Ukususwa

I-Dislocation kuwukulimala okubuhlungu okwenzeka lapho amathambo ejoyintini exoshwa endaweni yawo evamile. Ukuqonda izinhlobo zokuhlukaniswa, izimbangela zakho, kanye nokwelashwa okutholakalayo kubalulekile ekunakekelweni okufanele nokululama. Lesi sihloko sihlola izimpawu zokuhlukaniswa, izinkinga ezingase zibe khona, nezindlela zokuxilongwa. Iphinde ixoxe ngezinketho zokwelapha zokugudluzwa, amasu okuvimbela, kanye nesikhathi sokufuna usizo lwezokwelapha. Ngokufunda ngokususwa, abantu ngabanye bangazivikela kangcono futhi bazi ukuthi kufanele baphendule kanjani uma lokhu kulimala kwenzeka. 

Iyini i-Dislocation? 

I-dislocation iwukulimala ngokuhlanganyela. Kwenzeka lapho iziphetho zamathambo amabili noma ngaphezulu axhumene zihlukana ngokuphelele. Kwenzeka lapho amandla amakhulu efakwa emthanjeni, okwenza amathambo ahlangene akhishwe endaweni yawo evamile. Lokhu kulimala kungaba buhlungu futhi kukhubaze okwesikhashana futhi kuvimbe ilunga. Amalunga ayizindawo lapho amathambo amabili ehlangana khona emzimbeni, avumela ukunyakaza futhi anikeze ukusekela kusukela ekhanda kuye ozwaneni. 

Ukususwa kungenzeka kunoma yiliphi ilunga emzimbeni, kodwa okunye kuvame kakhulu kunamanye. Ihlombe liyilunga elivame ukuchezuka, lilandelwa iminwe, i-patella (idolo), indololwane, nenyonga. 

Izinhlobo Zokuhlukaniswa 

Ukuhlukaniswa kungenzeka emalungeni amaningi emzimbeni wonke, ngalinye linezici zalo ezihlukile nezinselele, njenge: 

• Ukususwa Kwamahlombe: Kwenzeka lapho i-humerus (ithambo lengalo engenhla) iphuma esisekelweni sehlombe, ikakhulukazi ngenxa yokuwa noma phakathi nemidlalo yokuxhumana. 
• Ukususwa Kweminwe: Zivame ukuthinta iqupha eliphakathi 
• Ukususwa Kwesandla: Okuphinde kubizwe ngokuthi ukuhlukaniswa kwesandla, ukususwa kwesihlakala kungase kuhlanganise noma yimaphi amathambo esihlakala amancane ayisishiyagalombili. 
• Ukususwa kwendololwane: Zidinga amandla abalulekile futhi ngokuvamile zihlanganisa ukuphuka okuhlobene. Lokhu kugudluzwa kungabamba izinzwa nemithambo yegazi, okudinga ukunakekelwa okuphuthumayo kwezokwelapha.
• Ukususwa kwe-Kneecap (Patellar): Ukususwa kwe-patellar kuvamile entsheni, ikakhulukazi amantombazane. I-kneecap inyakaza emaceleni iphume emseleni wayo, ibangele ubuhlungu nobunzima bokunyakaza kwamadolo. 
• Ukuhlukaniswa kwe-Hip: Zibangelwa ukulimala okukhulu njengezingozi zomgwaqo futhi zingaholela ezinkingeni ezinkulu. Ukugudluka okuningi kwe-hip kwenzeka emuva, okwenza umlenze othintekile uphendukele ngaphakathi. 
• Ukuhlukaniswa kwe-Ankle ne-Foot: Nakuba kungavamile, lezi zingenzeka ezingozini ezimbi noma ukulimala kwezemidlalo.

Ukuhlukaniswa kungahlukaniswa ngezinhlobo ezimbili ezilandelayo ngokuya ngokuthi amathambo emajoyintini asuswe kude kangakanani: 

• Ukususwa okuphelele: Ukukhishwa okuphelele (ukuxubha) kwenzeka lapho amathambo ekuhlanganyeleni ehlukaniswa ngokuphelele futhi exoshwa ngaphandle kwendawo ehlangene. 
• Ukukhipha Ingxenye: Ukususwa ngokwengxenye (i-subluxation) kwenzeka lapho ithambo lidonswa kancane noma likhishwa endaweni ehlangene. 

