I-Arthrodesis (I-Joint Fusion)

Ubuhlungu bamalunga bungakhubaza, ikakhulukazi uma ukwelapha ngokwesintu kungasebenzi. I-Arthrodesis iletha ithemba kubantu abaningi abahluphekayo izinkinga ezinzima zamalunga. Le nqubo yokuhlinzwa idala ukuhlangana okuhlala njalo phakathi kwamathambo amabili ukumisa ukunyakaza okubuhlungu futhi kwengeze ukuzinza. 

Odokotela batusa ukuhlinzwa kwe-arthrodesis ngemuva kokwelashwa okuvamile osteoarthritis zibonakale zingasebenzi. Ukuhlinzwa okuhlanganyelwe kwesimanje kuye kwanciphisa ukusetshenziswa kwakho, kodwa inqubo isalokhu iyinketho engcono kakhulu yokwelapha i-osteoarthritis yesigaba sokugcina sejoyinti lokuqala le-metatarsophalangeal elibangela i-hallus rigidus. Odokotela abahlinzayo bangasebenzisa le nqubo emalungwini kuwo wonke umzimba, okuhlanganisa umgogodla, amaqakala, izihlakala, iminwe, izithupha nezinyawo. Umgomo oyinhloko wesu lokuhlanganisa uwukuqinisa amalunga alimele, abuthaka noma alimele kuyilapho unciphisa ubuhlungu ngobuningi.

Iyini i-Arthrodesis?

I-Arthrodesis, eyaziwa nangokuthi i-joint fusion, ihlanganisa unomphela amathambo amabili endaweni ehlangene. I udokotela wamathambo iqondisa ilunga elimele, isuse uqwanga, futhi iqinise ithambo. Lokhu kuvumela ukuthi iphulukise njengesakhiwo esisodwa esiqinile. Inqubo imisa ukunyakaza phakathi kwamathambo futhi idale isisekelo esizinzile esingathwala isisindo ngenkathi sikhulula ubuhlungu.

Izinhlobo ze-Arthrodesis 

Kukhona izinqubo eziningana zokuhlanganisa ezisekelwe endaweni ethintekile:

• I-Triple arthrodesis: Ukuhlanganiswa kwamalunga angaphansi, i-talonavicular, ne-calcaneocuboid
• I-arthrodesis ephindwe kabili: Ukuhlanganisa amalunga amabili kwamathathu angenhla
• I-Isolated Arthrodesis: Ukuhlangana kwelunga elilodwa
• I-Pantalar fusion: I-Tibiotalar, i-subtalar, ne-talonavicular fusion

Odokotela bangenza le nqubo emalungeni emzimbeni wonke, ikakhulukazi emgogodleni, emaqakaleni, ezinyaweni, ezihlakaleni, eminwe nasezithupheni.

Izimpawu ze-Arthrodesis

Ubuhlungu bugqama njengophawu oluyinhloko oluphakamisa isidingo se-arthrodesis. Iziguli nazo zingase zibe: 

• Ukuqina okuhlangene
• Ukuhamba okulinganiselwe okwehlisa izinga lempilo
• Izinkinga ezihlobene nemizwa njengokuluma noma ukuphelelwa amandla emaphethelweni

Kudingeka Nini Ukuhlinzwa Kwe-Arthrodesis?

ezinzima sokuqaqamba kwamalunga lokho kuqeda uqwanga oluhlangene kuvame ukuholela ku-arthrodesis, njengoba amathambo eqala ukukhuhlana. Lokhu kuhlinzwa kuba inketho yokugcina ngemva kokwehluleka kwezinye izindlela zokwelapha. Izimo eziningana zingadinga ukuhlanganiswa okuhlangene:

Ukuphuka okukhulu kwamathambo okulimaza amathambo ahlangene

• I-Valgus noma i-varus foot deformities
• Ukungaqini kwamalunga
• rheumatoid arthritis
• Isifo samalunga esiwohlokayo

Ingozi Nezinkinga ze-Arthrodesis

I-Arthrodesis, njenganoma yikuphi ukuhlinzwa, iza nezingozi ezithile. Lezi zinkinga ezingaba khona zihlanganisa:

• Ukutheleleka endaweni yokuhlinzwa
• Ukopha noma amahlule igazi
• Umonakalo wezinzwa
• Ukuhluleka kwehardware (izinduku eziphukile noma izikulufu)
• I-Nonunion (amathambo ahluleka ukuhlangana kahle)
• Isibazi esibuhlungu
• Ukuqaqamba kwamalunga amalunga omzimba aseduze

Ukubuyisela kungathatha noma yikuphi kusuka emavikini ambalwa kuya onyakeni. Ilunga elihlanganisiwe ngeke lisanyakaza, kodwa iziguli ngokuvamile zizwa ukukhululeka ebuhlungwini.

