Mu ntangiriro za 1990, intiti z'abanyamahanga zafashe iya mbere mu gukoresha insinga zo gusana inyubako nka rotator cuff hifashishijwe arthroscopy. Iyi nyigisho yaturutse ku ihame ryo gushyigikira "ikintu kijya munsi y'ubutaka" muri Texas y'Amajyepfo, muri Amerika, ni ukuvuga, mu gukurura insinga y'icyuma yo munsi y'ubutaka ku nguni ya 45° ijya hasi, inyubako yo munsi y'ubutaka ikomera ku "ikintu kijya munsi y'ubutaka" ku rundi ruhande rw'insinga y'icyuma.
Ubuvuzi bwa siporo bwaturutse ku buvuzi bw'indwara z'amagufwa. Ni uburyo bw'ibanze kandi bukoreshwa mu buvuzi n'imikino mu nzego zitandukanye. Intego ni ukugera ku gusana neza imikorere y'umubiri nta mvune nyinshi, harimo imvune ya meniscus, imvune ya cruciate ligament, gucika kw'umugongo wa rotator, kudahagarara neza kw'urutugu, imvune ya SLAP, nibindi byose biri mu rwego rwo kuvura siporo.
Anchor ni igikoresho cy’ubuvuzi gikunze gukoreshwa mu buvuzi bwa siporo no kubaga amagufwa. Gikoreshwa cyane cyane mu gufata ingingo zoroshye (nk'imitsi, imitsi, nibindi) ku magufwa kugira ngo ingingo zikire kandi zisubire kumererwa neza. Anchor ubusanzwe zikorwa mu bikoresho bihuye n’ibinyabuzima kugira ngo umubiri ugire umutekano n’ituze.
Dukurikije uburyo ibikoresho by’inkingi bishyirwa mu byiciro, hari ibyiciro bibiri by’ingenzi: inkingi zitabora n’inkingi zishobora kubora.
Ibikoresho by'ingenzi bya anchors zidapfa kubora ni titaniyumu, alloy ya nikeli-titaniyumu, icyuma kitagira umugese, titaniyumu na aside poly-L-lactic; anchors nyinshi za anchors zikoreshwa mu buvuzi zikozwe mu byuma, bifite akamaro ko gufata neza, koroshya gutera no gusuzuma X-ray byoroshye.
Ibikoresho by'ingenzi bya anchora zishobora kubora ni aside poly-D-lactic, aside poly-L-lactic, aside polyglycolic, nibindi. Ugereranyije n'anchora zitabora, anchora zishobora kubora zoroshye kuzivugurura, nta kintu na kimwe zigira ku mashusho, kandi zishobora gukururwa. Zishobora kandi gukoreshwa ku bana.
Ibikoresho by'ingenzi by'inkingi
1. Ibikoresho by'icyuma
• Ibikoresho: Ibikoresho by'icyuma cyane cyane nk'icyuma cya titaniyumu.
• Ibiranga: Ikomeye kandi irakomeye, ishobora gutanga ingaruka nziza zo kuyifata. Ariko, ibikoresho byo gushushanya bishobora kubaho kandi hakabaho ibyago byo kugwa.
2. Ibikoresho bikurura ibintu bishobora kwinjiza
• Ibikoresho: ibikoresho bishobora kwinjizamo ibintu nka aside polylactic (PLLA).
• Ibiranga: Igabanuka ry’umubiri buhoro buhoro, nta kubagwa kwa kabiri gukenewe kugira ngo ivanwe. Ariko, igipimo cyo kwangirika gishobora kuba kidahindagurika, kandi imbaraga zo guhagarara zishobora kugabanuka uko igihe kigenda gihita.
3. Ibikoresho bya Polyetheretherketone (PEEK)
• Ibikoresho: polimeri zikora neza cyane nka polyetheretherketone.
• Ibiranga: Itanga imbaraga nyinshi ku mubiri w'inzara n'imiterere ya mekanike, kandi ikagira ubushobozi bwo guhuza neza umubiri n'ingaruka nziza zo gufata amashusho nyuma yo kubagwa.
4. Ibikoresho byo gufunga byose
• Imiterere: Igizwe ahanini n'icyuma gitera, inkingi n'umugozi.
• Ibiranga: Ni nto cyane mu bunini, yoroshye mu miterere, ikwiriye igihe amagufwa yo mu gisekuru atakaye cyangwa aho yashyizwe mu gitereko hagato.