Izimbangela Nezingozi Zokugudluka 

Ukususwa kungenzeka ngenxa yezizathu ezahlukahlukene, kanti amanye amalunga angenwa kalula kunamanye. Nazi ezinye izimbangela ezivamile zokugudluka: 

• Izimpophoma: Ukuwa kuyimbangela evame kakhulu yokugudluka. Amandla adluliselwe esilinganisweni lapho umzimba ushaya phansi, ngokuvamile ehlanganiswa nomnyakazo ophendukayo, angazungezisa ilunga liphume kusokhethi yalo. 
• Imisebenzi ehlobene nezemidlalo: Imidlalo yokuxhumana efana nebhola lezinyawo ne-hockey ibeka engcupheni enkulu, ikakhulukazi ekugudlukeni kwehlombe. Eminye imidlalo ehilela ukuwa okungase kube khona, njengokushibilika eqhweni, i-gymnastics, ne-volleyball, nayo ingabangela ukugudluka. 
• Izingozi: Izingozi zezimoto (izimoto noma amabhayisikili) ziyimbangela ehamba phambili yokugudluka.

Izici ezithile zandisa ubungozi bokuthola ukususwa. Lokhu kubandakanya: 

• Ukuba wesilisa phakathi kwenkathi yokuthomba kanye neminyaka engama-30 ubudala NOMA owesifazane oneminyaka engama-61-80 ngenxa yokugudluka kwehlombe. 
• Ukuba nomlando wangaphambili wokungaqini kahle kwamalunga noma izimo ezifana ne-Ehlers-Danlos syndrome, eyenza buthaka izicubu ezixhumeneyo, nakho kuphakamisa ingozi. 

Izimpawu Zokuhlukaniswa 

Ukususwa kuthinta kakhulu ilunga elithintekile, okubangela uhla lwezimpawu ezibonakalayo. Lokhu kubandakanya: 

• Ubuhlungu obukhulu endaweni elimele 
• Ukuvuvuka 
• Ukulimala eduze kwelunga 
• Ijoyinti elibonakala likhubazekile noma elingaphandle kwendawo 
• Izindawo ezithintekile zingase zizwe zithambile lapho uzithinta 
• Ukungakwazi ukunyakaza noma ukusebenzisa ilunga eligudlukile 
• Ubumbulu, ubuthakathaka, noma imizwa elumayo eduze kwendawo yokulimala 
• I-muscle spasms endaweni ethintekile 
• I-Sciatic Nerve Injury (nokususwa kwe-hip) 

Izinkinga 

Ukuhlukaniswa kungaholela ezinkingeni ezimbalwa ezibalulekile uma kushiywe kungelashwa noma kuphethwe ngendlela engafanele. Lokhu kungase kuhlanganise: 

• Ukwanda kwengozi yokugudluzwa esikhathini esizayo 
• Ukuphuka emathanjeni azungeze ilunga 
• Ukulimala kwezicubu ezithambile ezizungezile, okuhlanganisa imigqa, izinzwa, nemithambo yegazi, kungabangela ukungazinzi isikhathi eside, ubuthakathaka, noma ukuba ndikindiki endaweni ethintekile. 
• Ukuphazamiseka okukhulu kungaphazamisa ukugeleza kwegazi esithweni. Lokhu kungaholela ekufeni kwezicubu (i-necrosis) uma kungakhulunywanga ngakho ngokushesha. 
• Amagciwane ayinkinga eyivelakancane kodwa ebucayi, ikakhulukazi uma isikhumba siphukile ngesikhathi sokukhishwa. Lezi zifo zingadlulela ethanjeni, kubangele i-osteomyelitis, okuyinselele ukuyelapha. 