Ukuxilongwa kwe-Arthrodesis

Ukuxilongwa okufanele kubalulekile ngaphambi kwanoma iyiphi inqubo ye-arthrodesis. Udokotela wakho kufanele aqinisekise ukuthi ukuhlangana okuhlangene kuzoba yindlela engcono kakhulu yokukhulula ubuhlungu bakho.

• Ukuhlolwa ngokomzimba: Udokotela wakho uhlola ilunga elithintekile futhi ahlole ukunyakaza kwakho. Baphinde babuze ukuthi izimpawu ziyithinta kanjani imisebenzi yakho yansuku zonke. 
• Ukuhlaziywa kwegazi: Ukuhlolwa kwegazi kusiza ukuqeda izimo ezivuvukalayo noma izifo ezingabangela izinkinga zamalunga.
• Ukufanekisa:
  • Ama-X-ray abonisa ukuqondana kwamathambo nokulimala kwamalunga
  • Ama-MRI noma ama-CT scan anikeza izithombe ezinemininingwane yezicubu ezithambile nezakhiwo zamathambo
  • Ukuhlolwa kwe-Doppler hlola ukugeleza kwegazi eduze kwelunga

Ezinye izimo zidinga ukuhlaziya uketshezi oluhlangene ukuze kuhlolwe izimo ezifana nalezi i-gout or sofuba. Imijovo eqondiswa yisithombe iyithuluzi lokuxilonga elithembeke kakhulu. Lezi zinqubo zifaka i-anesthetic ngqo ejoyintini. Ubuhlungu obuhambayo buqinisekisa ilunga njengomthombo.

Ukwelashwa kwe-Arthrodesis

Odokotela baqale bazame izindlela ezingezona zokuhlinzwa—imithi, ukwelashwa ngokomzimba, ukuqinisa, noma ukujova. Ukuhlanganisa ngokuhlanganyela kuba inketho uma lezi zindlela zingasebenzi. Inqubo iyashintsha ngokusekelwe ekutheni yiliphi ilungu elidinga ukuhlanganiswa. Udokotela wakho ohlinzayo ususa uqwanga olulimele phakathi kwamathambo futhi aqondise ilunga. Bese bevikela amathambo ngehardware yensimbi njengezikulufu, amapuleti, noma izinduku. Ukuxhunyelelwa kwethambo kuvame ukusiza ukuphulukiswa - kungaba kusetshenziswa izicubu zakho zamathambo (i-autograft) noma i-donor/synthetic material (allograft).

Izikhathi zokululama ziyahlukahluka kakhulu. Ukuhlangana kwamalunga amancane kungase kuphole emavikini. Izinqubo eziyinkimbinkimbi ezifana nokuhlanganisa umgogodla kungathatha unyaka. Uzodinga ukuphathwa kwezinhlungu ngemithi kadokotela kanye nezinketho ezitholakala ekhawunteni kusenesikhathi. Iziguli eziningi zisebenzisa izinto ezisizayo njengama-splints, izinduku, noma izihambi lapho zelashwa. Ijoyinti elihlanganisiwe lizoba nokunyakaza okulinganiselwe. Nokho iziguli eziningi zibona ukunciphisa okukhulu kobuhlungu kanye nomsebenzi ongcono, okwenza imisebenzi yansuku zonke ibe lula.

Isiphetho

I-Arthrodesis ihlala iyisinqumo esihle sokuhlinzwa ezigulini ezinobuhlungu obukhulu obuhlangene. Ukuhlinzwa okuhlangene kuvamile manje, kodwa izinqubo zokuhlanganisa ziyisixazululo esithembekile, ikakhulukazi ezimweni ezifana ne-hallux rigidus.

Impilo yakho iyashintsha ngemva kwe-arthrodesis. Ilunga elihlanganisiwe ngeke linyakaze, futhi lokhu kungase kuzwakale kuxakile ekuqaleni. Iziguli eziningi zithola ukukhululeka kobuhlungu okukhulu okwenza imisebenzi yazo yansuku zonke ibe lula. Abaningi bathola ukuhwebelana phakathi kokunyakaza nokunethezeka kuwufanele, ikakhulukazi labo ababebhekana nobuhlungu obungapheli ngaphambili.