Dukurikije imiterere y'ibizingo, bishobora kugabanywamo ibyiciro bibiri: ibizingo bipfundikiye n'ibizingo bidafite amapfundo (nk'ibizingo byuzuye):
1. Ibikoresho bipfundikiye
Inkingi zipfundikiye ni ubwoko gakondo bw'inkingi, zirangwa n'igice cy'inkingi gifatanye n'umurizo w'inkingi. Muganga agomba kunyuzamo inkingi mu ngirangingo yoroshye akoresheje urushinge hanyuma agapfunyika ipfundo kugira ngo ingirangingo yoroshye ifatanye n'inkingi, ni ukuvuga ubuso bw'amagufwa.
• Ibikoresho: Inkingi zipfundikiye ubusanzwe zikozwe mu bikoresho bidapfa kunyurwa (nk'icyuma cya titaniyumu) cyangwa ibikoresho bishobora kunyurwa (nk'aside polylactic).
• Uburyo bwo gukora: Inkingi ishyirwa mu igufwa binyuze mu migozi cyangwa amababa yo kwaguka, mu gihe umugozi ukoreshwa mu guhuza ingingo zoroshye n'ingeri, kandi ingaruka zo gufata neza zibaho nyuma yo guhambira ipfundo.
• Ibyiza n'ibibi: Akamaro k'imishumi ifite amapfundo ni uko ubushobozi bwo kuyishyiraho ari ubw'ukuri kandi bukwiriye imvune zitandukanye z'imitsi yoroshye. Ariko, uburyo bwo kuyishyiraho bushobora kongera imbogamizi n'igihe cyo kuyikora, kandi kuba hari ipfundo bishobora gutuma umuntu arushaho guhangayika, bikongera ibyago byo kuvunika cyangwa gucika kw'imishumi.
2. Ibikoresho bitagira amapfundo
Inkingi zitagira amapfundo, cyane cyane inkingi zuzuye, ni ubwoko bushya bw'inkingi bwavutse mu myaka ya vuba aha. Ikiranga ni uko inkingi yose igizwe n'inkingi, kandi gufatana kw'ingingo zoroshye bishobora kugerwaho hatabayeho guhambirana amapfundo.
• Ibikoresho: Ibikoresho byuzuye bikoresha ibikoresho byoroshye kandi bikomeye byo gukurura, nk'imigozi ya polyethylene ifite uburemere bwa ultra-high molecular weight (UHMWPE).
• Uburyo bwo gukora: Udukoresho twuzuye two gufunga imitsi dushobora gushyirwa mu magufwa binyuze mu miterere yatwo yihariye yo gufunga imitsi no kuyishyiramo, mu gihe hakoreshejwe imbaraga z'umugozi kugira ngo ufatanye neza n'urugingo rworoshye ku buso bw'amagufwa. Kubera ko nta mpamvu yo guhambira imishumi, imiterere n'igihe cyo kubaga biragabanuka, kandi ibyago byo kuvunika imitsi no kurekura imitsi nabyo biragabanuka.
• Ibyiza n'ibibi: Ibyiza byo gukoresha imigozi yuzuye ni ukubaga byoroshye, ubushobozi bwo kuyifata neza no kwangiza gato ingingo zoroshye. Ariko, bitewe n'imiterere yayo yihariye, ikenera cyane uburyo bwo kubaga n'aho ishyirwa. Byongeye kandi, igiciro cy'imigozi yuzuye gishobora kuba kiri hejuru, ibyo bikaba byongera umutwaro w'amafaranga ku barwayi.
Inkingi zikoreshwa cyane mu kubaga imikino itandukanye, nko gusana uruziga rwa rotator cuff, gufunga imitsi, kongera kubaka imitsi, nibindi. Urugero, ibi bikurikira ni intangiriro yo kubaga inkingi zikoreshwa mu gusana uruziga rwa rotator cuff:
• Intambwe zo kubaga: Ubwa mbere, umuganga azasukura akanategura aho uruziga rwa rotator cuff rwakomerekeye; hanyuma, ashyire uruziga mu mwanya ukwiye; hanyuma, akoreshe imisumari kugira ngo ashyireho urugingo rwa rotator cuff ku ruziga; amaherezo, ashyireho uruziga n'igitambaro.
• Ingaruka zo kubagwa: Binyuze mu gushyiraho umugozi, ubushobozi bwo kugumana umugongo n'imikorere y'urugingo rwa rotator cuff bushobora kugaruka, bigatuma umurwayi akira neza.
Ibyiza, Ingaruka n'Amabwiriza yo Kwirinda Ibikoresho Bifunga Ibikoresho
Ibyiza
• Itanga uburyo bwo guhagarara neza.