Sifo 

Udokotela uqale ahlole ilunga elithintekile nendawo ezungezile. Iziguli zibuzwa ngezimpawu zazo kanye nezimo eziholela ekulimaleni. Bangase benze izivivinyo eziningana, okuhlanganisa: 

• Ama-X-ray: I-X-ray yelunga ngokuvamile iwukuhlolwa kwesithombe kokuqala okuyalelwa ukuze kuqinisekiswe ukugudluka futhi kuhlonzwe noma yikuphi ukuphuka okuhlobene. 
• I-Magnetic Resonance Imaging (MRI) ihlola: I-MRIS ingadalula umonakalo ezicutshini ezithambile ezizungezile njengemigqa nama-tendon. Lokhu kusiza kakhulu ekuhlukanisekeni kwehlombe namadolo, lapho izinyembezi ze-labral noma ukulimala kwe-rotator cuff kungase kwenzeke. 
• I-Computed Tomography (CT) Izikena: Lokhu kunikeza izithombe ezinemininingwane yamathambo futhi kungaba usizo ekuguzukeni okuyinkimbinkimbi, ikakhulukazi endololwaneni noma okhalweni. 
• I-Ultrasound: Ivumela ukuhlolwa kwesikhathi sangempela kwezicubu ezithambile futhi ingasiza ukuhlola ukulimala kwe-rotator cuff.

Ukwelashwa Kokususwa 

Ukwelapha ukugudluka kumayelana nokubuyisela ilunga endaweni yalo efanele, inqubo eyaziwa ngokuthi ukuthutha noma ukunciphisa okuvaliwe. Uchwepheshe kufanele enze le nqubo kuphela, njengoba ukuzama ukubeka kabusha ilunga ngokwakho kungaholela ezinkingeni ezinkulu. 

Ngemva kokuthuthela kwenye indawo, ukwelashwa kuvame ukuhilela ukungakwazi ukuhamba kusetshenziswa i-splint, isihlilingi, noma i-brace ukuze ubambe ilunga endaweni lapho liphola. 

Ukuphumula kubalulekile phakathi nalesi sikhathi ukuze ugweme ingcindezi kwilunga elithintekile. 

Kwezinye izimo, ikakhulukazi ngenxa yokugudluka okukhulu noma labo abanokulimala okuhlobene, kungase kudingeke ukuhlinzwa. Lokhu kungase kuhlanganise ukulungisa izicubu ezithambile ezilimele noma ukusetha kabusha ilunga uma ukuncishiswa okuvaliwe kungaphumeleli. 

Uzoyibona Nini Udokotela 

Ukuthola usizo lwezokwelapha ngokushesha kubalulekile lapho usebenzelana nezinsolo zokuthi ugudlukile. Kubalulekile ukuthi ungazami ukubuyisela ilunga endaweni yakho wedwa noma uvumele noma ubani ongeyena udokotela ukuthi anyakaze noma athinte ilunga elimele.

Thola usizo lwezempilo oluphuthumayo uma uhlangabezana:

• ubuhlungu besifuba 
• Ukuphefumula kanzima 
• Ubuthakathaka noma ukuba ndikindiki ohlangothini olulodwa 
• Inkulumo emisiwe 
• Ukuphelelwa amandla 
• Izinguquko esimweni sengqondo 

Prevention 

Yize kungekona konke ukususwa okungavinjelwa, ungathatha izinyathelo zokuphepha ezimbalwa ukuze unciphise ubungozi bakho. Lokhu kubandakanya: 

• Gqoka izinto zokuzivikela ezifanele ngesikhathi semidlalo noma ukwenza umsebenzi womzimba futhi ugweme ukudlala ngobuhlungu. 
• Nikeza umzimba wakho isikhathi sokuphumula futhi ululame ngemva kokusebenza kanzima. 
• Zifudumeze njalo ngaphambi kokuzivocavoca bese upholisa ngemva kwalokho. 
• Ukuze uvimbele ukuwa, gcina ikhaya lakho nendawo yokusebenza kungenayo imfuhlumfuhlu. 
• Sebenzisa amathuluzi afanele noma okokusebenza ukuze ufinyelele ezindaweni eziphakeme, ungalokothi ume ezihlalweni noma phezu kwamatafula. 
• Uma unobunzima bokuhamba noma ingozi eyengeziwe yokuwa, cabanga ukusebenzisa i-walker noma umoba. 
• Ukugcina isisindo somzimba esinempilo kuyadingeka, njengoba isisindo somzimba eseqile singabangela ukucindezeleka okungadingekile emalungeni, ikakhulukazi inqulu. 
• Zijwayeze ukuma okuhle ukuze unciphise ubunzima emalungeni futhi ucabange ukusebenza nomelaphi womzimba ukuze wakhe uhlelo lokuthuthukisa ukuma. 
• Ukuqinisa izivivinyo eziqondiswe emaqenjini athile emisipha kungasiza ukusekela amalunga futhi kunciphise ingozi yokugudluka. 
• Bandakanya izivivinyo ezifana nezandiso zenyonga kanye nokuthunjwa esimisweni sakho, kodwa thintana nochwepheshe bokufaneleka ukuze udale uhlelo oluphephile lokujima. 
• Ukugqoka amagiya okuvikela njengama-hip pad kungasiza ukumunca umthelela futhi kuvikele amalunga ekulimaleni kulabo ababamba iqhaza kwezemidlalo ezithintana naye. 
• Cabangela imisebenzi enomthelela omncane njengokugibela ibhayisikili noma ukubhukuda uma unomlando wezinkinga ezihlangene. 

