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Ukwenzakala kwaManiscal

Ukulimala kweMeniscal kwenzeka kwimidlalo eyahlukeneyo, ngakumbi imidlalo yokunxibelelana, kwaye iqhelekile kwimisebenzi yemihla ngemihla kunye nomsebenzi, ihlala idityaniswa nolunye ukulimala kwe-ligament. I-meniscus ye-medial yenzakaliswa ngokulula xa umlenze ophantsi ujikeleza ngaphandle ngokumalunga ne-femur, ngelixa i-meniscus esecaleni ijongene nokulimala ngexesha lokujikeleza kwangaphakathi kwe-tibia. Ukulimala kweMeniscal kunokuthi kwenzeke ngenxa ye-hyperflexion okanye i-hyperextension yamadolo okanye impembelelo ethe ngqo phakathi kwe-femur kunye ne-tibia. Iingxelo ezivela phesheya zibonisa ukuba ukulimala kwe-meniscus ye-medial kuxhaphake ngokuphindwe kahlanu kunokulimala kwe-meniscus ye-lateral, ngelixa iingxelo zasekhaya zibonisa ukuxhaphaka okuphezulu kokulimala kwe-meniscus ye-lateral.

Ukulimala kweMedial Collateral Ligament (MCL).

I-MCL iqulathe umaleko ongaphezulu kunye nonzulu ngaphandle komsantsa ocacileyo phakathi kwawo. Uluhlu oluphezulu luvela kufuphi ne-tubercle ye-adductor kwaye lufake kwicala langaphakathi lesiphelo esiphezulu se-tibia, ngelixa i-deep layer iqala kwi-epicondyle ye-medial kwaye ifake kwicala elingaphakathi kwi-top top of the tibia, igalelo kwi-capsule edibeneyo. kunye nokudibanisa kwi-meniscus yangaphakathi. Ukulimala kwi-MCL kubangelwa amandla asebenza ngaphandle, njengokubanjwa kwe-tibial kunye nokujikeleza kwangaphandle okanye ukunyuswa kwe-femoral kunye nokujikeleza kwangaphakathi.

I-Lateral Collateral Ligament (LCL) Ukwenzakala

Ukulimala kwe-LCL akuqhelekanga kwaye ngokuqhelekileyo kubangelwa ukusetyenziswa kwamandla ngaphakathi kwedolo elihlangeneyo okanye ezinye izizathu ezikhokelela edolweni lokulimala kwe-varus, ehlala ihamba kunye nokulimala kwi-capsule edibeneyo, imisipha ye-peroneal, i-biceps femoris, imisipha ye-hamstring, okanye nokuba. i-peroneal nerve eqhelekileyo.

I-Anterior Cruciate Ligament (ACL) Ukulimala

I-ACL iqala phakathi kweendawo zangaphambili ze-condyle ye-tibial kunye nophondo lwangaphambili lwe-meniscus yecala, luphela kwindawo yangaphakathi ye-condyle ye-femal lateral. Iqukethe i-posterior lateral bundle kunye ne-anterior medial bundle. Ukulimala kwe-ACL kuxhaphake kakhulu, ngokuqhelekileyo kuyingxenye yokulimala okudibeneyo, kodwa kunokuthi kwenzeke njengokulimala okuzimeleyo.

I-Posterior Cruciate Ligament (PCL) Ukwenzakala

I-PCL inamathele kwinqanaba elingaphantsi kwendawo edibeneyo ye-tibial, iqhubela phambili kwi-posterior ye-tibia, ihamba emva kwe-posterior medial bundle ye-anterior cruciate ligament, kwaye iphelela kwi-lateral ye-condyle ye-femoral medial. I-PCL inamandla, kwaye ngoko ke ukulimala kuncinci, ngokuqhelekileyo kubangelwa amandla angaphandle abalulekileyo kwaye kaninzi kuhamba kunye nokulimala okunye.

Uvavanyo lweKlinikhi: Kubandakanya ukubonwa kweempawu, uvavanyo lokuzinza ngokubambisana, umlinganiselo woluhlu oludibeneyo lokunyakaza, njl.

I-Imaging Studies: I-X-rays, i-MRI, i-CT scans, njl., esetyenziselwa ukujonga izakhiwo zamathambo, izicubu ezithambileyo, kunye nobukhulu bokulimala.

Uvavanyo lwe-Arthroscopic: Uqwalasela ngokuthe ngqo iimeko zangaphakathi zomdibaniso, ukuncedisa ukuxilongwa kunye nonyango.

Ukwenzakala kwaManiscal

Izigulane zihlala zinembali yokulimala, intlungu emva kokulimala ngokukhawuleza, ukuvuvukala kwamadolo alandelayo, intlungu engafanelekanga yendawo, kwaye kamva, intlungu yesayithi ethile. Emva kokulimala, i-joint effusion iyenzeka, kunye nokutshixa ngokudibeneyo kunye nokubonakala "kwendlela yokunika" ngexesha lokunyakaza kwamadolo, kunye nokucofa, kunye nokunyamezela kwendawo edibeneyo. Uvavanyo lukaMcMurray luqhelekile kwaye yeyona ndlela yoviwo isetyenziswa kakhulu. Uvavanyo lwe-Apply lunokubangela intlungu kwicala elenzakeleyo kwaye livavanye imeko ngexesha le-squatting phantsi komthwalo. Abanye benza uvavanyo lokujingi, babeke ubhontsi omnye kwindawo edibeneyo yecala elenzakeleyo kwaye bajiwuze ngobunono umlenze, beve i-meniscus ingena kwaye iphuma kwindawo, nto leyo ilungile ukuba ikhatshwa ziintlungu.

