara kukuvara

The venguva kupatsanurwa nyore, mwero kune zvikuru kukuvara, uye vakashandisa pamusoro nemarunda kubvaruka. By zvishoma zvakuvadza pamafudzi muhudyu, panongova nemarunda, anosanganisira ndichinanavira pamwe haasaruri kuvadza nemarunda ari fibers, apo kuramba pakururama midziyo ropa, tsinga uye tsandanyama. Dzinoratidzwa haasaruri avhareji mwero internet misodzi nemarunda, tsandanyama dzakapoteredza mugove akuvara muzvirongwa kwacho, vagari Kamudzira raigona sousingabatsiri. Wokutanga inobatana dhigirii kuminyuka, wechipiri - stretchability kukwana discontinuity.

Zvakakomba kukuvadzwa achiperekedzwa rakazara pakakoromoka mudzira kuvimbika mamiriro (shwashwa) - discontinuity papfudzi vagari nemarunda vemo vascular zvakakanganisika, uye tsinga kubatanidzwa urema vari pamwe Kamudzira. At ichi paunogona uye intraarticular avulsion mitswe, vadyi ropa (hemarthrosis).

Marapirwo nzira

Zvichienderana padanho kwokuomerwa kuvadza papfudzi pamwe shwashwa midziyo, kuchinja kana kushanda kurapa anogona kushandiswa. Kana pane zvishomanana kuparara pakati nemarunda pakati pamafudzi muhudyu, kurapwa ndeyevanyori kuchinja nzira. Zvakarurama analgesia uye immobilization (immobilization). Zvichida kumanikidza bintovoy kana varinamire chakakandirwa, zvichienderana kwokuomerwa, hunhu akatyoka uye Vhoriyamu kwakakanganisa zvivako. Bintovuyu kana varinamire immobilisation orthesis unogona kutsiva (zvisungo) pakati pamafudzi muhudyu kana yakaoma Kuda kutamba svikiro.

A zororo rakakwana, kunyanya kuchikuvadza tsandanyama uye vadyi capsules, akashandisa kuvhiya. Munhu wacho anofanira muchipatara kunotevera Profile uye zvimwe kwenguva vapore pashure zvinoerera kubva kuchipatara.

Operational mhosva kupora gwaro

Nokukurumidza kutsiurwa pakaputsika papfudzi pamwe nemarunda oparesheni richashandiswa, nani mikana kuti uzere kuzoita kwemajoini nerevane kudzikisa chikamu zvinokuvadza yematambudziko. Kuvhiya yokugadzirisa hunenge shwashwa (mudzira) pedyo tsandanyama, uye kubviswa zvaparadzwa vascular urema Kamudzira kunoderedza kuti crosslinking yavo.

Under vakawanda yokutindivadza (narcosis) mbune chinoitwa pamusoro hunenge locus layerwise kwetsinga uye kupatsanurwa tishu. Zvikanganiso ndikawana sutured. The ronda akavharwa akaturikidzana. Mukutanga postoperative nguva uchishandisa varinamire akakanda immobilization aine hwindo nokuda postoperative suture.

Misi varinamire immobilization uye muchipatara takatsunga ne Vhoriyamu zvakakanganisa hurongwa. Chinhu chinokosha kuti uwandu mubhedha-mazuva ndiyo zera murwere, hunhu basa rake, uye co-morbidities.

Kuvadza nemarunda pakati kugokora

Zviri chaizvo kusingawanikwi mumba ezvinhu, zvinokuvadza zvikuru runowanzoitika vatambi vari nyanzvi, kana kushandisa basa uye unopinza chinozunguzirwa ruoko, akatsivama panguva kugokora. boka pangozi zvinosanganisira, pakutanga kwezvose, tenesi vatambi, golfers, Handball, yebaseball, uye mvura Polo.