Isiphetho 

Ukunakekelwa ngokushesha kwezokwelapha kubalulekile lapho ubhekene nokucasuka okusolekayo. Ukuxilongwa nokwelashwa okufanele, okuhlanganisa ukuncishiswa okuvaliwe kanye ukuhlunyeleliswa kwesimilo, kubalulekile ukubuyisela ukusebenza okuhlangene nokuvimbela izinkinga zesikhathi esizayo. Ungakwazi ukuvikela amalunga akho kangcono futhi ugcine impilo yonke ye-musculoskeletal ngokuhlala unolwazi futhi uthathe izinyathelo zokuvimbela. 

Imibuzo Evame Ukubuzwa

1. Kubangelwa yini ukugudluka? 

Ukugudluka kubangela ubuhlungu obukhulu, ukuvuvukala, nokungakwazi ukusebenzisa ilunga elithintekile ngokujwayelekile. Kwezinye izimo, ukugudluka kungase kubangele ukuba ndikindiki noma ukuzwa okungavamile esithweni esithintekile. 

2. Ingabe ukukhishwa kubuhlungu? 

Yebo, ukuhlukaniswa ngokuvamile kubuhlungu kakhulu. Ubuhlungu ngokuvamile bushesha futhi bunzima, ikakhulukazi lapho uzama ukunyakaza noma ukubeka isisindo engxenyeni elimele. 

3. Iluphi usizo lokuqala lokususwa kwendawo? 

Usizo lokuqala lokugudluzwa luhilela ukunyakazisa isitho esithintekile ukuvimbela ukulimala okwengeziwe. Sekela indawo elimele ngomcamelo wesikhashana, isihlilingi, noma umcamelo. Phakamisa isitho uma kungenzeka ukunciphisa ukuvuvukala. Faka iqhwa eligoqwe ngethawula ukuze udambise ubuhlungu futhi ulawule ukuvuvukala, futhi ngokushesha uxhumane nodokotela wakho. 

4. Ungakwazi yini ukunciphisa ukugudluka? 

Ukunciphisa ukukhishwa kufanele kwenziwe kuphela ngodokotela abaqeqeshiwe. Ukuzama ukuhambisa ilunga eligudlukile ngokwakho kungabangela omunye umonakalo ezicutshini ezizungezile, imizwa, nemithambo yegazi. 

5. Yisiphi isikhathi sokutakula sokususwa? 

Isikhathi sokululama sokukhishwa siyahlukahluka futhi sincike ekuhlanganyeleni okuthintekile kanye nobukhulu bokulimala. Ngokuvamile, ilunga elihlukanisiwe lithatha cishe amasonto angu-6 kuya kwangu-8 ukuze liphole ngokugcwele. 

6. Yini okufanele uyenze ngokushesha ngemva kokuhlukaniswa? 

Ngokushesha ngemva kokuhlukaniswa, funa usizo lwezokwelapha oluphuthumayo. Ngenkathi usalinde usizo, gcina ilunga elithintekile linganyakazi futhi lisekelwe. Faka iqhwa ukuze unciphise ubuhlungu nokuvuvukala. Ungazami ukubuyisela ukujoyina endaweni yakho.

UDkt. Anurag Kawle

CARE Medical Team

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