I-knee joint arthrography sisixhobo sokuxilonga esisetyenziswa rhoqo, sincedisa kwindawo yokulimala. Nangona isasetyenziswa kwezinye iimeko, iye yathatyathelwa indawo ngokuthe ngcembe kusetyenziswa iindlela ezintsha zoviwo. Ukuhlolwa kwe-Arthroscopic kunomlinganiselo wokuqinisekisa ukuya kuthi ga kwi-90% kwaye ingasetyenziselwa utyando kodwa inemida ekujongeni uphondo lwangasemva lwe-meniscus ephakathi. I-MRI ibalulekile ekuxilongeni ukwenzakala kwamalungu athambileyo.

Ukulimala kweMedial Collateral Ligament (MCL).

Emva kokulimala, intlungu ebuhlungu ivela kwicala eliphakathi kwedolo elihlangeneyo, likhululekile kwaye ligqithise, likhokelela ekudumbeni kwangaphakathi kunye ne-ecchymosis. Kwi-30 ° ye-knee flexion, indawo engaqhelekanga yokuvula imvakalelo yokuvula indawo inokuvakala, ukunciphisa uxinzelelo lwe-MCL, kunye novavanyo oluhle loxinzelelo lwe-valgus. Ukwenza uxinzelelo lwe-valgus i-X-rays yokuthelekisa i-bilateral ibonisa ukunyuka kwendawo edibeneyo kwicala elichaphazelekayo ngaphezu kwe-10 °, ebonisa ukuphuka okupheleleyo kwe-MCL, kunye nokulimala kwe-anterior cruciate ligament. I-MRI inikeza ukuxilongwa okucacileyo.

I-Lateral Collateral Ligament (LCL) Ukwenzakala

Izigulane zihlala zinembali yamandla angaphakathi kwi-joint joint, emva kokulimala emva kokulimala kweentlungu zedolo, ukuvuvukala, kunye nokuthamba okubonakalayo kwendawo, ngokuphindaphindiweyo kunye nokuphulwa kwentloko ye-fibular. Xa uhamba nokulimala kwizakhiwo ezikufutshane, iimpawu ezihambelanayo zenzeka. Uxinzelelo lwe-Valgus lulungile, lunciphise uxinzelelo lwe-LCL, kunye nokuthamba okubonakalayo kunye nokuziva okungaqhelekanga kokuvula. Uxinzelelo lwe-Valgus X-rays lubonisa ukwanda kwendawo edibeneyo kwicala elichaphazelekayo.

I-Anterior Cruciate Ligament (ACL) Ukulimala

Ukulimala kwe-ACL kudla ngokuvela ngenxa yentlungu edibeneyo yamadolo, ukuvakalelwa ukukrazula, intlungu edibeneyo yamadolo, ukungazinzi, ukungakwazi ukuphinda ukunyakaza, okanye ukuqhubeka nokuzivocavoca. Ukuvuvukala kwamalungu alandelayo kunye ne-hemarthrosis kwenzeka, kwaye uvavanyo lwedrowa lulungile. Iintlungu ezibuhlungu ezibuhlungu zihlala zenza uvavanyo olucacileyo lube ngumngeni, kodwa iimviwo zinokuqhutywa emva kwe-anesthesia okanye emva kwexesha elibuhlungu. Uvavanyo oluhle lwe-drawer yangaphambili, uvavanyo lwe-Lachman, uvavanyo lwe-pivot shift, kunye novavanyo lwe-jerk lubonisa ukulimala kwe-ACL. Uvavanyo lweLachman olwenziwe ngokuxhoma umlenze wesigulane lulungile, lubonisa ukulimala kwe-ACL. Ii-X-reyi zokufumanisa iifractures ze-avulsion zinenjongo yokuxilonga. Uvavanyo lwe-drawer yangaphambili yangaphambili i-X-rays ibonisa ukufuduka kwe-tibial yangaphambili, ebonisa ukulimala kwe-ACL. I-MRI ibonelela ngoxilongo oluchanekileyo.

I-Posterior Cruciate Ligament (PCL) Ukwenzakala

Iimpawu zokulimala kwe-PCL zifana nezo zokulimala kwe-ACL kwaye zinembali ecacileyo yokwenzakala okukhulu. Uvavanyo lwedrowa yangasemva lulungile, kwaye i-X-reyi inokwenziwa ukuxilongwa. Izigulane ezilele phantsi kunye neenyawo zombini kwitafile yoviwo malunga ne-90 ° ye-knee flexion ingaba ne-posterior tibial sag; xa umhloli ebamba i-femur yesigulane ngokude kwaye eguqula i-hip kunye nedolo, ukuhamba ngasemva kwe-tibia ehamba phambili kubonakala ngakumbi, ebonisa ukuphuka kwe-PCL. I-X-reyi ibonisa i-PCL avulsion fractures. I-MRI ichanekile xa kuthelekiswa nokuxilonga ukulimala kwe-PCL.