Inqubo yokutakula idinga isineke. Ama-fusions amancane ahlangene aphulukisa ngokushesha, kuyilapho ayinkimbinkimbi afana nokuhlanganiswa komgogodla adinga isikhathi esengeziwe. Umzimba wakho ujwayela ukwakheka kwawo okusha, futhi izisetshenziswa ezisizayo zikusiza ukuthi uhlale uzimele ngalesi sikhathi.

Ukuhlinzwa ngokuhlanganisa ngokuhlanganyela kuyisinqumo esikhulu. Khuluma ngokukhululekile nodokotela wakho ohlinzayo mayelana nokuthi yini ongayilindela, izinkinga ezingase zibe khona, nesikhathi sokululama. Buza ukuthi inqubo iyithinta kanjani imisebenzi yakho yansuku zonke nendlela yokuphila. Lolu lwazi lukusiza ukuthi unqume ukuthi i-arthrodesis iyisinqumo esifanele sempilo yakho ehlangene.

Imibuzo Evame Ukubuzwa

1. Uyini umehluko phakathi kwe-ankylosis ne-arthrodesis?

I-Ankylosis yenzeka lapho amathambo ehlangene ehlangene ngokwemvelo noma njengengxenye yokwelashwa. I-Arthrodesis idala i-ankylosis ehlangene ngokuhlinzwa. Umehluko omkhulu usendleleni-i-arthrodesis isebenzisa izimila zokuhlinzwa ukuze kugcinwe ukujoyina kuzinzile ngenkathi iphulukisa, kodwa i-ankylosis ingenzeka ngaphandle kokufakelwa. Indlela yokuhlinzwa ibuye isheshise ukuphulukiswa, idale imiphumela engcono yokuhlanganisa, futhi inciphise ubuhlungu ngesikhathi sokululama.

2. Yiziphi izinzuzo ze-arthrodesis?

I-Joint fusion iza nezingqinamba ezimbalwa okufanele uzicabangele:

• Ulahlekelwa unomphela ukunyakaza okuhlangene kanye nokuguquguquka
• Ukubuyisela kudinga isikhathi eside ngaphandle kokunyakaza
• Amathambo angase angahlangani kahle
• I-Hardware ingaphuka noma ibangele ukungakhululeki
• Amalunga aseduze angaba nesifo samathambo
• Ukuhamba kuncipha ukusebenza kahle, futhi eminye imisebenzi iba nzima

3. Yisiphi isikhathi sokubuyisela i-arthrodesis?

Indawo yejoyinti ithinta kakhulu ukululama. Ukwelashwa okuphelele kuthatha izinyanga ezi-4 kuye kweziyi-12. Amalunga amancane njengeminwe aphulukisa ngokushesha kunezindawo eziyinkimbinkimbi njengomgogodla. Iziguli ezithola i-arthrodesis kathathu zigqoka ukhonkolo amasonto ayi-12 kuqala. Bese beqala ukubeka isisindo ejoyintini kancane kancane futhi babone imiphumela engcono kakhulu ngemva konyaka owodwa.

4. Iyini injongo ye-arthrodesis?

Umgomo oyinhloko wokuhlanganiswa kwamalunga uwukumisa ubuhlungu obungapheli obungathuthuki ngokwelashwa okujwayelekile. Ukuhlinzwa kwenza amalunga abuthaka noma alimele aqine futhi azinze. Kwakha isakhiwo esiqinile esiphatha isisindo esiningi ngaphandle kobuhlungu. Le ndlela isebenza kahle nge-arthritis enzima, ukulimala kwamalunga, ukulimala, kanye nokukhubazeka kokuzalwa emalungeni.

5. Iyiphi i-arthrodesis evame kakhulu?

I-arthritis enzima iphezulu ohlwini lwezizathu ze-arthrodesis. Inqubo yenzeka kaningi emgogodleni, esandleni, eqakaleni, nasenyaweni. Odokotela basebenzisa ukuhlanganisa umgogodla ukuze belaphe ubuhlungu besikhathi eside beqolo, ukukhubazeka, noma imigogodla engazinzile. I-Ankle arthrodesis isiza iziguli ezine-arthritis yesigaba sokugcina ekuhlanganyeleni kwe-tibiotalar.

UDkt. Jagan Mohana Reddy

I-FRCS (I-Trauma & Ortho), i-CCT - UK, i-MRCS (EDINBURGH), i-Diploma Sports Medicine UK, i-Postgraduate Diploma ku-Health Science
CARE Medical Center, Tolichowki, Hyderabad, CARE Hospitals, HITEC City, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

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