Kakawanda vakakuvadzwa annular shwashwa pamusoro nharaunda, ulna rubatso shwashwa, kana TOUR. Ndicho chiratidzo kuvadza marwadzo, kuwedzera panguva kufamba. Hwokuratidza edema, ropa munzvimbo dzakapoteredza tishu. Mukana hemarthrosis. Kana paine atsamwira pamusoro nemarunda rakakwana, angabatwa zvaizopedza zvishoma mapfupa honokono ari pejoinhi.

Radiography anobvumira kusiyanisa pakakuvara dislocation. MRI acharatidza apo vemunyika atsamwira pakati nemarunda ose kugokora. Mabatirwo haasaruri uye kukwana atsamwira ane kuchinja. Rinoshanda immobilization kwevhiki dzinoverengeka. A zororo rakakwana chakagadzirwa epurasitiki zvomusejari zvaparadzwa nemarunda.

Brief anatomi of chiningoningo muhudyu

Complex mu mamiriro vakaumba vadyi articular shwashwa pose mwaranzi mundiro uye ulna pedyo honokono uye scaphoid, lunate uye mativi divi bhurasho. Pisiform mapfupa iri mu mukati menyika mudzira uye zvakananga kuita paumbwe muhudyu haagamuchiri.

Simbisa vagari nemarunda shanu. The paitwa kugokora uye chiningoningo shwashwa kubva musana pamusoro - shure boka bhurasho. Panhivi ndivo lateral Palms (parutivi napagumwe roruoko) uye ulnar (shoma munwe divi) nemarunda.

Kuvadza nemarunda ari chiningoningo riri vashoma zvikuru kupfuura nemarunda pamusoro pamafudzi muhudyu kubvaruka. Asi kupfuura kugokora nemarunda.

Putsa chiningoningo nemarunda

The mashandiro kuti panowanikwa akuvara chokuita kuwa muna mberi pachena ruoko kana akarova kuti hwakakungwa kana anombotwasanudza bhurasho. Nzvimbo ruoko panguva kukuvara iri zvakananga kuhupenyu kuona izvo zviri shwashwa anogona sousingabatsiri. Vazhinji vose vakuvara connective chakatarisana mudanga nemamiriro bhurasho.

Top zviri shwashwa kukuvadzwa: marwadzo, edema, havachanyatsogoni kwemajoini nerevane nyoro tishu hematoma. Kana paine marwadzo ari kufamba ari minwe kana ruoko nayo anowedzera zvikuru pakutanga kwezana iri muhudyu, anogona vaifungidzirwa nemarunda abvarura pamusoro chiningoningo rwakashodoka. Zviratidzo zviri nechimwe kutsvakurudza nechirwere pamusoro Hardware: X-ray - kuti asava pfupa mitswe, Ultrasound uye / kana MRI. Ndivo zvakakodzera kuona hunhu kuzotadzira nemarunda nezvimwe zvinyoronyoro munyama dzakapoteredza pejoinhi.

Sezvo zvimwe mhosva ipi, kana paine mukaha nemarunda ari chiningoningo muhudyu, mishonga achaenderana kwokuomerwa makuvaro. In nepakati kukuvadza rinoshanda kuchinja pasi rinorema - operative nzira.

Zvisinei kuti kukuvara mhando yakaitika, chii hunhu kutyora pakururama pamwe zvivako, Joint wakuvadzwa, chiningoningo, kugokora, kana pane zvishomanana kana zvakakwana atsamwira pamusoro nemarunda pakati pamafudzi muhudyu, kurapwa vanofanira nguva dzose unofanira kutarisirwa nyanzvi. Fanira kubvunza ari Profile mupanda (kutsemuka kiriniki vane kunotevera pakiriniki kana kugamuchirwa dhipatimendi muchipatara traumatological). Izvi ndezvechokwadi kunyanya youduku kunotevera, sapamazuva varwere vaduku, pane nhamba wezera-chokuita zvinhu zvinogona tivhare paakakuvara. Uye kunonoka kutsvaka wezvekurapa rubatsiro kungaita kuti kunaka migumisiro yenguva refu.