• Ikoreshwa ku mvune zitandukanye zoroshye ku mubiri.
• Hari udukoresho tworoshye kunyurwamo kandi ntidusaba kubagwa kabiri kugira ngo dukurweho.
Imbogamizi
• Ibikoresho by'icyuma bishobora gukora ibikoresho by'ishusho.
• Igipimo cyo kwangirika kw'ibishingizi bishobora kwinjiza gishobora kuba kidahindagurika.
• Hari ibyago byo gucika kw'inkingo cyangwa kuvunika umugozi.
Ibikoresho by'ubuvuzi bw'imikino bishobora gukoreshwa mu kubaga bikurikira:
1. Epicondylitis yo ku ruhande isubiramo (inkokora ya tenisi) itari yavurwa neza inshuro nyinshi: Iyo uburyo bwo kuvura butagira ingaruka ku buzima busanzwe budakora neza, ubuvuzi bwo kubaga burashobora gutorwa, kandi agakoresho gashobora gukoreshwa mu kongera guhuza aho radial extensor carpi brevis ishyirwa ku ruhande rw'inyuma rw'inyuma rw'inyuma.
2. Gucika kw'imitsi yo mu bice by'imbere: Amarira aterwa n'ingendo zitari nziza, gukurura, gukubita, n'ibindi ashobora kuvurwa n'ibyuma bikingira imitsi. Ibikoresho bibiri bitwikiriwe mu gice cy'imitsi yo mu bice by'imbere, kandi insinga y'inyuma ishyirwa ku gice cy'imitsi yo mu bice by'imbere.
3. Gucika kw'imitsi yo mu gituza: Gucika kw'inyuma kw'inkokora akenshi biherekezwa no gukomereka kw'imitsi yo mu gituza, cyane cyane imvune y'imbere y'umutsi. Ku mvune y'imitsi yo mu gituza, abahanga benshi bakunda kubagwa hakiri kare. Uburyo bwo gufunga insinga bukoreshwa mu gukaraba ubuso bw'amagufwa aho imitsi ifatanye. Nyuma yo kuva amaraso mashya, insinga ishyirwa ku buso bw'amagufwa aho imitsi ifatanye, kandi insinga iboshye ku mpera y'umusumari ikoreshwa mu gufunga igiti cy'imitsi no kugikomeza cyangwa gusana imitsi ukoresheje urushinge.
4. Gucika kw'ingingo yo hasi y'umugozi wo kuvura: Imvune yo kuvura imyanya ...
5. Kudakomera kw'ingingo: biterwa n'imiterere y'amagufwa no kudakora neza kw'ingingo zoroshye. Intiti nyinshi zishyigikira ubuvuzi bukoresha insinga.
6. Kuvunika kw'inkingi ntoya ya Patellar: Ikoranabuhanga rya "wire anchor" rishobora gukoreshwa mu kuvura kuvunika kw'inkingi ntoya ya patellar. Mu gukosora kuvunika kw'inkingi ntoya ya patellar no kuboha no gukurura umugozi wa patellar, imikorere y'ivi ishobora kugarurwa kandi uburebure bw'imikorere y'ivi riva burakomeza.
7. Ikwiriye guhuza no gufatanya amagufwa n'ingingo zoroshye mu kubaga amavi, uruti rw'umugongo, urutugu, inkokora, akaguru, ikirenge, ukuboko no mu ntoki: Ifite imiterere y'umugozi ukozwe mu giti, byoroshye gushyiramo kandi bigatanga imbaraga zo gukurura no gusohora, kandi ikwiriye kubagwa mu bice bitandukanye.
Amabwiriza yo Kwirinda
• Imiterere y'amagufwa y'umurwayi n'imiterere y'umubiri w'aho akorewe ubuvuzi bigomba gusuzumwa neza mbere yo kubagwa.
• Hitamo ubwoko bw'icyuma gikingira n'ibipimo byacyo kugira ngo umenye neza ingaruka zo kubaga.
• Imyitozo ngororamubiri ikwiye ikwiye gukorwa nyuma yo kubagwa kugira ngo ingingo zikire neza kandi zigasubirane imikorere.
Muri make, ibizingo bigira uruhare runini mu buvuzi bwa siporo. Guhitamo ubwoko bw'ibizingo bikwiye n'ibipimo byabyo no gukurikiza ingamba zikwiye zo kubaga n'uburyo bwo kwirinda, ingaruka zo kubaga zishobora kwemezwa kandi umurwayi agakira neza.
Igihe cyo kohereza ubutumwa: Ukuboza 17-2024
